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Presenter: The patient came in looking very tense. She lay on the couch and remained silent. I asked her if she wanted to speak about the subject of payment which she had mentioned in the previous session. She got up from the couch, sat on it, opened her purse and took out an appointment book. She said she didn't think she would be able to pay me until the beginning of next month. I had the impression that she wanted to establish some kind of link, a complicity.
Bion: We can all now say what we would do if we had an experience of the kind that has been sketched out for us. It can't take the place of what the analyst already knows, but we can give our imaginations an airing. I don't want to appear to interfere with what you are talking about because I could call that ‘sacred’. What I would do if I had such a patient is more a matter of my peculiar mentality than of the actual analysis. The way that I do analysis is of no importance to anybody excepting myself, but it may give you some idea of how you do analysis, and that is important.
I don't think I would say anything about the previous reference to payment. But after a time, and if I thought the patient could understand, I would say, “I can understand now what you meant about the difficulty in paying. You are mentally constipated, so you are not able to give me any free associations – you can't give me any information and I can't give you any interpretation. So we can see how difficult this question is: how are you to pay me, and how am I to pay you? There are two people here, but this silence shows that neither of us can pay.” If I give that interpretation, then I have the chance of seeing from the patient's reaction whether it seems to be the right one, or whether I have made a mistake.
We know now what in fact you did say to her in the actual situation. So we can go on from there.
P: I told her that I didn't know for whose benefit she was explaining in such detail why she was unable to pay. She became very irrit