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Bernardine Bishop first joined the Foundation for Psychotherapy and Counselling seminars with her paper ‘When is a body not a body’, in the 2006 ‘Mind and Body’ series. The paper published here was given in 2011 in the FPC series on ‘Anxiety, Symptoms and Containment’.
The title spells out the general territory of Bernardine's paper: the anxiety caused by the return of the repressed; the creation of a defensive compromise in which the forbidden wish and the defence are united in a single formation, the symptom; the issue of how this unstable or all-too-stable and satisfying compromise, the symptom, is to be contained in psychotherapy.
For we know from Freud's account that any symptom, however distressing, provides the unconscious with a replacement satisfaction:
… by means of extreme condensation the satisfaction can be compressed into a single sensation … by means of extreme displacement it can be restricted to one small detail of the entire libidinal complex. It is not to be wondered at if we, too, often have difficulty in recognising in a symptom the libidinal satisfaction whose presence we suspect and which is invariably confirmed. (New Introductory Lectures, PFL, pp. 412-13)
Bernardine stresses the other side of the story - the symptom's alleviation of the most profound unconscious anxiety: ‘A symptom defends against the worst despair that has no story and can never change or end … Nameless dread, unmediated, is unbearable; a symptom imposes a shape on that dread, what I have called a story, a narrative.’ She sees the symptom as an ‘art form’, and thereby reminds us of the immense creative work carried out by the unconscious to deal with the difficulty of living, even though this may result in very fixed symptomatology.
How is the symptom to be contained and understood, even shifted? Only by ‘listening to the fine grain of symptoms … with full attention and without preconceptions, as one studies a painting … to see if we could find new shapes and colours in the obsc