Book Review: Boundaries and Bridges: Perspectives on time and space in psychoanalysis

Andrea Sabbadini brings together his clinical experience from a life's work in psychoanalysis with an existential interrogation of phenomena as they arise in the room. He does so through the open and receptive lens of film and literature, in writing which manages to be simultaneously accessible and rich with meaning. This book, therefore, is of interest to psychoanalysts, existential therapists and anyone with a keen interest in how the themes and experiences arising in the clinical situation can be found represented in over two thousand years of cultural expression. The book offers an interpretive medium through the arts, and in particular literature and film.

In some early chapters the book's title does not always appear uppermost on the author's agenda, and at times the links to these themes seem somewhat tenuous. This, however, never detracts from the quality of the material under discussion. Importantly, Sabbadini does not shy away from any of the big questions that are relevant to any modality, and most specifically what it is that we are attempting to do for our clients or patients. He challenges the psychoanalytic notion of 'treatment' as being central to the work, and points out that the German term behandlung, has more connotations of caring than the somewhat sterile and medical overtones of the English translation. He claims "treatment does not describe the nature of what takes place in my consulting room" (p xiv), begging the question, "If you do not intend to obtain [particular results for your patients] then why do it at all?", which he sets about answering through a model comprising three key principles: theoretical, technical and ethical. While the first is specifically psychoanalytic in its application, the latter two might be considered more relevant for the existential reader. However, the particular theoretical framework upon which one's training is based can be applied equally to the model, which Sabbadini uses to underpin and interrogate his own practice, and his interpretations and understanding, throughout the book.

While making no apologies for his assumption that many of the book's readers believe in the existence of the unconscious, Sabbadini invites readers from an existential belief system to consider the degree to which we are responsible for actions and behaviours of which we are not aware. This is explicated beautifully through use of literary metaphor, citing the case of Oedipus' marrying someone whom he does not know is his mother. It is through the interweaving of such rich symbolic material, throughout the text, that he engages the reader in understanding a common aim; namely that we are all attempting to make manifest the latent material of the client's memory, phantasy, imagination and experience, which can be conceived of in different ways and using different terminology, in order to generate greater self-awareness for the client, through being in relationship with the therapist.

Sabbadini gets to grips in Chapter 4 with the central issues in the text, and in particular the aspect of time in the analytic relationship. Through his excellent explication of the impact of temporal elements on the patient, he demonstrates the main difference between the psychoanalytic method and other forms of therapeutic help. The re-creation of specific conditions to bring about a more primitive timeless state are enabled by the very structure of working analytically for fifty minutes, five times a week, in an open-ended analysis. He claims that this coexistence of different temporalities enables a freedom from the exacting bonds of time similar to the omnipresence of time for the infant, allowing for deep connection to repressed and past states in the here and now. He draws upon rich cultural myths to exemplify the relationship between inner and outer and the boundaries in between, to show how time and space might be undifferentiated, such as in Sleeping Beauty, where the relationship between time within and outside the grounds of the castle create the conditions within which the original trauma can be worked through. His impressive knowledge of other fields, particularly myth and theatre, enrich the text as he draws upon ideas ranging back to Aristotle's Poetics, where the unity of time, place and action create the ideal circumstances for the internal drama to be played out to a satisfying conclusion, allowing catharsis as a release.

Sabbadini continues to expand upon these ideas in the next two chapters, offering interesting insights into the impact of the paradoxical nature of time-boundried sessions in open-ended analysis and, through this narrative, explores notions of endings and, ultimately, death. Other existential themes and ideas of fluidity of identity are considered implicitly, making the material interesting for the Existential Analysis reader. The method, however, is strictly psychoanalytic, in spite of Sabbadini's interrogation of purpose and meaning through existentially oriented thinkers such as Laing.

Where the book becomes less focused is half-way through Chapter 6 on the subject of the Millennium. The opening part lured me in through its expounding of unconscious and apocryphal phantasies associated with millennial boundaries and bridges, such as might appear and be explored in the clinical situation. I felt that this was not fully taken up, but rather, Sabbadini's extensive knowledge of social, political and historical material surrounding fin de siècle and millennial demarcations, appeared as an abridged history, interesting in its own right, but hard to connect to the book's ultimately psychoanalytic thread.

I found Chapter Seven, On the Couch, one of the most interesting. Counter to my expectation, I did not feel coerced into accepting the couch as a non-negotiable legacy from Freud's days. On the contrary – my own assumptions about face-to-face therapy as a paradigm for equality in the co-created relationship, were thrown into question. Through this invitation for reflexivity on some of my own previously unquestioned methods of working, I was reminded of Sartre's idea that accepting one's identity or role as fixed, rather than fluid and becoming, is indeed a kind of bad faith. This enabled me to consider the fixedness of my own approach and how it might actually conceal the imbalance of power in the therapeutic relationship. Sabbadini's contribution here was to sharpen my awareness of the requirement to take responsibility for everything said and done by the therapist, and its impact on our patients and clients. The author's openness to exploring the patients' resistance or willingness to submit to using the couch enabled valuable insights into their individual relationship to power and authority. In so-doing, Sabbadini enabled me to recognise his choice to work with the couch as an authentic reflection of the power dynamics and as an open acknowledgement of the operation of barriers or boundaries in the therapeutic situation, as distinct from interpersonal relationships in the outside world.

In addition to clinical vignettes describing the relationship between therapist and patient, for the lay reader interested in psychoanalytic models of the mind, Chapter 10 offers a good description of how internal objects are formed and relate to one another to develop thinking, creativity and a sense of self in the infant. Indeed Sabbadini's invitation to study the complex relationships between, inner, outer and between, promoted an attitude of reflection, reflexivity, tolerance and openness throughout the book.

Interestingly, the book's concluding chapter, 'In Between and Across', with its epigraph, 'We build too many walls and not enough bridges' (Sir Isaac Newton), was what drew me originally to want to review this book. In it Sabbadini brings together his deep interest in literature, culture, cinema, and myth, amongst many other fields, in a consideration of what they might bring to bear in psychoanalysis, and vice versa – and I felt encouraged by his writing to bring my own experiences from my theatre background, as another lens through which to experience the content of his thoughts and his clinical work.

There is so much more that could be examined and discussed in detail about each of the chapters, and I have attempted to give a flavour of the rich material present in the book, in the hope that the existential reader will feel invested enough to use épochè in coming to the experience of reading the book, in the same spirit of openness that they apply to their own clinical work.

The central focus is on a liminal space and time between the fixed confines of an ideology or field, where ideas can be transformed and spacio-temporal bridges might enable links and developments in understanding and thinking. Indeed the psyche itself links together feelings, experiences and learning to produce new thoughts and creative understanding, and as long as there is a safe container with appropriate boundaries in which to do so, one can see the value of such a bridge in our work for both ourselves and our clients.

For the existential reader, the reading of this book might perhaps be viewed as such a bridge, a container, where ideas from different schools hold common truths, and – in a symbiotic way – might produce new awareness, creativity and thought. I highly recommend the experience.

Donna Savery