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A phenomenological perspective on the unconscious.

'Man's state of being is lived and disclosed as a given demand for human articulation.' (Scott, 1973, p. 434).

The psychoanalytic world takes the concept of the unconscious for granted; it is the bedrock of all our understandings of ourselves and the world. As psychoanalytic practitioners we may not know its idiosyncratic contents, yet we know its workings and its tricky nature. We live as though we are familiars, the unconscious an old friend whom we have always in our minds. Yet this notion may be something we need to interrogate. We may, in our familiarity, become 'thoughtless' in our engagement with 'the' unconscious. We may also overlook that for our patients, our supervisees and our students, this familiarity may be still new or not even present.

The idea of the unconscious may appear simple or obvious given the ample theorizing which we have to inform our observation. Yet from a psychoanalytic perspective this obviousness is an illusion. In the training of psychologists we are profoundly confronted by the difficulties of working with the unconscious. We observe trainees' struggles to apprehend the unfathomable in their patients and how their own unconscious acts to further obscure what is already unfathomable. This is a humbling experience, highlighting that the sense that we are familiars, old friends, walking a well signposted path towards knowing, is also an illusion. This brings to mind Bion's (1970) famous dictum about commencing each analytic session with no memory or desire (1). He was clearly aware that the unconscious was not to be treated (or trusted?) as an old familiar friend but rather as someone we encounter anew each time of meeting.

This paper proposes that phenomenology is able to make a significant contribution to understanding the workings of the unconscious by fleshing out the lived experience of the unconscious. While the lived unconscious is intimately embedded in psychoanalytic theorizing, it is not as fully articulated as it is in phenomenological thinking. It is on this edge of a dialogue between psychoanalytic and phenomenological theorizing that this paper focuses.

The unconscious, as we understand it from both a phenomenological and psychoanalytic perspective, is the ground rock of human experience. Initially Freud (1915) postulated a topographical model in which the system unconscious comprised repressed contents denied access to consciousness. The contents were thought to be primarily childhood instinctual wishes. Freud's (1916) later understanding saw the term 'unconscious' not as a single agency but as part of the id, ego and superego. In this conceptualization the ego and superego are partly preconscious and partly unconscious. The id, in this later conceptualization, holds the characteristics previously attributed to the system unconscious. The id came to be conceptualized as the instinctual pole of the personality, as the origin of all instinctual energy.

Laplanche and Pontalis (1973) described the unconscious as 'primarily --and indissolubly--a topographical and dynamic notion formed on the basis of treatment ... certain contents only become accessible to consciousness once resistances have been overcome' (p. 330). Further, they noted that 'mental life is 'full of active yet unconscious ideas' and that symptoms proceed from such ideas (p. 330). They reason that 'as a psychical locality' [the unconscious] must be pictured not as a second consciousness but as a system with its own contents, mechanisms and perhaps --a specific 'energy' (p. 330).

Freud (1915) terms the contents of the unconscious 'instinctual representatives', lying on the border between somatic and mental processes. Significantly, Freud did not claim that all infantile experiences become unconscious. Rather, it is through the operation of infantile repression that experiences become relegated to the unconscious. The contents of the unconscious seek expression into consciousness. This press is opposed by the operation of repression and censorship, and where defences fail symptoms develop.

Freud was grappling towards articulating a particular clinical observation: that in our experiencing of ourselves, tension occurs between what is lived and what is known as meaningful. This is the phenomenon we see every day in our clinical work, the disjunction between what patients present consciously of their lives and what is actually lived unconsciously. The paper seeks to further this articulation through some aspects of phenomenological thought, to 'go behind' the scientific concepts 'to a horizon in which nature and culture are not yet separated and opposed' (Kockelmans, 1979, p. 23).

In this endeavour, we are informed by a Heideggerian view of man. Heidegger's (1953) seminal Being and Time, originally published in 1927, is an exploration of the meaning of Being as defined by temporality. Heidegger writes of being as man's relatedness to the world, for which he uses the term 'Dasein' or 'being-in-the-world'. Heidegger's understanding of Dasein is that at the most essential, primal level, our existence is dependent on and interwoven with our worldly relatedness. Our participation and involvement in the world is thus constitutive of our human being. 'Being-in-the-world' (Dasein) includes relatedness to the environment (the Umwelt), to a communal region (the Mitweld,) as well as relatedness to ourselves (the Eigenwelt). Man can only be disclosed (known) to himself in the context of his intimate relations to himself, his environment and a communal region. The value of Heidegger's thinking for this paper is the notion that man's being is his relations to the world, rather than some essence which precedes this engagement.

This line of thinking is reminiscent of Bollas (2009), who discusses how our architecture, i.e. the material, physical world we construct around us, both reflects and is reflective of our internal world. At a colloquial level we speak, for example, of knowing someone by how they dress and how they keep their homes. This suggests that man is transparent through his relations to himself and the world.

The primary point of thinking about Heidegger is to underline that understanding is seen as coming from a subjective, conscious reflection of what is pre-reflectively (unconsciously) known in experience. Here we have the beginnings of a link between phenomenology and psychoanalysis. Meaning, which is known in consciousness, is firstly pre-reflectively (i.e. unconsciously) known through the lived world. The unconscious holds meaning which is unknown but nonetheless experienced and lived.

We have many psychoanalytic marriages with this concept. To name a few, Bion (1962), Winnicott (1956; 1960) and Caper (1999) speak of how we understand that the infant's psychic life arises through the sensate experiences of its body (Winnicott's focus) and through the meaning making of the mother's ministrations to these bodily experiences (Bion's focus). In this way the infant comes to meaning, i.e. to a subjective, verbal awareness of that which is already unconsciously known in the infant's experience. Hence Bion (1962) is able to postulate that thinking arises from 'learning from experience', the experience of the body through which meaning emanates.

Heidegger (1953) proposes that our lived-ness is given meaning through 'existentials': shared existential meanings that transcend individual lives whilst simultaneously offering meaning to these lives. Heidegger argues that man is embedded in this world of existential meanings; existential conditions of selfhood which transcend selfhood. Scott (1973) refers to that 'state of being which transcends the particular intentions of self (p. 434). This phenomenological understanding draws the fine distinction that we live and are lived within structural meanings [existentials] which transcend our particular life, but which are nonetheless lived in intimately individual ways. For example, because we can imagine a future in which we all anticipate dying as a universal event, yet the experience of dying is unique to each dying person.

The implication of Heidegger's view is that experiences of the unconscious, as human experiences, are not only the experiences of a particular self but are also experiences of meanings, and fall within the domain of existential meanings or intelligibilities, which transcend the individual self. Laplanche and Pontalis (1973), in discussing Freud's (1915) concept of the unconscious, maintain that Freud's concept was primarily a topographical and dynamic concept. In terms of the topographical system, Freud pointed to the limitations of a purely conscious view of mental functioning. He claimed that clinical experience demonstrated that certain 'contents', i.e. ideational representations of what Freud termed instincts, were denied access to consciousness by a process of repression. Thus the 'contents' of the unconscious, although repressed, remain meaningful as individual meanings.

Yet as existential meanings, these contents are intelligible to us all. The repressed unconscious contents (unconscious meanings) become accessible through the working through of resistance (Freud, 1915). While one may criticise mechanistic notions of libidinal energy or neuronal excitations, eloquently argued by Boss (1958; 1979; 1982; see also Kruger, 1979), the conceptual significance of Freud's understanding lies in the idea that certain ideational representations are not accessible to awareness. We can reformulate this idea to state that certain 'meanings', while unconsciously known and unconsciously lived, are not immediately accessible to conscious awareness.

In terms of Freud's dynamic concept, emphasis is laid on the conflict of opposing mental forces. As discussed earlier there is a conflicting press for expression of unconscious contents into consciousness as well as an opposition to such expression. Thus not only do patients resist awareness, they also produce 'derivatives', the compromise between expression and opposition. Derivatives can offer access to awareness: through associations and symptoms, for example, we come to know something about the unconscious. We can conceptualize a derivative, in the psychoanalytic sense, as a communication from the unconscious. Within a phenomenological framework associations and symptoms are seen as meanings, pre-reflectively known. We can therefore propose the possibility of conceptualizing an experience 'away from consciousness' (as an outcome of resistance) and one 'towards consciousness' (pre-reflective communications as in a derivative).

This dynamic understanding is well captured by Fischer's (1985) qualitative research on self-deception, focusing on moments in people's lives that they could later identify as self-deceptive. Following a phenomenological research process, Fischer found that self-deception as a process has three sequential component aspects. Firstly, self-deception becomes a possibility when one is already committed to a particular understanding of some aspect of one's world. For example, as post-Apartheid South Africans, we may think and speak of ourselves as having transcended past racist attitudes. However, in attempting to make meaning of a difficult interaction with a person of another race, this original self understanding may become ambiguously uncertain as we catch ourselves thinking about the other in a racially stereotyped fashion. This ambiguous uncertainty about how to understand ourselves in relation to the other is announced by anxiety concerning the threat this uncertainty poses to one's previous liberal and non-racist self understanding. Our racially biased thinking comes as a shock to our former self perception as liberal and non-racist, leaving us uncomfortable and uncertain about what we really think and feel about people racially different from ourselves.

Self deception thus involves a denial, a refusal of the significance of the emerging meanings which render one's previous understandings ambiguously uncertain. It involves a turning away from the possibilities presented by the anxiety: 'It is to turn away from the possibility of taking up and allowing that anxiousness to inform, if not transform, that understanding. At the same time, it is to rigidly reaffirm the latter, or some variation thereof, as still unambiguously certain' (Fischer, 1985, p. 139-140).

Two of Fischer's findings are particularly important for this discussion. First, he found that his subjects sought to maintain to themselves what was already known of themselves, their particular understandings of some aspect of their world. In other words, they clung to a particular understanding of themselves in relation to another. In order to maintain these subjectively established certainties, they refused to entertain any other possible interpretations that might undermine this knowledge. Emerging significations (knowledge) which threatened this known understanding of the self Fischer called 'virtually present' to the subjects.

Fischer's second significant finding revealed that what is virtually present to the subjects could be explicitly discovered 'only if the ambiguity of the anxiety of self-deception is faced' (1982, p. 150). The anxiety is experienced in immediate, pre-linguistic 'physiognomic ambiguity' (1982, p. 70). By this is meant that we 'know' our self deception through our anxious body, i.e. the body registers the experience of self deception through the experience of anxiety. This concept links to Freud's (1917) understanding that when the unconscious threatens to break through we experience signal anxiety, an anxiety that alerts us to the perceived danger. According to Fischer (1985), should the subject face the virtually present ambiguity of his self-deception through taking note of his anxiety, then the meanings of his anxiety would become known. This notion appears very helpful in thinking about our need to keep what is unconscious unconscious, to keep self deception alive in the form of the unconscious. We use defences and various psychic mechanisms to maintain this status quo. What is clear from Fischer's research is that the meanings of what is virtually present knowledge is lived bodily, but is not consciously recognised at first. This phenomenological emphasis upon the body assists in foregrounding the fact that experience is both physical and mental. The phenomenological understanding of the role of the lived body broadens understandings of how we might understand and engage with unconscious experiences and meanings.

Fischer's (1985) finding of a pre-conceptual mode of being where, 'in an inarticulate and unreflected manner, an individual initially recognises and lives the anxious situation' (p. 82) is reflected in the writings of the phenomenological philosopher, Merleau-Ponty. For Merleau-Ponty (in Pontalis, 1983) the dualistic distinction between body and mind is untenable because psychological experience is always embodied. In his sense, the body is both within the experience and the experience itself. Gendlin (1962) develops a similar conceptualisation from clinical practice, in the concept of the 'direct referent', the felt experience: meaningfulness is implicitly felt in a bodily sense before being made explicit in words or thoughts. Gendlin (1962) maintains that rarely does one think (experience) in words. In contrast, 'meanings function implicitly as a present, concretely felt, experiencing' (p. 113).

Pontalis (1983), in examining Merleau-Ponty's exposition of meaning, elucidates the explicit differences of perspective between phenomenology and psychoanalysis. The former envisions from the outside, i.e. with fellow man. Primacy is therefore given to the external structures of what constitutes an experience, the existential meanings which transcend the individual self of man and are evident in the communal 'in-between' of social existence. Psychoanalysis emphasises a different locale by placing itself in the interior of the subject, and thus gives primacy to significations which indirectly convey information about this private realm. There are implications for a view of the unconscious: Does one focus on structures of shared human experience or the idiosyncratic significations of meaning sequestered in a private interiority?

Phenomenology would suggest a bridge between these apparently divergent perspectives. Man, as seen from a phenomenological perspective, experiences meaning through being-in-the world and thus experiences meaning as given through the shared structures of experience which transcend the individual self. However, experience is also radically individual insofar as the self constitutes idiosyncratic meaning through subjectively lived experience. Consider, as stated above, the experience of dying as a universal experience but one that can only be experienced in its uniquely individual meaning. This links with Heidegger's (1953) understanding that we both live and are lived within structural meanings (existentials) which transcend our particular life but which are nonetheless lived in individual ways.

For Freud (1916), meaning is inherent in intentionality, i.e. we are intending subjects always directed towards our objects--the aim of the drive is towards the object. For phenomenology, meaning is inherent in Dasein i.e. meaning is inherent in being-in-the-world, in man's relations to his world. It is not man striving towards the world but, rather, that the world of meaning exists because of man. Is there a contradiction between these two perspectives? Merleau-Ponty thinks not, and he looks to language to explicate the matter (Pontalis 1983, p. 86). Merleau-Ponty speaks of the signifying power of the speaking subject and the will to communicate inherent in instituted language, but he goes further to stress a pre-linguistic conceptualisation where the primordial articulation is perceptual rather than languaged: 'A type of being with regard to which the subject is not sovereign without nevertheless being inserted in it' (Pontalis, 1983, p. 87). By this is meant that the subject is not autonomous of experience, while at the same time the subject is the experience. Brooke (1987) advances this argument with his conceptualization of the human subject as 'perceptual intentionality ... embodied pre-reflectively' (p. 128). By this he means we find ourselves immersed in meanings without these meanings being immediately known to us. This would constitute lived experience whereby meaning is firstly a lived known or, perhaps more correctly, a lived unknown insofar as we cannot verbally articulate these meanings to ourselves.

To make an explicit link between phenomenological thought and psychoanalysis we could consider Bion's psychoanalytic theories, more specifically his theory of the development of thought. Bion (1962) postulates that the infant's first experiences are characterized by an experience of beta-elements, proto-mental sensory phenomena which are not meaningful until rendered so by maternal alpha processing. Beta-elements are unprocessed experiences (without meaning) which are projected into the container. Bion (1962) writes of the mother or environment as acting as the container to process, detoxify and give back to the infant a transformed experience, but one that has meaning in relation to the infant's personal existence. What Bion proposes is that through this process, meaning is given to a sensate (bodily), pre-linguistic experience. This turns the infant's sensations into coherent experiences that can then be represented and thought about.

Bion's explanation has two potential implications for the lived and meaningful unconscious. Firstly, the infant's beta-element experience has a bodily meaning intrinsic to the experience. The experience of hunger is still an experience of hunger even if the mother does not meaningfully label it as such. The meaning of the experience of hunger is inherent in the lived bodily experience of the child at a pre-reflective level. The infant needs processing and reflection of the experience to bring it to conscious meaning.

Secondly, Bion (1962) points to the inevitable experience that the environment may fail to reflect back appropriate meaning. This implies that whether the environment appropriately contains the infant's projections or not, there is already, for the infant, a meaning implicit in the experiencing body. Here we possibly have the most intimate link between the lived and the meaningful. The infant experiences something which is both pre-linguistic and pre-reflective, yet which speaks to the lived experience of the infant. Where mother does not reflect back to the infant this correct experience of the lived body we have the foundation for pathology, a distortion of self through a mis-reflection of the experiencing body. This understanding speaks clearly to the idea that the infant's being-in-the-world is firstly a lived experience whereby meaning is firstly a lived (un)known.

According to Merleau-Ponty (in Pontalis, 1983) the unconscious is not what we see but the lens through which what we see is perceived. This is a significant notion which clearly asserts that the unconscious is the ground through which our meanings are lived. There is thus a central blindness in our consciousness which Merleau-Ponty calls perceptive unconsciousness. Given this central blindness as the invisible which embodies the visible, we can return to Fischer (1985) and suggest that the implicit, the virtually present, is not what we see but that through which what we see is perceived. We see what the unconscious, the invisible, allows of the visible to be visible; the virtually present which is lived through 'physiognomic ambiguity' (Fischer, 1982, p. 70). Let us return to the example of discovering our racist attitudes. Let us assume that, as South Africans, we are inevitably racists given our development which has been embedded in a racist history. However, we might argue that racism is morally wrong. Knowledge of our own racism is therefore repressed and relegated to the unconscious. Thus we do not see that we are racist but it is through the underlying racism that we perceive others. The unconscious, the invisible racism, allows an aspect of the visible to be visible, i.e. that we emphatically maintain our non-racism to ourselves. It is when the virtually present meaning that we are actually racist becomes lived that we then experience the anxiety attendant upon discovering an unwelcome 'self.

It may be felt that the argument thus far misses the thrust and depth of the Freudian concept of the unconscious. As we know, Freud did not see the unconscious as readily accessible to conscious awareness but as an ever present tension to our conscious way of being. It would seem, however, that this difficulty arises only when we view the unconscious as some 'thing', some entity which provides the dynamic tension. The difficulty falls away if we view the unconscious as a dialectic of meaning, that through which the consciousness of our subjective and human lived existence finds necessarily limited expression. In this context, the foregoing discussion is informative in making a philosophical bridge between phenomenology and Freud's topographic and dynamic conceptualizations. However, the argument has not, at this point, addressed the concept of repression, of meanings made unknowable by defensive operations of the mind.

Romanyshyn (1977) develops Merleau-Ponty's ideas that to be unconscious is to be absent from oneself while being present to the world of observing others: 'I borrow myself from others' (p. 19). This concept suggests that the initiative for repression occurs between man and his social world. Man occupies 'a world of being with the other in which what is lent does not reflect what one intends to borrow' (Romanyshyn, 1977, p. 20). Romanyshyn suggests that we 'borrow' ourselves through the observing other who presents us with an image of ourselves. What becomes unconscious results from a disconnection between our experience and the other's experience of us. An aspect of ourselves that is offered to the observing other is not offered back in the form of an interpersonal recognition, and we thus become absent to ourselves. Our intentionality of being does not find a conscious context for expression in the world of the observing other. We may think of Freud's understanding that the unconscious is constituted through the operation of infantile repression. The totality of our being is not permitted to find expression in a world of shared existence, thus the need for repression of our desire.

The essence of appropriating another's view of oneself is that one ignores or sets aside a personal perspective. Romanyshyn (1983) conceptualizes this as a failure of the first moment of reflection. As a failure of reflection, repression characterises a world which does not mirror a particular experience of human life, for example our sexuality or aggression. What is lent is not there to be borrowed back. Merleau-Ponty (in Romanyshyn, 1983) writes of perceptions which are appraised by the perceiver without the perceiver being capable of placing the perceptions in context, and hence being unable to articulate them. Meaning may therefore be fixed by a failure of reflection which leaves an experience unable to be articulated and hence under the sway of repression. What transpires then is an experience (meaning) which conceals rather than reveals, i.e. in that first moment of reflection, the moment of finding oneself through the other, (the totality of) one's self disappears. Repression, therefore, is an 'intentional relation towards the world which finds no reflection in that world' (Romanyshyn, 1983, p. 22). A psychoanalytic understanding would accord with these conceptualizations. What becomes repressed is that which is not accepted (reflected) by the world and is therefore censured by a culture-bound superego. What is primarily repressed we assume to be the innate--but actually socially constituted--awfulness of being human; what needs to be hidden, our loves and hates.

Thus an aspect of our existence, which is the consciously shared context of experience, comes to constitute a hiddenness of being. Not all of one is welcome and reflected. Heidegger (1953) has pointed to the continual dialectic between disclosure and hiddenness; that in the act of disclosing there is hiddenness, so that one can never be transparent to oneself. Pontalis (1983) points out that 'the repressed transpires in the move itself--by which the subject strives to hide it' (p. 90). By this is meant that through repression what is repressed is apparent even though the subject attempts to hide it. Through the operation of repression--as in symptoms, defences, thought associations--we see that which is repressed. These are the manifestations of what is simultaneously hidden yet disclosed.

How then is one to understand the formation of symptoms? Scott (1973) suggests that in spite of oneself one strives for authenticity. We, by virtue of our humanity, are involved in a given demand for human articulation. We always strive to communicate and thus even the unconscious can be understood as that 'limited occasion of openness' (Scott, 1973, p. 441) through which symptoms strive for communication. This is an intriguing concept: Scott proposes that the unconscious, through remaining hidden, enables us to maintain to ourselves what we think we know of ourselves. Through this operation we are able to keep up self deception, as articulated by Fischer (1985). This experiencing occurs while we are concomitantly involved in existential realisation and striving for authenticity. The result is that we find ourselves inauthentic (following Heidegger), being-for-itself (following Sartre), self deceiving (following Fischer) or neurotic (following Freud). This is man struggling to articulate his meaning within the limits of what may be lived from the ground rock (the unconscious) of his existence.

Phenomenological conceptualizations posit that man's experience of himself is a basic hiddenness to himself. A dialectic process is proposed: the unconscious is understood as the invisible through which the visible, the consciousness, of our particular subjectively lived experience and the human lived condition is able to find expression.

An illustrative clinical vignette

Carveth and Hantman Carveth (2003) suggest that, far from disappearing, hysteria is alive and well and residing in the many modern-day ills of humankind. In the new hysterias a number of bodily symptoms represent manifestations of symbolic meanings. They highlight a host of modern-day ills, inter alia, chronic fatigue syndrome, allergic conditions, 'alien abduction' experiences and the like. Thus, linking to the thoughts of this paper, meaning is lived pre-reflectively in the body.

Following Freudian and phenomenological thinking, the patient presents with symptoms which have pre-reflective meanings hidden from him- or herself. Following Fischer (1982; 1985) and Scott (1973), through the hiddenness of the unconscious the patient is enabled to express to himself what he thinks he knows of himself, while hiddenness (the unconscious) finds expression in the manner in which he lives his life. Building on Fischer (1982; 1985), one may think of self deception as being maintained through repression and symptom formation.

Some clinical material will hopefully elucidate the argument above. 'John' had been in psychoanalytic psychotherapy for many years. He had initially presented as psychotic; he experienced hallucinations and was haunted by a terrible sense that unless he wrote his thoughts in his dairies he would cease to exist. This writing, upon which he depended, was deeply distressing to me as there was little logic or coherence to his thoughts, except for occasional lucid memories of physical abuse and familial violence. These were always traumatic and indicated clearly the chaos and fearfulness of his early years. I understood his writing as a very primitive attempt to process and make meaning of his experiences on his own by concretely (on paper) creating a container for experiences not made thinkable by an internalized container function. The quality of this container spoke clearly of the lack he had experienced as a child.

My understanding at this time was that John had suffered severe and very early physical and emotional abuse. Linking with Romanyshyn (1983) I wondered about a failure of the first moment of reflection, which characterises a world that does not mirror a particular experience of one's selfhood. In similar vein Merleau-Ponty (in Romanyshyn, 1983) suggests that perceptions may be appraised but are not capable of being placed in context, thus what transpires is an experience which conceals rather than reveals, i.e. finding oneself through the other (the totality) results in one's self disappearing. These experiences of self, while destructive, nonetheless remain the foundation through which one experiences the self.

John's writing was not a conscious interactional message but appeared to be a form of concrete projection, leaving the pages meaningless and me unable to make meanings. Only John appeared soothed by his writings. His solipsistic state came to be understood as a dead-alive space occupied by a dead-alive body. During this time John lived in his body in a deeply unconscious manner. He sat without moving, he was never ill, and appeared to never change. This was an illusion created by wearing the same 'uniform' regardless of the passing of the seasons and the years, and by a lack of emotional expression.

I understood John as being too afraid to be alive. By remaining in a dead-alive body he was able to negate the possibility of virtually present meanings inherent in his body and could maintain to himself what was already known of himself, however chaotic his sense of self was. Furthermore, he refused to discover anything that might undermine this knowledge. There was thus no experience of anxiety even though he was aware of being in a dead-alive body.

After a number of years I came to be experienced as the container of his mind. The compulsion to write lessened and then disappeared. He was left with the feeling that I held and contained, in safe keeping, all of him, i.e. his meanings and his mind which he did not yet possess. This seemed to be the primitive beginnings of being reflected by another in ways which were bearable, perhaps an authentic and welcome reflection of him which revealed more of his selfhood. John was able to say that he knew he was in (psychic) pain but did not know what this pain was about. He appeared unmoved by the facts of his tragic and traumatic life.

Suddenly he began to inhabit his body: he was consumed by physical pain and presented with various somatic symptoms which appeared to have no coherent symbolic meanings. Over a period of time he reported experiencing pain in a number of unrelated areas of his body. Each time he self-referred to either a physician or some other medical specialist. Each investigation resulted in yet another diagnosis. He was diagnosed as suffering from a brain tumour, heart disease, rheumatoid arthritis, diabetes, thyroid problems, failing kidneys, collapsed cartilage in his knees and multiple sclerosis. In that time only one medical professional diagnosed him as hysteric, an experience which deeply unnerved him. He maintained that this was the one doctor who ought not to be practicing. By this I understood John as experiencing all the other doctors, ironically, as making meaning of his suffering in organic terms, while this one doctor questioned the organic aetiology of his symptoms. His need for meaning was at the pre-reflective bodily, lived level of experiencing. He was beginning to engage with the virtually present meanings inherent in his body and significantly experienced an upsurge of anxiety, a manifestation of Fischer's 'physiognomic ambiguity'.

That his body spoke to us was clear and I felt this sudden development as an encouraging sign. It was as if his solipsistic state, dominated by an obsession to keep things the same, had given over into a more relational capacity. He was deeply distressed, indicating that the sensate, bodily experiences held pre-reflective meanings. John knew his body held meanings but, given the disjointed nature of his pain, neither John nor I were able to come to a virtually present understanding.

Nonetheless, he required an attuned and attentive other to contain and assist him with the processing of his experiences. That he sought so many containers apart from me was clearly a matter for thought and interpretation. While not germane to the focus of this paper, I would draw attention to two thoughts concerning John's seeking so many professional opinions. One is that he may well have felt so fragmented that he needed to borrow a sense of himself from each professional who assisted with his different pains, seeking to be lent a sense of himself through the observing other. The second thought is that this behaviour suggested a defensive refusal to engage with my single understanding of him. Such an understanding might have undermined his need for a sameness in his self-understandings, and so he split the observing others (containers) into many so that no one coherent reflection of himself was possible.

In terms of meaning emerging from the cries of his body, his body spoke of disjointed, fragmented, meaningless pain and punishment. John kept coming to his sessions, kept trying to reflect upon himself, and was deeply disturbed by his growing capacity to be more than the sameness that he sought. For example, he would feel amazed that he had had a thought separate from mine and a thought which he could retain, if not elaborate.

He knew his pain was not only physical. He spoke of feeling as if he knew something he did not know, and wondered if he was addicted to pain. We had previously used the metaphor of a dead-alive space occupied by a dead-alive body. Now we spoke of an alive-suffering space occupied by an alive-suffering body. In terms of 'physiognomic ambiguity', the pain inherent in John's symptoms held the meanings.

What was invisible--the unconscious--was made increasingly visible through his pain. Slowly his rage and anger began to have a life, yet with such fearfulness that his ever present need to kill himself was a real danger and of grave concern to me. He was severely unsettled by these new experiences of virtually present meanings.

The last of his symptoms was a burning sensation on his arms as if he were on fire. A visit to his GP, whom he had not consulted for many years, resulted in a diagnosis of an immune disorder. John visiting his GP was a strange comfort for me, as if the GP and I had been united as a stable parental couple. John ruminated for quite some time over the notion of a body which turns on itself and attacks healthy cells. The 'rightness' of the notion was experienced not in its use as a physical diagnosis but as a meaning which felt overwhelmingly 'correct' to him. For a while he was able to say that the significance of this diagnosis was known to him but he could not grasp it. He continued to ruminate on cells attacking healthy cells, as if punishing them. The meanings of his self-punishing symptoms were on the verge of becoming known.

He came to be able to speak about an awful experience of both coming together and disintegrating. I took this as indicating that an integration of meaning was being experienced. Such integration would act to affirm one's being in the world in a conscious way. However, with a move towards coherence what is also engendered is the awful existential loss of the omnipotent certainties of living within the limiting confines of delusion, of a defensive state. This would be the state where he had fixedly maintained to himself only that which was known to him. With the integration of meanings John was threatened by the virtually present becoming known. He had to face the ambiguity of his being. This ambiguity lay in John experiencing himself as a mindless, dead-alive body which yet suffered terrible psychic pain. To start to become aware and experience not only an alive-suffering body but to also experience this body as angry, attacking and self punishing was deeply threatening.

Over time John became consciously aware of the murderous rage he felt towards his family and his fear that this rage was dangerous and destructive. He felt that his body was within the experience of rage and that rage was the experience in his body. He entered a period of depressive anxiety where his hatred of his family was able to be become known and thought about, and his overwhelming guilt (Carveth & Hantman Carveth, 2003) was very slowly worked through.

Some concluding thoughts

The paper has considered Heidegger's (1953) view of man as embedded in his relatedness to his world and Fischer's (1982; 1985) research and understanding of self deception. It has also, inter alia, considered Pontalis (1983) and Romanyshyn's (1977; 1983) reading of Merleau-Ponty's conceptualizations. Man is both the subject of experience and the experience itself. This results in a central blindness in consciousness due to experience being first lived pre-linguistically. The unconscious, for both phenomenology and for psychoanalysis, is understood as both the ground of experience and that through which experience is known. These concepts convey that we live embedded in already given meanings due to our relatedness to the world shared with others, that these meanings cannot always be authentically faced, but that despite attempts to deny or negate meanings we nonetheless live them due to the pre-reflective nature of our experience.

The clinical vignette demonstrates how John lived a pre-reflective (unconscious) mode of being which kept hidden his rage and the trauma of his childhood experiences. His body lived, in an 'inarticulate and unreflected manner', a pre-reflective known (Fischer, 1985 p. 70). Significantly, however, through the progression of the therapy his body revealed the meanings of his pre-reflective experiences. His body pre-reflectively held the meanings of the deeply anxious psychic situation his terror of the murderous rage he felt. What John needed to know of himself was already existent in his body in a pre-reflective form. Initially his rage was such that what was able to be lived was only in a mindless, dead-alive body--his rage killed him rather than the other. This was all John was able to maintain to himself, a dead-alive state. For a considerable time in his psychotherapy he refused to discover what might undermine this knowledge. Yet through a slow process of becoming conscious of pre-reflective meanings and his lived experience there was a breakthrough. Fischer's (1985) virtually present knowledge came closer to consciousness. However, again as Fischer (1982) points out, such virtually present knowledge can only be faced when the ambiguity of self-deception is faced. This moment or process is marked by pre-linguistic 'physiognomic ambiguity' or an affected body.

John's was a deeply affected body; first there was the cry of a body's suffering not only to be understood, but also to be punished. His body pre-reflectively lived his abandonment and neglect in a dead-alive body. His body also came to live in a dramatic manner as seen in his overwhelming guilt and need for punishment due to his unknown (yet pre-reflectively known) attacks on his internal objects. His guilt and need for punishment lived in his malignant attacks against his own body and life, leading along the path towards an alive-suffering body. As his pre-reflective meanings came to greater conscious awareness his lived experience changed to that of the alive-suffering body where his guilt and need for punishment were virtually present experiences of his psyche. He had to face the ambiguous nature of his self deception, i.e. that his self punishment, being in a mindless dead-alive body, was punishment of the 'other' captive inside him.

When his rage could be faced he could then consciously face the psychic dilemma of this murderousness. In order to find meanings he had to face the extent of his rage. Further, he had to place his rage in the context of overwhelming pain and neglect. He could no longer continue to unconsciously punish himself as he was no longer able to unconsciously punish the other lodged 'inside' him. Neither, however, was he able to murder the abandoning and terrifying others. He was thus faced with the dilemma of having to find the meaning of his rage which, while individually his, also transcended him as common human experiences. These were meanings which led to a degree of compassion for the frailty, not only of himself, but also of his family.

What we may know is that John struggled with a complex and meaningful inner world which was too frightening for him to bring to consciousness. What he could know of himself was the depleted (paradoxically safer) position of being the dead-alive body. The unconscious alive aspects of his ego, as well as his capacity to think, were projected into me for protection. Through a process of containment and interpretation of John's inner and external experiences his defences were somewhat ameliorated and he could move to become the more explicitly alive-suffering body. The meanings of this suffering, conveyed through his somatic symptoms, led eventually to an interpretative base where his murderous rage could be faced. With this facing came an understanding of his overwhelming guilt for his destructive attacks against his objects, me included. Thus what initially could not be known, but was kept protected and secret in the 'depth' of his unconscious, came slowly to be known through his speaking body.

I, as therapist, shared in John's meanings because his meanings, while deeply individual and personal, are also the shared meanings of mankind. As Heidegger (1953) understands it, man shares existential meanings, thus existential meanings transcend individual lives as well as offer meaning to individual lives.

I would conclude that phenomenology and psychoanalysis, while premised upon such differing conceptual foundations, are able to speak to each other when the focus is on the experiencing patient. The semantic differences between the languages of psychoanalysis and phenomenology fall away when there is recognition that at core they share, as do most dynamic theories, an understanding of the suffering patient who suffers largely and paradoxically because of their need to censor and not know what is actually already known in their lived experience. Psychoanalysis and phenomenology understand that patients present in their lived world and in their way of being in the world what is known pre-reflectively of their unconscious. Phenomenology offers a deepened articulation of this dynamic. It understands man as being both within his experience and the experience; the unconscious as both the ground of experience and that through which experience is known.

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(1) 'What is to be sought is an activity that is both the restoration of god (the Mother) and the evolution of god (the formless, infinite, ineffable, non-existent), which can be found only in the state in which there is no memory, desire, understanding' (Bion, 1970, p. 129). Bion sounds remarkably like a phenomenologist in his thinking.

Jacki Watts

University of the Witwatersrand

Jacki Watts has been in clinical practice for the past 28 years. She has worked in academia at Rhodes University and the University of the Witwatersrand. Currently she is in private practice in Johannesburg.
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