ABSTRACT
The disturbed patient’s ‘attacks on linking’ is a Janus-faced concept—a defensive attack on analytic meaning or disorientating and destabilizing attacks levied on one’s own mind, an experience that could affect both partners. Bion’s bi-directional emphasis moved in the direction of two highly subjectively involved partners, one of whom sought analytic containment and understanding, all calibrated in the key of a real ‘here and now’ experience. He counterbalanced Klein’s ideas about in-born destructiveness with failures of environmental ‘containment,’ the claims of nature and nurture. Bion’s access to these core infantile experiences was facilitated by his focus on fragments of speech and motoric and sensory data. This strategy broadened treatment approaches with near-psychotic patients.
Since there were no publications on Kleinian technique in the 1950s, Bion admitted that he could summon no written explanations about how he worked in understanding disturbed states of mind. With borderline psychosis, Bion (and others) developed the new, hybrid construct of the ‘psychotically neurotic’ patient who displayed extreme but episodic madness. This formulation differentiated psychotically core experiences of analysands from irrational mechanisms operating in the borderline all the way to the lesser disturbed.
The generative longevity of Bion’s ideas has been discussed in the work of London Kleinians (Betty Joseph in the 1970s and 1980s and Ronald Britton in the 1990s and in the new millennium). Their work has continued to develop the Bionian conceptual framework, e.g., attacks on linking with its emphasis on the ‘difficult-to-treat’ patient through creative extensions, such as the need for a ‘dyadically exclusive’ or pressurized relationship with the analyst.
