The psychoanalysis of writing blocks: Resolving repression/ dissociation of trauma.

Resolving Writing Blocks in a Psychoanalytic Case

I have been seeing a woman in psychoanalytic treatment for 3 years now, who has writing blocks as her main issue.  She has been seeing me four times a week for almost two years now, and had been in treatment for a year before for 2 and then 3 times a week.  What is so striking in working with this woman, who I will call Renee, is that she has a primal trauma that we continuously see interacting with later levels of un-mourned losses and traumas, but also with significant degrees of repression of instinctual aggression.  We discover the devastating effects of the primal trauma to be continuously interacting with other levels of agony, which have had to be defended against. Rage emerges in the transference as going on strike against writing, where I interpret that Renee is acting out her rage by going on strike, screaming without words “I won’t produce for you.”

Renee turns her anal level rage against herself, in both mental and physical ways, until this rage emerges in the transference.  This blocks and paralyzes her.  However, it is overlaid with an earlier level in which she is profoundly attached to an absence, or in Wilfred Bion’s words a “no thing” (Bion, 1992). We discover the later stages of conscious memory, which reveal the meaning of the repressed rage, and its accompanying anguish.  Renee and I keep discovering specific subjective experience from other ages and times.  And all this does open Renee’s capacity to write, but every time Renee returns to the repressed trauma and loss, she can lose her ability to remember anything that has come before in the analysis.  In Thomas Ogden’

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terms, she loses her ability to be an “historical subject” (Ogden, 1986) as well as to be an “interpreting subject.”  Temporarily words become meaningless.  Consequently, Renee rejects me, the analysis, and interpretations at such times.

Renee comes alive again; however, as I interpret what triggered the new phase of the writing block.  More crystallized memories open, as Renee’s affects open.  Renee feels the past now, rather than just reporting it.  She begins to use words creatively once again.  Simultaneously, she begins to take in my words.  She begins to understand the symbolic meaning of the words in interpretations once again.  Further, she begins to be able to build on the analyst’s interpretations.  Following this, Renee is also able to write short stories again.  I can illustrate parts of this process.

Negative Transference

When Renee is blocked she shouts in her rage: “You don’t understand the frustration.  I am going to die without being able to do the one thing in the world I want to do more than anything!  This bullshit takes forever and I still can’t write.”  In truth, she has written several short stories since she entered analysis; but all this is wiped out for her as she once again feels like she can’t access feelings, and therefore cannot make words meaningful, because neurotic repression takes over.  However, Renee’s regression to dissociation compounds this.  At such times Renee can’t even remember what came before she became blocked again.  In fact, Renee blocks her capacity for experiencing time, and consequently time stands still.  Time is frozen, and words no longer have meaning or impact.

Nonetheless, as we work through another phase of memories, integration of memories, and pre memory trauma, I face Renee’s rage.  This is an old childhood rage that Renee had formerly turned against herself, until her muscles become paralyzed.  A new phase of reparation follows, and Renee begins to write again.  The repression block dissolves, and Renee opens to new memories.  She becomes present and intimate through conscious feeling and transference projections, as her feelings are felt in the present through the object connection with the analyst, and through her transference projections.  With each phase of conscious resolution of blocked memory, and with each phase of anger and sadness within a “Developmental Mourning” process (Kavaler-Adler, 1992, 1993/2013, 1996/2014a, 2017 et al.), Renee writes creatively again.

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Attaching to an Absence or “No Thing”

Renee’s earliest experience of trauma seems to reach back to a primal stage in her life, which she cannot remember, because she had no conceptual memory from that time.  Yet her unconscious remembers within her body, as well as through fantasies that evolved around the subjective experience of devastating primal loss. At one year and 9 months old, Renee’s mother left for a week to go to a hospital to give birth to her younger brother.  This is a common enough occurrence. Yet, for Renee her mother’s absence was at a critical time in her development, when she would have needed to “image” her mother at times when her mother wasn’t physically present (Mahler, 1971, 1975, Kavaler-Adler 2014b). She would have needed to be able to keep her mother alive in her mind until her mother actually returned. However, with the mother’s prolonged absence at this time, Renee could not have been capable of imagining her mother in her mind, to keep her mother psychologically alive. Renee enacts this in her analysis as the wiping out of time, memory and the meaning of words. Such defensive response also enacts the reoccurrence of developmental arrest, due to Renee being traumatically overwhelmed with a lifetime of rage. Yet there is a fantasy that is born in the transitional space between the patient and the analyst, a fantasy image that begins to define that which was only an absence, a “no thing.” Renee begins to see herself as the sole survivor after a Holocaust. She is all alone. There is nobody else there, which she begins to interpret as nobody else is alive. Grasping this image is the beginning of not being “all in it,” all in the infinite psychic void. She is enough outside of it now to see herself all alone in the world. However, as she relives this void experience, this “no thing” experience becomes modified.

Formerly, this void experience operated as an encapsulated and dissociated state. Yet, in the void itself, is the attachment to the “no thing,” or to what the poet Emily Dickinson has called “the abyss” (Kavaler-Adler 1993/2013). Why should Renee have to keep returning to this “all alone in the world after a Holocaust” experience? From Fairbairn’s perspective Renee is attached to the ‘”bad object” mother who was not there at this time, beyond what her infant mind could comprehend. From Bion’s perspective she was attached to the “no thing” absent mother. The mother herself was experienced through the absence of her, as well as through the child’s need to cling to the only mother that was there. Otherwise there is only psychic death. Consequently, the absent mother actually became part of the mother inside of her internal world. Further, in Bion’s

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terms, the absent mother can become an attacking mother within the Internal World (Bion, 1962).

So Renee keeps returning to the mother repeatedly. In the more Kleinian experience, before she could feel a subjective sense of self, I was the transferential cold ice breast.  Renee would say to me: “You’re as cold as ice.” Other times she would say I was revealing a compassion and warmth.  However, for a long time, I was just “cold as ice.” Yet Renee couldn’t leave. She was attached to the hope of psychoanalysis helping her.  Also, part of her remembered something meaningful had happened with me, as time went on.  But during the return to the “no thing” she would only experience me as the cold ice breast, which was not doing anything to help in her state of helplessness. And she would tell me that my words were all “blah-blah-blah,” meaningless impotent things, annoying her, enraging her, showing her how useless I was to her.  Yet she was attached — to me as a “no thing,” and to me as an “ice breast.” I was seen by her as unwilling to reach out a hand and rescue her from an unbearable state.  This is what people generally fear about analysis:  reliving the unbearable states that never had words or meaning to contain them. These states have actually been in the present, but were repressed, resulting in body/mind symptoms, not in the dissociation of whole parts of her psyche, as in more primitive character disorders.

Ronald Fairbairn (1952) would call it the return of the repressed, and would see it as the real bad objects from infancy coming out into consciousness, causing terror. Renee’s rage had a terror in it. However, when we got to Renee wanting to knife me, choke me, chop me up, and dismember me, she began to feel the power of her dissociated aggression. She began to feel some power. Consequently, she did not have to keep clinging to an absence, or to a “no thing” or “ice breast.” Then I could feel with her. Renee would then let me come alive again, as a Being resonating with her, as a presence she acknowledges.

Other Memories, Other Ages, Other Losses

Then she becomes seven years old.  The scenario came to life, as the blocked affects of grief pressured Renee into defensive opposition again. Going on strike against her inner life always sabotaged her.  But this was what was built into her psyche, with its unconscious defense that walled her off from her repressed feelings, impulses, bad objects, and memories.

Renee began to visualize the bricks in the wall inside her mind. Over time the bricks softened into wood, and more flexible yielding material. But at first the wall had bricks that were

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dense with the tension of solid resistance, which often manifested in her muscles as she got headaches, constipation, and helpless paralysis. Her inner affect escalated into what she described as “funk.” Renee also agreed when I called it shit.  It was a shitty feeling to feel blocked off and emotionally constipated, whether or not she became physically constipated.  Renee had built in each brick, although she couldn’t access her aggression consciously, not until her rage towards me in the transference, and towards her mother in her Internal World, opened into consciousness. Before, she had only felt like a helpless disempowered victim.

I propose that the absent “no thing” had been the internal mother of traumatic separation, from her second year. Such a “no thing” mother transformed into the actively abandoning mother in a memory from 7 years old. Renee lived this abandonment out with me, when she accused me of sitting back, while she was frustrated beyond endurance, fearing her life would end before she could write. Of course, Renee was forgetting she had been writing – several short stories that had won praise and interest. Renee threatened to quit analysis.

Renee demanded help, but also rejected the kind of questions I offered as help in a typical scenario of anal type of resistance, rather than relatedness. She was on strike! Unconsciously, she enacted “I will not produce for you!,” and I referred to her toilet training that had overlapped the era of her mother’s initial abandonment, when she was one year, 9 month, old. But under the passive resistant aggression, was the vulnerable child who felt she had lost her mother for good.  And although the earliest level was from a preverbal era, when she didn’t yet have words and concepts to be able to remember, the later levels of re-living the abandonment were increasingly ready to become conscious as conceptualized and felt memories, rather than as hysterical body conversions into her muscles.

So we entered the land of her seven year old agony together!  I had accepted her hatred, and so now Renee began to speak to me. She remembered crying profusely on one poignant night, when her mother was going to leave her with a baby sitter. Her mother and father, and another couple who she was taught to call Uncle and Aunt, were all going out to dine together.  They were eager for sharing their adult company for an evening. But Renee was bereft beyond relief!  Her crying was exhaustive and mind annihilating. She could not stop. The unconscious fears of drowning in her tears threatened to swallow her up. She choked. She felt like she couldn’t breathe. She did not know or conceptualize her agony at the time. Nevertheless, she could now have a memory of the scene, which testifies to her mind operating at a higher

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conceptual and visual level than at one year nine months. At seven years old Renee could conceptualize that her mother was leaving.  She desperately wanted to stop her from going!

Renee conjectures that her mother may have tried to soothe and reassure her for a while, but ultimately her “Uncle Paul” demanded that they finally exit, and go for dinner. When Renee’s mother turned and agreed to leave, Renee felt something else besides endless grief from object loss. She felt that her mother always rejected her to cooperate with someone else. She felt that her so-called Uncle was more important to her mother than she was. She relived this intense feeling state on the couch with me.

So in crying again, Renee remembered the feeling of sobbing so profusely, and for so long, that she thought she would die. But what came to her now was that she could travel through the sense of self-annihilating absence of the other, to a higher level conceptualized feeling of rejection. It was a shitty feeling, as well as a very familiar one, but it was not the more primitive “no-thing” of self-annihilation. It was the feeling of humiliation. Renee becomes conscious of feeling like shit. She was the discarded turd. She was disposable. But she still existed as a person. She was no longer in a void after a Holocaust. She was now aware of being on the outside, excluded, so she was not all “in it.” It was not just blackness and death that triggered a sense of her self dissolving and losing all shape. Renee now had shape. But she was shit. Shit has shape, but it also smells and drives people away.  Shit has no self-agency in it.

Through re-living her repressed agony of abandonment, mixed with rejection, Renee began to be able to write about her rage.   In fact, she wrote a story about her anger at me, related to when I failed to quickly comply, in the manner that she thought was in her word, “only human,” when she requested I lend her an umbrella. At first, blocked by guilt about writing critically about me and triggering the internal mother’s persecution, she was able to move forward into her tale that mocked me, the anonymous analyst in the story. She turned rage and hatred towards me, with all its transferential overtones, into creative writing. Renee began to transform anger into humor too, as well as into love and forgiveness. This was all part of her “developmental mourning” process (Kavaler-Adler, 1992, 1993/2013a, 1995, 1996/2014a, 2003a, 2003b, 2013b, 2014b).

Forward and Back in Time:  Increasingly Emerging Out of Repression

As I said, there were times when time was totally annihilated for Renee. She just felt like I was the withholding ice breast, or the inadequate shit breast. Then she was left in the lurch, in a

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No Exit scenario, which could only lead to death in her mind. In Kleinian terms, Renee had regressed back to the Paranoid-Schizoid Position, where there was only “the thing in itself,” with no symbolic representation of her sensory and mental phenomena. I was then Bion’s “beta element,” (Bion 1962) or Hanna Segal’s “symbolic equation” (Segal, 1985). When she was in this place I wasn’t a transferential mother, grandmother, or father.  I was just an unyielding thing that wouldn’t give to her that which she desperately needed in this negative eternal now moment, where there was “No Exit” in Sartre’s words. There was “no Exit” from murderous starvation that she could only call “frustration.” She came out of this state after I interpreted the trigger to her despair, related to envy of someone from her past.

Renee had been conscious of seeing her own state as one of intense frustration.  However, the degree to which she saw me as a withholding breast seemed to result from projection, with only a minor degree of the more primitive projective-identification, which would have actually induced in me a feeling of being cold, like the fantasized ice breast. Not feeling this clued me in to her capacity to employ the neurotic mechanism of repression, as opposed to being stuck in the more primitive modes of splitting and dissociation. Yet, it was only after Renee’s return from a regressed state that she could conceptualize her earlier experience as self-annihilation at the hands of a cold ice therapist, who was rejecting her by being like a breast withholding milk, or who was stopping her as a “mother’s voice” in her head that stopped her and censured her with reprimands, fears, and threats. Renee could only find such descriptive words when she returned to a depressive position state of mind, where words had meaning.    Only then was the sense of linear time restored. When time was restored, Renee would thank me, because she could then remember what happened between us, and in her mind. Her gratitude was evidence of a depressive position ability to recall the process and gains of her treatment, and to see me restored to a whole person, a picture of me being an experienced analyst who could help her. I was no longer a static, unyielding breast, nor any longer a limp shitty impotent breast that had nothing to offer her. Consequently, her words could flow now, as she was connected to her inner feeling life again.  Her unconscious blocking would return, however.

Another example of this loss of time and process occurred when Renee’s unconscious defenses were blocking her from writing again. In addition, Renee felt like she was uncoordinated in her body. She again felt analysis was worthless bull shit, as she again felt like shit. When I tried to be of use by reflecting back her enraged view of me and her useless

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analysis, she told me I was of no help. I only annoyed her by reflecting back her own thoughts, and trying to find words to articulate the repressed feelings behind them. She balked. We struggled.  She succeeded at making me feel pretty shitty, as she deflected a lot of her shitty rage affect into me, despite her capacity for projection, rather than projective-identification of split-off self parts. She was putting affect into me, but not dissociated self and object parts.  And then there was my own shitty feelings prompted by being rejected.

Renee wrote me an email threatening to not come for her next session, which was the last of her four sessions for the week. I wrote back that we had reached that which had triggered this state at the end of the last session. I suggested that it would be meaningful to follow up. She wrote back: “Blah, Blah, Blah, Blah!” I didn’t respond, and she surprised me by appearing the next day.  Her first words in the session were an ultimatum threat: “If you don’t have something useful to say to me I’m leaving!” She then added, when I decided not to yet speak: “What did you mean about what we talked about at the end of the last session?” I then said it was interesting that she didn’t remember. I added: “You seem to have wiped out the memory of us speaking of your envy of the writing teacher, who had gone to high school with you, and who now had a full career as a fiction author and teacher.” She then said she remembered this. I responded further, saying that she had been triggered into her “funk” state of blockage, and of memory loss, as well as loss of time and meaning, by her envy. I added that it was an envy that she had not been conscious of.

Renee agreed with me. I went on to interpret Renee’s defense process, beyond the content of the last session. I said that she felt like she was just a helpless, passive victim of not remembering something significant at the end of the session. Yet, it seemed to me that she was actively wiping out the meaning that had happened between us, because she wanted everything here with me to be shit, so that she could reject it all, and flush it down the toilet; by not coming to a session, or by leaving analysis altogether. I said that I knew that she didn’t experience herself as actively wiping out her memory of a part of the session that had meaning to her, but that there was an active part of her that was acting unconsciously to do this. I suggested that she gets paralyzed, helpless, and blocked because she does not consciously own this active and very aggressive part of her, a part of her that had a lot of power, power to empower. I also said that I understood that she had been taught as a child to suppress her anger, and that this made her

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helpless, and made her feel she needed someone to rescue her. I suggested that she now had an opportunity to own her anger, and to channel its aggression into an empowered sense of agency.

Renee began to be interested in what I said, and began to volunteer her associations to what I was saying as I spoke. Transitional space opened in time and space (Winnicott, 1953).  A dialogue emerged between us. We now had some transitional space, rather than being locked in a binary polarization between her view and mine, or between her mind and body, or between her phallic power of initiation and her feminine power of receptivity. We now had transitional space within which Renee could listen and understand the meaning of words in my interpretations, as well as understanding the meaning of my relational gestures towards her. My relational gestures had been rejected, such as when I had tried to reflect back to Renee her own point of view.

So I told Renee that she had an active part of her that not only had rage, but had murderous impulses behind it. Responsive now in our dialogue space, Renee was able to declare that she could visualize knifing, choking, shooting, and dismembering someone. I suggested that the someone she felt this towards was me. She could see this. Her ability to visualize began to develop, the ability that she had lost when her mother went to the hospital at one year 9 months.  In Margaret Maher’s words (1971), Renee could no longer image her mother, since the mother had been absent for too long.  At that tender age Renee could not sustain an ability to remember her mother, and to know that her mother would return. Thus she had been (in her mind) all alone after a Holocaust. She then lost her ability for imagination that would grow out of imaging. As she got older, she would actively stop her ability, not only to image or visualize, but also to find words, and to feel the affects behind words to give them meaning. She had been re-living the early loss of her mother by stopping her own ability to have meaning in words, or to have a sustained sense of time and consequence. She had repeatedly returned to a dissociated state of living in a vacuum.

Gradually, Renee is finding words to express her rage in images of murdering, waking from repression. Since I survived Renee’s hate (Winnicott, 1953), she opens to confiding in me.  She begins to feel that the thing that she is most angry about is the death of her grandmother when she was 13, and when she was not allowed to go to the funeral and say “good-bye.” From this realization, Renee begins to recall all these wonderful things about her grandmother’s warm mothering capacity. In fact, Renee’s grandmother had praised and celebrated her when nobody else did! Everyone else saw her as being too aggressive as she became a teenager. Everyone else

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told her to shut up.  Her mother threatened her with the guilt provoking emotional blackmail of saying: “You’re giving me a heart attack.” Earlier on, she had been told repeatedly by her mother to just keep quiet and to “Do what I say!”

As Renee became a teenager she still was not offered any explanation of why her mother was saying what she did.  So she was never encouraged to think for herself.  Becoming a teenager, Renee was seen as really threatening, as her one year nine month old rage became the assaults of a teenager’s accusations and searing curses. She was told to keep quiet in stronger ways.

Renee’s grandmother had listened to her, and now she felt the sadness of having lost her.  Renee began to feel her grief about her grandmother’s death, her capacity for grief affect and memory signifying her developmental achievement of the depressive position. She also recalled that her grandmother had stood up for her, when nobody else did, for instance when she was being emotionally abused by her father.  Renee began to recall a lot more now. A whole phase of remembering and mourning her grandmother unfolded.  She began to imagine that she could write about her feelings, but still worried that she wouldn’t find a plot for a story. Yet, I had seen these doubts many times dissolve into a beautifully evolved short story.

We had gone forward to her grandmother’s death, and now we went back. Renee managed, however, to not return to a full funk state.  This time, due to being aware of what could lead up to it, Renee actually sustained the process of going back into rich memories and feelings.  She could begin to have a beneficial therapeutic regression. Her most difficult feelings were emerging into consciousness, as she remembered rage that had so overwhelmed her in Junior High that she shoved a big desk right into her teacher’s body. Her teacher wouldn’t stand up for her, when the tough girls in Junior High bullied and belittled her right there in class. Renee couldn’t stand the overwhelming rage anymore! Instead of paralyzing herself, she acted out. She was promptly sent to the Guidance Counselor’s office where she didn’t have the capacity to communicate what had just happened.

However, now, in analysis, Renee could put it all together. She realized that she was feeling like a humiliated victim–feeling helpless and paralyzed. She began to convert her aggressive feelings into visceral body channels. She gave herself a headache and pain in the neck, as she remembered being treated like she was a pain in the neck. Meanwhile, the tough chicks of Junior High School were inside her internal world.  Internally, they were telling her

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that she had big feet and was weird in every way. She projects this at her swim club onto anonymous others. She protests in the session, as if she is now in the room with those girls, who had now come out into our transitional world, from her internal world. She says: “And I don’t even have big feet.”  I reflect back my compassion for feeling humiliated, mortified, shamed, and belittled.  But I then say “Now imagine you being the girls, and you screaming your anger out.”  She began to get into it. I said both parts of this memory scene are you, just as both parts in a dream are you.  You were the bullied victim, but now as you recreate it, because you were forced to identify with your abusers, you are also the bullies. You are actively recreating them. “So now own it, and say what you want to say back to them by being in their position. Be the bitch towards the bitches.”  She begins to do this, and her headache begins to go away.

Renee is seeing that she has a choice to feel her aggressive side now, and to put it in to words, so that it doesn’t destroy her or me, or anyone.  I tell Renee that she can re-empower herself in this way when she sits down to write too.

The Road to Bringing the Dark Side of Creativity into the Light

In some sessions with Renee, I feel temporarily transformed into the ice breast, as well as into the shit breast, going briefly beyond projection to projective-identification.  However, the boundary between me and Renee is clearer than in full Borderline Personality cases.  Renee may regress to borderline phenomena, but she does not have the fundamental psychic structure of a Borderline Personality.  She operates out of a neurotic psychic structure most of the time, and has containment with unconscious repression.  Her dissociated states are encapsulated and limited, related to pre-oedipal trauma, which is pre-conceptual and preverbal.  This is also why Renee has enough ego to have a working alliance most of the time, since– absent the times of being triggered into her 1 year 9 month old trauma–Renee operates out of a neurotic structure where self-reflection, psychic dialectic, observing ego, subjective self experience, and intersub-jective dialectic are possible.

Renee experiences a new sense of self agency and empowerment through conscious comprehension of her primal Internal World constellations. When Renee connects such experience with memories that repeat her impotent states, and when she understands the nature of her internal persecutor (and its origins in her early relationship with her mother), she becomes increasingly empowered to think for herself, and to figure things out for herself.

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As we continue our journey, Renee feels more empowered through true insight about her unconscious operations, even in states of writing block frustration. Instead of persecutory attacks, with split off manic intensity, she now becomes genuinely excited when her mind/body being opens up in new ways.  This affects her entire life, as well as her writing.

Just after I delivered this paper at a conference, Renee felt she had a critical creative breakthrough. She declared, with ecstasy, that she had for the first time felt a short story character she was writing about on an emotional level, within and through her heart, rather than remaining stuck up in her head, where she had only had an intellectual connection to the character. She was coming out of her mental prison through her heart connection.  However, Renee now repeats many times that she had only felt such a release through in – depth heart emotion “for a second.”  She then asks: “How can I make this happen again?”

This brings us back into her fears of where her heart could lead her, as her heart would often lead her back to the warded off loss of her mother, when dying from fatal illness, and to all the physical gory details of her mother’s suffering. However, now she said she could see that she was separate when she felt a resonance in her heart with her character.  It was empathy and compassion now, rather than a more primitive psychic fusion and merger, as she had in her past, when she would addictively cling to women, which had always led to rejection. Now she could feel for another as separate, and so she was increasingly free to speak for her characters, and to feel their dilemmas, rather than being stuck in their singular point of view.  Her story line could now be more character centered, rather than plot centered. The plot could now evolve from the evolution of a character, as opposed to sticking her characters into an intellectual agenda from her head (see study of Charlotte Bronte in Kavaler-Adler, 1993/2013).

Speaking about this was very meaningful for Renee.  She could now see the light, even when her internal mother’s persecutory attacks would crop up again, as she contemplated sitting down to write.  Her internal envious mother had not gone forever. But as the process continued, Renee could start to re-own the love for her mother in her heart. Even as this brought guilt for success and survival, it also brought her containing ability to tolerate owning and defining her aggression, so that she did not have to continually split it off into the psychically created fantasy of an internal disapproving and envious mother within. Without so much persecution from within, and with me now facing the persecutor with her, Renee could relax her compulsive

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instinct to oppose the persecutor with a resistant attitude of going on strike—the latter attitude having rebuilt the writing block wall repeatedly.

Further Development

            An organic developmental process began to unfold that culminated in self-integration, and in the flow of creative work.  Renee had increasingly connected with her internal feeling self and her Internal World.  This contrasted with how formerly Renee had remained split off in her head, as she had been arrested in a manic paced panic of polarized opposition within herself.  Renee began to truly feel her feelings, and the split second of feeling a character’s affect within a story she was creating, could then evolve and transform, with organic dimensions that highlighted both self-integration and separation-individuation (Mahler, 1975, Masterson 1981, Horner, 2000).  In fact, when Renee returned, with a successful story, to see her Writing Coach, she was heralded with exuberant praise, which included emphatic commentary on how Renee now had characters in her story that were vividly alive with their emotions, and with the sustaining of feeling experience throughout plot evolution. To me, Renee had begun to speak of how she was opening to feeling her characters, as her mind began to slow down from its life-long state of traumatized panic (Kavaler-Adler, 2014b, 2015). She could begin to be with her characters as she began to be with her Self, finally getting the intuitive message of how to “Be,” rather than to “Do” in her head.

Renee spoke of beginning to be able to have space for a “playground” in her mind, rather than being imprisoned behind a wall, which was laden with psychic bricks in the beginning of her treatment process. In Winnicott’s terms, Renee began to develop the “capacity to play” (Winnicott, 1971). In Melanie Klein’s language, and that of Thomas Ogden (1986), in his explication of Klein in “The Matrix of the Mind,” Renee entered the depressive position more deeply, even as she could regress to the paranoid-schizoid position. Now, Renee used the word “awe” to describe her astonished wonder at how all the elements of the psychoanalytic therapeutic action had come together, in a whole new state of mind, and in a whole new level of her creative process. This extended to her life process, e.g. swimming, receiving a whole person other, and relating to their separate subjectivity with compassion and empathy. She could open herself to receiving help more than ever.

The “critical mass” of transformation from the paranoid-schizoid to the depressive position had occurred (Ogden, 1986). The manic defenses of the depressive position were

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increasingly relinquished, so that a new sense of freedom brought true energy and excitement, as opposed to manic compulsion. Renee spoke of feeling like she was being “re-born.” She could, for the first time, own her identity as a Writer. It was a new identity for her.

I would like to share some of Renee’s own words to describe this organically evolving process. This process culminated in a passionate eagerness to write–whereas before sitting down to write was to sit in a state of internal persecutory attack that always became a state of torture–one part of her mind having tortured the other part, as in Ronald Fairbairn’s (1952) “antilibidinal ego” tormenting the “libidinal ego.” These are a series of strung together quotes from two sessions of Renee.

Renee: I got up this morning wanting to write. I’m really surprised at how much I’m looking forward to it. Each segment of my writing now is like opening up another part of the story’s character.  When I sat down to write I didn’t have any censoring in my head. I could be just be with the story and the character. This was highly novel…I’m highly focused now. Nothing is intimidating me. Something just clicked, and everything I’ve been learning here all pulled together. I’m really happy about it. I’m riveted in my focus and attention now, when with my writing.  I can stop and write a note to myself about adding something to describe a character’s experience. I could never slow down and think before.  The thoughts used to just rush past me.

Analyst: You’re no longer in a traumatized state.

Renee: Is that what it is? I don’t feel so overwhelmed now about my questions. Before, I didn’t know how to calm myself. I feel like I’m a Real Writer. I’m actually writing the way I wanted to write, without all the stops, halts, and obstacles. This seems to have happened overnight. How did it all happen? All of the elements of the analysis popped up overnight to help me. Now I find I am actually thinking about the characters, about the possibilities for them in the story. In fact, I’m listening to the characters, since I can slow down and be with them. I can also speak to my writing coach now, and receive her feedback. Before, I kept rejecting it. I don’t feel that panic anymore. I can put it all together now, and see how something relates to something else. I actually feel a space now for thinking. I feel a playground for my thoughts and ideas, when they come from my feelings. Before, I was sitting in a jail cell. I feel very excited and in awe as how it all happened. I want to put Red Shoes on to dance, to celebrate. It’s like some muscle developed in me. I’m letting go. I’m not clinging anymore (like she used to cling to women she wanted as lovers). I can be with Linda now (fictional name for her female spouse), and also be with myself and my characters. But how did I go from A to B to Z? It seems sudden, but it’s all coming together from all our work. It’s like being re-born.  I don’t hear my mother’s voice anymore censoring me and stopping me from thinking and writing.  I’m in awe that it all clicked over one night.

Analyst: But you know it’s been a bit by bit process. You have been remembering, and mourning.  You have been in a developmental mourning process; all your rage, fear,

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empty void states, and deep states of grief and sadness for your mother are all part of it. The process has its own organic evolution.

Renee: I’m even able to swim with ease now.  I was at the pool, floating and gliding. This happened when the flow in the writing happened.

Analyst: You are a whole. You are a hologram of change in all dimensions.

Renee: I can be kind to Linda now too. I can feel her side of things now. I can respond to her concerns and want to be there for her now, rather than feeling intruded on by her. I feel generous now, and I feel gratitude. I don’t feel so burdened and closed off anymore.  It’s like I’m reborn. I feel like I am awake and living for the first time. I’m even more curious and eager to hear from people, and see where they are coming from.  I feel like I have juice inside, energy.

Analyst: Rather than pushing yourself to run on empty.

Renee: My senses have opened up, and so my thoughts flow and open.

Renee has brought me flowers. She picked out all these beautiful spring colors, and arranged a bouquet for me.  We talked about the meaning.  She said she was happy for me, because I had mentioned I was receiving another award (16^th) for writing (a personal disclosure I would not normally share with patients).  Renee says she feels joy for me, rather than her former envy.  She used to look at my books with rage and envy, when she felt stuck, and an example of envy towards a published writer has been described herein. The other side of envy (as in Melanie Klein’s [1957] “Envy and Gratitude”) is being felt, the gratitude and empathy.

            I warn Renee, however, that things still go back and forth. She says she dreads going back into feeling stuck, but she has never had such a long period of flow before. Her writing coach tells her: “You have to send this one out to publish!”

CONCLUSION

             In Compulsions to Create (Kavaler-Adler, 1993/2013), the dissociated areas of a primal psyche operate out of dark psychic constellations. These dark psychic constellations manifest as eroticized bad objects: demon lover themes. By contrast, when the treatment issue is related to blocks in creativity, we see instead neurotic psychic structure, where repression is inhibiting as well as containing. In this latter case, dissociated phenomena from primal trauma interact continually with many levels of repression. In this case, the suppression of the psyche (by an

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incorporated part-object mother object) was empowered by the repression of the patient’s own aggression and instincts.

We have entered the clinical consulting room, to witness the treatment of the other side of the dark side of creativity (Kavaler-Adler, 2017), i.e., blocks rather than compulsions. I have shared some of the process of a psychoanalytic patient who attends four sessions a week on the couch, due to her continual need to work through the many levels of blocking of her inspiration, and of her capacity to write. She came for treatment with the explicit request to resolve her writing block trauma, and her related unconscious conflicts.

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