Response to Moving Out — Disruption and Repair to the Internal Setting by Marie Bridge

Many of us who live and practise outside London will be able to relate to Marie Bridge's feelings of dislocation in relocating her practice ‘out’, and her sensitive and thoughtful evocation of the difficulties and disturbances in relation to patients left behind, and the taxing business of juggling two practices. Her paper provides a valuable opportunity to think about a difficult problem, namely how to contain patients and to preserve the internal, as well as the external, setting while going through a major personal transition — whether through relocation or other reasons such as divorce, bereavement or serious illness.

Marie Bridge (2013) writes honestly and movingly of the insecurities she had to face. The levels of anxiety evoked both within herself and amongst her colleagues are powerful (‘committing professional suicide’; ‘you will go mad’), and she makes interesting connections between these and (projected) insecurities about ‘proper’ analysis, and the related issue of psychoanalytic self-idealization. But at the same time I think she risks falling into the trap she identifies. She acknowledges it is healthy to want to explore alone, and briefly airs the thought that those who cling to the centre may never achieve individuation — but without fully taking up these implications.

The paper is about disruption to the internal setting. But this is conceived of as being so dependent upon the continuation of the external setting, that one wonders what has happened to the process of internalization and the well-internalized good (analytic) object capable of facilitating a good separation. In this sense, the paper brings up more general, disturbing questions about the partial failure of too many analyses in this respect. I think this is a more fundamental point than the issue of frequency with which the paper is explicitly concerned. One might wonder what psychoanalysis is doing — no matter how many times a week it does it — if it leaves its former patients too anxious