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1. An Analysis of Intellectual Dysfunction
Robert Royston
ABSTRACT. Thinking inhibitions may affect a person's academic and professional
performance and damage aesthetic enjoyment. They can emerge in the analytic
encounter as an inability to digest interpretive ideas and insights. The present paper
describes the experience of intellectual blocking and offers a theory to account for the
psychodynamics and causes. The argument is traced through three case studies, using
an object relations theoretical approach that is distinguished from some other
psychoanalytic viewpoints.
My aim is to offer a psychoanalytical account of thinking inhibitions, to describe
their psychodynamic function and roots. Along with this, I offer an account of a related
phenomenon, negative therapeutic reaction.
My argument puts forward a two point theory concerning intellectual inhibition: (1)
That it arises from a relationship with a dominating autocratic object who in childhood
established with the subject a particular type of relationship: the autocratic object is a
parent or caretaker who is psychologically powerful but inwardly fragile with intense
narcissistic needs; the child's developmental agenda and establishment of an
independent self are impaired in service to these needs of the object; (2) That
intellectual blocking results from a defence against looking at or mentally digesting the
nature of childhood experience and, particularly, bad childhood caretakers. The
theoretical background for the latter point belongs, of course, to Fairbairn and I hope
both to apply his ideas as well as to extend them. One feature of this extension is to
show, in my third case, the negation of memory and its effect on intellectual
functioning and the capacity for aesthetic enjoyment. The therapeutic process in many
such cases involves a reassessment of the patient's objects and often the recovery of
suppressed memories. In technique, therefore, some emphasis is plakd on the
reconstructive or genetic aspect of transference interpretations.
Theoretical Background
I want here to situate this paper in the psychoanalytical landscape and differentiate
its point of view from some existing ones. I see the phenomena described as caused by
what might loosely be called environmental failure. This is consistent with the ideas of
the British Object Relations school. However, with the exception of Fairbairn's
contribution, British school writers tend to see the source of psychic distortion in
inadequate mothering in infancy, the period before the acquisition of speech. In
Winnicott's (1972) case study, `Fragment of an analysis', for example, we are not told
about the patient's real objects or childhood experiences. There are few transferentially
based reconstructions of childhood.
The theoretical position in the present paper sees psychic disturbance and ego
Robert Royston is a psychoanalytical psychotherapist and member of the London Centre for
Psychotherapy. Address for correspondence: 25 Dalmeny Road, London N7.
British Journal of Psychotherapy, Vol 12(1), 1995
© The author

2. 16 British Journal of Psychotherapy (1995) 12(1)
distortion as the product of relationships with pathogenic real objects throughout childhood.
Object Relations theory took a radical step away from the Kleinian view of the baby as
psychic capsule or Pandora's box, but focused on failures of maternal provision. The view in
this paper is that a further step - towards an assessment of pathogenic objects and their
influence throughout childhood - is necessary. This may, if you like, be called a Neo Object
Relations approach. In practice, Freud's emphasis on the genetic or reconstructive aspect of
transference interpretation is reinstated. This differs somewhat from the technique of
Winnicott in the case described above, and also from the classical Kleinian position where
the transference culture is a sealed world-in-itself.
Dysfunction and the Autocratic Object
Before presenting clinical material, I would like to describe the subjective experience of
intellectual dysfunction and of interaction with the `autocratic object'. This material is
gathered from different patients and from personal conversations.
The most common form of intellectual dysfunction is a simple mental block. The
paragraph, the idea, the numbers, sit outside the mind, forming an unworkable mass.
Increased effort, a determination to crack the problem, reduces the material to empty ciphers.
You grasp something but in a diminished form. Dynamic complexity lapses into truism or
formula as the originality and aliveness of the work leak away.
Cognitive disorder can be a type of deafness. Other people speak but the subject, almost
compulsively inattentive, can't quite follow. They feel inferior, a noncontributor who must
passively absorb in silence. They may gradually feel mentally abused: the other is talking at
them, not with them; then a teasing or chiding quality in the other person's words may be
experienced.
In meetings or public lectures the sufferer cannot concentrate and puts up a type of
counter-lecture or run of ideas or worries as a mental barrier. At the end, they have not taken
anything in. This manifestation of cognitive disorder creates a type of defensive psychic
membrane and substitutes self (the counter-lecture) for object (the speaker). If alien ideas are
ingested, they prove difficult to metabolize intellectually because the subject's mind is
passive and ideas tend to exist as inert facts.
Important, even dramatic known facts and information fail to connect, to ramify into
conclusions or to change the subject's picture of how things are. Opinion is inhibited, sides
are not taken; intellectual or political positions may be tenuously held, but there is no ability
to argue or defend.
Social dysfunction is sometimes a concurrent phenomenon. The self collapses in the
presence of a lively or animated social group. A type of amnesia is often a feature. Memory
blanks out in the face of others who are adept and insistent at self-expression. The subject is
stripped of a life story. Nothing interesting has ever happened to them; they know nothing.
Sometimes the only way to get into the dialogue is to offer oneself as an object of humorous
ridicule or to ask questions, cueing the other for further displays of knowledge, wit or life-
experience.
This lack of memory is often deep-rooted: years slip by but time leaves only a gap along
with a vexing sense of something ungrasped. Childhood is either not remembered, is
remembered in cliches and generalities, or idealized. When in the course of therapy the
patient recovers memory, this is accompanied by a sense of betrayal by the objects which
their amnesia has scotomized; this generates a type of

3. Robert Royston 17
mourning often accompanied by a transfiguring poignancy, a sense of aliveness and
mortality and a completely new compassion for the self, which many patients tenaciously
resist in favour of a rigorous assumption of blame (Fairbairn 1943). These experiences of
aliveness are often stamped out and have to be revived and consolidated through analytical
work.
Occasionally a person will ameliorate an intellectual disability by introducing some
small change in the material or by changing the mode of communication - by listening to a
tape recording or having a text read aloud rather than having to look at a page. This too
substitutes self for other. Thinking difficulties, it must be said, are sometimes partial,
affecting certain subject areas but not others and are most common in children of families
where thinking or academic achievement is positively cathected.
In the analytic situation, the patient with forms of intellectual dysfunction will at times
fail to grasp the therapist's comments and sometimes even forget an insight they have just
formulated themselves. The patient complains they can't understand: can the therapist please
repeat. If the therapist does so, rather than interprets the request, the patient begins to
comprehend only after several simplifying repetitions, at the point where the comment
ceases to be interpretive and starts to waste down into cliche or prescription.
Cognitive disorder is often connected to negative therapeutic reaction. The patient feels
compelled to defeat the therapeutic process. If this secret project fails and gains in insight are
made, the patient paradoxically does not improve but deteriorates.
The autocratic object is a person with the psychic power to effect the subject through a
range of covert, almost invisible interactions. People have described feeling bored and
trapped with such people. Everything they say to them meets with a complex non-response
so that the project of continuing a conversation becomes meaningless, wearisome, even
depressing, and yet for some reason they can't escape. In the meantime, the other becomes
more animated and traps the subject in what amounts to a claustrophobic soliloquy. In
psychodynamic terms, the autocratic object gives the self of the subject no space to flourish
and instead pushes its own narcissistic needs centre stage, forcing the other, in a variety of
different possible ways, to bear witness to the object's superiority. Primitive projective
processes are common here. This process takes many different forms and can be overtly
psychologically abusive: the autocratic object may force the subject to suffer deprivation or
trauma so that the subject enviously sees the object as powerful, free from suffering and
calm. This is superficially like the envy of the peaceful breast described by Bion (1967). `
Autocratic' is relevant because this type of object uses its interactive power to stifle the
individuality of the child and will not brook independent ideas or challenge to his or her
often dogmatic ideas and maxims.
Patient One
Presenting problems
The patient, who built up over the first year to five times a week therapy, presented with
states of emptiness and dissociation, unfilfillment in work and life, a sense of drift and
problems in relationships.
Thinking problems were powerful and affected his career. The following picture of
cognitive difficulty was pieced together over some time. At work he suffered from a dullness
or slowness of mind, an inability to respond to danger signals, particularly to

4. 18 British Journal of Psychotherapy (1995) 12(1)
do with cases of children at risk. Significances other workers saw in reports or events he
failed to grasp. Thinking about such, or indeed any, matters engendered a numbness which,
if challenged by him, melted into powerful apprehension of imminent catastrophe.
He could not criticize or judge, either aesthetically or logically, and experienced trouble
reading. Words were often dead signs on a page, refusing to be construed. He said that at
university, 'I swallowed books and reproduced them in exams; I didn't think or learn. I feel
envious of people who can work with ideas, I don't seem to have opinions; I'm not remotely
interested in politics or public affairs, actually I'm not interested in anything. It isn't exactly
that I'm bored, just that I'm neutral, I wish I was creative, but there isn't an idea in my head.'
Here is a description of a painful experience of cognitive failure. When his team leader
set up meetings to discuss professional matters, although an experienced staff member, my
patient could not function. 'My mind seized up. This often happens. Everybody talks around
me, but I can't speak. Everything I tried to say seemed stupid, but I knew I knew it all, I
couldn't get it together in my head. When I did speak I was too slow and quiet, they didn't
have any patience and swept me aside as though I didn't count. I seemed so slow, I hated
myself, but then it got worse and I didn't know where I was, it all buzzed around me.'
As though his mind had sprung holes, his professional self leaked away. He felt dazzled
among brilliant experts, felt both invisible and conspicuous, frightened that they would
suddenly focus on him, that his emptiness of ideas would be shamefully exposed. The
language bandied around him became a foreign jumble from which he could pick out only
odd phrases.
Childhood background
There were large gaps in his memory of childhood and what he did recall he could not
assess. One example was an episode where his mother lost control and hit his 8-yearold
brother repeatedly on the arms and face. Was this good or bad? He could see it from both
sides. But essentially it was a characterless event. Certain quite worrying pieces of
information - mental breakdown in one brother and persistent delinquency with damage to
property in another - were meaningless. They were `the sort of thing which happens'.
Nothing could be construed, his family was dead centre and average morally and
psychologically.
For several years he couldn't see any causal links between present problems and family
experience. The details of this intellectual (and emotional) disability were precisely
replicated in other areas, such as work and reading where things made little sense and causal
links were severed. In the sessions he gave an impression of someone quietly keeping his
head down, working as hard as possible to comply with the analytic modus vivendi, and
getting by with great difficulty and no support in a type of constant present tense. In the
transference relationship, however, struggle and violence were secretly at work.
The parents
Over the span of the treatment the patient described parental colonization of his thinking;
he had been used as an audience, his own thinking had been dismissed or aggressively
devalued. His parents had demanded his admiration of them, playing the role of buoyant,
exhibitionistic children.

5. Robert Royston 19
An example among many: the patient presented his mother, a medical journalist, with an
essay which had been praised by his teacher. Rather than show pleasure, she scolded him for
shallow thinking and typed the essay, reordering and developing the points in it, adding
others and drawing more sophisticated conclusions. This, she said, was to help the boy to be
more confident in his thinking. However, it was clear she wanted his admiration for what had
become her essay. He, of course, felt crushed. At other times she took him into her
confidence, telling him upsetting private information and comparing her Oxbridge childhood
in England to the anti-intellectual colonial culture in which he was growing up. The almost
aggressive non-recognition of the child's immaturity, of childhood itself with its needs for
praise and encouragement and vulnerability to narcissistic injury, is a common characteristic
of the autocratic object: the child is expected to function like an adult from early on. The
mother of the present patient had a seemingly endless capacity to theorize, but reacted with
irritation, not pleasure, to counter-argument. The patient remembered being closer to his
mother when little. She appeared to yearn for his early childhood and resent his growing up,
and he felt she wanted him to be weak or ill.
His father, a research scientist, was intellectually aggressive and treated his children as
adult competitors, making no allowance for inexperience. Facilitating the development of his
children's thinking and offering praise were not in his repertoire. He, like mother, required
homage. To think in his presence was to be shown up as cognitively incompetent. The
collapse of confidence and self-cathexis following an attack by him led the patient to
dissociation and a vaguely pleasurable mood of drifting anonymity. The pleasure was part of
a masochistic colouring often found where the autocratic object is an ambivalently admired
father who has focused narcissistic demands on the child.
The treatment
A pattern developed of a surface-level passive submission before the object combined
with a secret, violent rejection of the therapist's contributions. Wholesale agreement with
interpretive offerings was accompanied by attacking dreams which featured anally devalued
images of the therapist. Analytical comments did not encounter surface-level resistance, in
fact were worked with in a superficial way, but then quickly forgotten, or were held in a
bland neutral zone in the mind where they could have no efficacy. This phenomenon later in
the treatment became a cross-identification: I was the child and the latent attack on my
thinking a recapitulation of the patient's experience of attacks on his; at an earlier time it was
a way of preserving the subject's self and his thinking while in relationship with an autocratic
object. In other words, in covertly attacking, negating or eliminating the therapist's
contributions the patient was protecting himself from an intrusive object which posed a
threat to the self.
The transference object was an autocratic, intellectually narcissistic parent who
demanded agreement, submission and applause, and was angrily contemptuous of other
people's ideas, experiencing them not as contributions to the give-and-take of debate but as
threats, insults and targets for annihilation. The two-level submission/rejection approach was
the patient's solution to a problem faced by most people with cognitive inhibition: take in the
rigid, dogmatic object and surrender the self, or preserve the self and lose the object. A
possible solution is external compliance and internal attack; the ensuing secret devaluation
may look like an envious attack on linkages or a defenk against regressive merger wishes,
but is, more saliently, an

6. 20 British Journal of Psychotherapy (1995) 12(1)
expulsion of, and a revenge attack on, a colonizing autocratic object.
Cognitive disturbance often appears as a form of psychic anorexia/bulimia. Outside
ideas cannot be chewed over or digested, metabolized or excreted in the normal healthy
manner. Compliant submission is demanded. Everything must be swallowed whole by a
passive uncritical mind. The object demands this. Therefore, the mere activity of the mind of
the other is experienced as an act of colonization and is sometimes experienced as a
penetrating or piercing intrusion. In men particularly, this predicament is often accompanied
by heavily repressed or disguised images of homosexual submission or anal rape. The
therapist can be experienced as pushing formulation into the patient and getting from this a
sense of enhanced masculine pride.
At a certain stage in the treatment, the patient tested the transference object's tolerance
for the emergence of his self and began to have independent interpretive ideas. This was
dangerous because the autocratic object, despite its power, is fragile and uses the other as a
narcissistic source or mirror, and so resists, often with psychological violence, the efforts of
the vassal self to break free and complete its developmental agenda. The present patient
came to a new accommodation with the object. He had independent thoughts but gave them
to the therapist. Lucidly organized material was offered. All the analytical ideas and links
were there, but the concluding formulation was left for the other to fill in. If this did not
occur the material was repeated in clearer fashion. The therapist was meant to articulate the
patient's thoughts which he would then, through agreement, partially reclaim. It was a
delicate sculpting operation to create an area for the self in interaction with a tyrannical
object, an object greedy for the satisfaction of being clever and right.
Here is an example: the patient describes a situation at work with a difficult aggressive
client. As if to make matters worse for him his team leader seemed angry with him. But was
this really so? Was his team leader simply fed up generally and he, the patient, had chosen to
take it personally? He describes a feeling of strange satisfaction throughout the time with the
irritable team leader. There is a pause. He describes a letter in the agony column of a
magazine. The woman writer's partner provoked her and she screamed at him. He then
became very upset. The agony aunt said maybe the partner got something out of this
aggressive encounter. There is a pause. He talks about a client who was beaten up by her
husband but returned to him. A long pause, now. He drops the subject in favour of
something quite different. I suggest he has an interpretation of this material in mind, but
perhaps was trying to cue me to make the comment myself because I am the only person
allowed to be clever. He replies that he had come to a vague conclusion, yes; however it was
not up to him to suggest things such as that he might have masochistic tendencies. If he
consciously wanted to be beaten, that would be all right. He could tell me. He would then
simply be reporting a fact.
The autocratic object leaves the child unable to form two-way, give-and-take
relationships. It's either self or other. So with this patient therapeutic gains, such as an
improvement or good session, were seen as the object's triumph and the self's loss of a
crucial argument or survival struggle. We were on a see-saw. Sessions experienced by the
patient as good but not anulled in the customary manner lead to a deterioration, such as
depression or anxiety or a pervasive negative mood.
Cognitive disorder and negative therapeutic reaction, therefore, are closely related.
Freud (1923), before his formulation of the death instinct concept, saw guilt as a
fundamental factor in negative therapeutic reaction. He wrote:

7. Robert Royston 21
Something in these people sets itself against their recovery, and its approach is dreaded as though it
were a danger ... In the end we come to see we are dealing with a 'moral' factor, a sense of guilt,
which is finding its satisfaction in the illness and refuses to give up the punishment of suffering.
In the present case negative therapeutic reaction involved a sado-masochistic element
whose roots were embedded in a sexualization of the patient's relationship with the paternal
object. This sexualization helped the patient master a destructive relationship by introducing
pleasure.
Further, the patient was host to the parental object who, though autocratic, was
accurately experienced as the weak and dependent member of a parasitic relationship. For
patients burdened with this self/other dynamic growth axiomatically means betrayal; and
development means loss because the object is tragically unable to sponsor or accompany
growth in the time-honoured fashion of good parenthood. Many cases of negative
therapeutic reaction are not only attempts to salvage the self from the triumphant therapist,
as shown above, but are also attempts to delay the distressing loss of a parental object the
patient urgently wishes both to support and to see as lovable.
It is also important to note here Langs's (1976) contribution to the concept of negative
therapeutic reaction, stressing the therapist's possible contribution to the problem. The
therapist may unwittingly cause the autocratic transference to become intractably embattled
by omitting the genetic aspect of the transference interpretation and focusing exclusively on
the here and now. Transference interactions must be appropriately referred back to the real
object in childhood situations, and empathy preserved for the threatened self.
Point two of my argument is that the patient inhibits cognition to preserve the illusion of
good objects and a benign, stable environment. This is an elaboration of Fairbairn's Object
Relations psychology according to which the child will rearrange its perception of reality to
preserve an illusion of the all-important good-object environment.
Here is some session material on this point from the treatment of the present patient. He
says he wants to confront the truth. He thinks about a difficult situation with a client he is
supposed to care about and help but, for no good reason, hates and fears. The case has
enlarged in his imagination and fills him with anxiety. He can't think about the problem and
plan what he is going to say or do. He can't think about anything. He feels perpetually
anxious and worried. The act of thinking induces an oppressive fear and feeling of wanting
to retch. He talks more generally and says he is lost and despairs of getting in touch with
anything today. He feels marooned in a mentally blank state. Nothing is real. What
happened in the last session? Yes, it begins to come back. He was thinking about his
unhappiness as a child and his fear of his mother. Now he remembers: when he left the
session he felt extremely angry and upset. Many things came to him, such as an occasion
when his younger brother was self-destructive and his parents reacted with rage and shouted
at him. How incredible that seemed to him as he was going home. He could think clearly; it
was wonderful to feel his mind so free. However - he doesn't know how it happened, or even
when it happened - all of this now seems like the experience of another person on the other
side of the world. Today, instead, he has impulses to hit himself.
The patient in other words had two alternatives: one was to switch off his mind and
blame himself and feel dead and inexplicably anxious; the other was to look at the

8. 22 British Journal of Psychotherapy (1995) 12(1)
destructiveness within the family; here he would reassess his objects in the therapeutic
setting, lose his illusory good objects and go through a possibly disturbed period when
blocked off emotional states surfaced. Such experiences as that described above are a
common feature in the treatment of patients with intellectual dysfunction.
Perhaps I can quote a relevant passage from Fairbairn here (1943, p. 65), which contains
ideas that bear on all three of the cases in this paper:
If the ... child is reluctant to admit that his parents are bad objects, he by no means displays equal
reluctance to admit that he himself is bad. It becomes obvious therefore that the child would rather
be bad himself than have bad objects; and accordingly we have some justification for surmising that
one of his motives in becoming bad is to make his objects `good' ... outer security is thus purchased
at the price of inner insecurity.
Patient Two
This is a man who entered analysis in his late twenties with vague complaints, mainly to
do with relationships. He was highly sensitive to teasing and even playful remarks could
make him feel persecuted and bullied. His intellectual difficulties began at school where he
was not able to follow lessons or pass exams without cheating. He managed to get into
university but failed, then changed to a different course and passed. In adult life his reading
of books and situations involved a high degree of subjective tangential misinterpretation.
Cognitive disturbance in the analytic situation was at times florid.
The treatment - background
Before and during the first year-and-a-half of twice a week therapy the patient repeated a
pattern in his relationships. The women he became excited about were dominant, cold,
highly opinionated, often dogmatically political, and always destructively critical of him. He
took over their ideas and their critical attacks unthinkingly. If one said he was greedy, that's
what he was. If another said he was a self-denying martyr, that's what he was. The women
were `saints'. His persecuted reactions to their attacks were displaced onto other characters,
usually men, but as his relationship with the women progressed he developed an anxiety that
they were about to do indefinable harm to his computer, his car, his cooker or other property.
Displacement was just one mechanism which protected the illusory good object from
critical examinations. Cognitive inhibition was another and idealization a third. The original
object crucially preserved in this fashion was his mother who had teased him, particularly
when he first became interested in girls, and who had looked after him to a degree when he
was an infant, but then dropped him progressively as he developed so that he grew into an
ever colder maternal environment. His attitude to reading and learning reflected his
dilemma. He found it difficult to take in the text, to see it as it was, and instead
misinterpreted and excitedly idealized it, seeing now this book now that as the one which
would really change him and sustain him.
Two factors prevented this patient from understanding his objects. One was an accurate
fear that they would not permit challenge but required a dominant, often castrative role; the
other was his own dread of the truth. So his mind abrogated its right to select and reject and
metaphorically digest. It was downgraded to the role of a passive, unprotesting recipient.
The self, his own ideas and identity, were thus colonized and threatened with annihilation,
so he extruded what was now experienced as an alien mass and rapidly found someone else,
with other ideas, and took these in

9. Robert Royston 23
wholesale, in this way both filling the now complete emptiness inside him and also endlessly
delaying the act of thinking about the nature of his objects. The heartbreaking moment of
realization that his objects were bad was manically delayed.
The course of the treatment
This followed a path from an experience of treatment as void of insight to one where
ideas were acknowledged but could not be digested. This process was accompanied by the
gradual de-idealization of his objects and an acceptance of their badness.
The patient quickly became intensely excited about therapy, but invented its mode of
operation. Initially his excitement was displaced onto various books he'd discovered about
the mentally liberating properties of hallucinogenic plants. It was as if in the sessions my
interventions were seen as inscrutable, exotic cacti with hidden properties but no rational,
verbal substance. All he could remember was a sense of excitement at their imagined ability
to transform him. Poignantly, he dreamed of a frog transformed by the touch of a finger into
powerful shaman or mystic animal.
Our work focused on his need to idealize, his inability to assess soberly either his
memories of his mother or the nature of his girlfriends and, especially, the nature of my
interpretations. As the displacement onto hallucinogenic gurus was analysed an image
developed in the transference of a charismatic uncle, his mother's much younger brother.
This man was a highly valued figure and perhaps the only person who had helped the
patient in his childhood. However, he was an ambiguous character. Friends loved him,
apparently, and saw him as an exciting guru who could, through his erudition and wide-
ranging free-associative monologues and insights, change their attitude to the world.
During the course of analytical work the patient's unilateral model of the psychoanalytic
process changed from the hallucinogenic mode - interpretation as mind expanding cactus - to
one that admitted more meaning but was, in some ways, more reminiscent of Buddhism than
psychodynamic therapy. So while he did grasp psychological themes he couldn't allow
interpretations to come close. Instead they were exhibited in a museum case outside the self.
By reciting, almost chanting, the diagnostic labels or interpretive formulations, and by
staring blankly at pieces of interpreted behaviour behind the glass, his problems, he hoped,
would wither away Iike the spiritual devotee's attachment to his material body. He'd then
attain a higher state, purified of psychological problems. Thought of a kind, therefore, was
possible but could not be internalized. In his spare time at this stage he meditated and stared
for long periods at a blank wall. Behind the manic illusion of interpretation as spectacularly
empowering, was the image of a poisonous object.
His alternative models of therapy eventually waned as his idealization of the object
diminished. He appeared ready to engage with the analytic process. But now his thinking
problems inside the treatment took another turn. My words were fleetingly grasped before
evaporation. He wanted things shorter and simpler but could only grasp them when he had
repeated the therapist's sentences, turned them this way and that, and simplified them into
psychologisms so general as to be universally applicable and specifically meaningless.
An example is that he had become involved with a woman and reported that she had
told him she was lesbian and disliked men. He talked more about her and it appeared that
this dramatic pick of information had been sidelined. I said as much. He was

10. 24 British Journal of Psychotherapy (1995) 12(1)
dumbfounded. What had I said? He had the impression I had said something important but
what on earth was it? It felt he was in the silence after a clap of thunder. Had I said
anything? He could not now remember. I commented that he had to get rid of some
information quickly because it challenged his wish to see the woman as an exciting source
of what he so desperately needed. Suddenly he remembered, tried to think, but soon once
again forgot the subject in question. Reminded, he said he couldn't recall reporting the
woman's remark. Had she even said it? Having introduced, scotomized, reintroduced and
rescotomized information during the course of a session, he felt at the end confused and
disturbed.
Here the therapist and treatment, too, were bad, feeding poisonous information about his
objects, analysing protective idealization, injecting depression and want, reintroducing the
developmentally unnourishing mother who had filled him as a child with painful masculine
self-consciousness and shame, and taking him closer to a potentially disturbing core of
anger. While the object was de-idealized, so was the therapy, and its disturbing real nature
was becoming apparent. To avoid reliance on this toxic object the patient at this time took
extensive notes after each session to learn the analytical process so he could become self-
feeding.
At this time the twin themes of autocratic object and idealization of bad objects were
highlighted. The patient formed a new relationship. His feelings for the woman appeared
less manic. He proudly introduced her to his guru uncle. It became clear, but long before he
consciously realised it, that his uncle had started an affair with the woman and was stealing
her.
The patient's intellectual struggle to darken his mind against the nature of his one,
though ambiguous, good object was revealed in a repeated dream. There is something going
on in another room. He walks into the room. A couple make love in the bed. Who on earth
are they? The moment he is about to recognise them the lights go out. This physical
darkness parallelled his cognitive darkness in other areas.
Intellectual disorder in the first two patients suggests a psychic form of anorexia/
bulimia. It is a type of regulating mechanism with a role similar to that of some perversions:
it protects the self from annihilation. Incomprehension is a border or mental customs post.
Patient Three
The treatment of patient three involved the recovery of memories and the reintegration
of events remembered but disavowed. Intellectual blocking was the product of a suppression
of primal scene trauma, and a protection against recognizing the perversity of the patient's
caretakers. In addition, cognitive disorder was consolidated by external attacks by an
autocratic object.
The patient entered therapy because of escalating moods of tension and other mysterious
states of mind. Entry was precipitated by his reaction to a film which showed a man, shell-
shocked during the First World War, convulsively screaming during post-traumatic
nightmares. During the day the character appeared calm and normal.
The patient was haunted by the memory of the film and felt he too had experienced
something horrific. He wanted sympathy (a need he found puzzling and unwelcome) and
sought isolated places where he could cry unobserved about something whose precise nature
he could not grasp.
He said, 'I've lately experienced a type of tension which I can't describe. I have fantasies
of walking, visibly injured, into a room of people. I want people to be sorry

11. Robert Royston 25
for me. But why, what about? Sometimes I feel I have a painful swelling in my mind, it even
feels physical sometimes, like a lump.'
He described a dinner party where he was conversing normally but then had to leave the
room. He lay down on a landing and sobbed. He felt a dry, dragging pain and sorrow which
he couldn't explain. A year before the treatment he had often found himself compelled to
stare at some random spot or indentation that might catch his eye, such as a chip in a wall or
in the surface of a table. The spot appeared to magnify while the space around it shimmered
and buzzed. He had had to drag his attention away and ended these experiences by force of
will.
Cognitive problems were many and varied. Reading was slow and digestion of contents
partial and unpleasurable. He could not easily retain facts. Thought and argument were
difficult. He forgot whole areas in childhood and forgot things in the immediate past, too. He
was almost innumerate and sometimes suffered from a geographical disorientation in
neighbourhoods he knew quite well: the area would suddenly appear foreign. At times of
intellectual effort he felt as though an alien object was lodged in his brain. This was also like
mental interference, a distraction that was almost visual, like a fluttering or something
glimpsed in the corner of the eye. Sometimes this took the form of unwanted sexual images
and thoughts. He felt generally that he could not see clearly and complained of a sense of
flattened perspective. He was unable to appreciate form, colour, volume or composition in
art. At school in childhood his academic career had started excellently, but deteriorated with
final failure in all key subjects.
The parents
He described his father as completely inattentive to him, which he welcomed as the man
appeared to radiate threat, anxiety and violence. The patient avoided him at every
opportunity. The father's thinking was eccentrically repetitive, a collection of maxims and
truisms.
His mother was fragile, fussy and over-involved, obsessed with the notion that the patient
was ill, weak, unfit for the world. She grieved for his lost babyhood - his growing up was a
cause of mourning not celebration. While appearing to think he was a genius, destined for
some form of intellectual greatness, she paradoxically showed no interest in his conversation
or schoolwork, referred to him repeatedly as a pest, allowed him to avoid homework and
observed his academic deterioration without comment or resistance.
The treatment
The increase to four sessions a week catalysed an underlying transference relationship in
which the therapist was felt as superficially supportive with an underlying sadistic
substratum. Especially on Fridays, something I would say towards the end of the session
would seem peculiarly upsetting and nasty. At the time the remark seemed good but
gradually, on the way home, he grew suspicious and then felt abused and the weekend would
be dominated by unpleasant feelings: humiliation, depersonalization, indigestible anger, a
sense of having been perversely used and discarded. He said: `You offer the illusion of
comfort and support, but just want to get a finger up.'
Distress, he felt, was deliberately pumped into his system at times of maximum
vulnerability; this offered the therapist sadistic amusement, self-aggrandizement, and

12. 26 British Journal of Psychotherapy (1995) 12(1)
a sense of power. He felt `fucked up' and the therapist, it seemed, was an excited spectator,
triumphing in trickery and seductive powers.
The analysis of this phase of the transference produced memories. He recalled how his
mother extolled his academic virtues one moment, then quite savagely attacked his alleged
stupidity and character failings - which included `perversity' - the next.
An important relationship with an older brother came up. This older boy, though in
some minor ways positive, bullied the younger brother throughout childhood and harped on
the theme of mental incompetence. He would say to the patient, for example, `Before you do
anything, think. Have they taught you to think at school yet? Let me teach you how to think,
listen, I'm going to teach you the first ten points about how to think. Point one you remove
your thumb from your arsehole; stop! - don't do that, have you thought first, no - typical.
You can't think.' On catching the boy daydreaming he would approach quietly and shout
right behind him: `Don't just stand with your fist in your arse and your mind in neutral - do
something useful'.
When he caught the younger boy attempting some new task or tentatively displaying a
skill he would demolish the effort with raillery and criticism, leaving the boy feeling
dissociated and filled with painful, congested fantasies of murderous revenge.
A further teasing theme stressed the idea that the boy was secretly mad and would be
sent away. The brother had a pedagogic streak and enjoyed lecturing at length on how to live
life to the full, on his younger brother's various failings, on maths, the principles of
mechanics - all subjects the boy himself hated.
The patient's mother later told him that she and father had sponsored this bullying as a
deliberate `toughening up' policy because he was considered weak. Another aspect of this
policy was sending him to a school with a poor academic record and a bad name for bullying
and delinquency.
As the therapy progressed he was gradually able to speak about sexual events he had
experienced from an early age when his parents took him into their bedroom at night or on
Sunday afternoons. The sexual interludes were studded into highly deprived and minimal
relationships and became enclaves, pockets of intense positive attention which were then
denied and ritualistically sealed into blisters of time by the parents who abruptly discarded
him. A similar topography existed inside the patient's psyche. He remembered and didn't
remember what had occurred, the events were held within a memory capsule. Newly
liberated memories occupied a similar zone. They retreated after a session, but came back to
vivid life next time, as though the session was the temporal blister.
It emerged gradually that the patient had observed parental intercourse from infancy into
his early teens. He had, when very young, been invited to spectate from the bedside and had
occasionally been asked to direct proceedings, advising Daddy what to do next. He was
invited to look at his mother's post-coital vagina. There was a family game in which father
would silently approach the undressed boy at bedtime or after a bath and poke a finger onto
his anus. The boy was invited to do this to his mother. This was, however, rejected by her.
Games in bed involved fleeting contact with father's erection. His father masturbated in front
of him. At a later age, up to and into puberty, his mother invited him into the bathroom with
her to wash her back. Father regularly invited him into the bathroom to watch him defecate.
It appeared that his mother, to prevent disclosure of abuse, had sponsored the decline of
his cognitive faculties. His brother was used by her as an instrument for this purpose, which
in turn had gratified the brother's sadistic needs. The child's

13. Robert Royston 27
intellectual injuries inflicted by the brother had also, it appeared, gratified the mother as an
act of revenge on men, and was also an identification with her father who had, along
autocratic Victorian lines, forestalled the training, work and intellectual development of his
daughters.
The therapy provided the patient with an environment where he could re-evaluate his
objects within and outside the transference. The therapeutic environment supported him in
the emergence of a core of rage, depression, anxiety, disgust and hatred and in the loss of the
illusory good objects of his original family. This was, of course, distressing. He experienced
nausea and dizziness. In the sessions he was often rigidly controlled, complaining of a sense
of swollen and bursting cranial congestion. This was interpreted as his self-protective
identification with his father's erect penis and projection into the therapist of the innocent
child whom he must not violate with sexual emission. Disclosure, weeping, anger, even
sympathy for himself became synonymous with an abuse of the therapist, perhaps even of
orgasm.
This recalls Fairbairn who stated that the victim cleanses the environment of bad objects
to create a benign world. He does this by vacuuming bad objects into the self and identifying
with them. This is Fairbairn's moral defence, in which the patient feels the guilt appropriate
to the abuser. It could be said, further, that the subject often abuses himself or feels he abuses
- even in harmless acts - the person he relates to.
In the present case the patients' perversion helped them gain excitement and sexual
competence by pushing into the child an experience of eerieness and unreality, flooding
excitement, passive awe, horror and envy. The process here recalls Kohut's mirror
transference (1971). Like the analyst in the mirror transference, the child is an archaic
selfobject whose task is the show the parents a self-enhancing reflection of themselves. The
child's trauma is this image. In the trauma the dysfunctional parents see themselves as, by
comparison, powerful, in effortless possession of a world of sexual possibilities, thrills and
tricks.
In the analytic process in such cases the therapist frequently encounters a form of
depressive position the reverse of that classically described by Melanie Klein. The patient
realizes he or she has kept the bad object good. It is, depressingly, the object who has pushed
fecalized experiences into the child, rather than that the child has projected excremental
fantasies into the breast whose goodness is envied. This reverse depressive position - the
acknowledgement of bad objects rather than bad self - is the most strongly resisted
experience for many patients.
Further theoretical points
The role of envy in attacks on thinking and linkages is important. In the cases presented
here, however, envy is seen in a bipersonal object relations context. The autocratic object
arrogates to itself power and brilliance and holds the other as an admiring vassal. This was so
in the patient above where the parents used their son as an audience at their intercourse. This
situation, where the subject is required to swell the object's self-feeling, is potently
productive of envy, as too is the situation in my first patient, above, where the subject gives
his own cognitive ability to the object.
Also important is the suppression of aggression. The object must be treated with
comprehensive respect. A result is that the therapeutic work is often attacked rather than the
therapist. This can, deceptively, look like a hatred of meaning and linkages. One origin of an
inability to express aggression directly is the real parental object's inability to tolerate age-
appropriate challenge, rejection and rebellion. This occurs,

14. 28 British Journal of Psychotherapy (1995) 12(1)
particularly, in crucial stages in early childhood where the young child negotiates, often with
considerable emotional force, for power to oppose the parent and impose subjective will;
similar conflicts occur in adolescence.
Bion in `Attacks on linking' (1967) states that inborn characteristics - primary aggression
and envy - play a part in the potentially psychotic infant's attacks on `all that links him to the
breast'. The effects of this may be ameliorated if the mother can introject the infant's feelings
and remain balanced. However the psychotic infant, Bion claims, `is overwhelmed with
hatred and envy of the mother's ability to remain in a comfortable state of mind although
experiencing the infant's feelings'. He brings as evidence for this a patient who wanted him
to go through everything with him, then felt hatred because Bion was able to do so without
having a breakdown. He continues, `Attacks on the link, therefore, are synonymous with
attacks on the analyst's, and originally the mother's, peace of mind.' A little later he writes
that the mother's capacity to sustain the infant's projective identification makes it possible
for him to investigate his own feelings in a personality powerful enough to contain them.
The
mother may refuse this, or the child's innate destructiveness may prevent it. Both lead to
attacks on linkages with consequences for cognition.
The present paper does not contradict this theory but extends the investigation of causes
beyond infancy to childhood. Here the picture becomes more complex and the causes of
intellectual dysfunction are seen to lie in objects which do not merely fail to provide a
necessary good environment but are more actively, indeed often malevolently, involved. In
the patients discussed here psychic exploitation was sometimes a powerful causal feature in
apparent attacks on linkages. Envy and attack were generated by the actions of the object.
Environmental provision by parents appeared better in early infancy and it was the child's
movement towards independence and the acquisition of powerful self-feelings that could not
be tolerated by caretakers, often because the child's growth deprived them of gratification. In
all three cases discussed a marked lessening of cognitive dysfunction occurred in stages as
illusory good objects collapsed and real bad objects emerged into consciousness for
examination and painful metabolization. This was particularly so in the third patient, where
blocked intellectual capacities were almost completely regained.
References
Bion, W.R. (1967) Attacks on linking. In Second Thoughts. London: Karnac, 1987.
Fairbairn, W.R.D. (1943) Psychoanalytic Studies of the Personality. London: Routledge and
Kegan Paul, 1984.
Freud, S. (1923) The Ego and the Id. In Standard Edition 19. London: Hogarth Press.
Klein, M. (1937) Love, guilt and reparation. In Love, Guilt and Reparation and Other
Works. London: Hogarth Press and the Institute of Psycho-Analysis, 1975.
Kohut, H. (1971) The Analysis of the Self. New York: International University Press.
Langs, R. (1976) The Therapeutic Interaction. New York: Jason Aronson.
Winnicott, D.W. (1972) Fragment of an analysis. In Tactics and Techniques in
Psychoanalytic Therapy. London: Science House.