Knowledge and experience of time in primitive mental states

Abstract

The author proposes that time be considered an object of working through during the psychoanalysis of patients whose mental functioning reveals distinct primitive aspects. These so-called 'difficult patients' are particularly intolerant of the temporal limits of analytic sessions and often attempt to undermine the analytic setting. He presents some hypotheses about time and the mind's depth levels. A series of clinical vignettes taken from the analysis of adolescent, borderline and psychotic patients shows several ways in which the analysand's perception of and relation to time surfaces and is worked through in the course of analysis. Analyzing the relationship with time and the conflict between denial and acceptance of temporality proved a significant catalyst in the development of cases that had tenaciously impeded progress. It thus became possible to bring about important changes in the ways such patients experienced affect in the analytic relationship and in object relations, not by acting directly upon these relationships but by working instead on the formal parameters that organize the mind-and primarily on its spatio-temporal organization.

Flexibility of the Psychoanalytic Approach in the Treatment of a Suicidal Patient: Stubborn Silences as “Playing Dead”

“…For my part, I supported a progressive orientation rather than a regressive one, by actively stimulating A's interventions and associations. The psychoanalytic ideas that hinge on regression as the key to entering the atemporality of the unconscious levels (Freud, 1900) strike me as captive to a century-old theoretical bias, without taking any account of the clinical evidence that a tendency towards regression and atemporality is part of the patient's disorder (Lombardi, 2003); neither do they bespeak any familiarity with the evidence that the unconscious plays a part, to a varying extent, in every 280 LOMBARDI single mental act of ours (Matte Blanco, 1975). Hence I consider the clinical validity of psychoanalysis to be connected primarily to its relationship with the reality principle (Freud, 1911), which implies a linear conception of time, for which regression is not an option.…”

“…Not letting Antonio have his mental presence founder in the context of his sessions, but encouraging him instead to be present and to experience the temporal limits determined by the approach of a separation was particularly useful in avoiding the disappearance of an awareness of himself in which a place could be found for hatred and pain-both current pain and the pain he had been carrying about with him all his life. It did not seem incidental that, starting with this phase of his analysis, Antonio showed what appeared to be a certain sensitivity to the temporal course of his sessions (Lombardi, 2003), manifested by some new and quite noticeable events. Indeed the approach of the end of a session sometimes caused the emergence of phenomena that seemed to signify that his icy armor was beginning to melt away.…”

“…Working through the mental models and theories (Bion, 1962;Lombardi, 2003) involved in A's life-denying orientation was a high point in the evolution of A's analysis, which led to important changes in his life, such as a substantial reduction of anxiety and the disappearance of all references to the temptation of suicide, the total cessation of any form of gambling, as well as-on a more concrete level-the purchase of an apartment for himself and his family with the attendant exhausting move into the new apartment, which opened up new horizons for him. This was seconded, somewhat later, by a greater commitment to his profession and a career advancement.…”

On Time and Deepening in Psychoanalysis

“…Scarfone (2006) pointed out that the sense of a past and the sense of a present arise in the same instant-that we move from a state of unreflective timelessness to a sense of the present as a moment in time only by recognizing that the present differs from the past, that we cannot have both at one time. Fink (1993) and Lombardi (2003) presented material from the treatment of very primitive patients to show that the analyst's introduction of the awareness of time provides a leading edge of differentiation and reflectiveness that permits a broader reorganization of experience.…”

Exploring the troubling temporalities produced by fetal personhood

“…According to psychoanalytic theory, trauma interrupts this steady predictable time, resulting in disruptions in time (see Lombardi, 2003;van der Kolk, 1995; just 2 examples of many). Queer temporality, on the other hand, celebrates asynchronous forms of temporality (Dinshaw et al, 2007;Dinshaw, 2012).…”