Fragments of Sisters in the Mind : The Double Bind and Attacks on Thinking

The analytic process with A., a 28-year-old borderline woman, is described in the paper. The patient, three years into treatment, initially presented difficulties in speaking, as “the effort to think, before speaking, is too much, and makes me confused”. A. has two sisters (2 and 4 years older) who were always used by mother to neglect the subjective experience of the patient’s self. The relations among the sisters are described by the mother (with whom A. maintains a dependent relationship) in terms of negative primary injunction (“you’re bad if you don’t do this for your sister”) followed by a secondary injunction opposite to the first one, and involving the affective dimension (“I love you and you shouldn’t have done what your sister wanted”). Due to the psychological dependency, A. cannot choose to part from the confusional relationship with her mother (double bind). Consequently an attack on thinking occurs when A. tries to use her affects and turn them into thoughts. The patient perceives herself as torn by persecutory and contradictory internal objects: “bad, anxious, scared, full of rage”. A.’s experience, worked through in the transference/countertransference, represents a terrifying and chaotic flood of affects that threatens psychic equilibrium: the dissociative capacity of the mind is used as a primary defense. Excerpts from sessions illustrate the current analytic process ( projective identification and enactments especially) that has allowed A. to express herself, enabling to get her close to her affects without attacking thoughts, portions of reality and the relationships with her sisters.