Article

Trauma and psychoanalysis: Freud,

Bion, and Mitchell
C. Fred Alford
Department of Government, University of Maryland, College Park, MD 20742, USA.
E-mail: calford@umd.edu

Abstract A key problem for trauma theory is bringing internal and external sources
of distress together, paying sufficient attention to each. While Wilfred Bion is well-
known among psychoanalytically-oriented trauma theorists, the relevance of his work
to trauma is not always fully appreciated. Bion focuses on the inability to know. Freud
made Eros and death the driving forces of the psyche, particularly in his later work;
Klein made love, hate, and reparation central; Bion makes knowledge central. In con-
clusion, I turn to Stephen Mitchell in order to explain how focusing on the inability to
know helps us better understand trauma.
Psychoanalysis, Culture & Society (2018) 23, 43–53. https://doi.org/10.1057/s41282-
018-0070-7; published online 7 February 2018
Keywords: trauma; Wilfred Bion; Melanie Klein; Stephen Mitchell; psychoanalysis;
concept of O

Trauma theory poses a real challenge to psychoanalysis, for it makes the

intrapsychic secondary. Trauma originally referred not to a psychic state,
but to the blow that causes it: ‘‘blunt force trauma,’’ as it is often called in
physical medicine. Psychoanalysis cannot content itself with analyzing the
psyche. It must deal with the intrusion of the external world into the inner.
Of course, psychoanalysts do this all the time, but usually don’t make it their
thesis. Arguably, they should.
Several well-known trauma experts trace the de-emphasis of the external
world back to Freud. Judith Herman (1997, pp. 13–14), Bessel van der Kolk
(2014, p. 181), and Arthur Blank (2014, p. 285) believe that Freud was
mistaken in his later argument that women’s accounts of sexual abuse as
children at the hands of fathers and relatives were fantasies. All three
attribute Freud’s alleged mistake to his desire to fit in with Viennese society.

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www.palgrave.com/journals
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To hold that there was so much sexual abuse going on in bourgeois Vienna of
his time would have risked becoming an outcast. Most readers will recognize
that this argument is not quite so simple, for much of Freud’s later theory rests
upon his rejection of the seduction theory, which in turn opened the way for his
account of the dynamic unconscious, the foundation of what we do as
psychoanalysts and psychoanalytic theorists (Joyce, 1995).
Trauma theory continues to depend heavily on Freud (1898/1962), partic-
ularly his concept of Nachträglichkeit. Adam Phillips (1996) has perhaps the
clearest definition of the term: ‘‘In one sense, Freud’s theory of deferred action
[Nachträglichkeit] can be simply stated: memory is reprinted, so to speak, in
accordance with later experience’’ (p. 33). One does not remember the trauma;
one remembers the memory of the memory of the trauma. In another letter to
his friend Fliess, dated 6 December 1896, Freud writes of ‘‘memory traces being
subjected from time to time to a re-arrangement in accordance with fresh
circumstances – to a retranscription’’ (Freud, quoted in Phillips, 1996, p. 34).
Jean Laplanche (1999), who wrote extensively about Freud’s concept (often
translated as ‘‘afterwardness’’ or ‘‘après-coup’’), holds that for Freud it is not the
original intrusion but the memory of that intrusion that is traumatic. As
Laplanche (quoted in Caruth, 2001) puts it, ‘‘it is not the first act which is
traumatic; it is the internal reviviscence of this memory that becomes
traumatic.’’ Eickhoff (2006) elaborates on how Freud developed his view of
Nachträglichkeit over the course of decades, struggling with the question of
how later events could alter the memory of previous experiences.
The claim by van der Kolk, Herman, and Blank that Freud rejected his
original seduction theory, early or late, out of cowardice, and specifically his
fear of the censure of Viennese society, is interesting not so much because it
seems to be false (Freud’s motives had more to do with problems internal to his
theory), but because there is a certain literal-mindedness among some who think
that the concept of post-traumatic stress is theoretically and politically useful.
Bertolt Brecht admired plumpe Denken, clumsy thinking, or thinking that does
not try to be too clever. Often, that can be a good thing. Clever people can
become wrapped up in their own theories, and forget what their theory is about.
In the case of trauma theory, we are concerned with human suffering, where it
comes from, and how much traumatic suffering can take from us. The answer is
everything: above all, the ability to live life now, rather than being caught in the
endless loop of history.
For many years Bion was considered the intellectual successor to Melanie
Klein, the founder of object relations theory. His elaboration of projective
identification as a means of communication, and his theory of container and
contained, became fundamental to Kleinian theory, as the ‘‘basic components of
the ‘post-Kleinian’ episteme in London’’ (Grotstein, 2007, p. 20.) Subsequently
Bion developed his concept of O, which represents the absolute, though the
absolute of what is the question. I think O represents the absolute of trauma.

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However, most of what Bion wrote about O is more recondite, Zen-like. In any
case, Bion’s elevation of O resulted in his fall from grace in London
psychoanalytic circles, in which he became a ‘‘pariah of O,’’ in Grotstein’s
phrase (p. 20). (The pariah subsequently moved to California, where he received
a warm welcome.)
Through the abandonment of ego, we become O. The analyst achieves this by
living ‘‘without memory or desire or sensation,’’ entirely within the moment, but
O is not a strictly psychoanalytic concept (Bion, 1967a). Encountering O means
encountering reality in as unmediated a fashion as is possible for humans. O is
beyond words, beyond symbols. It resides within as much as without, so that O
is as much about being in immediate contact with one’s unconscious as it is with
the external world.
Those who write about Bion in a sympathetic vein, such as Grotstein and Meg
Harris Williams (1985), think that he may have reached O when he ‘‘… died on
the Amiens-Roye road on August 8, 1918,’’ as Bion puts it in an autobiography
originally published more than fifty years later. Throughout his adult life, from
a diary written for his parents to several volumes of autobiography and a
memoir forty years after the event, Bion refers to his experience as a teenage
tank commander in World War I. By the age of 20 he had already been
nominated for the Victoria Cross (Britain’s highest military honor), and
awarded the Distinguished Service Order (DSO).

As Kay Souter (2009) puts it,

[h]is autobiographies have the quality of survivor testimony, with the
associated emotional numbness, low self-esteem, grief and guilt. Editing
the fragment ‘Amiens’ after his death, Francesca Bion [his widow] gave the
title ‘Fugue’ to this account of 8 August, explaining it as ‘meaning ‘‘loss of
one’s identity.’’’ Although she does not further explain, it is clear that she
understood it to be an account of psychic flight and catastrophe. (p. 796)

Portions of ‘‘Amiens’’ are written in the third person, as in ‘‘Captain Bion had
felt extremely frightened.’’ A runner, Sweeting, accompanies Bion into battle,
and, amidst explosions, Sweeting and Bion take cover in a shell crater, with the
young boy, as Bion calls him, pressing up against him. Suddenly Bion (2015)
becomes aware that the boy’s chest has been ripped open by shrapnel and his
left lung is gone. Gusts of steam emerge from the void in the boy’s side (‘‘Why
can’t I cough, sir?… Mother, Mother, write to my mother, sir, won’t you?
You’ll remember her address, sir, won’t you? 22 Kimberly Rd, Halifax. Mother,
Mother, Mother’’ (p. 255)). It is only in his last account, ‘‘Amiens,’’ that Bion
describes his horror and repulsion. As Sweeting keeps begging him to write his
mother, Bion began to vomit repeatedly.

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‘Oh for Christ’s sake shut up,’ shouted Bion, revolted and terrified. ‘Write
to my mother, sir, you will write to my mother, won’t you?’ ‘Yes, for
Christ’s sake shut up.’ I wish he would shut up. I wish he would die. Why
can’t he die? Surely he can’t go on living with a great hole torn in his side
like that. (p. 255)

Eventually the dying man is carried away by two medical orderlies ‘‘Well, thank
God he’s gone, thought Bion, filled with passionate hatred of himself for his
hatred of the wounded man’’ (p. 290).

Relevance to Bion’s Theory: Attacks on Linking

Where Freud and Klein made love and hate central to psychic life, Bion adds
knowledge, particularly the inability to know. The inability to know results
from the failure to have found someone, generally in early life, willing and able
to contain unbearable feelings, feelings that cannot be put into words, but have
more the quality of fragments of feelings. It is only by encountering another
mind willing and able to hold these unbearable pieces of feeling that one can
learn to put them together for oneself.
Those unfortunate enough not to have someone to hold the pieces together
have experienced their first trauma (unless one believes in birth trauma), and
about experiences such as these it is difficult to say whether the locus of the
trauma is inside or outside. There are times and places, particularly in early life,
where the distinction between inside and outside is unclear. The category of
C-PTSD, or chronic PTSD, was intended to include early attachment-related
traumas such as this. It was not accepted by DSM 5, which continues to define
trauma solely in terms of external agency. An attenuated version of C-PTSD is
scheduled for inclusion in ICD 11 in 2018 (Alford, 2016, p. 16).
Uncontained emotional experiences result not just in our inability to know
these experiences, but in the attempt to destroy connections between our
associations, creating isolated islands of knowledge that cannot be connected in
thoughts or sentences. Attacks on linking are attacks on the associations
between thoughts that make knowledge possible.
The latter her patient after the war, Klein failed to analyze Bion’s dread,
presumably because trauma of the type Bion experienced was not an analytic
category of hers. For Klein, psychic experience comes from within. The result
was to leave unanalyzed, and thus untreated, the part of Bion ‘‘who was
amberized on the holocaustal side of O,’’ as Grotstein (2007) melodramatically
puts it (p. 119). Or, as Bion (1991) put it over fifty years later, ‘‘I would not go
near the Amiens-Roye road for fear I should meet my ghost – I died there. For
though the Soul should die, the Body lives forever’’ (p. 257).

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The Desire to Know

Bion’s great contribution to psychoanalysis is to see that, beyond the primary

passions of love and hate, there is an intrinsic desire to know, and that the
frustration of this desire, or rather its fragmentation in the face of terror, is as
destructive of Eros as hate. Ever since Plato’s Symposium, love wants to know,
and hate would break what we know into pieces in order to save us the horror
of knowing. Only it’s a doomed battle: the ignorance that would save us (what
Bion calls –K, or minus K) empties the world of the connections that give it
meaning, and life its vitality. Or, as Bion (1967b) puts it, ‘‘it is a short step from
hatred of the emotions to hatred of life itself’’ (p. 107).
Bion recognizes that unresponsive mothers, or anyone who fails to contain the
fragments of early or unbearable experience, make it more difficult for those
they care for to think. But in one of the less attractive aspects of the Kleinian
tradition, he tends to blame the victim, attributing the ‘‘failure to suffer’’ to a
character flaw (Bion, 1984, p. 7; Levine, 2011, p. 188). By ‘‘failure to suffer’’
Bion means the inability to acknowledge and bear the reality of experience. Of
course, character is itself partly an expression of upbringing, and so one could
go around and around about who is to blame. In the end, perhaps, it doesn’t
matter.
Or does it? What if we think about trauma as the rupture of the container?
The ability to contain experience, that is the ability to link associated
experiences, may be lost in the face of trauma, understood as unbearable
experience: ‘‘knowledge as disaster,’’ as Maurice Blanchot (1995, p. ix) puts it.
In the face of knowledge as disaster, the ability to link or associate experiences is
lost. It has nothing to do with a character flaw.

Rupture of the Container Explains the Symptoms of Trauma

The failure of linking accounts for many of the symptoms of trauma, from
flashbacks of isolated bits of experience, to the loss of a sense of time, in which a
split-off piece of time, the traumatic experience, is taken out of the flow of
experience, and so never becomes part of the past. The inability to put words to
the traumatic experience, or the enormous difficulty involved, is also a
consequence of the inability to associate experiences, and so put feelings into
words about feelings. More global traumatic reactions, such as the attempt to
damp down all experience, are a defense against the inability to associate
experiences, for in a dissociated world one can be surprised and overtaken at
any time by bits of experience.
To characterize these symptoms of trauma as attacks on linking stands in
opposition to the way Bion (1967b, pp. 101–102) himself sees attacks on linking:

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as an act of what Klein calls paranoid-schizoid rage at experience, designed to

shatter the experience and perhaps to protect the vulnerable container. From the
trauma perspective, attacks on linking are not the result of an internal rage at
experience, but an external assault, penetration, or blow – that is, trauma. As
previously noted, the term trauma originally referred to its cause. Only later did
psychoanalysts and others use the term to refer to its effect on the psyche.
This reflects an important way in which the trauma perspective on
psychoanalysis changes the way we think about inner and outer worlds. From
a strictly psychoanalytic perspective, all the action is within: people create links,
people destroy links, and so forth. While there is recognition of the role of
another person as container while these links are being formed – a role almost
always attributed to mother—there is little acknowledgement of the external
forces that can shatter even a securely built container (that is, the self), and the
links that have been made there. Though Bion didn’t think about attacks on
linking as destruction of the container, that seems to be how trauma works.
Trauma rips open even the most well-sealed container.
In her account of Bion’s constant return to the experience of comforting (or
rather failing to comfort) his dying runner, Souter (2009) says that Bion knew
that he could not let Sweeting’s suffering in, for to do so in the midst of combat
would have destroyed him. Bion could not contain such suffering alongside his
own dread, and so he told Sweeting to shut up, shutting him out. But this was
not without cost—immediate cost, as Bion vomited up his own insides, as
though to empty himself of all he contained; and long-term cost, as he dealt with
this trauma for the rest of his days, or at least well into his sixties. Bion’s guilt
was in not making himself available to Sweeting as a container for his terror at
dying. Who could in Bion’s circumstances? Only a far nobler man or woman
than most who walk the earth.
But if Bion could not make himself available to Sweeting as a container in the
midst of battle, he let himself be used as a container, someone who might hold
together the fragments of another mind until the mind could take them back in
the form of associations and links. Bion was traumatized by war, which is why
his theory is such a good trauma theory. Otherwise expressed, he recognized
that, along with love and hate, we need to know. To know, we have to be able
to think, which means being able to put thoughts together. Trauma destroys this
ability, whether it happens to an infant whose mother cannot contain his or her
bits of thought, or to an adult whose own developed ability to contain his or her
associations is destroyed by trauma.

What this Means for Psychoanalysis

Grotstein (2007) argues that the concept of O transforms psychoanalytic theory.

The pleasure principle, the death instinct, what Melanie Klein calls the

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paranoid-schizoid and depressive positions—all become defenses against the

experience of O, what Grotstein calls ultimate being (p. 121).
I think Grotstein is right, but I would put it differently. The experience of O is
similar to what Jacques Lacan calls the real. ‘‘The real is impossible,’’ says
Lacan, by which he means that it is beyond language. As adults we most
frequently encounter the real whenever we are forced to confront the materiality
of our existence. This encounter is often experienced as traumatic since it
challenges our sense of reality: the symbolic way in which we have ordered our
defenses against the real. That is, the way we get on with life. As Lacan puts it,
‘‘the real is that which does not depend on my idea of it’’ (Lacan, quoted in Fink,
1995, pp. 142–143).
From this perspective, virtually every concept of psychoanalysis is a symbolic
attempt to master the real, to make it a matter of a reality that can be
symbolically mediated and made knowable and acceptable to humans. In other
words, psychoanalysis is a defense against trauma, the intrusion of that which
cannot be symbolically expressed and mediated. This includes not just
psychoanalysis, of course, but all of human expressive activity that is in any
way symbolic.
Psychoanalysis is not simply a search for the truth of the inner world.
Psychoanalysis is, on the one hand, a search for the way in which we defend
against the real. At the same time, this search is the defense.
One might argue that there is a parallel or analogy between psychoanalysis as
a defense against the real and the experience of trauma. I would argue that the
experience of the real is trauma, and that all of psychoanalysis is an organized
defense against this trauma. Better an organized than a disorganized defense in
most cases, for an organized defense keeps us from going crazy. But it is
worthwhile and important to step back and see psychoanalysis in this light.
I think this is what Bion’s O did for him, especially if we see O as Bion’s way
of talking about an intensely traumatic experience from which he never fully
recovered. His increasingly imaginative and inventive autobiographies, partic-
ularly A Memoir of the Future (1991), are an attempt to approach O through
the language of art; at the same time, his autobiographies are artistic defenses
against this experience. Or, as he puts it, ‘‘there are many formulations of dread,
unformulated and ineffable – what I denote O’’ (p. 77).
Not just Bion’s theories, but every psychoanalytic theory is a defense against
O. This is as it should be. This is what civilization is for. Psychoanalysis is more
reflective than most enterprises about what it is doing, but precisely because its
theories presume to be about nameless dread we should not forget that they are
at the same time a sophisticated defense against such dread. In other words, they
give the dread a name. Trauma is this name, and even the most fundamental
concepts of psychoanalysis are defenses against this trauma. This cannot be
changed, nor should it be. But it can be recognized.

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How Psychoanalysis can Help: Mitchell

Links are relationships, not just among ideas, but relationships to other people,
as well as other parts of ourselves. Stephen Mitchell refers to the loss of
relationality in terms of the destruction of the vivifying links between primary
and secondary process thinking and feeling. The result is a loss of access to
sources of vitality deep within oneself, sources that are brought to life in
spontaneous and authentic relations with others, from families to strangers.
Think about the mind divided not into parts, but two processes, both of which
are continually online. Primary process is dedifferentiated, as Mitchell (2014)
puts it in Relationality. In primary process, we are part of all that makes life
worthwhile, above all our connections to those who have loved and cared for us,
those we love, as well as those we hate. Often they are the same people. Only
‘‘connections’’ isn’t quite the right word. In primary process, we are those we love
and hate, and they are us. Freud’s (1930/1961) discussion of that ‘‘oceanic’’
feeling, of being one with the all, captures primary process experience. As
Mitchell (2014) puts it, ‘‘there is a mode of organizing experience that continues
throughout life and in which later distinctions between self and other, internal
and external, fantasy and perception are dissolved’’ (p. 19).
Secondary process is that part of life we are familiar with: our hopes, dreams,
plans, and ways of getting from here to there. Secondary process is where and
how we interact with the objective world, or at least that part of interaction that
we are aware of. Mitchell’s idea is that this primary dedifferentiation between
self and world is not an illusion, nor is it less real than the differentiated process
of secondary process thinking. Psychoanalytically-oriented therapy is not about
bringing the traumatized person back into touch with reality. Rather, it is about
‘‘substituting meaning for rationality, imagination for objectivity, vitalization
for control. The central ameliorative impact lies in relinking’’ (p. 25). By
‘‘relinking,’’ Mitchell means relinking primary and secondary processes.
One would not ordinarily think of Bion and Mitchell as intellectually close;
Bion became more and more arcane, more inward looking. The story of O is an
inward journey. Mitchell, on the other hand, remained a relational theorist to
the end of his too short life. Both, however, see psychoanalysis as relinking
broken experiences, broken emotions, broken thoughts. For both, this is how
analysis enables a fuller, less constricted life, a shared goal. As such, they have
more in common than one might at first imagine.

How All this Differs from Ordinary Trauma Therapy

Most treatment for trauma has as its goal bringing the traumatized person back
into present reality, where IEDs (bombs) and snipers are not hidden at the

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shopping mall, and in which every sexual relationship need not re-enact the
abuse one suffered as a child. Relationality therapy (my name for it) believes
that these fears will take care of themselves once the traumatized person is again
linked to his or her primary processes, where the meaning of life resides in our
most intimate identifications with people and experiences. Primary process is
where the enthusiasm for life resides, the sheer pleasure in being alive. It is the
place where our most intense living and feeling are done, where we experience
Bion’s ‘‘O.’’
Traumatized people devote too much of their time and energy to controlling
themselves. Hypervigilance is a good example, but numbing and avoidance are
also means of self-control. These are, of course, the primary symptoms of PTSD,
along with intrusion (for example, flashbacks). Substituting control for
vitalization, as Mitchell puts it, is the way trauma does its work, robbing
everyday life of its meaning and pleasure.
It’s a terrible dilemma: monitoring and control are the way traumatized
people keep themselves together. At the same time, constant monitoring and
control is what keeps the traumatized person from engaging in a life worth
living. This self-holding, as D.W. Winnicott calls it, kills the spontaneity that
allows the traumatized person to dip into his or her primary processes for
renewal and refreshment (Winnicott, 1992, pp. 245–248, 1996, p. 261).
For most severe trauma there is no cure. But for most who suffer, life can be
made more bearable and more meaningful. Vitality can be restored, even if it
always remains under threat. That, however, takes time and funds: several years
of therapeutic work, sometimes more, and money to pay a skilled therapist,
neither of which is readily available to most people. The therapist’s degree
doesn’t matter – MD, PhD, LCSW. What is necessary is only that the therapist
have experience and commitment to the work.
The Department of Veterans Affairs relies on short-term therapy, ‘‘evidence-
based’’ therapies such as cognitive behavioral therapy and ‘‘prolonged exposure
therapy.’’ The latter is often retraumatizing, and in my opinion should be
banned. Most people don’t have the time or money to pay for better treatment,
a treatment that takes years.

The Long Road

Serious therapy is a long, tough road. First, an atmosphere of safety and

relatedness must be established between therapist and patient. This can take
months, even years, and may come and go throughout the therapy. Only when
such an atmosphere is established is it possible for therapist and patient to enter
the world of primary process thinking, one step at a time. Some patients,
however, are never ready for this next step, since the separation of primary and
secondary processes is the key to the defenses they have built up. If these

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defenses work well enough, there may be little motivation for change. For some
people the price of living a constricted and less spontaneous, vital life is worth it.
The therapist should not push this next step, but be ready to work with it
when it appears. This means listening for experiences (I will not use the word
‘‘fantasies’’) of union, separation, and ancient loves lost. Experiences of hate and
terror, too. If the patient can be drawn into a mutual reverie with the therapist
in which primary and secondary processes meet and mingle, when self and other
briefly become one, then the first steps on a path toward a cure may be taken.
How far each patient goes is mostly up to him or her, but the goal remains the
same: to encourage the type of musing and reflection in which primary and
secondary processes talk with each other. For this is the path to vitality in living.
When life is vitalizing, the need for defenses marked by constriction in living
lose their usefulness.

A Utopian Proposal?

As things stand now, very few traumatized people will be able to take advantage
of this type of therapy: some because they cannot let go of defenses that have
worked; more because the time and money is not available. I am not suggesting
that the therapy I propose is likely to become widespread. More likely it will
become rarer; managed care wants rapid results. Still, it is worth imagining
what the best trauma treatment would look like, even if it remains an
unapproachable ideal for most people. While it is unlikely the ideal will
stimulate better treatment, such imagining can in this way act as a guide to
therapy, and a hope for the future.

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