Patient-Analyst “Withness”: on Analytic “Presencing,” Passion, and Compassion in States of Breakdown, Despair, and Deadness

Abstract

This paper focuses on the analyst's "presencing" (being there) within the patient's experiential world and within the grip of the psychoanalytic process, and the ensuing deep patient-analyst interconnectedness, as a fundamental dimension of analytic work. It engenders new possibilities for extending the reach of psychoanalytic treatment to more disturbed patients. Here patient and analyst forge an emergent new entity of interconnectedness or "withness" that goes beyond the confines of their separate subjectivities and the simple summation of the two. Using a detailed clinical illustration of a difficult analysis with a severely fetishistic-masochistic patient, the author describes the kind of knowledge, experience, and powerful effects that come into being when the analyst interconnects psychically with the patient in living through the process, and that relate specifically to the analyst's compassion.

The Man of the House: Commentary on Thomas Burkhalter’s “Foregrounding Masculinities in Psychoanalytic Psychotherapy”

“…Many of us know the wrenching work of encountering the not-me in our clinical interactions and the relief when we remove ourselves from the primary mixup that patients often induce. However, our notions of therapeutic action now embrace these moments and ask us to engage with what may be dissociated or to consider that such vivid arousal engendered in the therapist is often a signal of projective identification that speaks to a more primitive self state calling out for recognition and withness (Eshel, 2013;Grossmark, 2012aGrossmark, , 2012b.…”

From Extension to Revolutionary Change in Clinical Psychoanalysis: The Radical Influence of Bion and Winnicott

“…In the many years that have passed since I treated Nir, I have come to realize that transformation in the most cut‐off, blocked, deadening, empty, desperate, and despairing psychic zones—zones of psychic breakdown, madness, annihilation, and catastrophe—may become possible only when the analyst/therapist is willing and able to be‐within (and with‐in ) the patient's experiential world and within the grip of the analytic process, with the ensuing patient‐analyst deep‐level interconnectedness or “witnessing” psyche‐with‐psyche (Eshel , , , , , , , ). This interconnectedness, which becomes at‐one‐ment when the analyst puts him‐/herself entirely within the patient's emotional reality, is difficult and demanding, an unyielding, ongoing struggle with the underlying catastrophe to reach a new and formative, deep experiencing, beyond epistemological exploration‐K.…”

“…In modern physics, different paradigms—classical physics and quantum mechanics—do coexist (Kuhn ). Whereas classical physics is based on assumptions of linear causality, determinism, and a sharp separation between observer and observed, quantum mechanics introduced into scientific thinking enigmatic principles of uncertainty and inseparability of observer and observed, the crucial formative effect of the process of observation, and the fundamental organization of unbroken wholeness that underlies our perceived world of separateness at the particle level (Bohm ; Botella and Botella ; Eshel , , , , , ; Field ; Godwin ; Kulka ; Mayer ; Sucharov ; Suchet ).…”

Compassionate Witnessing in the Face of Erasure: A Commentary on “Crows on the Cradles: Palestinian Mothers at a Frontline Vortex; Reflections on the Psychology of Occupation” by Judy Roth and Salwa Duaibis

“…Within the relational school of psychoanalysis, compassion may be beginning to acquire its rightful place in psychoanalysis as an important concept: the concept of “psychoanalytic compassion”, which is a dialogic and participatory process and attitude that implicitly affords the analysand the humanity and dignity of being the subject of their own experiences, while accompanying the analysand into the darkest recesses of such experiences (Orange, ). Eshel () further elaborates on this participatory nature of the psychoanalytically compassionate process and refers to it as “withness”. Eshel () describes how the emergent interconnectedness resulting from this process allows for a greater potential for psychoanalytic treatment of more disturbed patients.…”

“…Eshel () further elaborates on this participatory nature of the psychoanalytically compassionate process and refers to it as “withness”. Eshel () describes how the emergent interconnectedness resulting from this process allows for a greater potential for psychoanalytic treatment of more disturbed patients.…”