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Presenter: The patient, a woman of twenty-four, has been coming to me for nine sessions. Sometimes she sits on a chair; sometimes she lies on the couch; and sometimes she changes from one to the other during the session. In the session I am reporting she chose to sit on the chair. She said, “I would like you to explain what you said yesterday about my being unable to cope with my feeling of anger.” She fell silent, waiting for me to reply.
Bion: I would feel that I had explained it to the best of my ability. If the patient didn't understand what I said yesterday, what is the good of my saying it again today? One says it at the time when it is possible for the patient to know what one is talking about; the next day is a different day, a different situation. Is there any point in acceding to that request? On the other hand, is it a good thing for you to make no reply?
P: I had the impression that she was talking about feeling angry, but I couldn't see or feel any signs of anger while she was with me. I think she wants to talk about the past, while I want to talk about the present. She wants to build a wall around herself with rational words and remain inside that wall with her own feelings. I am somewhat anxious because I cannot put my finger on what she is actually feeling, and I haven't enough material to form an opinion.
B: You are not obliged to talk if you feel you haven't anything to say. Only you can know when you have enough evidence to give an interpretation.
P: I felt constrained by her behaviour to understand her feeling. This worried me.
B: This is typical of the way in which pressure can be put upon you by the patient: a demand for premature or precocious reassurance. But you have to be able to resist these demands.
M: I wonder why we feel compelled to give interpretations. If we have only been seeing a patient for a short time – as with this patient – we cannot give a profound interpretation.
B: It is usually because we are afraid of losing the patient. At t