Trying to Enter the Long Black Branches: The Analysis of Autistic States in Adult Patients

Abstract

Never to enter the sea and notice how the water divides
With perfect courtesy, to let you in!
Never to lie down on the grass, as though you were the grass
Never to leap in the air as you open your wings over
The dark acorn of your heart!
No wonder we hear, in your mournful voice, the complaint
That something is missing from your life!
(Mary Oliver 1997)

The verse from a poem by Mary Oliver’s poem, may speak of those who are mysteriously attracted to the analytic couch, whether it is to recline on it or to be seated behind the head of it. Perhaps what is initially missing from the lives of each of us is emotional contact with an elemental quality of self, a certain kind of lived experience akin to entering a courteous sea, being one with the grass, leaping in air, and even opening to the dark acorn of the heart.

Such unlived and unheard aspects of self, and their uncontained perceptions of encounters with the agony and ecstasy of living, often inhabit a hidden capsule within the ordinary neurotic, borderline, or psychotic adult. When a ‘coincidence of vulnerability’ in analyst and analysand occurs, impasse and interminable frustration is often the result for each member of the analytic couple.

This capsule may alternately be buried in somatic symptoms, encased in extremes of acting-out, ensconced in therapeutic enactment, and overlaid with a verbal message that may be deceptive in its expression. However, as disturbing, misleading, and distracting as these decoys may at times be, their effect upon the analyst (if one can bear to suffer it) is imbued with meaningful-if-encrypted communications, signaling a point at which a new aspect of ‘self’ might emerge. Unfortunately, encapsulations in the analyst’s personality, if left undetected and unexplored, can obscure insight, rendering the analyst deaf and dumb, unable to hear the infant in the adult, or to articulately cipher his plight and the analyst’s role in its revival. 

Dr. Judith Mitrani

 is a Member and Training and Supervising Analyst Emeritus at The Psychoanalytic Center of California in Los Angeles. A Fellow of the International Psycho-Analytical Association, she has published numerous papers in the area of primitive mental states in both international and American peer-reviewed journals and many edited books, and her work has been translated in twelve languages. She is the author of the books Framework for the Imaginary: Clinical Explorations in Primitive States of Being (1996, second edition 2008); Ordinary People and Extra-Ordinary Protections: a Post-Kleinian Approach to the Treatment of Primitive Mental States (2001); and Psychoanalytic Technique and Theory: Taking the Transference (2014). She is also co-editor — with her analyst/husband Dr. Theodore Mitrani — of the books Encounters with Autistic States: A Memorial Tribute to Frances Tustin (1997) and Frances Tustin Today (2015). She is the founding Chair of the Frances Tustin Memorial Trust (1995-2018) and still publishes, supervises, and lectures internationally on topics related to the treatment of autistic states in adults and psychoanalytic techniques with infantile transference. During the COVID-19 confinement in France, she wrote and published “The Most Beautiful Place in the World: A Memoir of a Psychoanalyst and the Realization of a State of Mind” and a Mystery Novel, “Couched in Blood,” both available on Amazon. She now resides in Paris, France with her husband Theodore, a retired Child/Adolescent/and Adult Psychoanalyst, and her tabby cat Mickey. 

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