Internal Reality, External Reality, and Denial in The Gulf War

In this paper, I will examine the impact of the Gulf War on analytic space from the point of view of the complex intertwining between internal and external reality. Since psychic and external reality share a dialectical relationship—psychic reality does not exist totally independent of external reality and vice versa—war and social violence can be expected to alter the analytic space. I will emphasize how denial (disavowal), as a mental operation directed toward external reality, plays an important role in times of social violence. Clinical material will be presented in order to illustrate the way in which war conditions, together with the operation of denial, challenge the analyst and the preservation of analytic space.

The meeting of inside and outside is in essence a complex one. There can be no inside without an outside to define it, and there is no outside without an inside to meet it. As Arlow stated (1969, p. 32): “The stream of perceptual data from the external world which passes before the outer eye is paralleled by a stream of perceptual data from the inner world, which passes before the inner eye.”

The complex intermingling of inner and outer is of importance, including all the different processes by which outer reality is taken in—such as the various aspects of internalization and all the different processes by which external reality is continually created, transformed, and projected according to the conditions of inner reality. Whatever “external” datum is internalized is itself transformed by the very process of internalization and then acquires the quality of inner experience. The external world delineates form and transforms the inner milieu while the inner world influences one's approach to the external world. Inner is made possible by outer; each creates the other and each is preserved by the other. The different degrees of approximation between these two dimensions provide variegated quality to the experience. For exa