Reading Ogden: On Psychoanalytic Virtues (#3)
We must invent psychoanalysis anew with each patient
Adam J. Rodríguez, PsyD is a psychoanalytic psychologist in private practice in Portland, OR. He is the editor and a contributor to “Know That You Are Worthy: Experiences from First-Generation College Graduates” (2023) with Rowman & Littlefield. He can be reached at email@example.com.
V – Thinking Out Loud
Thinking out loud is a form of dreaming. The patient’s dreaming takes the form of free association, whereas the analyst’s dreaming takes place in reverie. Note that these are, at their core, the same thing. What distinguishes them has to do with roles in the relationship. The patient is invited to share whatever comes to mind. Their reverie produces the material they are invited to share. The analyst’s way of speaking to the patient is informed by their reverie, but the analyst does not say whatever comes to their mind. Rather, they are selective about how to make sense of their intersubjectively-informed reveries to say something to the patient that may be utilizable for psychological work. When we speak to patients, we endeavor to do so in a natural, jargon-free manner which is individual and specific to that patient. The analytic third is a unique intersubjective pairing, which means that an analyst who speaks to all of his patients in the exact same way would be disingenuous and hollow. Rather, for an analysis to be alive, the analyst must “invent psychoanalysis anew with each patient” (Ogden, 2007, p. 575). Formulaic, rote, jargon-heavy and forced ways of being, thinking, and talking with patients are not alive. When speaking with patients, “we must in our attempt in our use of language … to be makers of music, rather than players of notes” (Ogden, 1997a, p. 4-5). As is true with music, “we have little choice but to accept that a word or sentence is not a still point of meaning and will not sound the same or mean the same thing a moment later” (p. 5). This form of talking is spontaneous and improvisational, borne of the analyst’s attention to his reveries, countertransference, transference, and dynamics of the analytic third. Ogden is careful to caution against a cavalier attitude when intervening in this manner. He states that one must remain attuned to the frame and that “it requires a great deal of training and experience to be able to talk in a way that feels and sounds spontaneous, unpracticed, uncontrived, undictated by analytic convention or prescription (Ogden, 1997a, p. 11).
Thinking out loud is essential for the patient as well. In addition to conventional forms of content, Ogden discusses the important of
“… forms of talking generated by the patient and analyst which may at first seem ‘unanalytic’ because the patient and analyst are talking about such things as books, poems, films, rules of grammar, etymology, the speed of light, the taste of chocolate, and so on.” (Ogden, 2007, p. 575)
As is true of Ogden’s paper on reverie, these forms of talking may initially appear to be irrelevant, but Ogden contends that “such ‘unanalytic’ talk often allows a patient and an analyst who have been unable to dream together to begin to be able to do so” (p. 575). In another paper, Ogden (2005a) has stressed the importance of “having time to waste.” Ogden prizes these as much as any other content that patients share, humanely opens up space for them and actively participates in them, and works with them as he does any other psychoanalytic content.
This form of talking, which Ogden calls “talking-as-dreaming,” is unlike ordinary conversation. It includes considerable primary process thinking and non-sequiturs (Ogden, 2007), akin to how we may think of a narrative dream occurring. It may appear like conventional forms of conversation, at least superficially, but the analyst’s participation distinguishes it from other forms of talking. The analyst, internally, is observing and thinking about the emotional experience of the conversation and the process of talking about the emotional experiences in an attempt to understand. The patient’s communications, which, again may superficially appear “unanalytic,” are informed and guided by this internal experience.
Ogden welcomes and embraces misunderstandings, with the belief that they lead to conjecture, possibility, and humility, traits that are necessary when confronting the human condition and its accompanying unknowable truths.
When speaking with patients, Ogden is focused less on what he says to patients and more on how he speaks to patients. He places an emphasis on avoiding language which leads patients or pulls them toward secondary process thinking. He welcomes and embraces misunderstandings, with the belief that they lead to conjecture, possibility, and humility, traits that are necessary when confronting the human condition and its accompanying unknowable truths. He disfavors and shies away from certainty on the part of the analyst, feeling that it undermines the patient’s potential for growth. Perhaps above all and most significantly, Ogden leans away from explaining what is happening during the analytic process, since the analyst cannot know with any certainty, and favors describing what is happening. Describing, rather than explaining, frees both patient and analyst from the need to understand or know. It is within the areas of not knowing, confusion, fluidity, and shifting meanings that truth emerges. I present an example from Ogden, which highlights avoiding knowing in favor of primary process.
“Earlier in my development as an analyst, if a patient in an initial meeting were to begin by telling me she was terrified to come to see me, I might have asked, “What terrifies you?” Or “Why are you terrified?” More recently, when a patient began by telling me she was terrified to come and see me, I said, “Of course you are.”” (Ogden, 2018, p. 404)
In this clinical example, the initial example of a response “What terrifies you?” or “Why are you terrified?” invites a secondary process response. Asking those questions asks the patient to think about their experience and offer an idea of what they are feeling. The primary process embedded in the patient’s declaration is related to fear and terror, which the patient cannot reasonably comprehend yet. To say “of course you are” is what Ogden calls a “description-in-action.” He considers this an ontological experience rather than an epistemological one. It is not concerned with the patient cognitively knowing or understanding something about their experience. Rather, it is concerned with accepting the patient where they are at and, especially important in an initial meeting, communicating to the patient that their fantasies are welcome in the analysis.
VI – Not Knowing
The importance of not knowing is central to the human condition and therefore also to the experience of psychotherapy. This is especially true when one is working with the unconscious mind. The ability to not know allows us to marvel at “the mystery, the utter unpredictability, and the power of the unconscious which can be felt, but never known (Ogden, 2005b, p. 15).
Bion implores the analyst to abandon any sense of memory, desire, and sensory experience. He issues a mandate that “every session attended by the psychoanalyst must have no history and no future,” which may seem both impossible and illogical. Ogden, however, states that this is not really about memory or desire, but rather about intuitive thinking and how we use intuitive thinking in the analytic situation.
The importance of Bion’s Notes on Memory and Desire, which Ogden describes as “an impossibly difficult paper” (Ogden, 2015, p. 285), can be seen in Ogden’s value of not knowing. Bion’s extremely brief paper, only two and a half pages, is referenced frequently by many, but often poorly understood, as may be said of several of Bion’s papers. In this paper, Bion implores the analyst to abandon any sense of memory, desire, and sensory experience. He issues a mandate that “every session attended by the psychoanalyst must have no history and no future” (Bion, 1967/2013, p. 17), which may seem both impossible and illogical. Ogden, however, states that the paper is not really about memory or desire, but rather about intuitive thinking and how we use intuitive thinking in the analytic situation. He is giving privilege to unknowable, unconscious thinking. Ogden (2015) says:
If the analyst is to be genuinely analytic in the way he observes, he must be able to abjure conscious, sensory-based modes of perceiving, which draw the analyst’s mind to conscious experience and modes of thinking (for example, memory and desire) that are fearful/evasive of the perception of the unconscious psychic reality (the truth) of what is occurring in the session. (p. 293)
Ogden uses the phrase “genuinely analytic,” suggesting that truly analytic work is attuned to and focused on the patient’s immediate experience, the pathway to the unconscious, and not rigidly adhered to theory or technique. The focus is on the unconscious experience unfolding within the patient’s psychic reality, which may surprise us in its novelty. Ogden continues:
“That form of thinking, which Bion calls intuition, has its roots in the unconscious mind …. The unconscious is free to view experience simultaneously from multiple vertices.” (P. 293)
Memory and desire stand in the way of truth as they are attached to something that has happened and removed from what is happening. What has happened is not immediately relevant. It is static and dead. In a previous paper, (Rodríguez, 2020), I compare this mode of intuitive thinking to jazz improvisation and compare the clinical encounter to a musical performance:
“Each performance varies in significant ways from the previous. Even if the musicians and venue remain the same, each musician is different from the last performance, from the last song, from the last note … The moment in time is new. It thusly requires a fresh and original approach… What the pianist played over a chord sequence during the first solo will be different from the last time the pianist played the chord sequence, mere minutes ago. It will certainly be different from the previous week. I may have accompanied that pianist through those chord changes in a specific way, and it may even be in a way that we both found pleasing and resonant, but to attempt to repeat the exact same experience would be foolish. Not only would it be impossible, but it would be stale and lifeless. It would be untrue.” (P. 131)
Therapists may become reliant upon theory and learned modes of technique so much that they become prescriptive and forced in their application. This is often done to relieve the therapist’s anxiety and dread of not knowing, which the patient experiences as obtrusive. Being present with the patient involves letting go of preformed ideas of what should be. Intervening intuitively, or without memory and desire, still requires that therapists are studious, well-read, have their own therapy, and seek consultation and supervision, but those learned ideas and models, along with the history of the past sessions, are consciously let go of, (but unconsciously held) in the immediacy of what is happening with the patient. We strive to integrate those ideas proprioceptively, so that we may affix our attention to the patient in a dream-like state and manner that facilitates the patient’s own ability to dream together.
A path of development can be traced across the course of Ogden’s published work, beginning in 1979, that leads him from a largely epistemological psychoanalysis to an ontological psychoanalysis. Ogden is wrestling with what it means to be human. Early Ogden explores our internal object world and intersubjectivity in his attempts to understand what it is like to be human. Later Ogden explores the dynamics of becoming human. These ideas culminate in Ogden’s recent work, expressed here:
“A radical change has occurred, rather unobtrusively, in the theory and practice of psychoanalysis in the course of the past 70 years, a change for which, until recently, I have not had a name. That transformation involves a shift in emphasis from epistemological (pertaining to knowing and understanding) psychoanalysis to ontological (pertaining to being and becoming) psychoanalysis. I view Freud and Klein as the founders of a form of psychoanalysis that is epistemological in nature, and I consider Winnicott and Bion as the principal contributors to the development of ontological psychoanalysis. Finding words to describe this movement in psychoanalysis holds a good deal of personal significance for me. This paper is, in a sense, an account of the movement in my own thinking from a focus on unconscious internal object relationships to a focus on the struggle in which each of us is engaged to more fully come into being as a person whose experience feels real and alive to himself or herself.” (Ogden, 2019, p. 662-663)
His recent work leans away from dense articulations of theoretical models to a focus on what it means to engage, psychoanalytically, with another human in a manner that allows the patient to become more fully themselves. The world of internal object relations provides a great deal of that compass, but he also repeatedly draws upon his love of literature and poetry. He is concerned with how to truthfully and authentically dream ourselves into being.
Ogden stresses the pursuit of a deeper, fuller sense of living as the goal of psychoanalysis. It is in this, and similar statements, that I recognize a connection to Freud’s writing. Freud remained very connected to what makes us human. Seele, German for “soul,” appears frequently in Freud’s writing, but was rendered into “mental apparatus” or “mental organization” in English. To Freud, the soul “is the seat both of the mind and of the passions … It is what makes us human” (Bettelheim, 1982, p. 77-78). The values that Ogden expresses in What I Would Not Part With — being humane, facing the music, being accountable, dreaming oneself into being, thinking out loud, and not knowing — all dialectically reinforce one another as they come together to form the central values which guide his work. They all remain tied to being with patients in a manner that promotes the ability for the patient to come more fully into himself or herself.
The values that Ogden expresses in What I Would Not Part With — being humane, facing the music, being accountable, dreaming oneself into being, thinking out loud, and not knowing — all dialectically reinforce one another as they come together to form the central values which guide his work. They all remain tied to being with patients in a manner that promotes the ability for the patient to come more fully into himself or herself.
The second half of the title of the paper on ontological psychoanalysis I just referenced, is “What do you want to be when you grow up?” Winnicott asked this question to every adolescent he saw and believed their response to be incredibly important. I will let Ogden (2019) express why he chose it his subtitle:
“This question is perhaps the most important question any of us asks ourselves from very early in life until the moment just before we die. Who would we like to become? What kind of person do we want to be? In what ways are we not ourselves? What is it that prevents us from being more the person we would like to be? How do we become more of the person we feel we have the potential to be and the responsibility to be? These are the questions that bring most patients to therapy or analysis, though they are rarely aware that this is the case, being more focused on finding symptomatic relief. At times, the goal of treatment is to bring a patient from a state of not being able to form such questions to a state in which he is.” (p. 662)
Adam J. Rodríguez has also made this 3-part essay available as a single article in a pdf along with additional material in appendix.
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Bettelheim, B. (1982). Freud and man’s soul: An important re-interpretation of Freudian theory. Vintage.
Bion, W.R. (1967/2013). Notes on memory and desire. In Wilfred Bion: Los Angeles Seminars and Supervision, (pp. 136-138), J. Aguayo & B. Malin (eds.). Karnac.
Ogden, T.H. (1997a). Reverie and Interpretation: Sensing something human. Routledge.
Ogden, T. H. (2005a). On psychoanalytic supervision. International Journal of Psychoanalysis 86, 1265-1280.
Ogden, T. H. (2005b). What I Would Not Part With. Fort Da, 11, 8-17.
Ogden, T.H. (2006). On teaching psychoanalysis. International Journal of Psychoanalysis, 87, 1069-1085.
Ogden T.H. (2007). On talking-as-dreaming. International Journal of Psychoanalysis, 88, 575-589.
Ogden, T. H. (2009). Rediscovering Psychoanalysis. Psychoanalytic Perspectives 6:22-31
Ogden, T. H. (2015). Intuiting the Truth of What's Happening: On Bion's “Notes on Memory and Desire”. Psychoanalytic Quarterly, 84, 285-306.
Ogden, T. H. (2018). How I talk with my patients. Psychoanalytic Quarterly, 87, 399-413.
Ogden, T. H. (2019). Ontological Psychoanalysis or “What Do You Want to Be When You Grow Up?”. Psychoanalytic Quarterly, 88, 661-684.
Rodriguez, A. (2020). Impressions: On jazz, improvisation, memory and desire. Free Associations, 78, 128-134.