Thinking about Aggression in Psychoanalytic Work

THINKING ABOUT AGGRESSION IN PSYCHOANALYTIC WORK: Challenges of Working With a Victim of Violence.

Note: THIS IS THE TEXT OF A TALK GIVEN AT WHITLEY COLLEGE, UNIVERSITY OF MELBOURNE, AS PART OF THE FREUD 150 YEARS BIRTHDAY LECTURES, OFFERED, BY THE MELBOURNE INSTITUTE FOR PSYCHOANALYSIS, DURING 2006.

Beginning tonight with some thoughts about meaning, it occurred to me that the words ‘aggression’ and ‘violence’ seem to have more to do with acting than thinking, - what my primary school teacher used to call ‘doing words’.

Not all the meanings of ‘aggression’ are negative. Aggression can mean moving towards, in the sense of exploration or curiosity, which I hope this talk will convey tonight. I also discovered that one of the meanings of ‘violence’ is ‘misinterpretation’, in the sense of the misinterpretation or misapplication of a word, - doing violence to meaning, - highly relevant to psycho-analytic work in general, and, as will be seen here, especially so, in working with patients whose experiences require extra thought and understanding.

I thought to start the psycho-analytic exploration of violence and aggression tonight with a quotation form Joan Riviere from a lecture she gave on Aggression in 1937. She says…..

“Now though we all know, or ought to know, that aggressive feelings do exist in ourselves and others, on the whole we do not much like the idea of them, so unconsciously we minimize and underestimate their importance. We do not focus our eyes on them, but keep them in the outer edges of our field of vision and do not let them form part of our whole picture of life; by keeping them a little blurred they do not appear so near and vivid, so real and vital, and thus so alarming as they would if we saw them clearly. This of course is a very primitive method of dealing with our fear of them; it is only comforting to ourselves and not really advantageous.” (Klein and Riviere “Love Hate and Reparation” 1964)

These seem to me to be such very carefully chosen words. What we all know, or – ought to know. The implication is we might not, that there is a constant need to revise and re-think what we should know or ought to know, as well as how we are so easily able to blur things in order not to know them. I think that Joan Rivieres’s thoughts on aggression are a very sensitive reflection on how difficult it is for us to think about and respond to violence and aggression whether it is our own or that of others, whether it is close up to us and personal or a very public event. By way of an example from recent experience, I thought about my own response to a documentary you may have seen, called 9/11 The Falling Man which aired on ABC TV just over a month ago.

It shows the story of Tom Juno’s unflagging, and at the time, not at all popular effort to identify one photo of a man, falling from one of the twin towers, as it burned. It became terribly important to Junot to bring this particular blurred image, and therefore anonymous victim, into clear focus. We follow his journey to find the origins of the picture and its photographer, to understand the circumstances in which the picture was taken, - also the responses of journalists as well as loved ones who are very ambivalent about claiming the falling man. It is not an image, that after it’s first sensational impact in the papers after the disaster anyone really wanted to contemplate further or own, and an incorrect identification occurs despite best efforts, initially. This requires Junot to go back again, and look and re-look, until by focussing more and more minutely he finds an identifying feature, of the falling man’s clothing, which then enables the correct identification to be made, from falling man to a particular man who can then be thought about and claimed in a much more considered way.

I found myself becoming aware of my own reaction towards viewing” The Falling Man.” At first having recorded the program I delayed watching it. I knew that people, had jumped from the doomed and burning buildings, but did not look closely at any pictures myself at the time, probably did not want to, - the scale was too large to take in at first. When I sat myself down to watch the recording some nights after it was aired, I found myself transfixed with the horror of what really did happen to people. Although at times it felt unbearable to contemplate, - the fear, the horror, the individual terror, pain and fear of last agonising hours, or minutes, I too, felt it essential to give a face and a name to the particular falling man on my screen, but it was brought home to me how blurred I may have wanted to keep this particular picture for, well now, five years.

In the late 1980’s in South Africa it was a very real and current reality that far from being 'blurred' or 'in the outer edges of our field of vision', aggression and violence was very much in focus and in the forefront of everyday common awareness. The final years of intense political repression before the un-banning of the ANC and the release of Nelson Mandela. At that time, l could not help noticing the discrepancy between what was being reported to us, officially, and what I saw with my own eyes. We were at that time constantly hearing news reports, about acts of callous brutality mainly by youths in black townships. Yet what I saw from my window while working up in my study at the University, were grown armed, beefy security police, beating up on young, defenseless students, who often got severely hurt in these increasingly common raids and attacks. To explain just a bit, the Charter of the University made its campus theoretically a free zone. The University had quite a number of black students who should have felt relatively safe within the grounds. In practice though and owing to the many rallies and demonstrations against oppression that occurred on the library lawns, police would arrive and students would flee into buildings, such as the one I worked in, to avoid teargas, beatings and arrests, and that is what was visible to me. The words of Winnicott (1984) to whom I often turned, as being so helpful in understanding deprivation seemed to come to life where he says in Deprivation and Delinquency that “youth, however violent and atrocious, are no more so than our own adult war-mongering selves.” This idea that what is going on in society is sensitively calibrated by the adolescent measuring instrument, has found frequent mention in the writings of both Erikson, (1968) and Winnicott. (1971 ).

In writing this talk I have been bringing myself more into present violent dilemmas, while reading Vamick Volkan’s “Blind Trust”. I notice how often he has also turned to Erikson for inspiration and explication in the way he has described so usefully the vagaries of the identity struggle, in both its developments and distortions, - the enormous difference between Basic Trust and Blind Trust. In this paper I would like to present and discuss the psychotherapy of a young adult who was, caught up in the crossfire of personal and social violence. To help me understand then, how living under Apartheid could reduce and impoverish the capacity to meet with and think about patients and people from very different situations to my own, I turned to some of the concepts of Melanie Klein which I then found most helpful.

In psycho-analysis no-one has given as great an emphasis to the dynamics of aggression. Her whole theory is built upon an understanding of the aggressive roots of the earliest stages of development. (Klein, 1932, 1975). In her developmental theory, Klein emphasised the innateness of the aggressive drives in the newborn. In reaction to its own innate aggression, which raises anxiety, the infant creates a split in itself between the all-good, loving parts of the self, and the all-bad destructive parts of the self. The purpose of this cleavage is to prevent fusion of these separate impulses. Splitting, however, is found to be not sufficient in keeping these two parts of the self apart, so the destructive impulses are deflected into the world, thereby creating a split in the infant's actual object relations as well. Essentially two separate objects are felt to exist at this stage -the good, loving mother towards whom all the child's libidinal desires can be directed, and the bad, frustrating mother who receives all the infant's aggressive impulses. Melanie Klein called this phase of object relations the paranoid/schizoid position, lasting for the first three or four months of life.

From 3-6 months the growing infant starts to become aware of its own separateness from others. Introjection is now the predominant mechanism and the infant starts to be aware of and take in a greater variety of the 'whole' caring mother. Aggressive impulses are now felt to threaten the good as opposed to the bad mother more directly, and this leads to anxiety and guilt at the possible loss of the good mother. Melanie Klein called this depressive anxiety and she described the phase of guilt, sorrow and reparative gestures which now follow as the depressive position. The depressive position is marked by a constant struggle between the demands of the omnipotent, destructive parts of the psyche and the demands of reality and survival.

It seemed to me, using these ideas, that apartheid was the very paradigm of splitting on a social level -keeping people apart, keeping groups apart and keeping ideas apart. Since schizoid, according to Melanie Klein, is the companion developmentally of paranoia it might be said that under Apartheid, keeping people and groups apart, allowed for the projection of hostility and violence into those groups outside of one's own. What was not possible, under apartheid, was interpersonal and social synthesis and reconciliation, as described in the emergence of depressive mechanisms. Developmentally, therefore, the culture of apartheid was at the most primitive level of development. Hate rather than love or concern was actively institutionalized. In the context of apartheid political suppression and repression was the State's swift answer to the open expression of any ideas, deemed in any way to be 'dangerous' to the state. On the psychic level, suppression and repression act in a way to keep hate parcelled-off, projected, and therefore untested and unameliorated. In the same way that some infants in their early parenting have their aggression met only by retaliatory responses, so did South Africans, black and white, have their attempts at healthy protest meet with persecution, silencing, confinement, and worse. Apartheid, therefore, could have been designated as a primitive 'hate' culture functioning so as to prevent the testing out, in any ameliorative way, of primitive feelings, fears and anxieties which had to do with the projection of destructive and persecutory intents. As such it could be said that apartheid reinforced and intensified paranoid schizoid mechanisms of individual defense.

TO ILLUSTRATE SOME OF THE DIFFICULTIES THAT ARISE IN WORKING THROUGH EXTERNAL AND INTERNAL STATES OF VIOLENCE AND AGGRESSION I HAVE TAKEN SOME EXTRACTS OF SOME PSYCHOANALYTICALLY-ORIENTED PSYCHOTHERAPY WORK WITH A YOUNG MAN WHOSE LIFE GOT CAUGHT IN AN EXTERNAL STRUGLLE WITH APARTHEID AND WHO PRIVILEDGED ME WITH GLIMPSES OF HIS INTERNAL STRUGGLE

I first met Ahmed as I shall call him in 1989. Ahmed is not his name, and the name he gave me back in 1989was not his real name either. This did not surprise me because in South Africa in 1989, at the time of referral, I was told he was a very high ranking political activist, youth leader, and that his identity needed to be protected. Ahmed was a short stocky 21 year old he had a small goatee beard. I was struck from the start by his proud bearing, and increasingly impressed over time by, how, given his experiences of severe deprivation and confinement, the attempt to ‘break him down’ as a prisoner in detention, had not succeeded. He had an intense and confrontational manner. His English was good and he had an unforgettable way of expressing himself. No small talk - - quite unusually so. No polite or elaborate greetings, he would just walk in, nod, sit down, and say something after a while. The first six months or so, - this took time, as he had been severely traumatised and was depressed, so the personality I am describing above took some months to emerge. In addition to the arrangement, to meet regularly, at the same time, for a 50 minute session of psychotherapy, every week - he had requested ongoing therapy from the referring clinician - he also received support from other organisations in more practical ways. Such as, a safe place to live, people to go to, a support network, yet I had the impression of how disorienting the loss of contact in solitary confinement, and the bad treatment while detained, must have been for him in the year he had been away from and cut off from his former everyday life.

He struggled with me initially. He arrived promptly every week. Sometimes he would look at books on my shelf and simply say ‘can I take this’ – this was a book called a short history of the earth. I still have it and he kept it for quite a while. He would sit and look at it and then say a bit about history, - perhaps the history of Africa or even his own, very slowly, as though the sheer effort of communication was taxing for him at first. I struggled too. I struggled to hear him because for the first few months, he mumbled and was repetitive, and I did not want to be intrusive or disrupt the tentative, fragile state he must have been in, as well as his understandably shattered trust. It was a struggle for him to get to me I was sure, and I would feel relief to see him arrive, on time as usual.

At the start, he had the full gamut of PTSD symptoms: Sleeplessness, jumpiness, lack of concentration, intrusive and obsessive thoughts, fear and suspiciousness, as well as lethargy and general depression. The worst thing that he said he had experienced in detention was the solitary confinement. In the first few months he spoke quite a bit about the stress of his experiences. The isolation, not being with his support group, his comrades, with whom he had been detained was the most painful thing, but he fought back. What he did was, he went on a hunger strike and this then brought about his being re-united with them. While’ in solitary’, he wrote poetry, - on prison-issue toilet paper. He told me this with pride, suggesting he was resourceful, and would waste no opportunity to use whatever small thing he could find no matter how hard his personal struggle.

Our therapeutic approach, working with released detainees at that time, was not to ask questions, bearing in mind they had almost certainly been subjected to forced interrogation, but rather leave it up to the patient to communicate It was as though Ahmed had to come back into the world from a horrible place and needed to get his bearings. {See in this context of rehabilitation from extreme political trauma the recent George Munster Award to Olivia Rousset for her work with the tortured and torturers of Abu Graib reported in “Big Ideas” where this interview describes very vividly the way in which a patient from Chile was treated by STARTT} On one occasion, after some months of regular contact he arrived still tearing from a bread roll and swallowing, in gulps, he was having his lunch on the run he said, had not had time to get something else, did I mind. It did not occur to me to ‘mind’ I just had the sense of urgency and hunger, his being ‘on the run’, - this patient was new to me, and the psychotherapy situation was new for him. I was relieved that his hesitant speech, jumpy manner and mumbling was giving way to a more lively confident energetic and outgoing Ahmed who hopefully felt more comfortable. At this time, Ahmed also received medical treatment from a psychiatrist, whom he saw every few weeks, to help him overcome the worst of his PTSD symptoms. Meeting with me regularly, sitting together for 50 minutes, also seemed to act as an anchoring experience. The next few months as a livelier Ahmed emerged I learned a bit more about him.

I was been struck by his name, which did not sound like a traditional African name. It did not surprise me to learn that his father held a leadership position as a Black Moslem cleric. He spoke proudly of his father who had left the family when he was 12, and had never returned. He remembers running away from home to search for him but his mother sent the police to fetch him back. His last picture of his father was of seeing him at what he described as a vast ceremonial gathering, and catching a glimpse of him from a distance. He struggled through the huge crowds to try to reach him, but the crowd was too dense, he was too small, he lost sight of him, and had not seen him since.

Ahmed’s mother was a Sangoma. A Sangoma is a traditional healer a position commanding respect. Sangomas may study for five to twelve years to achieve fully- fledged healer status. But this undertaking, regarded as a calling, also means a great deal of time away from home and family. According to Ahmed, Mother expected him to study hard, do household chores, and also look after his younger brother and sister. He told me ‘I was strenuously dutiful. I studied hard. I had all these chores to do. A long list. I could hear the other kids playing in the street outside, but I was not allowed to play I had to do housework or homework, and if my brother or sister misbehaved I would be held responsible’. (See my research)

The picture Ahmed gave me of himself as a boy, was that he was quiet, withdrawn, unhappy. Serious. So much so that when turmoil and protest against the apartheid regime overtook the schooling system in his community, he still carried on studying conscientiously as best he could, but eventually his studies were completely disrupted. However, he told me, his classmates perceived him as thoughtful, and so he found himself in the unsolicited position of student leader of his community.

This situation of being catapulted into a leadership position with or without one’s conscious intention, at a young age, is, I have recently learned fraught with dangers, - especially at the time of adolescent striving, and also in such a difficult social situations. Vamick Volkan writes very movingly about his interview of a young Palestinian heroine who he calls ‘Radiant’ he says that “although she gave me permission to use her name and write about her full story, I will refrain from using her real name and will refer only to those parts of her personal story that illustrate how she became a “living symbol” for Palestine” Volkan goes on to describe how Radiant, having lost her father, found herself ‘chosen’ as a symbol of her people. This is the part that I focussed on as being so similar to the dilemma of my patient at a similar point in time. Volkan says that as the interview was coming to an end he expressed curiosity about why she had agreed to open up so completely to a stranger and reveal her wishes and fears. She said that I quote “though she was aware of and attached to her role as a “flag” for the Palestinians in Tunis, she also knew that she was made of flesh and blood. She had dreams of finding a husband, marrying and becoming a regular person, she said, and she knew that it was impossible to be both a symbol and a woman. Having no solution for her internal struggle, she had developed a daydream in which she lost both identities” -----

This year to commemorate the Soweto riots – a time of student revolution in South Africa earlier than the one I am describing, a documentary on the 1976 uprising reviewed the life of it’s leader, Tsietsi Mahinini. Airing on SBS on June 22nd, it was called “WHAT HAVE WE DONE” and what it showed was how the glory of designated hero declined and so swiftly devalued into flight, illness and eventually disappearance, disease and tragically death, as this young man, at so young an age, with so much riding on him, could not cope with isolation, loneliness and lack of meaningful contact.

Somewhere between six months to a year, of our work, equivalent to the time he had been detained, Ahmed’s poetic started surfacing in the way he began communicating to me. The child who did not play but wanted to, appears at first, tentatively, in the way he offers some ideas, images, metaphors. There is a serious and deadly side as well, to all that emerges in his communications to me.

Among the many difficulties of this therapeutic work were aspects of the framework. Ahmed saw me regularly for nearly two years, but not in the usual therapeutic circumstances. I worked up at the university Monday to Friday, with some time off for public holidays, - Christmas, Easter, which Ahmed would have taken as well if they fell on weekdays, but we had no long breaks. There also was no payment. The system of referral, through which Ahmed reached the clinician who sent him to me was voluntary, - no payment was expected. I also had no way of contacting or reaching Ahmed. I knew of the area he lived in, but even there he did not remain in one place for his own safety. What did remain constant in our work was my office, and the departmental secretary who Ahmed had been introduced to in case of need. One day I missed a session. I was ill and unable to come in so I phoned in, and dictated a note for the secretary at work to give to Ahmed when she saw him. In it, I said he might phone from her office to speak to me if he wished. The following week he was there promptly as usual, - smiling cheerful. It was ‘quite alright my not being there the previous week” he said. ‘Better than lying around at home, it made me get up and come here’. In the week he had not seen me, Ahmed had been back to see the psychiatrist. He had a complaint. Before he started on the medication, he had been unable to sleep. Now he was oversleeping. The psychiatrist did not seem to think this was a problem, couldn’t Ahmed just get someone to wake him, ‘he doesn’t know how it is, - said Ahmed, ‘it is impossible to rely on others. Others are too busy with their own sleeping. Sometimes they are there or maybe not. I must rely on myself’. I took this as a reflection of his feelings about my not being there for him as well, the previous week. This feeling grew in my mind as Ahmed then started telling me about the iniquities that sparked the school boycotts and youth revolution he was caught up in ‘what would you do if you were starving’ he said ‘yet the only food you were offered was food you knew to be bad, - this is what my education felt like. Leaving school and becoming a student activist leader, is like pouring Sprite cold-drink into a flowing river. How, he said, can we separate the liquid poured from the river itself”. Then he asked me ‘has the psychiatrist phoned you. He said he would. If he hasn’t don’t phone him. Let us see what he does. If he does not, I will know him to be a person who lies. I like to give a person a chance to look within and redeem himself”

Ahmed did not appear at the usual time the following week. After 30 minutes or so, I left my office to walk down to the secretary to discover if she had seen him arrive, and on the way Ahmed, who had just arrived sighted me before I saw him. As soon as we were seated in my office he said ‘you failed to see me’ – Very angrily, and in an accusatory tone, sounded like he needed acknowledgment, so I said so, – that he was angry, felt let down, I wasn’t the person he thought I was. He would not accept this idea and took a while to continue on. Then he said ‘Do you know about the sheep in lion’s clothing?’ Sheep are very pleasing, he said, lions are not they are full of bad qualities.” Something about the way he said this as well as what he was saying alerted me. Some incongruity. Sheep sounded dead boring the way he said it, kind of silly, not at all appealing actually. Quite stupid. (and I made a note to myself here, that I have since learned in reading Black Hamlet , that John , whom Wulf Sachs interviewed in the 1930’s said he was forbidden to eat sheep because it is not a clever animal) Lions sounded much stronger more attractive. Also it was a reversal of the expression I knew, wolf in sheep’s clothing. Who was he talking about and what did he mean. I felt now a bit like the psychiatrist he had been railing against the previous week. Not able to know ‘how it is’ Would I get it, looking within was I redeemable in his mind, is he? These were some of my internal questions. At the time I made no initial comment of this kind, but tried to get him to tell me a bit more. I was also thinking at the time, that animal fable is a rich tradition in Africa, and so asked him to tell me a bit more. At the time I said are sheep really so pleasing, are lions really all bad. I was following his tone here rather than just the words, but he warned me off by saying “I am a dog” “Dogs are either tame or they bite”.

It may well be that I did some violence to understanding by not picking up on what it was he was disguising then. What I heard him say was lets keep away from anger, especially when you have let me down. I might just forget not to let myself down.

Throughout my work with Ahmed I was constantly aware of how many feelings must be coming back to bite him all the time, not the least of them surfacing here between us. The horrors of not being understood or of being misunderstood. Not being given any leeway.

Terribly painful for this patient must have been the response of his family to his arrest and detention. He went on to tell me he had received no support from them. No contact or communication. When he was released, they told him he had been irresponsible. The best thing he could do they said was to get himself a job, which they had found for him. It was as a night-watchman at a factory.

Listening to this I can remember how sad and horrified I felt, imagining how, alone and in a dangerous job at night, he might react to any fears in the dark, - given his PTSD. It sounded to me like banishment, as though he was expected to continue in a kind of solitary confinement, and to my relief, he had refused. It was not lost on him, that being alone at night would have been far too fearful an experience for him to even consider as suitable work, but by turning down their so-called help he also incurred their further rejection of him. And this is is a cautionary tale, that he was saying that he had to become bad and brave to hide a tamer and less daring self that really wanted to please and have others including me think well of him. Aside from the violence done to his life I also see the shape of the violent feelings of adolescence what Anna Freud describes as a kind of borderline syndrome when she says “I take it that it is normal for an adolescent to behave for a considerable length of time in an inconsistent and unpredictable manner; to fight his impulses and to accept them; to ward them off successfully an to be overrun by them …….. to be deeply ashamed to acknowledge his mother before others and, unexpectedly, to desire heart to hear talks with her …….

An enormous conflict for him given all the other conflicts he had to cope with.

With the un-banning of the ANC in 1990 Ahmed became involved with and excited by the political progress going on around him. He introduced many of these themes into our therapy sessions. For example he began one session “Well say, - one has all the tea and a cup and saucer and the other does not. That one got it through taking and bribery. Then they decide to give it back – the cup and saucer but not the tea”. This very powerful image, perhaps one central to the work with Ahmed, was contextualised at that time, by him in terms of the history of our country, he said, “this is how black people have been treated by white people since the 17th century. “

My reaction to this very confronting statement was that he may have been referring as much to the situation between us – the micro-politics, perhaps, of the therapy work, rather than just the macro-politics of the country we were living in. I was concerned that there was a history of un-even-ness between us, having to keep things tame and nice between us. Not being able to tell me up-front that the therapeutic nourishment, offered, might have felt inadequate. For example, that I didn’t know nearly enough, to understand him, or really appreciate that what he was getting was far too little, far too late.

This was a very difficult area to enter into with Ahmed, because among the many other problematic issues was his need of the help within a situation fraught with so many cross currents. One of which was, my being referred to by him as a comrade. If you were called a comrade, it meant you were affiliated to the ANC, on the same side, had been collaborating in a vital project, the struggle against apartheid, and therefore trust was assured, and was not disputed. The university was a designated safe zone, for our meetings, despite my being white and living in a different world. Talking to an insufficiency in the therapy, or my not being quite real, was to tread on thin ice, especially insofar as issues of trust were further compounded by Ahmed’s recent experiences in detention. When I felt I might raise the idea that he might also be talking about some problems of equality between us, now that the ANC had been un-banned - and could this be the signal for greater freedom for him to express any unhappinesses here - he responded immediately saying “no” quite emphatically. “Here we have real power sharing which is how it should be”, he insisted. Never mind either about any other inequalities, dependency needs, the awful history of colonial paternalism under apartheid, - Ahmed was adamant “I share my thoughts with you” he said, “because you know my inner mind”. This knowing of Ahmed’s inner mind was troubling to me, did he feel I had taken his mind over, I wondered? After all, despite his feisty manner and determined and lively approach, he had only recently come out of a horrible detention experience where there had been a real attempt to break his mind and spirit.

Some time later Ahmed offered this in one of our sessions, “Well you have power over me, - like a White Sangoma”. In calling me a white Sangoma, I guessed Ahmed was identifying me in his mind with his mother who is a Sangoma. A mother who according to him left him undernourished, certainly emotionally, - to use his image of deprivation and pretence of giving, but empty, as though with cups and saucers but no tea. A mother who is described as being oblivious to and quite insensitive to any of his needs. I felt all of this being transferred into our work.

The following week I had to be away but this time with preparation and forewarning. After this missed session Ahmed began “Some things are causing hating feelings – privatisation and nationalisation. The people cannot say what is good for them. Does Mandela really represent the people? We also have Cuba breaking away from Perestroika. It is just as well that Gorbachev has stopped running around. He should stay at home and sort out the problems of his own people. Just look at the Berlin Wall, and the floods of people pouring over it.” Ahmed’s flood of feeling went on to encompass other power sectors of tribalism and not surprisingly, an invective that included US support for non-ANC aligned groups. I waited for the outpouring to subside. I said to him that we had talked already a bit about feelings to do with my not being attentive, to my running around. He seemed to be worried today, all over again, about whether he really could depend on me to be mindful of his interests and aspirations. In my own awareness of him, I was aware of anger and hurt, as well as a large measure of distrust. I felt very concerned that not only had Ahmed lacked empathy and concern from a mother who sounded to have been punitive and controlling, but that his father was talked about with veneration, despite abandoning him. Whom could Ahmed turn to in his mind?

A short time after this Ahmed told me he was in love with me. He was quite insistent that I respond. He asked me what did I intend to do about it. Despite this insistence, he also made a distinction between the therapy relationship and his love as being, in his words “apart from the therapy”. He suggested that there should be a space for a love relationship outside. I thought he needed love in his life, quite desperately, and although I said that we will continue in therapy to try and understand whatever comes up and talk about it, but only as it happens here, he would not be encouraged to say a bit more about the feelings of love that had arisen. The suggestion of a parallel relationship became a bit of an opener to our sessions for quite a while. Had I thought more about his suggestion that we find time for love outside of the therapy work, and then he would go on to talk about other things including, after a few weeks, his own further thoughts about love, saying,: “ Men and women are different when it comes to love.” he said. “ Men are interested in time-spending love. Women want committed love”. It wasn’t clear at first what he meant by time-spending. I thought about our sessions, was it his way of suggesting there be a reversal, - time-spending like in our sessions, but outside, his equivalent of measuring out time, as though nothing better to do? He did eventually say that his time-spending love was sex that was fickle, a kind of take it or leave it dalliance. Was he asking how far this comrade would go, or was I just another empty promise without fulfilment. Cups and saucers – no tea. I was left to hold the idea that once again, like the mother who does not stay put, the father who pushes off, the schooling that collapses, the comrades who disband, even the known struggle that suddenly dismantles without forewarning of what freedom entails, it would be better if he could take or leave things. Not be lost in the stream of experience external and internal. Maybe even thinking of me as having a take it or leave it attitude to him.

There was so much going on, so many ideas running around, Ahmed was right, so little time in which to tackle all that needed holding, understanding, containment, but some summary of a number of his intense and conflicting feelings seemed to need acknowledgment from me as best as I could at that time. The impetus to offer some reflection of Ahmed’s inner turmoil, was also propelled by his beginning a session some 18 months into our work, and a few months after his telling me about being in love with me, with the reappearance of dilution as an idea in his mind about himself. Previously he had said he had become part of a stream, in his words “like Sprite cold-drink poured into a flowing river how can we separate the liquid poured into the river from the river itself, but now he told me that, “dilution means they all become one thing, dissolve together” It occurred to me, as he then went on to talk about Nelson Mandela that some kind of fusion of identity might be in his mind. I saw this as operating both on an infantile level, the wish to fuse with mother, an identity of needs and wishes, being totally wanted and protected, not having to experience separateness, but also struggling on an adolescent level with the identity diffusion Erikson describes, which can be the reactivation of that earlier un-resolved regressive infantile wish. On the one hand I thought, he felt diffuse and lost at times, had difficulty separating himself out from what was going on around him, yet he also perhaps wanted to be part of and identify with, even merge with a helpful figure, the little boy searching for father then swallowed up in a huge crowd and losing sight of this possibility quite hopelessly. These thoughts fitted I thought with what being in love might be about, in part, I needed to accept and respond to much more of him than I had been doing up till then.

I said to Ahmed that he does seem to have been struggling with a whole lot of different pictures of himself, and all sorts of feelings and frustrations some to do with himself others to do with me. Different wishes and fears that I was trying to picture. One of those pictures is that it would be helpful maybe if I were really with him, outside of the time we could spend here. If that could come about might not I then understand his feelings a lot better, get a close up experience of his suffering and joy. Another picture is that if only I and not he were on the receiving end of what he has had to endure. I might understand him better in that kind of way. He would even in some moments, prefer me to be the one receiving time-spending love. Yet at other times, maybe he thinks of me as a powerful person in his mind. If only I could come to his aid like a true father would, not just a father of the people, like Mandela but a real father to him that could have made a real difference. Having shared some of these reflections with him Ahmed nodded and smiled then looked serious and concerned.” You really see how it is, “ he responded to this. But extremely painful thoughts then followed and he said “I do not wish to sacrifice myself I do not aspire to become another Steve Biko. Look at the reality of what I have lost in the struggle. I have lost my education. I have lost my skills to earn a living. I have lost my family. I have lost and I have suffered.”

After these searing, painful truths, Ahmed became involved in local politics in the area where he lived. Being the leader of his local street committee, he told me, had involved him in meting out rough justice to a boy who had violated his mother and grandmother, over their not leaving dinner for him one night when he had arrived home late. Ahmed seemed proud of the stern way in which he had presided over this problem and told me with relish about the crimes in a great deal of detail, - as well as a blow by blow account of the punishment, also in detail. His manner in the telling was as though we were in perfect accord, on the committee together, even as though I might be proud of him, to be co-opted in this way. His lack of sympathy, for anyone, who did not make the right choices politically, as well as personally was intensely conveyed. He told me let them suffer and then “maybe through their own troubles they will see the error of their ways”.

A month or two later, violence broke out in the area where Ahmed was living. He told me he might not be able to get to see me as he would be in his words “lying low”. He phoned over the next few months, as a way of staying in contact and to say how much he would have liked to have continued his therapy, but that there had been too many practical difficulties for him.

Thinking about the therapeutic endeavour surrounded by as many difficulties as this therapy was, required resources from both Ahmed and myself at the time that could not enable it to continue past a certain point. Ahmed’s intelligence, verbal ability, rich cultural background and determination were so very promising. He was able to recover from his initial PTSD syndrome, and regain a large measure of functioning compared to his initial presentation. For a truly containing psycho- analytic approach, much more contact to offset the pain frustration and anxieties evoked, may have helped and held him further along. Another crucial omission, aside from the lack of sufficient contact, due to all sorts of difficulties, not the least physical and material, was that due to financial deprivation, no possibility of a contract involving payment, had been possible. Therefore the value of exchange as well as an exchange of value was, bypassed. Ahmed’s therapy, which would have been a very new experience for him, with its combination of formality and freedom coincided with moving to freedom, in surrounding society, but, an imperfect freedom, and some of those dynamics of what was permissible and what was not, mirrored in the therapy environment, might also have stalled the therapy work.

How can we understand the premature termination, - aside from these factors, so many external impingements? Could it also have been due to Ahmed’s reaction to a growing awareness of hurt and anger and a need to escape the mobilisation of so many frustrations suffered in the course of his life up till then. His being on the receiving end. One could theorise and speculate here as well about splitting and projection and the lifting of repression that may have been experienced by Ahmed as a double whammy. As he says himself he has been deprived not just of the things he should have had, but even of the things he thought he had, and the hunger for and anger about, all of that, may well have been experienced by him as running very counter to his pride in himself and his own resourcefulness.

The external situation of violence, deprivation and danger and frustration intersected a point in the therapy where dangers and frustrations internal as well as external were being experienced by Ahmed. I hope to have shown here in some way how in these kinds of situations and in this kind of work, all of our understanding needs to be utilised if we hope to begin to try to comprehend and help those like Ahmed, whose internal worlds have both mirrored and reacted to situations of aggression and violence.

I conclude with some words of Jaqueline Rose who wrote a very interesting introduction to another work dating from 1937 set in Africa and written by the psychoanalyst Wulf Sachs called “Black Hamlet”.

She wrote: - that there can be no last word – not psychically, not politically-- is, a fundamental principle of psychoanalysis.

Thankyou