Body as Enemy: The Risk of Coming Alive

Drew Tillotson, PsyD, Discussant Peter Goldberg, Ph.D.

Saturday Feb 26, 9:30 AM – 11:30 AM

Being and staying alive in clinical work is not always a welcomed experience. At times the analyst’s aliveness collides with patients’ anxieties, their psychic walls, or dead spaces. Hopefully these encounters penetrate barriers, and awaken nascent or truncated psychic development. At times we help enliven psychic deadness or awaken paralysis. For some patients this is experienced as dangerous, risky, destabilizing: a Bionian ‘catastrophic change.’ In this presentation, a case is used to illustrate the impact of a chronic bodily illness on the patient’s object world and its interdigitation with his struggles to come alive, both psychically and bodily. For this patient, illness sealed an early object identification with a dead parent that preserves an un-mournable object tie that blocks experiences of aliveness and bodily vitality. Coming alive engenders significant risks; changes are unconsciously dreaded due to an inability to mourn an object tie that has shaped the patient’s internal life. The experience of being with the analyst is foreign and confusing, accepted at times, rejected at others, even in the midst of relief from psychic isolation, and bursts of aliveness and pleasure. In order to successfully mourn and to come alive psychically, the patient faced substantial anxieties linked to his own bodily pleasure, excitement of mind, and encountering the analyst as an enlivening object. The ensuing catastrophe involved letting go of deadening object ties and relinquishing manic flights into a fantasied disease-free body. Peter Goldberg, Ph.D. will provide a discussion of Dr. Tillotson’s paper.

CE Credits offered: 2

Course Objectives

After completing this course participants will be able to:

1. Describe Bion’s concept of catastrophic change as it applies to the patient’s struggle between aliveness and a resignation to a deadened existence.
2. Explain John Steiner’s concept of identification with the object as a failure to mourn.

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