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The walls within: working with defenses against otherness

Online Conference 5-11 July 2021

Psychic Retreats: The Organisational Relevance of a Psycho-analytic Formulation

The idea of this paper dates back 18 months, when I first read John Steiner's book 'Psychic Retreats: pathological organisations in psychotic, neurotic and borderline patients'. John Steiner is a Kleinian analyst who works in private practice and was also, until recently, a consultant psychiatrist at the Tavistock Clinic. His book sets out to describe and understand clinical experiences with groups of patients who are 'difficult-to-reach' and 'make meaningful contact with '. The term 'psychic retreat' is introduced to refer to ways in which the patient can withdraw from such contact into states which are 'often experienced spatially as if they were places in which the patient could hide'. Such states may appear, consciously or in unconscious phantasy, as literal spaces: a house, cave, fortress, desert. But they may also take an 'inter-personal form, usually as an organisation of objects or part objects which offer to provide security (and which) may be represented as a business organisation, as a boarding school, as a religious sect, as a totalitarian government or a Mafia gang'. The patient appears, as it were, to be in liege to this organisation, which may be simultaneously feared and idealised.In his book, Steiner seeks to trace the origin of such states of mind in the patient's attempts to ward off or gain relief from intense anxieties and dread associated with either the paranoid-schizoid or depressive positions, driven by powerful innate destructiveness, or the impact of external trauma or the intolerance of separation, loss and inability to mourn. In more severely disturbed patients such anxieties may lead to a more or less permanent residence in the retreat, where all contact with the analyst or with external reality appears to be lost. But a retreat may also emerge in the treatment of less disturbed patients, at times when external or internal situations threaten 'the limits of (their) capacity' to contain mental pain.Steiner examines and explores with great sensitivity the particular challenges which patients inhabiting or inhabited by such states of mind present to analytic work and the various ways in which one can get drawn into enacting a role within the pathological organisation in which the patient is living. For example: 'the analyst may be tolerated only if he submits to the rules imposed by the organisation. Pressure is put on him to agree to the limits which the patient sets on what is tolerable and this may mean that certain types of interpretation are either not permitted or not listened to. If the analyst becomes too insistent that his task is to help the patient gain insight and develop, an even more obstinate withdrawal to the retreat may result and an impasse can materialise which is extremely difficult to negotiate. If, on the other hand, the analyst takes too passive a stance, the patient may feel he has given up, and may see the analyst as defeated or dishonestly caught up in a collusion with a perverse organisatio '. This quotation can serve to illustrate the impact of Steiner's writing on someone coming to his book from a very different experience of emotional work with clients. For it is hard not to read this statement without hearing echoes from one's own struggle, on occasion, to make contact with the world presented, either by individuals or by groups, within organisational consultancy. In fact, I think this metaphor of 'echoing' captures a good deal of what passes between psycho-analytic and group or organisational work. But it also has risks. Is it just one's own voice one is hearing back, or is it another's that can help one locate one's own? For a non-analyst, Steiner's book is not always easy to read. It demands a level of acquaintance with the analytic and especially Kleinian literature well beyond an amateur's reach. More importantly, the close, detailed attention to the texture of the individual case resists generalisation and occasionally one has the impression that the formulation of 'psychic retreats' is being used to carry more freight than it can handle. I am not qualified to, nor would I wish to comment in detail on Steiners' argument here. My interest is rather first, in what that argument suggests about the flow of interaction between or the inter-penetration of individual and organisational worlds; second, in what the idea of 'psychic retreats' may add to our understanding of organisational dynamics in the face of radical environmental or contextual change.Having said that, to get this paper off the ground, I need at least to try and capture something of what Steiner means by 'pathological organisatio '. For it is this phrase which both gives depth and substance to the concept of the 'psychic retreat' and which, in Steiner's usage, evokes the most direct echoes to experiences with groups and organisations.'