Chapter 24. Brasilia 1975. Clinical Seminars

Presenter: I would like to raise a point about a patient who has been in treatment with me for a year: whenever she makes any progress she becomes quarrelsome. This session took place last Monday. She arrived very happily saying, as she came into the room, “Now you must explain to me why I was so happy after Friday's session, and why I am happy now.” In fact the Friday session had not been a happy one; she had mentioned suicide and the fear that she was going to die of a heart attack. She said, “I don't understand what you say to me; you don't even talk to me. However did I manage to get better?” She lay down on the couch and said, “You don't need to be so nervous and so tense. Why are you making noises with your fingers?” I pointed out that she couldn't accept the idea that she could get better just by talking.

Bion: I suspect she is setting a kind of trap in order to find out what you think. I would be inclined to say something of this sort: “What you have just told me I could not possibly know unless you had told me. I am assuming that you are speaking the truth, otherwise we should have to consider why you tell me lies. As it is, you have drawn my attention to a mystery – you are feeling better when there is no known cause for it. We can now continue the discussion of this extraordinary problem.” That doesn't commit you to saying that you or analysis cures people – I think that is nonsense. Certain people do seem to be able to make use of analytic sessions in such a way that they become more capable of working, more socially acceptable. But why that is so I don't know. The only fact I know is that when I have given an interpretation, I have either been wrong – which doesn't matter – or I have drawn attention to what, in my opinion, is already there. I wouldn't say that to the patient, but nor would I allow her to

manoeuvre me into a situation where I am agreeing that I have cured her or made her feel better. One could say, “Assuming that you are right about th