IN THE BEGINNING IS MY END: The Initial Analytical Meeting from the Patients Perspective Meir Wigoder

Home is where one starts from. As we grow older The world becomes stranger, the pattern more complicated Of dead and living. Not the intense moment with no before and after, but a lifetime burning in every moment And not the lifetime of one man only But of old stones that cannot be deciphered (T.S. Eliot, East Cocker) Beginning is not only a kind of action; it is also a frame of mind, a kind of work, an attitude, a consciousness. (Edward Said, Beginnings)

I had no idea of how I had arrived at the entrance of the old Parisian hotel that was situated on a narrow street in a busy district of the city. I entered the rundown hotel and saw a clerk seated behind a dusty old counter. He waved his hand at me in the direction of the elevator with an air of boredom. I proceeded to enter a very narrow space that resembled a cupboard, fitted with dark wooden panels, a mirror, and a bare light bulb overhead that cast an unflattering illumination. After closing the stiff iron grid gate and then the wooden doors with glass panels, I pressed a stiff button that responded jerkily to my touch and made me reflexively aware that I was the agent of the action that had caused the elevator to jolt upward. There was something incongruous about being ushered upwards by the suggestive sound of the elevators mechanism and yet not being able to see where it was heading; I felt slightly apprehensive at the possibility of being stuck midway between floors and being alone in the
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dark. My arrival at the second floor was announced by a thud from the sudden stop of the creaking elevator, which let me out into a dark narrow passage that had only one source of light entering it from a window at the other end of the corridor. It took me a moment to adjust my eyes to the dim light as I started walking along a narrow strip of red carpet that muffled the sound of my footsteps. I glimpsed different people standing at the entrances to the rooms that were located on either side: here was a woman beckoning me to enter beside a half-open door that revealed the corner of a narrow love seat; and there was someone showing a man out of the room, who, upon noticing me, signaled me with a broad gesture to enter the room, whose oak furniture, leather top desk and dark draperies suggested a respectable attorneys office. Further on, a woman was leaning against a half-open doorway whose narrow opening revealed the bright cheap colors of a sleazy interior that appeared to have never been exposed to daylight. The room was fitted with red silk curtains, velvet armchairs and a matching sofa. I began to realize that every room had its color theme, and that the men and women who stood at the doorways were agents of a dream factory that enabled the visitors to escape the routine of their lives and enter these fantasy bubbles for the purpose of adventure. I continued to walk along the corridor in distracted bewilderment until I came across a man who had not come out of any of the rooms. He appeared to have materialized from nowhere and walked straight toward me until coming to a stop. I was surprised at how calm I was at the sight of this person whose white hair formed a halo around an invisible face. On closer inspection I realized that it was not the result of the light that came from behind him that had created the silhouette effect, but that in fact he indeed had no discernable facial features. Then, from out of this blank face I heard the most compelling voice: What can I do for you? he asked caringly. I replied softly: I am searching for a therapist, I need help. The memory of this dream arose in my mind as I was making my way to a referral meeting with a psychotherapist on the outskirts of Tel Aviv. After more than twenty years the memory of this dream had surfaced vividly from some forgotten realm of

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the unconscious for a very good reason: it was the first dream I had ever had about therapy and it served to prepare me in my search for my first therapist. It was a dream that signaled a prebeginning to a very important encounter that ushered, like ones first love, my journey into psychotherapy. Not only was this memory a welcome flash-back, it also gave me a clue as to how to start the upcoming referral session, in which I was about to explain why I had been absent from therapy for more than six years, after terminating four years of treatment, and what were my expectations and misgivings about starting again. I had been pondering about going to different, alternative, forms of therapy, hoping that some magic wand would lead me to a new savior, but in the end I found myself once again returning to the well-trodden tracks of traditional psychotherapy, hoping that the external changes that had effected my life, especially the deaths of my parents and my own mid-life crisis, would provide the necessary leverage to get me back on track. The ride in the cab to the referral meeting set the right mood for someone who was embarking on a new journey. I did not even want to arrive at my destination, wishing the cab would continue traveling forever, as I started to enjoy the status I had always loved best, of being in-between the point of departure and of arrival, when the task of reaching my destination was another persons responsibility, allowing me the freedom to daydream. The mere ability to sit in the back seat of the cab and be chauffeured across town awoke in me the happiest memories of being driven by my mother in my childhood; of how, during long drives with her, I could split my attention between the physical sense of security I felt sitting beside her and the liberty I had of being separate from her while I engaged in reverie through the window, looking at the happy-go-lucky movement of the crowds and the randomness of the traffic, which reflected the labyrinth of my meandering mind. During these kinds of rides my mother generously enabled me to be alone and creative but without feeling lonely or insecure. I did not disclose to the cab driver that I had no clue as to the direction in which we were going and that I had never visited this northern suburb of the city. While part of me felt rather ashamed of my ignorance, another side of me enjoyed the new

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liberty of unexpectedly looking at unknown parts of the city, with that tinge of disorientation that always stimulates the visual appetite: by simply slinging a camera across my shoulder I was able to see things that would have escaped my vision in any other situation. I relished meeting tourists and becoming their guide, because my mere presence beside them made it possible for me to see my city with a new-found enthusiasm, the sort that most people only experience when they travel abroad. As far as I was concerned the treatment had already begun: the ride provided me with a raw state of mind that attuned me simultaneously to my internal and external experiencesa gift that could have only taken place because I was traveling to this first, referral, meeting, knowing very well that in subsequent meetings in therapy it would take much hard labor and chipping away at the defensive guardians of consciousness to reach this kind of associative state of mind. Every good ride must eventually end. I arrived in the therapists house and started the session by recounting to G. my first dream about searching for a therapist, which I had recalled in the cab, and went on to tell her about my predilection for the object-relations school of psychoanalysis. It had all started just before I began therapy in my mid-twenties. I happened by chance to pick up a paperback whose cover was illustrated with a photograph of a teddy bear with button eyes. One eye was missing and this caused me instantly to feel sad. I was fascinated by the title of the book, Playing and Reality. It was one of the first psychology books I ever read and I later realized that the authors lucid writing was deceptive, in actually containing very complex ideas that I was not yet able to understand. (I continued reading other psychology books, much like a hypochondriac who reads medical books and is sure that every diagnosis is written especially to indicate his own imagined condition.) My impressionistic reading of Donald Winnicotts book led me to embrace two terms that had an enigmatic impact on me, in the manner in which religious people hold on to certain magical words and repeat them as mantras in order to reinforce their faith. I embraced the phrases potential spaces and transitional objects, in the hope that one day I would comprehend their meaning. I was making my first strides in studying English

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literature and poetry at the time, and not understanding these terms and the reasons why they held such a grip on me did not deter me from being fascinated by them. I was inspired by the helpful advice that T.S Eliot had given to any reader attempting the difficult task of reading Dantes Divine Comedy. He suggested that first we should commit ourselves to the act of reading and enjoy the sound and the rhythm of the verse; and then, if it grips us, we will also want to make the effort to understand it. I went on to interpret the dream as a paradigm for the type of therapist I was looking for. This dream acted as a warning to a personality that was easily swayed by the vivacity of colors, smells, sounds, and visual experiences; a person with hardly any protective skin and weak defensive barriers. It was indicating to me that I was not supposed to enter the rooms that represented over-stimulating experiences that could distract me from the process I was seeking to begin. In the dream the therapists consulting rooms had transformed into a French bordello and the therapists themselves into seductive whores who offered their services to their customers at an hourly rate. In this alluring atmosphere I did not find the therapist I was searching for in any of the consulting rooms, but in the transitional space of the corridor, compelling me with his voice and not with his appearance. In retrospect this dream can be interpreted in several ways: it is not uncommon for patients to bring to their first meeting a dream that encapsulates the main issues they wish to address in therapy. Underlying most of these dreams are the patients anxieties about starting therapy. An object-relations therapist may construe this dream as expressing the patients fear of being treated by a therapist who will remain anonymous and unable to provide the right mirroring. A more traditional Freudian interpretation would probably focus on the underlying sexual implications of the dream: the patients search is underlined by his anxiety of being seduced by the therapists and consequently is afraid of losing control; or, in a typical Freudian reversal of the difference between the manifest and the latent meanings of the dream, the patient worries that his own seductive charm will render the therapists work ineffectiveis there a direct relationship here between the mode of seduction and the fear of self destruction?

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I realized that the dream, in an almost embarrassingly literal manner, confirmed the traditional model of psychoanalysis: the blank face of the analyst did not only suggest the strategy of listening with no expression in order elicit the transference from the analysand; it also evoked the image of the couch in psychoanalysis on which the patient lies and relies on the voice of the analyst rather than on his or her face, which is hidden from view. In another sense, I believe that the dream was not only presenting me with a clue to the approach I should adopt in analysis, but also with a positive insight into the effect a voice can have on me: the texture of the therapists voice was crucial for mediating between my psychic and emotional worlds in order to help me reconnect the dissociated parts of my personality; it also made me recall the most innate memory of the role my father and mothers voices had had in providing me with models for intimacy, sociability and, especially, the playful space of illusion. After returning home from the referral session I found myself sitting opposite the computer and staring at a blank screen. It was the second time in my life that a referral meeting had had such a strong impact on me, causing the dams of my memory to be breached and flooded with a stream of emotions and memories that I had to write down without pause. During this frenetic writing session, in which the free associative mind was dictating the flow of spatial images of consulting rooms that I had attended in the past, I began mapping a spatial history (a kind of topography) of my personality through key events in my psychotherapy sessions. My automatic writing lasted more than ten hours and led me to wonder why these two initial encounters with the therapists had triggered such innate responses from the unconscious? Why were the spaces of the consulting rooms so important in these memories? Why did the objects in these rooms become so meaningful during my first encounters but later lose their aura and become almost unnoticeable? I questioned the role that the interior of the consulting room plays in the inter-subjective relations between patient and therapist: although the importance of space has been discussed amply in psychoanalytical writings, the tendency is to emphasize a mental space that is created between the two players in the analytical drama, while less emphasis is placed on the role of the concrete

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space in facilitating the patients connection between his internal and external experiencesa point on which I shall place further emphasis. In the psychoanalytical literature I found a particular helpful article, and then a chapter in a book, which discusses the importance of the preliminary encounter between the therapist and the patient. In The Initial Analytical Meeting Thomas Ogden (1989) broaches the subject lucidly and sensitively from the analysts perspective. His own literary inclination conceives of the scene as a drama that is about to unfold between two strangers that arrive with their own histories, anxieties and transferences as they embark on an unknown journey. Some schools of thought within the psychoanalytical movement advocate a benign approach to receiving the patient in the initial meeting: they recommend that the therapist tend to the anxieties of the patient by making him feel comfortable and hopeful about the possibilities of change, and be willing to answer questions about the way psychoanalysis works. Such meetings can have an introductory character as the patient is able to inquire about the methods of analysis and the therapist can interview the patient about the more factual aspects of his life (age, occupation, marital status, etc.). Ogden, on the other hand, advocates a different approach that goes straight into the thick of things, even at the risk of making the patient feel uncomfortable, because he believes it is important that the patient obtain an immediate firsthand experience of the way the analytical treatment works. For this reason he stresses that the initial analytical meeting is no different from all the rest of the sessions that will follow; but at the same time the whole purpose of his argument is to explain why this session is also different from the rest. For my own purposes I shall focus on only some of the principles of Ogdens argument: The success of the initial meeting is conditioned by the anxiety that both the therapist and the patient have about meeting each other for the first time. The therapists anxieties are less discussed but can be construed as uncertainty over whether to spend so many hours treating a certain patient, and one can conjecture that there may also be anxiety about being disliked and rejected. The gist of Ogdens text revolves around the methods the therapist must use in order to

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turn this anxious situation into a very productive creative experience, which may never occur again in the same way precisely because both the therapist and the patients defensive guards are down. During the initial meeting the therapist must be attuned to the patients cautionary tales. This is a term Ogden uses to describe the patients warning signs and misgivings about starting treatment. The anxiety that the therapy might fail echoes the patients previous failures in inter-subjective relations that have led him or her to come to therapy and address these issues. This is the reason why Ogden believes it is counter productive to ease the patients anxieties with pleasantries and other diversions. Instead, even though it may be awkward, the therapist must remain silent and let the patient start the session. By doing so he does not rob the patient of the privilege to initiate the drama he is about to enter; one that will hopefully provide him with new insights and a critical voice that he has probably never had before about himself. By bringing up the patients cautionary tales and addressing them directly in the initial meeting, the therapist shows the patient that he is not afraid of tackling painful issues and that he can treat the patient; an act that may make the patient uneasy but gives him hope that the therapist is capable of tackling difficult issues and therefore can be trusted. I found Ogdens ideas about the initial psychoanalytical meeting very helpful to processing my own thoughts about the subject; but I also felt they fell short of expanding on the differences between types of beginnings, especially from the patients point of view. For example, is it not possible to make a distinction between the first meeting and the initial meeting? The former represents the moment in which a patient arrives in therapy or in analysis for the first time and for this reason it can never recur againlike our first love affair. The initial meeting, on the other hand, can take place as many times as we like during our life time; it is a form of beginning that carries with it the weight of memories and expectations of all the previous times we started things and this can have positive or negative consequences. There is also the dream I recounted. The beginners dream, which the patient introduces in the first weeks of therapy, provides ample information about the main themes that will be addressed and is riddled with cautionary tales. Although the referral meet-

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ings are not a common practice (they are usually conducted over the phone), in two cases in which I had experienced such sessions I noticed the great value of such meetings and it made me ask the following questions: What role does the referral therapist play in initiating the analytical process that will actually only begin, properly speaking, when the patient meets the other therapist to whom he has been referred? If the transference between patient and therapist already takes place over the phone, while they are arranging their meeting, then what happens when the patient only sees a particular therapist once and then waits to meet the other therapist to whom he is referreddoes a transference get transferable at such a short notice? My first dream about searching for a therapist gave me the courage to phone the Tavistock clinic in London. I declined to tell the psychoanalyst, who was on the current-roster of referring patients to other colleagues, about the dream. How could I describe to him the texture of the voice I was now searching for? As a person who had voluntarily decided to leave his country of birth and live abroad, I wanted to engage with someone who would understand the meaning of being a stranger in a different culture and, for that reason, I believed that if I went to a psychoanalyst who was both a foreigner and Jewish I would gain from two different advantages: the immigrant would appreciate the problems of assimilation into a foreign culture, while being Jewish would enable me to connect with my own heritage, in which the traits of humor and irony were associated with my fathers Anglo-Irish background. The analyst I talked to over the phone told me that my specific shopping list made it hard to find someone immediately, but he was willing to try. One day, over a month after my conversation with the clinic, when I had almost given up hope of starting therapy, the phone rung and a strangers voice asked to speak to me. My heart pounded for a moment while I considered the nature of the call, giving me the hope that this would be the therapist because of the quality of the voice I was hearing over the phone. I had the instant impression that this voice could help me and lead me out of the depths of my confusion and depression. After we met, I realized that my initial intuition had been correct and that H., my first analyst, who was Jewish and came from South

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Africa, had quickly learned to use his voice to control my own loquacious character: like a very good American football running back, he knew how to run through the holes of my intellectual defenses and scored several touchdowns that left me speechless; holding my breath or fighting back the welling tears, I experienced those precious moments, however anxious, in which the most innate material erupts, not because it is remembered but because it is re-lived. On the appointed day I dressed quite formally for my first meeting with H. and traveled by cab to Swiss Cottage in London. I was already aware then of a sensuous feeling of space, which was triggered by the event of going to the first psychotherapy meeting. London suddenly looked as beautiful as cities often do when we are traveling toward the airport with the intention of leaving on holiday. (So many places can appear beautiful and heart warming merely because there is a prospect that it will be the last time we will ever see them.) The intermittent sunlight that peeked out of the clouds amplified my feelings of anxiety about starting therapy. The rays of sunlight highlighted the primary colors of the surfaces that London is famous for, which make its doorways and public transport look like a huge playground. All I recall from that drive are the red pillar boxes that looked like large toys from the perspective of a child who can only point his finger at them with amazement before he even has the language with which to identify them by name. H. instructed me to ring the doorbell several times to signal my arrival. It was strange to press the button of a bell that I was unable to hear. Then a buzzer sounded to signal me to push the door and take my first steps into a long corridorthe space in my dream that had initiated my search for a therapist. Only much later did I realize the significance of this act that initiated my first meeting. I wondered whether I was disturbing another patient still in session when I pressed the doorbell. I learned afterwards that pressing the button caused a light to turn on in the consulting room. In order not to disturb the session the bell was silent, replaced by a light switch that was hidden from the patients view. No matter how discreet the therapist tried to be, however, and despite the hidden light switch, his movement of reaching over toward the unseen button always signaled to me

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that the session was about to end. (Every patient becomes acutely aware of the way the therapist moves in his chair or changes his tone of voice to signal closure of the session that can never truly be brought to an end, especially for those patients who tend to start engaging just before they have to leave.) This small anecdote of the act by the doorway is important for me in order to frame the session. This is the image I want to draw: two hands reaching out toward each other (a modern version of Gods hand reaching out to give Adam life in Michelangelos Creation in the Sistine Chapel), but they will never touch because each finger feels the cold surface of a button against its skin. It is a gesture that rehearses each time anew the moment of our first arrival in therapy with so much hope and anxiety, as the press of one finger requests permission to be let in and the other responds by enabling the patient to enter. Consider the fact that the same hand gesture that opens the door to one patient is concurrently signaling the end of the session to another patient: the therapeutic session is framed as in a parenthesis between these gestures that signal arrivals and departures, which mark the special time frame of the analytic meeting. I entered a waiting room with a high ceiling in a large Victorian mansion style house. I sat down quite bewilderedly opposite several bells on the wall that reminded me of the earlier use of such instruments in mansions to let the servants know in what room they were required. I started pacing up and down the waiting room, whose walls and furniture gave off that familiar dampish smell of old London houses; smell that I had learned to appreciate because it suggested that the past has some sort of hold on us in the present, but I also disliked because it evoked a sense of neglect, which was the last thing I expected to feel in a therapists waiting room where the future was also at stake. I then paced to the window, transfixed by the view of the unkempt back garden where the grass was growing wild and the untrimmed shrubbery was usurping the fence. The view filled me with sadness. H. came to greet me. I was curious to see what he looked like and to match his face with the voice I had so liked over the phone. We shook hands and he directed me to walk up the steps to his office on the second floor. (This was the only time we

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shook hands until my final departure from therapy and the only time he came down the steps to greet me.) I walked up a creaky staircase and as I turned the corner I had my first glimpse of a therapists consulting room: through a gap in a doorway I could only glimpse, from this voyeuristic view point, the edges of a chair and a view of a low table. On it, like an object in a photograph of a pack shot for a sales catalogue, stood the cardboard tissue box with a single tissue rising up from it, waiting for a hand to whisk it out and dry a tear. We continued to climb and I discovered that this house was not the therapists home but a building that held several consulting rooms. The bells downstairs were meant to indicate to the patient when to go up to the respective room and start their session. I walked up the steps with an uncanny feeling that I had already visited this house in my dream. I recall starting my first session with a spatial observation about my arrival at the office. I said to H. that I felt a strong sense of dissonance between the feeling I had had while entering through the neat and almost artificial looking rose garden at the entrance to the house and the sad impression I received from watching the overgrown back yard. He replied, of course, with a question and started to explore my observations. We both realized that I was searching for a visual paradigm that would explain why I am starting therapy. We came up with quite a literal and banal interpretation, which, nevertheless, was very comforting for starting the process of therapy: I offered the supposition that the entrance, acting as the facade of the house, was kept clean because it was seen by everyone on the street, while the neglect of the backyard was due to it being hidden from view. I was in a consulting room that was situated between the wild overgrown (unconscious) garden and the tidy front entrance (symbolizing my own conscious and obsessive need to be tidy in order to compensate for my lack of mental organization.) I had come to therapy to treat the neglected backyard in my own mind and I knew that being tidy in such a controlling manner was not the solution. Lying on the analysts couch, between the front and the back gardens, provided me with an alternative third space that I came to acknowledge as the space of analysis. It was no longer the space of the room per se, but the fact that I was able

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to feel the analysts presence in the room while my eyes were free to gaze through the window and engage in reverie: a liberating space opened up for the mechanisms of the meandering mind that was able to connect the soothing voice of the analyst with the view of the sky and the drifting clouds. What was the difference between my first analytical meeting with H. in London and my referral meeting with G. in Tel-Aviv, many years later on? I became increasingly aware that G.s listening attitude was slightly different from the one she would have assumed had she met me in the context of an initial meeting: I had a hunch that the art of listening, which is required of the therapist during a referral session, relies on a double attitude: one that enabled G. to be attentive to me and simultaneously listen for someone else whose name and face she hoped would arise in her mind while I talked. This entry of a third person into the consulting room who was as yet unknown, but was already the principle reason for why we were talking, made me all the more aware of his or her absent presence in the room. For this reason the referral session had a wonderful, almost magical, effect that was able to coalesce the two different approaches of psychoanalytical thought to the way the therapist should act during the initial session: while G. allowed me to initiate the drama and become aware of the way the analytical session works (in the way that Ogden advocates it), the very basis of this meeting also catered to reducing my anxieties by the way G. allowed herself to ask me questions that she probably would not have done if I had come to be treated by her; knowing that this was only a casting session for the play made me less anxious that it might fail. (The anxieties arose immediately later when I became worried over whether G. would make the right match for me.) The referral meeting enabled G. and I to create a potential space whose elusiveness contained the components of an imaginary and a real therapist: while I conjured up the wishful ingredients of my ideal therapist, my interlocutor was already searching for the realistic concrete therapist to whom she would eventually refer me; both of us were engaged in creating a space of potentiality in which the therapist provides the patient with a sense of beginning for a process that has not yet started but at the same time has already begun.

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The non-committal realm of this meeting, which is an ideal space for the procrastinating patient who wants to defer the anxious moment of facing the intended therapist, gets projected on to the interim period between the referral meeting and the initial meeting. An in-between space opens up, characterized by feelings of uncertainty and anticipation, which I compare to the spectators experience of waiting before the curtain rises on an opera or a play: the glow from the chandelier still lingers in the darkness after the lights have slowly faded, while the faint murmur that has characterized the previous atmosphere when the crowd entered the theater dies down. While the fading lights attest to something that is ending, the spotlights that light up the stage curtain designate something that is about to begin. In a state of expectation everyone is looking in the same direction, unsure what will happen. The entire scene is possible only because the audience knows that the curtain will rise and the drama will start to unfold. In the case of the patient the drama is his own, unlike the audience seated in the darkness who are watching the dramatic events of other people from a relative distance and in safety. A new liberating space opened up after the referral meeting. The burden of finding the therapist was now on G. and all I needed to do was wait. In this state of open expectancy I turned into a passive attendant, able to sublimate my expectations and anxieties by becoming very creative and perceptive of everything around mea state of sheer mental and emotional rawness, like that of a childs sensitivity to everything that is immediately present before him, and which I did not want to end. I finally received the call with the name of the new therapist. I was especially glad to learn about the location of her office, in the heart of the city and at walking distance from where I lived. I had only once in the past had the opportunity to walk to therapy and found how helpful such walking was to free the associative mind, which prepared me for the session; in fact, walking, as it were, started the session before I had even arrived. The urban stroller in me had always fantasized about having psychotherapy in movementif only we could have adopted the walk as a form of treatment and escaped the confines of the couches and the armchairs, we would then have been able to write about

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the nuances of the way a therapist and a patient walk, how far they stand from each other, when do they stop, whether one walks slightly ahead of the other, and in what directions do their eyes look when they speak at crucial moments during the walking-session. I turn now to describing the preliminary feelings and associations I had upon reaching R.s consulting room, which reflected my apprehension about starting treatment with a therapist whom I had been referred to by another person whom I barely knew. Already from the start I was confused by the purpose of my coming to this address, as I entered the apartment block building and smelt a strong medicinal smell at the entrance to a physicians office. The disinfecting detergent bewildered me as to whether I was on my way to check a physical ailment or visiting a therapist. I walked up the steps of the building, looking at the unfamiliar inner courtyard and at all the windows that faced the winding steps. I was especially fascinated by the frosty glass windows beside a row of pipes that signaled these to be the bathrooms in the building. It was rare in Tel Aviv to climb up a staircase that revealed both the front doors of the apartments and the windows of bathrooms, which usually do not face inward to the staircase but only outward to the backyard. I immediately felt a sense of dislocation between the front and the back of the house; I lost my sense of direction and simply followed the steps until I reached R.s office in a residential apartment. Was this a proper way of starting the initial meeting? A strong medicinal smell attacking the body; a spatial confusion that led the mind to become dislocated; frosted glass bringing up connotations of blindness and the inability to look in or out through windows; and an entrance to an apartment in which a large dining room table was placed in a hallway, seemingly out of place and not in use. Finally, I entered a very small room whose old wardrobe revealed that it had once served as a bedroom. I sat in the swivel chair, already burdened with too much information. The chair was too small for me. R. noticed my discomfort and wondered whether I was not feeling at ease with her in the room. I thought her remark was interjected far too quickly into the space we had not yet created between us, but I appreciated her concern and directness. I told her how I felt

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about the small size of the room and wondered whether it was conducive to a process of therapy in which the mind has to free itself and search for broader expanses; the shut window and the closed curtain behind her did not help matters. The array of images on the wall did not appear to convey a unified taste. This led me to ask her whether the choice of images was hers or someone elses. I was baffled that she did not take the opportunity to explore my question and instead replied swiftly that all these images had been given to her as gifts from patients at the end of their therapy and each one held a very special memory and a singular narrative for her. Her reference to the end of therapy at such an early stage raised my anxieties: What was I supposed to do with this information and with these images that suddenly ceased to look like art works and instead resembled trophies or certificates that professionals place in their offices to verify to strangers that they have qualifications and are well educated? Were these images meant to please her or to impress me with the apparent successes of her previous treatments? It immediately elicited apprehension in me about the success of my therapy, as I wondered whether I would ever reach such a stage of ending treatment, and if so, being a photographer, what image would I choose to give her as a sign of gratitude? And if it fails, and I decide to terminate treatment, would our joint failure be signified by the fact that I did not bring her an image as a present? Among all the images in the room I found one intriguing photographic reproduction of A Woman with an Earring by Vermeer. It was a detail of the womans eyes and it hung right behind the therapists seat so that when I looked at her I saw two pair of eyes looking at me. The poster jogged my memory of an important dream I had had over twenty years ago. During the process of a long separation from a woman who was my first real love, I realized that my inability to separate from her could be due to my internal projections onto her rather than to the independent qualities that she held for me as a person. In melancholic terms, I was grieving for the loss of parts of myself that were invested in her. One night I had a dream in which I saw her exactly as the figure in Vermeers painting: I saw her from behind as she turned around, moving only her upper torso and

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looking at me in a candid fashion. She did not have the passive face that so many models in Western paintings have, who look as though they had been subjugated to a male gaze, but instead she appeared to have an independent gaze that turned me, in the dream, into the object of her own attention. Then she proceeded to turn and I discovered in surprise that she was pregnant with a child that was not mine. While it appeared that this figure in the imagined painting was directing her eyes at me for the first time, it was actually a gaze that set me free to move on and search for love on other shoresit was a look that signaled the end of our relationship. As I left the initial meeting I was pondering on three primary images that had left their indelible mark on me: knowing that the gaze of the woman in the reproduction of Vermeers painting will always be looking at me, so close to the therapists eyes, reminded me of my first true love and the fear that I would never again have such a strong emotional experience. The images on the wall, which I did not particularly care for, symbolized both a sign of hope that other patients have acknowledged the service of this therapist, but also raised the possibility that in my own case the treatment might fail. And finally, the sight of the large dining table in the hallway, at the entrance of the apartment, saddened me in that it was dislocated from its proper location. To see such an object that represents a familys social gathering orphaned in such a transitional space awoke in me my own sense of loss and displacement. When would this table, which was now representing the perpetual image of the attendant, find a new home and be used again?
A FEW ENDING OBSERVATIONS ABOUT BEGINNINGS

Having narrated my own personal experiences of starting psychotherapy sessions, I now turn my attention to a broader discussion of the character of beginnings. The initial meeting in therapy brings to mind the very significance we attach to all forms of beginnings, which may either remind us of former promising starts, or of disappointments that we now wish to remedy. In other words, the first encounter with the therapist awakens the feelings of both hope and apprehension that we

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have when we are on the brink of a new relationship, whether intimate or professional, and to which we attach a great deal of importance. In my own examples, the sense of anxiety that is so prevalent in the period prior to the initial meetings caused me to become very aware of space: I have described these feelings in the context of a heightened sensibility, in which the stimuli barriers are down, the associative mind is alert and vision appears immersed with the surroundings. My own predilection for beginnings stems from a photographic sensibility, which is rooted in a realist tradition. At the heart of the photographers addiction to chance encounters with strangers lies a paradox: the photographer relies on capturing the fleeting moments only in order to remove them from time all those little deaths that photographers experience every time they press the camera button in the name of capturing lifes contingent moments. I shall briefly note what is at stake in this temporal and spatial practice of the photographer, whose obsession for beginnings was first foreseen in the way the poet Charles Baudelaire (1964) characterized the first artists of modern life in the 19th century: the artist-flaneur was an urban stroller who had the gift of a kaleidoscopic vision, able to take in the fragments of emotionally charged experiences that quickly arrived and dissipated like abrupt shock effects in the rhythm of the multitude of urban life. This figure is of interest to us, especially because of the psychological resonance that Baudelaire attached to it: he characterized the modern artist as a child who relishes the present and perceives reality all the time in a constant state of newness. What makes the artist-child different from the real child is the ability of the artist to recover childhood at will: a childhood now equipped for self-expression with manhoods capacities and a power of analysis which enables it to order the mass of raw material which it has involuntarily accumulated (p.8). The creative process is described in romantic terms: the artist returns to his studio at the end of the day and goes into a cathartic trance as the raw materials he has seen reemerge in his mind. He recreates on the drawing board, with a degree of forcefulness, the scenes that he had witnessed during the day as if he was seeing them for the first time. The notion of the excitement potentially imbued in chance

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meetings with strangers is characterized by Baudelaire in relation to the urban experience of walking among the masses in the streets. The hold that the fleeting moment has on us is characterized in a poem by a contingent urban encounter in which the narrator falls in love with a widow who passes him in the street: He immediately realizes that his infatuation with her relies as much on the charm of our first sight of someone, as it does on the fact that he realizes that he will never see her again; this unfulfilled encounter was described by Walter Benjamin not as love at first sight but love at last sight.1 Roland Barthes (1985) describes a figure whose trademark is the search for beginnings in the guise of the sensual male cruiser: the body of the cruiser is in a constant state of alertness for its own desire and cruising implies a temporality that accentuates the meeting, the first time (p. 231). The seeming paradox of the act of cruising is embedded in the fact that while this ambulatory action is repeated many times it is actually construed as anti-repetition because its catch is absolutely fresh and it relies on the happiness of chance (p. 231). The photographer is the primary cruiser, out to find his catch in the frame and reacting intuitively to anything that can mirror his own feelings and vision. Both the artist and the cruiser belong to the realm of adventure which Georg Simmel (1971), the German sociologist of modern life, defined so aptly: We speak of adventure precisely when continuity with life is thus disregarded on principle (p. 189). The adventure always takes place in a present, with no before or after. It is its own island in a time frame that can be related to artistic creativity and to works of art that depict a slice of life that is removed from the continuous and mundane activities of everyday lifeI like to think of this island in terms of the way the framework of the analytic time provides the patients with the ability to be creative by taking time out from their habitual preoccupations in order to engage in reverie. I have pondered very briefly on some ways of considering the notion of beginnings in photography and art in order to return and ask whether it can be applicable to other aspects of the psychoanalytical practice other than only to my discussion of the initial meeting. I would argue that the notion of beginnings is evoked in the analytic experience by the very distinction we

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can make between analysts who rely over much on theory and apply their schooling in a dogmatic fashion, and those more creative analysts who have learned to take theory with a pinch of salt and know very well that what really matters is their clinical findings, which can change from one patient to the next. What better example can serve us than that of the father of psychoanalysis himself; Sigmund Freud preferred the innovative practices of treatment and the search for newness over the dead theories he had rejected as a student in the German university system; a preference that led him to go to Paris and become fascinated by the Frenchman Jean-Martin Charcots style of investigation, which relied on clinical observation. This enabled him, later on in life, to continue his own explorations at the cost of rewriting and contradicting what he had previously written in the name of creative innovation.2 The problematic duality between psychoanalytic theories and their analytical practice is noticeable in Jean-Bertrand Pontaliss autobiographical and literary style of writing. Known mainly for the way he introduced the Freudian psychoanalytical language to French thought, he is nevertheless critical of any rigid use of concepts, which he believes can never really encompass our understanding of each patients condition. In two of his books, translated as The Love of Beginnings and Windows, the subject of beginnings is alluded to in the way he probes into the role that language plays in analysis and in our own lives: like his distrust of anything that smacks of dogma and rigidity, which causes analysts or writers to perceive reality from the limited prisms of their ideological positions, language, accordingly, should not be perceived as something dead and fixed but as a fluent means of expressing our turbulent thoughts, which in turn reflect our journey from childhood to old age. To begin to speak, whether in those first attempts of the child who points his finger to indicate an object that he can now identify with a word, or when we pause for a thought and then re-start our conversation, reveals that speech always starts from that other space where silence reigns. The role of dynamic speech and the associative style of writing provides a vehicle for the nomadic thought and the intuitive glance, which is to be found everywhere in the book Windows.

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Beginnings are implied in Pontaliss (2000) definition of childhoods mythical time that provided us with the place where we were once able to feel, observe and invent the world, often in the most silent way, without the screen of knowledge and words, when all our senses were awake (p. 68). It is even imbued in his definition of nostalgia, which is not, as we would assume, the yearning for a lost childhood or a homeland from which we were exiled, but, instead, is the craving in the present for a sensibility in which whatever we do we will always search for that native land, the one where life is born and reborn: Nostalgia carries the desire, less for an unchanging eternity than for always-fresh beginnings (p. 29). By transferring such observations about childhood and nostalgia to the psychoanalytic work, Pontalis arrives at a similar demand for creative openness and a yearning for new starts: he complains about the case studies that analysts write in order to vindicate their theories, claiming that clinical experience contradicts, creates flux, and makes any prefabricated theory vacillate, beginning with its own (p. 10). Pontalis calls on analysts not to be over hasty in translating their patients thoughts into their own mental constructs; they should first pay attention to what each person brings with him. The analyst should be exposed to the passion, rage , and excesses of the patients in order to become astonished and even wounded by what is said, before shifting to the stage of interpretation, insight and discoveryall these shifts between listening and speaking, bewilderment and insight, immobility and mobility, take place precisely on the grounds where language and silence residethe analyst is required to listen attentively and be attuned to what Pontalis terms the infans or the silence of beginnings (p.11). In a broader sense, he wonders whether psychoanalysts, after Freuds era, are mere followers that are fated to retread those paths that have already been mapped out for them by theoretical constraints, or whether they too can be innovators and explorers. He arrives at the conclusion that there is no initial beginning . . . In whatever matter, we always come after and yet we are perpetually starting something, which leads him to believe that every analysis, however many years we have been in practice, is the first time (p. 95). One apprehends how Pontaliss demand for flexibility and

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creative intuitiveness, setting the contrast between theory and practice, idee fixes and improvisation, echoes the way Ogden re gards the initial meeting as a unique opportunity for the analyst and the patient to let down their guard: here the therapist must perform both as the controlled professional person who is listening from a position of authority, but also as novice, to use Ogdens term, who is willing to shed everything he knows and discard his habitual responses in order to be challenged by the initial encounter; here the analytic practice occurs between the poles of the predictable and the unpredictable, the disciplined and the spontaneous, the methodical and the intuitive (p. 194). The choice of the word novice, to characterize the analysts stance of listening to something, as though for the first time, recalls a literary term and an artistic stance that was in vogue in the early part of the twentieth century. Defamiliarization, or Ostranenie, the theory of making common things look strange and unfamiliar, was formulated by the Russian formalist theorist Viktor Shklovsky, as a critique of anything habitual that dulled the senses. Writers were supposed to find new ways of expression that would challenge peoples automatic responses to reality. This became a significant revolutionary tool in Russian art and photography, and was later on adopted as a purely empty formalistic tool by German photographers in their search for new camera angles by which to show mundane reality in an exciting new way that made it look artistic and unfamiliar.3 For our purposes it is worth noting that the origin of the term, defamiliarization, was already practiced among the Romantic writers, who protested against anything that smacked of the habitual and the commonplace. They sought spontaneous free expression. Some painters in the 19th century too sought an undifferentiated childhood vision that was not corrupted by experience, conventions, and knowledge; this entailed the belief in the ability of vision to restore a sense of Edenic purity that enabled the artist to perceive and recreate his vision of reality as though with no cultural and ideological filter, as though he was seeing it for the first time. To write about a beginning entails rethinking the idea of a beginning from a different time. This idea is evoked by Edward Said (1975) in his discussion of the subject of beginnings in liter-

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ature: What is a beginning? What must one do in order to begin? What is special about beginning as an activity or a moment or a place? (p. 30). He points out that a beginning can represent a discontinuity with regard to what has preceded it, and this brings up the question of what are the conditions that will enable us to call something a beginning. His probing into the actual action of starting the act of narrating fiction can be read in the context of our discussion; let us substitute Saids writer or narrator of fiction with our patient who is deciding to embark on starting analysis and is about to phone the analyst to arrange the initial meeting:
First of all, there must be the desire, the will, and the true freedom to reverse oneself, to accept thereby the risks of rupture and discontinuity; for whether one looks to see where and when we began, or whether he looks in order to begin now, he cannot continue as he is. It is, however, very difficult to begin with a wholly new start (p. 34).

The question of what takes place when a narrator embarks on telling a story made me question what is entailed when one picks up a book and starts reading, and this led me to reflect on my own first encounter with Ogdens text, which inspired me to enter into a dialogue with it by presenting my own subjective account and ruminations about the initial analytic meeting from the perspective of the patient. What expectations would the reader have upon picking up Ogdens book and coming across the title of the chapter, The initial analytic meeting on the contents page? The title sets a chain of expectations in motion: Will the text be as interesting as the promising associations one already has from reading the title? The reader is in some unease over the task of having to start reading, which forms a commitment of some sort to someone elses voice and thoughts: Can the actual act of reading be likened to the way Ogden describes the analytical session as being removed from our daily lives? Both the act of reading and being in a therapy session take place outside our normative quotidian time. Once we are inside, in both cases we move backward and forward in our memories that no longer have any relation to the clock that is measuring our real time of conversing or reading. We also seldom read an

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entire book in one go, thus, every time we return to read it, in the hope of finishing the story, we initiate a renewed act of reading that actually began when we opened the book for the first time. In both the analytic sessions and in the act of reading there is a meeting of minds between one voice that speaks and another that listens; one that writes and the other that reads; and in both cases the narrative voice sets into motion an addressee who must be receptive to being molded by the narrative, while at the same time keeping his own voice intact in order to interpret the text and give it a new meaning. The text is never complete and the narrative never ends as long as someone is listening or reading.4 In Ogdens book there are several beginnings to the chapter in question: the title of the chapter on the contents page is repeated on the actual page of the text. The authors own introduction is preceded by an epigraph that is not the voice of the author:
We shall not cease from exploration And the end of all our exploring Will be to arrive where we started And know the place for the first time

What is the reader meant to make of this epigraph, by the poet T.S. Eliot, which floats on the page, between the title of the chapter and the authors voice, set in its own margins and italicized?5 Is this distinctive island, which is both already part of the chapter but also separate from it, not unlike the status of the initial analytical meeting? On the one hand the act of reading has already begun but on the other hand the authors voice has not yet been heard. Is there a similarity between the way we are required to read an epigraph with no prefatory remark about its origin and the way the patient and the analyst are thrown into each others company in a similar unprepared manner: can we draw from this that the initial analytic meeting carries with it the same type of poetic, elusive, and cryptic weight that we experience when reading poetical epigraphs introduced at the beginnings of prose texts? Is it possible to compare between the analyst who advocates giving the patient the chance to start the initial meeting, in order to allow him the opportunity of becoming aware of his own new voice; and the reader who has now

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been given the freedom to freely associate about the meaning of an epigraph he does not necessarily know and whose meaning will most likely be changed for him after he has read the entire chapter and realized why the author had placed it there? The first impression the reader has from reading the epigraph, whether he is familiar with Eliots poetry or not, is of a cyclical movement in which the knowledge of the primary experience is actually given to us only at the end of our journey, setting the evocative image of an ending superimposed on the actual moment of a beginning, and the other way round as well. The reader familiar with Eliots poem knows that one of the most prevalent themes in The Four Quartets is the notion of time: As a Christian, the poet believes that the flux of time in the temporal world would not be possible if there was not a God overseeing it at the fixed point of the turning world; the flux of time turns into a pattern of timeless moments, which prove the presence of the existence of the eternal and unite within them both the past and the present. For a faithful Christian, the notion of beginnings and ends is different from that of the secular mind. Although the journey in the poems is from birth to death, one should remember that birth is construed in terms of our fall from grace and banishment from the garden of Eden, while we live a mortal existence in this world; and the aim is to redeem ourselves through death that is meant to liberate and provide us with rebirth. Ogden, whether intentionally or not, chose a passage that emphasizes the theme of salvation and also recapitulates the main themes of the entire Quartets. In the last phase of our life, after middle age, the poet advocates detachment and contemplation of history, which is not grasped in all its totality but, by being able to arrest even a single timeless moment, it is possible to contain its whole meaning and verify the existence of God. I want to believe that Ogden chose the paragraph for its poetic value rather than for its religious meaning. As a psychoanalyst he believes in change in this life, and yet the allusion to going back in time, which Eliot speaks of, is also inherent to the process of psychoanalysis. The Freudian concept of analysis has us believe that in order for us to change and have a more meaningful perspective on our lives, we need to return and investigate

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our primordial origins. And yet, we must question this assumption and ask ourselves whether we are really able, after all our process of exploration, to return to our beginning and know it for the first time? In his essay on The speech of analysis Maurice Blanchot (1993) explains the idea of the origin in Freuds thoughts on the analytical experience: Freud invites each of us to return and search for the primary event that is different for every one of us and constitutes our own individual history. But in doing so, we return to a place that simultaneously designates our beginning as a given fact but also as something abstract that always remains unknown; thus, we are doomed to grasp ourselves always in relation to a fundamental insufficiency. In psychoanalysis we are invited to interrogate the primordial conflict by talking about something we are not even sure happened, and thus construct a narrative in which the role of language and of speech is able to present the animated truth of the ungraspable eventungraspable because it is always missed, a lack in relation to itself (p. 232). I want to conjecture, through the use that Ogden made of the epigraph, a plausible link between Eliots religious concept of time and that of the secular mind in the guise of the patient assiduously attending the psychoanalytical sessions, just as the believer engages in daily prayer. Although the consulting room cannot be compared to the still point in the turning world, it does provide the patient with a place of respite in which he can take time out from the hectic and chaotic life to find time for contemplation. I shall take the creative liberty of comparing the moments of revelation, which Eliot alludes to in the form of epiphanies, which confirm the existence of God to the believer and affirm his own purpose in the world, with those rare moments of interconnectedness in psychoanalysis. Imagine the patient being able to have a glimpse of his whole history through a fraction of a second when a strong feeling suddenly wells up inside him. As the consulting room falls silent, and the eyes of the patient no longer see anything tangible in the room, the faint trace of the primordial space occupies his mind. At this point, as the time of the present is interlocked with the time of the past, his feelings escape the grasp of language and provide the sense of being able to touch the innate experience, as if without mediation. Then, once it has been recognized and ascer-

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tained by the cognitive mind, the timeless moment immediately vanishes. During such rare moments of personal insight (I hesitate to say enlightenment) the patient becomes aware of the most innate confirmation of the love he received in his infancy (or the lack of it) from which the entire complicated history of the formation of his character, its personal, social and cultural identities, were created later on in life. My choice of an epigraph from the Four Quartets was not only a reflection of my own deep appreciation for the poem and also for the fact that I had read a section from it out loud beside the fresh mound of earth of my fathers grave during the funeral. It was also a tongue in cheek response to Ogdens choice of epigraph: I wanted to counteract the implications of Eliots reference about a movement that returns us to our origin with another movement that Eliot refers to when he writes, In the beginning is my end. One may read this as a deterministic way of looking ahead, but I wanted to use it, from the point of view of the patient, to remind the readers (and especially the analysts) that we do go to analysis and hope to change, and for that reason we must imagine an ending as well. Every initial meeting, ending with the analyst showing the patient to the door, is already the rehearsal of the departure scene in which we hope one day to leave the consulting room with the knowledge that we are cured. But then of course this is only a fantasy, and in fact the notion of beginning analysis in relation to the stage of terminating the treatment is far more complicated. Let us end, therefore, (as far as we are ever able to) with the way Blanchot writes about the question of when is the analytical treatment over and, following Freuds formulation about the necessity of analysis to be both finite and infinite, he writes: When it begins it begins without end. The person who submits to analysis enters into a movement whose term is unforeseeable and into a reasoning whose conclusion brings with it, as though it were a new capacity [pouvior], the impossibility of concluding (p. 236).
NOTES

1. The poem in question is titled Une Passante (To a Passer-By) and Walter Benjamin writes about it in The Paris of The Second Empire in Baudelaire, Charles Baudelaire: A Lyric Poet in the Era of High Capitalism, p.45. London: Verso, 1985. 2. Freud stresses the importance of observation and innovation in his tribute to Charcot: He would say that it was wonderful how one was suddenly able

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to see new thingsnew states of illnesswhich must probably be as old as the human race. See Sigmund Freud, Charcot, in The Standard Edition of the Complete Psychological Works of Sigmund Freud, vol. 3, p. 12. London: Hogarth Press, 1953. 3. On the subject of defamiliarization see, Simon Watney, Making Strange: The Shattered Mirror, in Thinking Photography, ed. Victor Burgin, pp. 154 176. London: Macmillan Press, 1982. 4. In On Becoming a Subject Ogden perceptively describes the relationship that emerges between the reader and the writer at the precise moment when the reader starts to read a text and realizes its potential effect on him. Reading is about a tension, and even a battle, in which the reader must be open to receive another voice that may threaten and even displace the readers notion of self-identity and knowledge. Ogden discusses the creation of a third subject that emerges in the act of reading, which neither belongs solely to the writers nor to the readers voices. The notion of this third subject also exists in the relationship between the therapist and the patient during the therapeutic process. See, Thomas Ogden, On Becoming a Subject, in Subjects of Analysis, pp. 113. London: Karnac Books, 1994. 5. There is only one other italicized word in Ogdens chapter and it is a crucial one. When he talks over the phone for the first time with the patient, in order to arrange the time for the initial meeting, he prefers to use the word consultation in order to characterize this meeting. In doing so he indicates to the patient that their first encounter is not necessarily binding and does not obligate either side to start treatment. Hence, although Ogden labors to make the point that the initial meeting is already part of the analytical process and should be conducted as such by the analyst, it is still a tentative preface that has its own special character.

REFERENCES

Barthes, Roland. (1985). Cruising, in The Grain of the Voice. New York: Hill and Wang. Baudelaire, Charles. (1964). The Painter of Modern Life, in The Painter of Modern Life and Other Essays. New York: Da Capo Press. Blanchot, Maurice. (1993). The Speech of Analysis, in The Infinite Conversation. Minneapolis: University of Minneapolis Press. Eliot, T. S. (1959). The Four Quartets. London: Faber and Faber. Ogden, Thomas. (1989). The Initial Analytical Meeting, in The Primitive Edge of Experience. London: Jason Aronson. Pontalis, J. B. (1993) Love of Beginnings. London: Free Association Books. Pontalis, J. B. (2000) Windows. Lincoln and London: University of Nebraska Press. Said, Edward. (1975). Beginnings: Intention and Method. New York: Basic Books. Simmel, Georg. (1971). The Adventure, in On Individuality and Social Forms. Chicago: The University of Chicago Press. 4 Zeitlin Street Tel Aviv 64956 Israel E-mail: wigoder@bezeqint.net
The Psychoanalytic Review Vol. 96, No. 1, February 2009