Text read at Estates General of Psychoanalysis July 10, 2000, in the section “Relationship of Psychoanalysis with Art, Literature and Philosophy”.
Keywords: Shakespeare - “The Tempest” - psychoanalytic transference - anorexic patient - death
Summary:
The author's assumption is that, working as complementary hermeneutics, Literature and Psychoanalysis, both dealing with/at the interplay of phantasy and reality in the inner world, can enjoy mutual enrichment. If a psychoanalytic practice is based on the way interpretations are formulated and transference is understood, literary theory and criticism can provide useful tools in the analytic treatment, as the case of a young anorexic woman proves. The author shows how his understanding and work with her, a severally abused patient and the survivor of several suicidal attemptsÑin analysis with him for the last seven yearsÑhas been profoundly enhanced by his own reading of The Tempest
, Shakespeare's last complete work.
Like Prospero releasing his daughter from the Oedipal bond so that she can become herself an adult woman, the Author describes how he, approaching death and accepting his own anger and despair in dealing with it, helped this woman to replace her very destructive inner objects with more reparative and less compulsive ones and how, in relinquishing his own, magical, analytic powers he has created for her the possibility of a healthier and safer life.
I first came to the Sorbonne as a student in 1948 and had the opportunity to hear such great psychologists as Maurice Merleau-Ponty and Jean Piaget speak in this same auditorium, so that this is a moment of some emotion for me.
I have been a member of the Independent group of the British Society for more than forty years. My practice is based on my understanding of classical Freudian theory and its development by the Object Relations school in my country. Yet when I come to read the papers on line, I have a real sense of
dépaysement. This is not the clinically based psychoanalysis to which I am accustomed - As the early cartographers described unknown territories “here be dragons”. Part of the explanation may lie in Benvenuto’s footnote to his challenging paper “it is not possible to establish a scientific psychology of the inner world , but only of the public world which explains why , while the philosophers have engaged with Freud and Lacan, they have never discussed Klein, Winnicott and Bion, so that their paths have diverged”.
As a practising clinician, my work is informed by my patient_s experience of their bodies in both their inner and outer worlds and I try and understand the interaction between my patients and myself in terms of the celebrated dictum of Joan Riviere, the analyst of Donald Winnicott, who would say to students in supervision when they presented her with some brilliant intellectual construction “Very well, but who is doing what to whom with which organ?” -
Let me pose the question in an inverse direction. What has philosophy to teach the clinician? I quote René Major’s magisterial account of Derrida here. He says
PsychoanalysisÑits theory, its practice, its institutionÑis wholly a science of the archive and of the proper name, of a logic of hypomnemesis which explains the lacunae of memory, of what archives memory by transforming it, or anarchivizes, erases or destroys it: it is also the science of its own history, of that of its founder, of the relation between private or secret documents and the elaboration of its theory and of everything which in a subterranean manner can enlighten its appearance in the world.
You will note that in Derrida’s definition there is no mention of the body (Freud said that the Ego is first and foremost a body Ego) so that the teaching of Joan Riviere would seem to have no place in his psychoanalysis. As a practising analyst, which Derrida is not, this places me in a dilemma. How do I put philosophically based theory into practice? How much should theory enter into the way in which I formulate my interpretations and understand the transference? Applying Benvenuto’s terms It seems to me that Object Relations Theory is concerned with an inner world which we can only know inferentially: therefore it must be essentially hermeneuticÑbelonging to or concerned with interpretation-(OED) as of course is Literary Criticism. We may comment from a psychoanalytic view point on a literary production which is of itself not an account of a lived life but an interpretation of behaviour seen through the distorting lens of the internal and external theatre of the author -Jan Kott describes Hamlet as ”the central reflector” -but our comment always remains an interpretation and no more. Where literature and analysis converge is in the moment of overlap between the twoÑthe potential space of play that Winnicott defined as follows “play is in fact neither
a matter of inner psychic reality nor a matter of external reality. The place where cultural experience is located is in the potential space between the individual and the environment.” When we enter such a potential space in thinking about and working with our patients , when this in its turn can be related to such lived cultural experience as a play or a film , then these two hermeneutics offer us the potentiality of mutual enrichment. To illustrate the point I wish to make, let me turn to a patient who has been in 5 times a week analysis with me for seven years. My work with her has been greatly enriched by my reading of Shakespeare’s last complete play, The Tempest. This patient, Sarah, was twenty one years old when referred to me for analysis after various behavioural attempts to treat her severe anorexia had broken down. Her appearance is completely androgynous .
Sarah had been born by Caesarean section with the cord round her neck and her Mother clearly was never able to visualise her as a live child. She was taken over by her 50 year old Father whose first child she was. He is a very sadistic and controlling man , and he treated the new baby as an extension of himself and the recipient of numerous part object projections. As the contemporary British poet Philip Larkin puts it
They fuck you up , your mum and dad.
They may not mean to but they do,
They fill you with the faults they had
And add some extra just for you.
When Sarah was six years old, her Father began systematically to abuse her sexually, including forcing her to fellate him: this continued in secret for some five years. She never disclosed the abuse but grew up as a little strange creature who was neither boy or girl. Sent to boarding school at 13, she became a juvenile rebel and then when her menses began she decided to refuse food. With hindsight she can see that this was a refusal to accept a woman’s body and sexuality. She felt intensely guilty about her parents and their relationship and blamed herself for their difficulties. When her anorexia was discovered, she was sent to various treatment regimes, became clinically depressed and was given many ECTs and antidepressants and nearly died on several occasions. Eventually she was sent to my country for an analysis which was not available where she lived.
There are many ways in which this young woman’s illness might be interpreted. But my interest is to create an hermeneutic link here to the last play by Shakespeare, The Tempest. The play was recently revived in London at Shakespeare’s Globe theatre, with Vanessa Redgrave playing the part of Prospero. This experiment in cross gender acting was not a success. When I saw the play it was forcibly apparent to me that Prospero needs to be played by a man for reasons which will appear in this account of the play. I shall focus here on some of the attributes of Prospero’s role in the play with which I identified when I stood with my sonÑa distinguished interpreter of the role of Caliban in England and the United StatesÑamong the groundlings in the pit in the recreation of the old Elizabethan theatre.
Some years ago I published an interpretation of the play in Confrontation and The IJPA. The action takes place on a desert island where Prospero the magician and rightful Duke of Milan and his daughter Miranda have dwelt alone apart from CalibanÑa savageÑand ArielÑa spiritÑsince she was a baby. Using magic arts, Prospero conjures up a storm which wrecks his usurping brother Antonio, the King of Naples, and his son Ferdinand on the island. The action consists of the foiling of various plots against the lives of the rightful rulers while Miranda and Ferdinand fall in love. With the aid of his familiar spirit Ariel, Prospero achieves a situation which enables him to regain his Dukedom, to marry his daughter to the King's son, and redress the wrongs he has suffered at the hands of his usurping brother.
As I pointed out in Confrontation, Shakespeare here reworks the previous themes of Hamlet in a different senseÑthe murder of the king while sleeping is foiled by magic means the warring brothers are reconciled and the lovers united. This bald summary gives no indication of the subtlety and beauty of the play and the intricacy of much of the verse, which has made it one of the best loved and perhaps most misunderstood of Shakespeare's plays. The play is in the form of a Romance and like Hamlet contains a play within
a play
When thinking about Sarah’s analysis in the context of The Tempest, I could identify her partly with the virgin Miranda, who has never seen a man apart from her Father and the monster Caliban and partly as the asexual Ariel. As I have tried to show in my paper, Prospero is under no illusion: If the exile on the island has been his withdrawal into philosophical study and magical omnipotence, he must, at the end of the play, return to reality and release his daughter from the Oedipal bond; this denouement will lead to his end “my every third thought shall be of death”, and he finally releases ArielÑthe Imaginary is transformed at last into the
SymbolicÑreluctantly but for good. Prospero will return to Milan and to the humdrum daily round. That this may be a disaster, is of course a danger which he cannot ignore, but if he wants to hand on both the succession and allow sexual potency to his daughter and her husband, this in reality is the only choice that he can make. Acceptance of one's own mortality is the life-giving choice which will secure the dynasty. Nothing could be harder headed than Prospero's choiceÑnothing further from the holocaust at the end of Hamlet. Where René Major speaks of the “de-nomination of Hamlet”, perhaps in The Tempest we should speak of the “nomination” of the children who are to succeed and make their way in the world at whatever cost to the elders.
To return to Sarah, after eighteen months of analysis, Sarah disclosed her experiences of abuse by her FatherÑthe memory of which she had never repressedÑand an extremely painful period of her life began. She decided to inform her Mother, who had always shut her eyes to any awareness of the abuse, and following a family confrontation in which her Father denied everything, Sarah entered a period of frank psychosis: she hallucinated voices and visions, hid from me in various corners of the consulting room, was terrified of her visions of mocking faces: she was often exceedingly paranoid and she felt that she had to control all her thoughts and actions to protect herself from the attacks of others. The only people she trusted were her Doctor and myself. She had always been a self mutilator and she now cut her wrists almost daily. While I kept as strictly as possible to the analytic regime, I felt that it was necessary for me to be available to her by telephone at any time of day or night.
She also had times when she would become so guilty and responsible for the abuse that she felt she should dieÑfortunately she would telephone me and tell me that she had taken an overdose so that I could let her doctor or the police know and they could get her into hospital where we could tell them that she had informed us of her intentions and therefore the emergency room would resuscitate her rather than letting her die as is now becoming the practice in some hospitals in England. I would visit her in hospital when she was an inpatient and continued the analysis there until she was discharged. Progress was slow and halting, but eventually some nine months ago she decided that enough was enough, stopped taking the anti-psychotic and antidepressant drugs prescribed by her psychiatrist, eats moderately but adequately and has stopped mutilating herself. She is still distressed if she cannot remember the beginning of a train of thought, or forgets something which she has seen.
She has always called me Dr. HÑI have no proper name in her inner world. I suppose that you might call me a transitional analyst! In the transference I believe that I became a non abusing Father, a sort of magical Prospero who allowed her to communicate and contemplate her feelings in a reliable and protected environment. When she was a baby she always cried a lot because she was so hungry, so her Father decided that he was not to be dictated to by this child and would leave her in her cot in the kitchen to cry all night where he need not be awoken by her. In contrast, I became in her inner world a feeding breast which she could both use and attack through her acting in and out without retaliation or the need for excessive splitting and projection as heretofore. Her Father had been badly abused himself as a child and plainly used her as a surrogate for the hurt and abused little boy inside himself. By now refusing to meet him, she felt that she was able to discard these projections and reclaim her own individuality, and the possession of her own mind and body. I was also a Mother with whom she could communicate, although with great pain, about the penetrating attacks on her body and her mind, and who would feed her with ideas and interpretations which were not necessarily persecuting, although she could not identify with me as a sexual being of either gender. Close physical contact with anything other than her pet cat was impossible for her. Since we do not shake hands with our patients in England, I have had no physical contact with her throughout her analysis. This is the Ariel aspect of her character.
It is of course understood that the characters of The Tempest are not real people, but represent a potential web of internal relationships which the dramatist has staged for us. Frank Kermode in his recent book on the language of Shakespeare notes that when it comes to Caliban, the savage man, there are clear echoes of the parent-child conflict .
Prospero: “I indowed thy purposes
With words that made them known.
But thy vild race (though thou didst learn )
Had that in it which good natures
Could no bear to be with”.
to which Caliban replies
“Thou taught me language, and my profit on’t is,
I know how to curse”.
I wonder what a Lacanian analyst would have made of that interchange? It is a tenable Object Relations hypothesis that in reading Shakespeare we can discover through his plays the dramatic expression of the vicissitudes of anger, desire and envy directed at our objects in our inner worlds and the need to split off and defend against them. The Tempest also concerns the problem of the older man and the adolescent girl and his sexual power over her and his reluctance to give up this potency and accept the end of his reign, while she turns to other younger men and to potential motherhood. The fraternal conflict ends disastrously in Hamlet and Lear erupts into madness as he tries to continue to maintain his jouissance over his daughters. The Tempest, being a Romance, resolves these issues rather less tragically, but one cannot doubt that these issues and their ResolutionÑas in The TempestÑwhich are continuously being worked through by the poet.
Frank Kermode recalls that Henry James described The Tempest as a “disciplined passion of curiosity”. Kermode says that the linguistic discipline of the play is extraordinary: “The irruptions of Ariel, for whom, as for Caliban, a new dramatic language had to be invented, the pervasiveness of music, the quiet verbal insistence on dream, on spirit, on sea give The Tempest qualities which are in the end beyond description.”
For the analyst the hermeneutic, the interpretation of the play must lie with the way in which it expresses and underlines implied object relationships and their integration into new mental structures, particularly those to do with the acceptance and recognition of aggression, reparation and the reintegration of split off parts of the self, as expressed so beautifully by Kermode, together with the renunciation of jouissance and omnipotent sexual control by Prospero at the conclusion of the action. Moreover, even Caliban can reach to the beauty of the island as in this speech
Be not afeard, the isle is full of noises,
Sounds, and sweet airs , that give delight and hurt not.
Sometimes a thousand twangling instruments
Will hum about mine ears, and sometimes voices,
That if I then had wak_d after long sleep,
Will make me sleep again , and then in dreaming,
The clouds methought would open, and show riches,
ÎReady to drop upon me, that when I waked
I cried to dream again.
And of course he too learns that there is more to life and language than cursing. “I will be wise hereafter and seek for Grace.”
Let me turn now back to Sarah. Here the hermeneutic of her struggle to free herself from her very destructive internal objects lies in the action of the analytic work. It seems plausible to suggest that she was able to give up her illness through the internalisation of the analytic relationship and the replacement of intensely sadistic and cruel internalised object relations and her defences against them by much more reparative and less compulsive behaviours. Is all well then? This cannot yet be said. Despite the excellent results so far, more work needed to be done.
There were changes in my own health just before Christmas which led me to tell the majority of my patients that it was my intention to retire. I had held back with Sarah because of her evident fragility following her decision to give up her illness and a fear that she might relapse into psychosis. There was clear evidence in her material that she was unconsciously aware that I was ill (she gave me a book called Darwin’s Worms about death and reparation as a Christmas present). Eventually my health became so fragile that I decided that I could no longer avoid the decision. I had long felt that if I retired, then she should go to a woman analyst and I knew that an old friend who was well acquainted with my manner of working would be happy to take her on.
It was very painful to tell Sarah of my decision and the reason behind it, which was that I could not promise her to remain alive for the time which would be required to help her through the next stage of our work which I thought meant her coming to terms with her own sexuality and her own gender. I had a lot of material to support this in the form of dreams and associations about her body, about having a childÑsomething she had never been able even to contemplate before and the emergence of memories and the reworking of her feelings at school when she had begun to menstruate. She was aghast at first and said that she didn’t think that she could go to anyone else since no one had ever listened to her as I had done. She had a brief period of depression and mutism in the analysis. I made it clear that there was no way I was going to force her and the choice was entirely hers: but I could not go back on my decision to stop the analysis. Her reply was very illuminatingÑshe said that the problem did not lie there, but in her realisation that her suicidal attempts must have been enormously painful for those close to her and for me. For the first time she could emerge from her solipsistic world and realise the pain that her suicidal attempts must have caused to those who cared about her. She also felt that her struggles with her inner world must be far less than mine, compared to those of me and my family in facing the imminent prospect of my own death, and that she felt she could now get her difficulties into a better perspective .
A few days later she brought me a vivid dream: a seed had been forced into her mouth against her will and it had turned into a sunflower inside her. Tendrils of the plant had grown out of her mouth and nose and ears and she had felt enormously attacked and had awoken with feelings of terror. Her associations to this dream were very interesting: she recounted for the first time in this long analysis that when she was nearly two she had had an operation on her mouth because there was a gum flap joining the inside of her lips to the gum above her front teeth. She had resisted the general anaesthetic, screaming and the nurses had not been able to hold her. Her Father had held her down while the assault was made on her mouth. I interpreted the link between the attacks on her mouth, the fellatio and her feeling that I was now both cutting off the good analytic feed and forcing her to have a sexual intercourse and an oral child that she did not wish to accept. This interpretation made it possible for her to look more calmly at her situation and to express more clearly both her anger and her guilt about my illness, which would mean the end of our analytic relationship. She has been able to telephone her future analyst and arrange to meet her while we work towards a termination at the end of the summer.
For me the link between Sarah and The Tempest, the link which has enriched our work together, lies in Prospero’s painful acceptance of his own anger and pain and be reconciled to the imminence of his own death. This feeling was particularly clear when I was a spectator at the play, as I have described, and I could experience my own identification with Prospero when he says
graves at my command
Have waked their sleepers, opened, and let Îem forth
By my so potent art. But this rough magic
I here abjure, and when I have required
Some heavenly music- ....
I’ll break my staff,
Bury it certain faddoms in the earth,
And deeper did ever plummet sound
I’ll drown my book.
It is very hard for the analyst to give up his powers, something which came home to me when I did a literature search and found how little had been written concerning the impact of the disappearance or death of the analyst on his patients, and how few patients had had the possibility of some working through beforehand. I have no idea what will happen to Sarah in the futureÑthat is no longer in my handsÑbut in giving up my analytic role, I have tried to offer her the possibility of using her potential as fully as she may wish.
Finally to return to my theme. I have suggested in this brief clinical anecdote that Literature and Psychoanalysis can enrich one another as complementary hermeneutics and that it is possible for an analytic experience, provided it does not try to go beyond the single case method, to promote this process. I feel that many of the other philosophical systems, fascinating as they are in their theoretical elaborations, are secondary for the clinician who is dealing with the interplay of fantasy and reality in the inner world. I wish that there had been more time to elaborate on this difficulty. That they can explain ex post facto I have no doubt. For the present I have still to be convinced that they have much use to me in the heat of the analytic process, and that I do not and cannot think in such terms as I work with patients. Perhaps today's debate will do something to solve this problem for me.