I am very grateful to Dr Nathan Szajnberg for his rich and thoughtful review of my book, and his close reading of my clinical cases. Over the years of my analytic work, and particularly through my work with more disturbed patients, the lived experiences with my patients and enriching psychoanalytic theoretical and clinical influences have crystallized and developed into my own way of psychoanalytic clinical thinking. I tried to describe them in my writing as close to my own analytic experiences and thoughts as I could, even when going through obfuscating darkness in difficult treatments of severely disturbed patients, and beyond more established psychoanalytic terms. Thus, it is especially important to me that Szajnberg—with his helping inner influences of Winnicott, Bettelheim, Flarsheim, and primarily Giovacchini—could go along with me into and through these challenging and difficult clinical cases.
Yet, in this response I would allow myself, with the deepest respect, to add to, emphasize, refine, or even challenge and disagree with some of his points.
The book describes the evolution of my theoretical-clinical psychoanalytic approach over the years. This approach is grounded in the essential role of the analyst/therapist's “presencing” (being there) within the patient's experiential world and the grip of the analytic process, and the ensuing deep patient-analyst interconnectedness or “withnessing” that goes beyond the confines of their separate subjectivities and the simple summation of the two. Two-in-oneness, with its challenges, struggles, and mysteries.
Over the last decade, I have further expanded this dimension of patient-analyst interconnected being and experiencing, beyond recent analytic notions of intersubjectivity and witnessing, to more radical patient-analyst deep-level interconnectedness or “withnessing” that may
grow into at-one-ment or being-in-oneness with the patient's innermost experiences. I have come to believe that this dimension of analytic functioning, with its profound ontological implications, engenders markedly new possibilities for extending the reach of psychoanalytic treatment to more severely disturbed patients and to the most difficult treatment situations. It has become an essential and integral part of the way I practice, think of, and envision psychoanalytic work—I went-with my patients thorough “black holes,” dissociation, deadness, sleepiness, petrifaction, silence, longings, the depths of perversion, and the enigmas of telepathic dream; we “weave other-than-me objects [and experiences] into the personal pattern” as Winnicott writes in his “Transitional object” paper (, p. 3; )—the paper, Szajnberg tells us, through which Bruno Bettelheim introduced him to Winnicott.
But, Szajnberg writes that Bettelheim cautioned us that while we may never fully grasp the child's descent into Hell, we can reach down, extend a ladder or an arm and help the child clamber out. This, he thinks, is a variation from my technique. And, indeed, it is. For in an abyss and the depths of deadness and death, extending a ladder or an arm to help would not be enough to reach the patient. I came to learn from within my clinical experience that only the analyst's being thoroughly there with the patient, will enable the crucial possibility of going through and living through the patient's psychic reality of profound deadness, breakdown, and despair—this time t(w)ogether with the analyst—and eventually coming through it differently. No easy challenge, but a sustaining, life-giving struggle.
Supported by Winnicott's posthumous writings on early breakdown and madness (,) and Bion's late work (,), I regard the profound interconnected being of patient-analyst within deeper levels of traumatic or core experiences as the only state of analytic being that can stand in opposition to destruction, dying, and non-being; the state that can cut the lethal cycle of abuse and annihilation, and experientially transform the patient's most extremely dissociated, unknown, unrepresented states—mainly of unthinkable breakdown and mental catastrophe. Unlike Szajnberg, for me, Bion's late writing is not “experience-distant.” But it requires the suspension of memory, desire, and even understanding for the analyst to become “at-one” with the patient's unknown and unknowable emotional reality-O by being
in-tu-it (“intuit”), and thus to experience the “dark night” of the soul (, p. 159).
The critical question here is to what extent the analyst is willing and able to open his or her psyche and heart to the patient, especially in difficult, unbearable and devastated-devastating states.
And finally, some comments on Szajnberg's reservation that relies on the philosopher of science Stephen Toulmin, regarding the borrowing of terms from physics for psychoanalytic phenomena.
I love the use of interdisciplinary terms and ideas—from physics and astrophysics, as well as from biology, literature, theater, poetry, the Bible, mythology, and films. I feel that this interdisciplinary correspondence enables us to capture in a particularly vivid way something fundamental to the very nature of psychoanalytic experience and the psychoanalytic process. I encountered the issue of using terms from physics in an exciting occurrence 21 years ago, when my first paper in English “‘Black Holes’, Deadness and Existing Analytically” was published in the International Journal of Psychoanalysis. In this paper I made metaphorical use of the astrophysical term ‘black hole’ to describe a difficult analytic encounter with massive, devouring deadness. The term “black hole” had previously been used in psychoanalysis by Bion, Tustin, and Grotstein to describe the internal space in primitive mental disorders. But I expanded the metaphorical analytic application of the astrophysical black hole and the “event horizon” to an interpersonal phenomenon with regard to less disturbed individuals, whose interpersonal/intersubjective psychic space is dominated by a central object that is experienced as a black hole—the psychically ‘dead’ mother because of the intense grip and compelling pull of her world of inner deadness.
A few months later, I received an amazing letter from James Grotstein in Los Angeles (a letter with an envelope and stamps). I still treasure it today.
He wrote:
Dear Dr. Eshel,
I just read your paper, “Black Holes…” in volume seventy of the
Page 209International Journal of Psycho-Analysis. I read it with great delight and admiration—even before I saw that you had graciously cited my own work on the black hole. I very much appreciate the perspective you took on the phenomenon and congratulate you for not shying away from using the metaphor of astrophysics. I, myself, received a lot of criticism for invoking astrophysical metaphors.
I am in a process of rewriting my papers in preparation for a book and would very much like to cite your work. […]
Congratulations.
Sincerely yours,
Jim
Not only was I astonished to receive such an appreciative letter from James Grotstein; but I was even more amazed to hear that he had received a lot of criticism for invoking these astrophysical metaphors. I used and developed the astrophysical terms “black hole” and “event horizons,” and added “wormhole” in my article following physicists Hawking and Gribbin . But I used them when I saw that James Grotstein had introduced astrophysical terms into psychoanalysis. And this was what I wrote back to him.
In the years that followed, I wrote an article about “My use of concepts from modern physics in psychoanalysis” . “Black hole” (including my “Black hole” metaphorical analytic application) became an entry in Akhtar's Comprehensive Dictionary of Psychoanalysis . And perhaps most importantly, when I grappled with the mysterious transfer of thoughts, impressions and information in patients' telepathic dreams as the embodiment of an enigmatic “impossible” extreme of patient-analyst deep interconnectedness, this was facilitated by the far-reaching changes within science, technology and psychoanalysis in the 20th century, and particularly the quantum mechanics revolution in physics. The prevailing scientific world view has become one of entanglement and connectedness. I think that reflecting upon the enigma of telepathic information-transfer is more feasible from within the post-Einsteinian world view, which is underlain by the enigmatic basic interconnectedness of particles in quantum physics, or the “mythic implosion” of electric age telecommunication . For today, this mysterious
“sort of ‘other world’ lying beyond the bright world governed by relentless laws which has been constructed for us by science” (Freud, , p. 31), lies at the very basis of modern science and technology.
I thank Dr Szajnberg for the opportunity to reconsider and to feel once again that the correspondence with interdisciplinary metaphors and analogies in general, and from physics, in particular, has become over the years part and parcel of the way I revere psychoanalysis and the analytic endeavor. And if so, why not say it?