BRITISHJOURNAL OFPSYCHOTHERAPY

EDITORIAL

Volume 26, Number 3, August 2010bjp_1185 271..273

In my last editorial I wrote about the space that the BJP provides for‘detailed clinical work’ that ‘can be published and debated’, and the first twoarticles in this issue take up the opportunity fully. Anna Bravesmith’s andJackie Gerrard’s papers present the reader with a set of questions aboutcontext, modality, depth, transference and counter-transference in brief andlonger-term work respectively. The detailed presentation of clinical workallows the reader to engage fully with the process in the room and, equallyimportantly, in the therapist’s mind. Both papers offer a most open accountof the therapist’s deliberations.

Anna Bravesmith, in ‘Can We Be Brief?’, writes movingly about briefwork with a traumatized patient in primary care. The context is one ofNICE compliance and the Improving Access to Psychological Therapiesprogramme, with known difficulties for psychodynamic approaches inmaintaining their identity and availability to patients. Bravesmith’s is avery full account, with discussion of the implications of manualization forpsychodynamic work, of the particular techniques that may be employedin brief work, and emphasizing the interactive dialogue with the patient inarriving at an agreed focus for the work. Stressing that brief work is not‘simply a short version of long-term work’, and against a manualizedapproach, Bravesmith presents her work not as a prototype but as her ownway of working, and as a contribution to the development of clinical tech-nique. In particular, she addresses the role of the brief therapist in workingwith the patient’s defences: seeing brief work as a space in which to ‘bearwith’ the defences, rather than ‘strengthen’ them, for the latter mightmake subsequent psychodynamic work (should the patient seek it) moredifficult.

Jackie Gerrard, in ‘A Question ofAbsence’, takes us,directly, to the heart ofthe therapist’s dilemma: how to maintain a therapeutic stance when thepatient attends erratically, if at all. Gerrard interrogates her counter-transference meticulously, noting how (under the persecutory pressure of the

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patient’s absence over long periods in the treatment) she ‘became’ thecondemning, critical, punitive and rejecting mother that the patient had,actually, experienced. Gerrard’s hypothesis is that the absences were ‘neces-sary to convey, very powerfully, experiences that may not have been commu-nicated by regular attendance’. Noting that she was driven to the borders ofinsanity herself, Gerrard observes that ‘the relief of being able to process myresponses as fragments of my patient’s mind in her family of origin couldrescue my sanity’. Equally moving is the account, in Gerrard’s ‘After-thoughts’, of the dialogue between her and her patient about the paper (thisone) that Gerrard had written about her. It is moving because the patientcould bear knowing this, and could think about what her impact on hertherapist had been, in asking her, simply, ‘What am I like?’. One is left toponder the possibility that it was knowing that she really was held in hertherapist’s mind – as a writer, giving voice to a set of reflections about her thatmight be importantly true even if not wholly flattering – that may haveallowed her to make the developments in her external life that Gerrardreports.

We then move to two bodies of thought, and their bearing on psycho-analytic conceptualization in the round. Firstly, Steven Mendoza, in asearching, demanding meditation on the practice of Buddhism and of psy-choanalysis, ‘The O of Emptiness and the Emptiness of O’, finds a simi-larity between Bion’s sense of O and the Buddhist notion of emptiness. Ashe says, the paper is based on ‘personal experience of involvement in bothdisciplines’, and an awareness of the often-cited influence of oriental ideason Bion. In arguing that ‘the dual view of emptiness [in Buddhism] can beseen to be equivalent to Bion’s theory of thinking’, he extends the obser-vation to its grounding in the consulting room: Bion ‘is not talking abouthow the philosopher knows the world but how the analyst knows himselfand his patient’. With complex symmetry, he concludes that ‘Bion teachesthat we must be empty so that the patient can fill us. Buddha teaches thatthe realization of emptiness as wisdom is the means to the cessation ofsuffering’. Mendoza’s article leaves one to consider that while the word‘suffering’ might have different referents in a Buddhist and apsychoanalytic-clinical context, the affective impact may not, ultimately, beso different.

Secondly, the BJP owes Marguerite Valentine a considerable debt for herwork in bringing together an invaluable group of papers on the work ofIgnacio Matte Blanco. She has introduced the papers in a concise EditorialIntroduction, and I shall not duplicate her contextualization. Suffice to saythat Matte Blanco’s concepts of symmetrical logic, propositional function,the equation of the logical properties of the unconscious and of affect, andthe stratification of the unconscious come vividly alive through an initialtheoretical exposition by Richard Carvalho, followed by imaginative clinical,aesthetic and theological treatments by Alessandra Ginzburg, Marguerite

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Valentine and Rodney Bomford respectively. Here Matte Blanco’s principleof ‘unfolding’ or ‘translating’ of the unconscious is applied to an understand-ing of obsessive jealousy as a clinical phenomenon, an iconic cinematicrepresentation of the Vietnam War, and the nature of mystical contempla-tion. The papers speak for themselves.

Ann Scott[annscottbjp@aol.com]

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