Delving into the Never-Ending Challenge of Reinventing Psychoanalysis for Severe Perversion

The discussion of Rubin’s clinical case of a severely fetishistic patient is an invitation to delve into the years-long challenge of reinventing psychoanalysis for severe perversion, and more generally, into the challenge of extending the reach of psychoanalytic treatment to more disturbed patients and traumatic states of mind. Based on her clinical psychoanalytic experience and inspired mainly by the radical late writings of Winnicott and Bion on early breakdown and mental catastrophe, Eshel offers theoretical-clinical new possibilities of analytic presence and the ensuing patient-analyst deep interconnectedness, which forges a fundamental ontological-experiential dimension in psychoanalytic work. She focuses on the unique challenges encountered by analysts/therapists in going beyond epistemological (knowing) exploration and interpretation to being and becoming in the experience, interconnected with the patient’s psychic reality; a two-in-oneness that may deepen into being at-one-with the patient’s innermost traumatic, unrepressed and unrepresented, non-communicating emotional reality. The critical idea is that patient-with-analyst or patient-at-one-with-analyst, psyche-with-psyche, may undergo the devastating experience that made it impossible for the patient to be there and experience it alone. In being within the patient’s deeply unbearable states, patient-with-analyst are given a new chance to relive and break through massive traumatic impacts and catastrophic loneliness. This way of working also resonates with the ontological shift currently taking place in psychoanalysis. Finally, regarding the patient’s death in this analysis, Eshel reflects on the dangers inherent in this psychoanalytic work of reaching into and activating catastrophic depths of psychic traumatization, so that the change of deadness-aliveness in treatment is radical.