In the Session

Don Moss describes a disturbing session in which he is thrown off his analytic game when his patient tries to push away the image of a burning child from the war in Gaza, thoughts she calls a “distraction.” I very much appreciate Moss’s unflinching self-scrutiny as he recounts his reactions to this compelling session. It is not the subject of the war in Gaza that throws him, but the way she puts it: a “distraction.” Moss asks, “How can crying at the recollection of a burning child in a war be a distraction?” Indeed, framing it this way is curious, and as I have mulled over it, the crux of an important dynamic between Moss and his patient, and a question of significance for analysts working in this troubled world. This interchange appears in the context of the whole session (and relationship), which I turn to first.

Moss tells us that the patient sought treatment because of her worries that her attraction to sadomasochism might disturb her capacities to care properly for her child. Typically, contemporary women do not worry that their sexual behaviors will spill over into their maternal functioning. When a woman says she is worried she is not a good mother, she must have good, but perhaps unconscious, reasons for this worry. Why should her sadomasochistic sexual practices affect her mothering unless she senses her sadomasochism is more broadly and deeply embedded in her personality? Perhaps the worry reflects disappointments, conflicts and unhappy identifications with her mother, often entangled with a woman’s worries about being a good-enough mother. The latter seems a possibility as the patient during this session goes round and round about her mother’s competency versus her own competency as a mother. But competency does not insure being a good mother, anyhow. Doesn’t being a good mother mean being able to love and care for another, something less easy to define, akin to Kristeva’s maternal reliance. So maybe the patient’s worry about competency carries deeper worries. Sadomasochism often impedes, or substitutes for, loving intimacy, although over the two years of treatment Moss tells us that the patient has developed a more stable (and perhaps more caring?) relationship. Clearly she is attached to her analyst as implied in her opening remark.

The patient begins by saying that she got to the session so there is nothing more to say. I see this as a mild provocation (and a way of negating how much she wants to be there in her analyst’s presence), but Moss does not bite; he waits. The patient continues by telling how she screwed up by overfeeding her son, so he was too full to eat the supper her partner had prepared. She berates herself as an incompetent mother. Moss interprets this as a cover story to disavow her competency to which the patient responds by flipping back and forth about being like or not like her incompetent mother. At this point Moss links this material to the patient’s opening statement and suggests she is trying to get him to do the work of the session and take care of her properly. I sense this is familiar ground and that he has dealt with her wishes to be cared for by a wished-for mother before.

This intervention does not seem to sit well with the patient who takes it as an attack which she then turns on herself with an angry lament: “I’m always provoking. I’m always in the wrong. . . . I can’t quite take care of my son.” I think this turn to self-berating is very telling. Perhaps she habitually turns her anger upon herself.

It is at this moment she thinks, or tries not to think, of the young boy being burned by the Israelis. “They’re killing people who look like me. And all we can do is just watch them do it. I don’t want us to be here, both of us watching, with your arm around my shoulder. . . . sympathetic witnesses . . . a shame.” Thrown, the analyst tries to recoup as he emphatically puts words to her intense and unbearable feelings. She rejects his kindness, and her own wish for comfort, and says, in a negating way:

I don’t want you on my side. I want you over there, on a different side. . . . We’re too close otherwise. . . . This is analysis. What are we doing? . . . How can I take care of my son? Who’s taking care of me? Go over there, to your side. . . . How can I watch what’s happening and still be able to take care of my son?

She wants him “on [his] side” away from her even as she yearns for someone to take care of her.

Moss asks himself if he moved over too quickly to join her as horrified observer of a child burning. To be sure, his gaze was pulled away from the personal meanings it carried for the patient given her sadomasochistic susceptibilities, of which he is well aware. I think that the patient wished the image were a distraction from the realities of violence in the world and in another sense, a distraction, or a shift of immediate focus from disquieting but unacceptable fantasies and feelings within herself that could get played out with the analyst. With her words she draws him away, “distracts” him from what might be happening in the room. The operative word here is distraction. If she simply did not want to think and talk about the image because it arouses such horror and helplessness, she would not add the word distraction.

We can only guess what she is running from: At that point in the session in which she has been talking about mothering, she becomes angry at herself and the analyst who gets her when she doesn’t want to be called out. This sequence suggests that the burning boy may represent her son, or an identification with the victim, perhaps the victimizer; victimizer is a position she would more likely disavow. As a single mother wanting to be a better mother, she nonetheless must have angry feelings toward her son—a hungry boy who may represent the hungry, disavowed side of herself, intertwined with traces of frustrations about the maternal relationship with her own mother. She is palpably angry the rest of the session.

As I see it, the problem for this woman is she remains drawn to violence, attracted like a moth to the flame. There is no easy way to keep it out of her mind because it is already there, nor no easy way to keep it out of her relationships. Wanting to be a good mother, she poses the question how can she care for her son if there is horror in the outside world? She also is asking how can I care for him if there is violence inside me? This is a horrifying dilemma. She wants an analysis, but at a certain safe distance, just sticking to business. She is conflicted about closeness because it may excite sadomasochistic urges, and/or neediness. Caring and being cared for seem incompatible to her. Surely, sooner or later sadomasochistic proclivities will find their way into the therapeutic relationship. I see a whisps of provocation that drew her analyst into an active position. But she can’t stay with that possibility. She first puts him as a comforting observer “your arm around my shoulder” (not a fellow participant) in a sadomasochistic scene. She runs from one arena of sadomasochism to another. To be observer of the scene is also unbearable—to be a witness to violence makes us feel helpless, hopeless, or even complicit to it.

But for other reasons she does not want Moss on her side either. She wants there to be a barrier between the victim and the aggressor. She must stay on the side of the victim (or onlooker) and not the aggressor. The Israelis burn people who look like her. In moving to join the patient as onlooker, Moss moves from the differences between them to the similarities—being two parents watching in horror and helplessness at children burning. No matter how much she has come to trust and know him as a man horrified by violence, however, at the end of the day, Moss is white, male, and Jewish; she is black and female and not Jewish. Those differences are real and inescapable, but I imagine not easy to talk about for her.

To be clear, I am not saying that when patients talk about the realities and horrors in the world that these concerns can be or should be reduced to manifestations of their inner worlds, their personal fantasies, or the transference/countertransference. After 9/11 all my patients talked about it with me, save one, who was absorbed in herself and her troubled relationships. I felt I had to confront her by drawing attention to what she was not talking about. Ultimately, this turned out to be a useful encounter that shook loose memories of societal trauma as a child and some of her narcissistic defenses.

Moss describes his dilemma: the double mapping of being part of an analytic couple and also a citizen of the world who must endure its burning children. The image could reasonably be considered by many as an intrusion or distraction from the analytic work, but he does not want to marginalize it. I think of the issue this way: analytic work encompasses both inner and outer worlds and how they interpose with each other. Neither focus is necessarily a distraction or marginalizing but could function that way. It can be come dicey when analyst and patient really are on opposing sides of an issue, as in politics. As I see it, in this instance the analyst momentarily was pulled into a certain position by the patient, which narrowed his focus so that he could not think about what was happening. No wonder he was thrown off balance, not only because of the “double mapping” but also the patient’s communications kept shifting the ground—friend/foe; yes/no; we/you.

How can we go about our analytic business as usual fiddling while Rome burns? These kinds of events and experiences need to be talked about in analysis, although Moss’s patient does and doesn’t want to. Why she doesn’t want to talk about it is to my mind the important question. As he tells us, he tries to stand on the common ground of two human beings watching the world burn and comforting each other, two adults comforting their children, terrified and horrified by the world’s’ violence. But the patient can’t do this; she cannot put out of her mind that he is a Jew and a white man. She can’t put out of her mind her fascination with pain and violence. It is too painful and confusing not to have simple sides so you can draw the line between victim and victimizer, me and them. Otherwise, for her, and unfortunately for many, the ground is too dangerous and confusing—Who is friend and who is foe?

We cannot avoid interacting with our patients as human beings, occupants of the same planet. If we act otherwise, we cannot hope to make close analytic contact with each other. Moss laments that it is hard work balancing our traditional work as analysts with being alive and alert to the world around us. I agree, but both are difficult. For this woman, also, it is difficult being citizen of the world and part of an analytic dyad. How can she trust the world, herself, her analyst, and the process to keep her child safe? My hunch is that this patient needs to confront a disaster like the war in Gaza, or more importantly why she doesn’t want to do so, before she can tolerate and feel safe in exploring how the feelings it stirs up might be played out with the people who matter to her, including her analyst.