Voices from Israel

A column by   Orly Shoshani

"Voices From Israel" - is an open space for our Israeli members. In the past few years, the Israeli Self Psychology community has soared as its activities have accelerated and expanded. Within our Israeli community we have numerous initiatives including basic and advanced psychotherapy training programs, study groups, conferences and clinical seminars. As one of its flagship projects, the Israeli organisation is conducting a pioneering project called "The Human Spirit: Psychoanalytic Buddhist Training Program" in its new campus which is based in the city of Lod, and we have slowly begun to weave the threads that enable our members and students to contribute to the therapeutic needs of this town's weakened communities.

This column is meant to serve as a platform for Israeli members to present and share their ideas, thoughts, writings and experiences, related to their clinical practice, theory and activities with the broader IAPSP community, thereby enriching our international discourse.

I am happy to present Sigalit Boneh's insightful paper:
"Exploring How Selfobject Presence Per Se Enables the "Human Spirit" to Become: Experience-Near Clinical Moments with a Toddler who Suffers from Multi-Faceted Developmental Delay". As a candidate at the "Human Spirit" psychoanalytic-Buddhist training program taking place in the city of Lod, Sigalit shares with us experience-near clinical moments from her meetings with two and a half years old Ronny. Sigalit introduces us to a unique therapeutic setting called "escort" and its relevancy to the Buddhist - Self Psychology approach, which is part of the program's first eighteen months by describing the sessions she had with Ronny that all took place in his day to day environment rather then in the therapy room.

Exploring how Selfobject presence per se enables the "Human Spirit" to Become: Experience Near Clinical Moments with a Toddler who Suffers from Multi-Faceted Developmental Delay.

By Sigalit Boneh

"Human Spirit", a psychoanalytic-Buddhist training program in Israel, includes for the first eighteen months an introduction to psychoanalytic therapy, in which the students meet four hours per week with a patient in an escorting framework. Instead of having the patient step out of his or her everyday milieu and come to the clinical setting and therapy room, it is the therapist who comes to him and escorts his daily routine, wherever it may be. The aim of this unique setting, which we have called 'Escorting', is to exercise the presence of the selfobject per se as it manifests itself in the world. I believe this has revealed a bridge that renders help and therapy more accessible to a weaker population, to people who experience suffering and deprivation, yet are unable of their own accord to cross the gap between the reality of their life and the therapy room - be it physical, economic, emotional or cultural. In my case, the bridge became a two-way crossing and after a year and a half of escorting, both the escorted patient and I were able to move on to psychoanalytic treatment at the clinic. However, I here wish to focus on the escorting part, especially its beginning, and to observe more closely how the manifestation of the selfobject of a toddler, diagnosed as autistic, formed his emotional space and reinstituted his connection with the human world.

I first met Rony when he was two and a half years old, a toddler who suffered from multi-faceted developmental delay and was diagnosed as autistic. To the observer he is clearly a child well-cared for and loved by his parents, always clean and beautifully dressed, yet his face and his eyes are void of expression. He doesn't raise his eyes or present his face to the other. He lacks any face-to-face encounters, and precludes any such encounter with anyone seeking it.

Instead, his face carries bruises and sores, traces of his encounter with the world. Things collide with his face, they strike him before his eyes perceive them. Or, conversely, when he tries to reach or make contact with something, he falls down in the alien space between him and the object. He has no body image, no awareness of the space he is in. Rony is in constant motion, running from one thing to another. He falls, gets hit, collapses, is thrown off his course. He doesn't express pain or opposition, and he doesn't stop, he just continues forward and onward in quick motion. I imagined him as a consciousness lost in time and space, shapeless and unattached, moving ceaselessly in a stubborn attempt to encounter something familiar, comprehensible and permanent, where it could reside and rest.

When I began working with Rony, I myself completely entered the space he occupied, body and soul, and learned to see the world through his eyes, predicting his intentions and the path of his movements. My experienced hands learned how to complete the spaces for him so that he wouldn't fall, to move aside the barriers in his way, to open the doors and gates, to hit all the right switches, so as to provide him with an open space in which he could function in the world.

At the nursery school, covering the big door that exits to the play yard, is a large, wide, rolling electric shutter. This shutter was Rony's most beloved object and I learned to see it from his perspective: it is a rational, amazing mechanism of immense movement that lurches upward and then comes all the way down, without the force of gravity, without weight or effort, and it is operated by a small, comprehensible movement of one finger on the switch. The movement of the shutter embodies the partaking and enjoying of the beauty and force of motion in the world together with the pleasure of individual competence, of mastering initiative and action. The ideals together with grandiosity, the two facets of the experience of the self, are here intertwined inseparably.

Of course, the nursery school children were forbidden to touch the switch, which was located high up on the wall, far from the reach of Rony's willing hands. However, at times when the two of us were alone in the nursery school, a different set of rules took hold. Immersing myself in Rony's perspective spawned a single body that was able to easily and safely allow Rony's finger to reach the switch, for no other reason than to enable him to be both the doer and the witness of this wondrous motion in the world.

According to Kohut, in the first archaic stage the connection between the self and the selfobject is that of merger. The other does not exist as a separate entity, but rather as an extension that, through its presence, can determine whether or not a self-body will emerge, which functions as a cohesive unit of orientation and movement in the world. I do not exist as yet in Rony's consciousness, but he does. In answer to my question, "Who opened/closed the shutter?" he replied happily and proudly, "Shutter... I". The clearly defined movements in the world generated a coherent self-body experience within him that manifested itself in his answer, "I". Indeed, the cohesive and coherent movements also gave birth to language and words.

Immediately after this cohesive self-body emerge, he discovers that within this space between him and the shutter there is also the other person, someone who knows and feels with all her heart the immensity of this amazing occurrence. At that moment Rony has no problem lifting his gaze up at me, presenting his face to me, all lit up with excitement and joy, and discovering that my face too registers and reflects the same feelings. This is a more advanced stage in which the self is emerged, not by the merger with the body of the other, but by his/her resonating glance. The merger with the selfobject is based on similitude or twinship.

The shutter, just one example out of many, illustrates how Rony's face-to-face encounter was born and became something so simple and accessible to him. As if he had never had a developmental problem in making eye contact, as if this complex function had simply been superfluous and void of significance. Opening up the empathic channel between him and the other is what returned this function to Rony all at once, and not just between us. Rony became an open child, talking and communicative, full of love and happiness towards the other, so much so that his diagnosis and placement in the educational framework changed. That isn't to say that all his problems were solved and all the developmental gaps were closed. However, today Rony has no communication problems. On the contrary, his relationship with adults and later on with his peers became his strong points.

I may add that in relating to the shutter, other aspects were included - shape and body, motion and space. I couldn't imagine that, already then, it contained far broader meanings that had also waited for an empathic resonance in order to be born. A few days later, while all the children and staff were in the play yard, Rony sneaked inside, climbed on a chair and from there on to a table and pressed the electric switch himself. The shutter that came down confined everyone to the yard, while he remained inside, in sole control of the switch. I was later called in for a talk and duly reprimanded. Of course I understood and was very sorry about the potential danger and the discomfort caused to the children and staff. Yet part of me was glad and even laughed at the rather humorous situation that Rony had staged.

Beyond the motion in space and its physical existence, opening and closing the shutter also contained a certain wrangling and dramatization of questions that unfold in the expanse of human and emotional existence. Who is included and belongs, and who is excluded and locked out? Who here is captive in the world of will of the other and who lets his own will lead and determine? I know this also because these issues were repeatedly dramatized in clearer ways during our joint work later on, especially when analysis began. But that belongs to another chapter.

Before ending, I would like to describe another much-loved situation, which took place at the end of a day's vacation from nursery school, while I was at Rony's home, involved in all the routine activities of a toddler and his caregiver - playing together, going to the toilet, lunch and a shower - life. As the afternoon nap was approaching, Rony, washed and relaxed, with the sweet fragrance of all beloved infants, was lying on his bed, watching the children's channel. There, in that animated world, the lawn is always green and the water is always blue. The animals are colored pink and light blue and they jump around, chatter and laugh in sweet voices. Rony laughs with pleasure, his hand seeks out and finds mine, as if he is saying to me, 'Look, look'. 'I see a little boy, I see the sweetness, the open wisdom, the pleasurable laughter and the life within you', my hand says to his hand through its loving touch. He turns his head and looks into my eyes with surprise. And for a moment, once again, all the beauty of the world is spread out between his eyes and mine.

And what do the Buddhist studies contribute to this observation? In order for Rony to be able to live in an actual reality, clearly he must develop a cohesive self. To the question of who opened/closed the shutter, he gives the answer, "I". He doesn't know nor needs to know that behind his finger not only I am standing, but also all the teachers in the program - the psychologists and the Buddhist monks, the supervisors, the steering committee, the generous donor who made this program possible, the city's welfare and educational personnel, Rony's parents, and also of course Kohut in his philosophy and spirit, Emmanuel Levinas, Raanan Kulka, the Buddha Nature... and so much more, without an end. In the ultimate reality there is an entire world standing behind him and, and as in Barak Obama's campaign slogan says: "Yes (together) we can!"

Sigalit Boneh is a candidate in "Human Spirit" Psychoanalytic-Buddhist Training program in Israel. She is a clinical psychologist and supervisor, member of the Israel Association for Self Psychology and Graduated Self Psychology Psychotherapy Track at the Tel Aviv university. She has been the chief Psychologist in the psychosocial service for residential education, and was involved in the development of guidance and treatment of adolescents in boarding schools.


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