I want to begin by thanking Esther Meek for her reflections on, as she describes it, the encounter of oneself with the other. In her sensitive essay, Meek describes the “primal encounter” between mother and infant that sets the foundation for relationships across the lifetime, including relationships with and to the “other,” and she makes a philosophical argument for the significance of the other.[1] However, she also seems to assume that people have the capacity to engage with the other, which from a psychological basis is deeply problematic.
As a clinical psychologist and psychotherapist, I have developed experience engaging in encounters with the self and another, as well as with emotional pain, suffering, and the terribly important and formative encounter that occurs between a mother and infant. Early on in my vocation, when I was in my master’s program, I heard my professor, Avedis Panajian, speak of the psychoanalyst Karl Abraham. Abraham, he said, posed the following question: “What is the fate of the object?” In British object relations theory, the psychological idea of the object might be akin to philosophy’s other, and so Abraham seems to be warning that the original relationship is not necessarily a positive, nurturing, or emotionally available one for the other. The psychoanalyst Jeffrey L. Eaton parallels this warning, asking, “What is the fate of pain? Where does pain go? How does pain get organized?” Likewise, the psychoanalyst Ann Glasser, says this of patients: “They are surviving. They can’t suffer their experiences.”[2]
I have been deeply moved by these thoughts. I often ask myself, “How is my patient suffering?” And I am struck by the insight that people may not be able to suffer their experience. So many of my patients have needed to turn away from their experience—from genuine contact with themselves and with others—and to go it alone. What I’ve learned is that for these individuals, turning toward their experience can be terrifying and overwhelming, and therefore ends up being too much. This is particularly the case for two of my patients, who I will call Fred and Sally.
Fred and Sally have told themselves awful things like, “I am stupid. I am too much. I am ugly. No one wants to be with me.” But sometimes we must tell ourselves something in order to survive, because the absence of thought is more unbearable than a horrible message. A message presents some relationship with oneself, even if it is harmful. But a message of survival is not a thoughtful message; it doesn’t have any good mother in it—think of a child coming home to his mother after scraping his knee and how we imagine a good mother would respond.[3]
Many people have had very few experiences of a “good enough mother.” This absence of good-enough mothering I refer to as no-mother. Over time, it’s possible for patients to learn to suffer their often immense pain of no-mother and to develop a different experience with a therapist or analyst. This new experience offers a link for the patient of a m-other. Winnicott reflects, “For the baby there comes first a unity that includes the mother. If all goes well, the baby comes to perceive the mother and all other objects [others] and to see not-me, so that there is now me, and not-me. Me can take in and contain not-me elements, etc. This stage of the beginnings of I AM can only come to actuality in the baby’s self-establishment in so far as the behavior of the mother-figure is good enough.” Winnicott goes on to say, “The baby’s ego is strong if there is the mother’s ego support to make it strong; else it is feeble.”[4]
The two patients I mentioned earlier, Fred and Sally, reflect the wisdom of Winnicott, as well as this quotation from Wilfred Bion, who writes, “An emotional experience cannot be conceived of in isolation from a relationship.”[5] Indeed, Fred and Sally painfully show how conceiving of emotional experience takes place in relationship.
Fred is a thirty-eight-year-old man who is married, has one child, and is currently working at a large tech company in Seattle. He began his session by stating, “I was already mature by the time I was four years old. They used to say to me that I was too old for my age. By the age of four, I was already taking care of my two-year-old sister and trying to feed my little brother his bottle. He was six months old. I was mature. My mother was depressed, anxious, and so ashamed of me. I didn’t do well in school. Ultimately, I did OK because I am a multi-millionaire, ‘successful,’ and have worked in tech since graduate school. Now, when my mother looks at me—and it is a looking at me—I feel she just sees disgust and is disgusted by me.” Often, Fred expresses feeling hollow, empty, and detached. He states, “I can run a business, but I get so disgusted with others. They are lazy, even stupid.”[6]
Sally is a forty-year-old woman who is partnered with a forty-five-year-old man, both currently working as psychiatrists at a local hospital and outpatient clinic in Burien. Sally began her session by stating, “I am not going to make it. I feel the bottom just drops out—I can’t think, get so overwhelmed, feel so wobbly, shaky. You left me a Post-it note saying you would be with me in a few minutes. You are never late. I felt terrified, panicked. I wondered, had something happened to you? Was I here at the wrong time? Is it my fault? I see my patients all week, and I feel like I am a fraud. Sure, I am board certified, and I have all the bells and whistles. But you put the Post-it note there, and I want to go get it. It is something I would have to hold, to carry with me. Crumbs from my mother’s table.”[7]
These two patients’ experiences are very different from what Meek describes. On the surface, these patients are, as Fred stated, “successful;” they have professional accolades (e.g., as Sally stated, she is “board certified”), and they have significant interpersonal relationships. And yet most importantly, from the very beginning—and perhaps in utero—they both internally (intrapsychically) felt on the outside of their mother. They felt a sense of being unwanted, ugly, even, hated, disgusting, envied, ashamed, and turned away from by their mother. Glasser describes this as “never getting to first base with [the mother].”[8] It is not a given that someone receives an emotional foundation, that someone gets emotionally and psychologically to first base with their mother. Yes, Fred and Nancy’s mothers provided for their daily needs, even loved them, but neither mother actually knew her children, in part because neither of their mothers knew themselves.
This brings me to the definition of love. In a personal conversation with Glasser, she described to me how Wilfred Bion said everything hinges on how we define love: “to be taken care of and rescued (not love) or to be known and understood.”[9]
Meek argues, via Hans Urs von Balthasar, that it is the “mother’s smile” that is the root of knowing.[10] However, from my experience, it’s not the mother’s smile but the mother’s empathy—her capacity to feel deeply and honestly, in all of the complexity of feeling—that leads the child over time to emotional knowing and meaning. In reality, this is rarely a smile—think again of the child with the scraped knee, and imagine how damaging and unempathetic it would be if the mother smiled here. Think about what it would mean if a therapist smiled at a patient while he was telling her that he hates himself.[11] To understand a patient’s emotional experience, first and most importantly, we need the experience of working with these very painful experiences within ourselves: experiences of persecution, of collapsing, of feeling frightened or terrified, of not making it, of confusion, of feeling less than and shame.
Meek goes on to write that “it would never occur to the child that initiative might have come from within its own self—that it had produced the mother’s smile.”[12]In reality, this actually is something that occurs. The child not only feels that she has generated the mother’s smile but also can feel enormous pressure to continue to generate the mother’s smile so that mom can be OK or the child can feel special.[13]
I believe we need theoretical models of development and psychopathology to help us understand Fred and Sally’s experience and how they don’t have the capacity yet to be interested in others; I belive it’s because Fred and Sally have not experienced someone else’s deep, emotional interest in them (love, as Bion described love, a container-contained relationship; Winnicott, a holding environment), and so, as a result, they haven’t yet developed the capacity to be interested in their own emotional experiences. Nor do they know they can have a mind to think about this or that they can have their own mind.
Glasser has described how so many of us have the experience of “N-O mother.” We have no psychological, emotionally human-sized mother, who across time, labors to birth the mind of her infant. And to counter this “N-O mother,” we develop a “K-N-O-W mother.” An internal k-n-o-w-mother can provide us with concrete facts or information, but not emotional insight and deeper forms of meaning. Of course, k-n-o-wing doesn’t help, actually, but it can often look like the answer to countering the experience of N-O mother.[14] Both Fred and Sally know a lot. And it hasn’t helped them much internally. It has taken years for them both to become interested, to turn toward their experiences, to grow affection for themselves, to understand, and to feel their terrible losses of “no mother, no father.”
It is out of the mother’s care and interest in her own experience that she can welcome her infant into the baby’s own experience. This is the foundation for having a sense of self and for the development of recognizing an actual other as a separate, subjective self.[15] Indeed, with each of my patients, certain patterns start to emerge around their experiences of themselves (their inner being and intrapsychic world) and others (interpersonal).
I imagine that Meek’s thoughts are linked to her lineage and philosophical models. For context, my clinical roots are with Sigmund Freud, Melanie Klein, Wilfred Bion, Donald Winnicott, Donald Meltzer, Francis Tustin, Esther Bick, Harold Searles, Jeff Eaton, Franco Scabbiolo, and Ann Glasser. I need their thinking to help to make sense out of my clinical experience when people, myself included (i.e., not just my patients), attack others, attack themselves, and both. Clinical models work within a lineage. In working with Jeff Eaton, I have learned across time how each clinical model has “specific language expressed through specific terms and concepts used to describe emotional experience. The goal is to discover the models, be as clear as possible about the models, and then, to work with these models.”[16] Models are tools, in a sense, to help us understand our experience. We don’t apply models in a programmatic sense, but we can use them to learn how to talk with our patients—not educating our patients on models but to use those models and the language from our patients’ experiences to capture their feelings.[17]
The following is a gross oversimplification of clinical theory, yet I think even a brief look at that theory can be helpful here. As an introduction to that theory, particularly in the context of mothers and infants, the work of Winnicott is useful, as he described an important concept related to the environment in which the baby develops. Winnicott was a pediatrician-turned-psychoanalyst, and one of the things that captured my attention about him was that he actually looked at, and worked with, the mold that he took shape in: his mother. Rosalind Minsky notes, “He [Winnicott] would eventually speak of his own early childhood experience of trying to make ‘my living’ by keeping his mother alive.”[18] In my experience, so many people do not work with the mold they took shape in. This is not a criticism but an observation based on my clinical experience.
In his 1945 paper “Primitive Emotional Development,” Winnicott sets the stage for understanding how we all go through early development, but the “facilitating environment” often fails.[19]He describes this facilitating environment in his paper “Fear of Breakdown,” where he writes of the early stages of emotional growth:
The individual inherits a maturational process. This carries the individual along in so far as there exists a facilitating environment, and only in so far as this exists. The facilitating environment is itself a complex phenomenon and needs special study in its own right; the essential feature is that it has a kind of growth of its own, being adapted to the changing needs of the growing individual. The individual proceeds from absolute dependence (mother supplying an auxiliary ego-function) to relative dependence and towards independence. In health the development takes place at a pace that does not outstrip the development of complexity in the mental mechanisms, this being linked to neuro-physiological development. The facilitating environment can be described as holding, developing into handling, to which is added object-presenting. In such a facilitating environment the individual (infant) undergoes development which can be classified as integrating, to which is added indwelling (or psycho-somatic collusion), and then object-relating (other relating).[20]
A couple of things are important to note here: the baby is dependent on the mother and the emotional environment of the mother. Moreover, this emotional environment is a complex environment that has “a kind of growth of its own.” It is an environment that is a “holding, developing into handling.” It is a process that unfolds over time between the mother and the baby.
Winnicott elsewhere writes the following:
The word infant will be taken to refer to the very young child. It is necessary to say this because in Freud’s writings the word sometimes seems to include the child up to the age of the passing of the Oedipus Complex. Actually the word infant implies ‘not talking’ (infans), and it is not un-useful to think of infancy as the phase prior to word presentation and the use of word symbols. The corollary is that it refers to a phase in which the infant depends on maternal care that is based on maternal empathy rather than on understanding of what is or could be verbally expressed (pre-verbal).[21]
One question, though there are many, is what kind of emotional pain or distress is the mother’s infant in? How does this infant experience the emotional “music” in this mother as a response to the baby’s pain? In the infant’s communication, is the mother able to provide the digestive work of her infant’s sensorial and emotional experiences?[22]
Winnicott offers a useful way to begin thinking through these questions:
In the beginning the infant is in the environment and the environment is the infant. By a complex process the infant separates out objects (others) and then the environment from the self. There is a half-way state in which the object [the mother] to which the infant is related is a subjective object. Then the infant becomes a unit, first momentarily and then almost all the time. One of the many consequences of this new development is that the infant comes to have an inside. A complex interchange between what is inside and what is outside now begins, and continues throughout the individual’s life, and constitutes the main relationship of the individual to the world [others].[23]
Like Winnicott, I work from the belief that an infant does not have a consolidated sense of self and certainly not a sense of other. To have a sense of other is a developmental achievement that occurs across time in relationship to her mother (and the father in the background). The infant is hardwired to seek, to turn toward their mother. This mother, ideally, gives birth to her infant’s emotional experience and to her infant’s mind. Winnicott describes how infants have “absolute dependence” on their mothers. Across time, the infant grows and there is less dependence, as the infant moves toward “relative dependence, and towards independence.” Across time, the infant finds herself within the family structure. This infant cannot intellectually comprehend the complexities of her relationship to her mother as a separate, external person, as other, but the infant does have her experience of hearing her mother’s voice, her smells, the feels of sucking, her tastes, how her mother holds her, all the emotional music of the mother. In this experience of “absolute dependence,” the infant has not “yet separated out the ‘not-me’ from ‘me’—this cannot happen apart from the establishment of ‘me.’”[24]
From my clinical experience, many patients have not differentiated not-me from me, self and other. For me this is at the heart of the pain and confusion that Meek addresses. Meek writes, “There is no human person who has not been philosophically formed at birth to respond and reciprocate rapturous love to the other.” She may in some way be correct here—I’m not a philosopher, so I can’t speak to a philosophical origin, but without psychology I also don’t know how Meek is able to claim this as being formed. That said, psychologically speaking, I need to disagree. There are many people who are unable to respond to and reciprocate love to the other. How we understand this is terribly important. It is a “facilitating environment” that has been deficient.[25]
Conceive, in Latin, conceiver, means to “take into its womb, become pregnant.”[26]This is very painful to think about, but these are actual babies, adolescents, and adults, much like Fred and Sally, who are, as Bion says, “left in isolation,”[27] emotional isolation. In my experience, there is a defensiveness to thinking about the mother’s mind and her level of psychological development and the impact of her development on the mind of her infant. I often wish so many today could have had an analysis with Winnicott, who understood infant and childhood development and the object relations tradition. There is so much we need to “take into” the womb of our mind and become “pregnant with.”
[1] Meek, “The Other: Returning to Our Natal Philosophy in the Mother’s Smile,” The Other Journal 38.5 (2024): 1.
[2] Abraham quoted by Panajian in conversation with the author, 1985; Eaton, A Fruitful Harvest: Essays after Bion (Alliance, 2011), 3; and Glasser in conversation with the author, 2023.
[3] Glasser in conversation with the author, 2023; and Peter Hopkins in conversation with the author, 2024.
[4] D. W. Winnicott, Home is Where We Start From: Essays by a Psychoanalyst (W. W. Norton, 1986), 62–63 and 63–64. Glasser also contributed to my sense of no-mother (in conversation with the author, 2010).
Winnicott, Home,63–64.
[5] Bion, Learning from Experience (Karmac Books, 1962), 42.
[6] “Fred” in conversation with the author. I have changed or omitted identifying information to protect the individual.
[7] “Sally” in conversation with the author. I have changed or omitted identifying information to protect the individual.
[8] Glasser in conversation with the author, 2010.
[9] Glasser in conversation with the author, 2005.
[10] Meek, “The Other,” 7.
[11] Hopkins in conversation with the author, 2024.
[12] Meek, “The Other,” 8.
[13] Hopkins in conversation with the author, 2024.
[14] Glasser in conversation with the author, 2005.
[15] Eaton in conversation with the author, 2011.
[16] Eaton in conversation with the author, 2011.
[17] Eaton in conversation with the author, 2011.
[18] Minsky, Psychoanalysis and Gender: An Introductory Reader (Routledge, 1996), 134.
[19] Winnicott, Home, 72–74.
[20] Winnicott, “Fear of Breakdown,” International Review of Psycho-Analysis 1, no. 1–2 (1974): 103–107.
[21] Winnicott, The Maturational Processes and the Facilitating Environment: Studies in the Theory of Emotional Development (Routledge, 1990), 40.
[22] Bion, Learning from Experience, 11.
[23] Winnicott, Home, 72.
[24] Winnicott, The Maturational Processes, 46; Home, 62; and “Fear of Breakdown,” 62–63.
[25] Meek, “The Other,” 1; and Winnicott, “Fear of Breakdown,” 102–104.
[26] Online Etymology Dictionary, https://www.etymonline.com/search?q=conceive, under “conceive.”
[27] Bion, Learning from Experience