What is the psychic, how can it be grasped and understood? Bernd Nissen, Berlin

When can we speak of psychic quality? Does an affect, e.g., anxiety, already have mental quality? Does the expectation of the breast, for example, already have a psychological quality? The author puts forward the thesis that psychic quality only arises when elementary and conceptual levels are combined. The sensory impressions and sensations transformed into α elements combine in the conception, which is resulting from the realized pre-conception, and stabilize it. It is theoretically and metapsychologically explained how mental quality arises in a moment of presence and how the transformation of this moment into the presentational brings about a naming and the differentiation of the mental system. Since this process takes place in the analysis in the transference relationship, it is accessible to both participants and leads to understanding. Only the pair can discover and create psychic quality. In a detailed clinical vignette of an initial interview, this view is traced in detail and the interwoven interplay between emerging pre-concept and the grasping of sensory phenomena is traced. A young woman, severely ill with hypochondria, instantly stages a storm of sensual impressions that cannot be understood. Only an idea of the patient’s inner world opens up a perspective and can then connect with a specific silence that appears twice. In this way, an interpretation succeeds that makes the patient listening up.