ABSTRACT
The dependence of thought and the will on the cortex and the dependence of the emotions on the thalamus are well known and scientifically proven. Contemporary psycho-pharmacological research is extending and even transforming our understanding of these areas. At the same time, such advances have narrowed both the field of observation and the theoretical field: psycho-physiologists tend to reduce the living body to the nervous system and behaviour to the brain activities that programme it by collecting, analysing, and synthesising information. However fruitful this model has proved for biologists, it has also increasingly been imposed by state-funded research institutions on psychology, which is fast becoming the poor relation of brain neurophysiology. Indeed, it is often imposed with authoritarianism by the very “scientists” who insist on freedom of research, especially basic research, in their own disciplines. By focusing on the skin, a primary datum which has elements of both the organic and the imaginary, which is at once a system for protecting our individuality and a primary instrument and site of exchange with others, my aim is to propose a different model, solidly based in 4biology, that is the foundation of our interaction with those around us and respects the specificity of psychical phenomena as they relate to both organic and social realities—in sum, a model which I believe is capable of enriching the practice as well as the theory of psychology and psychoanalysis.
The functioning of the psyche, both conscious and unconscious, has its own laws. One of these laws is that part of it strives for independence, whereas in fact, from the beginning, it is doubly dependent—on the living organism that supports it and on the stimuli, beliefs, norms, cathexes, and representations emanating from the social groups the subject belongs to—first the family, later the cultural environment. Any theory of the psyche must hold these two threads together, without falling back on a combination of simplistic determinisms. Thus, following René Kaës (1979b, 1984), I shall postulate that the psyche has two anaclitic relationships: on the one hand a double anaclisis on the biological body and the social body and on the other a mutual anaclisis since, among humans at least, organic life and social life have just as much need for the virtually constant support of the individual psyche—as we can tell from both psychosomatic approaches to physical illness and the study of how myths or social innovations come to be—as the latter has for the reciprocal support of a living body and a living social group.
Nonetheless, the viewpoint of psychoanalysis is fundamentally different from that of psycho-physiology or psycho-sociology, for psychoanalysis is always aware of the existence and importance of individual phantasy—conscious, preconscious, and unconscious—and its role as a bridge and screen mediating between the psyche and the body, the world and other psyches. The Skin-ego is a phantasmatic reality: it appears in phantasies, dreams, everyday speech, body language, and thought disorders; and it provides the imaginary space in which phantasies, dreams, thought, and all psychopathological formations are set up.
There is an internal conflict in psychoanalytic thought between an empiricist, pragmatic, psychogenetic tendency, most common among the British and Americans, which holds that the organisation of the psyche is the result of unconscious experiences in childhood (especially those with object relations) and a structuralist tendency, predominant in France in the last few decades, which denies that structure may emerge out of experience, arguing on the contrary 5that any experience must itself have been organised by a pre-existing structure. I refuse to take sides in this conflict. The two attitudes are complementary and the antagonism between them should be preserved only so long as it enriches psychoanalytic research. The Skin-ego is an intermediate structure of the psychical apparatus: it mediates chronologically between the mother and the infant and structurally between the mutual inclusion of psyches in the state of original fusion and the differentiation of psychical agencies that corresponds to Freud’s second topography. If the appropriate experiences do not occur at the right moment, this structure will not be acquired or, more commonly, will be distorted. But the many different configurations of the Skin-ego, which I shall describe in Part III, are variants on a basic topographical structure, whose universal character may suggest that it is already inscribed in virtual form (pre-programmed) in the psyche at birth, and the aim of achieving it is always implicitly felt by the psyche (in this respect, my thinking is close to the theory known as epigenetics or “interactive spiral theory”).
Freud proposed, but did not formalise, a “model” of the psychical apparatus as a system of sub-systems, each governed by its own functioning principle—the reality principle, the pleasure-unpleasure principle, the compulsion to repeat, the principle of constancy and the Nirvana principle. With the Skin-ego we must add two more: a principle of internal differentiation and a principle of containment, both of which were hinted at by Freud in his “Project for a scientific psychology” (1950a) of 1895. The most serious pathologies of the Skin-ego—the autistic wrapping, for example—might even offer the possibility of importing into psychoanalysis the principle of self-regulation of open systems in response to “noise” which has been popularised by systems theorists such as Henri Atlan (1979). However, this principle, which helps living organisms to evolve, seems to be reversed when we move from biology to psychology, in which it appears chiefly to create psychopathological structures.
The sciences progress by means of an oscillation between two epistemological attitudes, which vary according to the personalities of the scientists and the requirements or the dead ends of a particular science at a particular moment. In the first case, the science possesses a valid theory which the ingenuity of laboratory workers is devoted to confirming, applying or developing; it remains useful as long as 6it goes on producing valuable insights or until its major arguments are refuted. In the second, the science is renewed by the inspiration of one researcher—sometimes from another discipline—who casts doubt on accepted ideas; this individual’s intuitions arise more from the creative imagination than from reasoning or calculations; moved by a kind of personal myth, which they cleanse of its phantasmatic baggage (though the latter may be projected into religious beliefs, philosophical speculation or related literary or artistic activities), they use it to draw out ideas that can be formulated in simple terms, verified under certain conditions and perhaps translated and transported into other fields. In the study of individual psychical functioning, Freud embodies this second attitude—it is no coincidence that as a young man I was interested in how he deployed his creative imagination through self-analysis, in his own youth, to discover psychoanalysis (see Anzieu, 1975a). Within this new discipline defined by Freud, the two opposing epistemological tendencies have continued to confront each other. Klein, Winnicott, Bion or Kohut, for example, invented new concepts (the paranoid-schizoid and depressive positions; transitional phenomena; attacks on linking; transferences of mirroring or the grandiose self) specific to new domains of study—the child, the psychotic, borderline states, and the narcissistic personality—which have expanded the scope of psychoanalytic theory and practice. Yet the majority of psychoanalysts cleave more and more to the first attitude: the return to Freud, with endless, almost Talmudic commentaries on his texts, mechanistic applications or adaptations of his ideas, not in the light of new practices but following “advances” in philosophy, the social sciences or the humanities, especially in the field of language (typified in France by Lacan). Now, in the last decades of the twentieth century, it seems to me that psychoanalysis has a greater need of people who think in images than of scholars, scholiasts, abstract or formalistic thinkers. My idea of the Skin-ego is not yet a concept; it is instead, intentionally, a vast metaphor—or, to be more exact, I believe it partakes of that fluctuation between metaphor and metonymy so well described by Guy Rosolato (1978). It is my hope that this idea will inspire psychoanalysts to think more freely and will enrich their spectrum of responses to their patients. Can this metaphor lead to a coherent set of operating concepts that may be factually verified or properly refuted? The task of this book is to convince the reader that it can.
7Every piece of research takes place within a personal and social context; I shall now try to describe the context of this one. At the end of the eighteenth century, the idéologues introduced to France and, beyond it, to Europe the notion of unlimited progress in thought, science, and civilisation. This idea was dominant for a long time but at last the bubble had to burst. If I were to sum up the situation of the west—perhaps of all humanity—at the end of the twentieth century, I would emphasise the need to set limits: limits to demographic expansion, to the arms race, to nuclear explosions, to the speeding-up of history, to economic growth, to insatiable consumption, to the widening gap between the rich nations and the third world, the huge scale of scientific projects or economic enterprises, the invasion of the private sphere by the media of mass communication, the incessant pressure to break records, at the cost of over-training and doping, the compulsion to go faster, farther, more expensively, at the price of congestion, nervous tension, cardiovascular diseases and general discontent. We need to set limits on the violence against nature as well as against human beings—air pollution, ground pollution, water pollution, the squandering of energy resources in the name of producing everything we are technically capable of, down to mechanical, architectural or biological monstrosities; limits on the breaking of moral laws or social rules, on the assertion of individual desire, on the threat of technological advances to the integrity of our bodies and the freedom of our minds, to natural human reproduction and the survival of the species.
To speak only of a field in which I am involved—not just as an ordinary citizen but through my near-daily professional experience: in the thirty years since I began therapeutic work I have noticed a significant change in the nature of the suffering of patients who come for psychoanalytic treatment, and this change is confirmed by my colleagues. In Freud’s day and in the first two generations of his followers, psychoanalysts found themselves dealing with clear-cut neuroses—hysteria, obsession, phobias or a mixture. Nowadays over half of a psychoanalyst’s practice typically consists of what is known as borderline cases and/or narcissistic personalities (assuming, with Kohut, that these are two separate categories). Etymologically, “borderline” refers to states at the border between neurosis and psychosis, which combine traits from those two traditional categories. In actual fact, these patients suffer 8from a lack of limits—they cannot perceive the frontiers between the psychical and bodily Egos, between the reality Ego and the ideal Ego, between what depends on the Self and what depends on other people; or these frontiers shift without warning and the patient has a depressive breakdown, can no longer differentiate between erogenous zones, gets confused between pleasant experiences and painful ones, and cannot distinguish between the drives, so that a drive, when it arises, is experienced as violence rather than desire (what François Gantheret calls the “Uncertainties of Eros”, Incertitudes d’Éros, 1984). These patients also suffer from narcissistic wounds, owing to weaknesses or flaws in their psychical wrapping: they have a diffuse feeling of malaise, of not living their own lives, of observing their mind or body from the outside, of being the spectator of something that both is and is not their own existence. The psychoanalytic treatment of borderline states and narcissistic personalities demands both technical adjustments and a new set of concepts, which would allow better clinical understanding; such adaptations are well described by René Kaës’s term “transitional psychoanalysis” (Kaës, 1979a; Anzieu, 1979).
Small wonder that a civilisation which fosters outsize ambitions, panders to the demand of the couple, the family and social institutions to take charge of the individual, passively encourages the collapse of all boundaries in the artificial ecstasy of chemical or other drugs, exposes the child, who is more and more often an only child, to the traumatic focus of the unconsciouses of both parents in a household that is more and more restricted in size and solidity; small wonder, then, that such a culture favours immaturity and provokes a proliferation of borderline psychical disturbances. To this one might add the dispiriting impression that, in no longer setting itself any limits, humanity is heading straight for a catastrophe which contemporary artists and thinkers are outbidding each other to represent as equally appalling and inescapable.
Thus, in my view, we face a task of the greatest psychological and social urgency: to rebuild limits, restore frontiers and create for ourselves recognisable and habitable territories. These limits and frontiers must both institute differences and enable exchanges between the newly defined regions—regions of the psyche, of knowledge, of society and humanity. Without being explicitly aware of this overall goal, scientists in a variety of fields have 9begun to take on the task, each within their own sphere of activity. In the abstract, the mathematician René Thom (1972) has studied the interfaces separating various regions of space, and it is no accident that he uses the term “theory of catastrophes” to denote the description and classification of sudden changes in their form. My own work is much in his debt. The eyes and ears of today’s astronomers, with the help of ever more refined instruments, are reaching towards the edge of the universe; and this universe has both spatial limits, constantly expanding, in which the matter in quasars, moving at almost the speed of light, is transformed into energy, and temporal limits, starting from the big bang whose echo still survives in the background noise of the universe and whose original deflagration created the primitive nebula. Biologists have transferred their interest from the cell nucleus to its outer membrane, discovering in the latter a kind of active brain which programmes the exchange of ions between the protoplasm and what lies outside; and errors in the genetic code may explain the increasing propensity for such serious illnesses as high blood pressure, diabetes, perhaps even certain cancers. The concept of the Skin-ego, which I am proposing in psychoanalysis, points in the same direction. How are the psychical wrappings formed, what are their structures, interleaved series and pathologies? And how, by means of “transitional” psychoanalytic treatment of the individual and perhaps even of groups and institutions, can they be re-established? These are the questions I ask myself and which I hope this book will begin to answer.
Ever since the Renaissance, western thought has been obsessed with one epistemological notion: the idea that we acquire knowledge by breaking through an outer shell to reach an inner nucleus or kernel. This notion is now exhausted, after having achieved some successes and also created many serious dangers—after all, it was nuclear physics that led scientists and the military to the point of atomic explosions. As early as the nineteenth century, neurophysiology called a halt to this, though it was not much noticed at the time. The brain is in fact the upper and frontal section of the encephalon; the cortex—the word means bark or shell in Latin and entered the vocabulary of anatomy in 1907—denotes the outer layer of grey matter that caps the white matter. We are faced with a paradox: the centre is situated at the periphery. In his article and later his 10book of the same name, the late Nicolas Abraham (1978) set out the dialectic between “the shell and the kernel”. His arguments confirmed my own findings and added weight to my hypothesis: what if thought were as much a matter of the skin as of the brain? And what if the Ego, now defined as the Skin-ego, had the structure of a wrapping?
Embryology can help us break away from certain habits of so-called logical thought. At the gastrula stage, the embryo takes on the form of a sac through the “invagination” of one of its sides, forming two layers, the ectoderm and the endoderm. This is, in fact, a more or less universal phenomenon in biology: with rare exceptions, the peel of all plants and the membranes of all animals consist of two layers, one internal and the other external. To go back to the embryo—its ectoderm forms both the skin (including the sense organs) and the brain. The brain, a sensitive surface protected by the cranium, is in constant contact with this skin and its organs; and the skin is a sensitive epidermis protected by the thickening and hardening of the parts nearest to the surface. Both the brain and the skin are surface entities, the cortex or internal surface—internal, that is, in relation to the body as a whole—being in contact with the outside world through the mediation of an outer surface or skin; and each of these two casings consists of at least two layers: a protective layer on the outside and, underneath it or in its orifices, another layer which collects information and filters exchanges. If we follow this model of the organisation of the nervous system, thought no longer appears as the segregation, juxtaposition, and association of kernels, but as a matter of relations between surfaces, themselves arranged, as Abraham astutely observed, in a series of interleaved levels in which each in turn takes the position of shell and then the position of kernel in relation to another.
“Invagination”, the term used by anatomy and physiology, wisely reminds us that the vagina is not an organ with a specific structure but a fold of the skin, like the lips, anus, nose or eyelids, without a hardened layer or protective cornea to act as a shield against stimuli and whose mucous membrane is exposed, so that its sensitivity and erogeneity are on the surface, reaching a climax on contact with the equally sensitive surface of the tip of the erect penis. And everyone knows perfectly well, unless they find it amusing to reduce love to 11the contact of two epidermises, 1 which does not always result in the full expected pleasure, that love has the paradoxical quality of bringing us, at the same time and with the same person, the deepest psychical contact and the finest epidermal contact. Thus, the three bedrocks of human thought—the skin, the cortex, and sexual union—correspond to three configurations of the surface: the wrapping, the cap, and the pouch.
Every cell is surrounded by a cytoplasmic membrane. In addition, plant cells possess a cellulose membrane which has pores enabling exchanges; this membrane covers the cytoplasmic one and gives the cell—and consequently the plant itself—a degree of rigidity; for example a nut has a hard outer shell and also a fine skin surrounding the kernel. An animal cell is supple and gives way easily when it meets an obstacle, which ensures mobility. The physico-chemical exchanges required for sustaining life take place through the cytoplasmic membrane.
Recent research has revealed the double-layered structure of this membrane—which corresponds to Freud’s intuitive grasp, in his “Note upon the ‘mystic writing-pad’” (1925a), of the two layers of the Ego, one a shield against stimuli, the other a surface for registering impressions. Using electron microscopy, the two layers can be seen as separate, sometimes with an intervening space. Two kinds of fungus have been distinguished, one with a skin that is difficult to peel apart, the other whose skin consists of two distinct layers. In another observable structure, membranes are superimposed like the layers of an onion—this motif has been discussed by Annie Anzieu (1974).
Psychoanalysis presents itself—or is generally presented—as a theory of unconscious and preconscious psychical contents. The concept of psychoanalytic technique that follows from this aims to make those contents, respectively, preconscious and conscious. But there cannot be a content without it being related to a container. A psychoanalytic theory of the psyche as container does exist, but 12it is far more fragmentary, approximate, and scattered. And yet the pathologies which the practising psychoanalyst encounters nowadays more and more often derive mainly from disturbances of the container-content relationship; and post-Freudian thinking has led analysts to pay increasing attention to the relation between the analytic setting and the analytic process, thinking about when and how the variables of the setting might be adjusted by the psychoanalyst or when and how the patient makes those variables into a substitute for process or a non-process (cf. José Bleger, 1967). The technical consequences of this epistemological reversal are significant: psychoanalysts now not only have to use the transference to interpret the flaws and defensive hypercathexes of the container, to “construct” the early encroachments, cumulative traumas, and prosthetic idealisations that created these flaws and defences, but also to offer their patients an inner disposition and a way of communicating which provide the possibility of a containing function that may be fully interiorised. My own focus for this theoretical reworking is the idea of the Skin-ego and the consequent readjustment of clinical practice is the above-mentioned technique of “transitional analysis”.
