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Presenter: The patient is a thirty-five-year-old woman who has been in analysis for seven years and is in her second year with me. We agreed at the start on two sessions a week because it would be impossible for her otherwise. In the second year this was increased to three sessions a week. Last year I considered ending work with her, but I changed my mind. This year I have had the impression that we are beginning to talk to each other.
Bion: What made you feel that it was hardly worth your while to go on?
P: I felt that there was some kind of obstacle preventing us from communicating so that we could not talk effectively to each other.
B: What is this impression which grows up? I ask because it can happen with any patient; the analyst feels that it is too unrewarding a relationship to continue. The sense of an obstacle can crop up in anything, but sometimes it presents a challenge, a stimulation which makes one want to go on. I remember, when I was a student, having a patient who seemed to be so boring that it was difficult to keep awake. And then I began to feel that it was so boring that it made me wonder how he did it. So you may begin to be fascinated by the obstacle, and then it is possible to go on. But when you feel that it is so unrewarding that it is not worth continuing, that is a matter to which we need to pay attention.
M: Do you agree that there are some patients who are unanalysable?
B: I think that is true. It is sometimes forgotten that analysis is in its infancy, and to assume that it can cope with all kinds of patients may be quite fallacious. It may not be the fault of the analyst or of the patient, but simply that we just don't know enough. In physical
medicine tuberculosis was not so long ago regarded as a fatal illness. Today many tubercle experts are without a practice; the specialists have become redundant because of the advance in medicine. There may be things which will be treatable analytically fifty or a hundred years hence, but that doesn't