The Wish for Breakdown

Patients often come into treatment with the wish that analysis will produce a breakdown – “a stark shock of embodied rapture, the angel dropping from the sky to smack [them] with clarity’s two-by-four” (Akbar, 2024, p. 82) – or add depth to the breakdown that brought them to the consulting room door. On their knees, awakened by the divine or a less heavenly smack, patients arrive pursuing their troubled pasts lived now in the present (nobody thinks of now as the future past) in the hope that they will break through their deadening fixations, their buzzing fugues, their compelling yet unproductive hatreds, their wish to save and save and save those who do not wish to be saved, their quest to repair those who cling to unrepaired and unrepentant ways, neglecting and abusing now as then. Loyalties are hard to foreswear. Still, patients seek to separate from the circular pull of their unmet desires, and to relinquish the dogged defenses that keep those longings alive. They push ahead in an effort to rebuild, wishing for clarity and a way to regroup, hoping to find their way out of depression, dissociation, and rage, while also struggling with the complex healing of grief, reconciliation, recognition and gratitude. If only it were so, or so easily so, if only rebuilding were that tidy and linear, if only inertia were that easy to disrupt – repetition not epiphany is the language of psychoanalysis – round and round we go, defenses flail, integration frays, defenses regroup, hate flares, the past in the present revolts and reignites, sometimes with insight (or at least information) but more often with blunted insistence and torpor. (“Why have a feeling when you can just be sick?” as my analyst was fond of saying.) Still, given enough time, the past slumps off, and sometimes grief, recognition and gratitude follow, yes, but if only recognition and gratitude were the faithful baseline to which one returned after passing through a requisite interval of grief, if only grief wer