Discussion - Talk about Trouble in the Family

by Kaye Nelson

It’s striking how frequently the language of natural disaster events is used in the literature to capture the impacts of boundary violations within Psychoanalytic organizations. Writers describe tsunamis of emotion; earthquakes shaking the foundations of beliefs; groups being flooded and swept away by their anxieties and fears. Such language is apt as it reflects the extremes of responses that can occur in societies when boundary violations by one of their own become known. (And Liz has elaborated very dramatically the kinds of behaviours we’re likely to see).

In her paper, however, Liz draws a distinction between disasters of the natural world and the disasters that befall psychoanalytic societies. These she proposes are not natural; they are against our own natures; attacks on the nature of our caring professions; attacks on what we do and how we think of ourselves. So, how do we think of ourselves and what we do? 

Scholars who research disaster events in the natural world argue against the notion of ‘natural disaster’. Rather they propose there are natural events, such as earthquakes, volcanic eruptions, cyclones which are termed ‘natural hazard’. The occurrence of a natural hazard is a necessary but not sufficient condition for the unfolding of a disaster, which by definition, causes catastrophic damage to populations and livelihoods. For example: a flooded river is not a disaster. A flooded river that overflows its banks and floods a nearby city built on a flood plain, is a disaster. From this perspective disasters are as deeply embedded in the social structure and culture of a society as they are in an environmental event. So that rather than being an external intruding force into a society, a disaster could be understood as a phenomenon partially produced by the society itself – a phenomenon generated from weaknesses in our system. (Scott, 2020) (Covid is an example – the pandemic has writ large the weaknesses in our governance.) 

As psychoanalysts and psychotherapists, we work in a highly volatile landscape where the notion of ‘natural hazard’ seems implicit. As we work, there is an ever-present psychic force or threat ready to break through or erupt under strain and potentially become a disaster if not well governed and contained.

The French/Swiss Psychoanalyst, Florence Guignard (2021) captures the elements and texture of this landscape – this psychic borderland in which we work - with her concept of THE INFANTILE. She describes it as: 

“a structure in motion, situated on the edges of our animality, on the frontiers between our unconscious and our preconscious system. It is the place of the first flourishing organization of Ego drives…it is also the acute point of the non-verbal emotions and feeling. The infantile can be observed in every human being whatever his psychic structure or pathology.” (Guignard, 2021 p. 7) 

It is this constellation of psychic phenomena that is engaged within the psychoanalytic encounter. As clinicians, we know that the work within this ‘borderland’ is demanding; disruptive to our equilibrium; challenging to our narcissism and above all – necessitates a highly disciplined practice. Additionally, it requires the backing of a robust and well governed Society with a capacity to ensure that mechanisms exist to reduce the risks posed by the ‘natural hazards’ in our work and to prevent them becoming disasters. 

Elliot Jacques (1955) proposed that one of the primary functions of membership in a group or organization is to defend against psychotic anxieties – the unbearable anxieties implicit in the functioning of the group. From this perspective the structure and organization of a society can be seen to function in the same way as the psychotherapeutic frame where its role can go largely unnoticed until there is a change or break in routine. Bleger (1967) writes of the frame having a “dumb” or passive presence that silently holds the anxieties and inner object relationships as the therapy progresses and it is only when a rupture in the frame occurs that we can know what is being held. (Louise Gyler’s paper tomorrow and the clinical work she presents gives a rich exposition of Bleger’s conception of the function of the frame and I’m very grateful to Louise for the discussions we’ve had about the paper.) When boundary violations occur, we come to know what the Society holds. 

Drawing on the research, Liz catalogues the range of primitive defences and enactments that occur when the levy banks of a Society are breached - the denial, splitting, omnipotence to ward off the anxieties inherent in who we are and what we do as psychoanalysts and psychotherapists. Societies that are unprepared or unwilling to grasp the inherent danger in their enterprise will be housed on a floodplain.

One of the most confronting aspects of the research noted in Liz’s paper is that training members and senior members of a group are one of the two main cohorts to come before ethics committees. Professors Celenza and Gabbard report that contrary to the stereotype of the psychopathic predator, most transgressors have had typical precipitating factors, most of which can be understood. They write that “we can all recall times when we crossed minor boundaries in a similar circumstance with a similar patient. Examples of such crossing come easily to mind but are usually shared only in private informal contexts with colleagues and friends”. (Celenza et al, 2006, p. 169) 

Florence Guignard counsels along these lines: the analyst must accept “not being perfect and omniscient, and to welcome the necessity to work with other psychoanalysts in order to get out of the impasses so vividly described by Herbert Rosenfeld.” (Guignard, ibid) As we know – following this advice is far from straightforward. Seeking counsel from colleagues is a powerful mechanism for reducing the risk in a society. But research indicates it has limitations. Similarly, the Training analysis is vital, but it too has inherent problems; education also has its limitations and is reliant upon the capacity of individuals to internalize a moral or ethical object and this cannot be taken for granted. 

The Covid pandemic has shown us that no one thing is everything – and that we need a range of measures to adequately respond to and mitigate the impacts of disasters. However, the compliance from any group will always be patchy and mandates do not seem to work and if they do, they don’t for very long. 

So, what to do? 

Liz’s Paper aimed to suggest entry points for discussion – it didn’t promise answers. And in responding, I’m not proposing any answers either. Nonetheless, in concluding I’ll offer an observation: 

It’s worth noting how much attention is given to what might be called ‘post disaster recovery’. Boundary violations don’t usually come to attention or at least are not discussed until after they occur and the extent of their damage to patients and societies begins to be known. However, it is the case that, as with environmental disasters where large scale events - the “unprecedented” flood levels, the 100-year droughts, the high intensity cyclones – gain the attention; in the psychoanalytic field it is the most egregious violations that command 4 attention. But what of those processes slowly unfolding in the background over time that have created the conditions for these disasters? Those everyday slippages, the bending of boundaries that become ‘normalized ‘and eventually become yet another aspect of a Society’s culture that leaves it weakened and less able to avert or mitigate the fallout when serious breaches occur. Here I have in mind the pessimism that Professor Gabbard references in the concluding chapter of his book which he says is born of our extraordinary capacity for self-deception and the mental gymnastics that help us to conceptualize ourselves as “special cases”. 

Is this the Climate Change equivalent for our Psychoanalytical Societies? - this slow unfolding of unattended processes that eventually become unstoppable. Might it be the case that the shocked attention we give to egregious sexual and non-sexual boundary violations, while essential if we are to survive, come at the cost of attention to the small breaches that weaken a society and create the conditions for a disaster? 

References 

Bleger, J. 1967. Psychoanalysis of the psycho-analytic frame. IJP. 48:511-519 

Celenza, A., Gabbard, G.O: Analysts who commit sexual boundary violations a lost cause? Journal American Psychoanal Assoc. 51(2): 617-636, 2003 

Guignard, F. 2021. “The infantile in Psychoanalytic Practice Today”. July 2021, Online paper. 

Jacques, E. Social Systems as a defence against persecutory and depressive anxiety. In: Klein, M, Heimann, P, Money-Kyrle, R.E. eds. New Directions in Psychoanalysis. London: Tavistock Publications, 1955. 478-498 

Scott, M. 2020. Two Disaster Paradigms. In “Climate Change, Disasters and the Refugee Convention.” Chapter 2, p 10-30. Cambridge Press.