Where Are You Speaking From?

Dr. Nilofer Kaul

Using poetry to illustrate her concepts, Dr. Nilofer Kaul takes a look at different stances to a breakdown and examines relationships to pain and to internal objects.


The term “breakdown” is used loosely to indicate a collapse of functioning, a breakdown of contact with  objects in the external world. Within psychoanalysis there are, however, other ways of imagining this collapse.  When pain crosses the threshold of endurance, the ego seems to withdraw into itself and rejects the world. This does not necessarily indicate fragility. In fact Winnicott argued that the patient who has been holding himself together by mobilising a “false self”, by erecting a crust around himself, is seeking to live authentically and to participate in the uncertain vagaries of life. Here, he introduces a new vantage point from where we can view a breakdown as coming from a desire to live spontaneously.

Profoundly he observes here that “the clinical fear of breakdown is the fear of a breakdown that has already been experienced. It is a fear of the original agony which caused the defence organisation which the patient displays as an illness syndrome.”   Freud’s idea of nachtraglichkeit  (the idea that memory takes shape from the present) is all ablaze here as Winnicott overlays the past with the present.

Alvarez’s work on levels of analytic functioning gives cues to where the patient may be at any particular moment. Her stratification of psychic functioning extends into locating different kinds of breakdowns. There is the frail self that shatters which may just be endgame. But for someone who is mostly autistic, a depressive breakdown ushers in a greater contact with his feelings as well as with pain he may have caused to others. Thus the term ‘breakdown’ might indicate not just fragility but a willingness to undergo suffering, whereas a flight/fight from pain may indicate psychic inelasticity.

In fact the most recalcitrant situation for me is the patient who has flown into delusion and omnipotence and will not be brought back; counter to the popular idea, one may say that the patient who refuses to breakdown is the one who has no capacity for truth. 

This reminds me of patient J who was in her 40s, very much financially and otherwise dependent on her family, but who seemed to have adopted a permanently manic front. She was coming only because her “sister was a hysterical bitch”. The family just wanted to outsource their duties, but J wasn’t “anybody’s fool”.  She said she would not actually come for her sessions, but would take the money for them for her fees. She had “hooked up” with dealers on dark web who would buy illegal stuff from her, she would then make her billions and live on her own island. She could buy herself a partner and get surrogate mothers to have her babies. “I’ve got it all sorted out”.  The work with J did not last. The breakdown could only be a holocaust, so rather like Milton’s Mammon she took refuge in equivocating. Mammon consoles the fallen angels upon their loss of heaven saying they should be grateful that in hell they are  “free, and to none accountable, preferring hard liberty before the easy yoke of servile pomp.”

Much of this may or may not be communicable through the manifest verbal content of the communication, but may rest in the syntax, the use of tense, the vertex of locution and the voice itself.  Is the patient keeping a distance from the breakdown by playing it down? Sometimes teaming up with the analyst and looking askance at something that happened long ago. Is the distance from the breakdown too great for us to travel?

 What in the syntax tells us there is a breakdown around? Was it long ago? Or is it happening in the here and now? Is the response to surrender or to fly? This brief paper — using poetry — locates different stances to a breakdown and examines the syntax of the relationship to pain and to internal objects.

1. Keeping a distance from it
Here for instance is Emily Dickinson who may well be describing a breakdown in: 

It Was Not Death

When everything that ticked - has stopped -
And space stares - all around -
Or Grisly frosts - first Autumn morns,
Repeal the Beating Ground -

But most, like Chaos - Stopless - cool -
Without a Chance, or spar -
Or even a Report of Land -
To justify - Despair.

This is very unmistakably the landscape of a breakdown of contact with reality, and deeper still, it is when the internal objects ( here embodied as time and space) that hold us in place lose their meaning. These two dimensions that anchor us, lose elasticity — time atrophies and spaces expand.  Again the ground  (or mother) is no longer visible, beaten down by the invasion of  hostile objects such as frost which makes the chaos unstoppable. The good objects are taken over by the hostile ones.  But this poem seems to be written afterwards — when the chaos gives way to some memory that organises the experience and maps the contours of it. The acuity of the description, the precision, makes evident the speaker’s wish to keep a distance from the pain. It is hard to tell whether it is a memory of the past or whether the non-psychotic part is describing the psychotic part.

In  'I Measure Every Grief I Meet',  the speaker wittily compares her suffering with those of others. Here is a recognition of human suffering but there is a possibility of playful irony, when she does not just look but looks with “ narrow, probing Eyes”, as if there were also a degree of rivalrous superiority:

I measure every Grief I meet
With narrow, probing Eyes- I wonder if It weighs like Mine-
Or has an Easier size…

Dickinson also ends by mock-elevating her suffering to that of Christ’s through her mention of Calvary:

A piercing Comfort it affords
In passing Calvary-
To note the fashions - of the Cross-
And how they’re mostly worn-
Still fascinated to presume
That Some are like My Own.

There is a playful pun on fashion — as in both popular style as well as manner of doing something. What kinds of badges of suffering are there and how do people display them? It is a matter of speculation whether any of them resemble hers or not. This constraint makes it very poised. You are invited to see her witty gestures, but you are kept firmly outside the breakdown. The distance from pain is established by the playfulness and the precision. The equipoise between wanting to speak of pain and keeping a distance from the place of suffering, makes for a tension which indicates  fragility, more than the words themselves that seek a seamlessness.  

2. Wrestling with it
Unlike Dickinson who writes from a distance Silvia Plath’s speaker in 'Tulips' attempts to split off her madness by projecting it into the flowers which acquire the shape of  a “bizarre object”. Here tulips are used as a mad double as she describes a hospitalisation after a breakdown:

The tulips are too excitable, it is winter here.
Look how white everything is, how quiet, how snowed-in.   
I am learning peacefulness, lying by myself quietly
As the light lies on these white walls, this bed, these hands.   

This sounds like peace, except it is more like a submission to a medical routine, incarcerated into well-being: 

I have let things slip, a thirty-year-old cargo boat   
stubbornly hanging on to my name and address.
…the water went over my head.   
I am a nun now, I have never been so pure.

But this state is not calm; disorganised objects won’t be contained:

The tulips are too red in the first place, they hurt me.
Their redness talks to my wound, it corresponds.

She is too easily disturbed by these blood red flowers from whose perspective she can

… see myself, flat, ridiculous, a cut-paper shadow   
…I have wanted to efface myself.   
The vivid tulips eat my oxygen.

There is a dualism here reminiscent of Manichean drama here. Much like the conflict there between dark and light, the psychotic and non-psychotic parts are in a deadly combat. The psychotic part is exploding from an inadequate container (hospital).  As the speaker attempts to distance herself from the psychosis that threatens to overtake her mind, her voice becomes more frantic and terrified:

The tulips should be behind bars like dangerous animals;   
They are opening like the mouth of some great African cat…”

The last lines of the poem take a more depressive turn where fragmentation can be admitted to:

The water I taste is warm and salt, like the sea,
And comes from a country far away as health.

This to and fro is reminiscent of moments in our sessions with patients who bring us the experience of bizarre objects.  Patient Sudha who keeps giggling throughout the session because there is a new chair now. “It’s watching us”, she keeps repeating. “I feel it’s staring at us.” Sudha is unable to find words for the experience, but the chair is a patchy internal object that seems to be cobbled together with bits and pieces of shredded internal objects. Like the tulips, the chair keeps a frayed ego from falling through.

3. Speaking from the abyss
Then there is T.S.Eliot’s early poetry which stays immersed in the experience of having a breakdown where hallucinatory voices multiply and there is no semblance of coherence. We may in fact read The Wasteland  as a description of fragmentation in the way disconnected voices follow in random order; a psychotic breakdown:

“You gave me hyacinths first a year ago;
“They called me the hyacinth girl.”
—Yet when we came back, late, from the Hyacinth garden,
Your arms full, and your hair wet, I could not
Speak, and my eyes failed, I was neither
Living nor dead, and I knew nothing…

Or the experience of derealisation:

Unreal City,
Under the brown fog of a winter dawn…

The breakdown of language reflects the debris within:

Twit twit twit
Jug jug jug jug jug jug
So rudely forc’d.

This is actually made explicit in:

On Margate Sands.
I can connect
Nothing with nothing.

The poem can be read as a map of barren relationships with splintered internal objects whose voices only amplify the fragmentation, the speaker is in the space of a breakdown. It embodies the disconnection and breakdown rather than describe it from memory. Most of us may recall patients who have whispered incoherently to us, unable to sew into words the debris that marks their internal world. The incoherence of dissonant internal objects who seem to blink and intermittently come alive as a travesty of real presences. 

From the equivocation of Mammon, to the equipoise of Dickinson, the failing battle with psychosis in Plath to the surrender in Eliot, we can hear different relationships with breakdown states. In different moments we may hear these varied tonalities: when like Superman, someone takes wing in delusions, at other moments watching the madness with ironic detachment as if it were another person, or else fighting with it, having put it into something else and finally, the moments when all contact seems broken and the voices remain hallucinatory. 

Alvarez, A.(2010). Levels of analytic work and levels of pathology: The work of calibration.91:4. 859-878.
Bion, W.R. (1957). Differentiation of the Psychotic from the Non-Psychotic Personalities. Int. J. Psycho-Anal., 38:266-275.
Dickinson, E. (1970).The Complete Poems of Emily Dickinson. New Delhi: Kalyani.
Eliot, T.S. (1963). Collected Poems. London: Faber.
Freud, S. (1918). From the History of an Infantile Neurosis. S.E. XVII.
Milton, J. Complete Poems. Harvard Classics:1909–14. 
Plath, S. (1960). “Tulips”. http://www.poetryfoundation.org/poem/178974 [Accessed 6 Aug. 2015].
Winnicott, D.W. (1974). Fear of Breakdown. Int. R. Psycho-Anal., 1:103-107.

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