(1999).

Journal of Child Psychotherapy, 25:167-198

Symposium on frustration
Edna O'Shaughnessy , Anne Harrison and Anne Alvarez
Following the publication of Anne Alvarez paper Failures to link attacks or deficits'? (Vol. 24 No. 2, August 1988), we asked Edna O'Shaughnessy for her views on this subject, and she suggested this format in order to explore the issue of frustration from different theoretical and clinical viewpoints. In this symposium the authors look at the core concept of frustration from Freud's original formulations of the pleasure principle and the reality principle, through Melanie Klein's and Anna Freud's extensions of this and Winnicott's precise distinction between the failure of libidinal satisfaction and the failure of the environment to offer something needed for development. Bion's taking forward of the concept in terms of its centrality in the developmentof thinking itself in turn paves the way for contemporary thinkers and practitioners to marry the insights of infant observation and child developmentresearch. This does not offer an alternative to previous thinking but presents a fuller picture which has both technical and theoretical implications. Clinical material is used by each author to illustrate their theme.

Edna O'Shaughnessy begins:

A Note on Frustration
The first question concerning frustration is: why should we tolerate it at all? For a moment we can behold a Paradise with no frustration and the fulfilment of all our wishes. For a moment we believe it is Paradise we see, and, then, further reflection shows it is not Paradise, but illusion, delusion, severe illness, even psychosis, that is there. Freud gave us the key to understanding how this is so. At work with his patients over many years he discovered that two opposite principles
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regulate mental functioning: one, the pleasure principle, omnipotently frees the mind from what is unbearable by providing instant hallucinatory gratification; the other, thereality principle, comes into being when there is sufficient tolerance of frustration to allow attention to reality, a noting and remembering of it, and an assessing of it fortruth or falsity, in other words dunking. Omnipotent functioning frees us from frustration but it makes a world of delusion. Thinking, based on an initial tolerance offrustration, orients us to reality. Freud stated these fundamental hypotheses formally in his classic paper Formulations on the two principles of mental functioning(1911).

Clinical Material
A psychotic boy of 11 had been brought home from school in a state of panic, weeping. He remained at home ruling the household, as his parents told me, unable to be alone, or go out, or take lessons. They also told me that Hugh (as I shall call him) has strange habits': he collects rubbish, especially tiny bits, which he stores in his room and allows no-one to touch or clean. His father brought Hugh to the first session. I saw a beautiful dark-haired boy, rigid and sad, with a nice smile. In the play-room, terrified, he clung onto a small chair, while he looked not at me or the furniture but at the spaces. From his hovering gaze I could tell that these spaces, for him, were full of small particles. On the second day, still standing, holding onto the little chair, he stared anxiously at the wall. He was able to tell me he was watching a hand pointing a finger. Hugh felt himself to be in a space of particles and over-sized looming things, another of which was a watching eye on the latch of the window. Hugh was justholding on to reality the little chair he held onto stood for the real world that stopped him from succumbing to a psychotic panic in a menacing space of fragments andbizarre objects. Interpreting his paralysing terror of inner break-down and the terror of the outside world he was in decreased his anxiety (which even so remained high) and enabled him to let go his hold of the little chair that gave him safety and, concretely, to creep into his object. He made a wall of his coat and crept behind it along the floor to reach the open drawer of drawing materials, toys, etc From the first session he had seemed glad to be understood and had communicated through small morsels ofspeech, pictures and headlines of newspapers he brought to the sessions, and from then on he was able to sit down at the table and use some of the toys, and the paper for folding and drawings.
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Hugh began to carry everywhere with him a transparent plastic bag with a book in it called A Creepy World. I understood this to express his feeling that, like the book inside the bag, he and his creepy world were inside the analysis. Hugh was responsive to interpretations, often making an affirmatory Mmmm and communicating further. Even so, there were days when he felt he had lost or almost lost his capacity to hold on to and distinguish the real world from his psychotic world which was always there. With finger movements, the flicker of an eye muscle, the grinding of a top tooth on a bottom tooth, he launched attacks on enemies in order to survive. Pulverizing these persecutors made him fear a return attack from small things any slight noise or movement made him rigid with fear. He was always frightened and on some days needed the parent who brought him to wait nearby. He repeatedly drew bits, pieces and vague trailing shapes which I understood as pictures of pieces of himself, and I came to know what he already knew, that he felt bits of himself seeped out in his breath and speech, or from his hands when he made drawings, and got mixed with me and the room. To staunch and to recoup this loss of himself he felt he had to be sparing of movement and speech, take his drawings home, and if he saw a piece of fluff or speck of dirt he examined it and then put it in his pocket to take home one of his habits', he told me tonelessly, he and his parents called it. In the way Hugh had initially clung to the little chair for safety he now tenaciously held to me, and, until the first analytic break, in an omnipotent phantasy of having crept inside me, he felt me as continuously around him. The day I told him about the coming Easter break he swung round to look at me and stared at me for a long time, his face widening in a shock of disbelief. The next day he arrived bringing to his session a drawing of interrupted concentric circles. Pointing at the gap in the outer ring he said: England and France were once joined. Then a volcano came and they got separated. He continued, The middle bit got sunk and now they are like this', showing me the mismatchings and the sunken shaft in the middle. I said he had brought a picture of what happened to him when I told him of the break coming in his sessions: my words pushed into him and sank him in his middle. He no longer felt, as he had before, that, whether we were near or far, we were joined and I was around him. Now it was changed I mismatched what he wanted. Hugh started letting out smell after smell and became very distressed that he could not stop. Later in the session he drew a picture of an earth and a distant moon with craters in it our new remote relations. In sum, Hugh responded to the first separation with elemental
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intensity a characteristic of psychotic children described by many authors. The shock of it left him feeling sunk in his middle, with his orifices open and incontinent, half still inside but also half out of his delusional object. He felt I had suddenly turned deadly and had violently tried to volcano him out, and he, in his turn, exploded away this deadly object to be a distant moon marked with the craters of my, and also his, violence. After the first holiday Hugh's beauty vanished; he returned with sores and pimples round his mouth, a cut on his thumb and he was dirty and dim looking, like an infant neglected for too long.

Discussion
In this clinical fragment we can see how, once he had crawled into his object, Hugh lived in an omnipotent phantasy of being always inside it, of having, that is, the analyst always around him like a transparent bag which expanded with distance. In this way he avoided the experience of separateness until my holiday announcement broke into his omnipotent phantasy. The frustration of his delusion of being continuously held is an intolerable experience, involving his and my hatred, both of which he explodes away to a distant moon. We can also see that Hugh's phantasy world in which he feels, and looks, beautiful is not Paradise, though it is a protective, and also a narcissistically fulfilling encirclement (which depends, in an unacknowledged way, on the continuous presence of the object) of a terrified self in a bizarre universe. Hugh is intolerant of its frustration and he accuses me of doing him a deadly wrong. As with so many ill children we treat, I think Hugh suffered frustration by his objects in another and, in psychoanalytic theory, secondary sense of frustration where frustration contrasts with gratification and means deprivation impediment, etc. Later on in his analysis Hugh brought two boomerangs to several sessions and threw them at the wall repeatedly, saying despairingly: They never go anywhere, they just come back to me, which I understood as his showing me how he feels his communications reach no container and that he despairs of being understood. Such frustrating in the sense of depriving objects threw him back on omnipotence andnarcissism, and, moreover, muddled him about whether it is his real strivings or idealized hallucinatory strivings that are being frustrated, all of which was clinically important in his analysis.

I am already using Bion's language, and, as is well-known, it was Bion who, after Freud, again took up the issue of intolerance to frustration, but in a different psychoanalytic context created partly by Freud's late
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theories, partly by Melanie Klein's new developments and by Bion's own. Freud wrote Formulations on the two principles of mental functioning at a time when he saw the conflict between instincts as being between sexual and ego instincts, and anxiety as coming from damned up and/or repressed libido. Overall, Freud saw the two principles of mental functioning as regulating, with an inherent tendency to reduce the amount of tension, excitation in one human system. When he wrote about how the baby is first confronted with the exigencies of life in the form of major somatic needs' and that hallucinatory wish fulfilment comes about because the baby, with primitiveomnipotence, wills it, Freud thought that what makes possible the identity of perception, as he calls it, between hallucinatory wish-fulfilment and real gratification is a circuit with a mnemic trace of a perception that had been part of an experience of the real gratification of the instinct. Later, Melanie Klein accounted for hallucinatory wish-fulfilment more directly, with a conception of the instincts as inherently object-seeking, so that built in to the experience of an instinctual need is the innate idea of an object that satisfies it. This was part of the wide change Melanie Klein brought about in psychoanalytic theory by placing object relations at the centre of psychic life. Freud had by then unshackled libido and anxiety, and he had also proposed a different duality for the instincts the life and death instincts, and Klein, linking these withobject relations, formulated a new theory of development in terms of paranoid-schizoid and depressive positions and gave the name projective identification to a defencemechanism that she saw as having a central part in the regulation of anxiety, love and hate between objects. Projective identification is an object relations version of, and a further development of, Freud's pleasure principle of the avoidance and discharge of unpleasurable tensions and stimuli. In Klein's terms, the young infant defends his ego from intolerable anxiety by splitting off and projecting unwanted impulses, feelings, etc., into his object, with consequences for himself, the object and the relations between them. Bion made a further discovery. Projective identification, in addition to being an early defence mechanism, is also the first mode of communication between mother and infant, and is the forerunner of thinking in relation to an object. That is to say, projective identification functions in two ways which correspond, in object relations terms, to Freud's two principles of mental functioning. In Bion's view, the disorders of thought in the psychotic personality stem from a congenital disposition with, among otherfeatures, an intolerance to frustration which makes for a hatred of internal and external reality. Bion sees the infant's tolerance
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of frustration and the mother's capacity for reverie (which in turn presupposes tolerance of frustration) as both crucial for the development of the infant's thinking. In the case of Hugh, the boy I described above, I think there was intolerance and avoidance in both mother and child. Bion writes (his italics) The link between intolerance offrustration and the development of thought is central to an understanding of thought and its disturbances the choice that matters to the psycho -analyst is one that lies between procedures designed to evade frustration and those designed to modify it. That is the critical decision (1962: 29). I remind us (I apologize for a selective and simplified history of ideas) of these familiar texts of Freud, Klein and Bion, because in psychoanalytic theory it is this sense of frustration, that is, the sense in which tolerance of frustration is opposed to omnipotent wish fulfilment that is primary for learning from experience. Where there is no frustration at all, there can be no thoughts no beta-elements (these are evacuated and form a bizarre world), and therefore no alpha-elements. In such a mind, the psychotic personality, as Bion calls it, there is no thinking; nor are there phantasies unconsciously working through contact with reality in depth. There are only phantasies and processes unimpeded by reality, or links, beginnings or ends, which form hallucinations, delusions, illusions, sometimes in a freely flowing continuousness, sometimes in bits. The medium in which such a personality exists is often felt to be not air, but something transparent, or glassy, or like water, fog, mist or sand. Working with such patients we may mistake for free associations what is only a free flow of words, or mistake for play what are really actions to control us and instruct us in delusional functioning. Some of our patients are like this in only part of their minds, or such states may alternate with another self that is in contact withreality. With others, however, it seems to be all or almost all there is: these are the children who feel in a universe of spaces and holes to get into or out of like Hugh, or feel there are tubes

connecting them with other things, or feel wired, or pulled like puppets on a string, or exist behind a glass partition, or in an enclosing transparent circle again like Hugh. I chose the example of Hugh for this Note on frustration because with a patient like him it is clinically writ large that aberrant processes are happening in sessions, that his anxieties are horrific, that he is living in the delusion that he is within me and that I surround him all the time, that he is intolerant to the frustration by a volcano that came (my holiday announcement) of his omnipotent wishfulfilment that England and France were once joined, that he accuses me of crimes of mismatching it and not supporting this delusional world by my
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continual presence. Hugh's shock is trauma mixed with outrage, and he makes a righteous moral(istic) judgement about me all of which are characteristic of thepersonality with an intolerance to frustration. Where the psychotic personality is less prominent, the operation of omnipotent wish-fulfilment may be less readily discernible. A psychotic core, or a delusional omnipotent phantasy arching over the whole of the therapy, can be maintained secretly and tenaciously. This is one aspect of what Betty Joseph (1989) in her papers ontechnique has over the years been calling attention to, viz. how a patient may have an urgent need to get the therapist to act in some situation with him, and that we need to become aware of this and the projective identifications involved and to try to understand our patient's need of them, so as not to be giving blind support, for example, to the particular situation I consider in this paper, viz., omnipotent phantasies which evade psychic reality. A short example. A young student came always late and hurrying urgently to her session after the weekend. In this first session of the week she related in minute detail what had happened to her since her last session of the previous week. Her words, though they appeared to be giving information, were really concretely negating a gap and making the therapist there with her. Over the weekend she did not feel in danger of losing her object, but of losing her near-delusion that patient and therapist were joined together; it was this that it was getting late for, and which she hurried back to recover. She was not psychotic, and indeed in some ways managed life rather well. Yet she had not faced the reality of her separateness from her objects and unconsciously maintained the delusion that she and they lived in a state of union which led to occasional grotesque inappropriateness of conduct, and panic (which is what brought her to treatment) when independent action was wanted from her. In her treatment, any event or interpretation that she could not see as either fitting in, or revise to make it fit in, with her delusion of no separateness, brought a disturbing change to otherwise moderately co-operative relations: the patient felt suddenly exposed to possible panic and hatred and being herself full of hate, all of which she instantly exploded away, and was then righteously outraged by her therapist's wrongdoing in a way similar to Hugh, though it took a more rationalized form and was soon split off as her delusional phantasy reformed. Of interest for this paper is the fact that in her therapy it was also very important that the therapist recognize other types offrustration: she was intolerant of frustration in the sense I have called primary, but she also suffered, and indeed herself inflicted, frustration in the sense of being balked and deprived by her objects.
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Winnicott's (1956) theory of the infant's need of a time free from the frustration of omnipotent illusions complicates, but I think it does not alter, the account I have given of the significance of intolerance to primary frustration, though it would lead, I think, at times to a different clinical technique. A patient's omnipotent functioning avoids pain and panic he believes he cannot bear, and situations he fears will be catastrophic he is sometimes right about this and sometimes wrong. In therapy he is intolerant to the therapist's interference in his system, which may be not so much psychotic as a psychic retreat in Steiner's (1993) sense. These patients work hard, notthinking, but reconstructing momentary breaches of their system, which, even if it is not Paradise, seems more ideal than the real because they feel they have control and mastery and are not helpless. Yet in reality such systems are destroying their inner world and external life. Though the pleasure principle can protect the self from seemingly unbearable realities, when it is permanent and predominant it coincides dangerously with the death instinct. In brief. The frustration I have emphasized is different from the frustration that contrasts with gratification and means deprivation or thwarting. I remind us that the frustration, and its tolerance or not, to which psychoanalysis has given fundamental place, is not frustration as opposed to gratification, but something more primary, something that could be called part of the initial conditions in the patient, so that the first fundamental point about frustration is not what the patient learns from experiences

of frustration as opposed to gratification (highly important though these are), but whether he or she can tolerate or not the frustration of his or her omnipotent wish-fulfilments enough to learn from experience at all.

Anne Harrison takes up the theme:

Introduction
Having been asked to write about frustration, I became aware that I think of the concept in two quite different ways. On the one hand, there is the frustration which is an inevitable part of our experience, unwelcome but developmentally necessary if we are to move beyond the
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demands of our immediate wishes to a state of psychic containment and autonomy. Understood in this sense, we regard a capacity to bear frustration as a measure of achild's emotional development and of an adult's psychic maturity. I found, however, that I think of frustration also in relation to a different order of experience: when that which has been withheld from the child is not the satisfaction of a wish, but an essential quality of relating with his object. It was in this latter sense that Anna Freud (1949) used the term when, drawing on her experience with children in the War Nurseries, she wrote of the consequences of early object loss and deprivation. Winnicott welcomed her thinking in this area as a necessary and timely development. He was insistent on one point, however, that, insofar as what was being described was not thefrustration of a libidinal wish, but of a developmental need, the appropriate term was failure. In this brief account I shall examine both aspects or, rather, orders offrustration, using clinical material to illustrate the difference between them.

Clinical Material and Discussion

Mr T was a patient in twice-weekly psychotherapy. He had come to see me some five months before with a view to beginning treatment, and had struck me as an intelligent and thoughtful young man, but with some real difficulties which I thought would require more intensive work. He was surprised when I said this, but was prepared to think about it. Since he seemed to have a genuine interest in understanding himself, but had no actual experience of the transference relationship, I agreed that we would begin with two sessions. Mr T attended regularly and was anxious to be seen by me as competent and coping. He was startled by the powerful feelings of unhappiness which would well up suddenly in sessions, often in response to a chance word of his or mine. This generally occurred in the context of his memories of being sent to prep school when he was 8, and of the separation from his mother with whom he felt he had had a golden relationship until then. Mr T often wept on these occasions and, if I commented on his distress, told me that he found something satisfying in his tears. At other times he would present me with explanations of himself based on his current reading, and was often hurt that I did not respond with admiration. His concern to have my empathy and approval, rather than that I should be someone who was concerned to think about and understand his unhappiness was beautifully illustrated in a dream: the patient
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was walking by the side of a stream; he had a feeling of dread and knew that there was something in the grass on the other side of the stream which he should look at; he avoided doing so however, but made his way up the stream towards its source; finally, having struggled past a large boulder, he came upon a deep pool and the feeling of dread left him, as if it had been dissolved. The patient was able to think a little about his dream and to consider my thought that his tears might, oddly, be a refuge from more difficult feelings. He also began to wonder if the years with mother before prep school had been quite so golden there had, after all, been the birth of his sister although he deftly dismissed this thought as no more than an intrusion from his reading. Some weeks later, however, I was obliged to cancel at short notice the second of his two sessions; I told him of this in the course of the first session and offered him an alternative time for the later one. Mr T was understandably put out by this, but what seemed to surprise him almost as much as the cancellation itself was the fact that I was prepared to offer him an alternative. He remarked on his surprise and relief that I had thought of doing so, in contrast with his own immediate conviction that, as soon as I had said that I must cancel, then that was that and that there was nothing to be done. Mr T came to his session at the altered time and said that he had been looking forward to it. He spoke again about how unexpected my suggestion of an alternative time had been, and of the fact that, in the

intervening days, he had found himself thinking about me and about what I said to him in a way which was different from before. While he knew that previously he had considered my comments only as clues to what might please or impress me, he now found that he was thinking about himself in the light of them. As he had done so, he had become aware of an uncomfortable perception of himself in relation to his wife: that he often presented himself to her as a precocious child and sought to have her attention constantly for himself. He recounted a series of events at home over the last few days by way of illustration. What struck me as I listened, however, was the fact that Mr T had been far from having his wife's constant attention, but had had to share her with one of her colleagues who had been staying for the week. When I remarked on this, he brushed my comment aside. I persisted, however, and said that I thought that my offering an alternative to the cancelled time had been helpful to him, in that he had not been left to cope entirely alone, as he might have expected; nevertheless, I thought that there was another aspect to the matter, which was difficult for him and which he
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tried not to think about: this, was that I had indeed been absent yesterday, that I had kept him waiting until today and that, even now, I excluded him from knowing the reason for this. Mr T was silent and then acknowledged, heavily, that this was so. It made him think of how important it was for him to feel that he and his wife were at one and that his relationship with her was different from that with other girlfriends, by whom he had often felt cast aside and rejected. As he spoke he had a memory of a particular night which he had spent, angry and humiliated, when his girlfriend of the time had gone to a party without him. He knew that he very much did not want to experience feelings like that again. I have chosen this vignette from an early stage of work with a patient because it offers an instance of frustrating experience, as it was brought alive in thetransference, in a way which can allow us to consider the role which frustration plays in ordinary development. My cancelling Mr T's session at short notice was not in itself a good thing; it is part of our task as therapists to maintain continuity and reliability in the setting. An interruption to this continuity is an intrusion, and frustrating for any patient. For someone in a regressed state it can feel like a breach or dislocation, about which he or she finds it difficult to think Although Mr T had sought in these early months to establish an harmonious, at one relationship with me, and to control my capacity for independent thought, he was, in the event, able to use my offer of an alternative time to accept the frustration of my cancelling without cutting off. In doing so he began to engage more actively in his thoughts both with me and with thereality of what he felt. In the eighty years since Freud (1920) described the cotton-reel game played by his 18month-old grandson, we have gained a wealth of understanding of the psychological life of the child in its formative stages, through observation and conceptual elaboration. Nevertheless, there is a simplicity in Freud's account of the little boy and his game which continues to evoke the essential poignancy of each child's situation, and the painful struggle with feelings of loss, helplessness and frustrationwhich he must negotiate in order to form a separate identity. When the baby moves beyond a primal sense of unity with mother and can no longer see her simply as part of himself, he is bound to her by a passionate attachment. Small and dependent as, in reality, he is, his drive to possess her for or as part of himself meets constantly with frustration, leaving him at the mercy of feelings of rage andhelplessness which are often overwhelming. Over time, however, and in a setting of parental love and empathy with his struggles, his inner world of representations is strengthened and he comes to see that his loved and loving mother
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is the same as the mother who frustrates and enrages him. This is the crucial stage of object constancy, when a child begins to recognize that his loving relationships are not destroyed by his anger, and so his experience of frustration becomes less absolute and dangerous. Sustained by his inner sense of being loved and understood, thechild is able to internalize this as the nucleus of his own ability to think about himself, and to use language and play to represent the feelings which previously left him helpless. With a capacity for affective thinking and symbolization, he is able increasingly to manage frustration and disappointment in a way which is real and not omnipotent. This, in turn, strengthens both his sense of self and his ties to his objects, and allows him to experience real dependency. In the early months of work with Mr T I had been struck by various things about him: his concern to have my attention and approval, his longing for emotional release, but also to cope all by himself and his fear of humiliation. The move to prep school had clearly felt abrupt and shocking for him, and had left him floundering to manage feelings not only of misery, which he could recognize, but also, I thought, of

helpless rage which he could not. Behind this, I conjectured, might well be the experience of his sister's birth and, I was beginning to see, the image of a mother who had often found anger and resentment difficult to bear. Nevertheless, I thought that his efforts to keep us at one were not, at this stage, to do with a real regression, but were for the purpose of defence: an attempt to ward off situations where he might feelrejected and angered by me, and where he believed that I would be unable to understand or accept this. He was surprised that I should think of his minding the cancellation and offer him a change of time. When he returned, it seemed that he had been able to identify with my thinking about him and to make independent use of this. In the course of the session, although reluctant, he was able to recognize the reality of my absence and not to disavow it, as he had done before. Although he was able to admit only the possibility of the angry feelings he had about this and which he would prefer to avoid, these would come, in time, to be central to our work. An individual, adult or child, is able to tolerate frustration and to use it only when he has reached a certain developmental stage and has gained a degree of emotionalstructure, and coherence, and when, crucially, he has been able to internalize an experience of being understood by his object. The term assumes another, more ominous meaning, however, when what has been denied the child has been sufficient emotional provision for psychic structuring and development.
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When, for example, a mother has been unavailable to her child to an extent that he cannot feel that his affective experience has been recognized by her, his capacity to hear frustration and to negotiate further differentiation is compromised. This may come about in various ways: a mother may, for example, be depressed and unable to respond to her child's emotional state or to bear the intensity of his demands, or else narcissistic and controlling to a degree that she cannot recognize him as a person in his own right; alternatively, there may have been a separation from mother which was abrupt or extended, at a time when he still required her immediate presence to mediate his emotional experience, and which was therefore traumatic for his growing sense of self and capacity to manage his affective state. In such a situation a child remains, on a deep level, intensely vulnerable to the primitive force of his feelings and trapped in a state of primitive, magical thinking. Frustrated in his developmental mental need for recognition and containment, he experiences disappointment only as a narcissistic attack, which threatens his precarious sense of equilibrium and coherence. He remains bound to his frustrating object but unable to experience real dependency on her, and is therefore forced to cut off from thereality of his inner experience, to avoid being overwhelmed by feelings of emptiness and rage. Such a child will inevitably distort the representation which he has of himself in a way which apparently disavows his need to maintain an immediate contact with his object. This may entail the development of a false self, in keeping with what he feels is required of him, or else of a precocious capacity to engage a mother who is otherwise withdrawn and unavailable. He may, alternatively, engage in a furious battling with her or else turn away from her to father or to another carer, in a way which is premature and untimely for development. Engagement with another person can make a crucial difference for such a child, but, insofar as the other is a substitute for motherand not truly a second object, it may come at the price of reinforcing splits and of obscuring recognition of mother's actual separateness. When, for either an adult or a child the experience of the self is discontinuous and unreliable and wishes retain the primitive force of need, knowledge of the object's separateness is potentially catastrophic, both in itself and because of the rage which it evokes. For this reason such individuals struggle against awareness of theirdependency and vulnerability and try to delete it in the mind of others. Patients like these require us to feel their experience but not to understand it, and are impelled to impose themselves in a way which seeks to dominate
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and deny their analyst's capacity to think about them. This serves an illusion that the analyst and patient are part of one another, and that it is the analyst who is left helpless at the time of separation replicating the patient's own traumatic early experience. Patrizia was 10 when she began analysis. Her parents' relationship was difficult but they had remained together, and they spoke of their respective childhoods as disappointing. They remembered the time of Patrizia's birth and babyhood as an idyll which they had shared, bound together in wonder at her rapid and effortlessdevelopment. This period had come to end with the birth of their second child, when Patrizia was 17 months, after which mother had suffered a period of depression. Patrizia displayed no hostility to her brother, but relations with mother became cold and remained so, with occasional sharp

exchanges. Her bond with father had intensified, however, over the years, apparently in step with her intellectual development. It was clear that Patrizia remained remarkable in both her parents' minds, distinguished from other children, including her brother, by her precocious intelligence and ability with language. She did very well at school, but was aloof and self-absorbed and did not make friends, her parents had sought advice because of her acute night fears: she was terrified of intruders and was unable to fall asleep without the presence of an adult on the same floor; later in the night she would wake in a panic and rush to her parents bedroom where she spent the remainder of each night on a mattress next to their bed. The fears had begun on Patrizia's 9th birthday, but it emerged that her difficulties were earlier and wider ranging: she was, for example, afraid to walk alone in the street. Although they were concerned and conscientious, it seemed that neither parent was able to focus on the immediacy of their daughter's terror. A recommendation was made for analysis which her parents accepted some six months later, when Patrizia's school work had begun to fail. Patrizia appeared shy when we met, but with a deliberate maturity in her manner. She spoke readily of her night fears, emphasizing that she had not done so with her parents but only with the teacher who tutored her after school. In he early sessions she went over the details, with a kind of wistful helpfulness which made me think of achild in an Enid Blyton story helping the police with their investigations. One detail was new, however, which was that, when she rushed to her parents' room in the early hours, it was her mother whom she had to see and touch. I said that this made me think that there might be a very little girl inside her who needed to be close to mummy. Patrizia regarded me
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solemnly: Whoever she is, I, don't know where she comes from; but I do feel very little when I wake up. She took with apparent readiness to the opportunity offered by her sessions. Within days she had begun to elaborate with fluency the story of a girl, Elizabeth, and her adventures. Soon after, it seemed that a more overt battling had broken out at home, particularly with her mother. When she arrived distressed for a morning session about a month after we had begun, I had an indication of what was really at stake in this analysis. There had been an argument at breakfast about how Patrizia should spend her Christmas money; she had cried and bitterly reproached herself for this, but, she said, I didn't tell them my real feelings'. Shortly afterwards she told me of theloss of her budgie, which had escaped through an open window when Patrizia had taken it out of the cage to fondle it. In matter of fact terms, she told me how brief its survival out of doors would have been and upbraided herself for her stupidity. My sense was of a loss which was not only inconsolable, but entirely inaccessible to consolation. Her story making continued with the aid of toy figures. Elizabeth acquired siblings, including a baby sister, and soon the children formed a self-sufficient little group, contemptuous of their hapless father and defiant of mother, who was powerful and indifferent. A few weeks later the baby sister had become Superbaby, greedy and omnipotent, who tricked and cheated everyone, yet often needed rescuing. Patrizia still listened politely to my comments on all of this, but it was clear that my only value for her was that I was prepared to play. At the beginning of the third month she asked to play Monopoly and within days Superbaby was in the room. What was remarkable in this was not only the intensity of this regression she played with the absorption of a tiny child, crowing when she won, making lavatory noises when she lost and snatching cards from my hand but the disjunction between this and the precocious schoolgirl, smug and condescending towards other children, which was now the only other part of her I was allowed to see. She was vindictive and denigrating when I spoke of her fear of losing and feeling small, and through gritted teeth informed me that she was not a child, ever, during the day. The first break was difficult for the family and mother was shocked by Patrizia's rage towards her and by her will to hurt. We learned, however, that before the break Patrizia had slept for four nights in her own bed. She was tense and controlling when we returned, as if determined that there had never been a break, then resumed her Superbaby persona with wheedling, manipulative baby talk. Some days later she
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was able to tolerate a brief exchange with me about her wish to have me feel what she was feeling, because she could not stand to hear me speak of it. Next day she raged against analysts and grown-ups' who kept things from her. By the end of the session she was sliding around the floor in a box, pretending to be a toddler. Patrizia's insistence on being a baby in her sessions continued throughout the term, and she was vehement in her determination that I should accept both this and her grown up persona without comment. At the end of a session when she had been a bird for me to discover in a nest, she stood up and composed herself for school. When she realized that she had forgotten her taxi money, however, she

collapsed on the couch unable to say anything but ask for her mother. Arrangements were made with the cab driver and next day in the session the feeling was brittle. Patrizia struggled to keep me silent and, when I spoke of this and what had happened the day before, she climbed onto the table. Circling the room from table to chair to couch, her feet never touching the ground, she hurled whatever she could find at me first objects, then furiously scribbled notes: I'm not listening, I don't hear you, absolute rubbish. There were odd moments of contact and recognition between us as the weeks went by, but I felt that these were almost immediately disavowed. I reflected on the nature of my frustration, and thought that it had not to do simply with being ignored or shouted down. I was conscious of the reality of Patrizia's primitive need andhelplessness, but also that her analysis was being used to act this out, but in such a way that it must never be acknowledged. After the incident of the taxi money we learned from mother that Patrizia regularly spoke in baby talk at home, ate like an infant and could not use the telephone. I thought that my experience, in which I was both used by Patrizia and, at the same time, silenced and deleted, almost certainly replicated her own intolerable frustration that her neediness was both indulged and, simultaneously, disavowed. When I learned at the end of term that Patrizia was now spending most nights in her room and that her school work was blooming again, I felt that I, too, might be offered a counterfeit success'. Relations at home were better over this break and it seemed that, in particular, Patrizia and mother had established an accord. When we resumed Patrizia taunted me that she had convinced her mother she had told me nothing of her feelings. She no longer attempted to enact her small child helplessness, but struggled to control and silence me, especially when I made
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reference either to that or to her fears about herself: you think, I know was a constant refrain. She was frequently overwhelmed by rage when her will to possess me was thwarted, when, for example, I withheld information about myself or before a weekend; on these occasions she would lie silent on the floor, grinding a crayon to pieces or shredding a piece of cloth. She remained determined that I should know of her experience, however, provided this was not recognized in words. There were several important drawings, for example, to do with her intense anal preoccupations and with her sense of herself as damaged and strange, each of which she destroyed or took away. In another drawing she precisely expressed the state of malign frustration in which we were both trapped. On an occasion when she sat pushing the table towards me with her feet, I remarked that she wanted me to feel that I was crushed in a corner and that I had nothing of my own. She did not reply, but settled down to a drawing of me as an ugly and old witch living in poverty. Laughing triumphantly, she pointed out that the witch's cat was also thin and starving. I said that she thought that she was starving me, but that deep down she knew that there was a small, frightened part of her which was hungry too. She immediately became furious and hurled her pencil at me, but on this occasion she managed to say goodbye at the end of the session.

Anne Alvarez continues the discussion:

Frustration and separateness, delight and connectedness: reflections on the conditions under which bad and good surprises are conducive to learning

Introduction
The essay discusses four features of the relationship between frustration and learning.
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1. Frustration promotes thinking only when it is not over the limits of the tolerable and thinkable; otherwise, trauma and despair may produce dissociation and cognitive disorder. 2. Apparent defences' against frustration and anxiety may in fact be attempts to protect against, overcome or regulate otherwise intolerable frustration or anxietyand to arrive at states of safety and trust. 3. The introjection and internalization of positive experiences are essential elements in the development of a) emotional life and b) mental life and learning. Good surprises are as alerting cognitively as bad ones, especially where frustration and despair have been the norm.

4. Containment or sharing of emotional experience facilitates the kind of introjection and internalization which promote thinking and learning. This applies to positive as well as negative experience. A few technical implications are pursued concerning the difference between interpretations which address frustrationand separateness and those which address relief and surprise at discovering a sense of connection.

Psychoanalytic Theories of Frustration

Psychoanalytic theory has grown and expanded as clinical experience with each new type of patient has led to the stretching and partial breaking of moulds. Klein's additions to theory, for example, arose from her experience with very young children and with psychotic phenomena. It may not be arrogant to suggest that, at this present period in the history of psychoanalysis, child and adolescent psychotherapists may have some contribution to make to questions of theory. Their training in the study of early development, in the observation of early parent-infant interaction, and their experience in recent decades with patients whose level of disturbance, damage and particularly of trauma and neglect goes far beyond that of those treated fifty years ago afford much opportunity for the testing of theory against clinical evidence. Work with such patients, I believe, puts to a severe test the emphasis in some psychoanalytic theories on frustration as the major impetus for learning. Psychoanalytic theorists from Freud on have asserted that it is the experiences of unpleasure that educate us and introduce us to reality. In many of his writings though by no means all (see Balint, 1968) Freud pictured the baby as beginning life in a state of primary narcissism, pleasure and gratification, and only gradually learning the truth that he is lord and master of neither his mother nor the universe (Freud, 1911). He at first identified the heartbreak of Oedipal sexual disappointment as
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providing the first major encounter with truth (1905), but later he added the pain and loss associated with weaning as an even earlier wake-up call (1917). Winnicott (1960), for all his passionate interest in the importance of play and the use of the imagination in developing creativity and, by implication, the mind, is nevertheless dose to Freud's position in describing the earliest state of the baby as one of illusion, with necessary disillusionments as the source of awakening. Although neither Freud nor Winnicott explicitly linked this level of gratification or illusion with low levels of cognitive or intellectual functioning, they both implied that the state is a somewhat mindless one. Melanie Klein (1952), on the other hand, insisted on the early presence of ego function in infancy. The explicit link of emotion with cognitive functioning, which began with Klein (1930) and Segal (1957) was developed much more boldly by Bion (1962). Bion was the theorist who made the strongest link between frustration and something much more than the simple emotional facing of painful emotional realities the actual process of learning and thinking itself. Bion made two crucial points: first, that a preconception had to meet with a realization for a conception to be born, and, second, that a conception had to meet with frustration for a thought to be born. (Interestingly, he wrote much more about the second stage than the first. It is also worth noting that his concept of the preconception meeting with a realization has some hints of the element of perfect fit implied in the theories of narcissism, symbiosis andillusion mentioned above.) In any case, Bion thought that real learning depended on the choice between techniques for evasion and techniques for modification offrustration (1962: 29). Bion links tolerance of frustration with the sense of reality. I am arguing that we also need to understand that some patients with impermeable or irreparable internal objects need a reality which can be experienced as modifiable. Note, however, that Bion's second statement is much more than a refinement of Freud's view. It seems close to Freud's Formulations of the two principles of mental functioning (1911) where he suggested that it was the pressure of internal needs, followed by disappointment of their satisfaction, followed by the inadequacy of hallucinatory wish-fulfilling dreams to gratify these needs in any longterm way, that eventually drove the mental apparatus to form a conception of the real circumstances in the external world and to endeavour to make a real alteration in them. A new principle of mental functioning was thus introduced; what was presented in the mind was no longer what was agreeable but what was real, even if it happened to be disagreeable. This setting up of the
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reality principle proved to be a momentous step (1911: 219). Freud, however, was stressing the importance of emotionality in this development. Bion in addition concentrated on the nature of the processes involved in the mental apparatus's forming of conceptions'. He was asking, but what does this setting up of the reality principle involve? He was talking, not only about a change of emotional

content, but about something much more radical, the acquisition of thinking itself. Thus came the great intrinsic link between emotion and thought, the theory of containment, and that of alpha function, the process by which thoughts become thinkable (Bion, 1962). I think it is impossible to overestimate the significance of this theory of thinking and its effect on clinical work and technique. Melanie Klein, of course, was the pioneer in this field, with her early paper (1930) on the development of symbol functioning in a young autistic child. She and Isaacs (1948) emphasized the way all thoughts were filled with and fed by unconscious phantasy and Segal's great work on the development of symbol functioning (1957) led to another huge step forward. However, their theories said little about whether there was thinking at the paranoid position (the implication of Segal's theory of symbolic equations, I think, is that it is a substitute for thinking). Bion, however, seems to me to have left room for the theory of thinking to be extended to even the illest or earliest of paranoidschizoid levels.Alpha function could be considered to operate, that is, on only one thought (or betaelement) at a time at the simplest and least integrated of levels (Bion, 1962: 35). I have left a fuller discussion of Klein's theories to this point, because I feel there is a central aspect of her theory that has been neglected by Bion in some of his emphasis on the importance of frustration for learning, and that in some of his statements (but not others see Alvarez, 1998) he took something of a backward step. BothMelanie Klein (1952: 76) and Hanna Segal (1964: 54) were careful to say that it was the strength of the ideal object and of the individual libidinal impulses that enabled theintegration of persecutory object relations and thus the move from the paranoid-schizoid position to the depressive. This is a two-part, two-element, bi-polar theory. In a way, so too was Bion's: he had stated that, before conceptions met with frustration to produce thought, the preconceptions met with realizations to form conceptions, but somehow this first stage of the process has received much less attention than the second. I think child and adolescent psychotherapists see many deprived children and also some autistic children, in whom the conception of a good or interesting object barely exists. We therefore find ourselves working at the more basic level of preconceptions, and learning
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to be alert to very faint signals of hope or interest in the possibility of a good object which may be hidden under the mantle of the usual indifferent, despairing, suspicious or cynical mood. Klein was famous for arguing in her controversies with Anna Freud for the technical importance of analysing the patients' deepest anxieties (Klein, 1932). Yet her actual theory of how people progressed from the paranoid-schizoid to the depressive position emphasized the struggle between love and hate and its outcome'sdependence on the extent to which [the person] has been able to take in and establish his good object which forms the core of his ego (1957: 76, italics added). With some of our illest patients it is that very taking in and establishment that is at issue and which must be addressed in the treatment. Possibly it was the brilliance of Klein's recommendations on technique, together with her work on envy (1957) and on manic defences against depression (1935). which led to Bion's emphasis (1959) not only on the negative forces within the patient's self, but on the importance for learning of the negative forces the self faced. Spillius has pointed out that in the 1950s and 1960s the Kleinian membership papers for admission to the British Psycho-analytical Society were inclined to emphasize the patient's destructiveness in a way that might have felt persecuting to the patient (1983: 324), but that destructiveness gradually began to be interpreted in a more balanced way. A similar balance is necessary, however, in the interpretation of the patient's sense of the badness or goodness in his object, and whether, when the material allows a choice, which it often does, we emphasize separations and separateness or reliable returns and a sense of connectedness. (The latter need not be described in symbiotic terms.)

When Frustration is too Great: The Problem of Terrible Surprises'

I shall not give examples of the way in which frustration promotes learning, because this has been extremely well described and argued in the psychoanalytic literature and needs no further elucidation from me (O'Shaughnessy, 1964). I shall concentrate, instead, on situations where it reaches intolerable levels. In a talk entitled The terrible surprise: the effect of trauma on a child's development, Helen Hand (1997) described how the death of a little boy's father in a car accident produced effects not only on his emotional life and his behaviour, but also on his thinking. His reactions to the trauma now had a life of their own, long after the
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event. The child could never finish a story, nor could he understand cause and effect. Despite the continuing loss, this was not a deprived child, but the sequelae were long-term. Many borderline traumatized children have suffered severe neglect as well as trauma, and the sense of good objects may be as weak as the sense of bad or abusive objects is strong. The strength of the good or ideal (Klein and Segal often use these terms interchangeably) object is exactly what cannot be taken for granted in the work. One severely neglected child, Dean, of alcoholic parents who spent the early months of his life in hospital with a succession of different carers, saw his mother fall dead in front of him when he was 4. At the age of 6 he was a frantic frenzied violent child who seemed to be steadying a very little as the early months of intensive treatment progressed. But when his therapist returned from the first long break, Dean said there were no care in his box. She showed him that the cars he usually played with were still there. He replied, Oh no, those are from a long time ago with another lady. Separation and loss occurring in the context of an internal object with practically no constancy or substantiality can throw such children terribly. The damage is cognitive as well as emotional. Perry (1995) has shown the effects on the infant brain of early psychological trauma, and the subsequent preponderance of attention deficits and dissociative disorders in childhood and adolescence. Disturbance and disorder may be accompanied by delay and deficit in any or all aspects of the personality: in ego function; in the self and its sense of identity, and in the sense of the constancy of objects. When the disturbance is too great, thoughts about separation may become unthinkable until thoughts about reliable returns can grow. We have much to learn about the conditions under which our patients can begin to think these new thoughts. Patients returning after a holiday may not be in a well enough or integrated enough state to be struggling as yet with feelings of missing or loss. They may have lost contact with any sense of a good or familiar object real enough to be missed. They may need help to find their good object again. I happened to hear about several sessions in the week after the Christmas holiday, in which deprived traumatized children seemed to be confused and disorientated. Reminders of the break and the separation seemed to make the situation worse, but alertness to the difficulty in feeling at home or finding something familiar in the room or in the therapist or in the child himself seemed to help. Interpretations about loss and separateness can sometimes serve to re-traumatize such children. Alertness to tiny beginnings of feeling at ease or comfortable or safe,
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or difficulties in doing so, can help the child to get back in touch. Then, if the child is well enough, feelings of missing, loss or anger may begin to emerge. For otherchildren, this second stage may take months to come, One severely abused child, Joel, returned from the break very disorientated and closed off at the start of the session. A little while later, he became desperate to fit some pieces back together in his play material. After much work on his difficulty in believing that he and his therapist were really back together again, and then some expression of his vicious fury, he calmed down a little, and seemed somewhat more focused. He drew something which he said looked like a fossilized feather. His therapist commented that it was interesting: you could see its softness but you could not feel it (note how slowly and delicately she approached his petrified softer feelings). He then added, with a note of wonder in his voice, It must have been very protected for 300 million years in Loch Ness! His therapist then commented on its survival and theirs. A little later, he looked out the wi ndow and said delightedly. I can see a blue tit! Here, one can see that the therapist's attention to Klein's deepest anxiety emphasized at first the attention to the anxiety about finding an object. Only when he began to express his fury did she address the anxiety and anger about losing it. And, in the end, it seems that through both sets of interpretations Joel was helped to find and then secure the object that he had almost forgotten existed.

Can Some Defences against Frustration be Seen as Attempts to Overcome or regulate Frustration and Disturbance?
Klein herself (1935) introduced the fundamental meta-theoretical differentiation between defences and overcomings in relation to reparative processes in the depressive position. She insisted that true reparation, unlike manic reparation, was not a reaction formation to guilt, but an overcoming of guilt. I have argued before that we may also need this meta-concept of overcoming for developments within the paranoid-schizoid position (Alvarez, 1992, 1997). What is at issue in the paranoid-schizoid position is the overcoming of outrage, fear and despair rather than of hatred, guilt and grief. If love has to be stronger than hate for hatred to be overcome in the depressive position, what, e.g., has to be stronger than fear to overcome, as opposed to defend against, persecutory anxieties? What enables outrage, fear or despair to be reduced so that good feelings can begin to emerge? Relief from overwhelming
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pressure of anxiety or frustration can initiate these healing processes and notions such as Klein's (1957: 188) good or ideal object which loves and protects the self, Sandler's (1960) background of safety, Bowlby's (1988) secure base, Winnicott's (1960) holding object and many others suggest a way in which such relief fromunbearable pressure may be obtained. (Note that these latter concepts of a safe object are different from that of a good object. In relatively secure children, the sense of safety may to some extent be taken for granted and remain in the background, as it were, whereas the good object seems to live more in the foreground. Yet, when abused children begin to conceive of the notion of trustworthiness, they often seem to think hard about it. I think their developmental trajectories are very different from those of more protected children.) Trust in safety or goodness is not a defence, although of course it can be used defensively. What I am suggesting is, of course, not new. Klein (1935) stated that idealization and splitting could be used in the service of development and Bion's (1962)concept of projective identification as a needed communication makes the same point. The use of such apparently defensive processes can therefore be seen to enable new introjections to take place under conditions which should be described as protective rather than defensive. A surge of hope or pride or a sudden feeling of relief is different from a manic state used as a defence. A recovery is not a denial, though of course it may be accompanied by denial. I have given (Alvarez, 1997) several clinical examples illustrating the way apparent defensive activities may contain within them not simply behind them or underneath them -deep underlying needs and healthy developmental strivings, but a single one here will have to suffice. A profoundly fragmented little boy called Adam, filled with bitter self-loathing, had very little capacity to play. He had had a difficult birth to an extremely depressed mother. Eventually, after two years of treatment, he began to play a game in which he was a friendly but placating little puppy scrambling about at his therapist's feet on the floor. When the Christmas break came, he directed the therapist to open her travel suitcase, where she was to find a wonderful surprise a puppy! When she suggested it might imply that he felt he was to be like a new baby for her, Adam could not let it be a baby. He insisted with some horror that it was just a puppy, and it seemed clear that he was not ready to surface as homo erectus. By the next Christmas break, the suitcase contained a baby. There had, in the meantime, been much work on his feelings of shame and his inability to believe he could bring pleasure as a human infant as well as on his own rather miserly and stubborn
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unwillingness to give pleasure, which was also marked. It seemed that he was finally able to rewrite his birth history and instruct the therapist to welcome him with surprise and delight. At this period Adam was not denying his birth history, he was rewriting it internally and symbolically (Segal, 1957). The birth phantasy did not seem to bebeing used as a manic defence against frustrating and cruel truths. Instead, it involved, I think, the beginnings of the construction and establishment of the positive relationship between mother and baby on which all sanity, hope and ego strength depends. I do not think he was wishing that his therapist would not or did not leave him at Christmas: I think he was beginning to develop a phantasy of an object which would want him back after Christmas. Such phantasies may succeed in giving form and structure to the meeting of a rightful need, not the denial of disappointment in the form of a defensive or denying wish.

Pleasure, Safety and Delight as Necessary to Emotional Health

Klein wrote that: the shaken belief in good objects disturbs most painfully the process of idealization which is an essential intermediate step in mental development. With the young child, the idealized mother is the safeguard against a retaliating or a dead mother and against all bad objects and therefore represents security and life itself. (Klein, 1940: 388). Klein is describing how hatred can shake such belief, but we know now that so also can abuse. Chronic doses of terror, pain and despair in young children almost always interfere with normal psychological development and may produce developmental arrest and deficit in the capacity to love, to enjoy and to feel self-respect; and in the quality of the superego and internal objects. That is, the positive side of the patient's personality may be just as underdeveloped as the persecutory side is overdeveloped. What is at issue is not simply marked splitting between ideal and persecutory or between good and bad (with the implication that both sides of the personalityand the world of internal objects are well developed) but lack of development of the good self and the good objects. When Klein wrote (1957: 188)

that a good objectwhich loves and protects the self and is loved and protected by the self is the basis for trust in one's own goodness, she was stressing the infant's libidinal
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investment in its first external object, and the way in which envy could interfere with this. When we are working with seriously deprived children whose external objects have been unable to receive these loving projections, we often get a sense that the children have given up, and we have to work, as it were, from both ends that is, from the problem of the inhibition in the child's love or failure of his trust, and also from that of the internal object's incapacity to like or care for the child. You can hardly believe that we are back together [Or] that I have returned when I said I would; or It is hard for you to believe that I do intend to return on January 4th [or] that January 4th will ever come. You are beginning to like coming here can be accompanied by You felt I liked you when you did that, or when that happened; or You are beginning to feel that I care what happens to you. We have to address what the child does or does not invest in his object, but also what he feels his object does or does not invest in him. For such patients, the process of the introjection of the ideal object and the building up of a sense of the loving or lovable self is a long slow process, yet it is vital to mental health. The therapist may address issues of the positive transference and the child's beginning hope of or belief in a positive countertransference without indulging in sentimentality, collusion or seduction. Strong countertransferences of a maternal or paternal nature need delicate handling but need not lead to implied false promises. Fear of implying that we will really adopt the child can sometimes lead to denial and inhibition on the part of the therapist and contribute to further despair where the child experiences the inhibition as rejection. Acknowledgement that someone should be adopting him, or that we should not be leaving him for a holiday at this moment, need not be done collusively. Yet such acknowledgement can be very different from interpreting to a despairing child that he wishes' we would not leave him. The interpretation of rightful need can strengthen the ego of a despairing child. An interpretation of a vain wish can weaken the ego and increase despair.

Pleasurable States as Active, Accompanied by Thought, and Thought-Provoking

Pleasurable states of mind have too often been described in psychoanalysis as passive, using images of adaptation, gratification, fit and symbiosis which imply a somewhat sleepy mindless state (Mahler, 1968; Winnicott, 1960). When the child is used to a daily diet of negative states, new
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experiences of a therapist's return, constancy, reliability, durability can be actively alerting, interesting and thought-provoking. These experiences take place in the presence of an object. When these states can be digested, they may promote mental development and learning. Klein wrote of the importance of building up a good objectfor emotional life, but it is clear, I think, that combining this idea with Bion's somewhat neglected concept of realization leads to the conclusion that positive experiences are as essential for mental as for emotional life. Klein herself (1952) said that the baby took in understanding along with the milk. I would go further than Bion and say that positive experiences of a live object are not purely realizing in the gratifying or symbiotic sense. I am sure, however, that they feel right but in a vitalizing, not a sleepinducing way. Because Bion wrote so little about this part of his theory, I am not sure if he really implied mindless gratification and fit, but I think the concept has a flavour of a perfect fit, with reality and thought coming in only when frustration and absence make their appearance. Yet positive factors can be alerting because they areinteresting. Bion (1962) posited K, the desire to get to know someone, as additional to L, the need to love, and to H, hatred but maybe K should be seen as a part ofL, not only of H. In normal development, pleasing surprises are just as alerting as nasty surprises. It is the element of surprise, of unexpectedness that may evoke delight, reflection and meta-reflection. And this may take place in the presence of an object which is human and alive. Infant observation and infant research (and Klein's theory, by the way) teach us that there are very few perfect fits, even when objects are present and gratifying. Because the object is alive and mobile, its presence is just as demanding and alerting as its departure and absence. Arrivals and returns are alerting, but so is the simple experience of looking at the mother or father's face during a proto-conversation. The mobile and expressive features, the widening, brightening, narrowing and dulling eyes, the changing tonal qualities and structurings as the parent speaks and responds all demand attention. As Stern (1985) and Trevarthen and Hubley (1978) and Beebe and Lachmann (1994) have shown, a live human being when present offers a complex, varied and constantly

changing presence, full of dynamic flows and temporal shapes. It may be pleasurable, but in a demanding way. I do not agree, therefore, with Bion and Freud that it is primarily through frustration, absence, separation and separateness that reality makes its appearance and thought is born. Modulation and regulation of presence is a task for the infant a mental as well as an emotional task which is probably prior to the one of maintainingobject constancy
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throughout absence. Introjection is often hard work, and surely introjection of experience has to precede a more durable internalization and representation. I think the question of introjection of experience is a subject which has not been sufficiently studied in psychoanalysis. Preconceptions need to meet with realizations, but this meeting is a living dynamic imperfect articulated link (Bion, 1957) not a static one. I am suggesting, therefore, that conceptions are thoughts too; that making a thought thinkable can occur even around delightful or joyful thoughts. When Leontes in The Winter's Tale (V, III, 109) discovers that his supposedly dead wife is not a statue, but a living being, he gasps, Oh, she's warm! Although this is a story about a man in the winter of his life emerging from terrible despair, I think such experiences happen regularly to tiny infants, too. They are processing what Stern (1983) calls the slow momentous discovery of connectedness. Babies, that is, think about present objects when they study their care-giver's smiling face, for example, or savour the taste of the milk or how the breast feels to their hand. It is a fascinating moment when babies begin to explore with their eyes and then with their hand the very breast they had previously known only by mouth. One 10year-old adopted girl who had been raised in an orphanage in a Third World country, said, musingly, to her therapist, to whom she was becoming very attached, Why are you called Jane? A little later, she briefly stroked the fuzzy sho ulder of the therapist's cardigan and asked, softly, Why is it so fuzzy? The language she was using and the question why was that of a 10year-old, but in reality I think she was doing what the baby does when it explores its mother's or father's face with its eyes or hands, getting to know reflectively and cognitively, as well as emotionally, not the whyness of his parents, but the whatness, the is-ness. There are many different versions of the present object, and that fact in itself is extremely demanding. Wolff (1965) found that babies showed intellectual curiosity not, by the way, when they were hungry or tired, but when they were well fed, rested and comfortable. Their curiosity was not driven by frustration, it was freed by satisfaction and good internalizations. Alpha function, I maintain, operates on present and pleasurable objects. Introjection of good objects precedes the internalization of which the Polish poet Zbigniew Herbert speaks: Good memory heals the scar after departure (1999: 15). I am arguing that, where there are no good memories and where thinking and memory are impaired, there is no healing.
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Containment or Sharing of Emotional Experience by Caregiver is the Major Means by Which Experience, both Positive and Negative, Achieves Internalization and Promotes Learning
Bion's (1962) concept of protective identification as a communication describes situations where the mother contains and transforms the projections of the infant in ways which make the unbearable bearable. He compares this to the containing function of the analyst, and there are many instances of this in clinical work where the patient is able to explore an unbearable experience via someone else. Joseph (1978) has drawn attention to the need for analysts to contain such experiences within themselves sometimes for long periods without returning the projection to the patient. Here it is the freedom from frustration which seems to promote thinking the opportunity to explore the experience in someone else who can feel it deeply and also think about it. A suicidal disabled girl began to urge her therapist to the up her (the therapists) legs with cellotape and to stay in that chair for the rest of your life. She was able to obtain relief from unbearable bitterness and despair by exploring thephantasy that this terrible thing was unjust, it should not have happened to her, it should have happened to someone else not her. Projective identification into a receptive object afforded relief from overwhelming frustration and began to enable the child to think about her experience from a safe distance to think about the previously unthinkable. The therapist did not, for some weeks of this game, remind the patient of what they both knew, that this was really the child's own experience. The game began sadistically, but, as the weeks progressed, became more symbolically dramatized, and eventually even at moments humorous. Returning the projectionprematurely would only have increased her already unendurable frustration and despair and prevented the slow exploration of painful truths.

The containment and sharing of positive states is equally important for the process of recovery. A very abused and abandoned borderline patient of mine, Richard, came back to his second session delighted to find that it would be as long as the first. He added that he liked things with no end, forever and forever. This was thirty years ago, and I am sorry to say that, instead of staying within the transference (the only place Richard would be able to build up a new and non-abusive maternal object), I mentioned his mother. (I knew that she had beaten him as a baby and abandoned him at 18 months.) I inquired if he saw her much
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nowadays, and he said, in, a panicky voice, Yes, forever! I felt great compassion for him at that moment, but nevertheless made myself treat this as a defence againstseparation that is, as a wish for foreverness in his mother and in me, to avoid deep sadness about her and because he knew we would be meeting only twice weekly. In those days, I saw the insistence on foreverness as a defence against sadness, whereas I now think it would be possible to view it as an expression of a rightful need for continuity. He was genuinely astonished and delighted that the second session would be as long as the first, and probably, I now suspect, that it had arrived at all. I could have said something like, You like the feeling that this treatment is going to go on for a long time, a nice forever feeling. This sharing and amplifying of a positive experience (Stern 1983) could have been done without encouraging phantasies of rescue by, say, adoption. In conclusion, I am not suggesting an alternative to previous ideas about how learning of reality takes place. I am arguing only for a fuller picture, for an addition. Oedipal frustration, oral frustration, the absence of the object, separation, boundaries, separateness are all alerting experiences. Links between different versions of a present object, however, have to be built alongside those concerning absent objects. That the object can reappear slightly before you expected it or indeed that it can appear at ail and that it changes its form from micro-moment to micro-moment is an intrinsic part of its aliveness and needs just as much processing as its capacity to leave whenever it wishes. In some patients, the texture, feel, sound, look of a kind or good object may be being introjected for what amounts to the first time. Such moments need delicate handling, and this need not lead to sentimentalization, collusion or the encouragement of manic defences. They are the stuff of what Freud and Klein called libidinal and what they and we would also call a loving life.

Acknowledgements
I am grateful to Britt Bonneviers, Janet Bungener. Lucy Griffin-Beale and certain others who wish to remain anonymous for permission to use clinical material.
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Article Citation
O'Shaughnessy, E., Harrison, A. and Alvarez, A. (1999). Symposium on frustration. J. Child Psychother., 25:167-198