Metaphor and Psychoanalysis: Containers, Mental Space, and Psychodynamics

     The explosion in the number of hypotheses and models in cognitive science during the last decade has generated new perspectives on the role of language in psychiatry, psychology and psychoanalysis. One concept of interdisciplinary interest is the concept of the container. It is widely used in psychoanalytic psychotherapy, and it has theoretical relevance to both the psychoanalytic theory of the mind and to cognitive science. It is the intent of this article to bring these two fields together and clarify a new theoretical perspective on this container concept.

        Experimental evidence supports the thesis that an image-schematic level of cognitive processing plays a fundamental role in an individual's ways of understanding and experiencing the world, her-/himself and others (Johnson, 1987; Lakoff, 1987; Sweetser, 1990). Image-schemata can be seen as biologically based organizing structures of meaning, and one particular kind of schema is the container-schema. The psychological function of the container-schema is to establish individuals as bounded entities. We directly experience ourselves and others with whom we communicate as entities with boundaries.

        Independent of the use of the container-schema in the field of cognitive semiotic science, there is a long tradition for using the concept of container in the field of psychoanalysis and psychodynamic psychotherapy. It has a long history in psycho- analytic descriptions of psychopathology (Bion, 1963, 1967; Meltzer, 1992; Steiner, 1993; Tustin, 1981) as well as in psychotherapeutic technique (Bick, 1968; Etchegoyen, 1991; Jackson, 1992; Sandler, 1988 ; Siegelman, 1990 ). In the study of borderline conditions and schizophrenia researchers have illustrated how some patients experience themselves as being trapped in the mental world of others: the `claustrum' phenomena (Meltzer, 1992 ). The concept of container, in these cases, denotes an inner space, filled with feelings and thoughts, which are projected out from or introjected into the space of the container.

        The container concept in both psychoanalysis and cognitive science denotes a schema, which has an organizing influence on speech and language. Many metaphors are based on the container concept and they extend our bodily based understanding of things to a large number of abstract things. `Blowing my top' and `jumping out of my skin' are container metaphors of the body; `coming out of a stupor', 'falling into a depression' or `falling in love' are examples of experiential states or conditions as container.

        We believe that the container concept needs to be understood in a more comprehensive fashion. This schema can be seen to operate within three distinct dimensions of psychic life. One dimension includes our perceptions of affects, i.e. sensory modalities internally directed toward the body's perceived states of affect. A second dimension, the fantasy dimension, concerns the structure of inner narratives, which relate one human being to another. A third dimension, the socio-interactive dimension, concerns the exchanges of narratives and viewpoints between one individual and another. Other tripartite structures such as the bio-psycho-social model (Engel, 1980 ), point to a similar way of understanding patients.

        The tripartite structure we suggest, however, has a less ambitious aim insofar as it narrows the investigated perspective to structural preconditions for meaning-making (Bruner, 1990). Movements within, through and outside the container will configure language expressions in each of these three dimensions. For example: a patient feels his anger `boiling' and has to `blow off steam' or he states that `he is out of his mind', and not `himself' but is drawn into and subjected to the 'will and whim' of others; and lastly, he states that he `is distant from and above other people who are trapped in conformity', while he `is outside their world, independent and in command of his own space'. Although these kinds of feelings may often predominate, sometimes, opposite feelings may also come into play. Hence, dynamic movements between one pole and its opposite in each of the three dimensions, the affective-perceptual, the fantasy and the socio-interactive dimension, are omnipresent.

        I. The cusp

        The cusp (Thom, 1975; Woodcock & Davis, 1978; Zeeman, 1976 ) is a foreign, although not a new, concept within the domain of medical psychology. A few remarks about its characteristics shall be advanced prior to more well-known matters.

        The cusp (Fig. 1) is based on a mathematical formulation (y = x⁴ + ax² + bx), which graphically displays the equilibrium or instability of the dynamics of attracting and repelling forces (e.g. emotional, cognitive and social forces) working across boundaries. In relation to cognition, the principle of the cusp asserts that the person is simultaneously or alternatively attracted to and repelled from desirable and undesirable objects, states or moods. In relation to the container, internal objects (e.g. the interior of the container) can function as attractors for external forces. The boundary of the container functions as a repellor, as a resistance to ingression. Each interior and exterior space can also be viewed as an attractor. The cusp model can be applied to continuous as well as discontinuous transformations of emotional states. The dynamics of the cusp model (Fig. 2) are based on the principle that the patient may be attracted to objects or states desired or needed, and repelled by undesirable objects or states.

        Accordingly, the patient may move towards the between bimodally opposed aspects of mental representations (positive /negative; euphoric/dysphoric; close/distant; warm/cold). This is equivalent to the situation in which the patient's inner awareness is driven towards the boundary of the container (from outside or from inside), but not with enough force to transgress it. A common clinical example is one in which the person wants to make contact with another but also fears losing his/her autonomy. Another example is one in which the patient clings to another in an adhesive manner, but fears the imagined intimacy of `getting inside' the other. When attracted by opposing qualities in a weak manner, the patient is brought to a state of excitation, and swings between one quality and its opposite. An excitative state may emerge in which the patient remains between the borders of the cusp (cf. Fig. 2a), or behaves in a relatively stable manner (Fig. 2d).

        If the attracting force is strong enough, a transgression of the border may occur. The patient then passes a threshold beyond which the balance tips towards the dominance of only one quality (Fig. 2c), e.g. the complete desire for another ('I want him here and now; if not, I die'), or an ultimate striving for isolation. If the patient is not attracted towards the opposing quality, by some strong 'external' factor, he/she may remain fixed in the transgressed state (outside the legs of the cusp (Fig. 2b). Here, clinicians may witness the patient trapped in an all-encompassing feeling of idealization or hateful devaluation or in the physiological-emotional state of emptiness or in a `stubbornness' of communication with others. The top of the cusp represents the state of chaos where the opposing dimensions fuse. From this state of fusion the patient may return to either side of the cusp. Clinically, this can be observed in the pathological intensification of the chaotic phase of an outcry of emotion after learning that the loved one has left for good or died. Hate, shame, guilt and panic fuse. The patient usually returns from this state into a depression, and must be supported before a sense of coherence returns. At other times, the patient returns from the chaotic emotions into a hypomanic state of elation.

        II. The container in psychoanalytic theory

        The term container has its origins in Bion's writings. However, the container concept is found, also, in Freud's early conceptualizations of drive and affect as organized according to the body surface and its openings (Freud, 1905 ). Mouth, ears, eyes, breast, penis, anus and vagina are not to be understood in their anatomical physiological sense, but imply borders and passages into the mind's functions. They are organized in accordance with libidinally invested object relations. Following Freud, Abraham (1924 ) demonstrated the introjective and projective mechanisms which operate in different psychopathological states. His pupil, Melanie Klein (1946 ), proposed a theory explaining how children project fantasies (mainly aggressive ones) into the mental body of the mother. She coupled Abraham's idea of objects expelled from inside with Freud's theory of the super-ego, an agency Freud himself had recognized as internalized (Hinshelwood, 1989 ). Klein suggested that part of the child's own self was projected back outside along with the internalized object. When the other unconsciously experiences the projection as a part of her-/himself, and hence complies, often unproductively, with projected emotions and content, then projective identification has taken place. Bion (1962 , 1967 ) established that the notion of projective identification is a complex one and that it should be categorized into normal and abnormal types depending on the degree of aggressiveness. In relation to the containing function, Bion (1970 ) outlined three basic forms of the container-contained relationship: the commensal form `in which two objects share a third to the advantage of all three'; the symbiotic form `in which one depends on another to mutual advantage'; the parasitic form `in which one depends on another to produce a third which is destructive to all three'. The last form, where no reciprocity between the container and the contained exists, is prone to difficulties. Lately, Meltzer (1992 ) has expanded on his notion of `the claustrum'. Here, certain patients act in both a claustrophilic and a claustrophobic manner. They are attracted to another person's inner mood states and thoughts. But after being captured by the other person's internal state, some patients will struggle towards an adaptation to, a flight from, or a fight against these processes, which are felt to take power over the patient's own psychic life.

        Recently, Rey (1994 , p. 165) has asserted that, from a psychotherapeutic point of view, topographic concepts such as encompassing containers, landscapes, domains, areas, attractors and repellors may provide clinicians with new tools for treatment. In this model, one relates the function of psychic energy quanta (desire, anxiety, aggression, etc.) to a frame, and this frame is often a `container type', e.g. body parts or the entire body.

        III. The container in cognitive science

        The schema as a cognitive unit has been recognized for more than half a century beginning with Bartlett (1932 ) and later revised by Paul (1967 ). The term schema denotes a persistent, organized mental set. It implies that this mental organization is the result of past changes in mental position and posture; schemes are actively doing something all the time; they are, so to speak, `carried along with us, complete, though developing, from moment to moment' (Bartlett, 1932; cit. Paul, 1967 ). Although the container concept as a perceptual Gestalt has also been recognized by psychologists for many years, its specific relation to psychic life is relatively new. Its achieved legitimacy within cognitive science had to await developments within cognitive semantics (Fauconnier, 1988; Jackendoff, 1983; Lakoff & Johnson, 1980; Langacker, 1986; Sweetser, 1984 ), which showed that many words directly imply boundary conditions.

        Cognitive semantics is a linguistic and psycholinguistic oriented research field which since the end of 1960s has been concerned with how sentences and utterances generate meaning. This research has taken a dramatic turn with the work of Lakoff (1987 ) and Johnson (1987 ). They state that speech and understanding, i.e. higher order mental processing; have a basic metaphorical character grounded in basic-level schemata which are embodied. That is, the structures used to put together our conceptual system grow out of bodily experience and make sense in terms of it; the core of our conceptual systems seems directly grounded in perceptions, body movement, and experience of a physical and social character (Lakoff, 1987 ).

        Within days of birth the human neonate `places' itself and its percepts in a fully three-dimensional geometry (McClelland, 1993 ). The encounter with containment and boundedness is one of the most pervasive features of our bodily experience, and cognitive scientists have become interested in the container schema because it can be conceived as a kinesthetic mental map upon which much meaning can be created. It is the embodiment of the container metaphor, which makes it attractive for cognitive science.

        IV. Mental space and the container

        Mental events are represented through language and are linked to one's identity through one's imagined relation to the interior and exterior of both oneself and others. The development of both symbolization and subjectivity depends on the schematic conceptualizations of beliefs, intentions, desires, emotions, thoughts, fantasies and narrations about oneself and others. Cognitive science and psycho-analysis converge, grosso modo, with respect to these facts.

        Both within psychoanalysis and within cognitive science, the container concept structures the experience of the `I' and hence, provides the person with some kind of identity. In cognitive semantics the container `gestalts' the relation between the body and the environment. In psychoanalysis, the container 'gestalts' unconscious and conscious fantasies about the patient's emotional relation to the inner world of others. Cognitive semantics views the emergence of meaning as the link between inner schemata and the outer world, while psychoanalysis views meaning through the psycho-sexual structure of emotional relations as expressed in dialogue and interaction. In spite of the dissimilarities, the two fields come into convergence through the container concept. Cognitive semantics tries to understand the mental in terms of the physical and the mind in terms of the body experience. Psychoanalysis, on the other hand, is inclined to understand the body in terms of the mind - a desire for the other's desire, a third subjectivity called `the alliance' or the intersubjective analytic third, simultaneously within and outside of the world of the analyst-analysand (Ogden, 1994 ).

        In the following, the container concept will be linked to the processes of thinking and symbol formation. The person's apperception of her-/himself and the relation of self to others in communication will be in the focus. The container concept and the model of the cusp may thus provide useful insight into psychodynamic psychopathology. Although an extensive clinical application of the model is beyond the scope of this paper, a few clinical vignettes are offered. The clinical focus of the container model is applied to patients with borderline personality organization (Kernberg, 1970 ).

        Furthermore, this article will introduce a model based on the dynamics of the cusp. This model organizes three interacting dimensions in which the container schema functions - the affective-perceptual, the fantasy, and the socio-interactive dimensions. The model thus advances the container concept from a one-dimensional configuration to one with three interdependent levels.

        V. The container concept in the three dimensions of language

The general structure of the container

        The structural elements of the container are the interior, boundary and exterior (Fig. 3). These constitute the general structure of the container. The dynamic entailments of this model include protection from and resistance to external forces. However, the limitations and restrictions on forces from within the container towards the outside and the accessibility of internal processes for external subjects are also important dynamic aspects of the container. These dynamics can be as follows: in this model, psychological movements constitute a dynamic continuum of changes in which the person is propelled or repelled, respectively, towards or away from the position of the other. The movements of the person are thus influenced by attractors (interior, exterior), resistances (boundaries) and the person her-/himself (with possible internal motivating forces). These forces, which make pathways in relation to the boundaries of the container, connect to meaning-carrying metaphors. According to the semantic theory of force dynamics (Talmy, 1988 ), resistances and strategies of interaction appear directly in the language structure of each individual patient. Force dynamics includes, for example, the exertion of force, resistance to such exertion, overcoming of resistance, blockage of a force and removal of blockage as these dynamics show themselves in the semantics of language. That is why one can detect defensive operations, style and coping strategies in the content of patient speech (Horowitz, 1991 ).

The affective-perceptual dimension

        From an early age we are intimately aware of our bodies as three-dimensional containers into which we put certain things and out of which other things emerge. We experience our physical environment as something into which we are enveloped and from which we can emerge. We move in and out of rooms, clothes, vehicles, friendships, jobs, events and other kinds of bounded spaces.

        Under normal conditions, individuals are in need of physical and mental attention and stimulation, and for a feeling of safety and satisfaction. We need to be inspired, to 'take in' and be filled up with good impressions, to be full of joy. Some patients avoid `taking in' the words of others, or they get `filled up' with problems. Some feel then are forced to `swallow' a `bunch of bullshit'; others cannot `digest' the meaning of words and narratives. Some patients carry murderous feelings `inside', or feel that they have to get the anger 'out' immediately.

        It is not only the individual body, the self or parts of the self, which are containers; but affects also carry the dynamics of the container: I can `bury myself in sorrow' or I can get `out of my mad mood'. Thus, moods and affects can serve as containers. The characteristics of this affective dimension of container language resides in the body itself.

The fantasy dimension

        This dimension concerns the stability, excitability and instability of internal objects, or repressed desires. It is partly conscious and partly unconscious. Erotic fantasies are aspects of this dimension. They are often related to a container language consisting of scenes and settings where movement into and out of contained space takes place. Submission, domination, reception and control are modes by which the patient is moved by the internal force of desire in imagination. This kind of unconscious `container language' differs from the language of the other two dimensions. The fantasy dimension is highly subjective, it cannot be exchanged in the moment it appears. One cannot really exchange dreams, repetitive sexual fantasies, or first memories; one can only tell somebody else about them. Although they are sexual, they are not necessarily bound to intimate erotic situations. This is beautifully illustrated in the film `Shortcuts', directed by Robert Altman. Here, a housewife walks round in her house, uses pornographic language when talking to her customers, and simultaneously changes her children's diapers, washes the dishes and waters the flowers.

        Meltzer's (1992 ) concept of the claustrum is a good example of how the container concept is influenced by the fantasmatic dimension of language. Some patients with borderline personality organization feel the need for repetitive projections into another person. They experience interpersonal relations, simultaneously, in both a claustrophilic and a claustrophobic manner. These patients let their thoughts enter, or rather intrude into, the other's imagination, which then becomes a claustrum, a prison, for them. The phenomena of life in the claustrum appear in the patient's way of thinking. They often feel and believe that they have prematurely and cruelly been pushed out of a previous, caring environment (maternal space, or maternal container), and therefore, they attempt to regain the right to reside inside such an environment (Steiner, 1979 ). Their way of symbolizing psychological events, e.g. their wish to remain inside and safeguarded, is primarily based on pseudo-symbols (Fiumara, 1992 ), and their wish will accordingly be perceived as parasitic in nature. They may demand access to information about therapists, and threaten them and their families, or they may behave as if the ward was their own home, subjecting everyone to their whims, wishes, demands, and other tyrannical attitudes. Once inside this maternal space, they feel both safe (an unrealistic idealization of the interior) and trapped in the claustrum. They struggle against others in order to adapt to the claustrum (aggression towards imagined `siblings', or towards a poisonous `breast'). Separation is dreaded because it is experienced as a terrible expulsion (cutting off all future possibilities). Alternately, when they unconsciously have seduced, cajoled or deceived the therapist into colluding with their demands, they begin to feel afraid of the closeness (Steiner, 1979 ). They are not able to be intimate. They attempt to flee from and fight against the other person's inner life and mental processes, which are sometimes felt to be indistinguishable from their own. They feel that their minds have been taken over by others, that they have lost their freedom and that the therapist or team wants them to behave in a certain way. The move to a life outside the container becomes a very difficult step.

The socio-interactive dimension

        The container metaphor may range side by side with the self as `agent', or `actor', or `role performer' in descriptions of `self'. When people communicate in a social context, they not only express themselves according to the way they perceive their moods or desires, but they also argue, speak about events, and tell their personal stories. These communications serve to lead, or `seduce' the other to take a certain perspective.

       The socio-interactive dimension concerns the exchange of messages and the way messages and narratives are received, understood and responded to by the other. It concerns the clarity, or vagueness, with which `I' (the ego) sees the other's arguing and story telling, and the reception, or rejection, of the other's messages. The person sways between the alternate intentional states of `ego' and `alter ego', which act as two containers in interaction. The role relationship model configuration (RRMC) of Horowitz (1991 ) illustrates this phenomena. Those RRMC configurations contain inferences about the interaction of wishes, fears, defenses and compromises: that which is given and supposedly taken over from the other or from self.

        VI. Psychopathology

        The container plays a constitutive role in how these alternate states are spoken about and experienced. Some patients may have difficulty putting themselves into the other person's shoes, or they may cling to what other people contain (what the other says or means) or they may go back and forth between the content of their own ideas and that of others. Some patients may feel that they have to hide their thoughts secretly from the other's penetrating gaze. One is `trapped in' a therapeutic relationship, (or in marriage, friendship, etc.), one works one's way `through' it and gets `out of it' by finding `openings'. Here is our container concept as it operates to configure language in this socio-interactive dimension.

        The existence of boundaries establishes a value, or valence system, a system of opposition, into the dynamics of the mental world. A person can be described as either being `in' or `out', e.g. belonging to the group or not being a part of it. One can be `self-contained' or be `out of one's mind'. One can `take in' good things (knowledge, art impressions) or `get rid of' bad things (nightmares, unhappy relationships and memories). In relation to the container, to be `in and up' is good and attractive, to be `down and out' is bad and repulsive. Also, `to look down at' or conversely, `to look up to' others illustrates a clear, socio-interactive dynamic in relation to the container concept.

        The patient with borderline personality disorder provides us with phenomeno-logical illustrations of states of mind in which the patient manifests enormous difficulty in feeling at ease. These patients are not able to achieve self-cohesion; positive and negative perceptions of self are not integrated in a supra-ordinate icon of the self. Instead, the patient is compulsively attracted to or pushed towards the borders of his compounded contained state of self. These borders cannot contain the affects, fantasies and social interactive needs of the patient. Some internal representations are thus expelled. The result is that the patient experiences himself as being either exclusively `positively valued' or exclusively `negatively valued' and caught in either an euphoric or, more often, a dysphoric state. Being in one of these states, the patient cannot imagine any alternative state of mind as being at its disposal. What the patient does and thinks is justified beyond question. Attempts at getting out of these states result in a chaotic fusion of the two, and often in a confusional anger and acting out.

        In the following we shall relate the borderline personality psychopathology to an elaborated tripartite model of the cusp. This model has been developed in an effort to explain human semiotic processing (Brandt, 1994 ). In this model the dynamics of the cusp operate in all three previously mentioned dimensions or modes: The affective-perceptual mode, the fantasmatic mode and the socio-interactive mode (Fig. 4).

        The model suggests that the three dimensions work, consciously and unconsciously, in the organization of thought, complex emotions and mood states, in interpersonal actions and in judgements of oneself. The spoken acts and turn takings in communication take place `through' the socio-interactive dimension. The other two dimensions (of a more inner nature) contribute to, but only become `visible', through the patient's speech and interactive behavior. This implies that all three dimensions may express themselves simultaneously. The dynamics of the dimensions and their interactions will be further explored in the following.

The affective-perceptual dimension

        Borderline personality disorder patients frequently express their emotional life in accordance with physiological connotations: they feel bored, alone, irritated, angry, empty, vulnerable, depressed, triumphant, excited, hopeless (Gunderson, 1993 ). These feelings are experienced as bodily sensations, appearing in different quantities, and regulated by an internal thermostat (without volitional control). They are usually not able to, or willing to, symbolize these sensations in detail, or to reflect on what ways the meaning of their feelings can be related to others (therapist or staff). It is sometimes as if the sensations carry no immediate interactional meaning.

        How does this impact the patient's understanding of what is communicated Borderline patients may treat words or lexemes as if they had the characteristics of physical elements (Garfield, 1986 ). They incorporate (eat, swallow, etc.) the other's words rather than think with them. Words can be perceived as quantities of atmosphere, or marked with different temperatures. Words might be treated as something preconceptual and its content may be immediately devalued or rejected as something disgusting. These judgements occur before any understanding has taken place, i.e. before the person has `tasted' the content. And lastly, words are used by these patients as tools for perceiving moods.

        Under normal conditions, similar emotions can be symbolized in one's communication with others; they can be `talked about' while one keeps some distance from them. But when the borderline personality patient is forced or compelled to symbolize his/her needs (for care, concern, mental feeding, and safety), and thus separates her-/himself from the object upon whom he/she depends, then he/she is led to states of dysphoria, anger, rage or confusion. It is hard, and often confusing, for borderline patients to revise, analyze, and conceptualize feelings, and to transform them into realistic plans or wishes, which may, or may not, be satisfied in the interaction with the other. The patient is the feeling. Thus, the borderline patient cannot integrate opposing feelings, and therefore cannot appropriately oscillate between them (Fig. 2a and d); he finds `stability' when the object is experienced as distant, cold, and empty (Fig. 2c and Fig. 4) or as near, warm and full.

The fantasy dimension

        Borderline patients are characterized by impaired object relations and rigid defense systems that inhibit the patient's capacity for symbol formation and thinking. The patient has difficulties in conceiving the thoughts, feelings and desires of others. Often, he or she feels as if he or she is contained in someone else's mind; a container of another person's thoughts and emotions. The patient is caught in repetitive processes of projection and introjection rather than entering a process of thinking. The patient is attracted to, as well as repelled by, the `other'. Regardless of the patient's outer appearance, the `other' - e.g. the intentions of the therapist, the friend, or family member who tries to be close to the patient - may from time to time be perceived as a physical, attacking entity or sometimes even as fragmented entities.

        For borderline patients, the fantasy foundation of basic trust has not been instituted. The imminence of vulnerable trust is turned into fantasies of being betrayed, cheated or abandoned by the other and fears of being bound and controlled by the other's speech and beliefs. By the same token, the patient sometimes cannot sort out his or her own thoughts from those of others. At other times, the patient feels and acts as if the relationship to other human beings leaves him/her no choice: people are either `good' or `bad' in their phenomenological appearance. The patient must either submit or dominate, either idealize or devalue, either destroy or be destroyed, either expel or be expelled.

        In general, the fantasy dimension provides a possible syntax for our unconscious, psychosexual language to others. This dimension is psychosexual insofar as the patient's desires are directed towards internal objects (Hinshelwood, 1989 ). These objects are unconscious, subjective representations of the others' imaginations. They contribute significantly, through projections, to the way external objects are themselves perceived and experienced. Internal objects are responsible for the ways in which we intimately associate with others. Psychoanalysis asserts that these relations appear as the other's desire, in the patient's erotic fantasies, daydreams, dreams, patterns of cognitive style concerning domination and submission and other aspects of psychic life.

        Internal object relations are also regulated by positive and negative valences: the protecting, nourishing, repairing aspects are opposed to the attacking, poisoning, disintegrating and destructive ones. The borderline patient does not master ambivalence of affect at all, except by splitting it. The `soft', protective, repairing mode of being and the `hard', attacking, destructive, phallic, law-giving mode cannot function at the same time. The result is that repetitive aggressive, meaning-destructive and alienating patterns recur, and the patient is predominately located on the negative side of the cusp of this level (Fig. 4).

The socio-interactive dimension

        Normally, an individual sways between the alternate intentional states of `ego' and `alter ego' (Fig. 4). The person is concerned with how to act and speak in relation to the other in order to make her-/himself clear and convincing. The relatedness between ego and alter ego is built upon a necessary illusion that viewpoints and communication codes are shared.

        By contrast, the borderline patient will, by means of different modes of action, coerce the other's communications to mean precisely what the patient wants it to mean; things are only allowed to be seen from precisely the same perspective as the patient, otherwise he/she will conceive things chaotically and retreat from interaction. The patient insists upon being preferably `ego', but not, or only reluctantly, `alter ego'. Alter ego is forced not to make demands on ego. Empathy does not often take place.

        Statements from borderline patients reveal this dynamic. A patient who isolates her-/himself, or only comes into social contact when he/she is in command says `No one wants to be close to me if they really get to know me'. Another patient who engages himself in self-destructive acts when he is together with others said `I must subjugate my wishes to the desires of others - or they will abandon me', `People will hurt me, attack me, take advantage of me. And I must protect myself'.

        The position of the patient is often located on the negative side of the cusp (Fig. 4), signifying a negatively valued social behavior. Utterances and acts are expected to be read and interpreted by the other person in accordance with `shared' viewpoints and may easily, and sometimes abruptly, lead to feelings of loss of the other's recognition and help. Since everyday dialogues put this belief at stake, the unexpected change of feelings is accordingly always imminent when speaking with the borderline patient.

        When communicating with staff, borderline patients often attempt to establish secluded interpersonal spaces where they can offer opinions to individual members of staff separately. Different viewpoints on, and information about, the patient's inner and outer life may coexist as separate container spaces in the unit. Important staff members may be `bound' by small `secrets' or `injunction', attaching him or her to the different semantics or different container contexts of the patient's narratives.

Interdimensional dynamics and therapeutic dynamics

        Everyday observation of borderline patients illustrates how confusion, misunderstandings and impasses in the turn-takings of communication (social-interactive dimension) may result in changes in mood and affect (affective-perceptual dimension) in both therapist and patient. In addition, they may result in the reactivation of defensive fantasies (fantasy dimension). Thus, all three components of the model work, simultaneously, in both participants of the dialogue. Normally, processes on the affective-perceptual dimension and the fantasy dimension contribute to the dynamics of the turn-takings and modulations of interpersonal communication in the socio-interactive dimension. This interdimensionality is somewhat similar to Garfield's (1995 ) ideas concerning the transformation of affect from body through cognition and into interpersonal enactment.

        Figure 4 also outlines an interdimensional dynamic, regulated by means of a `vertical passage', which runs through the apices of the cusps (cf. the `tubes' in Fig. 4). As mentioned, the apex of the cusp is the location of `catastrophe dynamics' in which positive euphoric and negative dysphoric qualities of feelings, fantasies or social values merge. The apex shows the moment where stability - of moods, fantasies, or meaning in speech-acts, depending on the level involved - is obliterated. Although those moments can be chaotic, they offer a potential for creative therapeutic opportunity as well.

        In psychopathology, this chaotic state equals the patient's (often extreme) confusion. If the ego may be established as cold, alienating and destructive, then when feelings of warmth appear in the body of the borderline patient, and when the other (therapist) appears nourishing or reparative, these feelings of self and other are experienced as contradictory, and are difficult to contain. When the ego is not stable in the apperception of warmth and closeness and when the other cannot be conceived as both alienating and nourishing, then the 'traffic' through the apices (Fig. 2b and 2c) may have a damaging effect. Conversely, if the alter/ego dynamic flows freely, then the moment of chaos may have a creative effect. Those moments where the ego discovers its own misperceptions and illusion may be a turning point for new ways of seeing others and understanding oneself.

        Temporary blockage of the cusp apex may occur at any level. If this happens, a patient may note that feelings `cannot be expressed', or are felt as `completely chaotic'; fantasies cannot be imagined in an ideation sufficiently distinct to make sense, and they cannot be thought through; situations cannot be described. In short, understanding cannot take place. Thus, the cusp model may explain why some borderline patients appear alexithymic and have difficulties in working through. The moment they experience an impasse in interpersonal relations (socio-interactive dimension), their fantasy dynamics react by way of chaotic confusion, and they are confused as to their awareness of their bodily feelings.

        Representations of self and other may be displaced or shunted to the level of fantasy, and if these are equally chaotic then the displacement will continue through to physiological symptoms and moods in the affective-perceptual dimension. Whenever passage from one level to the other takes place exclusively through the vertical tubes then coherent modes of thinking, feeling or behavior is obstructed. In some difficult-to-treat patients, these passages may take place in a complete uncontrolled way, leading either to emptiness, isolation, or mindlessness.

Case example 1

        A borderline patient feels compelled to pay attention to interpretations of her behavior proposed by both staff and therapist. She finds their explanations meaningless and reacts with fierce protest (social-interactive dimension), which evolves into a screaming monologue taking off the steam (affective-perceptual dimension). Through the vertical passage, envy and destructive omnipotence are activated (fantasy dimension) and fantasies of burning others, and cutting herself ensue, so that she `can be joined with her father in Heaven'. In this transitory state of fusion of `good' and `bad', a passage is now traversed from fantasy level back to the affective-perceptual dimension: anxious shouting, motoric acting out, blind rage, withdrawal, hopelessness, aloneness and emptiness ensue. For a period of an hour, the space between the dimensions fantasy and affective perceptions is vertically traversed through the tube in a vibrating manner. The vibration implies that the patient's state of mind oscillates between a fusion of `good objects' and `bad objects' on the fantasy level and a fusion of bodily perceptions. Faced with these expressions of fusion, staff members feel that the patient tries to establish a full-blown dominance over them, and their subsequent fusion of rage and anxieties reflect the projective power of the dimensions but do not help the patient change her physiological dominated symptoms.

Case example 2

        A patient is confronted by a staff member, who points out different views on the content of an interaction (the socio-interactive dimension). The patient experiences this as a lack of empathy and as neglect of her entire existence. This feeling of abandonment and attack on a benevolent object (fused at the fantasy dimension) gives rise to anger and dysphoria (in the affective-perceptual dimension) and the patient manifests feelings of emptiness, boredom and uneasiness. Subsequently, she seeks immediate pleasure and relief by means of `soothing' drugs like hash, alcohol and cigarettes.

Case example 3

        A 26-year-old single woman with borderline personality disorder was in treatment for two years when she attempted to live on her own. Her sense of being trapped in aloneness in her apartment resulted in her walking in a dangerous neighborhood late at night to `find company'. She was robbed and had no money for food and she became suicidal. In treatment, she felt that the therapist was distant and of no helps. He declared that he was suicidal from his worthlessness as a therapist, she paused and then burst out laughing. From her physiological containment in aloneness, she moved to a fantasy level of an unsuitable and punishing therapist.

        In the socio-interactive mode the therapist drew her out of her contained state to the apex of the cusp where a creative confusion allowed her to playfully re-establish a good image and alliance with the therapist. When these kinds of communication are perceived by staff, new understandings are required for therapeutic work to take place. In deciphering them, therapists and staff may want to analyze the influence of different components of the expressive attitudes of both patients and members of staff in accordance with the container model. Clinicians need to pay attention to their own language and emotions. They will often react differently to the patient's expressions of one of the three language container components. Staff who are bound by the patient's affective-perceptual expressions (those who cannot free themselves from the patients' dysphoric mood, feelings of boredom, emptiness, tiredness, and unmodulated complaints about the perseverance of symptoms), and who cannot feel free to move the focus from these `somatic' symptoms to concurrent psychic conflicts, might end up harbouring dysphoric attitudes themselves (feelings of worthlessness, emptiness, dysphoria aggressiveness), parallel to the emotions of the patient. The emotionality in the staff may then result in frustrating repetitions which lead to further impasses in the socio-interactive dimension of the dialogue.

        VII. Concluding remarks

        The container concept and the metaphor of containment are deeply rooted in notions of body and language. Indeed, the functions of the container seem universal. Metaphors and the ways in which individuals conceptualize one another are windows into and expressions of the container components, which are active in psychic functioning. Dynamic semiotics (Brandt, 1994 ; Peritot, 1990 ) has already proposed models of sufficient complexity to account for some phenomena met with in clinical work. Integrating container models from cognitive semiotic science and psycho-dynamic psychotherapy holds significant potential for providing a new perspective on clinical psychopathology. Container dynamics, illustrated by the cusp, may have potential for describing and indicating moments of therapeutic intervention in the treatment of certain kinds of psychopathology. Over a greater time span in therapy, patients may move from a domination of bodily expressions of symptoms to a more profitable integrated oscillation between the fantasy and social-interactive dimension of thinking as well.

Acknowledgments

        A grant from the Danish National Research Foundation made this study possible. Thanks to Dr Phil. Per Aage Brandt, whose generous and inventive lectures at the Center for Semiotic Research in Aarhus have provided the basis for the development of the dynamic semiotic models; the application of the models to the topic of borderline is our responsibility. Helpful critical readings by Prof. Leo Goldberger, Prof. Harly Sonne, Dr Morten Birket-Smith, Dr Colin James, and Christian Grambye have helped to provide further clarity.

References