March 18, 2020
Paris is empty, very empty.
Very strange. But it is even possible to feel a beauty in this emptiness! I have never seen Paris this way and in this state. Since Tuesday, we have lived in a complete confinement, “lockdown.” We have to stay inside our houses, without permission to go out. We need a certificate to go out and buy our food.
Since Wednesday, the police have issued fines if you do not have this certificate. Many people have gone to the country, hoping for less virus. There is a lot of medical theories, good and bad knowledge, fake news, etc. Governments change knowledge and information every day. Fortunately, some of us are doctors and have friends who work in research laboratories. But discoveries change daily.
We all live in great uncertainty.
All precautions (washing hands twenty times a day, etc.) and guidelines are only useful for spreading the number of patients over a longer period of time; that doesn’t stop you from getting sick; there is no healing yet.
You know too that 50 percent of the people who have these complications are less fifty years old.
As of last week, it was necessary to reorganize the scheduling of sessions. It is not easy for some patients to find a quiet space favorable to the regression of free association.
At first, the traumatic neurosis is triggered—and we need more time, latent time, to re-find the logics of the “après-coup” (or the deferred effect). For the moment, everything we are doing is inscribed in the logic of the first traumatic time.
The elusive viral disease is a great source of threat and negative irrational transference. The belief in the power of super-mother super-father is broken; the demand that the government, the doctors and scientists, and psychoanalysis offer all-powerful solutions comes with great anger and sadness and reproaches about the abandonment, the distress.
Fortunately, it is possible to work on the psychic implications, so the interest of the analytic work is preserved.
Many things could be developed about the gap between representations and perceptions, and about the variations of this gap in the current situation for the patient and for the analyst.
But at the moment, in France, the theoretical reflections on remote analysis are not the main subject. Maybe because the disease started several weeks ago.
Especially because the number of deaths increases every day in Italy-Spain-Germany-France at high speed (twice as much every day).
The number of deaths has reached the peak of the curve since yesterday, but not the top of the peak!
In Italy yesterday, more than 400 died during one day—each day. And it will continue during a week or two, maybe more!
So, we cannot have a debate on remote analysis in this context. Remote analysis is imposed on us.
Everyone is concerned with their health and that of those close to them. And the logics of “traumatic neurosis” dominate. At the moment, all my thoughts about remote analysis are based on the number of deaths, which is increasing each day.
Jean Cocteau found the words: “Mirrors are the doors through which death comes and goes.” (The Wedding Party on the Eiffel Tower) For us, it’s by phone and sound that threat and dread come and go, come back and return; and sometimes the issue of our own disappearance is disguised in other clinical forms. Libidinal co-excitement and masochism of the renunciation linked to the lack of perception when perception is reduced to sound only, are the ways by which thought can be reborn, by which the infantile can re-find its place. Only then this new situation will be able to be thought “après coup.”
Hoping for all of our health.
Take care and stay safe,
March 29, 2020
After 12 days of confinement
Fortunately, we have some tools to work with in the new context of remote sessions. Many psychoanalysts and patients have agreed to adapt their sessions to this new protocol, which retains the audio and video channels for face-to-face treatments.
Fortunately, the traumatic tonality which is evoked by the horror of the current situation does not force all our patients to remain in traumatic neurosis, even if this is the background of all that happens during the sessions.
Of course, many generic memories arise during the sessions and are accentuated due to the lack of the usual conditions—generic memories of illnesses, childhood infectious diseases, school breakups, confinement due to contagion, and the lack of teachers and classmates; memories of staying at home, close to the mother and other family members; etc.
Many specific memories are also evoked about traumatic illnesses and other traumatic experiences and mourning that they had to endure. And also memories pertaining to the specific relationships that each one lived with their family, in relationship to the disease, to the doctors, to the drugs, and the many theories about the body; the many means that families use to seek care and achieve healing; theories on the omnipotence of the mother who nurses and cares, and its opposite, the imago of the fatal mother who gives sickness to her children; and all the theories and fantasies about contamination and contagion, etc.
I just want to emphasize a point about our internal “frame” and the differences and gaps between the current situation and the previous one, that of the couch-armchair.
The “game” or play between representations and perceptions changes both for the analysand and for the analyst when the exchange is reduced to the single sound path and when what is missing becomes all the more important.
The analysand imagines his analyst in his usual, familiar office. He uses his representations; he is deprived of perceptions. Sometimes the representations become frightening hallucinations; then, the analyst becomes present at home; the patient prefers not to have phone sessions.
The analyst can imagine his patient physically absent but without any familiar stable representation. His listening and his thinking are deprived of the stabilized sensory presence of his patients in his office.
We will have to think little by little about all these concrete aspects, these gaps and changes, these new deprivations in order to be able to improve the theories of face-to-face and distance sessions.
Be careful and stay safe; above all, do not give in to the temptations of leaving the confinement too early.
Bernard Chervet, MD, is a training/supervising analyst in the Paris Society, past president SPP, representative IPA Board, and director French Speaking Psychoanalysts Congress (CPLF).
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