BION: I must explain why I have to speak English. It is partly because I don't speak French, although I have learned or been taught French as it is spoken in the English Public Schools, it is not the sort of French that you would understand. There are other reasons which will become clearer as we go on with our discussion.

I would like you to regard this as a working conference in which this problem is one which faces all of us. For example, a young man of twenty-five complains of having an unsatisfactory family life; I am not sure what family he is talking about, and in the course of a preliminary discussion I ask him his age and he says forty-two. Forty-two? But I said twenty-five just now. As I see him more closely I notice lines on his face, and every now and then I think he looks more like sixty-two than forty-two or twenty-five. Well, what is his age?

The first question I put to you is, will you take this patient or not? I am not suggesting that you should tell the patient or me or anybody else, but what do you tell yourself? If you want to write down your immediate impression now, it would perhaps be interesting to you to make a note saying 'yes' or 'no’. To answer that question I propose to use a procedure in which I assume a 'vertex' from which I could form some impression as to whether I want to see this patient again.

Suppose you walked into a bookshop, picked up a book, turned a few pages and read what I have just said. Would you put the book down and pass on to another? Or would you like to turn over some more pages before making up your mind whether to read that book or not? So there's my second question: are you interested in this story; do you want to read any more of it?

I'll try another one: suppose it was a piece of music you were hearing. Would this sort of music interest you? Would you decide to go to a concert and hear the rest of the piece of music? Or would you decide that it was not your kind of music? That is another vertex. Of course, in reality, we haven't so much time, but here we can play this little game.

Changing the vertex again: suppose you were walking through a building and saw on the ground a pattern of colors thrown by the light coming through a window. Heredia, in the poem 'Vitrail',(reproduced below), describes the effigies on the tombs: they cannot see, cannot hear, but with their eyes of stone, they see these colors spread out on the floor. As this patient is talking to me and the light falls on this conversation, what colors do you see? Do you like them? Would you like to spend some more time there? Would you like to study the window through which the sunlight penetrates to find out what sort of design there is in the glass of that window?

I won't suggest any more because I would like you to think of various vertices which you can employ when confronted not with a book, not with a painting, not with a window, but with a person. What sort of shadow does he cast in your mind?

Getting back to the analytic situation, shall we tell this patient to come again? Shall we, as it were, open another page of the book, or listen to some more bars of music, or shall we stop there? Each one of us has to answer that question all alone. I am not asking you to take a psychiatric vertex at this point - it is too early. You have only had a few sentences (of conversation) and only a few moments in which to see this man. Do you feel inclined to say, “Well, I think I had better see you tomorrow”, or next week, or “I would like to see you again in a month's time''? Nobody can tell you what to do because nobody knows what kind of person you are or what you are capable of.

Another reason why I am speaking English is this: I am familiar with phrases such as, green with envy, yellow with jealousy, black with despair, red with rage. Do you think like that? If so, what are the colours that you see in this conversation? In what colors would you paint that conversation? You may say you are not painters, but it is very important for you to know who or what you are. That is one reason why we advocate that people should have an analysis in order to get accustomed to who they themselves are. It is very unlikely that you have discovered that yet. So although your tendency may be to say you don't paint, I say you do. Therefore, get out your colors; don't write notes about this story, make some marks on paper. Use a few simple colors like blue, black, yellow, green. Then look at it; there you will get an idea of how that patient struck you. If you were a musician, what piece of music would you compose? If you were a writer, what language would you choose? French? French as it is spoken in Paris, or the Midi, or the Touraine?

So, listening to the conversation between yourself and your patient, what language is being talked, either by him or her, or yourself or both of you?

Q: It is interesting to note that in French we say, 'Yellow with envy' rather than green.

Bion: That is why it is so important to know not what language is spoken in France or England - these geographical boundaries are not of importance when it comes to a question of the mind or character or personality - but to borrow the language of painters, musicians and so on, and to use it in this extraordinary subject with which we are concerned.

Q: Do you think we are able to choose the vertex?

Bion: Yes, and the more you know about yourself, the more you know which vertex to choose in order to look at the problem. For example, looking at this man who I have tried to describe, would you choose him to go mountaineering with? Would you choose him as one of your team in the Tour de France? Never mind about psychoanalysis or psychiatry for the moment - is there anything you would choose him for? Whether we like it or not, the choice is an arbitrary one because analysis has to be done by each of us alone - it is a lonely occupation.

We have become used to the idea that psychoanalysis is an attempt to make a scientific approach to human personality. It is a view that attaches great importance to facts, to the truth, to the real thing. If that is so, there are plenty of people who are scientists without that official categorization. A painter, for example, may believe that a painting should be true to truth, should show you some aspect of reality which you might otherwise not notice. He is not a psychoanalyst, but he paints a picture. Look at this picture and then you may see what a tree or a face looks like. If an author writes about imaginary characters like Falstaff, Lear, Othello, Macbeth, they ought nevertheless to remind us of real people. Does the last scientific article that you read in the International Journal of psychoanalysis remind you of real people, or doesn't it?

Q: Are you suggesting that the analytic experience can be a dehumanizing once?

Bion: I think that there is a great danger of it. I come across a lot of what is thought to be scientific psychoanalysis, but it doesn't remind me of anything except boredom.

The situation in the consulting room, the relationship between these two people, could be like the ashes of a fire. Is there any spark that could be blown into a flame? In this little bit I have described, we would have to examine, observe, devote care to mental debris - bits of what we have been taught, bits of what we have learned, bit of what the patient has been taught. In analysis one is seeing the totality of debris. What has happened to the face of a man of forty-two? Why does he look twenty-five or sixty-two? Why does he say he is forty-two? It is all part of the debris. Do those pieces come together? Would you be able to put them together so that they make sense'

Q. (an inaudible reference, to 'psychotic experience')

Bion: The idea that it is a psychotic experience is very cerebral. In analysis, we are concerned with something which might ultimately be expressible in cerebral terms, but that is not how it appears to us as practicing analysts That is one reason why we have to reconcile ourselves to the fact that patients do not come to us with little labels tied to them saying, 'manic', or 'depressive', or 'manic-depressive', or 'schizophrenic'. if they do come with such labels we should regard them as more pieces of debris. I do not mean by calling it debris that it is not worthy of attention; I mean that it is something which has to be observed and scrutinized with very considerable care, otherwise you might throw away the necessary, vital spark. One cannot afford to cast aside imaginative conjectures on the grounds that they are not scientific - you might as well throw away the seed of a plant on the grounds that it is not an oak or a lily but just a piece of rubbish. This applies to all that goes on in your consulting room.

But I suggest that it would be worthwhile considering it not as your consulting room, but as your atelier. What sort of artist are you? Are you a potter? A painter? A musician? A writer? In my experience, a great many analysts don't really know what sort of artists they are.

Q. What if they are not artists?

Bion: Then they are in the wrong job. I don't know what job is any good because even if they are not psychoanalysts they need to be artists in life itself A mathematician can see that an algebraic formula is a beautiful one; a musician can hear a manuscript which is simply black marks on paper Even using the language I know best, I cannot tell you what an 'artist' is; I prefer you to go beyond that word and see what I am trying to convey to you by this very inadequate word. It is certainly not somebody who is able to deceive your eyes, to make you think that there is a tree there when there isn't one, but somebody who has made you able to see there really is a tree there and its roots even if they are underground.

I suggest that behind this forty-two-year-old man is hidden a person, and that person has roots, an unconscious which, Like the roots of a tree, is hidden from sight. There are not only branches which are ramified and have veins, but under the surface it has roots. So when this person comes into your room, what do you see? I am not asking simply what do you see with your eyes, but also what does your intuition enable you to see?

Q. When you relate the roots of the tree with the unconscious, do you have an image of something that can be experienced as roots of the unconscious or the unconscious as roots?

Bion: No. 'Unconscious' is simply one of these words invented by Freud in an attempt to draw attention to something that really exists. But, as usual, one gets caught up in the word, and then there are these interminable, wearisome -to me- arguments about Kleinian theory, Abraham theory, and all sorts of theories.

I cannot be interested in them because they obscure the fact that there is, as far as I am concerned, actually such a thing as a human mind or personality. I don't believe that anybody has yet discovered how that human character or personality is to be described although a really good portrait painter can paint something which shows not just the color of the skin or the shape of the person. An artist in England painted a portrait of Winston Churchill. His wife hated it so much that she destroyed it. And yet plenty of people thought it a very fine portrait. The artist, Graham Sutherland, was not a psychoanalyst, not in that category, that box, but was he an analyst or wasn’t he? Similarly, you might say to me, 'Ah yes, but I m not Cezanne, I’m not Sutherland'

I don't want to flatter you, but all I can say is, how do you know that you aren't? Have you been to your atelier and discovered what sort of artist you are?

Q. Would you say something about what you have described as a catastrophic situation.

Bion: The word 'catastrophe' has also to be understood in the light of something which goes in the opposite direction. I think of it as 'breaking down' which is very close to the metaphor, ‘breaking up'.

In an analytic situation the analyst is concerned with trying to make conscious, trying to bring to awareness something which the patient has often spent his life trying to make unconscious. There are two people in the room who come together at the same time, in the same place, but the directions in which they are thinking are different. They could agree if the analyst consented to become very disturbed and afflicted with the same kind of neurosis or psychosis as the patient, but it is usually supposed that the analyst should not lose his capacity for being aware of the world of reality, although he may be drawing attention to a world of a different form of reality. The simplest example I can give is this: we are in the state of mind which is usually known as being awake or conscious and aware of what is taking place - so we think. But when we are asleep we are in a different state of mind. This division into day and night is not very illuminating, but I think it is useful if one can retain the valuable quality of being able to go to sleep, as well as the valuable quality of being able to wake up. That 'marriage' often seems not to be harmonious. For example, patients may admit that they had a dream but they don't take it seriously; they don't feel disposed to tell you where they dreamt and what they saw. They say, ‘Oh, I just dreamt it'.

I don't know why they 'just dreamt it'. If the acorn said, 'Oh, they're just roots', what would one think? After all, even an acorn on an oak owes something to the roots. So what is one to make of a patient who thinks he 'just dreamt it'? Freud considered that dreams ought to be treated with respect - I think that is the most important part of his work, but I don't believe we have got anywhere near to reaping the consequences of treating dreams with respect.

Q. (Questions about the meaning of the terms 'breaking down' and 'breaking up'. There are no direct equivalents in French)

Bion:What does the patient say to you when he thinks he is going mad' ?

You have to find out from the patient what it means. When he says he is breaking down, presumably that is what a breakdown looks and sounds like. You don't have to believe that the patient's diagnosis is correct, but you can look at the picture yourself which he calls 'breaking down'. You then have a chance of using your senses to tell you what this word means and also what language the patient is talking. It is no good saying he is talking French or English that is too clumsy.

Q. Is it the specificity of the language which develops in the 'atelier'?

Bion: Yes, and the specificity of what the analyst does. Cezanne's pictures of the Montagne Sainte Victoire are not the same as mine would be if I took photographs of it. What is the difference? You have to look at the paintings to find out; they are the only language Cezanne could speak to convey to me what I ought to be able to see if I look at that mountain.

Your patients are not really very good artists, but they do usually know what it feels like to feel their feelings. When they try to tell you, they haven't much of a vocabulary. So you listen to what they say and look at what they are, compare the two and then form your own conclusions about whether they are - to use the English language - breaking up, breaking down or breaking through.

The patient is usually describing something which I am sure exists - mental pain.

When it is physical you can ask, 'What sort of pain is it?'

With the kind of patients that we have we need to be able to recognise the different names which are given to pain: anxious, frightened, terrified, embarrassed, ashamed, and so forth. They are all different varieties of pain. If you were trying to paint them you would have to use different shades of colour, but psychoanalysts have to invent the language; Our material is not visible, it is not palpable.

Sometimes a patient doesn't seem to be able to communicate and wants to hold your hand, to have a physical method of communication. Most analysts restrict themselves to verbal communication, but that is only a recently discovered method of communication - not a very good method but the best we know.

Q. I recently had a patient who didn't feel it was necessary to talk in order to communicate with me.

Bion: Such patients don't really understand the possibilities of verbal communication. They do understand the possibilities of being able to evacuate their urine, their faeces, and even their breath. So when they talk they are aware of the muscular activity of expulsion, not the mental quality of thinking.

Q. That confirms my experience with this patient. Once he was frightened about a friend called Pierre. He thought he was very hard ..(inaudible sentence....) …similar to throwing stones out of his mouth.

Bion: It is very difficult to get any impression unless you are with the patient. One possibility is that he is impressed by muscular movement. In that way he would be afraid that he would either lose some part of his personality if he spoke, or he might injure the analyst with these stones; he could say things which were very hurtful, rude things, insults. Even, a rational conjecture could be, that he is afraid that if he is spontaneous or natural he will say insulting things which would make the analyst very angry.

When this patient talks to the analyst what aspect of himself is being expressed? Could he be aware of the growth of renal calculi (stones – Ed) long before any thing showed in X-rays or in physical palpations? As well as the more accepted ideas of our response to the free associations of the patient, there can be this complication: a bodily symptom, a chemical symptom, the formation of calculi, shows up earlier in the mind than it does in any other way. The question is, what are you to say to the patient?

How do you transform your thoughts, feelings, ideas about what is presenting itself to you, into a verbal language which the patient would understand and which would also be correct. It is a very tough problem and I see no way of answering it unless you are in your consulting room.

Q. I wonder if it is what happens with children as well ... (inaudible passage)

Bion: It is difficult to know where the origin of the pain is. Children today are often acutely sensitive to what is going on; they know a great deal about their schools, their teachers, the town or city or country that they live in. But it is not the same thing we know as grown-ups. So when they tell you something you can be reasonably sure that their information is very acute but their experience is not great; they have not lived long enough to be able to understand what their knowledge or their senses tell them. It may be perfectly natural for a child to be loyal to its contemporaries and not therefore want to pass on information to somebody who is of a different generation. So there is a division which is not simply between one's unconscious and one's conscious, although it is similar to that; it is a division between what the child reminds you that you once were, with what you know you are today.

You may have forgotten that the child you were was loyal to other boys and girls and did not tell your parents things you knew and didn't regard as dangerous, because you did not have enough experience to know they were dangerous.

So you have this problem which is partly to do with yourself, partly to do with the actual child who comes to you, but is also concerned with what I have described as 'the vogue'. I am not talking about the mode, just a passing manifestation of the vogue, but the vogue itself - that force which exists, always exists and is very powerful.

I feel that we have left the interview with the man of forty-two for rather a long time. Here we can discuss the problem at considerable length, but not in the consulting room. The question is, why does he remind me of a young man of twenty-five? And why, as I look at him, does he remind me of a man of sixty-two? At this point I wonder if he has any children. Would they make him older or younger? I think I would like to see him another day; I might then find out whether he is married or not, or if be and his girl friend have produced children.

I am used to the idea of mental conflict, but are there physical conflicts? Can a person look twenty-five and sixty-two at the same time, but not forty two? What bodily muscles are being used? Some of them are vocal cords. but what else? What about his skin? What about the lines or the lack of them on his face? How is that done? Do we as psychoanalysts have to be aware of physical as well as mental conflict?

I recall one patient who was always very co-operative and after a time - probably after too long a time I'm afraid - it became clear to me that he was the only patient who didn't disturb the appearance of the couch; when he left, it was almost as if nobody had lain on it. Then it occurred to me that he lay in exactly the same place every time he came. That made me think that it was a sort of catalepsy, mental catalepsy.

I could never honestly say he had a dream; I could never honestly say he was awake; he was between the two. He wasn't unconscious; he wasn't conscious. How did he live in such an exact state of mind? Physically he could lie in exactly one position on the couch: now it became clear that he was doing the same thing mentally.

Q. There are two points I would like to raise. First, here in Paris there are complaints that there is no discussion about the choice of patients. Second, I have been told several times that patients want to stop analysis but their analysts don't want to wean them.

Bion: I would fall back on an expression I find useful, borrowing a term from the mathematicians: 'absolute initiative'. By 'absolute' I mean in either direction - initiative to go back; initiative to go forward. The important point is the initiative, not the direction. That seems to me to be very close to something fundamental and basic, even physically, almost like the functions or the impulses which are born when the adrenals become active, making it possible to fight or run away, to run into the danger or away from it. I say 'initiative' to give this neutral spot in between the two. Who gives birth to a child? The mother, or the full-term foetus? Does the full-term foetus in some way indicate that it has had enough of being in the mother's inside? Or does the mother indicate that she has had enough of carrying that load with her? That is putting it in pictorial terms. Let's start again.

Does the patient want to see the analyst, or does the analyst want to see the patient? I think the cataleptic situation does represent a sort of refuge; you don't do either.

The other day I heard an interesting account of a patient who seemed to mention the Fourteenth of July. He apparently said quite a lot, but nothing about the Fall of the Bastille or the people dancing in the streets celebrating the holiday. That seems to me to be rather like looking at an X-ray in which you can see the lungs, but why is it hazy in this part? Why can't you see the ribs clearly? What is the matter with this story? While you are looking at this debris, as I call it, you also need to be aware of what is wrong with the story that you are being told. What is missing? You have only heard the beginning and would almost certainly have to see the patient again. But when you do that, you are also starting analysis and you may discover that you don't want to go on with that patient but that patient: does want to go on with you. You have to be aware of that possibility at any moment. The same thing applies in your atelier: you may not have decided what sort of artist to be, but as you see what you are fairly good at, you may have to 'make the best of a bad job', as we say, and decide to find out what you can do with what you have in your atelier.

It is very important to be aware that you may never be satisfied with your analytic career if you feel that you are restricted to what is narrowly called a 'scientific' approach. You will have to be able to have a chance of feeling that the interpretation you give is a beautiful one, or that you get a beautiful response from the patient. This aesthetic element of beauty makes a very difficult situation tolerable. It is so important to dare to think or feel whatever you do think or feel, never mind how un-scientific it is.

Tr. Francesca Bion

September 1999

Vitrail

Cette verrière a vu dames et hauts barons

Étincelants d'azur, d'or, de flamme et de nacre,

Incliner, sous la dextre auguste qui consacre,

L'orgueil de leurs cimiers et de leurs chaperons;

Lorsqu'ils allaient, au bruit du cor ou des clairons,

Ayant le glaive au poing, le gerfaut ou le sacre,

Vers la plaine ou le bois, Byzance ou Saint-Jean d'Acre,

Partir pour la croisade ou le vol des hérons.

Aujourd'hui, les seigneurs auprès des châtelaines,

Avec le lévrier à leurs longues poulaines,

S'allongent aux carreaux de marbre blanc et noir;

Ils gisent là sans voix, sans geste et sans ouié,

Et de leurs yeux de pierre ils regardent sans voir

La rose du vitrail toujours épaniouie.

Heredia