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Lia Pistiner de Cortiñas looks at Bion's work with a particular emphasis on the origins of thoughts, feelings and experience. Applied to the treatment room, mental growth is about recognizing patients' difficulties in thinking or feeling their problems, not the problems themselves. Such a shift in focus is crucial because you cannot help someone with a problem that they are not able to experience. Pistiner, via Bion, notes that this capacity to “take in” experience can be impaired in early development, when desire gets overly frustrated or when pain finds no containment. What is left can be omnipotent projective identification, an underdeveloped ego that splits experience into minute particles that get ejected into experience, only to return as bizarre and persecutory objects, which once again have to be ejected. One could see these projections as fragmented psychic particles, the broken pieces of the contact barrier, looking for another person to contain them and carry them to term. Pistiner also reorients us to Bion's idea of knowing, which, when it leads to truth, stimulates emotional and psychological growth. This seems to come from Bion's idea that:
… healthy mental growth seems to depend on truth as the living organism depends on food. If it is lacking or deficient the personality deteriorates. I cannot support this conviction by evidence regarded as scientific. It may be that the formulation belongs to the domain of Aesthetic. In practice the problem arises with schizoid personalities in whom the super-ego appears to be developmentally prior to the ego and to deny development and existence itself to the ego. The usurpation by the super-ego of the position that should be occupied by the ego involves imperfect development of the reality principle, and exaltation of a “moral” outlook and lack of respect for the truth. The result is starvation of the psyche and stunted growth. (p. 38)
As Pistiner makes clear, the discovery and apprehension of knowledge is a deeply