An object relations approach to dreams: From protosymbolic to symbolic – in dream content and within the therapeutic object relationship.

INTRODUCTION

The content and process of object relations work with dreams can be considered in terms of developmental progressions, from dissociation and body disconnection to body connection and self-integration in relation to whole object representations. This growth – from body disconnection to body connection – can be seen in the content of dreams and in “therapeutic object relationship” (Grunes, 1984). Further, there are parallel developmental paths seen through dreamwork and treatment, in relation to symbolism vs. protosymbolism, whole object representations vs. dynamic internal part objects, as well as growth from patient enactments in therapeutic sessions, in which dreams are presented – to associative dialectics between patient and analyst. Once the associative dialectic can be established within the dreamwork, the patient has achieved the depressive position level of an “interpreting subject” (Ogden, 1985), which encompasses self-reflective capacities and observing ego capacities. As we look at these developmental progressions through dream content and therapeutic dream process, we need to consider the opening of “potential space” (Ogden, 1985) along with the analyst’s object survival

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of primitive aggression. We need to consider the development of self and object intrapsychic dialectic, which allows for a critical developmental mourning process to proceed, as opposed to fused and sadomasochistic constellations of self and object (Kavaler-Adler 1995b). We need also to consider the development of the “capacity for concern” (Winnicott, 1963), which is another avenue of growth as whole object relations develop through successful mourning and self integration, thus allowing for the subjectivity of the other, as well as for the subjectivity of the self, to flower.

Unlike the classical model of psychoanalysis, the object relations analyst is less concerned with discovering latent meanings and unconscious instinctual wishes within dreams, but more in engaging with the analysand’s basic capacity for entertaining meaning at all. The analysand’s “attacks on linking” (Bion, 1959) between self and other, self and analyst, and between mind and body, inside and outside, past and present, love and eroticism, initiative and aggression – are all actively engaged by the object relations analyst through the therapeutic object relationship. Such a focus precedes interpretation of intrapsychic conflict, but does not exclude it. The emphasis on metabolizing splitting and projective-identification, as it is experienced within the room with the analysand, and processed as observation or as induced countertransference, is related to the degree to which a patient manifests the psychic structure of the paranoid-schizoid position as opposed to that of the depressive position (Klein, 1948). Manic defenses (Klein, 1935, 1940) against depressive anxieties are also a primary focus. For those with more neurotic characters, who are more centrally located in the depressive position, intrapsychic conflict and latent meaning are an important focus. For the object relations analyst, however, the therapeutic object relationship, and its holding and integrative functions, is attended to throughout, and regressions from symbolic association to protosymbolic enactments is engaged through relational interpretations that are posed as parallel phenomena with that being communicated through dream and thematic content in regards to the intrapsychic domain with its transference phenomena. This paper will focus more fully on borderline patients than on neurotics.

CASE of MS. P.

In the case of Ms. P., the dreams chart the patient’s journey from the external view of her own affect states to the inner experience of subjective affect and object connection, leading to a

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profound developmental mourning process (Kavaler-Adler 1992). Object survival of primitive rage is addressed in the transference to the analyst, placed in the role of the bad object, and was critical in this case (Kavaler-Adler 1995). Dreams of holocausts and nuclear explosions externalized the archaic rage from preoedipal trauma, combined with later trauma from the loss of the mother to death at the age of nine, and the trauma of the father’s sexual molestation as well as physical emotional abuse. Following dreams of such externalized explosions, in which the rage is symbolized as a part object, cut off from object connection, the patient presents a dream to the analyst that has more differentiated figures and relationships. But again the internal affect is split off and deflected outward, however, not now into the environment, but into the transference object. Ms. P. dreams of the analyst as a mother with an infant in her arms. She gives the infant to a nurse or nanny, and the patient is not allowed to hold the baby. The patient’s response to the dream is to react, rather than to associate. She cries, “You didn’t trust me to hold the baby!” There is no potential space for dialogue between patient and analyst here, and no room for internal psychic space that would allow for self-reflection. There is no interpreting subject in this patient to see that there is symbolic meaning in the dream. She only reacts as if being impinged on in a victimized way by the analyst’s distrust—in terms of the analyst not letting the patient, in the dream, hold her baby (the baby probably being symbolic of the part of her that does want to surrender to the analyst). Potential meaning is foreclosed by the reaction, rather than opened through affect-object and conceptual links that occur in free association. We find Hanna Segal’s “symbolic equation,” the thing in itself (Segal, 1957). This foreclosure of psychic and analytic space is seen then to parallel in the dream content the externalization of body and emotional experience, cutting off links to potential subjectivity and to having an “inside.”

After the analyst gives the baby to the nanny, rather than to the patient, there is a scene in the dream where the analyst’s husband’s car is crashed into by a truck. Ms. P. seems to be placing her reaction to the analyst’s distrust outside of herself. The disowned internal reaction comes back at her as a murderous impulse. But she herself evades this murderous attack by creating a dream in which the analyst’s husband is crashed into. This could be seen as an attack on the analyst indirectly, but also it preserves the analyst and kills off the husband, who can be seen as a father figure. She could be killing off her own father to preserve the transferential

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mother, the long lost mother who died during her childhood and who is eliminating the abusive father. Her rage is used as a weapon against this father. In this way, Ms. P. avoids feeling her rage towards her transferential mother, who she wishes to maintain as a symbiotic self extension, who is unambivalently loved.

Following this dream, Ms. P. expresses a conscious rage towards the analyst. As she splits the good symbiotic mother, who holds the infant, and the mother of separation who becomes colored by the demonic father, she experiences deep hatred for me as the preoedipal bad object in the transference. She screams at me about how she “won’t do me one little favor!” after I say “no” to her request to change her session time, because it is raining. She accuses me of being a “classical analyst who charges her for missed sessions,” basically cursing me and displaying her suffering, while demanding an explanation from me, the analyst, for her refusal of a request for an alternate session time. She also threatens to leave treatment. When her rage subsides, I say to her that those who accuse others are often feeling guilty themselves. Ms. P. sounds very curious about this comment, allowing space for dialogue for the first time in the session, after the urgency of her rage. She asks, as opposed to proclaiming and accusing, “What do you think I feel guilty about?” I say, “We can get to it,” thinking that Ms. P. may be harboring guilt over her mother’s death. After this session, in which I survive Ms. P.’s rage in Winnicott’s sense of suffering the expression of the rage, without retaliation or abandonment, object related contact can be established at the end of her session, after the Fairbairnian “exorcism” of the bad object in the rage. Ms. P. has another dream. She brings this dream into our session in a very different manner than ever previously. She presents four parts of the dream, in clear detail, in a tone of curiosity and interest, so markedly different from her reactive expressions of victimization in earlier dreams. Now, there is potential space and for the first time, Ms. P begins to associate and to allow analytic space for a dialectic, paralleling a freeing up of intrapsychic dialectic from sadomasochistic impingements that have blocked symbolism and dialectic.

Ms. P. describes four scenes – the first is a scene of her dead mother coming down to her, from above. She reaches out her hand to her, and is sobbing and sobbing in the dream (expressing the potential mourning that as yet has not been done). The second scene is of her being in the bedroom of her childhood home, where she lived with her father after her mother’s death. She is on the bed with her girlfriend and is sucking her girlfriend’s breasts. She begins to

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become sexually aroused, and just at that point, a man starts to enter the room. She jumps up and hides under the bed.

The third scene in the dream is of a black boy delivering food to a white man. When reporting this scene she has transference associations. She says the white man is me, the analyst, but she says I am Ronald Reagan in the dream. She says the black delivery boy is her. She comments that the black boy is delivering fast food and she hates fast food (unlike the slow food of breast feeding). She wonders out loud why I am paying her in the dream since she usually pays me, and she wonders why I am paying her so much. It seems to her that I am paying her far more than the food is worth. She sounds perplexed, but is operating on a conceptual and symbolic level – apparently unblocked by the expression of rage in the last session (Kernberg speaks of defending against symbolic capacities that are developmentally established) – rather than reacting as if impinged on. She reports one last scene in the dream, where there is someone on a bicycle riding away from her, and she can’t identify him or remember who he is.

She then leaves the room for me to enter a dialogue with her about the dream. She curls up in a fetal position on the couch. She doesn’t have any more thoughts about the dream, but she wonders about the third part in which I am the Ronald Reagan figure giving her, the Black boy, money. I say that I have some thoughts about that part of the dream, and Ms. P. responds rather than reacts. She maintains the potential analytic space between us. She invites me into her psychic space with a tone of curiosity. I ask, “Do you want me to tell you what I’m thinking?” She says, “Yes, I really want to know.” So I plunge in and say “You think you are paying me so much, giving and giving to me and I am taking and taking, but in your unconscious, as expressed in the dream, you seem to feel just the opposite.” Your feeling seems to be that I am giving and giving to you and you are using me up, just like you feel you used up your mother and killed her.” Ms. P. erupts with an agonizing cry at this point, screaming and gyrating, saying: “It’s true! I did it! I did it! It’s true! I did it! She loved me so much and I hated her. I wanted a younger mother! Then I got my sister-in-law when my mother died! But I wanted my mother! I killed her. I don’t love her the way she loved me: I killed her! I did it! She used to do so much for me! I just took it and took it all from her!”

For the first time, Ms. P. gave vent to expressions of grief for the loss of her mother. This was following the transferential rage of the last session, and the sobbing scene in the first part of

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this new dream, in which she gave symbolic representation to the grieving that she had not yet been able to do in reality. She sobbed and cried in this session, saying how her mother had called her a special name that nobody else called her – mourning her loss by expressing how much she missed her mother. At the end of the session, she let me reach out to her without spoiling and destroying me as she usually did. I said I was glad we had gotten to this point and she agreed. I remarked that she had not responded with her usual verbal sarcastic slaps, and had validated her ability at that point to take me in, to not spit me up or repulse me. She sustained the contact until she left the session.

In the next session, Ms. P. regressed from the symbolic level of this dialectical dream interpretation and engendered mourning process to a protosymbolic sensory level. She fell asleep and slept peacefully throughout the session. While she slept, I felt the relaxation in her sleep, and experienced it as a beginning regression to an early symbiosis, prior to the traumatic separation of her mother’s death, which came in a relationship with a mother who could never separate from the symbiotic tie between her and her daughter while alive. This mother could never say “no” to anyone, including her husband and her daughter. Consequently, her death came as a dramatic and traumatic disruption, rather than as any tolerable separation. There had been no preparation for it. Ms. P. experienced her mother’s death as a cataclysm, as sudden, acute, and murderous in its cutting off intensity, and in its abandonment of Ms. P. to her father. This was true despite the fact that the mother had been in the process of dying from cancer for at least a year.

As Ms. P. slept in the session following the acute opening of her developmental grieving process, a symbiotic mode of relationships was experienced between her and me. I felt it in the induced countertransference, based on her projective identification. I felt a sensory kind of communion with Ms. P. through baby feelings induced in my lips and finger tips, a phenomenon I have not felt before or since. During this session, while Ms. P. slept, I also felt like I heard a kind of musical lullaby in the background. Ms. P. slept throughout the session, and when the session was over she responded naturally to my saying it was time to go, waking like a sleepy child, and then able to let go of me as formerly she had not been able to do at the end of the session time.

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CASE of MS. R.

In the case of Ms. R. another developmental progression, in object relations terms, can be seen both in the content of dreams and in the process around the use of the dreams in sessions. Ms. R.’s initial dreams (during the first months of treatment) were expressions of disconnection from her body as well as from others. Within the therapy session, this was reflected by a state of detachment, alternating with an extreme vulnerability. In her vulnerable state, she responded to empathy for her inner experience, which was filled with the sense of shame. But her backlash reaction to receiving an empathic response to her vulnerability was to kill meaning with me through clichés and sarcasm (see Klein 1935). One such cliché was that I might be selling her snake oil with my suave empathic manner. This destruction of the links that create object connections, disrupted the growth of love and meaning, and such destruction of love and meaning is seen in parallel with the original disconnection in the body.

The intersection of dream content and the process of sessions in which a dream is presented can be seen in Ms. R.’s first dream. She describes herself as the observer in this dream, excluded and outside. She aligned herself with the central ego (Fairbairn, 1952) which stood outside of the sadomasochistic psychic structure she carried with her, in which victim and aggressor part objects displayed themselves.

In this first dream, Ms. R. was an observer, an outsider, watching a group of people in the ocean who were attempting to scuba dive. She was off in some exotic environment, far from home, far from her vulnerable emotional center. She was emotionally sealed off (Kavaler-Adler 1991). In such a position, she spoke with the tour guide, who she agreed could have been me, the analyst. The guide told her that the swimmers were using the wrong scuba diving equipment. Instead of fins, they had baggies on their hands and feet, so that they were unable to either swim or to feel their way under water. They were numbed out and sealed off from contact, which put them in great jeopardy with the elements under the water.

As Ms. R. related this dream to me, she displayed the same kind of numbness, detachment and disconnection that she represented in the dream by the swimmers with baggies. She couldn’t connect with any of the feelings in the dream. She was the outsider or else the person whose senses were sealed off by plastic baggies. She was numbed off from contact with the ocean of feeling around her, and numbed off from contact with other swimmers. The guide in

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the dream could not only be me, but also could be a projection of the detached and eviscerated shell of her ego core, Fairbairn’s (1952) “central ego” part of her. In the session, in which she reported the dream, Ms. R. was blank, unrelated, and numb to all feelings. By choosing to be on the outside as an observer, she avoided feeling helplessly excluded by others, Klein’s (1940) manic stance. But she paid the price of her position of omnipotence. She lost all feeling and she was, therefore, crippled like the swimmers with baggies on their hands, instead of fins to swim with.

My main approach to contact with Ms. R. in this session was to tell her that the detachment in the dream was shown in her disconnection from me and from herself in this session. She was numbed out, as if she was an eye watching outside her body. The more she kept away from all feeling within herself, the more she unconsciously feared all feelings as threatening assaults from an overwhelming ocean. In her view she had no fins to get through this ocean of feeling. Feelings were foreign to her as she warded them off. As she warded me off, she detached herself so as not to be touched, while other times showing herself to be intensely vulnerable to my sensing her internal experience. As I made the connections for her between her detachment in the session and her numbed out state in the dream, with her body warding off feelings with baggies split away from the mental eye in her that observed as an outsider, she began to experience some of her detachment and distancing. Due to her level of disconnection (at the early time), she was not able to be present at a symbolic level. She could not have associations to a dream. She could not join me in a mutual association process. Her experience was sensory in a negative sense, which meant that sensation was lacking and replaced by numbness and void, related to isolation. Ms. R. appeared to be warding off the sealed off self in which an ocean of feeling was tied up with internal persecutory and victim counterparts, reflecting a developmental arrest in which a sadomasochistic psychic structure presided. This also demonstrated a deficit in self-and-object dialectic for psychic structure. Such lack of dialectic at first arrested potential mourning. At this time, Ms. R. reacted to the dream rather than responding to it. She became ‘it.’ Rather than be in a symbolic dialogue with it, she was in a semi-merged state with it. Through projective-identifications, she projected herself into the dream and resisted the contact with the dream as a separate other. She failed to be an “interpreting subject,” who could see her interpretations and associations as feelings and

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thoughts that had symbolic meaning. In parallel with this lack of observing ego and interpreting subject capacity was her failure to experience a sense of agency outside the dream. She was merely an outsider in relation to the other characters in the dream. She was living in it, through projective-identification, and it was living inside of her. There was no potential space. Split off parts of her, components of a sealed off core self, appeared to perpetuate her frozen state. The dream is as follows:

These women are struggling on a lake of ice, trying to hold on to mountains of ice (ice breasts) in order to not drown in the ocean that was expanding as it consumed the ice melting within it. The ocean threatens to swallow all the women up. The women continue to cling to the ice, struggling to survive. [While watching these alter-ego women, Ms. R. remains detached. Ms. R. says she knows it is a hopeless situation, so she doesn’t even bother to struggle. In the dream, she knows she is going to drown and die.]

Ms. R. enacted her role as a distant observer in the session in which she presented her dream to me. Although she didn’t have associations that suggested a symbolic engagement with the meaning of the dream, she could discuss her feeling reaction in the dream, a feeling of hopelessness and doom. One way of interpreting her feeling is as a psychic fantasy of persecutory anxiety reaching the pitch of annihilation anxiety or of Winnicott’s (1962) degree of “unthinkable anxiety.” This is a pre-symbolic or protosymbolic (‘beta elements’ in Bion’s language) experience. In response to the feeling sense of the dream, I open the avenue to entering her internal world, as it exists in the dream, through understanding the feeling expressed by Ms. R. I respond to her in relation to her entrapment with her own internal closed system, within her psychic structure. The dream fantasy captures the internal threat. As I address the threat, the terror of contact with me as a transference figure, and as an “other” outside of her closed system, I am offering her a new object relationship. My explanation is both related to her state of being trapped in her own psychic structure and in the distant place she is in the session, from which she is impervious to loving and needing, and cannot take in my presence and its potential internalizations. My explanation is also allegorical. I help Ms. R. to see that this dream illustrates why Ms. R. desperately needed to avoid contact with me, maintaining the position of an observer. I told Ms. R. that the dream revealed her fear that she was coming close to a dismal

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fate. I began to focus on Ms. R. on the use of the dream. If we see the women who are struggling as a composite split off part of her, a part warded off, we see the child victim in her, frozen out of contact by an “ice breast” mother. With an ice breast mother, she has no mother to support her sense of self, and feelings become an overwhelming ocean that she expects to drown in. Ms. R. knew at an unconscious level that she would drown if there was nobody there to help her contain and process her feelings, her oceanic unconscious.

A critical stage of mourning within treatment helps Ms. R. to own split off parts and to enter a level of symbolic free association, in which intrapsychic conflicts related to shame, guilt, and envy can be dealt with. A full blown oedipal state merges, and Ms. R. owns her capacity to love and to create. Through the grieving of her lost father, her inadequate internal mother, and the parts of the self that have been split off due to the trauma of her childhood experience, Ms. R. both develops and re-owns her capacities to love and to create. She connects to longings for a former love, as well as to jealousy for the man’s current girlfriend, who formerly was experienced as a preoedipal mother to be envied. She connects more directly to her creative work than ever before, as the compulsion to create, which is tied into an addiction to her internal demon lover is relinquished. Through the grief process, Ms. R. turns compulsion to free creative motivation and connects to her work as she connects to the deeper core of ambivalent love within her. She then overcomes blocks and resistances that stood as obstacles to connecting to her work, these blocks and resistances relating to dis-owned shame, guilt, and envy. These obstacles become avenues to connecting with her internal self and its capacity to love her internal objects, and thus to sit down readily to connect with her creative work. She claims that she could never before sit down so readily to her work, and engage with it. Having mourned the shame of needing the parental objects of her past, she can now need these internal objects as symbolized introjects within her internal world, and thus she can need her creative work, and express the needs through symbolic themes. Her ultimate creative writing theme, at the end of treatment, is of the melting of a frozen off self (placed in the climate of Alaska), and the yielding to affection and love. Her dreams show this developmental progression both in content and in dreamwork. She has a dream later in treatment (end of second year) of cuddling with a teenage boy in a romantic atmosphere, in which she also sees her male object as vulnerable, rather than as omnipotent. The male character in the dream is prone to embarrassment, reflecting a mild residue

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of her own shame, but now is integrated with the affection and capacity to love that such mild vulnerability allows. The dreamwork has been transformed by the mourning process into a depressive position symbolic free association process. No longer is Ms. R. in a state of detachment in her sessions, where she must rely on me, her analyst, to initiate feeling state responses to her dreams through the engaging with her psychic structure and the confrontation of the enacted disconnection in both the treatment session and in the dream content. As mourning and separation proceed, she becomes capable of initiating all her dream association processes, becoming prolific in her symbolic metaphors, relating now to highly differentiated subjected feeling states. Such connection with symbolized subjective states allows Ms. R. to differentiate male and female genders, and the dialectics of affection and romance between the genders. She has owned and developed the formerly devalued female part of her, and it has grown up to engage with masculine and vulnerable figures, symbolizing the whole object masculine side of her own internal world and of her personality.

DREAMS and DREAM-WORK with MS. K.

Ms. K. has been in treatment three times a week for almost two years. She is a twenty- five year old woman writer, formerly a Rhodes Scholar.

When Ms. K. first came into treatment, she was in a constant rage. She was full of accusations, full of emotional blackmail, and terrified behind her aggressive attitude. Her early dreams reflected the state of disconnection she was living in, as her narcissistic character defense of constant achievement and success was not holding up. The rejection of her first novel drove her crazy. In the first sessions, she proclaimed with absolute and adamant seriousness: “I have to be famous!” She claimed she was a victim of her parents’ projections and expectations, but seemed to find some relief when I didn’t agree with her, as I said she would have to find out about her own projections.

In one of her earliest dreams, Ms. K. was outside herself, disconnected from both her body and from the characters of her internal world, who emerged as part objects, part objects engaged in sadomasochistic scenes she obsessively watched on a porno cable T.V. channel. She would watch such T.V. as one way of forestalling an internal sense of an engulfing emptiness and darkness.

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The first dream was simply that of a man beating a woman (Kavaler-Adler 1995). Ms. K. was a witness to this, but was outside the scene. She thought in the dream that if she could steal this film of the man beating the woman she would be cured. But she was too intimidated to steal the film when she was told not to take it.

At this early time in treatment, Ms. K. was unable to have symbolic associations to the dream, in contrast to her later prolific manner of association. At that time, she merely reacted similar to Ms. P. and Ms. R. in the beginning of treatment. Being outside the internal world scene, she was outside also of her symbolic capacities, lacking the three dimensions, not only of whole objects in her dreams, but also of symbol, symbolized and her own alpha function agency as an interpreting subject. Her reaction to this dream was an exclamation that she could have taken the film. She said that she could have found out what was wrong with her. Later sessions showed that the “film” was not only a kind of schizoid barrier within her that mimicked the porno film she watched on T.V., but was also a symbolic screen memory of an adolescent for a trauma. The trauma was that of oral rape, which occurred when she was twelve, and the sealed off view of self perpetually carried this trauma and pressed her towards violent reenactments.

Another dream from her first months in treatment again displayed the state of disconnection she was in, living outside her body and being sealed off from the vulnerable and needy part of herself (Grolnich, Barkin, & Verner, 1978). The dream took place in a writing colony, but it was supposed to be a medical school. The women studying at the medical school all had their uteruses in plastic bags hanging on the wall. She again was on the outside as an observer, but the women were also outside their bodies, looking at their insides from outside. As Ms. K. described the dream, she did associated from uterus to fetus, which related to an interpretation I had made of her feeling about herself, which was continually projected into images of snails and protosymbolic sensory experiences of snails. Ms. K. had been preoccupied with snails from the beginning of her treatment. She was obsessed with snails. Initially when feeling like she was falling apart, after the narcissistic injury of her book rejection, she had psychotic delusions of living in her own secret world, where she was the king of the snails. She then saw snails in a lamp in my office, and saw snails all over. When I said the snails might be like her self in a fetus form, she reacted with a powerful affirmation: “Yes! Yes! Yes!” she cried, with her usual intensity and drama.

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At the time of this dream of women with their uteruses in plastic bags hanging from the wall, suggesting that they had dissected themselves for personal inspection and study, Ms. K. immediately thought of characters outside uteruses as fetuses. But she was able to remain at this time on the level of such a symbolic association. She became flooded with snail sensations and visions, conjuring up the snail as fetus and the fetus as snail. The sense of a body part, which defined a core feminine part of the self as being sealed off in plastic suggested an eerie sensation of schizoid barriers, excluding the feminine part of the self from connection with the rest of the body self. To view the excluded and numbed out feminine part as a fetus suggested a total primitive self excluded from the body it was to reside in. It suggested abortion and the merging of levels of sexual trauma and primal abandonment trauma.

Although Ms. K. could be prolifically verbal and symbolic at times, she remained numbed as if she was shielded in plastic. Another dream of being behind glass mirrored the disconnection from the world and from the body connection to that world.

This dream became a prologue to an intense sequence of sessions in which oral rape symbols and memories were finally deciphered. Progressions to the symbolic level were quickly reacted to with a backlash to the sensory implosion of the protosymbolic level of the paranoid- schizoid position, in which persecutory anxieties dominated Ms. K.’s psyche.

During her initial days in therapy, Ms. K. had been a psychic bulimic, taking me in whole, splitting me out, and getting nauseous in her first session because of the conflict between taking me in and splitting me up (Kavaler-Adler, 1996, 2014). Gradually, she was able to take me in and sustain some connection, digesting slightly, but the urge to orally expel me was overwhelmingly compulsive. When Ms. K.’s sensory level snail preoccupation began, therefore, to transform into a symbolic key to an oral rape trauma, Ms. K.’s capacity to let me be with her as an ally was quite new and alluring. At the moment she grasped the image of the snail in a totally novel way, as the combined image of her lips and the male rapist’s penis on which her lips were forced, a whole mystery yielded its story. Darkness had turned to light through this deciphering of the snail symbol, just as other dreams of hers suggested that when dark places turned into bright, open, and sun-drenched apartments.

Ms. K. and I shared a feeling of ecstasy as this deciphering of her snail hieroglyphics unlocked the mystery of her personal Rosetta stone. The collaborative effort at this time was

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given representation in a dream where I was seen as fellow Rhodes Scholar entering a haunted house with her, searching for ghosts (Dickinson, “to scan a ghost is faint, but grappling conquers it”).

Yet, her regression from this parallel growth in symbolic capacity, free associative capacity, and the sustaining of a therapeutic alliance, quickly collapsed into a protosymbolic level of enactment. Ms. K. began to act like I was the demon lover rapist, forcing her to submit to experiencing the pain and memory of the rape, forcing her to submit to experiencing the pain and memory of the rape, forcing her to remember the inner scream that was chocked within her, the kiss forced into her and the penis forced into her mouth. Since it all took place by the ocean, I wondered if she had hallucinated herself into the state of snail on the beach at the moment when her mouth was forced into fellatio, when she felt like a “screaming cloud of pestilence” erupting without release. She said that she had been thinking of snails the whole time, and might she not have traveled outside of her body, dissociating enough to feel on the outside looking in, or sealing off behind a film of plastic; like a disconnected uterus or fetus lying on the beach or hanging on a wall.

Back and forth we traveled from the protosymbolic to symbolic level, and back again, and then forward to new symbolism as memories begin to come alive in a more differentiated form. She remembered standing in a hallway, being carried over a shoulder, with a hand over her mouth, so that all the screams inside imploded within her. She felt like she was clinging to an electrically charged fence, eruptions of electrical charge battering her from within, beating her down from within.

Soon after this entrance into the symbolic level digestion of memory, in between sessions, Ms. K. lost me in between sessions, and when alone trying to write, words and images converted back to protosymbolic body sensations. Since the creative act, just like an analytic session, had become the scene of enactment, of going into the dark cave or black hole, from which she never would return, her attempt to sit down in a room alone retraumatized her. Ms. K. explained that she had lost me when telling me about this, telling of the snails that began to swim in her mouth, erupting from symbolic containment into protosymbolic sensory impingement– engulfing her and terrifying her. Following this Ms. K. had a dream of snakes and of holding onto a snake, not being able to let it go. Dreams of dinosaurs evoking her oral rage, and of snakes

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evoking her terrors of phallic penetration, seemed to be part object images of dissociated body feelings, just like that of the snail. At the paranoid-schizoid level of the dream, where persecutory terrors predominated, she remained more reactive than reflective, yet she had a moment of reflection as she asked: “Why couldn’t I let go of the snake? I could have let go of it. I kept holding on to it.” Would Ronald Fairbairn’s view of holding on to the bad object to control it be appropriate here? Perhaps we can see the snake as an essential part of her own body self, also merged with a bad part object, which she couldn’t relinquish like an externalized uterus or fetus? Rodents expressed rage in her dream. Snakes may have expressed erotic intensities without subjective passion, as they seem to have done in the poetry of Emily Dickinson (see Kavaler-Adler, 1993). Ms. K. clung to the split off intensities that invaded her and controlled her, when she could not integrate them and experience her own subjective desire. While dreaming of snakes and imagining snails, the oral rape memories were accompanied by her fear of me as the ‘demon lover’ snake, the snake that suggested her own insatiability as she lived in a sealed off state, prior to critical mourning. Snakes, snails, and dinosaurs are also split off erotic intensities without subjective passion, as seen through the work of Emily Dickinson and other women writers I’ve written about in The Compulsion to Create, who are obsessed with a demon lover, and who have no adequate inner container to tolerate their own subjective desire.

As Ms. K. began to grieve the anguish of the rape, she reverted back to a defensive enactment of the protosymbolic level. She said the rapist had forced her to work so hard, forced her to work so hard in her analytic sessions to recover from the rape. The rapist had forced her to need me and treatment. I was then perceived as having too much power then, because she had revealed her secrets to me. I could control her like her father, forcing her to submit (later in treatment, she spoke of wanting to be forced, and the fear of freedom when she was not forced). She exclaimed that I was coming on top of her, reflecting incestuous desires, terrors in relation to her father’s phallic sexuality. The snake dream showed that she was clinging to the snake that could both bite and strangle her. This biting snake was a part of her, a part of her that she had felt and expressed towards her sister in childhood. She had torn up her sister’s room, reminiscent of Klein’s tearing up the breast, and she had felt her teeth tingling from the fantastic urge to bit her sister’s nose off.

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Ms. K. had several dreams of being in a writing colony that is about to be invaded by Nazis. Nazis represented the hostile part of Ms. K.’s psyche that demanded she work ten times harder than she was ever working. As she put it, in her family everybody had to keep working. If anyone stopped working it was a terrifying threat to everyone else in the family, because it meant someone had need, and nobody could deal with their own needs so they couldn’t stand the exposure of the needs of another. Ms. K. said that rather than feel neglected when everyone else was working, she had worked twice as hard as everyone else. This had brought her many overt awards, including the coveted title of Rhodes Scholar. But the compulsion to work and to create in her creative work drove her into a state of manic frenzy, alternating with despair, which she and I often spoke about as the Red Shoes syndrome. At the time studying at Oxford, she had broken down into a state of debilitating despair. She found the world of lauded Scholars, which she was chosen for to represent a world of what she described as a Nazi standard of excellence. She claimed to be persecuted by a Nazi part of her that demanded more and more from her to the point that she would work night and day on a project. Then when the project was over she would fall apart. She would feel eviscerated, emptied out and like she was falling down endlessly into darkness. Yet, just as she held onto the snake in a dream, so too did she hold onto the Nazi in her. It was her demon lover, and when she was not worn out from her manic flights into the compulsion to create, she would turn her demon lover back into the inspiring muse that initiated the whole cycle again. In the transference, I appeared as the Nazi demon lover in her analysis. She said that she came to see me because I was tough, rather than being a hand holder. But she then became frightened that I was a “ruthless academic.” Along with this she thanked me for having “de-fanged” her.

In the first dream of the Nazis invading the writing colony, Ms. K. was still merged with her muse-demon lover. She was still possessed by her manic states. She was still losing her connection with me as a good object, which resulted in her becoming overwhelmed by compulsions to create herself into a star through her work, in order to ward off the darkness and ugliness she felt within, which had been symbolized by her snakes, her big grey and dripping snails surrounded by floods of mucous and semen, and her dinosaurs. The dreams reflected the engulfment by her dark inner world and its bad part objects, as it reflected engulfment by her own rage. The Nazis were coming to the oasis she found in the writing colony. The writing

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colony allowed her expression for her deepest desires, as she expressed her inner life in her novels, but it was also vulnerable to the onslaught of her inner Nazis. These Nazis demanded that she write for some purpose of excellence or achievement that took her away from her internal self. In the first dream of Nazis invading the writing colony, she was overwhelmed by the threat of the Nazi invasion. She clung to her girlfriend, who was also at the writing colony, wanting her to pack and escape with her. She hands the novel she is writing to her girlfriend. It is an offer of a gift of herself, of her very essence; but her girlfriend looks away. Instantly, the room becomes filled with rodents (rats), which is Ms. K.’s term for Rhodes Scholars. Ms. K. is then gets surrounded by rats and threatened by the Nazis invading. She feels alone with the rats and the Nazis, abandoned by her girlfriend.

When Ms. K. reported this dream, she was still at a protosymbolic level or in the paranoid schizoid position, where she reacted rather than associated. However, I gave her some of my own associations, which she was able to take in and respond to. She reacted by saying that she always had vile animals and Nazis in her dreams. She proclaimed that they live inside of her. I say that the rats coming out seem to express the rage she feels when her girlfriend is indifferent to her book. She agrees and then is able to say in response that she is left all alone because of her rape and injury.

She says she feels paralyzed, as though her girlfriend’s rejection of the book is a total rejection of her. This leaves her surrounded by rats, Nazis and darkness. In the session she is enacting the paralysis and helplessness of the rage turned inward so that her symbolic capacities have to be inspired by my own associations. This tendency of hers to rely on my associations changes dramatically as she slows down in treatment and begins to connect with me, so that a successful developmental mourning process can begin. However, at this time, my associations related to her rage in the dream help her to connect to her blocked state of paralysis operating within the session in which the dream is presented.

When Ms. K. next dreamed of a writing colony, with the theme of the invading Nazis, she is in a very different place. During the interim between these dreams, Ms. K. has learned how to slow down from the whirling dervish dance of the Red Shoes. She has gone from rage and terror to deep states of sadness. She has become increasingly able to let me be with her and to directly express her need for me to me. This has given her the containing space to internalize

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me, and despite all her backlash reactions in which she returns to a helpless despair and self hating anguish, she has been able to feel the grief of the core object loss within her. As she allows me to be with her and to contact her grief, she is able bit by bit to mourn and to internalize our being together, building in the psychic structure to contain and process mourning from within. This modifies the sadomasochistic aspects of her psychic structure, allowing her to experience her erotic fantasies, such as of a man beating a woman, without her living it out in her life. The mourning process is a separation process, which has allowed her to separate from the Nazi part of her.

Therefore, her next dream about Nazis invading her oasis writing colony reflects quite a different self state. Already we have seen in the progressive sequence of her dreams, throughout the psychoanalytic object relations process, Ms. K.’s transformation from being outside of herself, outside of her body, and an outsider in her internal world, into being a subjective character within her internal world. Her dreams now give life to her subjective experience. Even in the dream where her rage is split off and placed outside of her in the image of rats, she is still in the dream, no longer looking on from the outside. In the later dream of the writing colony and Nazis, which came in the second year of treatment, Ms. K. is not only within herself and her own subjective states, but is able to associate to states of initiative and agency that have grown within her through the internalization of our therapeutic object relationship. There is more desire in this dream than persecutory fears. She at first wants to leave the writing colony to travel on a vacation and invites her girlfriend to go with her. Her girlfriend is disinterested, but rather than feel abandoned or enraged, she tells her girlfriend that the Nazis are coming. She and her friend start to pack to leave. Then Ms. K. realizes that she is going to have to go on her own. She has left a book given to her by her father, Anna Karenina, and then realizes that she doesn’t need it. Ms. K. does not wait for me to say anything about the dream. She begins to comment on the sense of initiative she felt in the dreams. She remarks that she did not feel helplessly dependent on her girlfriend to go with her, nor on her father. She could let go of her father’s book, as well as his philosophy of life. She has gained a sense of self agency and leaving the writing colony becomes colored by the pleasure of travel. She is no longer overwhelmed by the persecutory anxieties related to the Nazi part of her. The Nazis appeared less as a threat in this dream and more as something she uses for her own purposes, to convince her girlfriend to leave the writing

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colony to travel. She has separated from her internal Nazis and from her mother-sister figure seen in her girlfriend. Her girlfriend’s indifference to her doesn’t cause an externalized rage rejection as in the rats and rodents of the last dream. She contains her emotional reaction and has the subjective experience of initiative and choice.

A dream following this one shows Ms. K.’s developmental growth into a capacity for concern, as guilt and loss are felt and understood between us in the therapeutic mourning process. She is now able to have a dialogue with parts of herself that were formerly split off and disowned.

In this dream, Ms. K. comes into the place where she is employed in a political job and another “girl” who works there is depressed and envious. The girl says to Ms. K. “You’re lucky! You have your writing. I only have this job.” Ms. K. tries to listen to the girl’s distress, and leads her out into the sunlight, where she can listen to her better. She feels compassion for her. She tries to understand her. She comforts her.

In her association to this dream, Ms. K. says that she feels concern for this girl, who she could see as a part of herself. She feels inadequate when she doesn’t sustain a sense of what she has, and in this dream one part of herself is reminding her that she has something special. She’s able to empathize with the part of herself that feels inadequate, rather than to have contempt for it. She is separating from the inadequate part of herself, rather than using a manic grandiose defense against it. She is owning what she truly has, as symbolized by her writing, rather than trying to be a “star” to avoid feeling the darkness within her. Ms. K.’s associations particularly focused on her ability to lead this other girl from the darkness into the light, reflecting how Ms. K.’s internal world darkness had changed. Whereas she used to feel an endless engulfing darkness, like the void of a black hole, she now had a differentiated darkness, where she was in the darkness of her work environment or in the memory of waiting in a dark apartment for her mother to come home. She now had a contained and boundaried darkness, like a vagina with limits, as opposed to a vampire biting mouth or the illusion of the no limit vagina seen in demon lover fantasies of women writers (Kavaler-Adler, 1993, 1995).

More recently, after more than one and a half years of treatment, Ms. K. dreams a dream that highlights the manic theme of her “compulsion to create” (Kavaler-Adler, 1993), the myth of the Red Shoes.

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In this dream, she is the smallest child in a play. The following is Ms. K.’s description of the dream.

“I was playing the youngest child in a play with other girls (sister?). There was this Don Juan figure (father). The mother, who was like you, wanted to have sex with the man. But he had this young mistress like person with him. …It was suspenseful in the dream, like a murder mystery. My mother had on really red shoes – like in the Wizard of Oz. She put on the shoes to get the man. – Oh! The dance of the Red Shoes! You had them on! You, monster!”

Ms. K. stops after reporting this dream. I asked her why she stops and doesn’t respond to her dream. She says she wants me to tell her what it means. I tell her we can find out what it means together if she tells me her thoughts. I also see that her taking this passive role is also an enactment of the child position in the session that is symbolized in the dream. No longer is she enacting being a rape victim as she had in sessions at the time of her early dream of a man beating a woman. Now, she is enacting the role of a child in the session, in which she presents a dream in which she is in the child role.

Ms. K. is able to respond to my invitation for us to collaborate together on an association process, which illustrates the level of interpersonal and intrapsychic dialectic she has reached. She says: “I think the mother in the dream is eroticized, and it is related to my mother getting this grant to write a book. I connect success and sex. Now that she got this grant she’s in a position to have sex with a man.” She says: “The dream puts me in the position of being the youngest child in the play. I don’t want to play it anymore. I want to be an adult!”

I ask: “Why do you have to be in this child role?”

Ms. K.: “Because she’s going to leave me for this man. Yea! She has Red slippers on.

But she’s like the more adult part of me. I think. Woof! Woof! (she makes animal sounds)” I say: “Can’t you put that into English?”

Ms. K.: “I feel scared—upset—longing and fear.”

I say: “I think it has to do with your going away next week.”

She says: “Yes! You a monster! I also feel rejected, angry, and mad. I feel mad at the New Yorker!”

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I say: “You feel left by the New Yorker too, as well as by your mother, who’s going away with her grant.”

Ms. K.: “The New Yorker has gone from a great opportunity to a nightmare.” I say: “You’re going away and you feel like everyone is leaving you.”

Ms. K.: Whimpering… “That car you hear screeching. That’s what I feel like. I feel

mad!”

I say: “You get mad when you’re scared. Separation is hard for you and you’re saying

good-bye to me for a whole week. We won’t see each other three times next week.” Ms. K.: “What do I do?”

I say: “You can feel it and talk about it, while you’re here with me, rather than letting it hit you when you’re alone.”

Ms. K.: “My family is leaving me for success—my mother and my sister too.”

I say: “You turn the pain of losing them into the image of yourself as a failure. You go into your hall of negative mirrors to avoid the feeling of loss, when you can’t wear the red shoes and see yourself as a star.”

Ms. K.: “I envy them. Are these real feelings about being a failure or a defense?”

I then take us back to the dream, since the dream is speaking to this question, about the red shoes as a compulsion to create, as a manic defense against the fear of loss and abandonment that Ms. K. is feeling throughout the session.

However, I make the mistake of making an oedipal interpretation that goes nowhere. We then return to the underlying theme of losing mother, which leads into both the leaving of me in the transference, and the leaving of me as representing the whole therapeutic object relationship (see Grunes, 1984).

I say: “in the dream, your mother has success and sex. You’re a child. She can have the man, but also the man has a younger mistress who is probably you. You’re in competition with her and you don’t want to deal with it, so you stay in the “part” of a child, just like you regress here into child language. But you’ve also created a mother, who doesn’t feel sexual without the Red Shoes of success images and star roles. She has to have a manic form of success to feel sexual.

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Ms. K.: “Last night my mother was listening to me on the phone—trying to help me. I got off the phone and thought, ‘This isn’t helpful! I am rehearsing all my anxieties for my mother!’” I say: “You’re rehearsing before your mother just like you’re rehearsing in the dream. You’re acting out a part, like being in a play.”

Ms. K. responds vehemently and enthusiastically! “Yes! My performance is talking about my anxieties these days!” Seeing the link between performing for mother, in the session and in the dream, Ms. K. brings our discussion back to the red shoes image in the dream.

Ms. K. continues: “There were two pieces of shoes next to each other. One pair had a buckle over the in-step and the other was plain. My mother had one pair of shoes and you had the other.”

I ask: “So which shoes did she have and which did I have?”

Ms. K. changes the subject: “I can’t remember! I saw this woman at the airport when I landed. I imagined that she had been away at school. She was being picked up by her mother. I just looked at her and thought that she made me feel like something’s missing from my life. I imagined this woman was surrounded by love and affection. I imagined her life wasn’t hard.”

Instead of responding to her movement into object related longings for love, and to the sense of losing her mother, or having never had her ideal fantasy mother, I bring her back to the dream image of the Red Shoes, returning to her pathological mode of manic defense. She follows me, and then we get back to the theme of love and loss in the session. The therapeutic object relationship gives her a context for her feelings of loss in separating from me, her analyst, and her transferential mother.

I say first: “With the red shoes on, you don’t have to work hard! They do all the work.” Ms. K. responds: “I want a pair of them!”

I say: “You sure do! The only problem is they kill you at the end.”

Ms. K.: “They do not! I like them!” She acts like a cute child here and starts making animal sounds, “Greer!” But I have imposed my red shoes myth on her dream and her symbolism. My red shoes myth is about the manic compulsion to create a dance of death— substituting the narcissistic intensity and image of creative work for real sexual desire, which risks love and loss. My red shoes lead the woman who wears them to her death, as she marries the internal god muse demon, who keeps driving her to narcissistic achievement. However, Ms.

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K.’s red shoes may be different. They symbolize manic success, and success as sex substitute or as a prerequisite to getting a sex object, without risking sexual desire. However, since she also relates her red shoes to the magic shoes given by the good fair god mother in the Wizard of Oz they are also associated with magically returning home to mother, without any effort. Dorothy’s magic hoes brought her back to her home in Kansas. Therefore, the red shoes represent a regressive defense as well as a manic defense.

The underlying theme of the session is of wanting her mother and losing her—wanting the good mother who would give her the gift of the red shoes, and the fear of losing her mother to her mother’s addiction to the Red Shoes, and to a false and magical form of sexuality in relation to the man. Ms. K. is not ready for my oedipal interpretation about her retreating into childhood to avoid competition with her mother. For although she may be the young mistress of her Don Juan father in the dream, she isn’t—can’t compete with a mother for this Don Juan man because she wants her mother more than she wants the man. Her longings for her mother and her abandonment fears are dominant. Also, the Don Juan man is not a separate whole male figure. She is not jealous but envious. The man is a narcissistic extension of her mother (phallic- narcissistic, or Melanie Klein’s [1926] man ‘inside’ of the mother’), not a fully differentiated whole other. The conflict is not yet an oedipal one, but one over separation. She wants her mother to stay tied to her, and yet she needs to let her mother go so that she can separate, and have her own success in the world, and her own sexuality.

The session in which the dream is presented ends on the note of loss and separation. After Ms. K. says that she wants the Red Shoes, and makes more animal noises after I say the Red Shoe leads to death, I ask her if she can translate her sounds into the language of an adult. She makes an angry “Greer!” sound again, and then I interpret her wish to stay a child. I say to Ms. K.: “Maybe you want to be little like the littlest child in the play in order to avoid having big feelings… Maybe your feelings feel too big!” Ms. K. responds powerfully to my comment. She says, “They are! I’m sad!!!” I then say: “It’s good you can feel it now. Then you can stay connected to me this week.” Ms. K. repeats that she’s “sad”… It’s time to go, and she looks at me sadly as she leaves. She waves good-bye to me like a little kid and says “I’ll miss you!”

Ms. K. has gone from mad to sad. We have gotten to the sense of loss underlying the session. She has been able to contain the sadness by sharing it with me at the end. This helps to

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lessen the need for her manic defense compulsion, in which she drives herself to assume the image of the Red Shoes success star, in which she possesses a man as a part object as a sign of the narcissistic intensity of the creative mystique. The theme of her mother leaving her in the dream is brought full circle to her leaving me as her transferential mother and grieving the separation at the end of the session. This allows her to tolerate loss during the week when away. When she begins to obsess about herself by a failure she thinks back to my telling her of how her negative hall of mirrors, failure images are used to ward off the feeling of loss, just as are the Red Shoes success images are. She is able then, on her own, to identify who she is longing for, from her past, at that moment when she assumes the negative mystique of failure and becomes narcissistically preoccupied.

This dream of the Red Shoes demonstrates that Ms. K. has developed to a level of body connection in which it is only her differentiated feminine sexuality that has a manic disconnected life of its own. Ms. K. is now in herself, but is still a child in the dream, an outsider to her adult feminine body. But to own it she has to tolerate separating from her mother and feeling the loss of separation. In the therapeutic object relationship with me she is able to tolerate this as our relationship supports her capacity to feel both her rage and her sadness bit by bit, in tolerable doses. The increasing connection with me through these feelings, and the increasing internalization process, allows Ms. K. to be increasingly in herself and therefore to separate enough from her thoughts and feelings to own them as thoughts and feelings, and to create symbols and associations out of them, instead of being trapped in them. She has become and interpreting subject (Ogden, 1985). Ms. K. demonstrates her capacity to be an interpreting subject in her approach to her last dream.

The last dream of Ms. K.’s I will discuss occurred a few months again, within the second year of treatment. It follows the red shoes dream and is an interesting contrast to it. In this dream, Ms. K. feels genuine and intense sexual desire, as opposed to the red shoes manic erotic intensity. The feeling is powerful, and she fears overwhelming, and it is generated by her new relationship with a truly emotionally available man, who has recently entered her life. Prior to the dream, this man touches her on the cheek and she feels a surge of sexual desire, which becomes an intense feeling of passion in the dream. However, Ms. K. cuts off her desire by returning to a position of narcissism and envy. She sees her girlfriend with her boyfriend in the

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dream, and thinks that she envies her because her boyfriend is thin. The man she is attracted to is heavy. She again, as in the last dream of the Red Shoes, envies a woman for having a man who is a narcissistic self extension. In this dream, Ms. K. retreats from her intense object related sexual desire to the position of envy for the mother and the man ‘inside’ of her mother’s body, the idealized phallus as an extension of the mother.

Ms. K. quickly responded to her own dream at this time. She did not hold back as she had when reporting the Red Shoes dream, taking a child position. She quickly initiated her own association and interpretation process. Her interpretation of the dream was that she had killed off her own sexual desire and the man who was the object of that desire with her envy. She analyzed her own spoiling process and we talked about her fear of wanting an available man and her fear of being wanted. She then was able to speak of her defensive distancing, through criticism of the man, and in this case of his weight, at any time when she begins to feel loses to him. She was now experiencing and analyzing her own psychic conflict and her own ambivalence, particularly her ambivalence about moving into sustained object relations, with all its threats of love and loss. In all these patient dream sequences we see the movement form body disconnection, psychic dissociation, and depersonalization to connection and self integration through the therapeutic object relationship. Interpretations of disconnection versus contact are made throughout, both in relation to the dream content and to the process around the dream experience in the session (Kavaler-Adler 1987). Parallel movement is seen in body connection, self integration, sustained good enough relations and internalizations in the therapeutic object relationship, and in the capacity or symbolic association as opposed to enactment, projective expulsion and protosymbolic sensory experience, rather than symbolically represented experience (Kavaler-Adler 1993a, 1936b). The capacity for creating and sustaining meaning grows along with the capacity for concern (Winnicott 1963). Attacks on linking and meaning (Bion, 1955, 1963) are seen in conjunction with body/mind dissociations and body disconnection, and are modified as the mind/body splits are experienced and analyzed in the context of the therapeutic object relationship.

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A NOTE FROM THE EDITOR

This paper was presented in 1995 at The PostGraduate Psychoanalytic Society and Institute conference and at the Object Relations Institute for Psychotherapy and Psychoanalysis Annual conference, but never was published. All the ideas expressed by the author over twenty years ago are relevant very much for today’s psychoanalysts and psychotherapists, as they touch upon very deep cords of relations with one’s internal objects (and with the SELF), and working with dreams of so-called pre-Oedipal characters.

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