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I had been seeing Tessa twice a week for individual psychotherapy for nearly a year when the following vignette occurred.
When 1 reached the door to the waiting room, Tessa spontaneously smiled. I responded by smiling at her. It seemed an ordinary exchange, a welcoming beginning to the session at the start of a new week. No words had passed between us, but my recognition of Tessa's pleasure at seeing me was enough to produce an immediate scowl. She elbowed past me, saying “I'm not smiling, I'm frowning upside down!”
Such an obvious disavowal of my perception took me aback. I felt bewildered by how convoluted and confusing this brief encounter had become. It was as if neither of us was to see what we saw or to know what we knew. The “accusation” that I had jumped to conclusions—wrongly—was precipitated, I thought, by the way in which my response made her aware of her pleasure at seeing me. From her point of view, I literally “returned her smile.”
In the above exchange, Tessa did not allow her true feelings to have meaning and to enrich her inner world. The problem of not being able to tolerate or to acknowledge what is seen or known creates a complicated situation. Britton (1994) draws attention to a state of mind that Freud (1893) described as “blindness of the seeing eye” (p. 365). This nonpsychotic form of denial, in which “one knows and does not know a thing at the same