Symbolic Attitude and Reverie- Problems of Symbolization in Children and Adolescents

8/13/2019 Symbolic Attitude and Reverie- Problems of Symbolization in Children and Adolescents

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00218774/2002/4702/241 2002, The Society of Analytical Psychology

Published by Blackwell Publishers Ltd, 108 Cowley Road, Oxford OX4 1JF, UK and 350 Main Street, Malden, MA 02148, USA.

Journal of Analytical Psychology, 2002, 47, 241257

Symbolic attitude and reverie:problems of symbolization in children

and adolescents1

Gustav Bovensiepen, Cologne

Abstract: In comparison to the 1970s and 1980s, we now treat more children andadolescents who, because they have had traumatic experiences of violence, child abuse,deprivation or chronic physical illness, are not able to adequately use their symbolizingfunction. The question is which qualities and which analytical attitude we should andcan offer in analysis to help a child regain his or her capacity to symbolize, irrespectiveof how poorly developed or blocked this capacity may be. In contrast to Jung and some

Jungians, the author argues that although the transcendent function is a natural processand hence archetypally grounded as Jung maintained, the transcendent function does notwork spontaneously. Rather it requires a matrix based on the childs earliest relation-ship, which can later be re-enacted in treatment. Jungs general concept of a symbolicattitude can be complemented and focused in a specific way through the use of Bions

concept of reverie, which contributes in a fundamental way to symbol formation withinthe transference/countertransference. This idea is illustrated by clinical material from anine-year-old boy who suffered from a severe congenital intestinal disease and wasblocked in his capacity to symbolize. From the perspective of treatment technique, theauthor shows how the drawing of comic book narratives in a reciprocal exchange wasbrought into the treatment. The drawings evolved in a way that he understood as a modi-fied form of active imagination with children. The drawing process helped the boygradually to develop a symbolic space in the therapy and to contain a psychic space inhis mind.

Key words: active imagination, alpha-function, reverie, symbol, symbolic attitude,

transcendent function.

1 I would like to dedicate this paper to the memory of two Jungian colleagues from London: JaneBunster and Mara Sidoli, who died far too early and to whom I am personally as well asprofessionally indebted. In the late 1980s, Jane Bunster worked in Berlin for two years as oursupervisor in the observation of infants, which followed Esther Bicks method. Mara Sidoli andI founded the International Workshop for Analytical Psychology in Childhood and Adolescencein 1984. We cooperated closely for many years, and I learned a great deal from her. Not least sheand the other London colleagues of the SAP were instrumental in introducing me to MichaelFordhams concept of the self in childhood and to the ideas of W. R. Bion, whose thought isintimately related to some of Jungs own ideas.


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Introduction

Symbols play a key role in analytical psychology. Jung sketched his ideasabout the transformative function of the symbols of libido for the first time in1912 in Symbols of Transformation, the work that caused the professionalsplit between Jung and Freud. In analytical psychology, a symbol expresses apsychological function, which Jung later referred to as the transcendent function.This function mediates between opposites and effects transitions between,and transformations of, different psychic states. For Jung, this was the mostimportant psychological function, and he writes:

It is a natural process, a manifestation of the energy that springs from the tension ofopposites and it consists in a series of fantasy-occurrences which appear spontaneouslyin dreams and visions.

(Jung 1916/1928, para. 121; authors italics)

Jung considered this psychological function of symbol formation to be goal-oriented and prospective. He was less interested in how it developed in theinfant psyche and how it worked. When we look at the specific issue of sym-bolization in children and adolescents, we are thus confronted with the generalquestion of how the transcendent function develops.

It has only been since the 1950s and hence comparatively late that Jungians

have turned their attention to the perspective of developmental psychology.Erich Neumann in Israel (1963) and Michael Fordham (1985) in London werethe pioneers of a post-Jungian Developmental School (Samuels 1985). It doesnot surprise me that those Jungians working within the framework of develop-mental psychology, that is, with infantile conflict and early object relations, or,to put it in another way, with the inner child in the intersubjective practice oftransference and countertransference, are the most involved with other psycho-analytic traditions. There is, for example, a large group of Jungians who havetaken a closer look at Kohuts psychology of the self and at current infant re-search (Jacoby 1999). There is also the work of Michael Fordham in London,which has been strongly influenced by post-Kleinian views, particularly thoseof W. R. Bion.

Twenty-five years ago in Berlin, I myself did my analytical training at aninstitution housing both a post-Freudian and a Jungian institute. Even today,several of my Jungian colleagues and I frequently experience a certain gapbetween Jungs topical theoretical conceptions of the unconscious and trans-formability of the psyche and his lack of theory for analytic technique. Thisgap is acutely visible in the realm of symbols and symbol formation, an areawhich, ironically, has been thoroughly researched by Jungians. Or perhaps, to

express it more poetically, Jungians like ourselves too often have our heads inthe clouds, and we can learn from psychoanalytical treatment technique tobring us back down to earth.

In comparison with the past, we now treat more children and adolescentswho, because they have had traumatic experiences of violence, child abuse,

242 Gustav Bovensiepen


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deprivation or chronic physical illness, are not able to adequately use theirsymbolizing function. There is a consensus among most child analysts and

child psychotherapists, irrespective of their theoretical tradition, that the usualmethod of treating children which was developed from working with neuroticchildren, is not always appropriate for heavily traumatized children. Onereason for this is that these children frequently lack the ability to play. To useHanna Segals term for it, they have not managed to create an adequatelyfunctioning psychic space during the course of their development (Segal 1991).Psychic space and the transcendent function are the conceptual background ofthis paper.

Within this framework, I shall concentrate on two issues. The first of these

is the symbol and the ability to symbolize, as they are used in the Jungiantradition. Secondly, with an eye to treatment technique, I am interested in deter-mining which qualities and which analytic attitude we should and can offer inanalysis, in order to help a child regain his or her capacity to symbolize,irrespective of how poorly developed or blocked this capacity may be.

I treated a boy who had suffered from a traumatic colon disease since birth.As a result, he had not been able to develop enough psychic space or makeadequate use of the transcendent function in symbolizing. I shall draw on thismaterial to illustrate my hypothesis. I shall investigate Jungs claim that the

transcendent function can only unfold if we succeed in assuming the analyticalattitude that he called the symbolic attitude. This is one of the few of Jungsconcepts from which he explicitly deduced a treatment technique, that ofactive imagination. Since the prerequisite of active imagination is a differ-entiated and stable ego, it is not, in my opinion, an appropriate techniquefor patients who are structurally disturbed at an early developmental level.I believe that the gap between Jungs fundamental, but very general concept ofthe analysts symbolic attitude and the analysands inability to symbolize canbe bridgedby Bions concept of reverie within the container-contained rela-tionship. I include the earliest, mostly non-verbal exchanges between motherand infant in what Jung referred to as the symbolic attitude. I therefore pro-pose that, although Jung assumes it is a natural process and hence arche-typally grounded, the transcendent function does not work spontaneously,but requires a matrix, which is based on the childs earliest experience of arelationship and which can later be re-enacted in treatment.

Tom: I dont need to be understood container/contained and reverie

Before I address some of the theoretical aspects of my subject, I should like to

describe the early stage of the treatment of the ten-year-old boy, whom I shallcall Tom. I will fill in more clinical material from this case later in the paper.From the first session onwards, Tom was intent on making me understandthat he could survive perfectly well without being emotionally understood,and that he did not need empathic sympathy or an understanding of sense and

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meaning as nourishment, in order to thrive psychologically. In our sessions,he was primarily preoccupied with inventing guessing games, like those on

a quiz show, which he had to win. When I could not come up with either aquestion or an answer fast enough, he got very angry, derided me, jumped upand down on the couch or around the room, threw pillows at me, and tried toinvolve me in violent boxing and biting matches. After such eruptions, whichwere rife with lust, aggression, and agitation, he would lie down on the couchor roll around in the bean-bag chair. He seemed to be in a bad mood andapathetic; he seemed, above all, to be completely drained and absent-minded.After a while, just when I was able to start thinking about our being together,he would greedily and tyrannically challenge me to come up with a new game

at once. If I did not give in to his demands immediately, but instead saidsomething like, Now you feel completely empty and you think you would feelbetter if I made something up for you, he did not reply with words, butinstead moaned loudly and squeezed his buttocks together as if having a bowelmovement, and farted with abandon. Or he would swallow air and belchsaying, Thats your punishment!

I should like to use this episode to briefly introduce some of Bions conceptsin order to relate them to Jungs conception of symbols. It is typical in treat-ment that children first fight against the verbal formulation of the analysts

thoughts. Toms farting and belching, his replies to my efforts to understandhim and his extremely dictatorial quizzes, struck me as rather desperate andomnipotent attempts to destroy my ability to think about him with emotionalsympathy, my capacity to contain. In other words, he wanted to destroy myability to absorb his emotional emptiness and his fears, contain them withinme and work through them to the extent that he himself would then be ableto make use of my expressed understanding. He wanted to force me to matchhim perfectly. In my view, his eruptions represented an expression of hisdefences of the self, as Fordham has described them, as a way of protecting hisself against psychic breakdown (Fordham 1985). The tyrannical question-and-answer game is a typical product of the initial stages of treatment, when thechild and the therapist are trying to work out what the other is thinking.OShaughnessy emphasizes how much time is taken up in treatment by thepatients anxiety that the analyst will not understand him or her. She writes,

At depth this is anxiety about the analysts capacity for reverie, in Bions sense. Apatient wants understanding based on actual events of emotional containment, hewants his analyst to be open to his first mode of thinking viz, to communicationby projective identification. Can the analyst receive primitive projected states andknow what they are?

(OShaughnessy 1988, p. 187)

One could interpret the belching and the farting simply as the oral-aggressiveand anal-aggressive venting of drives void of any symbolic meaning. In thelanguage of Bions theory of thinking, they are beta-elements, that is to say,



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raw elements of perception cast as sensual and emotional experiences, which,however, cannot be represented. With the help of a psychological function, to

which Bion has given the abstract term of alpha-function, they can be turnedinto alpha-elements, which means that they are endowed with psychic meaning.Bion writes:

In contrast with the alpha-elements the beta-elements are not felt to be phenomena,but things in themselves (authors italics) Beta-elements are not amenable touse in dream thoughts but are suited for use in projective identification Theyare objects that can be evacuated Beta-elements are stored but differ from alpha-elements in that they are not so much memories as undigested facts, whereas thealpha-elements have been digested by alpha-function and thus made available forthought. It is important to distinguish between memories and undigested facts beta-elements.

(Bion 1962, pp. 67)

Apparently, Tom had to free himself from what were for him unbearable,indigestible physical and emotional experiences that had surfaced in the trans-ference. In the countertransference, I found him to be rather unbearable atthese moments. At the same time, however, I could not possibly evade him.In terms of treatment technique, the problem was how I could put my alpha-

function at Toms disposal and achieve a condition of reverie, in order to gaina thinking space for myself in which I could assume a symbolic attitude andprepare a symbolic space between us. In this context, Bion used the earliestmotherchild relationship as a modelfor his concept of reverie. Given sufficientaffect attunement, the mother intuitively puts her own psyche at the infantsdisposal, lending a container into which the infant can project his or herunbearable affects, fears, and psychosomatic sensations. Through her lovingunderstanding, the mother turns these into tolerable experiences by namingthem and endowing them with subjective meaning or sense, which can then bere-introjected. As we have learned through infant observation, there are cata-strophic consequences when an infant retains no personal space in the parentsfantasy and psyche, as when some parents talk about their infant as if it werean inanimate object. When everything goes well, however, a mother consistentlyand continuously endows the events of everyday life with meaning, includingthe behaviour of her infant. In doing so, she is adopting a symbolic attitude.

At this stage, Tom hardly ever communicated in a symbolic fashion butrelied on projective identification. He did this by forcing beta-elements, thefarting and the belching, into me. In the light of his early lack of containment,emotional experiences were apparently too painful for him, so that he could

not use his capacity for understanding and assigning meaning to them. Histranscendent function did not work. Hence, a tyrannical wish to achieve totalconsensus dominated him: just as on a quiz show, there was only right orwrong. Nevertheless, was there not some communicative meaning in hisfarting and belching? Was it an expression of an unconscious fantasy or did



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it retain a meaning that only revealed itself from a prospective point of view,not from a defensive one? I should like to make some observations about the

symbol and the symbolic attitude, which I shall then relate to those ideas ofBion that I have already discussed.

The symbol, the symbolic attitude and symbolic space

Jungs understanding of symbols occupies a central place in his thought. Hisideas on this topic vary greatly throughout his writings, however, and are byno means uncontradictory. That said, the symbol is also perhaps the only con-cept that is directly relevant to the theory and technique of treatment, apart

from his 1946 article on The psychology of the transference. In symboliza-tion, the effect of the transcendent function manifests itself. Jung writes thatthe transcendent function expresses itself in this remarkable capacity of thehuman psyche for change (Jung 1917/1942, para. 360); it mediates betweenthe body and the psyche. The symbol combines conscious and unconsciouscontents and mediates the transition from the ego to the unconscious (Jung1916/1958, para. 131). In other words, individual unconscious fantasiesexpress themselves in symbols in the same way as archetypal fantasies do.The symbol not only leads to intellectual understanding, but also to what Jung

calls understanding through experience (Jung 1916/1928, para. 184). In hisarticle The psychology of the child archetype, Jung locates the origin of thesymbol in the body when he writes:

The symbols of the self arise in the depths of the body and they express its materialityevery bit as much as the structure of the perceiving consciousness. The symbol is thusa living body, corpus et anima The more archaic and deeper, that is the more

physiological, the symbol is, the more collective and universal, the more materialit is.

(Jung 1940)

For Jung a true symbol is a living symbol. Another characteristic of a truesymbol is a surplus of meaning. All of its possible meanings can never be fullyunderstood, and much remains hidden.

Together with the assumption of a transcendent function, Jungs conceptionof the symbol results in an analytic attitude, the so-called symbolic attitude. In1921, Jung defined this as follows:

The attitude that takes a given phenomenon as symbolic may be called, for short, thesymbolic attitude. It is only partially justified by the actual behaviour of things; for therest, it is the outcome of a definite view of the world which assigns meaning to events,whether great or small, and attaches to this meaning a greater value than to bare facts.

(Jung 1937, para. 899)

I believe that Bion, with his concept of beta-elements, which he also called thething in itself, thought of something comparable to Jungs bare facts. Jungsconception of a symbolic attitude means that we endow events with sense or



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meaning in analysis when we succeed in establishing a link between innerreality and the outside world and between personal and collective experience.

I believe that human beings are equipped with an innate need for sense andmeaning, and that this need enables them to create a link between objects,just as do the drives, particularly those of love and hate. This need for meaningwhich, even in children and adolescents, amounts to a search for sense,resembles Melanie Kleins epistemophilic instinct or Bions K-links. Thesymbolic attitude is not the same as these concepts, however, because itpossesses a prospective and teleological quality and because it is archetypallygrounded.

In treatment, the experience of a true symbol can lead to a deep feeling of

being understood and being connected. In contrast to Freud, Jung not onlyregarded the formation of symbols as the psychic representation of the instincts,he also believed that symbolic activity reshaped and transformed the psyche(Jung 1912). In the struggle between the ego and the unconscious, Jung con-sidered symbol formation to be the production of a third (Jung 1916/1958,para. 181) against the background of the transference/countertransference(Jung ibid., paras. 1456). An individuals striving to differentiate between thesymbolized and the symbol, between the bare facts and the meaning andsense, is a triangulating attitude, which, in turn, leads to the creation of

an internal psychic space and a symbolic space in the analytic framework.Referring to the Oedipal situation, Britton (1998) has called the psychic spacea triangular space. In the analytic situation everything which happens can orshould be perceived with a symbolic attitude. In this context, symbolizationtakes place not solely in the semantic or in the iconographic realm, which isimportant to bear in mind, since people often regard only words and imagesas true symbolizations. In my understanding the analysis in its totality is asymbolic spacepar excellence.

In relation to the transformative activity of the psyche, Jungs transcendentfunction bears a certain resemblance to Bions alpha-function, which turnsbeta-elements into alpha-elements. As we have seen, Jung regards a surplus ofmeaning to be one of the most important characteristics of a true symbol.Similarly, Bion uses the metaphor unsaturated, derived from chemistry, todescribe alpha-elements. In other words, alpha-elements are open for anynumber of possible relationships and meanings.

From Toms treatment: the creation of a symbolic space

Prologue

Let us now return to Tom. There were surprising parallels between his chronicphysical illness and his psychological functioning. He suffered from a con-genital megacolon or enlarged colon. This condition, which is hereditary, isa disease of the intestines. Here, several sections of the intestines, particularlyof the colon, do not have autonomous nerve ganglia. As a result, no peristaltic



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bowel movement can occur in these sections; to all intents and purposes, theyare shut down. Consequently, parts of the intestines are massively bloated

while others are constricted. Soon after birth, children with this disease beginto suffer from diarrhoea and vomiting alternating with constipation. Althoughfood enters the system, it leaves it again immediately, without being suf-ficiently digested or absorbed. If the illness is not diagnosed early enough,heavy bacterial inflammations can occur coupled with catastrophic diarrhoea,which can even lead to death. Usually, treatment consists of removing theaffected sections of the intestines during infancy but the remaining scars oftenlead to a re-constriction of the intestines. Patients have to avoid certain foods,such as sweets, fats, and fruit, for their entire lives, if they do not want to be

plagued by chronic diarrhoea and flatulence.Tom was sent to me by a colleague who was treating Toms half-brother,who was two and a half years older. My colleague got the impression thatTom required immediate help. Toms parents told me that he was very restless,that he constantly dropped things and that he never listened. He was said tobe chaotic and forgot everything immediately. His mother sounded extremelyangry and desperate when she said, If you tell him something, it goes in oneear and out the other. Being strict or punishing him had been to no avail. Hisfather complained, above all, about his extreme untidiness. His mother was

also worried because he frequently seemed so absent-minded, as though hewas lost in his thoughts. She was afraid that he might be run over by a car.She added that there was a great deal of jealousy between Tom and his half-brother, who frequently threatened him and entered his room without beingasked, actions against which Tom could not adequately defend himself. Tomalso wet his bed. He wore nappies at night until just a short time beforetreatment began, and he still wet the bed about once or twice a week.

Tom was not a planned child. During the difficult divorce from her secondhusband, his mother, who comes from Denmark, became pregnant by herfuture, third husband, a management employee in an industrial company. Shesaid that, physically, she had been in great shape, but that psychologically,she felt overburdened. She had tried to breastfeed Tom, but he threw upimmediately and began to suffer from acute diarrhoea soon after birth. After afew days, his mother said, her milk dried up from one day to the next. Afterten days, Tom had to go to the hospital, where his intestinal disease wasdiagnosed. He spent most of the first year of his life in the hospital, and hisintestines were operated on repeatedly. Between the ages of one and three years,Tom must have experienced his relationship with his mother as sadisticallyintrusive, since she had to push metal pins up his rectum three to four times a

day, in the hope that this procedure would widen the constricted sections there.Tom had little contact with children of his own age and frequently spent

hours by himself playing with Lego or doing puzzles. He repeatedly sufferedfrom indigestion with heavy flatulence, or from diarrhoea. Although he actedup at school, he still managed to be a good student. While his mother told me



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this terrible story in a hectic, intrusive and determined fashion, I was neverable to establish any real emotional contact with her. The father remained

silent for most of the time. Despite the abundance of facts, everything she saidremained strangely flat and empty and two-dimensional. I could, however,detect some feelings of guilt because his parents suspected that, as a result ofhis many stays in hospital, Tom may have felt that they had pushed him away.

Tom was not yet ten when I met him for the first time. I was surprised byhow tall and heavy he was and by how vital he seemed. During our firstmeeting, he bombarded me with tales of his life and his problems. Everythingsounded rather terrible but he recounted it in an emotionless, manic, and oftenboastful and over intimate manner, as if he wanted to tell me that none of this

mattered to him. I had the impression that internally he was in chaos, like hisdissected and deformed intestines. He ignored or rejected any remark of mineoffering emotional understanding. There were brief moments when I glimpseda deep forlornness, but for the most part, Tom struck me as being filled frombottom to top with a desperate anger. Towards the end of our initial interviewhe spoke of becoming a policeman when he grew up, and he drew a picture ofa little black policeman who shoots dragons and pours fire over them.

I was a little surprised by the twist that it was the policeman who pours fireinstead of the dragon spewing fire, and I thought that both of them actually

looked quite friendly. This picture awakened my sympathy for Tom, which Ihad not really felt before. In the picture, a strong red arc of fire connected thehead of the little, black policeman to the nostrils of the mighty, green dragon,whose body was riddled with black bullet holes. I sensed that the dragon andthe policeman were also connected in a strongly libidinous way, with the dragonperhaps personifying the entire dangerous and unintelligible chaos of Tomsintestines. The black bullet holes in the dragons body made me think of themany intestinal operations Tom had undergone. I did not voice this suspicion,however. Tom then left, with the assurance that he would like to return.

Excerpts from treatment

Tom came to treatment twice a week. I would have preferred it if he had comethree times, but I could not convince his parents.

As I have already mentioned, Tom tried to control and dominate me in avery omnipotent and intrusive fashion right from the outset. He made it verydifficult for me to assume a symbolic attitude or one of reverie, or to developmy own thinking space in order to understand and consider what he wastelling me. The situation escalated over the next months as Tom became

increasingly aggressive and chaotic. During one session when he was in theprocess of getting violent again and threatened to throw a chair at me, I toldhim in an uncompromising tone of voice to stop. I also reminded him that wehad agreed that there would not be any physical fights and that neither of uswanted to get hurt. In a more conciliatory tone, like a referee, I added, thats



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against the rules here. He stopped immediately and threw himself on thebean-bag chair with a growl. I suggested that he draw what he would like to

do to me on the blackboard. He accepted the proposition and spent the rest ofthe session drawing, in a rather aggressive manner, nuclear missile attacks onthe Bovensiepen-Zombie.

In our next session, he enthusiastically continued this activity, but withoutany direct physical attacks. There were no physical attacks in the sessions thatfollowed, but the emotional atmosphere of tyranny, a desire for destructionand total control, through which Tom wanted to enforce my complete sub-mission, intensified accordingly. I told him that I thought he wanted to makeme feel how he actually felt when he had a fight with his elder brother who

forced his way into Toms room, namely helpless and defeated because he hadno way of defending himself. He confirmed my suspicion. For the very firsttime, he accepted an intervention that conveyed an understanding of hisemotional state, and he began to express something of himself in words.

He spoke about his grandmother, whom he always visited on those week-ends when his half-brother went to see his own father. Tom told me that heliked being at his grandmothers because she was not strict about followinghis dietary regime. Then, however, he unexpectedly recalled that she had onceknocked out one of his teeth. I had the feeling that he was only half-joking

when he told me this, and I must have looked somewhat incredulous while, atthe same time, expressing my empathy. He apparently interpreted my mixedreaction to mean that I either did not believe him, or at least did not correctlyunderstand him, or that I could not distinguish between a lie and the truth, or what was even worse that I suspected that he could not tell the differenceand that I myself was lying when I commiserated with him! He reacted bygrowing very impatient and angry, farting constantly, and saying that he nowhad to go on a revenge crusade against his grandmother. I did not attemptto interpret his angry eruption as a grandmother or mother transference,but instead suggested that he tried to depict this revenge crusade as a picturestory in a comic strip. He immediately took me up on my suggestion, butinsisted that I had to begin. He then went to his personal box for the first timein therapy, fetched a sketch pad and crayons, and divided a piece of paper intotwelve squares by drawing one vertical and five horizontal lines. When hehad finished, he pushed the piece of paper over to me and said, Come on, getgoing. I hesitated for a moment since I was unsure about offering somethingof myself when I did not really know what he needed. I had the impressionthat he used his farting as an anal-aggressive attack to fend off his fear of thebad non-understanding and intrusive maternal object, and that he felt I was

turning into the mother who was penetrating his anus when I tried to talk toand understand him. On the other hand, I wondered whether his triumphantlyand omnipotently employed ability to fart at any time was actually a con-crete expression of his deeply rooted conviction that he could only producefoul-smelling air in his chaotic psyche, which he had to communicate to me



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through projective identification. I also asked myself whether he was domin-ated by the unconscious fantasy of a destructive parental primal scene, the only

product of which could be senseless thoughts, foul-smelling air, or a zombiebaby that had to be expelled.

Be that as it may, I sensed that it was crucial for him at this moment thatwe could find a way to name his state of mind, entering into an exchange ofthoughts in the form of a pictorial dialogue. It was crucial that I offered himsomething living of myself; he needed something that would give him a sparkof hope, even if this did not necessarily signify understanding yet. So, I drewa relatively motherly, portly figure who greeted Tom, and he then drew hisgrandmother being riddled with bullets. Youre the grandma! he exclaimed

triumphantly. He then added in a friendlier tone: But youre not bad, wereonly acting as if. He continued working on the picture story until the end ofour session. It was an interactive game. He drew a scene to which I had toreact by drawing another scene, to which he reacted by drawing anotherpicture, and so on. The story primarily revolved around the grandma beingpursued and having to be annihilated, and she could only save herself by chang-ing into another figure. Mercilessly and sadistically, Tom employed every possiblemeans to annihilate her, while I had to come up with ideas about how I/thegrandma could survive, which I repeatedly tried to accomplish with the help of

a transformation spell. Our session ended when the grandma retreated into anatomic bomb shelter because she was being threatened by nuclear missiles.Tom really enjoyed drawing these stories. For me, it was not the content

that was important, but the fact that this activity represented a nascent possi-bility that we might be able to create a symbolic space, however temporary,in which an intersubjective exchange of fantasies could occur without theemptying of undigested emotional experiences and physical sensations: wereacting as if.

Tom kept returning to these picture stories during the course of treatmentand we continued to work with them. They became a consistent and safe partof his inner world. Even though his therapy box was overflowing with chaoticsketches and papers or plasticine figures, and he threw everything out everyfew months, he took great care of his collection of picture stories, which hadto be filed and given titles. He frequently tested me to see if I rememberedcertain characters and scenes or the names of the different stories. In this way,a process of working through the anxieties and their defences could unfold asthey were enacted in the stories. For him, the stories seemed to represent anobject that gave him hope of not losing the mind-to-mind contact with thetherapist; metaphorically one could say Tom suffered from a psychic

diarrhoea. Slowly he began to feel how painful the experience of loss is, andthat his problems had something to do with being able to master his namelessanxieties and chronic depression.

After about a year and a half of treatment, a relatively safe symbolic spacehad been established within Tom. This was evident from the fact that he only



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rarely tried in his tyrannical fashion to force me to submit, that he startedvoicing his interest in my thoughts, that he was curious to find out more about

my private life, and that he wanted to know whether my colleague in thepractice was also my wife, whether I had children and so on. He also startedthinking about what might be going on inside his father when the latter washaving one of his frequent fights with Toms brother. Increasingly he was ableto assume an observing position, evidenced by the fact that his intrusivesadism, born out of despair, was frequently replaced by an intrusive humour.He wondered, for example, why so many random letters of the alphabet wereprinted nonsensically on the back of the sheets of paper that I provided forhim to use in such quantity. I told him that my personal computer had spewed

out a large number of misprints. In response, he said with amusement, Yourcomputer must have been thinking, Im going to bug the old man!His ability to explore himself, to understand himself, and to achieve this by

other means than mere externalization developed very slowly. He no longerreacted to my verbal interventions physically but instead answered in kind,with verbal commentary. To my interpretations he frequently answered, forexample, that I obviously wanted to intrude upon his private sphere, or, mydear Mr Bovensiepen is one-hundred-percent gay!

Nevertheless, for a long time, the scope of his denial of a basic emotional

need for dependence and his defences against a relationship based on under-standing and meaning remained frightening. He sensed this and although hecontinued to be unhappy and depressed, this was an important step forwardin his development.

Discussion

Tom is an example of a child who does not possess the capacity to contain andis thus seriously impaired in his ability to symbolize. Although Jung may havebelieved that symbolization is a natural process based on the transcendentfunction, I would like to modify this assumption, since, in clinical situations,we are frequently confronted by patients who cannot symbolize at first. If weunderstand Toms problems with symbolization as analogous to his problemsof digestion, we can say that digestion is a natural process, but it can also beimpaired. Following Jung, Verena Kast has argued that the complexes spontan-eously unfold in symbols (Kast 1990). This may hold true for many neuroticpatients, but not for those with an undifferentiated ego-structure. Further-more, this assumption focuses too heavily on the contents of the fantasiesor symbols. We should, I believe, place much more emphasis on theprocess of

developing a symbolic space, which results from the matrix of the transference/countertransference and which, like the early mother-child relationship, canlead to a transformation of emotional experience in a dyadic relationship.I think that this concept fits well with Jungs idea of the symbolic attitude,which a mother also assumes when she succeeds in creating a place for her



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child within her psyche. With Tom, the most striking problem was his lack ofcontainment: he showed extreme and rigid splitting and everything went into

one ear and out the other.If the symbolic attitude is primarily understood as a relational process

instead of an intellectual amplification of symbolic contents, this understand-ing would expand our treatment options for patients who are, above all,plagued by difficulties with symbolization. I believe that the symbolic process,a natural process according to Jung, can only naturally unfold in treatmentif the therapist assumes an attitude that is as open and as receptive to his ownfears and fantasies as to the patients fears and fantasies. This is an attitudethat I believe is best expressed in Bions conception of reverie.

I would like to comment on an important aspect of Toms fantasies/picturestories because it expresses facets of the transference/countertransference. Fora long time, the stories revolved around the idea that the persecutor and thepersecuted could only save themselves by constantly transforming themselves.This is an archetypal motif that we know from many fairy tales: the hero, whohas been an apprentice to a sorcerer or a sorceress, for example, can only freehimself at the next stage of development by using the tools of his trade tomagically transform himself and escape. With his pictures, Tom showed howhe was identified with the magical power of his mother complex as a part

object and needed to distance himself from this identification by means of anescape through transformation. It took a great deal of time in therapy for himto work through his identification with a powerful, intrusive mother introject.My introduction of drawing picture stories can be understood as a modifiedform of active imagination. For a while, drawing was my form of reverie, whichI had attempted at first to offer as the verbal reverie that Tom attacked soviolently at the start of treatment in order to master his anxieties. In contrastto classic active imagination, in which the patient unfolds his or her fantasies,here, I had to become active first and had to offer something prospective ofmyself. One could argue that he intrusively compelled me to offer something.But this was obviously the right food, served in the form of a living andenlivening symbolized object relation, because Tom was able to accept it anddevelop it further. I think the method also turned out to be the right one becauseit enabled Tom to make his unconscious thoughts thinkable in order to satisfyhis need for sense and meaning.

In my view, Jungs prospective function of the living symbol, which hestressed repeatedly, corresponds to the above-mentioned need for a living objectmaintaining the mind-to-mind-contact with Tom and the need for meaning inJungs sense or for knowledge as Bion puts it. Hence, the primary issue with

severely disturbed patients is not so much to interpret the defensive meaningof the symbolism in relation to a lack or loss, but to help them to create thehope of being able to think about lack or loss, being able to imagine beforeseeking means to overcome lack or loss. This is what I understand as thepro-spective function of the symbol. Anne Alvarez from the Tavistock Clinic, who



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has made so many significant contributions to the treatment of severely dis-turbed children, put it poetically, if you like, in a Jungian way, when she wrote,

We need symbols for sunset, but also for a new morning (1992, p. 168).

TRANSLATIONS OF ABSTRACT

Ve srovnn se 70. a 80. lety minulho stolet nyn lcme vce det a dospvajcch, kternejsou schopni adekvtne pouzvat svou symbolickou funkci, protoze maj za seboutraumatick zkusenosti nsil, zneuzit, deprivace nebo chronick fyzick nemoci.Vyvstv dulezit otzka, jak kvality a jaky analyticky postoj mme a muzeme

v analyze nabdnout, abychom dteti pomohli znovu nabyt jeho schopnostsymbolizovat. A sice bez ohledu na to, jak nedostatecne tato schopnost muze bytvyvinuta nebo nakolik muze byt blokovna. Na rozdl od Junga a nekterych junginuautor tvrd, ze ackoli transcendentn funkce je prirozeny proces a tedy je archetypovezalozena, jak rkal Jung, presto tato funkce nepracuje spontnne. Spse potrebujematrici zalozenou na nejrane jsch vztazch dtete, kter mohou byt pozdejirestaurovny v prubehu lcby. Junguv obecny koncept symbolickho postoje muze bytdoplnen a specifickym zpusobem osvetlen uzitm Bionova conceptu snen (reverie),ktery zsadnm zpusobem prispv k tvorbe symbolu v rmci prenosu/protiprenosu. Tato myslenka je ilustrovna klinickym materilem devtiletho chlapce,

ktery trpel tezkou vrozenou intestinln chorobou a jeho schopnost symbolizovat bylazablokovna. Z hlediska techniky lcby autor ukazuje, jak bylo pri vzjemnmsetkvn vneseno do lcby kreslen comicsovych vyprven. Kresby se rozvinulyzpusobem, ktery chpal jako modifikovanou formu aktivn imaginace s detmi. Proceskreslen chlapci pomohl postupne vytvorit symbolicky prostor v terapii a ovldnoutpsychicky prostor ve sv mysli.

Nous traitons aujourdhui beaucoup plus denfants et dadolescents que dans lesannes 70 et 80 parce quils ont subi des expriences traumatiques de violence, de

maltraitance, de privation ou de maladie physique chronique et quils sont incapablesdutiliser correctement leur fonction de symbolisation. La question se pose de savoirquelles qualits et quelle attitude analytique nous devrions et nous pouvons offrirdans lanalyse pour aider un enfant retrouver sa capacit de symbolisation, quel quesoit le niveau de dveloppement ou de blocage de cette dernire. En opposition Junget certains jungiens, lauteur avance que mme si la fonction transcendante est unprocessus naturel qui senracine dans une dynamique archtypique, comme Jung latabli, elle nuvre pas spontanment. Elle requiert au contraire une matrice qui reposesur la relation primaire qua connu lenfant et qui peut tre r-active au cours dutraitement. Le concept gnral dattitude symbolique avanc par Jung peut tre

complt et cern dune faon particulire en utilisant le concept de rverie propospar Bion, qui contribue de faon essentielle la formation du symbole lintrieurde la relation transfrentielle. Cette ide est illustre par le matriel clinique dungaron de 9 ans qui souffrait dune grave maladie intestinale congnitale et se trouvaitbloqu dans sa capacit symboliser. Sintressant la technique de traitement,lauteur dcrit le recours au dessin de bandes dessines dans un change mutuel. Les



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dessins ont volu dune faon qui lui semble tre une forme modifie dimaginationactive avec les enfants. Le processus de dessin a aid le garon dvelopper peu peu

un espace symbolique dans la thrapie et contenir un espace psychique interne.

Verglichen mit den 1970ern und 80ern behandeln wir jetzt mehr Kinder undJugendliche, die nicht in der Lage zu einem adquaten Gebrauch ihrer Symbolisier-ungsfunktion sind, weil sie traumatische Erfahrungen von Gewalt, Kindesmibrauch,Deprivation oder chronischer krperlicher Erkrankung erlitten haben. Es ist die Frage,welche Qualitten und welche analytische Haltung wir in der Analyse anbieten solltenund knnen, um einem Kind zu helfen seine Symbolisierungsfunktion wiederzuer-langen, unabhngig davon, wie drftig entwickelt oder blockiert diese Fhigkeit ist. Im

Unterschied zu Jung und manchen Jungianern argumentiert der Autor, da die trans-zendente Funktion, obgleich ein natrlicher Proze und somit laut Jung archetypischbegrndet, nicht spontan funktioniert. Vielmehr braucht sie eine Matrix, die auf derfrhesten Beziehung des Kindes basiert, welche spter in der Behandlung re-inszeniertwerden kann. Jungs allgemeines Konzept einer symbolischen Einstellung kannvervollstndigt und in einer besonderen Weise fokussiert werden durch den Gebrauchvon Bions Konzept der Reverie, die in einer grundstzlichen Weise zur Symbol-bildung in der bertragung-Gegenbertragung beitrgt. Diese Idee wird illustriertanhand klinischen Materials von einem neun Jahre alten Jungen, der an einer schwerenangeborenen Erkrankung des Magen-Darm-Traktes litt und in seiner Fhigkeit zu

Symbolisieren blockiert war. Vom Standpunkt der Behandlungstechnik zeigt der Autor,wie das Zeichnen von Comic Erzhlungen in einem reziproken Austausch in dieBehandlung gebracht wurde. Die Zeichnungen entwickelten sich in einer Weise, die erals modifizierte Form von aktiver Imagination mit Kindern auffate. Der Zeichen-Proze half dem Jungen, nach und nach einen symbolischen Raum in der Therapie zuentwickeln und einen psychischen Raum in seiner Psyche zu halten.

Rispetto agli anni 70 e 80, noi ora trattiamo pi bambini e adolescenti che, a causadi esperienze traumatiche di violenza, abusi infantili, deprivazione o malattie fisiche

croniche, non sono in grado di usare adeguatamente la funzione di simbolizzazione. Laquestione quali qualit e quale atteggiamento analitico noi dovremmo e possiamooffrire in analisi per aiutare un bambino a riguadagnare la sua capacit di simbolizza-zione, indipendentemente da quanto scarsamente sviluppata o bloccata tale capacitpossa essere. Contrariamente a Jung e ad alcuni junghiani, lautore sostiene che,sebbene la funzione trascendente sia un processo naturale e quindi fondata in modoarchetipico, come sosteneva Jung, tale funzione non si attiva spontaneamente. Amzi, habisogno di una matrice basata sulla relazione primaria del bambino, che pu pi tardiessere riattivata durante la terapia. Il generico concetto junghiano di un atteggiamentosimbolico pu essere completato e specificato con luso del concetto bioniano di reverie,

che contribuisce in modo fondamentale alla formazione del simbolo allinterno dellarelazione di transfert-controtransfert. Tale idea viene illustrata con il materiale clinicodi un bambino di nove anni che soffriva di un grave disturbo intestinale congenito edera bloccato nella sua capacit di simbolizzare. Come tecnica terapeutica lautoremostra in che modo, attraverso una scambio reciproco, venne inserito nel trattamentoil disegno di racconti comici. I disegni si sviluppavano in un modo che egli comprese



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come una forma modificata di immaginazione attiva con i bambini. Il disegnare aiutil bambino a sviluppare gradualmente uno spazio simbolico nella terapia e a contenere

uno spazio psichico nella sua mente.

Comparndonos con los 70 y los 80, actualmente tratamos mas nios y adolescentesquienes, debido a que han tenido experiencias traumticas de violencia, maltratoinfantil, abandono o enfermedades fsicas, n pueden usar adecuadamente su funcinsimblica. La pregunta es que condiciones y que actitud analtica debemos y podemosofrecer en anlisis para ayudar al nio o nia a obtener su capacidad para simbolizar,independientemente de que tan pobremente desarrollada o bloqueada est esta funcin.En contraste con Jung y algunos Junguianos, el autor argumenta que an cuando la

Funcin Trascendente es un proceso natural y por lo tanto enraizado arquetipalmentecomo deca Jung, la funcin trascendente no trabaja espontneamente. Ella requiere deuna matriz basada en las relaciones tempranas del infante, las cuales pueden serreactivadas en el tratamiento. El concepto general de Jung sobre la actitud simblicapuede ser complementado y focalizado en forma especfica a travs del uso del con-cepto de reverie de Bion el cual contribuye en forma fundamental en la formacin desmbolos dentro de la transferencia/contratransferencia. Esta idea se ilustra con elmaterial clnico de un nio de nueve aos que sufriera una severa enfermedad intestinalde origen congnito y cuya capacidad simblica se hallaba bloqueada. Desde laperspectiva del la tcnica teraputica, el autor nos muestra como trajo al tratamiento

en intercambio recproco el dibujo de las narrativas de historietas cmicas (comicbook). Los dibujos evolucionaron en tal forma que l los comprendi como unamanera modificada de la imaginacin activa con nios. El proceso de dibujar ayudal nio a desarrollar gradualmente un espacio simblico en la terapia y contener unespacio psquico en su mente.



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References

Alvarez, A. (1992). Live Company. Psychoanalytic Psychotherapy with Autistic,Borderline, Deprived and Abused Children. London: Routledge.

Bion, W. R. (1962). Learning from Experience. London: William Heinemann MedicalBooks. Reprinted 1984: Karnac Books.

Britton, R. (1998). Subjectivity, objectivity and triangular space. In Belief and

Imagination. Explorations in Psychoanalysis. London: Routledge.Fordham, M. (1985). Explorations into the Self. The Library of Analytical Psychology,

Vol. 7. London: Academic Press.Jacoby, M. (1999). Jungian psychotherapy and contemporary infant research: Basic

patterns of emotional exchange. London: Routledge.Jung, C. G. (1912). Symbols of Transformation. CW5. (1916/1928). Relationship between the Ego and the unconsciousness. Two essays in

Analytical Psychology. CW7. (1916/1958): The transcendent function. CW8. (1917/1942). The psychology of the unconsciousness. In Two essays in Analytical

Psychology. CW7.

(1937). Definitions. In Psychological Types. CW6. (1940). The psychology of the child archetype. In The Archetypes and the

Collective Unconsciousness. CW9i. (1946).The psychology of transference. In The Practice of Psychotherapy. CW16.Kast, V. (1990). Die Dynamik der Symbole. Olten: Walter Verlag. (The Dynamics of

Symbols: Fundamentals of Jungian Psychotherapy. New York: Fromm International,1992.)

Neumann, E. (1963). Das Kind. Struktur und Dynamik der werdenden Persnlichkeit.Zrich: Rhein-Verlag. (The Child. Structures and Dynamics of the Nascent Person-ality. London: Hodder & Stoughton, 1973.)

OShaughnessy, E. (1988): Bions theory of thinking and new techniques in child

analysis. In Melanie Klein Today. Developments in theory and practice. Vol. 2:Mainly Practice, ed. Elizabeth Bott Spillius. London: Tavistock/Routledge.

Samuels, A. (1985).Jung and the Post-Jungians. London: Routledge.Segal, H. (1981). The Work of Melanie Klein. A Kleinian Approach to Clinical Practice.

London: Aronson. (1991). Dream, Phantasy and Art. London: Routledge.

Acknowledgement

I would like to thank Elisabeth Adametz and Miranda Davies for their

thoughtful and helpful comments on this manuscript.



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Symbolic Attitude and Reverie- Problems of Symbolization in Children and Adolescents

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Transcript of Symbolic Attitude and Reverie- Problems of Symbolization in Children and Adolescents