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Appendix: An introduction to Bion's model of the mind

Bion, Wilfred R. Harris Meltzer Trust ePub

Meg Harris Williams

This appendix is a brief introduction to Bion's picture of the mind, its origins, and how it grows by receiving and developing thoughts, through the turbulent process which he calls ‘catastrophic change’. And, in the reverse direction, how it retreats from growth and development. Psychoanalysis offers a distinctive method for engaging in this process, set in motion by the encounter between two minds, in a way which has vital links with art, science, philosophy and religion. Asked if there was a psychoanalytic way to the truth, Bion replied ‘None whatever. Psychoanalysis is only a technical instrument, something we can make use of for any purpose we want…to mislead or deceive people, and so on. It all depends on who is making use of it.’

Bion experimented with many metaphors in his attempt to convey his model of the mind and the way that the mind develops (or fails to develop); and he preferred to use his own terminology as he felt that existing psychoanalytic jargon was too ‘saturated’ with fixed meanings that could not expand to include new observed phenomena. However, essentially, his picture did not change over the years, even though its expression took various forms, from the mythical to the mathematical.

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Four

Bion, Wilfred R. Harris Meltzer Trust ePub

Bion: Seeing patients many times as we usually do, it is difficult to achieve that degree of naiveté in which we can see them each time as if we have never seen them before. It is easy to think, ‘Oh, here's the same old stuff again – yesterday, the day before that, for weeks, months, years’. It cannot in fact be so because tomorrow the patient we saw yesterday, or last week, month, or year, will not be the same person. We should get as near as possible to feeling that it is the first time we have ever seen that patient. It is difficult because we always feel that we ought to know his history and so on and so forth – a backwash of our own medical training. It is useful for two or three sessions, but after that this information which one has from hearsay is unimportant. From that time on we should be launched out into a different realm altogether – not the realm of the patient's history.

Question: You are really saying that you don't have to take notes. Each time a person comes in he is a new person and it is only what is being presented at this moment that is important.

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Three

Bion, Wilfred R. Harris Meltzer Trust ePub

Question: Do you still do group work, or are you still interested in group work?

Bion: I am still interested in it, but I get very little chance to do it because I get so much pressure on me for individual analysis which I find extremely rewarding and interesting. Is anybody here taking groups?

Question: Yes; but I doubt the use of applying group relations methods to patient work. I don't think it works very well from what I can see of running a small group of hospitalised people.

Bion: You don't find it helpful with the actual family group?

Question: I don't feel ready to use it with families yet. I do get a sense of sub-groups forming and of groups getting into basic assumptions – I think family life is an established basic assumption, the pairing group in a sense. At present I find it difficult to deal with the complexity of the inner actions in my own life.

Bion: One thing which strikes me in dealing with the individual is how little consideration seems to be given to this question of what is basic, what is fundamental. Is there any way in physical medicine of defining what the fundamentals are? What does the doctor concern himself with? What could you call fundamental in the sense of wishing not to diffuse your observation or your time?

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One

Bion, Wilfred R. Harris Meltzer Trust ePub

Question: I should like to hear you talk about the theory of projective identification.

Bion: I don't think there is much to be said beyond Melanie Klein's version – what she called an omnipotent phantasy; a phantasy that a person can split off feelings, thoughts and ideas he does not want and evacuate them into another person, more particularly into the mother, and more particularly still at a primitive stage of existence, namely, at the breast itself. Of course the infant doesn't do anything; nothing happens. But the infant feels as if it could do that, and feels that it gets rid of some characteristic which it doesn't like and then becomes afraid that that same characteristic is directed toward it by the other person – originally by the mother, or by the breast into which it projects it. The theory was not intended as a substitute for already existing psychoanalytic theories, but as an addition to them.

Question: You have used the term ‘bizarre bits’ to describe one aspect of projective identification. Could you elaborate on that?

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Two

Bion, Wilfred R. Harris Meltzer Trust ePub

Question: I have been wondering why taking a history during an interview is important to me. I don't think I could give that up yet.

Bion: The first thing you have to consider is yourself and your way of working. If it is convenient to you to start off in some particular way you should do so. You can readjust it if you run up against a case in which it seems unsuitable. Patients are often used to this routine of giving a history, and you may as well let them feel at home by allowing them to do exactly that – otherwise it is so strange to them. If you start off by saying, ‘Now, what do you want?’ or ‘What can I do for you?’, the patient may reply, ‘That's what I came here to find out’, and will not move from that point. You are straight away in the middle of a story without knowing anything of its beginning. The essential thing is to give patients as much help in that way as you can, because they are the people who don't know what they are up to. If it can ease the situation for them to follow the sort of routine they are used to that's a good idea.

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