On Basic Unity1

In the analysis of patients whose transference manifestations are of a psychotic rather than a neurotic kind I have found two characteristic phenomena which I want to examine. One is a particular position which they attempt to force me to accept; the other is the supreme importance for them of body happenings, as shown in their acting-out—i.e. body memory.

These patients are people who cannot in any circumstances take survival for granted. There exist in their memories experiences of something which we must really regard as annihilation; in many cases there has been in early infancy some actual threat to life—illness of the infant, or mother, hostility in the environment, etc.

They have been variously described; objectively, as suffering from, e.g. a 'basic fault' (Balint, 3) or 'psychological catastrophe, or disaster' (Bion, 4) and subjectively, by themselves, 'I am cut off from my roots', 'I have a fracture-dislocation'.

Their insistent, prolonged, and exhausting efforts to repair this condition have been described by a number of writers as attempts to establish a 'symbiotic' relationship with the analyst, but I think this use of the word is a misleading one. In my experience it is not a state of symbiosis that the patient seeks to establish, but rather one of total identity with the analyst, and of undifferentiatedness from him.

Some clinical illustrations may help us at this point.

• i.Miss E. told me that, when I first went to the hospital where she was, in place of the doctor who had been treating her, she had thought to herself 'Here's a new doctor; she wants a patient'.

• At first sight this could be seen as a piece of realism, and secondly it can readily be understood as projective identification; it was in this way that I interpreted it to her, and she accepted my interpretation. Only after many years of analysis did I come to recognize that it had meant much more than that, and that although she accepted the interpretation she could not really use it. She had