Book Review Seeds of Illness, Seeds of Recovery by Antonino Ferro. London: New Library of Psychoanalysis/Routledge, 2004. 125 pp.
Laura Ambrosiano (Italian Society)
In order to comment on the latest book by Antonino Ferro, I should like to take as my point of departure a metaphor which will serve as an orienting theme for presenting my observations. As one reads this book, one has the impresssion that Ferro is inviting the reader to his analytic restaurant, where he displays the rich range of dishes that are offered to the patients. The clinical vignettes enable us to grasp and appreciate the way Ferro communicates with the patients, his mobility and his permeability during the session.
On the other hand, when Ferro leads the reader into the kitchen, he shows all the prudence and modesty of someone who is aware of being in an intimate and personal space, a space where disorder may reign, where the tools of the analyst and the ingredients offered by the patient in the form of raw material are piled up pell-mell.
In this brief commentary, I want to try and take a quick peep into Ferro’s psychoanalytic kitchen, by making use of the discreet invitations scattered throughout the text.
In so doing, I shall only be able to describe my own Ferro, as Ogden says in his introduction, that is, the Ferro encountered in his publications, but also the one that I met often at the Centro Milanese di Psicoanalisi, along with other leading figures and authors who have marked the evolution of the Milan group.
What interests me personally is to follow Ferro’s psychical apparatus in what I imagine to be a perpetual movement back and forth between the restaurant and the kitchen, crossing a corridor (the contact barrier) which distinguishes and connects the two mental dimensions.
Among the analytic tools that I seem to get a glimpse of in the kitchen, I notice, slightly unexpectedly, Freud’s lesson ‘Constructions in Analysis’ of 1937. I am referring to what Freud says when he describes the way that the analyst, starting from the raw material provided by the patient (dreams, memories, associations, transference), proceeds by successive integrations and recompositions to formulate constructions. For Freud, constructions are vast elaborations of a series of polyvalent and contradictory conjectures; they are hypotheses waiting to be verified or refuted. When the analyst formulates these conjectures, Freud continues, he cannot forget that the analysis is an encounter between two different scenarios, and that the link between these two scenarios, that of the analyst and that of the patient, is problematic and can be a source of errors. To my mind, the link to which Freud refers approximates to Bion’s formula of contact barrier, to the corridor between the kitchen and the restaurant.
The analyst’s errors, Freud adds, can be corrected and the construction rectified by virtue of the new material proposed by the patient.
When the construction is probable, we have the strong conviction of having found in the raw material a point of encounter between past experience and present experience, of having identified intimate relations of meaning between there and then, between here and now, between internal world, transference and the analytic relationship.
Taking up again these passages of Freud, Bion reformulates them in terms of the notions of constant conjunctions and selected fact. The selected fact introduces unexpectedly a new meaning where before there reigned the chaos of the raw material: detached and non-homogenous perceptual and proto-emotional fragments which are waiting in the kitchen for a psychical apparatus capable of thinking them. The selected fact is not a conscious mental operation; it emerges, and the analyst has the responsibility of gathering and transforming it into a shared language, that is, of cooking it, so that the patient can benefit from it.
The selected fact emerges when constant conjunctions appear which will facilitate the thinkability of the ongoing experience.
Grasping the constant conjunctions so as to be able to identify a selected fact is a work which is carried out in the psychoanalytic kitchen, before serving at table. The analyst’s intervention is the fruit of this work; it bears its traces, but it is also dissimilar from it because the raw material has been the object of a complex mental manipulation.
This is why I think that it is important, having been guests in Ferro’s restaurant and having appreciated his gifts as an original and creative cook, to go into the corridor – the contact barrier – and from there to imagine the kitchen.
In this kitchen, instead of vivid and lively interventions illustrated by clinical vignettes, we find the long wait.
The patient, Ferro writes, does not cease to recount his experience, past and present, giving the analyst the possibility of ‘modulating his participation’ according to a ‘common theme’ which allows him to regulate his comprehension with increasing precision, until the moment when a selected fact suddenly emerges, reorganizing the whole.
This long wait enables the analyst to acclimatise himself to the material proposed by the patient (to use C. Neri’s fine expression), which naturally includes the way the latter understands or does not understand the analyst’s interventions. H. Faimberg and L. Nissim Momigliano have explored these aspects further. Their contributions facilitate Ferro’s work, for instance, when he apprehends his own errors or the patient’s incomprehensions as fissures, he writes, through which undigested facts of the past and unthought material from the patient’s history and internal world erupt into the here and now.
Obviously, it is the work that takes place in the kitchen, more at a distance and less published, which gives us the impression that Ferro’s interventions described in the clinical vignettes have a character of specificity.
Faced with his patients’ communications, Ferro, as he says, and as he theorizes coherently, privileges the axis of the here-and-now, the dysfunctionings of the analyst’s psychical apparatus as they are gradually understood by the patient. But his restitutions are impregnated with the patient’s emotional history; they retain her/his idiom, they touch her mental functioning and that of her internal objects.
Whereas with Camilla he speaks of the “fear that one sprays deodorant to avoid having to face something disagreeable”, with Francesca he speaks of her “need to flee from an analyst whose psychical apparatus is humid and soaked”. With Clara he speaks of the “experience of abandonment that the analyst’s distracted listening arouses in her” whereas, with Igea, who seems to notice that the analyst’s psychical apparatus is obtruded by a dark anxiety, he speaks of an “allergic reaction which covers her with rashes and blisters”. And so on, with each clinical vignette. Each of the analyst’s interventions seems to bear a specific character, namely that of the particular language we speak with each patient, but also that of the patient’s personal vicissitudes, of her history as it has continually been recounted during the session.
In Ferro’s kitchen constant conjunctions stand out which emerge from the journey back and forth that he makes between the past and the present, between the internal world and the analytic relationship. From this coming and going the selected fact emerges that allows him to cook the elements that he will offer to this particular patient in the restaurant.
The psychic structure is transformed, but it retains an element of invariance which renders it recognizable in its specificity.
Ferro’s kernel of invariance is certainly represented by his theoretical hypotheses, by the Bionian matrix of his thinking, as it has been revisited by Corrao, Gaburri, Neri, Riolo, Ferro, and others. But the other kernel of constant conjunctions derives from his way of continually retranscribing the patient’s history into the language of the session and of the analytic relationship.
A young girl was brought to the analyst because she had inexplicable pains in her legs, pains that were so violent that they prevented her from sleeping and made her scream. Ferro’s narrative of a mother “inhabited by a pitbull biting the young girl’s legs” seems to present itself to the reader as an hypothesis capable of giving meaning to the field. I suppose that it emerged after other hypotheses had alternated in the analyst’s psychical apparatus, hypotheses that he perceived as being too partial or not expressive enough.
We can imagine that much long work was necessary before arriving at this hypothesis, silent work during which the analyst’s psychical apparatus constantly recounted the story of the little girl, but also hard work to maintain within the field his own pitbull aspects which were no doubt the key to the inception of the hypothesis itself.
Bion taught us that each analyst gives different interpretations depending on his theories, understanding theories as groups of transformation of raw material, which means that each analyst favours different invariants. The invariants depend on the technique used, just as the painter transforms things in terms of the type of vision that he wants to communicate. It nonetheless remains indispensable for us to identify the stable elements in order to be able to recognize what changes.
The themes Ferro works on and privileges are, as he says, already known: the centrality of the personages who appear in the session; the occasional signalling of the dysfunctionings of the analyst’s psychical apparatus by the patient; narrative transformations, the dream thoughts from the day before, and the micro-transformations during the session. Alongside these themes, which constitute the invariant elements of his theoretical references, in this text he shares with us his way of understanding pathology, the elements of the diagnostic work which is specific to the analyst in the consulting room. It is not a question of constructing a nosography, but of grasping the loci of the patient’s specific pathology: a deficiency of alpha function, traumatic situations provoked by an excess of beta elements which hinder thinkability. It is thus a question of loci of pathology, of diagnostic places that are of immediate use to the analyst in the session, which can indicate to him the priorities and timing that should modulate his presence. This way of seeing pathological suffering implies a conceptualization that is different from notions such as narcissism, omnipotence, the death drive, the compulsion to repeat, the defences etc., which Ferro considers from the viewpoint of the success or failure of the encounter with the other.
Corrao says of the observation that the analyst makes of a particular event that it is structured by the co-presence of continuity and discontinuity. Each of the movements of one of the interlocutors present in the session modifies the situation, produces a new state of the field. As Riolo stresses, it is the event which determines the state of the field and makes it describable.
All this makes it possible to understand the apparently bizarre, technical suggestion that Ferro puts forward in this book: ‘speak before thinking’, a suggestion which seems to evoke the famous reversal effected by Lacan of the Cartesian affirmation cogito ergo sum into I am where I do not think.
In Ferro’s metaphor, the kitchen is the mental space where the transformations take place which permit us to intervene with our patients; it is from the kitchen that the elements and the conjunctions of elements emerge, which, through the contact barrier, can be manipulated in order subsequently to be brought into the restaurant.
The work taking place in the kitchen is not conscious and this is why, I think, Ferro speaks about it less, or in terms that are already organized theoretically. This, however, entails the risk that the reader may get the impression that he is only being offered the final product of his work, already ready for the restaurant, which may come as a pleasant surprise but also sometimes arouse a feeling of incredulity. The impression the reader may sometimes get when reading the clinical vignettes is that they are easy to interpret precisely due to this difficulty of inviting us into a mental space/kitchen which does not have the characteristics of consciousness. It is then up to the reader to notice the pauses, the moments of suspension, of trouble or confusion which, like brief sighs, form part of the otherwise rapid and brilliant rhythm of his narratives.
On the basis of invariants the analyst notices that the facts about which the patient is speaking to him are the same as those that have appeared as symptoms, as fear, as hypochondria, as delusion, as transference, as personages, that all these communications manifest the same mental functionings.
It is the observation of the patient’s mental functioning, as well the analyst’s, that Ferro privileges, convinced that “if it does not encounter another psychical apparatus capable of thinking and metabolizing the experience”, the psychical apparatus fills itself up with dinosaurs, with killer thoughts, which become increasingly unthinkable, split off and dissociated.
For this function to be effective, a great deal of work is needed in the kitchen. Before being a place where the raw material is elaborated, something of which Freud spoke, the kitchen is the place where the long wait of the analyst occurs (negative capacity, arrest in PS, unsaturated thoughts), until a constant conjunction emerges, offering a vertex of transformation into O.
To tolerate this waiting, one has to have great confidence in the psychoanalytic instrument and in its capacity to extend the quotas of thinkability. My gratitude towards Antonino Ferro is linked to this confidence which the reading of his writings succeeds in enlivening.
(translated from the French by Andrew Weller)
n1 These new aspects were particularly highlighted in the presentation of the book that Monica Horovitz made at the EFP Conference in Vilamoura, 2005.