Nr 18. 2008 sid. 31–44
Before discussing the sessions with Sarah, let me provide some hypotheses, which help me to convey my perspective in trying to understand the material. I want to stress that I wouldn’t say to Sarah, the words I here put in Sarah’s mouth (about her needs). I use them (because I have only words), as a way of putting images to what I imagine is Sarah’s experience of a very primitive link, which is reproduced, in the therapeutic relationship. Only the therapist can know what to say, how to use it, and in what moment.
I suspect that the therapy with Sarah must have been difficult because of her intolerance of frustration and difficulties in maintaining her basic feeling of continuity (her feeling of going on living) due to a primitive lack of internal affect representation. There is, probably, a gap between a primordial unrepresentable affectivity and another level of representable affects; the registers of affects and representations do not coincide. Sarah’s different and disconcerting levels of functioning make me think that her outbursts, her retreat in the world of sensations, (spinning around), looking for a dizzy sensation, furnishes a feeling of being alive in a world of empty loneliness.
These sessions made me think (from a developmental perspective) about the importance of the object’s loving gaze; the concrete way, through which the mother conveys the loving mental matrix, in the process of dreaming her child’s experience. I mean the mother’s capacity for reverie and alpha function. When there are difficulties in this sense, the infant cannot develop a reflective attitude through the introjection of primitive (alpha) function, to link images to emotions, affects to representations, which would confer meaning to the emotional experience of the infant’s self. A meaning that Sarah now desperately looks for, (fortunately!). Having said this, I don’t exclude the child’s receptivity to the loving care, or her tolerance of frustration. My hypothesis is that, for one or both reasons, a link of not meeting had developed between Sarah and her mother.
imagine that, from the beginning, the therapist must have been following
Sarah very closely, trying to describe sensations and name emotions not
imposing her presence and trying to fit with her expectations. I can see
the therapist engaged in a careful observation in the session (looking
at her and looking for her) trying to give meaning to Sarah’s emotional
experience. My hypothesis is that this process gave way to a reliable
therapeutic link. Sarah developed the hope of being understood and
contained. Now she has the notion of a containing object (although very
fragile inside) to whom to address her desperation and anger in the hope
of being understood and contained. Good!
The following two therapy sessions take place after almost one and a half years of treatment. Sarah has been in therapy twice a week. Her parents meet with a therapist every second week in separate sessions. Now Sarah has a much better contact with her father and she sees him regularly.
Sarah has brought two soft animals with her; she says that one of them is her pal animal. She takes them out of her bag and shows me, one big and one small soft dog. For a long while she now tries to get the small dog to stand on his feet. Again and again she tries to raise the little dog. She is patient and she doesn’t get angry, which she otherwise often gets. I say that I can see that the little animal tries to stand upright with his staggering legs. Sarah doesn’t answer but after a while she asks if there is ice on the edge where she tries to get the dog to stand. I say: “Mm, you can feel that way if your legs don’t feel steady.” She moves the dog to the sofa and manages to get it to stand for a long while. She looks upon me and looks really delighted. “You are happy when you can stand with staggering legs”, I say. She smiles.
Sarah seems pleased and walks with the dogs to the cupboard and brings a game called Memory. It is a game where you are supposed to find pairs of cards, two of the same kind. She wants us to play. The big dog may watch while the small one with the staggering legs is supposed to take part in the game. At the beginning everything goes fine, Sarah seems pleased and we take turns in the game. Sometimes Sarah looks at the other side of one or two cards on the table. When she finds a pair she makes a point of telling: “I didn’t peep, I didn’t cheat, you know”.
After a while she pulls out a drawer in the drawing table and she finds two brand new rubbers. She picks them up, turns them around and says that they are so very fine. She reads the long row of digits on them and notes that they have different numbers although they are quite alike in all other aspects. She drops a rubber on the floor and says: “look, it disappeared”. The rubber is right under her chair. I show her the rubber. She leans over and says: “I see nothing”.
Copyright: Allt material ©