When Feeling Is Unbearable: Commentary on Paper by Paul Williams

I was struck, in the first instance, by Paul Williams's observation on Bion's remark that an intrinsic gap exists between the analyst's knowledge and the patient's experience. He followed this comment by posing a question: “Is it possible that terms like ‘good’ object, ‘relationship,’ and ‘mother’ are the equivalents of anthropomorphisms when used in relation to a psychotic personality? In frank psychosis there is an asocial, inhuman quality of functioning for which ‘narcissism’ … is too advanced a term and superego … is commensurate with the dissociation involved.” This brought to mind the experience of a mother with a new baby in the first days, even weeks, of life; at this stage, the mother is used by the infant in a way that might approximate asocial, inhuman. It is as though the baby were living dominated by its impulses and awareness of the object is barely there. One might note the rooting response in its insistence, which is preparatory to the relationship with the breast. It seems to me that, through much of the analysis, Williams was faced with finding a way of being with his patient that encompassed continuous living with someone utterly embroiled in primitive, unfiltered experiences.

It is understandable that he speaks tellingly of the “post-hoc coherence of the paper.” It is a remarkable account of a most unusual treatment, bearing witness to both the vulnerability and resilience of the analyst: vulnerability, because the analyst is called on to expose in himself quite fearful (literally) areas of experience; resilience, because by his having done so, some hard-won contact became possible with the patient. In describing this in terms of vulnerability, I aim to draw attention to the particular quality of countertransference experience that such a patient arouses in the analyst. Confusion is primary,