What is the role of psychoanalysis at a time like this, when we all have reasons for anxiety? There is, obviously, the basic fear of catching the virus and becoming ill. But the crisis has brought concomitant concerns. Lockdown is terrible for many people, leading to money worries. In some relationships and families it means increases in domestic tension and even abuse. People who are in strict isolation\u2014the old and those otherwise particularly vulnerable\u2014are often depressed.<\/p>\n
Workers on the front-line\u2014in the health service, care homes, supermarkets\u2014are not only exposed to risk of infection but have also seen their workload increase exponentially. Others\u2014the unemployed, the laid off, the furloughed and those suspected of having the disease\u2014suffer from an opposite threat: that of idleness and loneliness.<\/p>\n
An emergency like this one not only sparks new, rational fears; it can also reignite old, irrational ones. For example, both the threat of the virus and the measures put in place to limit its transmission may heighten someone\u2019s pre-existing paranoid tendencies.<\/p>\n
So no one would claim the situation was anything other than very difficult. But as well as hardship and fear, there are opportunities for valuable change. And we psychoanalysts might be able to help here.<\/p>\n
Wilfred Bion, Samuel Beckett\u2019s therapist, used to say that his job as a psychoanalyst was to introduce a patient to the person with whom they\u2019ll have most dealings throughout their life, namely themselves. (As if one has never met oneself at all.)<\/p>\n
Critics might demur. Is not psychoanalysis navel-gazing? Is it not indulgent, narcissistic? Of course, it can be. The therapist may fail to see or take up the patient\u2019s narcissism, or may be narcissistic him or herself. But the space given to the patient for thinking should lead to awareness of\u2014and empathy with\u2014other people, as well as to himself. The same is true for the analyst.<\/p>\n
Bion once commented: \u201cIt\u2019s fascinating how boring this patient is.\u201d His fascination with this \u201cboring\u201d patient would have prompted him to consider whether his reaction said more about himself than about the patient. Or was there something in the patient\u2019s way of being and talking that was shut down, closed off? Perhaps the patient was deadeningly deferential, puffed up with pomposity, or full of hidden resentment. The analyst\u2019s work is to help the patient to be less clamped up in the \u201csame old\u201d ritualised emotion and thinking, and to be less full of fears arising from their unconscious assumptions and from nightmarish fantasies.<\/p>\n
Psychoanalytic therapy, when it works well, addresses the self and the other simultaneously. The pianist Jonathan Biss has, over the past nine years, recorded all 32 of Beethoven\u2019s piano sonatas. Asked if he had learned a lot about the composer as a person, he responded: yes, he had learned not only about the composer\u2019s intensity, but also his humanity; in such a turbulent person there was a great deal of love, even tenderness. But Biss believes he himself is a better person for it, more aware of the humanity in the other. \u201cThere is nothing like Beethoven for enlarging one\u2019s empathy,\u201d he suggests.<\/p>\n
A relative of mine told me that she had felt low for the last few days. She hadn\u2019t been able to get to work on her book. Then a word occurred to her: what she really felt was \u201cwinnowed\u201d (the word refers to the separation of wheat from chaff by air currents). I said \u201cWell, that\u2019s something to think that!\u201d \u201cYes,\u201d she said, \u201cI\u2019ve felt less depressed after the word came to mind.\u201d She had got hold of a fine, open-ended image. It freed her from being over-dutiful, or was, at least, part of that process. Sometimes, finding a word can lead to a sense of achievement and release.<\/p>\n
Finding an image may enliven us, too. Our three-year-old granddaughter, who is in lockdown abroad in her father\u2019s hometown, drew a picture, one element of which was a tall yellow shape, perhaps a house, perhaps a person. Asked by my wife what the yellow was, Maia said, \u201cIt\u2019s something that helps me talk about things when I can\u2019t.\u201d They talked more. Since then, her English speech, which developed a little more slowly thanks to her bilingual upbringing, has come on fast; she has also become more relaxed, more settled, less volatile. She loves stories, even over Skype. Her pictures tell stories, as do her words.<\/p>\n
During the time of lockdown (and after), might psychoanalysis find a wider place in society? Full psychoanalysis occurs clinically when patient and analyst meet several times a week, without any pre-set ending date. Each session offers a pause from the routine, pragmatic activities of everyday life, including earning a living, and a space in which one is not in the bosom (or whatever) of the family. It offers a space in which thoughts and feelings hitherto unknown (or \u201cunknown knowns\u201d) may be articulated. Patients may come to realise that they are imprisoned by basic assumptions and repetitive patterns of feeling, thinking and behaviour, and thus become freer.<\/p>\n
Not everyone is suited to the intensity of orthodox analysis. Nor can everyone afford the time or money; it\u2019s a labour-intensive process. But in this current, universal crisis, whether overwhelmed with overwork or desperate in isolation, people need help, sometimes urgently. We are, essentially, all in it together, however much the burden falls more heavily on some than on others. We all may struggle with old panics, with a sense of not being good enough, with terrors flaring up through imagination. We all need to find ways of creating a pause, and of being listened to. Even a short conversation with an analytic therapist, not part of a formal programme of therapy, may be beneficial. It may re-set our thinking and orientation.<\/p>\n
Psychoanalysts are tentatively setting up help-lines. In London, some are making themselves available to hospital managers and to other NHS workers. I heard of one twenty-minute conversation arising from an emergency call to an analyst in Lisbon. The analyst was able to help the caller begin to \u201cwinnow\u201d his past terrors (of death) from the current situation, to turn ghosts into ancestors. He could begin to make that distinction for himself. He left the conversation less terrified than when he began, with a new tool for thinking at his disposal.<\/p>\n
It is only a beginning. I am aware that we are a long way away from psychoanalysis being a port of call for most people. But a journey around the world has to start with a single step.<\/p>\n