The Wisdom of Lived Experience – Maxine K. Anderson, Karnac, 2016

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page 67    “Civitarese (Intl Journal of Psychoanalysis, 2015 describes how the analyst’s attempt to rescue the patient gripped by hallucinosis requires the analyst’s loosening his or her ties to external reality.  Following Bion’s advice, the analyst deliberately attempts to divest himself of the products of memory and desire, that is, contact with the cortical cognitive functions.  This step facilitates regression to the level of his encumbered patient and perhaps, via mirror neuronal functioning, to resonate with that unverbalisable pain.  This function, as described by both Bion and Civitarese, is not a violent act, as described with one who succumbs to frustration intolerance.  It is an action that is more measured, suggesting that cortical mediation is not entirely switched off.  But this level of hallucinosis is of value only when the analyst can subsequently “wake up” and re-engage his dreaming, symbolizing self to be able to think about the just experienced pain.

The use of hallucinosis, … operates as a rescue mission, dipping into the well of the inexpressible but then reconnecting with potential thought.  This description of hallucinosis might be thought of as cleaving the union of the input from the external world with its links to the past (memory) and the future (desire) in order to venture via resonance and mirroring towards the wordless, affective upwellings with their intrinsic emotions.  Solms’ notation that these interior upwellings must be linked with cognition for recognition and representation would be what the ‘waking up’, as described by Civitarese (2015) would accomplish.

It is interesting to consider that Bion’s dreaming and the transformation of the concrete involves the right hemispheric contributions of imagery and mental space along with the verbal symbolic functions of the left associational cortex, all sent forward to the prefrontal cortex, which reconnects these aspects with the affective upwellings to reconsolidate the core sense of a conscious self.  Solms and Turnbull (The Brain and the Inner World, 2002) note that the function of the prefrontal cortex is a close correlate of the functions of maternal reverie, that needed object, which can apparently cause such frustration.  Transformations in hallucinosis may, then, be thought of as both the violent destroyer of the link with the needed object as well as offering the initial steps towards rescue of the mind, which needs reunification with that object.”

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