Psychic Pain

By Shahid Najeeb

I have been asked to give two lectures in the Bion series. This makes the rather generous assumption that I know something about Bion. So I need to start with a disclaimer, that although I am intrigued and at times inspired by some things that Bion has to say, I am no expert. For me he has the kind of fascination that any child might have for that special, but elusive toy, which it would be wonderful to get ones hands on. To have such an aspiration, like any child in a toy shop, is sadly not the same as being able to get hold of an exciting toy, much less to possess it. Even Bion as a boy was not immune to such childish aspirations. For him it was toy trains that epitomised the sense of marvellous wonder and infinite power that little boys can only dream of. There is a rather sweet story from his autobiography that I would like to share with you, for I think it might help set the tone for these two lectures and perhaps help indicate something of my relationship with Bion. The episode is from the first part of his autobiography in which he nostalgically remembers the first eight years of his life, which were spent in India where he had been born. He had been asking his father for a toy train and this incident describes that amazing day when he finally did receive one of these incredible pieces of machinery as a birthday present. However, before reading out this incident, I need to preface it with an explanation of two elements in the description that need some introduction, for they might not be very familiar to this audience. Without this preface, much of the significance of the incident might be lost.

The first element is the term bearer. Bearer in India was a kind of generic term for servants. This audience might feel very uncomfortable with the idea of servants, but they were an essential part of life during the Raj and they still are in contemporary India. The slight difference between then and now is that for British children like Bion, Indian servants were clearly a different kind of human being, but as they spent more time with them than their often distant Victorian parents, they generally had emotional and affectionate ties with them that transcended race and reason. Second, ever since Eastern cuisines have so successfully and voluptuously penetrated the table culture of bangers and mash, the term ghee is not one that would be alien to this audience. However, what this audience might not be familiar with is the fact that ghee in India is used not just for cooking, but along with fire, is a central and essential element of Vedic religious ritual. No one of course knows the origins of this sacredness, buried as it is in many thousands of years of tradition, but it probably has at least a twofold aetiology. It is probably a vestigial remnant of Vedic sacrifice and secondly, ghee is something that is obtained by serial extraction from the basic sustenance of life, milk. In this way it resembles and perhaps symbolises the essence of life, the soul, particularly because ghee, like the soul, is part of a larger reservoir of life-energy, symbolised by fire which consumes everything. Ghee, like the soul sustains that greater fire, into which it eventually disappears without trace.

So now back to the incident where Bion receives his toy train as birthday present -

_It was unwrapped by me and after much fumbling it stood revealed. It was a beauty - a model of one of the latest London trains, perhaps even of the first London electric train. In a fever of excitement not, I was pleased to note, shared by my sister, it was set up, the battery fixed and the motor set off with a slight push from my fathers finger. _

_ _

_That initial jolt was the highest speed it ever achieved. As I watched the miserable crawl I tried to see it devouring the miles in its headlong rush through space; I might even have succeeded if it had not, like my tank many years later, stopped. It just stopped. _

_ _

Its stopped? I said inquiringly. My father was as upset as I was. He picked it up and examined it. I watched his face, and as I watched I could see from his expression that it had indeed stopped. My sister, who was being taught to read by Mother, came to life, Full top?

_ _

_Full top indeed. Never mind, said my father brightly, well soon get it going after Ive seen to the mails, and he went to the office tent. _

_ _

_I told the bearer who was a good friend of mind, but no engineer. He reassured me and, mobilising his religious beliefs, carried the train off to the kitchen supply tent. There he smeared it plentifully with ghee ... Then he set it down in the hot sun telling that after an hour or so it would rush off cured. _

_ _

Will it go fast - really and truly very fast? As fast as ... ? I could not think of anything fast enough, but so it would assuredly be.

_ _

_An hour or so later my father found me sitting watching it. Now, he said, let me have it and we shall soon get it .... But whatever is this? He put it down suddenly to wipe the greasy mess off his fingers. _

_ _

Did you do this?

_ _

_Thank God , no. I cowered away, I feared. I wanted to tell my friend the bearer to run, run for his life .... _

_ _

I didnt do anything, I said starting to weep.

_ _

_My sister, who always seemed to appear at the wrong time, had already started to scream. For a wild moment I had an impulse, immediately stifled, to point at her and say she had done it. _

_ _

To have two yelling brats on his hands was too much. This time my father turned and fled. [i]

Lovely story! I quote it here because I suspect that I am a reincarnation of his Indian bearer. You see I not only look the part, but I have come here tonight saying with some hesitation that I can make this shiny train called Bion, that only a few know anything very much about, run. This would be sheer hubris if you didnt understand the term bearer and the sympathetic relationship between Bion and his bearer, each wanting to help the other. For this purpose, as Bions loyal bearer, I will draw on my deepest beliefs and having drawn on them, will proceed to smear the good name of Bion liberally with them. By the end of these two lecture you will be able to judge for yourself, whether Bion runs for you or not!

So now for the first dollop of ghee. When I was asked to do these two lectures I procrastinated endlessly for I didnt have a clue about what I could possible say about Psychic Pain or for that matter about Bion the Mystic, the titles of the two lectures I was asked to give. All I kept coming up with was the fact that it was psychically painful to think about something that was totally mystical to me! Then suddenly I remembered a couplet from a second century Buddhist philosopher, called Nagarjuna that linked them. He stated the link in a famous couplet, which very roughly translated goes something like this -

Neither is sansara different from nirvana,

_Nor is nirvana different from sansara. _

_The scope of sansara is exactly the scope of nirvana, _

Nor is there the slightest difference between them.

How is that for Indian mysticism and obscurity? But I hope by the end of these two lectures, you will come to understand that this is not mystical or obscure, but just a statement of life as it is. These lines from Nagarjuna, are the basic substance of these two lectures. All I need to do now is expand on these lines for approximately two hours! The first lecture tonight expands on sansara and the second lecture, on nirvana. Hopefully you will come to understand by the end of the second lecture what Nagarjuna means, and that these two lectures are but different dimensions of the same reality.

So first to Sansara, the subject of this lecture. Sansara in Buddhist philosophy is inextricably linked with pain and suffering. It is important to note that the Buddha never talked about physical pain and suffering, to which he was subject like anyone else, but about mental anguish. It is this dimension of pain that we will talk about, hence the title Psychic Pain, though we will digress to physical pain sometimes for purposes of elucidation, illustration and comparison.

We tend to use the terms pain and suffering interchangeably, but as we shall see, although suffering always involves pain, it is possible to have pain without suffering. So the broad outline of this lecture is to first talk about pain, its origins and communication. Then to talk about pain with suffering. Finally to talk about pain without suffering.

ORIGINS OF THE TERM PAIN

The English word pain is derived from Poena, which is Latin for penalty. Poena, was the Greek goddess of revenge, retribution, vengeance and recompense, so the term comes to us heavily laden with Greek and Latin meaning. What I wish to emphasise here is that not so much the origins of the word, but the fact that the experience of pain always has meaning. Pain, especially physical pain, is a sensation, but despite that, pain always carries some meaning for us. This meaning might be small, as in physical pain, or considerable, as in psychic pain. Hippocrates is reputed to have said in his book The Nature of Man that pain is a defining human characteristic. What he might have meant was that although animals no doubt feel pain, pain in humans is inevitable connected with meaning and meaning is a very human characteristic.

Before moving on to psychic pain, it might be useful to say something about the sensation of pain and its importance to us.

THE ORIGIN OF PAIN

Pain has a very ancient history, which goes back to the very origins of life. I dont know exactly at which point, but very early in the piece, when there was the first protective aversion of a creature, we had the precursor of pain. It was not pain yet, but the external surface of an amoeba, when it experiences something noxious, turns away. It is this turning away that will in time become pain. With the development of multi-cellular organisms the external cells, i.e. those in contact with the environment, serve the same function as the cell membrane of a unicellular organism. The signal from the exterior has to be unpleasant, otherwise there would be no turning away. Those organisms that didnt experience that sense of unpleasantness, didnt turn away and so died out. This unpleasant experience, in the course of development, became pain and is obviously necessary for survival. However, not all sensations are noxious. Some are necessary and need to be turned to. So a process of differentiation is also necessary for survival. This process of differentiation doesnt stop at attraction or aversion, but develops gradually into a perception of the external world, initially only proximal, but gradually more distally with highly differentiated and specialised organs, whose function it is to distinguish stimuli in each sense modality. Throughout this process of development, the capacity to appraise dangerous sensations as being necessarily unpleasant, remains fundamental, for without it, as I said, there is no survival. So what does this have to do with psychic pain?

THE DEVELOPMENT OF PSYCHIC PAIN

The development of psychic pain occurs as a natural extension of physical pain. It does this by the development of the brain, which is the organ that experiences psychic pain. The brain develops from that layer of external cells that first experienced aversion and attraction. This layer is called the ectoderm and forms our skin. Very early in our development in the womb a very sensitive layer of the skin becomes a fold. This fold becomes a tube, with the skin closing over this supersensitive tube, to protect it. This develops under the skin and later under the skull to become the brain. The brain therefore has it origins in the cells that developmentally were once part of the skin. The brain and its nerves are thus the organ eminently suited to experience the external world in all its complexity.

The mind develops in a similar way. Just as the brain develops to understand the external world, the mind develops to understand the internal world, which in part, is also a reflection of the external world. The brain is directed externally and mind is directed internally to make internal sense of these external sensations, but also to make sense of sensations from within the body and sensations from within the mind itself. The external world is of course not totally know by us, as we are limited to the data of our senses. In the same way the internal world is not completely known to us as our understanding of it is limited by what we are conscious of. This is a correlation that was made by Freud in what can be regarded as the first psychoanalytic study, The Interpretation of Dreams. He states _"The unconscious is the true psychical reality; in its innermost nature it is as much unknown to us as the reality of the external world, and it is as incompletely presented by the data of consciousness as is the external world by the communications of our sense organs."[ii] _

This intuition of Freuds has been substantiated and developed extensively by subsequent psychoanalytic workers and we now have a much better understanding of this shadowy internal world. What we do know is that that the external world is mirrored by an internal world. This internal world is intimately related to the external world and reflects it giving meaning and significance to every element of the external world. Likewise, every experience from within the body and within the mind, is given meaning by the mind. This meaning is something that is personal to every individual, for meaning accumulates in accordance with our propensities and our experiences. Every element of the external and internal world exists in the internal world, and every internal world has a very personalised meaning, so no two internal worlds are the same. The elements of some internal worlds are so heavily coloured by personal meaning that they may be hard to recognise, but the process is the same.

The function and purpose of psychic pain is exactly the same as physical pain. In fact both physical and psychic pain seem to use the same brain circuits. Recent MRI studies have revealed that .... When jilted participants looked at pictures of their exes, their brains engaged the same pain circuits that lit up when they were probed with a heat sensor ...[iii] Like physical pain, psychic pain also signals the presence of danger, except that the danger is now of an internal situation. This internal situation is extremely complex and so is the pain. Very broadly speaking internal pain exists in two forms, anxiety and anguish. Other names for anguish are depression or simply pain. The experiences are qualitatively different but they are both unpleasant and both related to complex internal situations. Anxiety tends to have an anticipatory quality so though it is rooted in past painful experiences, it tends to dread them in the future. Anguish generally relates to past experiences, with present experiences being echoes or reminders of those experiences. Sometimes a clear distinction can be made and sometimes not. People that dont understand the mind, often regard these experiences as being silly or inappropriate to the current situation. This opinion is based on a lack of understanding that there is such a thing as mind and that the mind deals not only with external situations, but internal ones as well. When psychic pain is viewed from this perspective, with some understanding of its enormous complexity, then it will be understood that the pain is far from silly or inappropriate. For psychic pain has exactly the same survival value as physical pain. Sometimes just as physical pain has little or no survival value, such as pain in a phantom limb or pain in the sensitised tissues of a damaged back, psychic pain too can have little survival value as it is often pain of a non-existent mental situation, that functions like a phantom limb, or pain in sensitised parts of the mind. Sometimes the current situation is not the previous situation that occasioned the pain, but is sufficiently like it, to trigger the pain response, either as a warning or because the area is highly sensitised. So long as one has a mind, the meaning of every situation will be provided by that mind and that mind in turn is dependent on its propensities and past experiences. To not understand this simple fact is to be in effect, mindless.

THE COMMUNICATION OF PSYCHIC PAIN

I think a few words need to be said about the importance of the communication of pain. Unlike physical pain which can be relatively easily communicated, psychic pain is extraordinarily difficult to communicate. The reason is that the location of physical pain can generally be pointed to, but how do you point to an internal situation? How can you say it is hurting here, much less say how it is hurting and even less, why it is hurting the way in this way or with this intensity. The problem is compounded by the fact that language too has its origins and meanings that are individual to both participants in the dialogue, so one cannot presume either a capacity to express accurately what is being experienced or the capacity to comprehend accurately what is being expressed. The complexity and poignancy of this situation is described by Bion with his usual depth and perceptiveness -

_When a patient co-operates so far as actually to present himself for inspection, the doctor from whom help is being sought is being given the chance of seeing and hearing for himself the origin of the pain. No need to ask, Where does it hurt? - though it would clearly be a comfort to have to have his query answered in a language that he understands. The anger that is so easily around is the helpers reaction to an awareness that he does not understand the language, or that the language he does understand is not the relevant one or is being employed in a manner with which he is unfamiliar.[iv] _

So you can see from this description that while the experience of pain cannot be denied, exactly what it refers to and how it is understood, or more importantly, how it is misunderstood, is sometimes as important as the original pain, and can sometimes severely compound it.

So now having understood something about pain, let us move on to pain with suffering.

SANSARA OR THE WORLD OF SUFFERING

Sansara is the phenomenal world of our experience. Our experience of this world in inherently painful. It is true that sometimes we seem to enjoy ourselves or feel happy, but inevitably we return to the baseline of pain. This obviously needs some explanation, for I intend to show that this in not a pessimistic appraisal of life, but realistic and necessary.

There are two dimensions of Sansaric pain. The first is the inherent pain of existence and the second is the necessity of pain for growth.

1. The inherent pain of existence

So the first step - let me make an absolutely truthful statement that everyone in this room will find painful. Everyone in this room will be dead within a very short space of time, say in thirty or at the outside, fifty years. Not only dead but completely forgotten. Here we are all alive. Our lives mean so much to us, but shortly we wont be, nor will there be any trace left of us. True our names might be found in an obituary notice, a headstone, or mentioned in some text, but no trace of what we are this very moment will exist. We are so alive, so vibrant, so full of life this very moment and then nothing, nothing at all. Totally irrelevant. Just so many waves that briefly crest the ocean then disappear back into it without trace. If you can bear to look at this realistically and understand its truth, you will experience pain. Sure you can distract yourself from this truth, but this truth always exists and awaits your discovery, should you care to know anything about the meaning of your existence. This is the truth of sansara.

Can you indulge me with another little dollop of ghee, a very small one? It is a couplet from the fifteenth century mystical poet Kabir. Kabir might feel a bit offended with my likening his couplet to a dollop of ghee, for he had a strong aversion to any kind of religious ritual. His simple devotional poetry, written in a peasant dialect, locates God in the human heart. Kabir sings -

_Seeing the stone mill turning, Kabir wept. _

Between the two slabs, none remains whole.

If you watch a stone mill turning, you will see how it consumes grains of wheat. Some go into it quickly, some slowly, some early, some late, some go in standing, some lying flat, some go quietly, some shudder, but every single grain goes in and not one remains whole. We are all broken in one way or another between the twin immovable slabs of birth and death. We are all consumed, some slowly, some fast, some early, some late, some in this way and in some in that. Keats expresses this beautifully in his Ode to a Nightingale

The weariness, the fever and the fret

_ Here, where men sit and hear each other groan;_

Where palsy shakes a few, sad, last gray hairs,

_ Where youth grow pale and spectre-thin, and dies;_

_ Where but to think is to be full of sorrow_

_ And leaden-eyed despairs;_

Where Beauty cannot keep her lustrous eyes,

_ Or new Love pine at them beyond tomorrow. [v] _

Death is cumulative. We all die slowly in a thousand different painful ways, a thousand grains of wheat in an impersonal and relentless stone mill. If you sit still and quietly and very gently open your hearts, you might just hear Kabir weeping softly, ever so softly. This is sansara.

**2. The necessity of pain for growth. **

Amongst Bions most significant contributions are his contributions to the study of psychic pain. He makes a distinction between pain that can be suffered and pain that cannot be suffered. So I will talk continue to talk about pain that can be suffered and then after that about pain without suffering.

Pain with suffering is the pain that we have been talking about so far. We have used the terms pain and suffering interchangeably because till Bion, we thought that pain inherently meant suffering and that suffering inherently meant pain. So the pain of existence that we have described is this kind of suffered pain. This pain has been studied in psychoanalysis since Freud, such that all the mechanisms of defence that he and his followers described, can all be understood as defences against pain.

There is a second kind of suffered pain. This is the pain that Bion describes as the pain of growth. In his book Learning from Experience Bion talks about what he calls the K or knowledge link between two people. We tend to equate knowledge with the information that a scientific outlook yields. Often the meanings of the two terms are very close. Bion concedes this and says that if the object of knowledge is inanimate, then we can say that we have a piece of knowledge or concrete information, about the object of study.[vi] He then goes on to say that if the object of knowledge is another person, then that person being a living creature or animate, is in a constant state of flux and transformation and being so, cannot be acquired like a relatively stable piece of knowledge. Instead something different happens, for instead of static acquisition, we have a dynamic state of getting to know. This state of getting to know the other person occurs simultaneously with the other person being in a state getting to be known, which of course influences in complex ways the getting to know the other person. This process of getting to know is fraught with uncertainty and the danger of making mistakes, which can have horrendous consequences. Hence this process is inherently risky and painful. Because of this, there are two possibilities, either to evade or to modify the pain according to the capacity of the personality to tolerate frustration. So it is not surprising that there is a tendency for all researchers into the dynamic animism of human beings, to reduce the humanity of the person being studied, to the status of an inanimate object that can be quantified and measured in various ways. In so far as human beings can be so reduced, such investigations are successful. However, to the extent that human beings cannot be reduced to inanimate things, such investigations are largely irrelevant. Life is essentially a dynamic process and includes the process of growth. The process of psychotherapy attempts to understand life, but also to stimulate growth. Growth is essentially a dynamic and animate process. What has to be undertaken in any psychotherapy is essentially a process of life, which includes within it, the process of growth. Growth involves the risky and fraught process of getting to know and be known. Ever since Bion, we have come to understand psychoanalysis in this way, not as a means of yielding knowledge, but as a therapeutic transformation of pain by the process of growth. Bion understood the psychoanalytic dialogue as as a participatory process in the field of pain. By participating in this risky, unsure and painful venture, transformation is possible, growth is possible. It is through the process of transformation and growth, that psychic pain can be modified.

Bion in his book Attention and Interpretation states - _Of all the hateful possibilities, growth and maturation are feared and detested most frequently. This hostility to the process of maturation becomes most marked when maturation seems to involve the subordination of the pleasure principle and the emergence of the reality principle.[_vii] Like most of Bions remarks the simplicity of his words conceals the complexity of his meaning. What I think he means is that it is relatively simple to evade the pain and most of us do it most of the time in various ways. Likewise, when we come to therapy, there is no reason why this process of avoidance should not continue. However, growth is something that is real and to engage with reality, as we have been saying, is enormously painful. It is painful to know the truth about ourselves, including the truth of our transience, the truth of our irrelevance and the truth of the ways in which we continue to hurt others. If there is to be growth within ourselves and within the psychoanalytic process, then we necessarily have to engage with this pain, unpleasant and hated though it might be. Because pain is so hated and because growth and maturation invariable involve pain, growth and maturation too are hated. However, if we can somehow suffer this pain, the pain of our existence and the pain of trying to understand it, then there is a possibility of growth, both in our capacity to understand pain, and our capacity to suffer it.

PAIN WITHOUT SUFFERING

We now come to the very complex area of pain without suffering. Before Bion I dont think anyone had, in any substantial way, explored the world of pain without suffering. So what I have to say here draws totally on what Bion has to say on this matter. This is how Bion describes it -

_The patients, the treatment of whom I wish to formulate theories, experience pain but not suffering. There may be suffering in the eyes of the analyst because the analyst can, and indeed must, suffer. The patient may say he suffers, but this is only because he does not know what suffering is and mistakes feeling pain for suffering it. ... The intensity of the patients pain contributes to his fear of suffering pain. ... Suffering pain involves respect for the fact of pain, his own or anothers. This respect he does not have and therefore he has no respect for any procedure, such as psychoanalysis, which is concerned with the existence of pain.... Frustration and intense pain are equated.[viii] _

The crucial words here are The intensity of the patients pain, contributes to his fear of suffering it. So we need to be clear from the outset that Bion is not suggesting that patients who cannot suffer pain, dont do so, not because they are some kind of inferior human being, but because the intensity of pain is so great, that it cannot be held in the mind and so suffered. It might be the very sensitivity of these individuals that intensifies their experience of pain. Anyone that has read or knows anything about Bion, would acknowledge that he was a man of great courage, but also a man of great sensitivity. We have from his autobiography a description illustrating an experience of pain that exceeded the capacity of even his great mind to hold. This description comes from the first world war in which he was a combatant as a very young man. Please notice that although this was written down by him towards the end of his life as an old man, the description is as fresh as if had taken place the day before. The tissues of his mind were so acutely sensitised, that age did not weary them.

We also need to be reminded of the horrors of the first war, that for us are unimaginable. Trench warfare was warfare at close quarters, death at close quarters and with a very high casualty rate. In all the engagements that involved Bion, the mortality rate was a horrific one in three or one in four in every encounter. So with a sufficient number of encounters, one was reasonable certain of being killed.

Here is his description following a period of intense bombardment where he felt _like a cornered rat .. And I couldnt even sit on my hind quarters and put my little paws together and pray the damned swine to let me off - just once! Just this little once! Oh God! I will never be naughty again - never! _

_ _

_For two more days nothing happened to break the monotony of constant, vigilant staring at no-mans lad - the crater edge, the slow rise to the crest of the ridge, the grey mud so similar in all but colour to Hill 40, inspired a state which was not nightmare, not waking, not sleep. It was an animal existence in which the eyes held sway. One did not think; one did not look; one stared. What we felt reminds me of a young child who had been sexually assaulted by the Germans in their last days of power in a village near Lille. She had been cutting some meat off a dead mule by the roadside when we came upon her. She looked up, stared and silently slid away leaving the meat as a cat might abandon its prey. While she disappeared down steps to a cellar we waited and then realised she was watching us from behind a door.[ix] _

I want to relate this experience of Bions to a psychotic experience, where pain is experienced, but not suffered. To do so, first I wish to set out side by side his war description of ...not nightmare, not waking, not sleep, with his description of a psychotic patient, to show the similarity. His description of this patient many years later was ... It occurred to me that I was witnessing an inability to dream through lack of alpha elements and therefore an inability to sleep or wake, to be either conscious or unconscious.[x] As you can see Bions first hand war experience is not hugely different from the experience he describes in his patient many years later.

Second, I wish to paraphrase Bions war description to illustrate something about psychosis. To do so is admittedly to take liberties which I dont think he intended. I do so because of my special relationship with him as his former bearer. For me the description of that horrific war situation is also a description of psychotic processes. This poor girl had been sexually assaulted by the retreating Germans. Not only had her body been savagely and violently intruded into, but also her mind. The whole description is of a mind that has been savagely violated with unbearable pain. The description could equally be of an army officer, little older than a boy, whose extremely sensitive mind had been repeatedly violated by the savagery and carnage of violent death at close quarters. Pain that the mind cannot bear, shatters the mind, and we call that process psychosis, which reduces it to function in an almost animalistic way. However, the mind is not completely destroyed. Some thin part of it still functions on the periphery of this terrible disaster, forever watching and listening. Anyone who has been in the presence of florid psychosis will tell you how there is no recognisable person left, but then suddenly, and ever so briefly, as with the girl, you sense the presence of someone that seems to be _watching ... (as if) from behind a door. _When Bion says _What we felt reminds me of a young child .. _he is saying that was his state of mind. Since Bion we have come to appreciate the psychotic parts of the self in apparently normal people. It might be equally useful to appreciate the peripheral normal functioning of a mind that has otherwise been devastated. It is presumably this aspect of the mind that drives the attempts to repair, for instance through delusion formation, as Freud pointed out in his understanding of the case of Shreber.

You can see from these descriptions that when we talk about pain without suffering, it is not as if there is no pain. There is pain and the pain and its circumstances, are so horrific, that it cannot be held in the mind and so suffered or thought about. There needs to be a mind that is relatively coherent to suffer the pain or even to erect defences against it.

The centrality of pain and its relationship to suffering is thus complex. Bion puts it very succinctly -

_Pain cannot be be absent from the personality. An analysis must be painful, not because there is necessarily any value in pain, but because an analysis in which pain is not observed and discussed, cannot be regarded as dealing with one of the central reasons for the patients presence. The importance of pain can be dismissed as a secondary quality, something that is to disappear when conflicts are resolved; indeed most patients would take this view. Furthermore it can be supported by the fact that successful analysis does lead to diminution of suffering; nevertheless it obscures the need, more obvious in some cases than in others, for the analytic experience to increase the patients capacity for suffering even though the patient and analyst may hope to decrease pain itself. The analogy with physical medicine is exact; to destroy a capacity for physical pain would be a disaster in any situation other than one in which an even greater disaster - namely death itself - is certain.[xi] _

It is implicit from this description that the mind that cannot suffer pain, is a mind that suffers that greater disaster, as it is destroyed by pain. It is this destruction of the mind that is the negative part of psychosis, while the repair through delusion formation, the positive.

CONCLUSION

We have been on a long journey. We started off by trying to understand psychic pain by comparing it to physical pain and thereby suggesting the necessity for it. We then travelled through the long road of pain, which is also simultaneously the journey of life, and we discovered that life and pain are inextricably entwined. We did not succeed in extricating one from the other, but we did try to extricate pain from suffering. With Bions help we were able to understand something of this relationship and in doing so, we glimpsed one of the most horrific scenes in the minds vast repertoire of images, the image of a mind destroyed by pain, the mind of psychosis. This is a terrible way to end this lecture, but if you can bear with it, we might have other perspectives to offer in the next lecture, Bion the Mystic.

References

[i] Bion W. 1982 The Long Week-End 1897-1919. Part of a Life Fleetwood Press. Abingdon. P16-17.

[ii] Freud S. The Interpretation of Dreams. S.E. Vol. P. 613.

[iii] Alice P. 2011 Love Hurts. Time Magazine. 11 April 2011.

[iv] Bion W. 1985 All My Sins Remembered: Another Part of a Life Fleetwood Press. Abingdon. P.38.

[v] Keats, J. Ode to a Nightingale Palgraves Golden Treasury of English Songs and Lyrics. Dent and Sons Ltd. 1906.

[vi] Bion W. 1977 Seven Servants - Learning from Experience Jason Aronson New Yok, N.Y. p. 47.

[vii] Bion W. 1977 Seven Servants - Attention and Interpretation Jason Aronson New Yok, N.Y. p. 53.

[viii] Bion W. 1977 Seven Servants - Attention and Interpretation Jason Aronson New Yok, N.Y. p. 19.

[ix] Bion W. 1982 The Long Week-End 1897-1919. Part of a Life Fleetwood Press. Abingdon. P 209-210.

[x] Bion W. 1977 Seven Servants - Learning from Experience Jason Aronson New Yok, N.Y. p. 21.

[xi] Bion W. 1977 Seven Servants - Elements of Psycho-Analysis Jason Aronson New Yok, N.Y. P 61-62.