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Patients are … anxious about the analyst's capacity to understand them… . Children do research on the analyst's capacity for reverie and bring material for the purpose of testing whether he can think, notice [and] remember … emotionally understand-as opposed to verbally mechanically, or from books… . Can he know me? And how does he do it? Anxiety-ridden research into the analyst's mind rather than into his own may be the focus of the analysis for a long time.
Henry Markman has provided us a provocative and moving account of a difficult clinical situation, one that would befuddle any of us, possibly driving one into helplessness and despair. Raising many questions, Markman presents his dilemma in a manner inviting us to think, and to consider his work in an open manner.
I will begin my discussion with Markman's bold opening statement, “Matt and I were not communicating.” He continues, describing an impasse, including numerous instances of “not knowing” going both directions between patient and analyst. Bion taught us that “not knowing” is a crucial state of mind to be heeded by the analyst. It is its own state, to be taken on its own terms and, one hopes, eventually “understood,” but first felt to be true and important. Melanie Klein wrote movingly about the young child's urgent desire to know his or her mother, both mind and body-the epistemophilic drive, thereby imputing a third instinct to the human mind. Bion (1961) went on to develop these ideas in his groundbreaking theory of thinking.