ABSTRACT
In the outpatient treatments, Bion’s writing has been an invaluable lens. Michael Eigen has written, “A sense of catastrophe pervades Bion’s work”. The sense of catastrophe we find in Bion is enriched by including Winnicott’s work on the fear of breakdown. Catastrophe pervades Bion’s sense of psychic life; Winnicott, in contrast, locates the catastrophic in particular experiences. Winnicott briefly lists a number of primitive agonies, along with their characteristic defenses. These include a return to an unintegrated state, falling forever, loss of psychosomatic collusion, loss of sense of the real, and loss of capacity to relate to objects. The anorexic patient has made use of physical emaciation to manage his sense of catastrophe. He has said “No” to the growth and buildup of experience. It has become too dreadful to be thought and, somehow, has been imploded.
