Bion and Cure
In beginning his first Los Angeles lecture on April 12, 1967, Bion encouraged the members of the audience to consider with him a patient. The patient is not a specific one: it is not one from his history or the history of an audience member. Rather, Bion instructed those present to think of the patient they “will see tomorrow” (Aguayo & Malin, 2013, p. 2). The advantage of this, according to Bion, was that “we all start as equal, because you don’t know what’s going to happen and nor do I” (Aguayo & Malin, 2013, p. 2). This state of not knowing permeated Bion’s thinking of psychoanalysis, and his implicit teachings on what cures. Bion’s ultimate goal for every session was to come into contact with the truth of what was occurring. This absolute truth was termed by Bion as O(Grotstein, 1996). Bion was acutely aware of the fact that somethingis always occurring between patient and therapist, and his aim was to get at the truth of that reality. “Since I don’t know what the reality is, and since I want to talk about it,” Bion said, “I have tried to deal with this position by simply giving it a symbol ‘O’ and just calling it ‘O,’ ultimate reality, the absolute truth” (Aguayo & Malin, 2013, p. 3). Even though it is somewhat too reductionistic, it is possible to boil all of Bion down to his insatiable desire to get at, come in contact with, and sense the truth of an analytic moment. The way in which Bion went about this task is just as unique as the man himself.
Bion believed that theory and technique can sometimes stand in opposition to intuiting the truth (Grotstein, 2007). To wit, he spent much of his time, when talking about the work of psychoanalysis, discouraging the use of technique. His most famous admonition in this vain is found in his short paper “Notes on Memory and Desire” (Bion, 1967). In it, Bion stated that memory (of what has already happened) and desire (for what might happen) both serve to obscure the truth. Instead, Bion stated that a therapist must eschew memory and desire (Aguayo, 2014) in order that the therapist can better attend to what is happening immediately in front of him.
A similar image to that of listening without memory and desire is Bion’s image of “a beam of intense darkness” (Grotstein, 2007, p. 10). When faced with uncertainty about a patient, Bion noted that the common therapist will fall back on theory in order to guide him. Bion (Aguayo & Malin, 2013) advocated for the opposite reaction.
Now the point that I want to stress about that is this: that when you have a particularly dark spot, turn onto it a shaft of piercing darkness. Rid yourself of your analytic theories. Rid yourself of what you picked up about the patient; get rid of it. Bring to bear on this dark spot a shaft of piercing darkness . . . If you want to see a very faint light, the more light you shut out the better, the bigger the chance of seeing the faint glimmer. (p. 9)
Falling back on theories, for Bion, only gets in the way of seeing the faint light. Instead, ridding oneself of the assumed knowledge that has come about outside of the therapeutic relationship (i.e., in supervision, in books, in conferences) allows for the truth of the therapy to emerge.
The final point related to Bion’s directives for how to carry oneself in therapy concerns his affinity for negative capability. Although first used by Keats, Bion coined the term to mean a therapist’s willingness to tolerate frustration, not-knowing, and uncertainties (Green, 1973). Bion believed that any endeavor to discover the truth would always travel through periods of not-knowing. In fact, Bion came to prize the position of not-knowing because it was from a position of not-knowing that knowledge could develop (Grotstein, 2009). Bion was not deaf to the fact that welcoming negative capability would place a great deal of stress on the therapist. He was also aware of the fact that most therapists found comfort in knowing. However, Bion would not let the discomfort, or anything for that matter, get in the way of coming into contact with the truth, but more than arriving at the truth and holding onto it, Bion prized the journey, the process—with all of its pitfalls. In order to take the journey to the truth, the therapist must slough off theory, knowing, memory and desire. Without those things, it is possible to really come into contact with O.
Bion’s wife, Francesca, told a story of Bion, and the importance he placed on not-know and openness to finding out the truth.
“He believed that “La résponse est le Malheur de la question;” both in his professional and his private life problems stimulated in him thought and discussion-never answers. [He would say,] “I don’t know the answers to these questions—I wouldn’t tell you if I did. I think it is important to find out for yourself.” (F. Bion, 1980, p. 5)”
“La résponse est le Malheur de la question” is translated as, “The answer is the misfortune of the question.”
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