The clinical challenges of working with primitive states of mind

Marcus West

Primitive states 2

Experiences of annihilation, shame, dying, murderousness, rage, powerlessness, despair, worthlessness, badness, depression, and suicide lie at the heart of borderline states of mind. These experiences are overpowering and unbearable for the patient and sometimes for the analyst as well, and can lead to impasse and perhaps breakdown of the analysis. Developments in our understanding of trauma, and early relational trauma in particular, can help us better understand these states of mind that lie at the heart of our analytic work.

In the first of two talks, in January 2017, I will be concentrating on the clinical challenges of working with experiences that are traumatic and thus unbearable to the patient (the definition of traumatic) – they remain unbearable! It is very important that analyst and patient can both come to understand the nature of these experiences and thereby constructively address them.

There is great pressure for the analyst to alleviate these experiences and, furthermore, when the traumatic complex is triggered, as inevitably happens at some point, and the patient is retraumatised, certain dynamics follow that can be extremely distressing for both patient and analyst, as communication, understanding and trust can break down. I will be exploring these dynamics in depth and, in the workshop section of the morning, looking at examples which participants are welcome to bring.

I have called these states of mind primitive because they are powerful, intense and all-consuming (the individual has few resources to contain or alleviate them) and, as I will explore more fully in the talk in June 2017, they are related to primitive fight, flight, freeze, collapse and hypervigilant states which we have in common with many animals (I will be exploring Porges’ polyvagal theory related to this).

Primitive states 1Psychoanalytic theorising typically holds the patient responsible for these responses, yet their primitive nature shows that they are way beneath the level of intention, which suggests a different attitude and manner of working with them in the analytic relationship. Jung’s concept of the complex is invaluable in helping us conceptualise, understand and work through these most disturbing and distressing experiences and relational dynamics.

With many thanks to Joshua Tutt for the illustrations.

To book Marcus’ talk

 

Leave a Reply

Your email address will not be published. Required fields are marked *