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    Lisa Pistiner de Cortines

    On Mental Growth. Bion's Ideas that Transform Psychoanalytic Practice.

    Karnac, London, 2017, $36.8 (US), paperback.

    Edwin Harari

    Having done all my professional training in Anglophone countries, I was surprised by the seeming widespread acceptance of and respect for psychoanalysis and its related therapies which I encountered when visiting the Spanish speaking countries of South America, particularly Argentina. Those countries have a long and proud tradition of clinical practice and theory development in psychoanalysis, only a fraction of which appears in English in either the published literature or at conference presentations.

    That is why the book under review is so welcome, even though it appears in an English translation four years after its original publication in Spanish. It is an exemplar of the best of psychoanalytic thinking and practice from Argentina by an author who, I am ashamed to acknowledge, I had not heard of until reading this book.

    Bion and his ideas are its subject. Unlike most of my previous experiences of reading books by or about Bion, I actually enjoyed reading this one. As you might expect of any book that offers an explanation of Bion’s ideas, the usual suspects are assembled and reviewed: a biographical summary of Bion , an explication of his ideas including basic assumptions and group dynamics, preconceptions, clinical facts, alpha function, contained-contained, psychotic aspects of the personality, plus K and minus K, the enigmatic “O” and a particularly interesting chapter on the functions of dreaming. But a mere listing of topics does not do justice to the thoughtfulness and elegance of the author's writing, the clarity and aliveness of her exposition of ideas that could so easily have become dutiful, mechanical and sterile summaries, and her respect for Bion's lived experiences which informed his ideas and clinical practice.

    The author presents her subject in terms of two emerging, immanent quests, both related to Truth viz the growth of the capacity to know, which is addressed in the first part of the book, and the growth of the mind, which occupies most of the second part of the book and which concludes by elaborating one of Bion's lesser understood concepts using a term borrowed from Aristotelian biology, namely “tropism”.

    Both these inter-related domains carry highly contested historical and philosophical freight which Bion systematically distilled in constructing his infamous familiar ‘Grid’. The author does not dwell too long on this.

    While she provides summaries of each of Bion’s main ideas she is careful to refer the reader to Bion's original texts at every point, maintaining throughout a writing style which is admirably light and discursive but disciplined. She also illustrates her interpretations of Bion with references to works in popular culture, including two perceptive, chapter-long studies of two films, “Pi” and “Twelve Angry Men”.

    While this book, like most of its predecessors, touches on the likely influence on Bion of poets and the mystics and specifically of the philosopher Immanuel Kant and the mathematician Henri Poincare, these are just glances which do not interrupt the reader’s attention to Bion’s creative assimilation of these thinkers in the evolution of his own ideas. Indeed, as the book notes, Bion memorably said that ‘the psychoanalyst and the philosopher struggle with the same questions. The only difference is that the next day, the psychoanalyst faces the patient.’ (author, date, page number and reference in reference list at the end).

    As the book demonstrates, for Bion as a psychoanalyst, the search for Truth is not the result of detached armchair reflection and the impersonal application of the rules of logic or clinical algorithms, but originate in a “catastrophe”, (I would leave in catastrophe) a process of internalisation, rearrangement and transformation of the constitutive elements of psychic life. As is well known, Bion used biological metaphors of the activity of the alimentary system to represent this activity of the mind, which, in turn nourishes the mind and promotes its growth.

    Bion characteristically eschewed founding his own school of psychoanalysis and discouraged discipleship, while remaining actively engaged for many years in seeking non-destructive, non-idealising resolutions of the unavoidable interpersonal, organisational and political tensions which arise in psychoanalytic training and practice. I think that he understood psychoanalysis as emerging from and contributing to two great traditions of civilisation: that of thinking i.e. the human will to know Truth, and healing i.e. the human wish to heal suffering in oneself and others.

    What human infant could aspire to do otherwise? And what price the inevitable failure? And how are the effects of such failure to be mitigated by individuals and society for whom neither Truth nor immortality are attainable?

    I strongly recommend this book and congratulate the author. She has provided us with a refreshingly clear and useful guide to a great psychoanalytic thinker whose ideas are often difficult to understand but who always kept in mind the suffering patient and fallible psychoanalyst.

    Edwin Harari
    Clinical Associate Professor | Department of Psychiatry, University of Melbourne.
    Consultant Psychiatrist | St. Vincents Hospital Area Mental Health Service. Fitzroy, Vic 3065

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