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Presenter: The patient, an economist, is thirty-eight years old and has been in analysis with me for almost a year. He and his sister were sent, as children, to live with the grandparents because the parents decided to devote all their attention to the brother who is mentally deficient. The patient refers to himself as “an orphan with living parents”. His physical appearance is good; he is well-mannered and is punctual. I have the impression that his contact with me has some ritualistic aspects.
Bion: What part of his behaviour seems to be symptomatic of a ritual?
P: His walk is rather mechanical; the way he walks to the couch and lies down seems like a well-finished product of something. I notice it also in the way his first phrases are constructed at the beginning of the session. For example, he breathes in deeply and then always says, “Very well, Doctor”, and he uses certain expressions such as, “I have brought you some dreams today”, or “I want to believe that we are going to work well today.”
B: Why does he say they are dreams?
P: He simply tells me so.
B: It is one of these words which are so commonly used that people think they know what dreams are and speak about them without question. On what grounds do we say that the patient had a dream? And what strikes you about the patient's statement that he had a dream?
Member: I would first ask myself why he starts telling me that he had a dream.
B: Yes, it is an important question. We do not ordinarily say to a stranger, “I had a dream.” So why does the patient come to see a
psychoanalyst and say he had a dream? I can imagine myself saying to a patient, “Where were you last night? What did you see?” If the patient told me he didn't see anything – he just went to bed – I would say, “Well, I still want to know where you went and what you saw.” If the patient said, “Ah, well, I had a dream”, then I would want to know why he says it was a dream.
P: I get the impression that when he says he had a dream, he wants to let me kn