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This paper was first read to a conference of English-speaking analysts of European societies in London in October 1976, and was first published in 1981 in J. S. Grotstein (ed.) Do I Dare Disturb the Universe? A Memorial to Wilfred R. Bion, Beverly Hills, CA: Caesura Press, 92-102.
‘People exist who are so intolerant of pain or frustration (or in whom pain or frustration is so intolerable) that they feel the pain but will not suffer it and so cannot be said to discover it … the patient who will not suffer pain fails to “suffer” pleasure’ (Bion, 1970, p. 9). This description of Bion's is central to my thinking in this chapter. I want to describe a type of movement and a type of pain that I think is experienced at periods of transition between feeling pain and suffering it — a borderline situation. Some of our patients describe to us a certain type of pain which is, from their point of view, indefinable. The quality or nature of the pain is not comprehensible to them and they often feel that they cannot convey the experience to the analyst. It may appear to be almost physical, it may be connected with a sense of loss, but it is not what we would define as depression: it may contain feelings of anxiety, but it cannot just be seen as a sense of anxiety. It is, as our patients point out to us, ‘pain’. It is this apparently indefinable phenomenon that I want to discuss here.
I am thus trying to describe a type of pain that emerges, I think, at moments when there is an important shift in the balance maintained by the personality — a shift and alteration of the state of mind, which can in some cases even be the precipitating factor that finally brings the patient into analysis. In others this shift is part of the analytic process, and if it can be resolved, can be a very positive step in terms of progress and integration. It is interesting to see how frequently it is felt to be almost physical, the patient locating it often in the lower part of the chest, and yet he or she kno