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In her latest book, Judy Eekhoff takes the reader to the terrifying depths of unmentalized states of mind in certain patients that have suffered childhood abuse or neglect. Like Dante descending she takes us to the various early tiers of infantile suffering that remain unabated without words or concept and that frequently are triggered and erupt in adulthood. She locates the eye of the storm at what she terms as the “primal position” (preface xvii), ahead of the paranoid/schizoid position. From this starting point Eekhoff eloquently describes the undifferentiated states that rest in the body that are either not symbolized or transformed into language. Informed by Bion's ideas and bracketed by Freud, Klein, Ferenczi and Meltzer, she lays out a virtual road map of how this trauma-induced no man's land may be traversed by the analyst, using the processes of symbolization, somatic receptivity and countertransference in helping the traumatized patient to slowly build, for the first time, an accessible self. Using clinical case examples, the author invites the reader to take a deep dive into the abandoned and terrifying states of mind of often outwardly successful people who have been crippled by the inability to understand and describe their own experience.
In Chapter 1 Eekhoff reminds us that “all loss ultimately recalls the early loss of the breast” (p. 2). If separation from mother comes too early it is traumatic and not mentalized, remaining in the body in undifferentiated form. The breast is not adequately grieved and therein follows primitive defenses such as massive projection, concreteness, adhesive identification and mimicry. These defenses become a fragile scaffolding around a “missing piece” (p. 7), a no-self, a Black Hole. In this regard, the author carefully advises analysts to take a different approach to such patients, given they have not developed a self or internal object.
Eekhoff notes that the analyst can, in fact, become a threat just because he or she