Bion Dissertation

USE OF THE NONSENSUOUS IN PSYCHOTHERAPY
On the Use of the Nonsensuous in Psychotherapy
A dissertation submitted
by
Daniel Brown
to
Pacifica Graduate Institute
in partial fulfillment of
the requirements for the
degree of
Doctor of Philosophy
in
Clinical Psychology
with emphasis in
Depth Psychology
This dissertation has been

accepted for the faculty of
Pacifica Graduate Institute by:
Dr. Avedis Panajian, Chair
Dr. Patricia Berry, Reader
Dr. Judy Eekhoff, External Reader

USE OF THE NONSENSUOUS IN PSYCHOTHERAPY ii
OCTOBER 6, 2020
Copyright by
Daniel Brown
2020
USE OF THE NONSENSUOUS IN PSYCHOTHERAPY iii
Abstract
On the Use of the Nonsensuous in Psychotherapy
by
Daniel Brown
This study offers an original contribution to the field of clinical psychology by
integrating the theory of the nonsensuous psyche with the practice of psychotherapy. The
concept of the nonsensuous psyche was developed in relation to psychoanalysis by
Wilfred R. Bion, who built from a philosophical tradition stemming from Plato to
Immanuel Kant and the process philosophers. In this study, the theoretical basis
established by Bion, which considers the psyche to be a part of nonsensuous, or ultimate,
reality, was used to develop a clinical strategy relating to the practice of psychotherapy.
This study encompassed an alchemical hermeneutic method that was supplemented by an
adaptation of the common factors framework. The epistemological and ontological basis
of this study, relating to both the research topic and its methodology, was examined as a
matter of central importance to resolving the challenges inherent to investigating and
articulating the concept of the nonsensuous.
Keywords: psychotherapy, nonsensuous, Wilfred Bion, philosophy,
psychoanalysis, alchemical hermeneutics, clinical strategy, clinical technique,
epistemology, methodology
USE OF THE NONSENSUOUS IN PSYCHOTHERAPY iv
Dedicated to Janice
Special thanks to:
Barry Westbrook, Thomas Johnson, Jeffrey Baergen, Jim Milne, Ben Wade, Tim
Hedberg, and Avedis Panajian

USE OF THE NONSENSUOUS IN PSYCHOTHERAPY v
Table of Contents
Chapter 1. Introduction ...................................................................................................... 1
Purpose Statement ................................................................................................... 1
Relevance for the Field of Clinical Psychology ..................................................... 5
Statement of the Research Question and Problems ................................................ 9
Chapter 2. Literature Review ........................................................................................... 12
Philosophical Background .................................................................................... 12
The Mystical Account of the NonSensuous .......................................................... 15
Previous Research on Bion ................................................................................... 16
Differentiating Psychotherapy from Psychoanalysis ............................................ 23
The Common Factors Framework ........................................................................ 25
Chapter 3. Methodology .................................................................................................. 30
An Ontology of the Psyche ................................................................................... 30
Philosophical Approach ........................................................................................ 32
Research Procedures ............................................................................................. 39
Ethical Considerations .......................................................................................... 42
Organization of the Study ..................................................................................... 44
Chapter 4. Bion’s Basic Concepts ................................................................................... 45
Bion’s Original Conceptual Framework ............................................................... 46
Container-Contained ................................................................................. 46
Alpha Function, Alpha and Beta Elements ............................................... 50
Linking (L, H, & K/-L, -H, & -K) ............................................................ 53
Bion’s Developments in Light of Psychoanalytic Theory .................................... 56

USE OF THE NONSENSUOUS IN PSYCHOTHERAPY vi
Development of Klein ............................................................................... 56
Development of Freud .............................................................................. 60
From Content to Process ........................................................................... 61
Moving to the Nonsensuous.................................................................................. 64
Examples of the Nonsensuous .................................................................. 66
The Paradox of Using Language to Represent the Nonsensuous ............. 68
Chapter 5 The Non-Sensuous Strategy for Psychotherapy ............................................... 70
The Common Factors of Bion’s Thinking ............................................................ 70
At-One-Ment ............................................................................................. 70
Intuition ..................................................................................................... 71
Binocular Vision ....................................................................................... 73
The Unknown............................................................................................ 75
A Nonsensuous Strategy for Psychotherapy ......................................................... 78
The Therapeutic Relationship ................................................................... 80
Summary of the Therapeutic Relationship ............................................... 86
The Therapist’s Sincerity .......................................................................... 86
Summary of the Therapist's Sincerity ....................................................... 89
The Use of Attention................................................................................. 89
Summary of the Use of Attention ............................................................. 95
The Necessity of Courage ......................................................................... 96
Summary of the Necessity of Courage ................................................... 103
Chapter 6. Conclusion.................................................................................................... 104
Summary of Significant Findings ....................................................................... 104

USE OF THE NONSENSUOUS IN PSYCHOTHERAPY vii
Relevance of the Findings for Clinical Psychology ............................................ 106
Theoretical Developments Resulting From This Research ................................ 108
A Reflection on the Findings in Light of Previous Research ............................. 110
Limitations of the Present Study ......................................................................... 111
Inadequate Documentation of Methodology .......................................... 111
Challenges in Synthesizing Bion’s Thinking .......................................... 112
Directions for Future Research ........................................................................... 113
Conclusion .......................................................................................................... 115
References ....................................................................................................................... 117
The style used throughout this dissertation is in accordance with the Publication Manual
of the American Psychological Association (6th Edition, 2009), and Pacifica Graduate
Institute’s Dissertation Handbook (2019-2020).
USE OF THE NON-SENSUOUS IN PSYCHOTHERAPY
Chapter 1
Introduction
Purpose Statement
The purpose of this study was to articulate the use of the nonsensuous for the
practice of psychotherapy. The concept nonsensuous, which has been used throughout
history by philosophers, especially in the domains of ontology epistemology, describes an
aspect of human experience not derived from sensory perception but that is, nonetheless,
real. Many philosophers throughout history have debated how and why this experience is
real, and most have agreed with the position taken by Immanuel Kant, who asserted that
“ultimate reality” is separate from human subjective consciousness and, by its nature,
cannot be perceived as it is “in itself” (Noel-Smith, 2013, p. 132). This is because human
perception, which depends upon the action of the sense organs, always necessarily exists
behind a veil of subjectivity. These sense organs transform reality into something else
which, while apprehensible by human consciousness, is not what Kant referred to as
“ultimate reality” (Noel-Smith, 2013, p. 132). Following Wilfred Bion, this study
suggests that the human psyche also belongs to this domain of ultimate reality and, as
such, cannot be known as it is. The human psyche, like ultimate reality, is, in fact,
nonsensuous. However, that which can be known about the nonsensuous psyche is of
central importance to the practice of psychotherapy, and therefore the methods for
investigating it should be explored in great detail. In this study, this aim is furthered by
presenting Bion’s thesis that the technique for knowing the nonsensuous psyche is
through an active, dynamic, and organic participation in the transformation of lived
experience. In other words, Bion (1970) posited that the psyche can be known in so far
USE OF THE NON-SENSUOUS IN PSYCHOTHERAPY 2
as one can become it. The psychotherapeutic technique associated with this obscure
clinical recommendation is the point of departure for this study, and what follows is the
integration of Bion’s thesis as applied to the practice of psychotherapy.
Despite the fact that psychotherapy deals with the domain of the nonsensuous, it
is yet uncommon for clinicians to conceptualize their work in this way. It is even less
common for clinicians to thereby utilize a clinical strategy based on the nonsensuous. As
a result of this limitation, the latent value and utility of the technique of the nonsensuous
is mitigated. This becomes a matter of importance when considering how certain clinical
challenges, especially those associated with treating severe forms of psychopathology1 or
providing a depth-oriented treatment, could be resolved through the use of the
nonsensuous. In the absence of such a basis for clinical engagement, clinicians tend
rather to withdraw from patients, resort to defensive interventions, or, at worse, terminate
treatment altogether. This study was therefore intended to fill this gap by articulating the
use of the nonsensuous in psychotherapy. Though it is complicated and demanding, the
technique associated with this nonsensuous basis pays great dividends, providing a rich
grounding for clinical practice that increases its scope, depth, and efficacy.
In order to accomplish its purpose, this study was conducted in a step-wise
manner, beginning first with the task of establishing a foundational understanding of the
concept “nonsensuous.” Despite the fact that this concept has a robust philosophical
lineage, its integration with psychotherapy remains minimal. The closest points of
contact with psychotherapy that I have found is in the work of Wilfred Bion, in the
1
The term psychopathology is used in this study, for convenience, to denote the area most apropos the
focus of psychotherapy. In this sense, it is a helpful term. However, I would like to note that insofar as it
limits the understanding of psychopathology as a form of human suffering inextricable from the complexity
and nuance of lived experience, the term is ultimately not preferrable.
technique associated with archetypal psychology (Berry, 1982/2017; Butler, 2012;
Hillman, 1975/1992), and in the theory associated with phenomenological psychotherapy
(Boss, 1963). In this present study, it is Bion’s theoretical developments that are treated
as primary because they address the concept of the nonsensuous most directly.
From this foundation, the next task in this study is to extract the essential features
of Bion’s theory of the nonsensuous from the domain of psychoanalysis and apply them
instead to the practice of psychotherapy. This is necessary because, despite significant
areas of overlap, the practice of psychotherapy remains distinct from psychoanalysis in
important ways. These include, generally, differences in treatment aim, frame, method,
and patient population. Previous attempts at developing Bion’s thinking for
psychotherapists have been hindered by not fully acknowledging these notable
differences. By examining and identifying these differences, and by adapting Bion’s
thinking to bridge the gaps they create, this study presents a decidedly psychotherapeutic
version of Bion’s thinking.
However, the nature of this task also presents formidable challenges. The
complexity inherent to the topic of focus, in this instance, the nonsensuous, is
compounded by Bion’s notoriously complex writing style. This study served to resolve
this obstacle by first dividing it into two general categories, relating to context and
complexity. A method of alchemical hermeneutics was combined with the framework of
the common factors model in order to overcome both of these challenges. The
alchemical hermeneutic method, as described by Romanyshyn (2013), utilizes the
researcher’s complex relation to the topic at hand as a means of investigation. As such, it
is uniquely suited to resolving issues related to the study of the nonsensuous. This
method was supplemented by the common factors framework, as originally developed by
psychotherapy outcomes researchers, such as Rosenzweig (1936), Frank and Frank
(1991), and Wampold and Imel (2015). In this study, this framework was used in an
adapted form, moving it from its basis as an empirical research method to a means for
theoretical inquiry. This integration of the common factors framework results in a
methodology suited to the integrating Bion’s thinking about the nonsensuous with the
practice of psychotherapy.
Another challenge presented by this study was associated with the attempt to
articulate something ineffable. In this sense, I faced the same challenges as the musician
teaching students how to discover soulful improvisation, the mystic seeking to notate the
experience of union with God, or the poet depicting what it is like to be lost in the arms
of a lover. Any form of experience is essentially nonsensuous because it builds from a
state of being. Since this study was an effort to articulate a clinical technique based on
being, it was doomed from the start. That is, what I sought to depict in words can only be
known by experiencing it. What follows, therefore, amounts to a best attempt. As such,
it does not depict clinical experience as it is “in-itself” (Noel-Smith, 2013, p. 132), but
provides a strategy to guide the clinician in discovering their own personal engagement
with the nonsensuous through methods of being and becoming.
The various sections of this study should therefore be seen as a variety of
perspectives from which to look at something in order to get as full a picture as possible.
Just like circling a mountain presents different ways of seeing the same mountain, this
study circles around the topic of psychotherapy and presents various ways of seeing the
same thing.
The primary literature for this study came from Bion’s original texts (1962, 1963,
1965, 1967, 1970, 1977/2018, 1994/2008) as well as from writings about Bion such as
from Biran (2015), Bléandonu (1994), Civitarese (2008), Grotstein (2000, 2007), Meltzer
(1984/1992), Ogden (2004), Sandler (2005), and Vermote (2011, 2019).
Relevance for the Field of Clinical Psychology
This study was grounded in a research approach based on the psyche. Throughout
the methods and findings presented, an attempt was made to reveal (and recover) the
relevance of the language of the psyche for psychology. Psychology has its etymological
basis in psyche (soul) and logos (language). As such, this study utilized a human science
approach to scholarly inquiry, not to explain, as in the natural sciences, but to understand.
For, as Wilhelm Dilthey said, “We explain nature; man we must understand” (Palmer,
1969, p. 115). This study utilized a psychological approach grounded in the psyche as
most suited for understanding human beings, who cannot be quantified or empirically
validated.
In consideration of the racial, social, and political tension present in the United
States and the world, it is my opinion that the need for grounding psychology within
human experience has never been more urgent. However, in this area, psychology has a
sordid history, and there has long been disagreement about whether its methods should be
grounded within the natural sciences or the human sciences. While not denying the value
of the former (especially as it relates to the biological basis of behavior) in this study I
sought to balance the dominant trend in the field of psychology by reinforcing the value
of the human sciences as a means of engaging with, and understanding, the social,
political, and cultural dimension of human experience.

This study therefore intersected with the field of clinical psychology across
several domains; namely, that of psychotherapy, psychoanalysis, philosophy, and
research methods. Because of its overarching emphasis on psychotherapy, its most overt
point of contact was with psychotherapeutic technique. Clinicians reading this study will
deepen their understanding of psychotherapy in terms of the nonsensuous. While in some
ways this study offers new perspectives, including the nonsensuous basis of
psychotherapy and the associated technique based on being, in many ways it simply casts
some of the most familiar components of psychotherapy in light of their (often
unacknowledged) grounding within the nonsensuous.
At times, this study presents clinicians with practical recommendations for
therapeutic technique. These recommendations, generally, are an invitation to step
outside the constructs of knowledge and theory into a form of engagement that prioritizes
the radical unknown of being and becoming one with experience. This complex
technique, which necessarily requires adopting a position of radical not-knowing, is
unconventional and therefore conflicts with the contemporary emphasis on so-called
evidence-based practices. The result is a considerable demand on the person of the
clinician. The technique introduced here, which is akin to something like jumping off the
high dive, requires stepping away from the conventional approach so as to discover
instead one’s personal engagement with dynamics of the nonsensuous. This move
ultimately demands both courage and faith. The potential payoff of this leap is the
expansion of technique in terms of its scope (i.e., the type of patients and problems that
can be treated), depth (i.e., the extent of clinical engagement possible within the psyche),
and vocational satisfaction (i.e., the ultimate meaning and purpose derived from the
human ritual referred to today as psychotherapy).
Because the method for achieving these aims requires integrating diverse
theoretical perspectives, this study has relevance to the domain of clinical psychology
known as psychotherapy integration (for instance, as reported by the American
Psychological Association [APA] in the Journal of Psychotherapy Integration and in The
Society for the Exploration of Psychotherapy Integration). This study coalesces with the
efforts of this domain to develop perspectives on psychotherapy that have relevance to all
forms of therapeutic practice, regardless of theory. The perspective presented in this
study is not meant to displace a clinician’s theoretical grounding but to expand it by
showing its nonsensuous dimension. By examining and identifying the factors that
distinguish psychotherapy from psychoanalysis, this study integrated clinical techniques
developed for the psychoanalytic framework within that of psychotherapy. Considering
that the practice of psychotherapy faces challenges of a unique nature entirely, it presents
a point of focus for the integration of psychoanalysis with psychotherapy. Historically,
failure to appropriately consider these differences has diminished the value of
psychoanalytic technique as used in the practice of psychotherapy. This is especially true
for the development of Bion’s technique (Ivey, 2011). As such, this study has relevance
to the domain of psychoanalytic psychotherapy.
Because the cogency of this study depends upon establishing a philosophical basis
for the concept of the nonsensuous, it also intersects directly with the domain of
philosophical psychology. Although the concept of the nonsensuous has a rich heritage
within the field of philosophy, it has not been adequately considered in relation to
psychology or therapeutic technique. This study also served to examine the point of
intersection between psychology and the philosophical topics of epistemology and
ontology. This study therefore shares the emphasis on the domain of clinical psychology
that seeks to deepen psychology by extending its roots within the grounding of
philosophy, as reported, for instance, by the APA publications of the Journal of
Theoretical and Philosophical Psychology and in the Routledge journal, Philosophical
Psychology.
And finally, this study has relevance for the domain of clinical psychology
devoted to developing and strengthening scholarly approaches to research and
methodology. As noted, this study encompassed a human science approach that is
grounded within an ontology and epistemology based on the psyche. As such, it is
differentiated from the more conventional approach to research, based on the natural
sciences, which seek empirical or quantifiable explanation, and instead investigates the
living, dynamic engagement created between researcher and research topic. This
alchemical hermeneutic approach, in combination with the adapted version of the
common factors approach, will be shown to be uniquely suited to the task of integrating
psychology with the philosophical and psychoanalytic concept of the nonsensuous. More
generally, it will be shown to have unique potential for the task of engaging
psychologically with complex theories from diverse multi-disciplinary domains. And,
finally, it will be shown to be the method of choice for integrating the political, social,
and ecological dimensions of human experience that are so urgent to contemporary
society and, by extension, clinical psychology.

Statement of the Research Question and Problems
The primary question in this research study regarded the use of the nonsensuous
in psychotherapy. This question yielded several problems that had to be resolved. These
problems can be generalized across four domains.
The first, and most significant, problem was the absence of a model for
conceptualizing the nonsensuous basis of psychotherapy. This gap not only required an
exposition of psychotherapy itself as a nonsensuous endeavor, but also necessitated the
larger task of establishing a philosophical basis for understanding the concept of
nonsensuous, generally.
The second problem came from the complexity of Bion’s writing. In order to
resolve the problems associated by a gap of understanding the nonsensuous, the work
Wilfred Bion had to be examined. However, Bion’s writing creates problems for
researchers because it is notoriously complex, abstract, and nonlinear. Most every author
seeking to develop Bion’s ideas comments on this challenge created by his thinking and
writing. This results from the complexity of his topic, for the nonsensuous is, by nature,
indefinable. Furthermore, because Bion did not try to develop a form of knowing but,
rather, a way of being, his writing relies upon a style that places the onus of learning on
the individual reader’s experiences. As a result, his style is dynamic and constantly
evolving. This creates an experience Ogden (2004) described as “clarifying obscurities
and obscuring clarifications” (p. 285). These features of Bion’s thinking and writing
amount to a considerable problem that had to be resolved if this research attempt was to
be successful.
The third problem this study faced was the notable differences between
psychoanalysis and the practice of psychotherapy. While Bion developed an
understanding of the nonsensuous dimension as applied to the practice of psychoanalysis
and, as such, provided an invaluable basis for understanding the nonsensuous in clinical
technique, the sizable differences between psychoanalysis and psychotherapy must be
bridged in order to make his thesis relevant to psychotherapists. Failure to sufficiently
address this problem has impeded previous research studies that developed Bion’s
thinking.
The final problem was the absence of an established research method appropriate
for investigating and integrating Bion’s thinking with psychotherapy. As implied by the
aforementioned problems, certain features of Bion’s thinking and writing create
challenges for the task of integration. This final problem required developing a research
methodology appropriately suited to the task. Previous research attempts excluded issues
relating to epistemology and methodological rigor, thus limiting the utility and value of
their findings.
These four problems each yielded a corresponding question that needed to be
answered systematically before the primary research question could be addressed. These
questions can be generally categorized as follows:
1. What is the nonsensuous basis of psychotherapy?
2. What are the obstacles that have prevented the integration of Bion’s thinking
with psychotherapy?
3. What are the essential features of psychotherapy as compared to psycho-
analysis?
4. What is the best methodology for integrating Bion’s thinking with
psychotherapy?
This study presents one way among many possible ways to answer these
questions. Future researchers will undoubtedly discover their own answers to these
questions, as well as discover new questions altogether. In this present study, the
procedure of addressing each question individually, one at a time, was used as the method
for creating a basis to answer the primary research question in this study: What is the use
of the nonsensuous in psychotherapy?

Chapter 2
Literature Review
While the development of the nonsensuous as it applies to psychotherapy
comprises a novel research study, it is not without precedent. The following review of
the literature provides a theoretical background for this study, beginning with the
philosophical basis of the concept of the nonsensuous. It then moves to a consideration
of the literature already devoted to developing Bion’s thinking. It concludes with a
review of the literature pertaining to the practice of psychotherapy, especially to that of
the common factors approach.
Philosophical Background
The concept of the nonsensuous, as it is found in Bion’s writing and as it will be
utilized in this study, has a rich philosophical lineage. In terms of historical proximity,
the closest point of reference to Bion’s context was the theoretical developments
proffered by the process philosophers, Henri Bergson (1896/1911) and Alfred North
Whitehead (1911, 1929/1978). Nuno Torres (2013) provided a valuable review of Bion’s
integration of these philosophical developments. Bergson conceptualized reality in terms
of its essential dynamism and organic movement, and as the “ever-rolling stream of time
in a ceaselessly changing process” (Torres, 2013, p. 20). In this sense, reality is
nonsensuous in the same way time is nonsensuous, for neither can be apprehended as
with sense perception. Or, to say this in a different way, “living reality can never be
communicated by images or concepts, but must be directly intuited” (Bergson, 1912, pp.
12–13). For Bergson (1912), reality is the state of constant movement and change and is,
essentially, alive. The capacity to speculate about reality as a static object is a result of
functional and utilitarian demands of day-to-day human existence and is made possible
by the highly developed central nervous system unique to the human neo-cortex. This
highly developed central nervous system of human beings allows for an impulse to be
separated from action, with the gap created between them now ultimately being filled in
by thought. While necessary for survival and participation in daily life, Bergson
(1896/1911) considered thinking to be, fundamentally, a disconnect from reality as it
really is. In other words, reality as it is can never be known through utilitarian and
conceptual thinking. It can only be known through participation in it. On the other hand,
Bergson (1896/1911) considered intuition to be the most pure form of mental activity
because in it one participates with reality unmitigated by sensory perception.
A.N. Whitehead (1911, 1929/1978) presented a similar basis for conceptualizing
nonsensuous reality. In An Introduction to Mathematics, he showed numerical
representation and mathematical thinking to be nonsensuous because numbers do not
represent anything that can be perceived sensuously. For instance, the purpose of the
number 0 is to represent absence. The discovery of a symbol to represent absence is of
great significance for understanding thinking, generally. In thought, sensuous forms,
such as the number 0, are used to represent nonsensuous reality. This is explanatory for
the trend in the natural sciences to quantify research findings, for the nonsensuous
domain of numerical representation, distinct from any sensuous domain, is for that reason
considered to be the most ideal form for representing knowledge about the world.
However, in agreement with Bergson, Whitehead (1929/1978) presented a view of
thought and language as indicative of a substantial disconnect from reality as it is, and
emphasized instead the value of pure being, for “life refuses to be embalmed alive” (p.
339). In Torres’s (2013) view, the influence of this philosophy on Bion was that it
grounded his view that “the ultimate nature of reality is a multitude of dynamic processes
of becoming and relatedness, beyond the possibilities of verbal expressions derived from
the sensuous perception of objects in space” (p. 30).
Centuries before process philosophy was introduced, Immanuel Kant (1788/1997)
developed a philosophical system based on distinguishing internal experience, which he
referred to as the domain of phenomena, from that of ultimate reality, which he
considered to be the domain of noumena. For Kant, thoughts, words, and sensory
experiences all comprise phenomena. This phenomenal basis of the internal world is a
representation of the numinous ultimate reality. The inevitable dependence of
phenomena upon sense perception, which transforms ultimate reality, means that ultimate
reality, which consists of noumena, or “things-in-themselves”, cannot be known as they
are “in-themselves” (Noel-Smith, 2013, p. 129). In Kant’s system, ultimate reality is
nonsensuous and only becomes sensuous after perception by the senses.
This conceptualization of the nonsensuous ultimately builds from Plato’s original
conceptualization of the nonsensuous as found in his concept of “Forms or Ideas”
(Copleston, 1962/1993, p. 163). For Plato, there existed universal forms or ideas beyond
the realm of sensory experience, “in a state of isolation one from another and apart from
the mind of any Thinker” (Copleston, 1962/1993, p. 164). These nonsensuous forms
included such things as beauty and goodness. Thought was seen by Plato as the best
means available for grasping this nonsensuous reality. He concluded that “the object of
thought, as opposed to sense-perception, i.e. universals, must have reality” (Copleston,
1962/1993, p. 164). As in Whitehead’s (1929/1978) analysis of the number 0, Plato

considered thought (e.g., the thought that something is beautiful or good) to be a
representation of an ideal form that cannot be known as it really is. For Plato, the true
nature of this universal form exists in heaven, outside the realm of sensory experience.
The Mystical Account of the Nonsensuous
Mystics throughout history have also provided a significant contribution to an
understanding of the nonsensuous. The unique value of their collected writings stems
from the fact that, since God is considered to be nonsensuous in nature, knowledge of
God is presented in terms of the experience of God, not in thoughts about God. Since
mystics are motivated to bring their knowledge of the divine experience to the realm of
mundane human existence, a survey of their literature provides valuable insight into the
means for resolving the paradox of using language (which is sensuous) to depict the
nonsensuous. Meister Eckhart, the 13th century German mystic, presented a noteworthy
example of how this method encourages surrendering the domain of sensuous thinking to
open oneself to the domain of nonsensuous experiencing. For instance, he preached that
one “should love God mindlessly, by this I mean that your soul ought to be without mind
or mental activities or images or representations. Bare your soul of all mind and stay
there without mind” (Fox, 1983, p. 46). Additionally, Eckhart wrote of the paradoxical
relation between knowledge of God and experience of God: “The more you seek God, the
less you will find God. If you do not seek God, you will find God. God does not ask
anything of you except that you let yourself go and let God be God in you” (Fox, 1983, p.
52).
Previous Research on Bion
While the heart of my study stands alone as an original research endeavor, it
emerges from a background of previous research that develops Bion’s thinking. The
following review of this background literature serves to orient readers to some of the
most notable works on Bion and to demonstrate the necessity of this current study by
revealing the limitations in these attempts. These limitations includes the decidedly
psychoanalytic focus of these writings, the absence of a model integrating Bion’s ideas
specifically with the practice of psychotherapy, and the absence of an appropriate
methodology for articulating the hidden simplicity of Bion’s complex thinking and
writing style.
Rudi Vermote’s (2019) text, Reading Bion, provides a comprehensive review of
Bion’s thinking. By explicating Bion’s thinking in terms of pre-caesura and post-caesura,
Vermote (2019) demonstrated a method for collating and simplifying the evolving nature
of Bion’s ideas throughout his career. Moving in a chronological manner through Bion’s
thinking, Vermote (2019) organized complex shifts in concepts by fitting them either
within the domain of transformations in knowledge, the pre-caesura category of Bion’s
thinking that seeks “to understand psychic processing or the mind,” or within the post-
caesura category of transformations in O, “in which Bion reinterprets his former concepts
from the dimension of the unknown and unknowable” (Vermote, 2019, p. i). In this
sense, caesura is more than just a theoretical concept. It also marks a point of division in
Bion’s thinking from his focus on transformations in K to that of transformations in O.
Vermote (2019) ultimately considered this caesura to be punctuated by Bion’s move from
London to Los Angeles. This approach develops Vermote’s (2011) previous attempts to
present Bion’s thinking in terms of “a dual track model of psychic change” (p. 1089).
Altogether, Vermote’s (2011, 2019) contribution is a significant achievement that
effectively provides readers an organized orientation to the most significant features of
his thinking. Moreover, by providing numerous references to multidisciplinary sources,
Vermote contextualizes Bion’s ideas and situates them within the broader domain of
scholarly inquiry related to the nonsensuous.
Gerard Bléandonu (1994) provided an overview of Bion’s thinking which, in
contrast to Vermote, is supported by a comprehensive biographical account of Bion’s life.
Bléandonu divided Bion’s thinking into four distinct periods, which he labeled the group,
psychosis, epistemological, and final period. The value of Bléandonu’s review is that it
is theoretically comprehensive while remaining oriented to the focus on clinical
application. However, the relevance of his text is limited by leaning too heavily on the
psychoanalytic lexicon, a pattern most apparent when he uses Bion’s concepts without
adequately explaining them. For this reason, Bléandonu’s contribution ultimately verges
toward the same degree of complexity that impedes readers studying Bion’s original
texts. This can be justified when considering that, overall, Bleándonu’s treatment of Bion
is decidedly psychoanalytic and intended for psychoanalysts. At one point, he even
suggested that the technique Bion described “is recommended only for those practicing
analysts whose own analysis has brought them to some recognition of the Kleinian
paranoid-schizoid and depressive position” (Bléandonu, 1994, p. 222). However, for this
reason, his review is limited in terms of its relevance to the psychotherapist.
A more accessible overview of Bion’s thinking is provided by James Grotstein
(1981, 2000, 2007). In his texts, the reader is oriented to Bion’s thinking as it was
developed in the latter part of its theoretical development. The theoretical review it
offers is integrated with Grotstein’s personal reflections on the meaning and value of the
ideas and is often supplemented with the benefit of Grotstein’s personal acquaintance
with Bion (which includes as an attendee of his lectures in Los Angeles as well as
participating in analysand with Bion as a patient). Altogether, Grotstein’s contribution
can be viewed as metapsychological in the way it seeks to digest the main ideas of Bion’s
thinking. This approach to developing Bion’s thinking has the benefit of creating for the
reader a context to personally discover the meaning and utility of his ideas.
Symington and Symington (1996) have also presented an introduction to the
themes they considered to be “the main contours of Bion’s thinking” (p. xii). Their book,
The Clinical Thinking of Wilfred Bion, is organized around Bion’s grid, which they
considered “the schema around which his mature thinking is symbolized and structured”
(p. xiii). Throughout, Symington and Symington emphasized features of Bion’s thinking
as applied to the clinical setting; ultimately concluding that Bion’s thinking comprised a
“radical departure from all conceptualizations which preceded him” (p. xii).
Paulo Cesar Sandler (2005) made an invaluable contribution to the scholarly
development of Bion’s thinking by cohering the theoretical concepts found throughout
his writing into a dictionary format. This resource provides researchers not only with a
means of clarifying the obscurities of Bion’s conceptual style (which are numerous), it
also acts as an index of Bion’s concepts. It thus provides a tool for cross-referencing
Bion’s ideas with various multidisciplinary sources as well as observing the evolving
nature of Bion’s concepts throughout his career. Sandler’s dictionary ultimately serves to
organize the important concepts in Bion’s thinking and provides readers with a valuable
resource for discovering the hidden coherence of this thinking.
Thomas Ogden has contributed several articles that develop important aspects of
Bion’s work. In, “An Introduction to the Reading of Bion,” Ogden (2004) provided a
valuable starting point for reading Bion for the first time. In this article, Ogden (2004)
divided Bion’s work into an early and late period. He described the necessity of
immersing oneself in Bion’s writing so as to create the possibility of learning from the
emotional experience of reading. One of the unique contributions Ogden made is in his
evocative use of clinical case examples to demonstrate the clinical application of Bion’s
complex concepts. In particular, it is the demonstration of Bion’s technique of reverie,
what Ogden (2017) described as “dreaming the analytic session” (p. 1), that is
particularly poignant. Additionally, by integrating Bion with Winnicott, Ogden (2003,
2014) presented a poignant point of intersection for understanding how the concepts of
truth, language, and unlived experience have relevance to the clinical setting. In
particular, in “On Language and Truth in Psychoanalysis,” Ogden (2016) demonstrated
an application of Bion’s concept of language of achievement (although Ogden does not
reference this concept directly).
In The Courage of Simplicity: Essential Ideas in the Work of W.R. Bion, Hannah
Biran (2015) provided another introduction to some of Bion’s most essential concepts.
Biran’s book is distinguished by efforts she made to present the basis of Bion’s thinking
in a manner that is simple and easy to read. To this end, she utilized a style of
interpreting Bion’s thinking based on the belief that “behind his enigmatic writings are
some very simple issues” (Biran, 2015, p. xxi). Additionally, Biran presented a view of
Bion that shows their connection to courage. Whereas Biran’s strength comes in its
emphasis on simplicity, the contribution is ultimately limited by oversimplifying Bion’s
ideas. This limitation could have been avoided if more thorough references to the
theoretical nuances implied by Bion’s concepts had been provided.
In consideration of Bion’s late life theoretical development and writings, the
contribution made by Guiseppe Civitarese is particularly noteworthy. In “‘Caesura’ as
Discourse on Bion’s Method,” Civitarese (2008) presented new dimensions for thinking
about clinical experiences in terms of Bion’s focus on emotional experience and “at-one-
ment.” Ultimately, Civitarese’s method is to amplify Bion’s (1977/2018) edict,
“transcend the caesura” (p. 53). He situated this method within the larger conceptual
background of Bion’s thinking about transformations in O. In so doing, Civitarese shows
how this clinical recommendation utilizes the concepts of reversible perspective and
binocular vision to focus on the psyche in terms of life and movement. He demonstrated
how this method is actually destabilizing, because “the binary system of producing
meaning is deconstructed through the systemic use of non-pathological—i.e. not static
but dynamic—reversible perspective” (Civitarese, 2008, p. 1123). While showing this
method to be both complex and disconcerting, Civitarese also demonstrated its
constructive side, explicating how this method engages with the psyche by shaking it free
from rigidity. This disruptive engagement is ultimately life-giving because it creates the
possibility of movement and of discovering new thoughts. Civitarese explained that
Bion’s technical recommendations require the capacity to hold tension between opposite
points of view so as to generate new thoughts and new ways of seeing clinical
experiences. When read in conjunction with Bion’s late-life articles, Civitareses’s article
is an indispensable supplement for understanding the concepts of binocular vision,
reversible perspective, and transcending the caesura. The limitation of his contribution
comes in terms of its complexity, which is attributed both to his use of Bion’s concepts
without adequately explaining them as well as his use of “Sassuerian linguistics” (p.
1132).
In his book, Dream Life, Donald Meltzer (1984/1992) provided an outline of
Bion’s thinking that is unique in tracing its development from the background of
psychoanalytic theory of Freud and Melanie Klein. Meltzer presented Bion’s theoretical
contributions as a novel development of the theory of psychic functioning. In his view, it
is the psyche’s constant and active unconscious phantasy, or what he calls dream life, and
especially the function of this dream life in relation to emotional experience, that
distinguishes Bion’s thinking and situates it within a uniquely relational and emotional
matrix. Meltzer amplified Bion’s metaphor of the psyche as a digestive tract to present
dream life as a form of emotional digestion that occurs, like digestion, both day and
night. Following Bion, Meltzer proposed that knowing truth, which requires the capacity
for digesting emotional experience through dreaming, ultimately nourishes the psyche
and allows it to grow. By contrast, mental illness is etiologically linked to the inability to
perform this dreaming function and results from the psyche’s recourse to seeking
nourishment from lies. Although valuable in its entirety, the most significant
contribution Meltzer makes is in the chapters of Part A. In this section, he grounds
Bion’s thinking within an aesthetic, relational, and emotional basis and distinguishes
Bion’s theoretical developments from those of Freud and Klein. In this way, Meltzer not
only provided a valuable orientation to Bion’s thinking, but also provided a basis for
contextualizing the ongoing developing nature of psychoanalytic theory, generally.
The literature integrating Bion’s thinking specifically as it applies to the unique
dimensions of psychotherapy is minimal. The majority of studies devoted to developing
Bion’s thinking do not address how his ideas need to be adapted when applied to a
psychotherapeutic setting. In my review of the literature, there are three common
features among the studies available on Bion that limit its applicability to psychotherapy.
First, studies tend to be focused on only one or a couple of isolated dimensions of Bion’s
thinking (c.f. Brown’s [2012] study on the alpha-function; Ogden [2017] on dreaming).
The second common feature is focusing on only an isolated aspect of clinical application
(c.f. Capozzi & De Masi’s [2001] study on understanding dreams in the psychotic state;
Giffney’s [2013] study on desire in psychotherapy; and Levy [2012] on the process of
symbolization). And the third common feature is development of a model of Bion’s
thinking that applies to psychoanalysis or to clinical work, generally, but does not
consider the practice of psychotherapy specifically (c.f. Bléandonu [1994], Symington &
Symington [1996], and Vermote [2019], who each present an overview of Bion’s thought
without reference to psychotherapy as distinct from psychoanalysis).
Aside from one article by Gavin Ivey (2011), my review of the literature did not
uncover any studies directly addressing issues relating to the integration of Bion’s
thinking with psychotherapy. As a result, as Ivey (2011) noted, Bion’s thinking has
generally been “ambivalently regarded by psychotherapists as the embodiment of an
analytic ideal, whose developmental theories are important, but whose practical utility is
doubted . . . in the context of the typical therapeutic setting” (p. 92).

Differentiating Psychotherapy from Psychoanalysis
The task of developing a nonsensuous basis for psychotherapy requires adapting
Bion’s psychoanalytic theory to fit within the realm of psychotherapy. To do this,
psychotherapy needs to be differentiated from psychoanalysis. This can be achieved by
identifying the unique features of psychotherapy. The following review summarizes
some of the literature on differentiating psychotherapy from psychoanalysis.
The confusion between where psychoanalysis ends and psychotherapy begins has
long been a topic of debate in the field, having been the focus of many committees,
panels, and debates (English, 1953). For instance, in 1947, the American Psychoanalytic
Association formed a committee to resolve this question. However, despite several years
of work, it ultimately reported that “this Committee was never able to pass the initial and
vexatious point of trying to arrive at some modicum of agreement as to exactly what
constitutes psychoanalysis, psychoanalytic psychotherapy, and possibly transitional
forms” (Rangell, 1954, para. 2). The inability to achieve a consensus on what
distinguishes psychotherapy from psychoanalysis demonstrates the uniquely human
grounding of this discussion. One conclusion that has emerged throughout the years is
that the answer to this question is more a matter of personal appraisal than objective fact.
Yet, there are some differences between the two that are more substantial than
others. For one, psychotherapy is largely considered to be more theoretically eclectic
than psychoanalysis. As Shane and Shane (1996) noted, “Psychotherapy as a construct is
designed to cover many different types of therapeutic work, including cognitive therapy,
behavior modification, hypnotherapy, reality therapy, biofeedback therapy, group
therapy, gestalt therapy, and the like” (para. 6). One implication stemming from this
observation is that psychotherapists are generally expected to be experts in delivering
effective treatment in relatively quick order. That is, the goal of psychotherapy is
considered to be establishing what Rangell (1954) called “intermediate points of
stability” (para. 21) for a patient. This goal exists in contrast with the psychoanalytic aim
of seeking a greater depth of understanding and personality change (Wallerstein, 1969).
The mandate to help patients concretely, and in relative short order, is particular
to the practice of psychotherapy and applies as much to patients suffering from severe
pathologies as to those with limited means or capacities for participating in treatment. In
this sense, psychotherapists are considered experts at discovering ways to help a diverse
range of patient population. Compared to psychoanalysis, what may be lost in terms of
depth of clinical engagement is made up for in terms of breadth of technical flexibility.
While psychoanalysts may be considered specialists in working with “transference,
countertransference, resistance, and . . . the ego’s defensive function”; psychotherapists,
on the other hand, specialize in working with “the patient’s resistance to change and the
strategems he or she unwittingly uses to defeat the therapeutic efforts” (Strupp & Binder,
1984, p. xiv). In support of this view, Binder (2004) noted the value of a therapist’s
ability to improvise. Any form of improvisation, including in psychotherapy, requires a
thorough working knowledge of theory combined with a capacity to think freely and
creatively. In conclusion, the features and skills that distinguish psychotherapy from
psychoanalysis are the same that equip psychotherapists to provide more or less rapid
relief from a diverse range of symptoms, to work with a broad patient population, and to
demonstrate technical prowess within a large variety of different treatment settings.

The Common Factors Framework
This study relied upon the common factors approach to psychotherapy outcomes
research in two important ways. First, I used this approach as a framework. That is, by
mirroring its methods, I was able to distill disparate themes in Bion’s thinking into four
common factors. Second, I used the common factors literature to establish essential
features of psychotherapy. In its conventional usage, the common factors approach is an
empirical research method aimed at validating psychotherapy outcomes as based on
particular operative factors. In this study, I adapted the common factors approach from
its original context to use it instead as a tool for theoretical inquiry.
When Saul Rosenzweig (1936) first observed that “no form of psychotherapy is
without cures to its credit” (p. 412), he suggested that this could be explained by implicit
factors common to all forms of effective treatment. This view departed from the
conventional model of efficacy of the time, which is still dominant today, that attributed
treatment outcome to a particular theoretical model and was not generalizable to common
factors found across models. Rosenzweig’s suggestion that common factors accounted
for efficacy originally pointed to four factors. These were, first, the influence of what he
called “the indefinable effect of the therapist’s personality” (Rosenzweig, 1936, p. 413).
Second, the salient effect of any appropriately applied psychological theory that serves
the function of organizing and structuring the personality. Third, he suggested there is a
therapeutic effect of the features that are inherent to all psychotherapy treatments, such as
the action of catharsis or the presence of a caring therapeutic bond. And, finally, in every
effective therapy there is the salient effect of reconceptualizing aspects of an individual’s
psychology, which moves the patient from a problematic view of the self and their
problems to a more adaptive and workable one. By proposing that it was the presence of
these four factors, as found within any theoretical model, that leads to efficacy,
Rosenzweig presented a foundation for what is referred to today as the common factors
approach.
In the years since its inception, a great deal of evidentiary support has been
generated for Rosenzweig’s hypothesis that psychotherapy works not because of a
theoretical model but because of the factors common to all psychotherapeutic procedures
(Wampold, 2001, 2007). In a review of this literature, Grencavage and Norcross (1990)
identified that over 90 common factors have been listed as contributing to outcome.
Several notable attempts have been made at developing a coherent and integrated model
of the common factors in psychotherapy. In Persuasion and Healing: A Comparative
Study of Psychotherapy, Jerome Frank (1961) conceptualized this in terms of the idea that
effective psychotherapy provides relief for the demoralization that occurs concomitant
with mental health symptoms. He thereby oriented psychotherapeutic procedures around
the task of remoralization. This task, he concluded, is not limited to particular theoretical
approaches, but includes factors common to all forms of psychotherapy. Later, Frank
refined this model further and suggested all psychotherapy consists of four common
factors (Frank & Frank, 1991). These are, first, the emotionally charged, personal
relationship between therapist and patient. Second, the context of a healing setting which
the patient expects will offer some help. The third factor is the therapist’s utilization of a
well-organized conceptual model, ideology, or myth. And, finally, the fourth factor
includes healing rituals or procedures that align with the aforementioned model,
ideology, or myth. In Frank’s view, any treatment consisting of these four factors can
exert a healing effect (Frank & Frank, 1991).
Building from this basis, Wampold and Imel (2015) proposed a slightly different
view of the common factors. They suggested six factors commonly found in all
psychotherapy treatments that contribute to effective outcomes:
First, the therapist combats the client’s sense of alienation by developing a
relationship that is maintained after the client divulges feelings of
demoralization. Second, the therapist maintains the patient’s expectation
of being helped by linking hope for improvement to the process of
therapy. Third, the therapist provides new learning experiences. Fourth,
the clients’ emotions are aroused as a result of the therapy. Fifth, the
therapist enhances the client’s sense of mastery of self-efficacy. Sixth, the
therapist provides opportunities for practice. (pp. 48–49)
Wampold and Imel have used this common factors framework to develop what
they call a contextual model of psychotherapy. They described the contextual
model as “a theory about theories” (p. 45), and used it to study the practice of
psychotherapy as isolated from any individual theoretical model. This view
presents psychotherapy as ultimately inextricable from three factors which,
altogether, function to establish a virtuous cycle between “symptom reduction”
and “better quality of life” (Wampold & Imel, 2015, p. 53). The first factor of the
contextual model is the relation established between two human beings. In their
view, psychotherapy capitalizes on the human need to experience a feeling of
belonging and relatedness. This aspect of the contextual model establishes the
necessity of the relational bond as the sine qua non for all effective
psychotherapy, and distinguishes it from, for instance, the isolated forms of help
that are available in self-help books or meditative practice.
The second factor is related to a patient’s expectations about psychotherapy.
Given the status of psychotherapy as an identified healing practice and its locus within
the medical community (e.g., covered by medical insurance plans), this factor must
involve an expectation that participating in psychotherapy will be helpful. Every
theoretical model of psychotherapy offers patients a different explanation for their
distress and suffering. Within the contextual model, what matters is not the scientific
veracity of these models, but whether or not the patient “believes the explanation and that
engaging in therapeutic actions will improve the quality of their life or help them
overcome or cope with their problems” (Wampold & Imel, 2015, p. 58). If this occurs,
“expectations will be created and will produce benefit” (Wampold & Imel, 2015, p. 58).
The final factor refers to the “specific ingredients” of a therapeutic treatment (Wampold
& Imel, 2015, p. 60). The contextual model considers this factor in a different light than
does the medical model, which is focused on determining whether certain therapeutic
ingredients are more or less effective than others. The contextual model presents a view
that, regardless of which specific ingredient is utilized, enacts efficacy because the patient
believes it will be helpful and, accordingly, makes changes in alignment with this
particular intervention. These changes, regardless of their form or theoretical basis, have
a therapeutic effect.
The contextual model, as a specific development of the larger common
factors approach, contributes to a framework that distills the complex factors of

psychotherapy into isolated common factors. This framework provides a basis for
conceptualizing the essence of psychotherapy in terms of its identified common
factors. Based on my review of this literature, the four common factors used in
this study were the therapeutic relationship, the therapist’s sincerity, the clinical
use of attention, and courage.
The common factors framework introduced here can also be adapted for
use in distilling Bion’s thinking into a comparable set of common factors. In this
study, these common factors are at-one-ment, binocular vision, intuition, and the
unknown. Taken together, these two sets of common factors were juxtaposed in
service of the task of integrating Bion’s thinking with the practice of
psychotherapy.
Chapter 3
Methodology
An Ontology of the Psyche
The research approach and method used in this study is grounded within an
ontology of the psyche. The word ontology derives from onto, meaning “being”, and
logos, meaning “language.” This branch of philosophy considers the nature of human
consciousness and of being, generally. The ontological ground for this study is the
movement of the psyche. In this sense, the psyche is considered to be a valid source of
scholarly, even scientific, inquiry. Whereas this ontological view is relatively marginal
when compared to the mechanistic, materialist view that dominates the natural sciences
today, it nonetheless has a rich historical lineage implicit in the word psychology (psyche
+ logos) itself. Additionally, this ontological view contributes a theoretical basis for
integrating the fact that even the most robust scientific research is still a complex, human
experience.
The word psyche as used in this study denotes the movements and characteristics
of what was, in years past, referred to as soul. Distinct from the mind or the personality,
and certainly from the brain, the psyche denotes the inner, dynamic movements of the
human being. James Hillman (1975/1992) identified four characteristics of soul that help
remove it from its religious or spiritual context. First, he identified that the soul
possesses a personifying tendency, by which he meant the psyche implicitly imbues the
world with meanings unique to human consciousness. This can be observed within the
indigenous mythological traditions throughout the world today and in historical Greek
and Roman culture which serve as the basis for contemporary Western civilization. Next,
he identified the soul’s pathologizing tendency, by which he meant the tendency of the
psyche to express itself in symptoms. Hillman then presented a view of the psyche as
“seeing through” an idea to a broader consideration of its inherent multiplicity. That is,
in its nature, the psyche sees through an idea presented as a unified whole and instead
examines its relation to many other ideas. And, finally, Hillman presented the movement
of the soul as essentially dehumanizing, by which he meant the psyche relativizes the
humanness of ego relations as compared to other forms and states of being, for instance,
in the divine or the animal.
A research method grounded in this view of the psyche facilitates an immersion
of the researcher in relation to the research topic in order to observe, over time, the
dynamic movements of this relationship. These movements, traced through such
methods as dream journals and the transference dialogues, are submitted to analysis in the
same way a scholarly text would be analyzed. This research method has been developed
by Romanyshyn (2013) as “alchemical hermeneutics” (p. 259). This view builds from
the hermeneutic emphasis on valuing and integrating the inevitability of a researcher’s
subjectivity, or “horizon” (Gadamer, 1962/2006, p. 306), but extends the scope of this
integration to include the unconscious aspects of the researcher’s psyche. In so doing,
this research method mirrors the ancient science of alchemy, in which various ingredients
were placed within a hermetic jar, sealed tight, and then allowed an appropriate amount
of time to mix together on their own accord. This mysterious act of mixing was likened
to a spiritual process of transformation. In the research method of alchemical
hermeneutics, the ingredients that are placed within the hermetic jar are the research
topic, which includes the variety of scholarly texts analyzed during the process, the
researcher’s psyche, which includes conscious and unconscious aspect, the research
topic, and the contextual field in which the research occurs, including the racial, political,
social, and ecological domain (Coppin & Nelson, 2005, p. 131).
The following section provides a grounding for the philosophy of this approach to
research. The purpose of this explication is to assist future researchers in situating
themselves within an appropriate theoretical context for the study of complex issues
pertaining to the human psyche. This section is then followed by a detailed description of
how the methodology of alchemical hermeneutics was used in this study. While the
intent here is to provide a detailed template for future researchers to follow, the value of
these methods is not limited to the study of Bion or the nonsensuous. Rather, the
methodology described here applies to any scholarly inquiry that endeavors to overcome
the modern myth of an unbiased, objective observer and instead integrate the reality of
the psyche with the spirit of robust scientific inquiry.
Philosophical Approach
The following articulation of my philosophical approach to research situates the
methodology used in this study and distinguishes it from alternative methods that could
have been used. Defining the epistemological basis in this way not only defines the
limits of the methods used, but also functions in a more general way to delineate what is
considered to be real and what qualifies as a valid focus for scientific inquiry. This
section is especially important in this study because, as noted, previous attempts at
developing Bion’s thinking have neglected to document a thorough epistemological
engagement with issues relating to methodology.

The philosophical approach defined in this section is uniquely suited to the task of
both the development of Bion’s thinking and its integration with psychotherapy.
Regarding the former, the complex topic Bion writes about suits itself to the alchemical
hermeneutic method, which emphasizes the researcher’s immersion with the text. The
value of this method is bolstered when considering Bion’s (1992, p. 261) own emphasis
on the value of personally discovering the meaning of his ideas through the experience of
reading. Regarding the latter, the necessity of lifting Bion’s ideas from the context of
psychoanalysis and applying it to that of psychotherapy has necessitated supplementing
the alchemical hermeneutic method with that of the common factors framework. The
value of this combined method is that it provides a way to distill complex, nonlinear ideas
into simple concepts which can then be placed in conjunction with each other in order to
conduct a type of comparative analysis. In Bion’s language, it creates a variety of
different vertices from which to look at the topic and emphasizes the invariants (i.e.,
those elements which remain unchanged despite broader shifts in context and form) as a
means of deducing an underlying meaning.
Because this method is actually a mixture of methods (alchemical hermeneutics
combined with the common factors framework), it is therefore distinguished from both.
It diverges from the alchemical hermeneutic method, as described by Romanyshyn
(2013), by placing less overt emphasis on formally documenting the “transference field
between the researcher and the work” (p. 133) through the use of transference dialogues.
Rather, the reverie Romanyshyn recommended extending toward the transference
between researcher and topic is directed instead toward the vertices created by comparing
the common factors of Bion’s thinking with those of psychotherapy. More specifically,
through the use of reverie, an effort was made to establish two separate sets of common
factors as distilled from an immersive engagement with Bion’s ideas and with the
literature on psychotherapy. Reverie as a research tool was also utilized to uncover the
complex relation between my own psyche, the issues related to my sociocultural context,
and the research topic.
The common factors approach provided a framework for this task of distilling
complex ideas into isolated concepts. The approach as it was used in this study is an
adapted version of how it is used in its conventional form. Typically, the common factors
approach is used to support empirical research method for analyzing psychotherapy
outcomes. In “Psychotherapy: The humanistic (and Effective) Treatment,” Bruce
Wampold (2007) provided an overview of both the history of the approach and its
contemporary status, noting its growing prominence in the field of outcomes research.
In my study, which is qualitative by design, the common factors framework was
used to support a human science research approach. In contrast to the natural sciences,
human science research is most appropriate when studying the nature of lived experience
or, as was true in this study, when the process of inquiry integrates the researcher’s
subjectivity. The value of this epistemological grounding was articulated in Wilhelm
Dilthey’s trenchant observation that “We explain nature; man we must understand”
(Palmer, 1969, p. 115).
Historically, this qualitative approach to research was acknowledged as the
foundation for all scientific inquiry, a fact that was especially true within the field of
psychology (Coppin & Nelson, 2005, p. 23). However, this shifted as psychologists in
the late 19th and early 20th centuries were motivated to establish psychology’s status as a
reputable scientific discipline in the eyes of the scientific community, in culture,
generally, and most importantly, in the eyes of grant funding sources, who increasingly
have demanded empirical verification that their money is being put to good use. These
early psychologists especially voiced concern over the popular view that “everyone was a
psychologist” (Danziger, 2001, p. 59). In response to these demands, psychologists have
endeavored to distinguish psychology’s status by identifying with the empirical
methodological characteristics of the natural sciences.
Today, however, there is renewed interest in recovering the value of qualitative
methodology for psychological research, especially as a means for integrating
sociopolitical dynamics into its domain. Levitt et al. (2018) confirmed that qualitative
methods are uniquely valuable for theory development, exploratory research in new areas
of inquiry, critical engagement with systems of ideology, and the elucidation of dynamics
relating to race, social class, justice, and power. In this last domain, qualitative
methods—in contrast with natural scientific methods—have proven especially effective.
Researchers have noted that qualitative methods function to give “a voice to historically
disenfranchised populations whose experiences may not be well-represented in the
research literature” (Levitt et al., 2018, p. 28). As can be seen, the value of the human
science research design in these domains, among others, is that it facilitates a type of
research approach that uncovers meaning within the domain of complex human
experience.
In terms of epistemology and ontology, the assumptions made by the human
sciences are starkly contrasted by those of the natural sciences. The natural scientist
seeks as a primary aim the conversion of research findings into a quantified, numerical
form. These data have immense value in certain contexts, such as delineating natural
laws of physics, chemistry, and biology. However, as the hermeneutic-phenomenological
critique has stated, its use is limited when studying human beings or social systems by its
inability to integrate either the subjectivity of the researcher or issues relating to
sociocultural context.
The natural science approach operates from the modern myth, stemming back to
René Descartes’ philosophy, that it is possible (in fact, preferrable) to observe the world
as an objective, unbiased observer. As Descartes’ wrote, scientific inquiry is for those
“who have the ability and the desire to withdraw from the senses and at the same time
from all prejudices” (Zimmerman, 2015, p. 22). Descartes’ lived in France during the
17th century, a time when disagreements about what was scientifically true were
punctuated not by debate, but by bloody conflicts and war. For this reason, Descartes and
his contemporaries were highly motivated to establish a concrete and unbiased view of
the world because, as he lamented, in philosophy, “no single thing is to be found in it
which is not of dispute and which in consequence is not dubious” (Copleston, 1963/1994,
p. 64). Descartes thereby revolutionized scientific inquiry by utilizing the concrete and
objective language of mathematics to resolve issues of prejudice in science.
Another ideological change stemming from Descartes’ philosophy was the
development of dualism, which encompasses a subject-object dichotomy. This way of
seeing the world suggests that the inner world of the mind is alive and contains a spark of
the divine. Conversely, the world outside the mind with all its objects, is but dead matter.
The most prominent example of this is the split between mind (res cogitans, or the
“thinking thing”) and body (res extensa, or the “thing out there”). This subject-object
dichotomy was widely accepted by scientists of the enlightenment era, and today is
treated as an unquestioned fact of human existence. However, this style of thinking
diverges significantly from other possible ways of seeing the world. For instance, each of
the historical, indigenous, mythological, and feminist views present a fundamentally
different view of the world not built upon the concrete division between subject and
object.
The critique of dualism was voiced even during Descartes’ lifetime, by the Italian
historian and philosopher Giambattista Vico (1725/2001). In, The Principles of a New
Science of the Common Nature of Nations, Vico refuted Descartes’ mechanical and
mathematical view of the world, and the subject-object split it implied. He called instead
for scientific inquiry to integrate the researcher’s humanness, what he referred to as “the
world of the human spirit” (p. 1). Vico presented a view of the world based on wisdom
and outlined a “poetic” approach to science (pp. v–x).
Despite suggesting an alternative, more holistic view of science, Vico’s
(1725/2001) ideas have remained marginal until recent years. The ascendence of
hermeneutic philosophy has introduced a new and powerful critique of the Descartes’
epistemology and the hegemony of the natural sciences, and has catalyzed a renewed
interest in the study of Vico. As the German hermeneutic philosopher Wilhelm Dilthey
pointed out, it is increasingly apparent that the natural scientific methodology is ill-suited
to understand human experience (Palmer, 1969, p. 100). Utilizing the hermeneutic
method—a method based on integrating inquiry with the inevitability of human
interpretation—Dilthey contrasted Geisteswissenschaften (the human sciences) from

Naturwissenschaften (the natural sciences) on the basis of the causal mechanisms of
nature versus understanding the human spirit.
Since Dilthey, the hermeneutic-phenomenologist Martin Heidegger has also
furthered the hermeneutic emphasis on interpretation (Zimmerman, 2015). He
endeavored to revise Western ontology altogether by returning to Descartes’ point of
departure and instead grounding an understanding of human knowledge in alignment
with the nature of being, which he called Dasein. In Heidegger’s view, knowledge is
always based upon the foundation of being and is inextricable from the always-already
meaningful relation of an individual within the world. This world includes the world of
language, tradition, and beliefs; but also the very human exigencies of daily function
(e.g., eating, sleeping, etc.). Essentially, this means the endeavors of human beings, even
the scientific ones, are always-already bound up within a background world of particulars
that is “nonexplicable,” able to be neither articulated nor transcended, but altogether
necessary for making sense of the world (Dreyfus, 1991, p. 4).
Ultimately, this hermeneutic critique is both ontological and epistemological. It
claims that even the most rigorous of research endeavors cannot untangle itself from the
background of human interpretation and the facticity of being contained therein. Hans-
Georg Gadamer (1962/2006), a 20th century hermeneutic philosopher, critiqued the
natural sciences for privileging the human subject as the starting point of knowledge.
Compared to other ways of knowing, such as the historical or indigenous, Gadamer
showed that the natural sciences operate by disconnecting the subject from the world. He
described that this form of inquiry requires standing apart from the world and analyzing
it, as if from a distance. He points out that different cultural and historical knowledge
traditions have taken a different form altogether. In these alternative views, an
individual’s subjectivity is treated as but one element within a larger experience and
process of discovery. Gadamer sought to revise natural scientific inquiry by integrating
the fact that truth is more than just an empirical set of data derived from a disconnected
observation of the world. Instead, Gadamer explained, truth is an event that happens to
us, which we participate in through the act of interpretation (Zimmerman, 2015, p. 53).
In the present study, these hermeneutic critiques are supplemented by the
ontology and epistemology unique to depth psychology. Depth psychology has presented
a particular approach to inquiry that extends the view of what comprises the human
relation to the world to include the unconscious psyche (Coppin & Nelson, 2005). This
ontological view provides the epistemological basis for integrating the researcher’s
unconscious experience into the research process. The alchemical hermeneutic methods
described by Romanyshyn (2013), which treats dreams, reverie, and the transference
dialogues as vital tools in the quest for knowledge, builds from this basis.
Research Procedures
The following account presents the methods of research in this study in such a
way as to provide a template for future researchers. In this study, articulating a
nonsensuous approach to psychotherapy has required integrating Bion’s nonsensuous
model of the psyche, as related to psychoanalysis, with the field of psychotherapy. The
form of textual analysis that this process demanded was one of immersion within the
literature on the topic of Bion’s thinking and within that of psychotherapy. Immersion
here means a depth and breadth of study defined by a period of concentrated study of
texts on the topic that endured for an extended time. This research procedure can be
compared to the alchemical hermetic jar, within which my psyche, the literature relating
to Bion and psychotherapy, and the research field (e.g., my sociocultural context, the
requirements for writing a dissertation, and my ongoing clinical work) were allowed to
mix. Over the course of more than 2 years, these elements mixed and morphed within
this jar, transforming until the final analysis could be completed.
Specifically, immersion within this hermetic jar consisted of a pattern of weekly
readings of texts on the topic of Bion and psychotherapy. This immersion with text
generally occurred on Thursdays and Fridays and sometimes extended into the weekends.
The topics of study would then linger over the weekend and into the week of clinical
work that typically occurred, typically, Monday through Wednesday. Over time, this
unique admixture of theory, practice, and life contributed valuable perspectives about the
research topic. It is worth noting the significance of other ingredients mixing in the
hermetic jar during this time, including especially those experiences related to the
escalating racial, social, and ecological distress and unrest that occurred as a constant
backdrop for this process of research. Where I live, in Seattle, the year 2020 was marked
by the introduction of coronavirus pandemic; escalation in Black Lives Matter protests
sparked by instances of overt brutality and racism in police forces across the nation;
wildfires raging in the Pacific Northwest; and Seattle’s unprecedented levels of urban
density and record prices in rent.
In this research process, reverie was used as a procedure for investigating my
psyche’s complex relation to the topic. As is common with reverie, this would typically
occur at times when I was not explicitly focusing on the topic. For instance, research
conclusions would occur to me in the middle of the night, during a long walk, or in the
midst of watching a movie.
Another method of analysis used in this study was the practice of free writing. By
adopting a practice of writing to discover, I adapted the transference dialogues to instead
explore the development of theoretical implications of what I was studying.
Ultimately, these methods allowed me to discover two sets of common factors,
one relating to Bion’s thinking and the other to psychotherapy. They also provided a
means for analyzing the conjunctions created by integrating them. Following Bion and
Romanyshyn, I used the conjunction created between these two sets of common factors
as providing perspectives to consider, with reverie and a practice of free writing, the topic
of the nonsensuous as applied to psychotherapy.
While this study was an attempt to provide a robust explication of Bion’s
theoretical constructs and their application to psychotherapy, it is undeniable that its
findings are suited uniquely to me and my psyche. In the final analysis, what is offered
here is unavoidably and undeniably my approach to psychotherapy, perhaps even more
than it is Bion’s.
This fact of the research is attributable not only to the overtly subjective
alchemical hermeneutic method, but also to something unique about Bion. For example,
O’Shaughnessy (2005) confirmed there to be “widely different readings of Bion’s
writings” (p. 1523). Moreover, as Bianchidi (2005) acknowledged, even after studying
Bion for 30 years, she is still able to “find new meanings and understand/discover
something unexpected” (p. 1529) in his writing. And, further still, Ivey (2011) wrote that
“not only are there divergent interpretations of his work and its clinical relevance, but
there are also no ‘Bionians’ to tell us how to interpret and use him” (p. 93). Ivey
concluded that “anyone who invokes Bion in order to tell us how to think and act as
therapists betrays Bion’s radical individualism and insistence that we think for ourselves
and find our own way” (p. 93). While the process of research for this current study was
an active and recursive dialogue with the text, the personal nature of the findings
demands a similar engagement from the reader. Insofar as these findings have meaning,
it will largely be constrained to the degree to which they are a catalyst for the reader’s
own process of personal discovery.
Ethical Considerations
As this was a theoretical research study, no human or animal participants were
utilized. I have made every effort to reflect the texts utilized in this study with the utmost
clarity and have sought to remain true to my impression of the author’s original context
and intent for the texts.
Depth psychologists have an appreciation for the multidimensional nature of the
researcher’s complex relationship with the topic being studied and the inevitable
limitations in fully understanding the unconscious relationship to the work (Coppin &
Nelson, 2005; Romanyshyn, 2013). Therefore, before moving on to the remainder of this
research, I want to address issues related to reflexivity. Reflexivity is important because
“we don’t assess objects neutrally from a distance, but they disclose themselves to us as
we move around in an already existing totality of meaningful relations” (Zimmerman,
2015, p. 39). In this research study, this can be observed across three dimensions.
First, as a researcher I have approached this topic with a personal set of
ontological and epistemological assumptions. Namely, that the significance and impact of
unconscious life on human experience is undeniable and has relevance for scientific
inquiry. Moreover, my attention is specifically focused on what is going on beneath the
surface (at times even more so than what is consciously expressed). As such, it is my
view that the unconscious domain of the psyche, as evidenced in dreams, fantasies,
daydreams, and free associations, are valid sources of scientific data.
Second, as an individual who has engaged in a long-term psychoanalytic therapy
conducted in line with Bion’s theoretical constructs, it is undeniable that I am bringing
my own experiences and wishes from that domain into this research. Through the
utilization of free-writing and transference dialogues, my relation to my therapist, which
mirrors an unconscious relation to my father, has been discovered as an important
motivation for this study. At times it was seen quite obviously that my desire to
understand Bion’s thinking was driven forward by an unconscious desire to be close to
my therapist and to make sense of our relationship. This, I discovered, contained the
deeper desire, left over as a remnant from childhood, to be close to my father, to whom I
always related most comfortably through the intellect.
Finally, and in light of these issues, it ought to be reiterated that what is offered in
this study is unavoidably and undeniably mine. The portrayal of Bion’s theories as well
as their technical application to psychotherapy are all permeated by my own complex
relationship to the subject at hand. Nonetheless, this study may yet achieve its stated
purpose by providing the most faithful and rigorous explication and application of the
version of Bion that I have discovered. These issues of reflexivity were not seen to
disrupt the nature of the research conducted. Any effect of this sort was mitigated, in
part, by ongoing monitoring of my unconscious relation to the research process, my

involvement in consultation with depth psychological advisors, and through my ongoing
participation in a personal psychoanalytic psychotherapy treatment.
Organization of the Study
In the following chapters, my findings about the use of the nonsensuous in
psychotherapy are presented. Beginning in Chapter 4, entitled “Bion’s Basic Concepts,”
a conceptual framework for Bion’s thinking is provided. The intent of this chapter is to
orient the reader to features of Bion’s thinking that will be important for distilling its
common factors.
Chapter 5, “The Nonsensuous Strategy for Psychotherapy,” is the heart of the
study. It first presents the core elements of Bion’s theory. The common factors of Bion’s
thinking are established as intuition, at-one-ment, binocular vision, and the unknown. It
then integrates these factors with the common factors established as the essence of
psychotherapy. These are the concepts of therapeutic relationship, the therapist’s
sincerity, the clinical use of attention, and courage. This process created conjunctions
between the core factors of Bion’s thinking and of psychotherapy and produced a variety
of vertices from which to see both. The intent was to catalyze in the reader a process of
discovery, based on new ways of seeing, relating to the use of the nonsensuous in
psychotherapy.
In chapter 6, entitled “Conclusion,” various reflections are presented as a means
of reviewing and concluding this research study. Specifically, in this section, I discuss
my findings in relation to clinical psychology and previous research, address questions
regarding the efficacy and limitations of the study, and make suggestions for future
research.
Chapter 4
Bion’s Basic Concepts
Of the many contributions Bion made to psychoanalytic theory, the focus of this
study was on the psyche’s transformation of nonsensuous reality (which Bion [1970]
called transformations in O). While this discovery ultimately led Bion to revise clinical
theory and technique, this was a relatively late development in his thinking. During the
early and middle parts of his career, while working with groups and psychotic patients, he
had first developed a theory of thinking based on the transformation of emotional
experience (Vermote, 2011, 2019). The conclusion he ultimately reached during this
period, which served as the point of departure for his later developments, was that the
psyche transforms emotional experience in order to represent it in the symbolic form of
thinking. His findings at this time coincided with similar developments in psychoanalytic
theory, such as Hannah Segal’s (1957) work on symbolic equation.
At this stage, Bion had proffered that pathology (and suffering, generally) results
from the fact that transformation of emotions and perceptions was impeded as a defense
against pain. In this view, painful aspects of emotional reality were barred from ever
entering consciousness at all. The most extreme instance of this can be observed in the
psychotic experience, a phenomenon which Bion (1962; 1967) devoted a great deal of
attention. This period of his thinking produced such concepts as alpha and beta elements,
alpha function, container-contained, and linking. Taken together, Vermote (2011)
referred to these concepts as comprising “a theory of thinking,” or what can be generally
referred to as “Transformations in K” (p. 1089). Ultimately, this version of Bion’s theory
described “how an emotion or perception that is not yet psychic can become psychic, and
how this process can be enhanced” (Vermote, 2011, p. 1089). In order to lay a
foundation for the development of Bion’s thinking as it occurred later in his life, his
thinking at this stage will now be reviewed in detail.
Bion’s Original Conceptual Framework
Container-contained. Like many of Bion’s concepts, the concept of container-
contained evolved in its meaning throughout his career. The concept, generally,
demonstrates the view of the psyche’s inextricable relation to emotional experience in the
development of the thinking capacity. Considered from this perspective, emotional
experience requires a relationship if it is to be registered consciously at all, which also
forms the basis of the capacity to “learn from experience” (Bion, 1962, p. 1).
At this stage of his thinking, Bion (1962) focused on the observation that
emotional experience needs to be contained if it is to become meaningful to the psyche.
This type of containment is dependent upon a real, external, relationship. This
relationship, first established between an infant and mother,2 involves a dynamic process
of unconscious emotional communication that has been referred to as projective
identification (Bion, 1967; Klein, 1946).
To understand this in more detail, consider the example of an infant’s sensation of
hunger, which Bion considered an emotional experience. In his view, the hungry infant
in this example has not yet developed the capacity to realize that this particular emotional
experience can be contained by the concept of hunger. The infant therefore only
2
The infant’s earliest relation to a primary caregiver will be referred to, in general form, with the mother.
This terminology serves the function of simplifying the matter at hand, as it follows both the general form
used by most authors in describing the infantile experience and the fact that the most common caregiver at
this stage is the mother. However, I would like to note that the use of this terminology risks placing undue
focus on the mother as contributing to psychopathology in addition to diminishing the fact that, very often,
the infant’s primary caregiver is someone other than a mother.
experiences the corresponding sensations, something akin to a state of incompleteness
verging towards death. The truth that these sensations indicate hunger cannot be known
because there is not an apparatus for thinking. Although the infant cannot know the truth
of its hunger in this cognitive sense, there is yet “an inborn pre-conception that a breast
that satisfies its own incomplete nature exists” (Bion, 1962, p. 69). When the infant
meets the breast that provides milk, this preconception is thus realized and results in the
birth of a concept. In other words, when the preconception of “a breast that satisfies” is
mated with an experience of being satisfied by a breast, a concept is born and the process
of thinking is generated. In Bion’s (1963) view, the concept here relates to a conjunction
established between a preconception and an experience.
Conversely, consider now the instance in which the hungry infant is left alone in a
state of incompleteness. In this situation, the need for the breast and the preconception of
it still exist. However, since this preconception is not realized by an experience, the
resultant sensation of incompleteness is now compounded. The absence of milk to fill
the stomach is amplified by the corresponding absence of an experience to fill the
preconception. In Bion’s theory, the psyche’s relation to this type of absence has
immense significance. As Grotstein (2007) explained, “The manner in which the infant
relates to this frustration, either through denial or through modification of it, becomes
decisive for mental growth and determines—as well as is determined by—his embrasure
of truth and authentic life” (p. 66). In other words, if this frustration can be tolerated, the
possibility to relate to it symbolically, through thought, emerges. In this outcome, the
experience of absence is contained by, and within, the thought “no-thing” (Bion, 1962, p.
34).
This example of a hungry infant demonstrates Bion’s view that thought develops
as a type of relationship in its own right. In this way, Bion likens the infant’s relationship
to thought to its relationship with the mother; both provide containment for emotional
experience. However, thought functions uniquely as container for the experience of
absence. In this view, absence itself is the catalyst for the development of a thinking
capacity. Since the infant’s need for relationship persists even when alone, absence
essentially catalyzes the discovery of thought as a substitute for relationship. The
relationship is now with a particular type of thing that can be referred to as a “no-thing”
(Bion, 1962, p. 35).3 In sum, Bion’s container-contained model presents a view of
thinking as an inherently relational process based upon the most basic human need for
containment of emotional experience.
This concept of container-contained provided a basis for Bion to revise
psychoanalytic technique. On one hand, the treatment relationship could now be viewed
as intervening on the deepest dynamics between container and contained as they exist
within the psyche. This honed the clinician’s focus on how emotional experience is
contained and how one relates to the experience of being contained. More specifically
still, clinical attention could now focus on the patient’s need for containment as either
met by familiar, though outdated, forms of containment or as remaining unmet for long
enough to discover new forms of containment, such as that offered by the therapeutic
relationship. This deepened appreciation for how the psyche receives containment from
negative or persecutory thoughts. And, conversely, it also highlighted how the
3
This position is mirrored in Whitehead’s (1911) analysis of the development of the number 0 as serving
the function of representing absence.
transference relationship might facilitate sustaining the frustration of absence for long
enough to discover new thoughts that provide containment.
It is now possible to describe a development to this model that Bion (1970) made
in his later theoretical developments. Drawing from Nietzsche’s (1885/1982) observation
that the survival of a society rests upon its function of producing a genius, Bion sought to
show how this same container-contained dyad functions intrapsychically to bring life to
the psyche. This nuanced intrapsychic dynamic can be exemplified by considering
instances throughout history of the mystic in relation to the establishment. It “is
exhibited in its most exaggerated … form in the account of Jesus and his relationship
with the group” (Bion, 1970, p. 111). In this example, Jesus has experiences with God
that could bring life to the entire group. In an optimal setting, this would happen because
the relation between the mystic and the group would be commensal. In the commensal
relation, “the advantages of the mystic’s communion with God or ultimate truth or reality
may be shared at one remove by the ordinary members” of the group (Bion, 1970, p.
111). However, as typically occurs, the container-contained dynamic created between the
mystic and the group is more destructive. This may occur because the group is
threatened by the mystic. This conflicting dyad becomes parasitic in its nature, and one
member of the dyad feeds upon the other to the destruction of both. For instance, Jesus’
fate was crucifixion, while the kingdom of God he preached became fractured. Bion
(1970) utilizes this sociocultural dynamic, which has occurred in various domains
throughout history, to demonstrate how container-contained dyad within the individual
psyche and created in the therapeutic relationship relates to “a messianic idea” (p. 112).
The value of these revisions in the container-contained model provided Bion a
basis for examining the value of reverie, or intuitive thinking, as a clinical technique.
Etymologically, the word reverie stems from Old French rever, meaning “to dream.” In
its colloquial use, it typically refers to “a state of abstracted musing; daydreaming”
(American Heritage Dictionary, 2016, p. 1502). Bion (1962) concluded that reverie, like
the dreaming that occurs while asleep, ultimately functions on its own accord (that is,
independent of volitional control) in response to the psyche’s ongoing demand of
discovering containment. In the clinical setting, the implication is two-fold and
reciprocal. To begin, Bion (1963) considered the nature of a container-contained dyad to
be marked by dynamic oscillation between the experience of containment and the loss of
it. This he depicted with the symbol , as in containercontained (Bion, 1963, p.
3). When containment is lost, reverie is a tool for facilitating movement towards its
discovery. Additionally, the capacity for reverie sustains the self during the experience
of the absence of containment, preventing the typical recourse to persecutory forms of
containment or other means of closing down the openness of discovery. Bion (1963)
identified this emotional experience as related to the chaos and anxiety Klein (1946)
attributed to the paranoid-schizoid position. For this reason, Bion (1963) also extended
the dynamic oscillation between container and contained in terms of the reciprocal
oscillation between the paranoid-schizoid and depressive positions. He extended Klein’s
(1946) model to represent her move from paranoid-schizoiddepressive to a more
dynamic form, representing it instead as paranoid-schizoiddepressive.
Alpha function, alpha and beta elements. The concept of alpha-function is a
neologism that Bion (1967) coined as a way to speak about the nonsensuous psychic
process that transforms experiences into something ultimately suitable for thought and
which can thus have meaning. The value of this neologism is that it reifies a process that
is abstract and, in a similar sense, not real. It thus functions like the mathematical use of
a numerical digit which, as Whitehead (1911) observed, can exist independent of a
relation to anything real.
The concept of the alpha-function provided an expansion of the container-
contained model. It depicts in greater detail a process within the psyche whereby raw
sensory experience (what Bion [1967] called beta-elements) are transformed into
something that can be used by the psyche (referred to as alpha-elements). Drawing upon
the metaphor of digestion, alpha-elements become food for thought, while beta-elements
cannot function in this way because they are raw and undigestible. For this reason, they
are ultimately destined to be rejected by the psyche. This occurs through such means as
projective identification (expelling them into a relationship with another person) or
somatization (expelling them into a relationship with the body).
Here Bion (1962; 1967) conceptualized the experience of the newborn infant as
characterized by bombardment of raw, meaningless beta-elements that have no use within
the psyche because there is no apparatus for thinking about them. It is ultimately the
containment provided by relationship with the mother, who lends her alpha-function to
this experience, that transforms the chaotic meaninglessness of sensory experience into
digestible thought material. The alpha-function thus serves as a process of
transformation within the psyche, which is first dependent upon the real relationship
infant and mother. The link established between them is simultaneously physical (insofar
as it involves bodily contact) and emotional (insofar as it involves projective

identification). When the infant faces emotions too big to digest (beta-elements),
projective identification within a relationship provides an outlet that is different in
consequence than discarding beta-elements into the void of empty space. If the mother is
open to receiving projective identifications from her infant, the possibility is introduced
that these elements may be transformed into something digestible for the infant through
her alpha-function. In this container-contained dyad, the infant benefits from the
mother’s alpha-function both concretely, in the form of modified experience, and by
internalizing a capacity to be used for oneself (Bion 1962; 1967; Vermote, 2019).
This stage of Bion’s thinking introduced a novel view of infantile development,
specifically as it relates to the development of the capacity for thinking. Caper (1998)
noted how the absence of an early container-contained relation has disastrous
consequences for the infant’s capacity to relate to emotion in the form of symbolic
thought. As Bion (1962) explained, “the failure to establish, between infant and mother,
a relationship in which normal projective identification is possible precludes the
development of an alpha-function” (p. 115).
This concept expands the dynamic of container-contained to the clinician’s
capacity to remain open to the patient’s projective identifications, which facilitates the
use of the clinician’s alpha-function to stimulate the patient’s growth. Growth can thus
be framed as the result of nourishment received from the truth of emotional experience
and through introjection of the alpha-function. It also presents an opportunity to consider
a problem of psychic functioning characteristic of personality and psychotic disorders. In
these disorders, patients present as being trapped inside an extremely limited way of
being. They are essentially unable to have a new experience. Despite the painfulness of
this way of life, patients will paradoxically block clinical interventions aiming to ease
pain. Bion’s (1967) model of alpha-function provided a means of conceptualizing this
perplexing phenomenon as indicative of a reflex that impedes the transformation of beta-
to alpha-elements as a means of defense. It is essentially as if a person who has
experienced too much frustration and deprivation in life constructs a type of protective
screen around the psyche that effectively blocks new experiences of any kind from being
consciously registered altogether. Bion (1962) referred to this as a “beta-screen” (p. 23).
In effect, it is as if the psyche has announced, “I’ve had enough frustration with trying to
share my pain with other people. I don’t need anyone anymore. I’m going to do it all on
my own from now on.”
Because of this beta-screen, clinical interventions that cannot deepen beyond the
superficial level of experience are meaningless. Therefore, as Bion (1967) proffered,
what is needed is the discovery of a different way to listen to clinical experience. Bion
(1967) compared this to learning to listen the music of the session, and to use the music
itself as the basis for new interventions.
Linking (L, H, & K/-L, -H, & -K). Another novel concept Bion introduced
during this stage of his thinking was of the psyche’s innate drive, present from birth, and
possibly before, to form relational links with the objects and people the compose the
external world. These links are emotional in nature, and are built upon the psyche’s
inherent passions. Bion (1963) used the word passion to “represent an emotion
experienced with intensity and warmth though without any suggestion of violence” (p.
13). The passions inherent in the human psyche are that of love (L), hate (H), and the
drive to know (K). Here, Bion built upon Klein’s (Klein & Riviere, 1937) view of the
psyche. Klein originally proffered love and hate to be held in a dynamic tension within
the psyche. These forces were balanced by the presence of a third factor, the
epistemophilic instinct (e.g., the drive to attain knowledge) from birth (Segal, 1964). In
Klein’s view, the etiology of psychopathology could be understood as based on the
conflict between these conflicting drives, and especially in their pathogenic effect on the
formation of object-relations (Bléandonu, 1994, p. 161). Bion ultimately retained Klein’s
basic postulation of the early significance of the passions of love, hate, and especially, the
desire to know, using them as the basis for his model of linking.
The linking established through the passions is the prerequisite for the
development of a container-contained relationship. For Bion (1962), any passion can
form an adequate link. A relationship defined by H can be just as beneficial to the psyche
as one defined by L. In particular, Bion (1962) proffered that no authentic relationship
can escape the presence of both L and H. However, it is the K link that is most
predominant and that contains L and H within it. Although Sandler (2005) disagrees with
this point, Grotstein (2007) asserted that “We emotionally know someone by our
awareness of our love and/or hatred of him or her” (p. 311). The K link is so pivotal to
Bion’s thinking because it is also presented as an essential component of projective
identification. The intensity of the link is correlated with the degree to which projective
identification functions. For instance, a mother has an intense link with her infant, and as
such, she is more open to learning about her infant emotionally than would a
schoolteacher or babysitter.
Bion (1962) developed an important nuance of linking by showing that it is also
possible to form a link in the negative form, as through the absence of passion. In this
type of relation, built upon absence, links are referred to in their minus form, as -L, -H,
and -K. In each, the result of this link is not growth but destruction, or antigrowth. This
type of linking implies that the connection between two things (typically between people)
is marked by a destructive factor akin to Freud’s death drive or Klein’s envy.
The concept of negative linking reinforces once again Bion’s (1962) view that the
psyche responds to absence with a type of no-thing. For the psyche, there is no such
thing as absence or emptiness. In other words, even absence comes to be experienced as
a form of presence. Whereas in healthy linking two people become joined through
passion and the relationship is invested with life, in negative linking, it is the absence of
passion that binds. The bond established through absence becomes destructive, and
creates chaos and meaninglessness, and can be likened to a situation in which one eats a
meal solely for the purpose of creating the conditions necessary for vomiting.
This concept of linking provided a basis for Bion (1962; 1963) to reconceptualize
vital aspects of clinical technique. To begin, it is now possible to consider with more
specificity not only the necessity of a clinician’s passionate link with the patient, but also
the form and character of this link. If this link is not formed, or if it is formed in the
negative, there will be no emotional groundwork from which to build upon and clinical
work will be ineffective. Focus on the nature of linking obviously applies to the clinical
assessment of these same dynamics emanating from the patient to the clinician.
Evaluating experiences from this vertex deepens engagement with container-contained
dynamics created in the therapeutic relationship. It also provides a vertex from which to
integrate the full significance of experiences that are unpleasant and difficult to manage,
such as in the presence of hostility, apathy, or chronic confusion, which are each assigned
a special place of meaning in light of negative linking.
Bion’s Developments in Light of Psychoanalytic Theory
Development of Klein. Having participated in psychoanalytical training within
the British Psychoanalytical Society at a time when Melanie Klein’s influence was at its
peak, and having receiving his second analysis from Klein herself (a treatment that
endured for 8 years: 1945–1953), it follows that Bion’s theoretical developments at the
early and middle stages of his thinking would be strongly situated within a Kleinian
framework. During this time, Klein’s innovative development of Freudian principles had
excited the analytic community, revitalizing an interest in the possibility of expanding the
scope of the psychoanalytic methods to the analysis of children and patients suffering
from psychosis (Segal, 1964).
As Petot (1979) has shown, Klein’s theoretical developments build from a
presupposition of the overwhelming influence of unconscious phantasy on all conscious
thought, affect, and behavior (p. 56). Isaacs (1948/1989) captured the significance of this
viewpoint, writing that Klein “showed that the inner world of the mind has a continuous
living reality of its own, with its own dynamic laws and characteristics, different from
those of the external order” (p. 81). In Klein’s view, the significance of unconscious
phantasy permeates the psyche in terms of its primitive defenses, the paranoid schizoid
and depressive positions, and projective identification (Segal, 1964).
Early on in his career, Bion relied on these Kleinian positions to develop his
theory of thinking. The significant role the primitive defenses in the life of the psyche,
especially in terms of psychopathology, is evident in his collected papers on psychosis

(Bion, 1967) and in Learning from Experience (Bion, 1962). During this phase, he
agreed with Klein that primitive defenses, especially splitting, are used with immense
destructive intensity within the psyche as protection against painful affect. In particular,
the infant’s use of this primitive defense against the pain and terror of nonexistence was
foundational for Bion’s (1967) theory of the development of language and symbolic
thinking. In this model, Bion integrated Klein’s emphasis on the primitive defenses into
a conceptualization of both patient and clinician as experiencing reality, internal and
external, as based on emotion.
Another theme permeating Bion’s thinking at its early stage is the development of
the paranoid-schizoid and depressive positions. Klein (1946) originally posited that
people never fully outgrow the regressive tug of infantile phantasies and primitive
defenses characteristic of the paranoid-schizoid position. This position is marked by the
psyche as operating in the dynamic act of splitting off and projecting outward, with
varying degrees of intensity and destructiveness, primitive mental states. The correlating
emotional experience of this position is that of persecutory anxiety, and the unconscious
phantasies are largely omnipotent in their nature. According to Klein (1946), emotional
development involved integrating these split-off parts of the psyche, a gradual process of
psychic integration that coincides with and facilitates movement to the depressive
position.
In the depressive position, the reality of one’s separateness, and the corresponding
vulnerability and dependency, can be consciously acknowledged. The painful truth of
this reality is experienced more in its depressive form than in a regressive, primitive state
of denial and splitting which marks the paranoid-schizoid position. For Klein (1946), this
developmental process is unidirectional. The movement from the paranoid-schizoid
position to the depressive position is thus depicted as PSD.
Bion deepened and revised this configuration. In his view, the psyche is caught in
an ever-changing oscillation between the persecution of the paranoid-schizoid position
and the relative calm of the depressive position. The dynamic oscillation between these
states he represented with the revised symbol of PSD (Bion, 1963, p. 3). Although it
is more complicated, this is not necessarily a pessimistic conclusion. While people can
never escape from the reality of disorganization, breakdown, and loss, Bion (1963)
implied that this is an experience all people have in common, and one can discover the
capacity to tolerate this reality. As Vermote (2019) summarized, Bion thought “human
beings are already regressed and must learn to deal with it” (p. 24). In essence, this
position considers both patient and clinician as fragmented because they are depressed
(and depressed because they are fragmented), and that this reality becomes part of the
clinical experience and work for both partners. The point relates to the development of a
capacity to tolerate the dynamic movement between fragmentation and depression as it
occurs in the clinical experience; an achievement which corresponds with developing a
capacity to, in a sense, swim without drowning.
Klein (1946) had originally described projective identification as a form of
primitive defense whereby the split-off aspects of the psyche are projected, in phantasy,
into an external object. This complex relational process corresponds with an underlying
unconscious phantasy that omnipotently dominates, controls, and uses the object in
service of avoiding emotional pain. The Kleinian use of the concept is focused on “that
which is projected into the mother and how the experience of the mother is altered in the
infant’s phantasy” (Brown, 2010, p. 670). In this sense, its use is always viewed as
indicative of underlying psychopathology.
While Bion retained Klein’s use of the concept to describe psychopathology, he
expanded it to depict a healthy, normal component of psychic life that serves the purpose
of emotional communication. Projective identification, in its healthy sense, forms the
basis for emotional communication between infant and mother that is of paramount
significance for developing the capacity for symbolic thought. In this revision, Bion
(1967) had suggested that the infant’s terror of nonexistence was primarily
communicated to the mother via projective identification (pp. 114-115). He proffered
that the mother, if she was open to receiving her infant’s projections, contained,
modified, and returned this terror in a more manageable form (Vermote, 2019, p. 76).
Among the many nuances of this revision, one implication is that this unconscious
emotional process corresponds with a realistic counterpart in the form of the external
object’s identification with the projections (Brown, 2010). In other words, the recipient
of the projected material is altered by it, whether consciously or not, in terms of emotion,
thinking, and/or in behavior.
The breakdown of healthy projective identification in the infantile relationship
can lead to severe psychopathology, including psychosis. In this sense, Bion ultimately
agreed with Klein (1946), who posited, “if this projective process is carried out
excessively, good parts of the personality are felt to be lost . . . this process too results in
weakening and impoverishing the ego” (p. 9). Bion (1967) elaborated on this precept,
suggesting that this projective process can split off and project more than just emotion.
He wrote that, in some cases, the defense against the pain of reality requires splitting off
functions of the mind, such as the capacity for thinking altogether (Bion, 1967, p. 51).
Once split-off, these psychic functions themselves become subject to projective
identification and can thus be felt to belong to another, a situation that illuminates some
dynamics of the psychotic process.
Development of Freud. Wieland (2013) has observed that “Bion used Freud to
transform Klein, or Klein to transform Freud…. both statements are true” (p. 117). One
way to grasp Bion’s theoretical development of Freud is through considering how the
psyche is involved in a process of transformation. In Bion’s (1965) book,
Transformations, he compared the process of transformation in the psyche to the theory
of transformations as observed in algebraic geometry. He ultimately concluded that the
origin of all transformations in the psyche occurs at a place where the psyche comes into
contact with ultimate reality itself, which he called “O” (Bion, 1965, p. 139). This
relatively late-career development led Bion to attempt a deeper examination of the
psyche’s nonsensuous nature, which is ultimately unknowable, resulting in the theory
Vermote (2019) categorized as “transformations in O” (p. 1). At this stage of his
thinking, Bion was building from points that were already present in their nascent form in
Freud’s thinking.
When Freud (1911/1959a) posited consciousness to be like “a sense-organ for
perceiving psychic reality” (p. 4), he thereby differentiated between psychic reality and
external reality. By suggesting that both realities require a “sense organ” to be perceived,
he implied both as nonsensuous in their essence. Freud (1915/1959c) explicitly
acknowledged the ultimately unknowable nature of both the psyche and reality, and
engaged the philosophical background of this question about the knowability of reality
directly. As he wrote, “Kant warned us not to overlook the fact that our perceptions are
subjectively conditioned and must not be regarded as identical with what is perceived
though unknowable” (Freud, 1915/159c, p. 171). While addressing the nonsensuous
nature of reality and the psyche, Freud did not fully develop the implications this
statement contained.
Rather, this foundation served as the point of departure for Bion’s theoretical
developments. Bion (1965) ultimately situated the entire psyche as a thing-in-itself,
belonging to the numinous realm of ultimate reality. He proffered that the nonsensuous
psyche exists in a state of dynamic contact with reality, producing consciousness through
a process of transformations that occur at a basic and unknowable level. Bion (1965)
represented the ultimately unknown and unknowable nature of the psyche as it is in itself
with the symbol O, which he used to denote ultimate reality or the thing-in-itself. As he
explained, “When I assigned O to denote the reality, the impression of which the
individual submits to the process [of transformation], I had in mind what Kant describes
as the unknowable thing-in-itself” (Bion, 1965, p. 31). Like all noumenon, O cannot be
known directly as it is in-itself. It is here that Bion (1970) would make his greatest
theoretical leap. He wrote “O does not fall in the domain of knowledge or learning save
incidentally; it can be ‘become’, but it cannot be ‘known’” (Bion, 1970, p. 25).
Unpacking this statement comprises a major focus of Bion’s later work (1970;
1994/2008; 1977/2018).
From content to process. Bion’s (1965; 1970) discovery of transformations in O
shifted psychoanalytic theory from its focus on thinking and the content of thoughts
toward a new focus on being and experiencing and the process of thinking. Some
consider this change to be a radical departure from orthodox psychoanalysis. According
to Symington and Symington (1996), “Psychoanalysis seen through Bion’s eyes is a
radical departure from all conceptualizations which proceeded him” (p. xii). On this
point, the field is divided. O’Shaughnessy (2005) offered a contrasting view, asserting
that Bion’s thinking can be firmly grounded within the theoretical lineage tracing through
Klein and back to Freud. In O’Shaughnessy’s view, the developments Bion contributed
are reflected in similar findings in the work of his colleagues, especially Rosenfeld
(1952), Segal (1957), and in the larger theory developed by Donald Winnicott (1970).
According to Bion (1970), my contribution should “not replace any existing psycho-
analytical theory, but is intended to display relationships which have not been remarked”
(p. 87).
Despite disagreement about its significance and position within the
psychoanalytic corpus, Bion’s contributions undeniably shifted clinical focus from
content to process. Because of his work, it is now widely considered to be more exigent
to the clinical task to discover a means of being human with the patient than in finding
the correct interpretation to give to them (Vermote, 2019). In this way, Bion’s work does
diverge significantly from Freud and Klein.
In Freud’s original conceptualization, the analytic task was confined to the
content of thoughts and, especially, to their relation to an underlying latent meaning. The
emphasis on the content of thoughts represents a commonly held 19th century
perspective, grounded in a view of the psyche as always preoccupied with the task of
repression. The view that the act of repression ultimately generates symptoms, referred
to in depth psychology as “the return of the repressed” (Freud, 1915/1953, p. 154), forms
the basis for the psychoanalytic method. This method was intended to examine the
relation of symptoms to repressed thoughts, and to discover their latent, undisclosed
meaning. This treatment aim was justified by the view that bringing unconscious
thoughts into consciousness would thereby free up psychic energy otherwise used for
repression for engagement in reality instead. This clinical method, as Freud showed,
equally applied to understanding symptoms, dreams, slips of the tongue, free-
associations, and transference phenomena; each of which reveal, in Freud’s model, the
hegemony of infantile sexuality within the psyche.
Melanie Klein expanded this conceptual base by integrating it with an emotional
and relational view of the psyche (Meltzer, 1984/1992). In her analysis of young
children, Klein discovered dynamics of aggression and destruction as being prominent
from even the earliest stages of life. These destructive psychic forces, Klein posited,
created a conflict in the psyche’s drive to form object relations. Because of the threat it
poses, the psyche defends its object relations by splitting aggression away from
consciousness. In this way, aggression serves as a theoretical basis for the prominence of
projection, introjection, and projective identification in psychopathology (Meltzer,
1984/1992). Whereas Freud had conceptualized pathology in terms of a disconnect from
reality, it is Klein’s articulation of the primitive defenses that informed her view of
pathology (Meltzer, 1984/1992). By highlighting the significance of this earliest
relational drive within the psyche, and the dramatic conflict created by aggressive
impulses, Klein effectively established a view of the psyche as emotional and relational
in its basis. Despite this shift in focus, her analytic method ultimately maintained a
clinical technique based on analyzing content of thoughts.

It was Bion who would ultimately move psychoanalysis away from this focus on
thoughts (Meltzer, 1984/1992). He did so not by severing the connection to Freud and
Klein, but by deepening it, developing ideas present in a nascent form within each of
their theories (Wieland, 2013). In the early and middle stages of his career, Bion had
already begun this development by examining the process of thinking as a product of the
transformation of emotional experience (Vermote, 2019, p. 18). Whereas the early stage
of Bion’s thinking demonstrates his emphasis on the process of thinking as a
transformation, it was with the theoretical developments of his late career that he fully
developed a model for considering the origin of this transformation. The result of this
shift in focus was a model for conceptualizing an unknown process of transformation that
occurs where psyche contacts reality. The corresponding technique to this theoretical
shift was “a living, experiencing form of psychoanalysis from an attitude of radically not-
knowing” (Vermote, 2019, p. 13).
Moving to the Nonsensuous
The move Bion made to consider the nonsensuous in psychoanalysis amounts to
what Vermote (2019, pp. 135-139) considered to be a monumental leap, with significant
personal consequences for his career and status within the psychoanalytic community.
Many scholars consider Bion’s discoveries beginning at this stage of his thinking to be
reflective of a decline in the caliber of his thinking, with some suggesting the possibility
of an even more significant detriment in his mental capacities (O’Shaughnessy, 2005).
This view is supported by the fact that the theoretical changes at this stage in Bion’s
thinking were punctuated by his unexpected move from living in London to Los Angeles.
Despite these critics, the value of Bion’s thinking at this stage can be clearly discerned as
related to a deeper engagement with the psyche as a nonsensuous entity.
While in California, Bion established a clinical practice and, through clinical
seminars, continued articulating the concept of the nonsensuous into clinical technique.
A major theme of this stage was his return to the necessity of discovering a means of
becoming one with the transformations of O. He continued to lecture widely on the idea
that O can never be known as it is in itself, but that the transformations in O can be
known in so far as one can participate in it, or become it.
Bion’s thinking at this stage now departs significantly from orthodox classical
analytic technique. Bion presented the psyche alongside “ultimate reality,” the
nonsensuous, numinous dimension which cannot be known as “a thing-in-itself” (Noel-
Smith, 2013, p. 128). From this new perspective, conventional clinical theory and
technique can be seen as too dependent upon sensuous layers of transformations. Bion
(1994/2008; 1977; 2018) supplemented this critique with new dimensions of technique he
considered more suited to engaging this dimension of the psyche. As Vermote (2019)
explained, “Bion concluded that an approach based on the senses is not apt and may even
be a hindrance to facilitating and apprehending [transformations in O]” (p. 17). If Bion’s
approach is radical, it is because of the nature of the techniques he developed for
“facilitating and apprehending” transformations in O, which orient the clinician to a
process of being, becoming, and experiencing contact with the transformation of
unrepresentable and unknowable nonsensuous aspects of “ultimate reality” (Noel-Smith,
2013, p. 127).
Examples of the nonsensuous. A principle aim of Bion’s theoretical
writing at this stage is to orient the clinician to the nonsensuous, undifferentiated,
and not yet represented zone where psyche meets reality. Since this technique
cannot be taught directly, Bion provided many different vertices from which one
could conceptualize this theme. He considered a multitude of alternative points of
view as functioning like viewing a mountain from different angles.
One example Bion (1970; 1977/2018) often cited is of mystics who throughout
history have sought to differentiate nonsensuous experience of God from the necessity of
using sensuous language to talk about God. The conflict between mystics and religious
establishments reaches something like an archetypal dimension in these examples,
demonstrating an inherent tension that exists between the nonsensuous realm of pure
experience and the ways these experiences seek to become represented (and ultimately
controlled) by language, scientific theory, and by institutions of every kind. The 13th
century mystic, theologian, and feminist, Meister Eckhart, who was notably condemned
as a heretic by the religious establishment of his time, taught that true spirituality is an
experience of becoming and being God, writing that “In God, action and being are one”
(Fox, 1983, p. 96). Eckhart juxtaposed the experience of God from knowledge about
God, explaining that “One should love God mindlessly, by this I mean that your soul
ought to be without mind or mental activities or images or representations” (Fox, 1983, p.
46). Here Eckhart demonstrated the nonsensuous basis of spirituality, which necessarily
eschews knowledge and words about God because they are falsifications of God. He
explained that “God is not found in the soul by adding anything, but by a process of
subtraction” (p. 45). The negation of knowledge is a movement away from thinking and
instead a movement toward being, as is also expressed by another mystic, St. John of the
Cross. St. John of the Cross expanded this view by describing how “memory must also
strip itself of all those forms and kinds of knowledge, that it may unite itself with God in
hope” (Bion, 1977/2018, p. 38).
Another vertex for looking at the nonsensuous technique Bion developed
comes from considering the act of play. Like spirituality, a moment of genuine
play cannot be taught, it has to be discovered as it is created and participated in.
In his analysis, Gadamer (1962/2006) stated that in true play there are no players.
This view highlights Bion’s emphasis on being over knowing, for the concept
player itself presupposes a conceptual or, as Bergson (1896/1911) said, a
utilitarian relation to the world. This is most apparent when one tries to theorize
about playing. By contrast, “true play does not belong to the realm of theoretical
knowledge” (Gadamer, 1962/2006, p. 103). And, further, “play fulfills its
purpose only if the player loses himself in play” (Gadamer, 1962/2006, p. 103).
The experience of becoming lost in play illustrates an important feature of what
Bion (1970) called at-one-ment. In at-one-ment, the concept of the self is lost or
submerged, along with all other forms of reflective and self-conscious thought,
within the state of union with “ultimate reality” (p. 30).
A final vertex for understanding this theoretical basis comes from
considering development of consciousness as it occurs primordially within the
womb. Martin Buber (1958) suggested that “in the womb man knows the
universe and he forgets it at birth” (p. 50). This view presents an evocative
opportunity for considering how the prototype of consciousness is as not yet

experiencing any form of absence, and therefore not needing any thought. Prior
to birth, the fetus exists in the state of one-ness with its environment, the womb.
This one-ness typifies the pure, unselfconscious state being of that is called at-
one-ment and also typifies religious ecstasy. Consciousness in this state, in
whatever nascent form it might achieve, operates freely and without demand for
the symbolic representation of thinking. In other words, it exists in a state of
being that does not reflect on itself. This state of being is so thoroughly saturated
by being that there is no self. As Buber suggested, this state of being is like a type
of divine union with the ultimate Mother of the universe.
The paradox of using language to represent the nonsensuous. The extent to
which Bion (1970; 1977/2018) emphasized these examples of the nonsensuous, and
especially their use in perceiving the nonsensuous psyche, confirms its prominence in his
thought at this stage. He also acknowledged the considerable challenges he faced in
articulating this technique. An engagement with the nonsensuous is, by its nature, an
achievement that must be created, discovered, and experienced by the individual person.
Responding to the paradoxical challenge of developing a theory about something
inherently antitheoretical, Bion’s late career theoretical developments adopt a style that
integrated theory with the necessity of personal discovery. In other words, Bion’s (1970;
1994/2008; 1977/2018) theory now functioned like a container for discovering one’s own
relation to the ideas he introduced. This method of teaching the unteachable resulted in a
complex and fluid style that characterized his work at this stage and catalyzed the
personal engagement with the text. Bion (1994/2008) commented on this necessity,
saying that “the analyst you become is you and you alone; you have to respect the
uniqueness of your own personality” (p. 15).
Ultimately, what Bion presented is a model that aligned clinical technique with
the truth that life and reality are in a constant state of dynamic movement. Working
clinically within such a reality mandates constant diligence to notice within oneself the
unfolding tension between the necessity of closing down life (e.g., in word and thought,
or in the necessity of organizing experiences into theory) and opening up to the unknown
of life (e.g., the reality that lived experience is constantly unfolding toward the infinite).
Chapter 5
The Non-Sensuous Strategy for Psychotherapy
The Common Factors of Bion’s Thinking
The four factors that can be isolated as foundational to Bion’s thinking about the
nonsensuous are at-one-ment, intuition, binocular vision, and the unknown. These are
considered common factors because together they comprise the essential components of a
clinical strategy grounded in Bion’s thinking. Despite variations in form, content, or
style, this strategy is ultimately distinguished by its orientation to the nonsensuous.
At-one-ment. The concept of “at-one-ment” (Bion, 1970, p. 30) simultaneously
coheres the foundational elements of Bion’s thinking about the nonsensuous while also
anchoring a specific strategy for clinical work. At-one-ment with ultimate reality, or O,
is a state of pure, unselfconscious being, such as that which occurs in spiritual union with
God, in true play or love, and, most basically, in the consciousness characterizing the
primordial fetus within the womb. Its most notable feature is the absence of self-
consciousness. This state of being is the exact opposite from the tendency to close down
experiences by seeking refuge within knowledge and theory. The concept of a self
depends upon the sensuous domain of words, thoughts, and feelings, and is the basis for
self-consciousness. However, in at-one-ment, the psyche surrenders to a state of pure
being that exists in accordance with the unfolding of reality. For this reason, Bion (1962)
asserted at-one-ment to be “essential to harmonious mental growth” (p. 145). This view
is bolstered by the fact that important experiences in life (e.g., an infant with mother,
union with God, pure love, etc.), and the intense feeling of safety and security associated
with these experiences, are intricately related with a state of at-one-ment. Accordingly,
Bion (1967) considered mental illness to obstruct the experience of at-one-ment. He
considered the terror of surrender to necessitate an unrelenting dependence upon the
sensuous domain. This intractable dependence on language and thinking makes at-one-
ment impossible and exists as a matter of course in mental illness.
Clinically, at-one-ment is the basis for a clinical strategy based on being and
becoming. By becoming one with ultimate reality, clinicians are able to learn about the
psyche through a participation in the process of transformation. This experience is
distinguished from the analysis of a state of being. It effectively integrates components
of being with the patient and functions as a means of learning how the patient relates to
ultimate reality. However, since this type of knowledge is impossible to represent
sensuously, it is ultimately the experience of being and becoming that matters most.
Intuition. Reverie and dreaming both operate as a form of intuition. Intuition
generally forms the basis for a clinical technique that relates to at-one-ment, but is
distinguished by being more practically apprehended. The theoretical development of
intuition as a clinical technique amplifies and integrates ideas from a variety of
multidisciplinary sources, especially from the philosopher Henri Bergson. According to
Goudge, Bergson established that “living reality can never be communicated by images
or concepts, but must be directly intuited” (Bergson, 1912, p. 13). Bion’s use of intuition
grounds a method of perceiving the non-sensuous transformations in O. This theoretical
development ultimately distinguishes the technique of the nonsensuous from other
medical treatments. As Bion (1970) explained,
The point that demonstrates the divergence most clearly is that the physician is
dependent on realization of sensuous experience in contrast with the psycho-

analyst whose dependence is on experience that is not sensuous. The physician
can see and touch and smell. The realizations with which a psycho-analyst deals
cannot be seen or touched; anxiety has no shape or colour, smell or sound. For
convenience, I propose to use the term “intuit” as a parallel in the psycho-
analyst’s domain to the physician’s use of “see,” “touch,” “smell,” and “hear.” (p.
7)
This view of intuition distinguishes technique not only from that of regular medical
practice, but also presents a point of divergence from the conventional view of clinical
technique, more generally. Whereas Freud and Klein both articulated techniques for
analytic thinking, by emphasizing the use of intuition for perceiving the non-sensuous,
Bion (1970) presented the necessity of antithinking.
Intuition is a type of mental activity that operates distinct from the sensuous,
utilitarian, and speculative forms of thought that characterize daily life. Whereas the
concrete thinking of daily life serves to close down and limit the infinite openness of the
psyche by adding structure, intuition extends awareness beyond these concrete structures.
It extends awareness toward the psyche’s inherent dynamic alive-ness, its constantly
unfolding evolution of experience, and to the process of being (Torres, 2013). This type
of intuitive perceiving is a subtle craft. In Bion’s (1970) view, it can only be achieved by
“blinding oneself artificially” (p. 58). Despite its novelty in this context, the development
of intuition as a clinical technique was not without precedent in Freud. Freud
(1912/1959b) hinted at his own use of intuition, which he described as adopting a state of
“evenly hovering attention” (p. 110). And, in a letter to Lou Andreas Salome, Freud
(1916/1992) hinted at the value of an intuitive type of thinking by describing an effort to
“blind myself artificially in order to focus all the light on one dark spot” (p. 312)
Binocular vision. In the normal visual experience, eyesight is experienced as a
single, unified field of perception. This seemingly indivisible visual field conceals the
fact that vision is the result of a relatively seamless act of integration derived from two
distinct visual fields. In Bion’s (1962) thinking, this binocular nature of vision
represented a general, albeit abstract, fact about the psyche. It shows how the psyche
integrates disparate viewpoints in order to form a unified thought. Just as healthy
eyesight depends upon the process of integration, so too does healthy psychic life depend
upon one’s innate capacity for the integration of multiple perspectives.
The concept of binocular vision receives its first mention when Bion (1961)
worked with groups. In a paper written during this stage of his career, the concept was
used to represent how different ways of seeing dynamics in group experience yield
deepening dimensions of insight. Using the metaphor of “looking through a microscope
at an overthick section” (p. 48), Bion (1961) observed the necessity of making
adjustments in one’s perspective. For instance, from one perspective, the discord created
in a group by the absence of two of its members was seen as a setback, an unexpected
regression in the groups’ otherwise satisfactory development. However, by displacing
focus on a different dimension of seeing, the experiences of the group could be seen as
illuminating an unacknowledged fact that these two members had hitherto been serving
the group as unwilling leaders. From this new way of seeing, their absence was a form of
silent protest, a message sent to the group that needed to be integrated so as to move
toward a more authentic form of unity.

The concept was revised further in Bion’s (1967) work with patients suffering
psychosis. At this stage, he expanded the concept by considering the inability to achieve
binocular vision. In the absence of this capacity, the psyche resorts to a style of thinking
typified by opacity between perspectives, a type of monocular vision that impedes
integration. In other places, Bion (1962) surmised that this was a salient feature of
mental illness, wherein the “contact barrier” (p. 27) between multiple perspectives and,
specifically, between the conscious-unconscious, becomes overly rigid and thereby limits
appraisal of the self from more than one perspective. What results is “the view of one
part by the other [that] is, as it were, monocular” (Bion, 1962, p. 54). Monocular vision
indicates, and exacerbates, severe forms of thought disturbance. It is indicative of a
larger inability to achieve unity within the self. Sandler (2005) described this deficit in
terms of the “self-apprehension of one’s own self. In other words, [the capacity] to
apprehend whom one really is” (p. 83).
The concept of binocular vision expanded conceptualizations that Bion (1967)
had earlier made about the psyche’s “imaginary twin” (p. 3), which he proffered to
always exist in a state of unconscious tension with one’s conscious self-representations.
Impediments in binocular vision amount to a denial of one’s imaginary twin which, in
effect, obstructs the possibility of integrating this feature of one’s psyche in service of
self-knowledge and growth. Bion (1962) suggested that a clinician ought to utilize one’s
own capacity for binocular vision to complement this deficiency in the patient’s psyche
to “form models and abstractions that serve in elucidating the patient’s inability to do the
same” (p. 104).

In Sandler’s (2005) view, Bion’s development of binocular vision serves as a
model that integrates disparate dimensions of his theoretical developments. It functions
as a way of orienting clinicians to the necessity of seeing both the sensuous and
nonsensuous at once. Importantly, this combined way of seeing has a generative effect
and gives birth to new types of thoughts. This generative component of binocular vision
“expresses a basic fact of human life as it is: the fundamental ‘supremely creative
couple’” (Sandler, 2005, p. 83). In conclusion, the concept of “two-ness,” and the
generative result of their union, summarizes a more general theme permeating Bion’s
thinking that integrates “pre- and post-catastrophe, sensorial and ineffable, imaginative
speculation with wild and stray thoughts and a disciplinary, very strict frame” (Vermote,
2019, p. 54).
The unknown. Perhaps more than any other concept, it is the unknown that
comprises a most central factor of Bion’s thought. Whereas Freud (1915/1959c)
acknowledged the ultimate unknowability of the unconscious, Bion (1970; 1977/2018)
developed this view to its logical end. Considering the psyche to be “a thing-in-itself,”
he proposed that one must constantly discover the means of displacing the stasis of
knowledge so as to remain open to the living evolution of the psyche as it exists in the
transformation of reality (Noel-Smith, 2013, p. 128). This view situates the entire
nonsensuous strategy at the intersection between the known and the unknown. As such,
it guides clinicians toward an innately uncomfortable technique.
In nonsensuous technique, clinicians are confronted with disconcerting aspects of
reality that are typically obscured by the closing-down tendency of the mental
functioning that dominates daily life. The psyche instinctively avoids the unknown,
seeking instead the confines of concepts and structures. Because of this aversion, clinical
technique based on openness to the unknown creates experiences of anxiety and
desperation, including the feeling of being lost, confused, ashamed, and scared (Ferro,
2019; Vermote, 2019). Instead of seeking recourse in the realm of the known, Bion
(1970) highlighted the clinical development of a capacity which, following John Keats
(1817/1931), he referred to as the “negative capability” (p. 125). This negative capability
is necessary for tolerating the doubts and anxieties of the unknown.
In order to develop this capacity, Bion (1970) suggested that the clinician must
discover faith. However, the type of faith he recommended is not religious faith. Rather,
it refers to faith “that there is an ultimate reality and truth—the unknown, unknowable
‘formless infinite’” (Bion, 1970, p. 30). Bion (1970) here described the clinical use of
faith as relating to achieving a state of patience and security. In this regard, faith
contributes to a paradoxical type of clinical action that is actually a non-action; that is, the
capacity to wait within the “dark and formless” (Bion, 1970, p. 30) of the unknown with
an expectation that some degree of illumination will, in some way, emerge from it. This
is an “act of faith” because it is grounded in openness to the unknown and is receptive to
“contact with the layer of hallucinosis from where thoughts arise”, but is without
volitional action (Vermote, 2019, p. 153). According to Bion (1970), this dimension of
hallucinosis is “always present but overlaid by other phenomena which screen it. If these
other elements can be moderated or suspended hallucinosis becomes demonstrable; its
full depth and richness is only accessible to acts of faith” (p. 36).
This nuanced clinical technique related to the unknown finds a poignant
articulation in the following dream, depicted by Leo Tolstoy (1882/2005) in his memoir,
A Confession. Tolstoy here recounts a dream he considered representative of his
prolonged experiences with depression and emotional tumult:
I saw I was lying on plaited string suspenders attached to its sides: my feet were
resting on one such suspender, my calves on another, and my legs felt
uncomfortable. I seemed to know that those suspenders were movable, and with a
movement of my foot I pushed away the furthest of them at my feet—it seemed to
me that it would be more comfortable to do so. But I pushed it away too far and
wished to reach it again with my foot, and that movement caused the next
suspender under my calves to slip away also, so that my legs hung in the air. I
made a movement with my whole body to adjust myself, fully convinced that I
could do so at once; but the movement caused the other suspenders under me to
slip and to become entangled, and I saw that matters were going quite wrong: the
whole of the lower part of my body slipped and hung down, though my feet did
not reach the ground. I was holding on only by the upper part of my back, and not
only did it become uncomfortable but I was even frightened. And then only did I
ask myself about something that had not before occurred to me. I asked myself:
Where am I, and what am I lying on? And I began to look around. (p. 77)
When Tolstoy realized he was dangling above an abyss by suspenders that become more
loosened with each movement, he successfully soothes his panic. From this state of
motionless attentiveness, he suddenly hears a voice announce to him, “Notice this, this is
it!” (p. 78).
Tolstoy’s dream demonstrates the psyche’s method of depicting nonsensuous
experience (e.g., his depression and emotional tumult) with sensuously derived imagery
(e.g., dangling over an abyss). This depicts the form of psychic activity Bion (1970)
referred to as “hallucinosis” (p. 30). Commenting on this feature of the psyche as it
appears in its pathological form (the psychotic’s hallucination), Bion suggested that
What may then appear to the observer as thoughts, visual images, and
verbalizations must be regarded by him as debris, remnants or scraps of imitated
speech and histrionic synthetic emotion, floating in a space so vast that its
confines, temporal as well as spatial, are without definition. (pp. 12–13)
In Bion’s (1970) thinking, this “state of hallucinosis” (p. 36) exists in a pathological and
a non-pathological form. The clinical capacity to pay attention to its non-pathological
form is a function of the negative capability. Tolstoy’s dream accurately depicts the
nonpathological state of hallucinosis made possible by the negative capability, especially
by emphasizing the requisite capacity for non-action that characterizes it. Nonaction here
refers to the eschewal of literal movement, such as in speaking, as well as psychic action,
such as in thinking, remembering, and desiring. By juxtaposing the phrase “notice this”
with the paradoxical urgency to not move, Tolstoy’s dream effectively depicts the clinical
engagement with the unknown and demonstrates the anxiety and terror that can be
evoked by positioning oneself in this stance of openness.
A Nonsensuous Strategy for Psychotherapy
The following recommendations are intended to present a strategy that guides
clinical action in psychotherapy. Since the practice of psychotherapy is distinct from that
of psychoanalysis (from which Bion developed his ideas about the nonsensuous), a
working definition of psychotherapy needs to be established. Wampold and Imel (2015)

simplified the practice of psychotherapy by defining its most essential features, which are
as follows:
a primarily interpersonal treatment that is a) based on psychological principles; b)
involves a trained therapist and a client who is seeking help for a mental disorder,
complaint, or problem; c) is intended by the therapist to be remedial for the client
disorder, problem, or complaint; and d) is adapted or individualized for the
particular client and his or her disorder, problem, or complaint. (p. 37)
This definition of psychotherapy grounds the practice in terms of its most basic feature:
the relationship established between two human beings. In order to qualify as a
psychotherapeutic relationship, one member of the relationship must possess training in
the domain of psychology. Binder (2014) indicated that psychotherapy training typically
involves immersion in three varieties of psychological models: (a) relating to how the
personality works, (b) an explanatory model of psychopathology, and (c) a model for
how healing occurs in therapy.
The following section presents four factors of effective psychotherapy. Each
specific factor is proffered to be common to the practice of psychotherapy, meaning it
exists independent of any particular theoretical model. These factors are presented in
conjunction with corresponding common factors distilled from Bion’s thinking.
The intent of this method is to articulate a nonsensuous strategy for
psychotherapy. “Clinical strategies” are different from theoretical models and from
technical interventions (Goldfried, 1980, p. 994). Rather than identifying particular
features of any of the three psychological models related to psychotherapy (i.e.,
personality, psychopathology, and healing), strategies operate more generally, as a guide

for therapeutic work. These strategies can be considered “clinical heuristics that
implicitly guide [the therapist’s] efforts during the course of therapy” (Goldfried, 1980, p.
994).
The clinical strategy described in the following sections balances the tension
between a theoretical framework and specific clinical technique. What results is a
strategy composed of a compilation of reflections on various aspects of clinical
experiences. These reflections have a variety of implications for therapists working
within any clinical context, and are amenable to fit within any theoretical framework.
They are bound together by the common thread of relating to the nonsensuous. Insofar as
the following sections include specific technical recommendations for therapeutic action,
they are presented as relating to generalized common factors, or what Wampold and Imel
(2015) called “incidental aspects” of psychotherapy (p. 40). As such, they are not bound
to any one particular theoretical modality.
The therapeutic relationship. The therapeutic relationship is considered to be
the sine qua non for all forms of effective psychotherapy treatment (Strupp & Binder,
1984; Wampold & Imel, 2015). In its most basic form, this bond can be understood
simply as “the engagement of a therapist and client in a healing context” (Wampold,
2010, p. 53). As such, this relationship provides the context for the work of creating and
discovering an experience of “at-one-ment” (Bion, 1970, p. 30). In order to utilize at-
one-ment as a guiding heuristic for clinical interventions, the therapeutic relationship
needs to be grounded within the container-contained model. Ultimately, what results
from this shift in emphasis is a perspective of the therapeutic relationship as engaged in
the work of assisting “a person struggling to be born” (Bion, 1994/2008, p. 45).

The therapeutic relationship itself is one of the oldest common factors to be
identified as necessary to healing practices. Historical records of healing rituals in tribal
communities show special emphasis placed on the bond forged between the healer and
the sick (Ellenberger, 1970). In 1750, German physician Franz Anton Mesmer,
progenitor of contemporary psychotherapy, taught his students that his methods depended
upon rapport, by which he meant physical touch, that was established between patient
and doctor (Ellenberger, 1970). It was Mesmer’s predecessors who would then apply this
emphasis on rapport instead to the nonphysical therapeutic relationship.
Pierre Janet, the French psychologist and neurologist, was fascinated by the
psychological significance of this therapeutic relationship. In 1897, he published a study
on the intense feelings evoked by this relationship. He focused specifically on what he
described to be the “erotic passion, filial or maternal love, and other feelings in which
there was always a certain kind of love” (Ellenberger, 1970, p. 154). Confirmation of the
significance of this observation was acknowledged in the psycho-analytic method by
Freud’s discovery of the transference.
In Freud’s earliest account of his method, he emphasized the significance of the
bond forged between doctor and patient. Following Janet, Freud emphasized the
intensity of this bond as particularly significant. Freud investigated this bond specifically
in terms of its blatant erotic nature, ultimately concluding that unconscious feelings, “a
reliving of the Oedipal conflict,” are transferred on to the contemporary relation with the
doctor (Singer, 1994, p. 288). In addition to concretizing the prominence of the
therapeutic relationship in therapy, Freud’s concept of transference had another, more
subtle, effect. The transference concept facilitated a form of clinical engagement

whereby he could simultaneously analyze the clinical experiences and participate in
them. The result, as Thomas Szasz (1963) noted, was that “the threat of the patient’s
eroticism was effectively tamed by Freud when he created the concept of transference:
the analyst could henceforth tell himself that he was not the genuine object, but a mere
symbol, of his patient’s desire” (p. 36). With the concept of transference in mind, Freud
participated in the relationship with Anna O in a new way, essentially maintaining a form
of emotional engagement with her despite the intensity of erotic feelings that had deterred
Breuer.
Whereas Freud did not conceptualize the effect of this theoretical development as
providing an emotional container for clinical experience, Bion’s (1970) theoretical
developments provide the possibility to make this conclusion. The concept of
transference can now be seen as a container for clinical experience that allows for deeper
engagement within the experience. The clinician’s containment, which is at least
partially provided by theory, creates a basis for experience that, in turn, provides
containment for the patient. In other words, by being contained by his newfound theory
of transference, Freud himself was free to become a container for Anna O in ways Breuer
could not.
As it relates to this present study, clinicians need to be able to use the therapeutic
relationship in terms of its underlying container-contained dynamics. Using the
relationship as a basis for investigating container-contained dynamics is an important
nonsensuous strategy that expands several dimensions of clinical interest. Primarily, it
presents a means to understand the significance of two psyche’s coming together in the
act of psychotherapy, which essentially provides a context whereby the psyche’s

instinctual search for containment can unfold. In this sense, the therapy relationship
creates something external that reflects its internal reciprocate. The same internal
container-contained dynamics of the psyche, such as occurs between an emotion and
language, are created within the therapeutic relationship. Moreover, this dynamic
recreates, in a historical sense, the original container-contained dynamics as it unfolded
between the infant with the mother. As such, the therapeutic relationship provides the
therapist a place of unique privilege for helping the patient develop more reliable forms
of containment.
The container-contained dynamic of the therapeutic relationship can be deepened
a step further by examining how it mirrors the larger relational dynamics created between
a society and an individual. In Thus Spoke Zarathustra, Nietzsche (1885/1982) presented
this idea in a nascent form, arguing that the purpose of a healthy society was to grow a
genius. The purpose of the genius, he proffered, was to nourish and invigorate society,
expanding the confines of its ideas and values, bringing freshness and life to its culture.
Following Nietzsche, Bion (1970) considered the purpose of psychotherapy as fostering
this same type of “commensal container-contained dynamic” that grows a genius or, in
Bion’s terms, “the mystic” (p. 95). In the therapeutic context, the growth of the mystic is
understood in its nonsensuous form, as a part of the patient’s psyche as a “messianic
idea” created between patient and therapist (Bion, 1970, p. 117). Like the true mystic
within an establishment who invigorates through spiritual experience, the mystic or
messianic idea in psychotherapy does so through the experience of at-one-ment. In
spirituality, the mystic “claims direct access to the deity with whom he aspires to be at
one” (Bion, 1970, p. 87). In psychotherapy, this mystic corresponds to a part of the
psyche that experiences union with O. This experience needs to be discovered, created,
and sustained by the therapeutic relationship.
In terms of a clinical strategy, the onus of this process of creation and discovery
falls to the therapist. The therapist must discover a means on their own to foster a part of
their mind that orients to the patient in a particular form characterized by receptivity and
openness, like a container waiting to be filled up. In grounding this task in terms of the
non-sensuous, Bion (1970) described this as the “capacity of the apprehending object to
apprehend” (p. 88). In other words, the clinician’s personal discovery of an
“apprehending object” is a counterpart to, and a container for, the discovery of the
experience of at-one-ment in the therapeutic relationship.
The different clinical experiences that unfold over time in the relationship will
collectively demonstrate to the therapist not only a patient’s container-contained
relations, but also how a patient treats the possibility of experiencing at-one-ment. Based
on this knowledge, the clinical task of fostering at-one-ment requires filling gaps in
functioning for the patient so as to facilitate this experience. Whereas in infancy it is the
mother’s physical touch that provided the concrete containment needed to facilitate at-
one-ment; in psychotherapy, it will be the containment dynamic created in verbal
interventions that provide the basis for at-one-ment. The development of symbolic
equation (the process whereby thoughts and words contain experience and provide a link
to reality) grows in psychotherapy by internalizing this commensal form of container-
contained relation.
As a therapeutic strategy, this deepens clinical engagement in several ways,
including especially in treating severe forms of psychopathology. This occurs by

orienting the clinician to an understanding of how patients of this sort live trapped within
an intrapsychic container-contained dyad that oppresses at-one-ment, like a society that
stifles the growth of a mystic. In its most severe form, this stifling effect extends to
reality-testing itself, which thus cannot be contained and results in the breakdown of the
psychical “apparatus for awareness of reality” altogether (Bion, 1962, p. 51; Freud,
1911/1959a). While not all patients present as overtly psychotic, every personality
contains this “psychotic kernel” (Eigen, 1986, p. 1), and needs to be treated with great
significance. The therapist needs to be aware of how pain contributes to this oppressive
dynamic.
The psychotic part of every personality responds to pain, and the breakdown of
containment that it threatens, by attacking the link to reality. This response reveals a
certain logic; reality is, after all, the source of all pain. In the instance of psychosis,
rather than modifying the pain and frustration of reality, the attacking response seeks to
evade it altogether. Within the container-contained model, this extreme evasion destroys
the containing function of language and thought as it relates to emotion and reality. In
the absence of this containment, this extreme form of evasion is the only option available
for the psyche. In psychotherapy, the effect of this subtle psychic dynamic manifests in
ways that become observed in patterns. These patterns thus define styles of
communication, behaviors, and, generally, a therapist’s felt experience of being with the
patient. From this relational basis, verbal interventions should be discovered that fit the
experience and function to notate and assign meaning to emotions. If successful, this
will, in turn, provide containment. Consistently completing this process routinely over
time provides a reliable basis for the patient to surrender to new experiences, ultimately
deepening their capacity for the experience of at-one-ment
Summary of the therapeutic relationship. The clinical strategy presented in
this section is based on the therapeutic relationship as a means of fostering the experience
of at-one-ment. This view depends on the therapeutic relationship as functioning like that
of a healthy society in relation to a mystic. That is, it should discover and foster the
growth of something new within the psyche and within the therapeutic dyad which will
be generative and life-giving. In psychotherapy, this is directly related to the experience
of at-one-ment. At-one-ment is a pure form of being in which the psyche exists at one
with reality as it is, unmediated by self-conscious thought or reflection. In terms of
technique, the therapist remains grounded and open to the concrete components of
therapeutic relationship so as to understand the different dimensions of the psyche’s
container-contained relations. Ultimately, the therapeutic relationship needs to become a
reliable source of containment for the patient, because containment is the basis and
prerequisite for at-one-ment.
The therapist’s sincerity. The link between sincerity and an effective
therapeutic experience has long been recognized (Kociünas, 2009; Růžička, 2011). Carl
Rogers (1957) notably emphasized the value of sincerity in psychotherapy,
recommending that therapists adopt a posture of openness and what he called
“congruence” (p. 97). According to Rogers, the state of congruence is one which a
clinician is “freely and deeply himself, with his experience accurately represented by his
awareness of himself” (p. 97). He described how this method of openness achieves an
“empathic understanding of the client’s internal frame of reference” (p. 96). Kolden,
Klein, Wang, and Austin (2011) have noted that this type of openness requires “mindful
self- awareness and self-acceptance on the part of the therapist, as well as a willingness to
engage and tactfully share perceptions” (p. 65). In other places, these same therapeutic
dynamics have been labeled as therapeutic authenticity or genuineness (Lietaer, 1993).
Despite nominal differences, it can be seen that the psychotherapy literature clearly
emphasizes the value of a therapist’s “ability and willingness to be what one truly is in
the relationship” (Gelso & Carter, 1994, p. 297). In this section, this type of openness
will be considered in terms of its relation to the nonsensuous dimension of experiences.
The etymology of the word sincerity comes from Latin sincērus, meaning pure,
and from the Roman goddess of agriculture and growth, Ceres. Sincerity therefore
denotes a type of presence that grows naturally from experience and, as such, is pure. It
typifies a way of being that is without self-consciousness, such as in love, true play,
gratitude, or even hate. Sincerity deepens the possibility of engaging the container-
contained dynamics that occur within the therapeutic relationship by becoming a partner
in experiences with the patient. This is an essential feature of the therapeutic
relationship, for it provides a deep sense of safety. This safety is experiential and, for
that reason, surmounts the type of security derived from simply talking about trust. This
type of experiential safety relates especially to a mutual willingness to open oneself up to
new emotional experiences as they unfold within the clinical setting. A consequence of
the therapist’s sincerity, which is expressed implicitly as an openness to experience life
alongside the patient, the relationship is imbued with the reliability and trust that
overrides the familiar containment typically derived from persecutory anxiety.

Becoming a partner in experiences with the patient not only increases the potency
of the container-contained dynamic, it also provides the therapist with an inside view of
what is going on for the patient. This amounts to a perspective that considers the
nonverbal dimensions of experience. For this reason, the partnership created between
patient and therapist becomes a powerful channel of emotional communication as, for
instance, through projective identification. Accordingly, as a partner who has earned the
patient’s trust, the therapist now has privilege to say things about experiences that no one
else in the world could say.
Altogether, this partnership results in the subjective experience of being known.
This state of being known is the emotional correlate of containment, as occurs when an
infant is held by a mother. Contemporary research on affect regulation has shown that
this experience forms the developmental basis for what Fonagy, György, Jurist, and
Target (2004) termed the reflective function, and what Schore (1994) described as the
capacity for affect regulation. The juxtaposition of one’s own mind as simultaneously
separate from, but joined with, another mind fosters the capacity to reflect on both the
nature of one’s own thinking as well as the reality that the other has a mind, too.
Nonsensuous technique based on sincerity is guided by openness that extends to a
state of presence in which unspeakable dynamics become present through intuition, or
reverie. This follows Henrí Poincaré’s description of how intuition can give rise to a
“selected fact” (Bion, 1962, p. 72). A selected fact emerges in accordance with
nonsensuous psychic dynamics and is related to transformations in O. When a selected
fact emerges, it corresponds with a palpable shift in emotion that indicates an

organization of scattered clinical fragments. Poincaré wrote of this shift in his work with
intuitive mathematics, which he described as follows:
If a new result is to have any value it must unite elements long since known, but
till then scattered and seemingly foreign to each other, and suddenly introduce
order where the appearance of disorder reigned. Then it enables us to see at a
glance each of these elements in the place it occupies in the whole. Not only is
the new fact valuable on its own account, but it alone gives a value to the old facts
it unites. . . . The only facts worthy of our attention are those which introduce
order into this complexity and so make it accessible to us. (Bion, 1962, p. 72)
Summary of the therapist’s sincerity. In this section, the concept of a
therapist’s sincerity has been extended to consider a form of openness that integrates
nonsensuous experiences. This relates sincerity to a technique grounded in the use of
intuition. As such, this therapeutic posture guides clinical action towards a way of being
that is pure, thus creating the possibility of becoming a partner with the patient in new
experiences. The value of this pure form of being is twofold. It relates to the value
inherent in participating in new experiences but also presents to the therapist aspects of
being with the patient that reveal previously unknown, and unknowable, aspects of
psychic function. This latter dimension includes the use of intuition as a unique form of
perceiving. This method of perception synthesizes and organizes the nonsensuous, as in
the emergence of a selected fact.
The use of attention. Comparing the therapist’s attention to a camera,
nonsensuous clinical strategy does not so much expand the lens as refine its focus.
Focusing on the nonsensuous sharpens the therapist’s perception of what is happening in

the here and now by examining how emotional pain is being treated. This form of
attention, which depends upon binocular vision, has several implications.
To begin, it depends upon avoiding the impulse to devote attention to what has
happened in the past or what will happen in the future. “One cannot go back,” as Bion
(1977/2018) wrote, “to childhood or infancy” (p. 45). What matters is not the past or the
future but the unfolding experience that is happening right now. As a clinical strategy,
this diverges from the conventional form of technique that focuses interventions as based
on a patients’ history. The nonsensuous use of attention instead focuses on the effect of
past experiences as they are becoming present in the process of living here and now.
This clinical approach utilizes a type of attention that remains constant despite changes
from one moment to the next or when working with different patients. Regardless of
these changes, the therapist’s approach is consistent, focusing on understanding how life
is being lived right now.
Attention based on binocular vision extends further to include the paradox that the
therapist must discover a means of becoming aware of things that, by their nature, cannot
be known. As Bion (1970) explained, “The analyst must focus his attention on O, the
unknown and the unknowable” (p. 27). This means that attention directed toward
ultimate reality presents a paradox akin to looking for something invisible. In
nonsensuous technique, the metaphor is like the fact that although one cannot see the
wind, one can see the effects of the wind. This type of clinical attention requires the
negation of knowledge which, in turn, produces an experience that orients a therapist to
the effects of the wind, or to what Bion (1970) refers to as transformations of O. As Bion
(1970) wrote, a therapist cannot know the “‘ultimate reality’ of a chair or anxiety or time
or space, but he knows a chair, anxiety, time, and space. In so far as the analyst becomes
O he is able to know the events that evolutions of O” (p. 27). The key to this strategy is
becoming O, by which Bion meant surrendering to the unfolding state of experience
without self-reflection, memory, or desire.
A binocular form of attention also applies to a method of focusing on verbal
communication. Within the nuances of verbal communication, unseen aspects of a
patient’s world become available for perception. For instance, patients typically
experience a rigid form of seeing oneself and the world. This type of monocular vision
indicates, and exacerbates, mental illness and corresponds with underlying impediments
to adaptive containment. Since language relates directly to emotion in a container-
contained manner, the way a patient speaks provides a means of perceiving this
dimension of psychic life. In order to pay attention to this feature of clinical experience,
a therapist’s attention must be binocular, focusing on the superficial meaning of language
while considering its relation to nonsensuous container-contained dynamics.
This type of attention leads to a specific strategy for speaking to the patient.
Since language operates by containing emotion, the therapist’s language needs to be
understood as a tool for developing a commensal container-contained dynamic within the
therapeutic relationship. However, in order for this to occur, the therapist faces the
challenge of first capturing the patient’s attention.
When speaking with a patient, a therapist increases the possibility of getting a
patient’s attention by adapting one’s own language so as to fit with the idiosyncratic form
used by that particular patient. “What is one to say to the patient?” Bion (1994/2008)
asked, “This is where you come into it: you are there and you know by this time
something about the language that this patient understands” (p. 12). Adapting one’s way
of speaking to model a patient’s language ensures that whatever needs to be spoken about
will take a familiar form, will be easily understood by the patient because it originates
from within the meaningful matrix of their own symbolic functioning. This also ensures
language does not introduce too much complexity at once. As Bion (1994/2008)
explained, “You can’t launch out into a great explanation of the biology of the alimentary
canal to a baby. . . . It may be true, it may be the correct interpretation, but it is a
nonsensical waste of time” (p. 12). The amount of focus demanded to discover how to
speak like the patient is the same for every clinician. Regardless of skill and experience,
this process demands paying attention to the experience of each particular moment with
the patient.
Based on these complexities, capturing a patient’s attention and bringing
awareness to previously unrecognized aspects of experience is an achievement.
Following John Keats, Bion (1970) spoke of this in terms of what he called “the
Language of Achievement” (p. 125). This phrase is used to indicate several dimensions
of clinical experience. Broadly, it is intended to orient a clinician to consider how
speaking is itself an action. Vermote (2019) described the language of achievement as “a
language that is in contact with the origin of psychic reality, with the [nonsensuous],
undifferentiated, unrepresentable O” (p. 140). This type of speaking is intended to evoke
psychic change. In other words, it is intended to bring movement to the psyche. As such,
it is a form of clinical action. Insofar as this action seeks to catalyze something that
might occur within the patient, it also a type of catalyst for action. For this reason, Bion
(1970) concluded that the language of achievement “is both prelude to action and itself a
kind of action” (p. 125). The reference to Keats comes from the fact that this unique use
of language builds from what Keats had described as the negative capability: “when a
man is capable of being in uncertainties, mysteries, doubts, without any irritable reaching
after fact and reason” (Bion, 1970, p. 125).
The negative capability requires that a therapist tolerate resistances designed to
keep the reality of pain out of awareness. The nonsensuous technique is uniquely suited
to overcoming this challenge by employing a type of “reversible perspective” that
transforms the patient’s language into a new, and surprising, form (Bion, 1963, p. 54).
This maneuver, something akin to playing with words, captures attention by introducing
novelty into the familiar. Speaking like this depends upon the generative creativity that
occurs in binocular vision when two ways of seeing are brought together. Mating two
ways of seeing gives birth to new language. A therapist’s attention must be binocular and
use a perspective that can consider the reverse side of language. To this end, a clinician
may adopt a style of thinking and speaking that flips words on their head, breaks them up
into smaller parts, or capitalizes on an unintended double-meaning of a word. The
specific form in which the therapist applies this strategy will be personal and always
related to both the context of the particular clinical moment as well the therapist’s own
personality.
Bion provided examples of this form of speaking in various ways throughout his
writing and clinical seminars. One example, as already shown, was breaking the word
atonement down to “at-one-ment” (Bion, 1970, p. 30). Here, Bion (1970) captured the
reader’s attention and directed it toward a new understanding of the religious experience
of reconciliation with God, framing it instead in terms of a nonreligious experience: the

one-ness achieved by the psyche in union with ultimate reality. In another instance, Bion
(1970) transformed a patient’s memory (“I remember my parents being at the top of a Y-
shaped stair and I was there at the bottom”) into the phrase “a why-shaped stare” (p. 312).
This move captured the patient’s attention and assigned meaning to a previously
unacknowledged aspect of emotional experience (i.e., the prominence of criticism and
doubt permeating relationships). And, finally, Bion (1976/2008) demonstrated the
technique of reversible perspective by transforming the concept of “psycho-somatic
illness” to “soma-psychic illness” in order to emphasize the body’s primacy, existing
beneath and before the psyche (p. 318).
Finally, clinical attention that is nonsensuous requires binocular vision because it
listens to the meaning of language in addition to its inherent music. All spoken language
has a type of music to it, referred to as its prosody. Prosody, deriving from the Greek
suffix pros-, meaning “toward,” and ōidē, meaning “song,” refers to those aspects of
speech that are also shared by musical instruments. In this sense, therapists should attune
their attention to the patient’s voice as it relates to the “music of the psyche” (Eigen,
2004, p. 120). The fact that emotional meaning about the psyche is communicated
through prosody ultimately follows from Melanie Klein’s original emphasis on the
overarching role of unconscious phantasy behind all thought, behavior, and action (Petot,
1979, p. 56). As Susan Isaacs (1948/1989) noted, the “manner and tone of voice in
speaking” relates to a “particular changing sets of phantasies at work in a patient’s mind”
(pp. 100–101). Listening to the music of language, both the patient’s and one’s own,
orients attention to a purely emotional basis of communication not found in word itself.
Throughout the course of a psychotherapy treatment, there are many reasons for
the therapy process to falter. The strategy associated with binocular vision contributes to
better treatment outcomes because it sustains focus on the nonsensuous dynamics of at-
one-ment that unfold beneath, and in tandem with, sensuous aspects of experience that
ultimately lead to terminated treatments. For instance, a most common impediment to
sustaining a treatment relates to the impulse to avoid pain. Although both patient and
therapist face this same impulse, patients generally lack the means for containing the
impulse, which also explains their impaired capacity to sustain binocular vision that
views pain in relation to at-one-ment. The psyche generates a plethora of resistances
designed to interrupt clinical focus on the nonsensuous. The more desperate the need to
defend against pain, the more intense and unsettling these resistances become. These
resistances intersect with and compound the clinician’s own resistances to the
nonsensuous, which includes resisting the arduous, sometimes painful, use of the
negative capability. Therefore, the professional capacity for perceiving the nonsensuous
psyche is a subtle craft refined by dedicated work. And yet, there is no shortage of
distractions that impede this work. No clinician of any degree of skill can sustain focus
on the nonsensuous ad infinitum. Focus that is good enough always returns to an
awareness of experiences as an evolution of a lived reality that is dynamic and full of
meaning but sometimes painful. Achieving good enough focus results from developing a
capacity to perceive how the experience of distraction is itself related to the meaningful
evolution of experience.
Summary of the use of attention. This clinical strategy expands the concept of
attention by relating it to binocular vision. Most basically, binocular vision is the

capacity to see two instead of one. When two perspectives are united, there is naturally a
generative effect, resulting in the birth of new perspectives. In this section, the
imperative of mating two perspectives has provided a basis for discussing a new form of
clinical technique. This technique directs attention to nonsensuous aspects of experience
that are otherwise obscured by the overtly sensuous aspects of experience. It was shown
that this applies directly to the realm of language. A patient’s language reveals
nonsensuous container-contained dynamics and a clinician’s language can be used to
facilitate the desirable commensal containment that yields life and growth. However, for
this to occur, the clinician must discover a method for balancing the need to capture the
patient’s attention while not introducing too much complexity at once. This requires a
language of achievement, which thus depends upon a negative capability. A practical
form of the language of achievement was presented in terms of the reversible perspective,
in which familiar, conventional forms of language are flipped to be seen from their
reverse angle. Ultimately the strategy described in this section integrates the clinician’s
attention with the concept of binocular vision to depict methods for engaging the
nonsensuous dimension of clinical experience.
The necessity of courage. Courage, from Latin cor, meaning heart, has been
defined as “the attitude or response of facing and dealing with anything recognized as
dangerous, difficult or painful, instead of withdrawing from it” (Prince, 1984, p. 49).
This definition applies to the experience of utilizing nonsensuous clinical technique,
which necessarily presents therapist’s with “dangerous, difficult or painful” experiences
that demand “facing and dealing . . . instead of withdrawing from it” (Prince, 1984, p.
49).
Utilizing nonsensuous strategies in psychotherapy compounds the fact that any
form of psychotherapy, generally, demands courage. The relation of courage to
psychotherapy has been prominently noted by the existential-phenomenological approach
(May, 1975). Within this approach, it has been established that efficacy in psychotherapy
depends upon looking at truth directly, even if it is painful (Prince, 1984). This
inevitably implicates the personal life of the therapist. As Prince (1984) described, “In
the therapeutic encounter, decisions have to be made and actions taken that are the
individual responsibility of the therapist and which cannot be foisted off, however subtly”
(p. 48). Painful emotions, fear of the unknown, and the demand of responding to a
patient’s needs from within oneself all coalesce within here-and-now of therapeutic
experience. Bacha (2001) has noted that it is courage that allows one to stay present in
the face of these challenges (p. 287). And, additionally, Prince asserted that “the core of
psychotherapeutic courage is the ability to face and deal with one's inner experiences of
being a therapist” (p. 48) as it occurs in the moment.
The fact that psychotherapy requires courage if one is to remain true to oneself
even in the face of immense pressure is bolstered by considering Paul Tillich’s
(1952/1954) conceptualization of courage as presented in his book, The Courage to Be.
In this book, Tillich proposed courage as preserving one’s own personal truth despite
existential pressures that threaten it. Tillich reduced these pressures to three forms of
anxiety: (a) the anxiety related to one’s own fate and death, (b) the anxiety one feels
when confronted with emptiness and meaninglessness, and (c) the anxiety related to guilt,
condemnation, and exile. Psychotherapy intersects with each of these dimensions and
demands a personal choice to be true to who one is. Utilizing nonsensuous techniques
which, by nature strip away the structure and pretense of sensuously derived comfort,
amplifies this necessity.
Following Maurice Blanchot (1969), who wrote that “the answer is the question’s
misfortune, its adversity” (p. 13), the clinical strategy relating to the nonsensuous is
ultimately a method for retaining one’s orientation with the unknown. As a matter of
course, it guides one toward a routine eschewal of certainty so as to retain the value of the
question. The value of the question is not in the ultimate discovery of an answer, but in
the process it invokes. This process of searching requires openness, curiosity, and
sustained attention. As a clinical strategy, this guides therapists toward a form of
openness related to experiences with the patient that occur against a backdrop of not
knowing what they mean, in a formal or theoretical sense. Not knowing what
experiences mean is, in essence, a technical move away from the realm of thinking and
knowing about the patient instead into the ever-unfolding unknown domain of being,
becoming, and experiencing.
Antonino Ferro (2019) touched upon this aspect of nonsensuous technique when
he described his efforts to always consider what “has not been thought yet” (p. 244). In
so doing, he wrote, “I discover and construct in a tentative and preliminary manner,
without being afraid of this indefinite character and without shame” (p. 244). Ferro’s
description here suggests that the hazards of this technique requires courage because it is
related to feelings of being afraid and of shame. These feelings are a natural response to
the vulnerability of the unknown and thus underscore the necessity of courage in
nonsensuous technique.
Despite this fact, Bion himself did not elaborate on the clinical use of courage.
This is intriguing when considering the prominence of courage displayed by Bion’s life
and, according to those who knew him, his character (Grotstein, 2007). Robert Caper
(2011) underscored Bion’s relation to courage, noting that he had received the
Distinguished Service Order (DSO) medal for his conduct as an English commander on
the battlefield of World War I. Despite the opinion that Bion actually eschewed this
honor, it is notable that he cited it on the authorship of the four books he published
between 1962 and 1970. The following citation, from the official governmental records
designating DSO appointments, sheds light on the prominence of courage in Bion’s
character:
AWARDED THE DISTINGUISHED SERVICE ORDER.
T./2nd Lt, Wilfred Ruprecht Bion, Tank Corps.
For conspicuous gallantry, and devotion to duty. When in command of his
tank in an attack he engaged a large number of enemy machine guns in
strong positions, thus assisting the infantry to advance. When his tank was
put out of action by a direct hit, he occupied a section of trench with his
men and machine guns and opened fire on the enemy. He moved about in
the open, giving directions to other tanks when they arrived, and at one
period fired a Lewis gun with great effect from the top of his tank. He
also got a captured machine gun into action against the enemy, and when
reinforcements arrived, he took command of a company of infantry whose
commander was killed. He showed magnificent courage and initiative in a
most difficult situation. (Caper, 2011, p. 98).

In addition to this overt demonstration of courage and gallantry, Caper (2011)
underscored the courage Bion demonstrated in withstanding the pressures of conforming
to groups, both clinical and collegial: “The courage that characterized the man and his
work is…fully in view in his calm resistance to the forces trying to recruit him into a role
that would quell the group’s anxieties without first understanding them” (Caper, 2011, p.
98).
Clinically, this type of courage relates to the capacity to persevere in the face of
great pressure, to look honestly at what is happening, and to offer an “unwavering
interpretation of what Meltzer called ‘‘the phenomenology of the consulting room’”
(Caper, 2011, p. 98). For this reason, as noted by Grotstein (1981), people “supervised
and analyzed by [Bion] have . . . noted that peculiar admixture of confusion and clarity
when in his presence” (p. 4). This observation from Grotstein relates to the courage Bion
demonstrated to speak truth even when facing significant pressures and anxieties.
Many have since elaborated on the necessity of courage required for the technique
based on not knowing. Earl Hopper (Biran, 2015) described it as follows:
The courage of simplicity is a function of our willingness to free ourselves from
the restraints and constraints of the determinants of our perceptions. We must
allow ourselves to become unfettered from the sources of our security and safety
and from all that is familiar to us. Such courage demands flirtation with madness
and the experience of psychotic anxieties, including the fear of annihilation
caused by failures of dependence, and perhaps above all the experience of
profound loneliness. Such courage also depends on finding one’s own voice and
one’s on vision of what is true and what is real. (p. xiii).

One of the most concrete clinical applications of courage is found in the notion of
caesura. Caesura is a concept found in Bion’s (1977/2018) writing used to indicate the
paradox that the psyche operates within the point of tension between separating things
out and binding them together. The concept of caesura is intended to denote this point of
dynamic tension. It is also related to a process of transformation, found in life and the
natural world, which integrates a movement/change vertex with that of stasis/consistency.
As a clinical strategy, Bion (1977/2018) focuses specifically on two components
of caesura. First, the necessity of transcending caesura and, second, demonstrating how
the fundamental nature of all change is catastrophic. Change is catastrophic because it
requires moving through the caesura and, therefore, always passes through a period of
discontinuity. These two subjects comprised a central theme in Bion’s late-stage
theoretical developments. In the concept of caesura, clinicians are invited to participate
in and experience the dialectical tension that exists within the psyche between movement
and stasis, order and chaos, and, most generally, between life and death.
Following the tenets of process philosophy, reality is always involved in an
ongoing state of organic and dynamic movement or unfolding (Bergson, 1896/1911;
Whitehead, 1911). Amplifying this view from a psychoanalytic vertex, Bion (1977/2018)
showed how the psyche has caesurae which both divide and unite its relation to ultimate
reality. The paradoxical tension of caesura hones clinical focus on the tension inherent in
the deepest layers of human experience, at the place where transformations in O occur.
All acts of the psyche strive for a necessity of balance between structure and continuity.
However, this striving is ceaseless, never accomplished, and always dynamic. What
matters is therefore not achieving stasis, but developing the capacity to tolerate
movement.
The clinical strategy of transcending caesura disrupts this process and introduces
a period of discontinuity that is felt to be catastrophic. In Bion’s (1977/2018) view, all
change has this fundamentally catastrophic basis because it always requires breaking
through the caesura.
The process of transformation requires passing through stages of discontinuity.
Despite changes enacted by periods of discontinuity, some features remain unchanged.
These features correspond to essential components of the psyche. Drawing from the field
of visual arts, Bion (1965) exemplified this by discussing the process of painting a field
of poppies. He pointed out how a painter succeeds in depicting a field of poppies on his
or her canvas through a process of transformation that retains enough of what was true
about the field of poppies to make it recognizable as an object within the painting. As he
described:
We can recognize that the latter represents the former, so I shall suppose that
despite the differences between a field of poppies and piece of canvas, despite the
transformation that the artist has effected in what he saw to make it take the form
of a picture, something has remained unaltered and on this something recognition
depends. (Bion, 1965, p. 1)
Bion (1965) goes on to label this something as an invariant. Despite changes that
occur in psychotherapy, therapists should focus on what remains invariant while
moving in and through the caesura. By noticing what remains constant, despite
periods of discontinuity, a therapist thus gains insight about the most essential
features of a patient’s psyche. This technique demands focus on invariants while
also modulating the anxiety relating to the catastrophic nature of change. For this
reason, this nonsensuous strategy demands a great deal of courage.
Summary of the necessity of courage. This section has discussed courage as it
relates to the unknown. It was suggested that, while any form of psychotherapy is a
courageous act, the nonsensuous strategy of psychotherapy demands greater courage
because it exists in a necessary relation to the unknown. This relation to the unknown is
pronounced when considering the nature of caesura within the psyche. Caesurae function
to simultaneously bind together and separate apart. Since caesurae can become overly
rigid, the technique of transcending caesura was discussed as a necessary means of
catalyzing movement in the psyche. However, this requires courage because it
necessarily creates a process of discontinuity. Discontinuity is inevitable with all change.
And, for this reason, all change is essentially catastrophic. While essential to catalyze the
psyche toward movement and life, the technique relating to the caesura demands courage
because it evokes a period of discontinuity in which unknowns are amplified and
catastrophic.
Chapter 6
Conclusion
Summary of Significant Findings
The purpose of this study was to describe the use of the nonsensuous in
psychotherapy. This endeavor required developing a method for integrating Bion’s
thinking about the nonsensuous as it applied to psychoanalysis with that domain of
clinical work unique to psychotherapy. This ultimately resulted in articulating a clinical
strategy, based on the nonsensuous, that could guide one’s own practice of
psychotherapy.
The method found to be most suitable for this research task was the combination
of the alchemical hermeneutic method with the common factors framework, which was
adapted from its original context as an empirically based method of psychotherapy
outcomes research. This method of inquiry required my immersion within the “hermetic
jar” (Coppin & Nelson, 2005, p. 105) that facilitated a process of transformation among
my psyche, the research topic, and my sociocultural context. This process of inquiry
produced a distillation of psychotherapy and Bion’s thinking into essential factors. The
four essential factors of psychotherapy were: (a) the therapeutic relationship, (b) the
therapist’s sincerity, (c) the clinical use of attention, and (d) the necessity of courage.
These factors were placed in conjunction with the four essential factors of Bion’s
nonsensuous technique, which were: (a) at-one-ment, (b) binocular vision, (c) intuition,
and (d) the unknown. The conjunctions created a multiplicity of vertices from which to
view a nonsensuous strategy for psychotherapy.

In conclusion, I found that a clinical strategy that integrates the nonsensuous basis
of the psyche with the practice of psychotherapy is grounded by the following
imperatives:
 commitment to expanding the scope of psychotherapy beyond a focus on
pathology to the unique experience created by two psyches in relationship;
 focus on moving outside the sensuous confines of language, theory, and
knowledge;
 considering at-one-ment as a way of being one with transformations in O;
 the use of binocular vision that expands meaning and pushes life forward
based on the generative power inherent in uniting different ways of seeing;
 the use of intuition as a means of artificially blinding oneself to the realm of
the sensuous and thereby discovering a new way of seeing;
 faith in an unknown ultimate reality that can be known insofar as it can be
experienced or become, and in the emergence of a selected fact;
 achieving a negative capability for attentive and patient openness to the
unknown, withstanding doubts and agitations associated with not-knowing;
 the therapeutic relationship as the basis for container-contained dynamics that
produces transformation;
 courage to survive a leap into the unknown and the catastrophic change
created by discontinuity of caesura and through the inherent process of
transformation.
Taken together, these imperatives balance the importance of a theoretical framework with
the necessity of stepping outside this conceptual structure towards the experience of
being present, without pretense, within the clinical experience. As Butler (2012) noted,
there are a variety of possible ways to organize clinical experiences, a fact that has
yielded today’s multitude of theoretical orientations, each named after the feature that
organizes it (e.g., behavioral, cognitive, dynamic). In contrast with these theoretical
orientations, the nonsensuous strategy presented here is not meant to replace any
theoretical grounding, but to be used as an expansion of it. What matters is not the
theoretical structure one uses to organize clinical experiences, but one’s capacity to move
beyond it toward an engagement with the nonsensuous. The necessity of leaving behind
one’s theoretical home-base is akin to jumping off a high dive, a move that requires faith
and courage as prerequisites for the plunge into the nonsensuous waters of
transformations in O.
Relevance of the Findings for Clinical Psychology
The findings presented in this study have relevance to clinical psychology across
several domains. Because of its focus on articulating a nonsensuous strategy for
psychotherapy, the most apparent contribution is to psychotherapeutic practice. Since
this has its background in psychoanalytic theory, it also pertains to the domain of
psychoanalytic psychology and, for similar reasons, the domain of psychology known as
“psychotherapy integration” (as reported by APA in the Journal of Psychotherapy
Integration). Additionally, because of its emphasis on methodology, exploring the
application of alchemical hermeneutics as well as developing the common factors
framework, this study relates to the domain of psychology’s research methodology.
By virtue of the considerable focus placed on developing a philosophical basis for
psychotherapy, this study was related to philosophical psychology. Specifically, to the

intersection of psychology with epistemology and ontology, as well as with the
hermeneutic, social-constructivist, phenomenological, and existential approaches to
philosophy.
This study also contributes to psychology’s integration with sociohistorical
dynamics relating to power, oppression, race, gender, and economic status. The findings
in this study are presented at a time when the field of psychology is undergoing a
radicalization that mirrors the broader polarization occurring within the United States.
This “catastrophic” season of change (Bion, 1965, p. 8) is related to psychology’s
confrontation with the nonsensuous issues it faces, both institutionally and individually,
in terms of race, class, and climate. To call these issues nonsensuous is to identify their
decidedly nonempirical basis of individual and social experience which cannot be
quantified. At a time when these social bases of power pose a greater threat to the well-
being of our nation and citizens than ever before, it is imperative for the field of
psychology to be equipped with a means of understanding this nonsensuous domain.
Returning again to Wilhelm Dilthey, “We explain nature; man we must understand”
(Palmer, 1969, p. 115).
Finally, this study joins a growing body of research intended to balance the
contemporary emphasis on presenting psychology as a natural science. In contrast with
this view, this study conceptualized psychology instead as a human science that
integrates the meaningful, personal relation of the human psyche with a scholarly
approach to research methods and findings.

Theoretical Developments Resulting From This Research
In contrast to participant-based studies, this philosophical and theoretical research
study presents results related to the development of existing theory or the discovery of a
new theory. This study developed four domains of theory.
The first domain is the theory related to integrating Bion’s thinking with
psychotherapy. The most notable development in this regard resulted from identifying
the obstacles that have thus far impeded integrating Bion’s thinking with psychotherapy.
The obstacles, which were viewed in two categories, are the complexity of Bion’s
thought and the contextual differences between psychoanalysis and psychotherapy.
The second domain encompasses the methodology suited to resolving these
obstacles. The challenge of overcoming obstacles required theoretical development of
methodology. Throughout this research process, I found that the complexity of Bion’s
thought demands an immersion of the researcher’s psyche with the text, a process
facilitated by the alchemical hermeneutic method. Additionally, since the differences
between psychoanalysis and psychotherapy demanded a shift in context, I found that the
common factors framework provided an effective means for integrating Bion’s thinking
with psychotherapy. To this end, I adapted the common factors framework for use as a
theoretical method, using it as a template for identifying essential factors of both
psychotherapy and Bion’s thinking. These factors, when placed in conjunction, created
vertices from which I was able to describe one version of use of the nonsensuous in
psychotherapy. This approach retained Bion’s (1994/2008) emphasis that the discovery
of meaning must grow from the personal, or what Gadamer (1962/2006) called the
“fusion of horizons” (p. 305).

The third domain of theory development related to the philosophical concept of a
nonsensuous psyche. Following Vermote’s (2019) emphasis on the ultimate evolution of
Bion’s thinking as reaching its zenith in describing “contact with or the becoming of an
undifferentiated life-giving psychic zone” (p. 14), I built a strategy to guide the practice
of psychotherapy from the basis of Bion’s persistent emphasis on the necessity of
discovering a personal nonsensuous orientation to clinical experience. As such, this
study developed a theoretical foundation for understanding what is meant by the phrase
nonsensuous psyche. I focused on developing a philosophical basis of this concept,
tracing its lineage from Plato, Kant, the process philosophers, and the mystics. I
concluded by discussing its prominence in Bion’s thought and considering its relation to
dynamics of therapeutic technique.
The fourth domain developed by this study encompassed the theoretical
advancement of Bion’s (1965; 1970) concept transformations in O. Through this study, I
developed a theory proffering that what can be known about the nonsensuous psyche is
available only through participating in the experience of being and becoming one with it.
I developed a strategy based on this view of experiencing, being, and becoming as a
means of engaging the nonsensuous psyche clinically. As a way of reinforcing this
theory, I provided several examples of nonsensuous engagement with being. These
examples included the spiritual view depicted by the mystics throughout history and
exemplified specifically in the writings of Meister Eckhart. The example of Gadamer’s
(1962/2006) true play was also used to emphasize how the state of play exists outside the
pretense of reflective thought. Another example was based on Buber’s (1958)
speculation of the fetus within the womb as existing in a state of seamless union with the
universe. And, finally, I provided examples based on actual clinical experiences a
psychotherapist might encounter. Altogether, this assortment of examples functioned to
develop Bion’s concept of transformations of O.
In sum, this study developed theory as related to the integration of Bion’s thinking
with psychotherapy, the methodology of alchemical hermeneutics in combination with
the common factors framework, the philosophical concept of the nonsensuous, and of
Bion’s concept transformations in O.
A Reflection on the Findings in Light of Previous Research
Many previous research projects have shown the applicability of Bion’s thinking
to clinical work and have, in turn, successfully implied the relevance of Bion’s thinking
for psychotherapy. These research endeavors correctly identified that Bion shifted focus
from the content of thoughts to a process of being with, and thus expanded clinical
technique to encompass a broader range of pathologies, including psychosis and
personality disruption. However, previous research has been limited by a focus on
isolated dimensions of Bion’s thinking, its relevance to isolated clinical application, or,
more generally, to developing a model of his thinking as it applies to clinical work across
a broad variety of contexts but not psychotherapy specifically.
In my review of the literature on integrating a nonsensuous basis for research with
psychotherapy, the nearest research I could find addressing these concerns was
interestingly not about Bion at all. In the pioneering work, Imagining an Archetypal
Approach to Psychotherapy, Jason Butler (2012) developed a nonsensuous basis for
psychotherapy that parallels the aim and method of this present study. Specifically,
Butler focused on identifying defining features of psychotherapeutic practice, the

epistemological and methodological concerns germane to integrating theory with clinical
technique, and an exploration of clinical techniques suited to aspects of the psyche not
conforming to sensuous conceptualization. Despite differences in theoretical grounding,
Butler demonstrated a notable example of theoretically and methodologically grounding a
nonsensuous approach to psychotherapy. However, his study ultimately reached a
verdict that diverges from mine. In his conclusion, he stated that “it is this author’s
opinion that archetypal psychology is not the primary treatment of choice” for more
severe forms of pathology (Butler, 2012, p. 102). By contrast, the findings in my study
are precisely the opposite: that the nonsensuous strategy comprises the most effective
basis for treating the most severe forms of pathology. My conclusion is based on the fact
that severe forms of pathology ultimately stem from disturbances in transformations in O.
Accordingly, the strategy it articulates is based on methods of nonsensuous engagement
required for treating this depth of pathology.
Limitations of the Present Study
In addition to advancing theory, this study was also limited by several significant
limitations that need to be acknowledged. These limitations can be conceived broadly as
relating to the following categories.
Inadequate development of methodology. A considerable limitation in this
study resulted from an inadequate development of methodology. Because I discovered
the my method (combining the alchemical hermeneutic method with the common factors
approach) relatively late in the research process, I did not sufficiently establish or
document the utilization of this method from the beginning. In effect, this decreased the
utility of the method and the transparency and validity of my research process and
findings. Furthermore, having established this method earlier in the research process
would have contributed structure to the research process that would have subsequently
afforded a deeper engagement with the research topic and a more thorough analysis of
my findings.
Overreliance on the personal or subjective horizon of interpretation. Another
limitation in this study was an overreliance on the personal, or subjective, horizon of
interpretation. Because of a gap in previous research attempts to integrate Bion with
psychotherapy, this current research was too reliant on my own personal assessment of
how to accomplish this task. While individual subjectivity is inextricable from any
hermeneutic or theoretical research study, especially the alchemical hermeneutic method,
in retrospect I recognize that this component needed to be balanced by a more thorough
engagement with textual sources. A concrete example of this limitation was revealed by
the process of establishing four core features of psychotherapy and of Bion’s thinking.
Although the factors I utilized resulted from a thorough engagement with the text, they
ultimately depended more on a process of personal choice than on scholarly inquiry.
This exerted an undesirable effect on the validity and scope of relevance for my research
findings.
Challenges in synthesizing Bion’s thinking. A final limitation of this study
resulted from challenges inherent to synthesizing Bion’s theory. An intrinsic aspect of
Bion’s thinking is its situatedness on the border between the “closing down” of theory
and the “opening up” of being. This can also be conceptualized in terms of the tension
between the finite and the infinite. As such, the researcher engaging with Bion’s
theoretical constructs discovers their dynamic and evolving nature. For me, this created
an experience of something akin to shooting at a moving target. For instance, it was not
uncommon for an extended period of writing to ultimately result in uncovering new,
contradictory dimensions of Bion’s thought that consequently demanded revision of what
I had previously written.
The efforts Bion made in his theory to bridge the gap between the finite and the
infinite were necessary. However, they create significant challenges for researchers, like
me, seeking to apply his thinking to a context other than where it originates. The
necessity in this study of “closing down” the dynamic movement of Bion’s thinking for
long enough to apply it coherently to psychotherapy created unexpected challenges that
ultimately restricted the research process. The concrete effect of this limitation can be
observed in the insufficient representation of some notable factors of Bion’s thought.
There were regrettable omissions from this study of concepts that other scholars consider
foundational. This included, to name but a few, consideration of the concept of the
contact barrier, envy, and the grid.
Directions for Future Research
Reflecting on the limitations of this study presents an opportunity to make
suggestions for future research. Future research seeking to develop Bion’s thinking
should be grounded from the start within the methodology of alchemical hermeneutics.
For this, future researchers are referred to the descriptions provided by Romanyshyn
(2013) and Coppin and Nelson (2005). Both of these sources will serve to orient the
researcher from the start to an organic and dynamic approach to inquiry. A thorough and
well-documented use of transference dialogues will serve to highlight more explicitly the
researcher’s complex relation to the topic as well as provide a basis for analysis of this
relationship (Romanyshyn, 2013).
Future research should devote attention to identifying areas of overlap between
alchemical hermeneutics and Bion’s thinking. This can be seen as most apparent in terms
of their shared ontological basis. Efforts to this end would provide considerable
improvement to methodological engagement with the developing Bion’s thinking.
Future research should also investigate the utility of the common factors model as
it can used for theoretical research. This would involve immersion within the common-
factors approach to psychotherapy, as developed by Rosenzweig (1936), Frank (1961),
Wampold (2001), among others, for the purpose of documenting its theoretical basis.
This would also serve the purpose of clarifying, with concrete reference points, which
factors can be established as essential to the practice of psychotherapy.
As it relates to the integration of Bion’s thinking with other topics, future research
projects will benefit from an emphasis on discovering the hidden simplicity in Bion’s
thought. This applies equally to research endeavors seeking to extend Bion’s thinking to
psychotherapy or to that of any other domain. The recommended template for this
process includes (a) immersion within the text of Bion and within the text pertaining to
whatever topic is being investigated (e.g., psychotherapy, in this present study), (b)
distilling both topics into a few isolated common factors, (c) creating vertices by placing
factors in conjunction, and (d) analyzing what can be seen from these various vertices in
order to arrive at conclusions. In terms of expanding and developing the nonsensuous
approach to psychotherapy, future research can follow the same method.

Throughout my research process I have uncovered an unexpected resonance
between Bion’s conceptualization of the nonsensuous and the findings articulated by the
school of archetypal psychology. Future research should investigate the area of overlap
between these two seemingly divergent schools of thought with more scrutiny. Research
conducted in this domain may in fact bolster the findings in this present study and
contribute to a nonsensuous strategy for psychotherapy. Other areas of overlap with
Bion’s thinking that should be investigated is the phenomenological-existential approach
to psychotherapy, especially the Daseinsanalytic approach based on Heidegger’s
philosophy as articulated by Boss (1963), and the Jungian approach, as has already been
attempted by some researchers (Sullivan, 2010; Williams, 2006).
Conclusion
In conclusion, this study found that the use of the nonsensuous in psychotherapy
requires the discovery of one’s own personal method for becoming one with the
unfolding of experiences. The research method used to examine this topic was
alchemical hermeneutics combined with the common factors framework. This provided a
basis for engaging with the thinking of Wilfred Bion. Both the findings and the methods
in this research study share an ontological grounding within the nonsensuous psyche.
Regarding the latter, my process of inquiry required forging a complex relationship
between the text, the research topic, and my sociocultural context. More specifically, this
included (a) my immersion in the literature relating to Bion and psychotherapy, (b) my
ongoing clinical work as a psychotherapist, (c) my personal engagement as a patient in
psychoanalytic psychotherapy, and (d) factors relating to the ecological, political, social,
and economic upheaval in the world, the United States, and in the city of Seattle, where I
live, that occurred during this research process.
The research findings themselves depicted a strategy to guide psychotherapeutic
technique based on the fact that the object of the therapist’s focus, the psyche, is
ultimately unknowable as it is in-itself. Therefore, rather than depicting a sensuously
based theory of knowledge, the findings in this study suggest a form of engagement
based on one’s own experience of being and becoming. Both the technique and the
research methods depicted in this study balance the paradoxical tension between
remaining opening to the process of discovery and closing it down in order to describe
what has been experienced. Ultimately, this tension is ongoing and irresolvable. In
consideration of this finding, this study has sought to catalyze within the individual
reader and therapist the process of discovering their own method for engaging in the
tension that exists, not only in the clinical setting, but in life, generally. Therefore, this
study has ultimately addressed the tension between movement and stasis, infinite and
finite, and, ultimately, between life and death. Meister Eckhart’s (Fox, 1983)
recommendation for spiritual life summarize the findings of this research study, “One
should love God mindlessly, by this I mean that your soul ought to be without mind or
mental activities or images or representations. Bare your soul of all mind and stay there
without mind. Moreover, I advise you to let your own ‘being you’ sink away and melt
into God’s ‘being God’” (p. 46).

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USE OF THE NONSENSUOUS IN PSYCHOTHERAPY

On the Use of the Nonsensuous in Psychotherapy

Pacifica Graduate Institute

This dissertation has been

Dr. Avedis Panajian, Chair

Dr. Patricia Berry, Reader

Dr. Judy Eekhoff, External Reader

On the Use of the Nonsensuous in Psychotherapy

This study offers an original contribution to the field of clinical psychology by

concept of the nonsensuous psyche was developed in relation to psychoanalysis by

established by Bion, which considers the psyche to be a part of nonsensuous, or ultimate,

This study encompassed an alchemical hermeneutic method that was supplemented by an

matter of central importance to resolving the challenges inherent to investigating and

articulating the concept of the nonsensuous.

Keywords: psychotherapy, nonsensuous, Wilfred Bion, philosophy,

psychoanalysis, alchemical hermeneutics, clinical strategy, clinical technique,

Special thanks to:

Hedberg, and Avedis Panajian

Chapter 1. Introduction ...................................................................................................... 1

Purpose Statement ................................................................................................... 1

Relevance for the Field of Clinical Psychology ..................................................... 5

Statement of the Research Question and Problems ................................................ 9

Chapter 2. Literature Review ........................................................................................... 12

Philosophical Background .................................................................................... 12

The Mystical Account of the NonSensuous .......................................................... 15

Previous Research on Bion ................................................................................... 16

Differentiating Psychotherapy from Psychoanalysis ............................................ 23

The Common Factors Framework ........................................................................ 25

Chapter 3. Methodology .................................................................................................. 30

An Ontology of the Psyche ................................................................................... 30

Philosophical Approach ........................................................................................ 32

Research Procedures ............................................................................................. 39

Ethical Considerations .......................................................................................... 42

Organization of the Study ..................................................................................... 44

Chapter 4. Bion’s Basic Concepts ................................................................................... 45

Bion’s Original Conceptual Framework ............................................................... 46

Alpha Function, Alpha and Beta Elements ............................................... 50

Linking (L, H, & K/-L, -H, & -K) ............................................................ 53

Bion’s Developments in Light of Psychoanalytic Theory .................................... 56

Development of Klein ............................................................................... 56

Development of Freud .............................................................................. 60

From Content to Process ........................................................................... 61

Moving to the Nonsensuous.................................................................................. 64

Examples of the Nonsensuous .................................................................. 66

The Paradox of Using Language to Represent the Nonsensuous ............. 68

Chapter 5 The Non-Sensuous Strategy for Psychotherapy ............................................... 70

The Common Factors of Bion’s Thinking ............................................................ 70

Binocular Vision ....................................................................................... 73

A Nonsensuous Strategy for Psychotherapy ......................................................... 78

The Therapeutic Relationship ................................................................... 80

Summary of the Therapeutic Relationship ............................................... 86

The Therapist’s Sincerity .......................................................................... 86

Summary of the Therapist's Sincerity ....................................................... 89

The Use of Attention................................................................................. 89

Summary of the Use of Attention ............................................................. 95

The Necessity of Courage ......................................................................... 96

Summary of the Necessity of Courage ................................................... 103

Chapter 6. Conclusion.................................................................................................... 104

Summary of Significant Findings ....................................................................... 104

Relevance of the Findings for Clinical Psychology ............................................ 106

Theoretical Developments Resulting From This Research ................................ 108

A Reflection on the Findings in Light of Previous Research ............................. 110

Limitations of the Present Study ......................................................................... 111

Inadequate Documentation of Methodology .......................................... 111