Wednesday, May 30, 2012

Britton & Steiner - Interpretion: Selected Fact or Overvalued Idea?

"We have tried to illustrate the formation of interpretation from the selected fact and the difficulty of differentiating this from an overvalued idea. Before we consider this distinction further it is necessary to describe briefly Bion's notions on interpretation and how they are dependent on his theory of preconceptions, of the container/contained, and of the cyclical movement from the paranoid-schizoid to depressive positions (PS D).

In a situation where meaning is not apparent and facts are accumulating, the relationship of one psychic particle to another is not determined until the analyst's attention is taken by something which thus becomes the selected fact, and there emerges a configuration as the other psychic particles cohere by virtue of their relationship to it.

This configuration of elements in relation to a selected fact is highly specific to a particular patient at a particular moment in his analysis. It provides the substance (the contained) for an abstract form (the container) which already existed in the mind of the analyst, of which this newly emergent configuration becomes the incarnation. This previously empty form or 'state of expectation' (Bion, 1962, was awaiting an exemplary situation to give it life. The 'empty form' was the background theory in the analyst's mind that found expression in this new formulation. These theories or expectant containers accumulate in the mind of the analyst and are derived from his general analytic theories, his own subjectively-based theories about people, his clinical experience of other patients, and his accumulating experience of this particular patient. 'Conception is that which results when a pre-conception mates with the appropriate sense impressions.' In this context it should be the analyst's mind primed with its theories which awaits as a receptacle for its expectations to be fulfilled by experience of the patient. This requires a capacity to wait, and if the analyst is unable to tolerate the uncertainty of not understanding he may turn to his theory as a source of reassurance and look for a patient to act as a container for the theory. Bion emphasises that the analyst's pre-conception has to act as a container for the realisation, and 'NOT' the other way round (Bion, 1962).

Bion's notion is that we move from a fragmentary psychic state (PS) to a coherent psychic state (D), and at each encounter with new experience we traverse this route. In analysis, therefore, both patient and analyst have to face periods of disintegration as new experiences are confronted before they are assimilated and understood. The initial disintegration represents a move towards PS, and this has to be contained before a true integration towards D can result. We think this is only possible where there is a sense of containment already in existence which provides a limit to the sense of fragmentation and incomprehension, so that it is not boundless, nullifying all meaning. Otherwise the experience is of 'nothingness', terrifying 'bottomlessness', or complete 'incoherence'. For many patients, for at least a good deal of the time, the analyst's presence and the setting provide this outer container. When this is not the case the situation is very fraught and often dramatic. Meaning is then sought, not to make sense, but to provide an alternative to the missing container.

We suggest that this is one reason why ideas become overvalued by either patient or analyst. They are used to buttress the fragile sense of stability in psychic space and are therefore required to have the qualities of permanence and substance. In such circumstances, interpretation may become a means of seeking security rather than of inquiry, and its constancy more highly valued than its truth. In this scheme of things there is no waiting for the evolution of the selected fact. The overvalued idea becomes the 'pre-selected fact', which is not emergent but mandatory in every psychic situation, compelling other psychic particles to orient themselves around it as if it were permanently the selected fact....

Two situations would seem likely to give rise to the intrusion of an overvalued idea into the analytic field, thus obscuring or preventing the natural evolution of the session: (1) the patient with an intolerance of uncertainty or doubt, who does not feel adequately contained in the analytic situation, presents material or interprets the analyst's behaviour in conformity with an overvalued idea, thus constricting the analysis within the confines of his existing mainly unconscious beliefs; (2) the analyst who relieves his fear of losing his analytic identity in a situation of uncertainty or confusion by attaching himself to an overvalued idea, for which he seeks confirmation in the patient for the beliefs which, unconsciously, he thinks are necessary for his psychic equilibrium.

In the first of these instances, the analyst's task is to discover the undisclosed defining hypothesis of the patient, i.e. the patient's overvalued idea, which may be unconscious. In the second, his task is to recognise his own overdetermined use of an idea and to try to understand his own behaviour. This may be unfinished business in his own analysis or it may be a specific countertransference to his patient, in which case the unravelling of this is part of the patient's analysis and may reveal a re-enactment of an unconscious object relation in the transference.
" (pp. 1076-1077)

Ronald Britton and John Steiner (1994). Interpretation: Selected Fact or Overvalued Idea?. International Journal of Psycho-Analysis, Vol. 75, pp. 1069-1078

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