Friday, February 24, 2012

Martin Schmidt on Psychic Skin

"Psychoanalytic practice and theory is fundamentally concerned with boundaries and containment. This requires the establishment of semi-permeable, flexible membranes that can create space, hold and control the passage of that which goes in and out. The consulting room and its furniture, the building that it is in, the person of the analyst, the words we choose, the silence, the transference and the analytic hour itself, all provide a kind of metaphorical ‘skin’ for the analysis.

Freud states that ‘the ego is ultimately derived from bodily sensations, chiefly from those springing from the surface of the body’ (1927, p. 26). In her seminal paper, Esther Bick (1968) argues that in its most primitive form, the parts of the personality are held together by the skin functioning as a boundary. Just as the Psychic skin: psychotic defences, borderline process and delusions psychological functions of nourishment, reassurance and comfort are dependent upon the introjection of the warm and receptive breast, so too the mental function of containment is dependent upon the introjection of an external object capable of providing a ‘skin-container’ function. Without the incorporation of this containing function, the concept of a space within the self cannot arise and consequently introjection itself (i.e. the psychological construction of objects in an internal space) is impaired. Unrestrained projective identification ensues and all the confusions of identity associated with it.

Following in Bick’s footsteps, Joan Symington (1985) describes how the baby lives in constant fear of its psychic skin being breached and spilling out into ‘unintegrated states’. If the mother is able to contain the baby’s distress, the psychic skin is strengthened. If, however, the mother fails or is absent, then the infant has to resort to its own means of holding itself together. She has observed a number of ways in which the baby attempts to do this: by focusing its attention on a source of light, sound, touch or smell; by engaging in repetitive movement and by muscular tightening/clenching. Adult equivalents of these primitive omnipotent defences include pacing the floor, continuous talking, self-stroking, watching television, plugging into headphones and compulsive exercise. The perpetuation of these survival mechanisms may lead to the development of what Bick calls a ‘second muscular skin’, based on robustness and muscularity, rather than identification with a containing object. If unmodified, this can become a defensive-offensive armour which we see in schizophrenia.

Didier Anzieu (op.cit.) developed these ideas and formulated the concept of a ‘skin ego’, a bodily pre-ego, a mental image based on the infant’s experience of the skin which it uses to support the functions of the ego. He argues that as every psychical activity is anaclitically dependent upon biological/physical functions, the functions of the ego mirror the functions of the skin: a container/sac for retaining thoughts, affects and good experiences accumulated through feeding, touch and bathing in words, an interface which protects against penetration and a means of communication with the outside world.

This skin ego provides a kind of ‘narcissistic envelope’ to protect the psyche. Anzieu imagines that there is a primitive fantasy of a skin common to mother and baby which is followed by a flayed skin (with separation) and then the establishment of a skin of one’s own. At this point, I would like to clarify my own use of the term ‘psychic skin’. There is a tendency in psychoanalysis to use metaphor to describe psychological functions/capacities in terms of body parts; e.g., Symington says the ‘optimal containing object’ is the nipple in the mouth and Bick directly equates psychic skin to physical skin. However, as Warren Colman points out, there is a danger in exaggerating the physical source of the metaphor: ‘The process of reduction back to the physical body has the effect of imbuing the physical body with meaning that it did not necessarily have before’ (Colman 2005, p 653).

I am using the term ‘psychic skin’ as a metaphor for an abstract psychological capacity, namely, the containing and protective function of the psyche. This is informed by the infant’s actual experience of its own physical skin and the actions of its parents (e.g., their touch); also by the integration of their feeling/thinking containing function (which processes and makes bearable the infant’s anxieties) and other archetypal factors which I will aim to describe.
(pp. 23-25)

Martin Schmidt (2012) Psychic skin: psychotic defences, borderline process and delusions. Journal of Analytical Psychology, 2012, Vol. 57, pp. 21–39

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