Thinking in a marrow Bone: Embodiment in Vajrayana Buddhism and Psychoanalysis

A Brief Review of the Psyche/Soma Psychoanalytic Literature, Through the lens of Dualism/nondualism

In this brief outline of psychoanalytic thinking about the body, I will describe a few distinctions between dualistic and nondualistic modes of thinking and perceiving. Any complex system of thought may contain aspects of both dualism and nondualism, and I argue that this is true of psychoanalytic thinking. The body has been vitally important in psychoanalysis since its inception. At times, however, psychoanalytic thinking has wedged psyche and soma apart. In some of its iterations, psychoanalysis has privileged language, insight, and symbolic representation in ways that have diminished attention to the soma. From a Buddhist point of view, there is something inevitable about this tendency to divide and hierarchize. We do perceive dualistically. This mode of perception is inflected by social and cultural factors but is also ubiquitous. From a Buddhist perspective, dualism is not the only reality, although dualistic thinking does tend to reify abstractions as ontological givens (Klein 2013; Sella 2018; Varela, Thompson, and Rosch 1991). Nondualistic frameworks suggest bodily perceptual and intuitive capacities that are obscured by a dualistic lens (Klein 2013; Ray 2002, 2016; Simmer-Brown 2002).

Descartes’ view of the body as a machine was pivotal in constructing an argument, incredibly influential in Western intellectual history, that describes a reliance on the mind to represent a separate external world. In The Embodied Mind, Varela, Thompson, and Rosch (1991) point to findings in cognitive science that accord with many of the insights of Buddhism and the work of Maurice Merleau-Ponty. Cognitive research challenges the dualistic perception that a pregiven world exists and is then represented by an independently existing mind. Varela and colleagues point out repeatedly that this is how things appear in ordinary experience, but that this perception does not match how things are. They illustrate, first, that cognition depends on the body as a whole and not just on the brain. They also demonstrate that this body is not deciphering input from a separate world; it is embedded within that world. “The nervous system,” they note, “does not process preexistent information in the traditional computationalist sense; it creates information in concert with the rest of the body and the environment” (p. xxvi). Although they emphasize that none of them has had a personal experience with psychoanalysis, they argue that psychoanalytic theorizing has largely ignored this insight.

While some psychoanalytic thinking does consider the mind as embodied (Goldberg 2004, 2012; Elise 2017; Lombardi 2017; Markman 2020; Miller 2018; Milner 1969, 1987; Winnicott 1949) and as embedded in the world from earliest interactions (Goldberg 2004, 2012; Milner 1969; Winnicott 1949, 1953), many psychoanalysts have pointed out that the embodied mind has been difficult for psychoanalysis to take seriously (Lombardi 2017; Sella 2018; Sletvold 2014). Lombardi (2017) argues that the concrete material body is constantly in danger of being dissociated in psychoanalytic work. When this happens, mental processes become abstract, impersonal, and often imitative. Anzieu cautioned in 1990 that unless psychoanalysis integrates “everything to which . . . bodily therapies draw attention, . . . it will be shelved in the storehouse of obsolete accessories, that are no longer talked about” (p. 69, quoted in Sella 2018).

Psychoanalysis has attempted to think psyche and soma together throughout its history, beginning with Freudian drive theory. Although in the Freudian model the soma has tremendous importance, the drives are knowable only by their psychic representatives. There is an excess in the drives that threatens to discharge, and the mind is pressed to transform these id impulses into unconscious object representations. The libidinal drive pushes toward representation, but it is not assumed to be linked with representation from the start. The drive is linked with a thing presentation that can then be linked to a word presentation. At this point, once the drive has become bound and linked to representation, it becomes psychic and ultimately available for thinking (Freud 1892–1897, 1915).

While it is beyond my scope here to examine drive theory in greater depth, I want to highlight a few of its implications. First, there is a vertical and dependent relationship between the soma and the mind. Psychic work is vitally linked to the body, but the nature of that work is to bind the excess that threatens to spill over from this link. This view leaves the tenacious impression that when something is somaticized, it is because it cannot be mentalized. The task, then, is to translate this fixation at the level of the body back into the mind and, ultimately, into words. Symptomatic expression in the body is often viewed as a narcissistic withdrawal that is the result of and reinforces an impoverishment of representation.

Winnicott’s claim, in “Mind and Its Relation to the Psyche Soma” (1949), that “the psyche and the soma are not to be distinguished except according to the direction from which one is looking” (p. 246) would resonate with many nondualistic traditions, including Vajrayana. He elaborates: “the word psyche here means the imaginative elaboration of somatic parts, feelings and functions” (p. 246). He also goes on to describe the potential for the psyche to get “‘seduced’ away into this mind from the intimate relationship which the psyche originally had with the soma. The result is a mind-psyche, which is pathological” (p. 249). When the psyche has become unmoored from the body and is located in the mind, thinking can become too fixated on intellectual understanding. Winnicott’s observation applies as much to the analyst as to the patient. It underlines the importance of practicing analysis in an embodied state and warns of the potential seduction of too much focus on the mind. Such a focus may be at odds with the rhythms of less formed dimensions in the analytic encounter. When in the grips of a mind-psyche either patient or analyst may, in Lessing’s words, “define, as an act of self-protection” (p. 518).

Lacan’s theory of the mirror stage has some resonance with a Vajrayana view of embodiment. In Lacan’s view, the preverbal child identifies with her image in the mirror. This image promises an illusory wholeness that calls the ego into existence. This ideal ego, which answers the desire of the Other, is incongruous with the infant’s experience of her body. Prior to this stage, the infant experiences the autoerotic drives as chaotic and fragmented and certainly at odds with this newly acquired ideal of coherence and mastery. While I will not examine the multiple affinities and differences between Lacanian theory and Vajrayana, I want to draw attention to one parallel. Vajrayana also sees the body as coursing with energies that are alien and threatening to a reified and illusory self. A Vajrayana view sees quite different possibilities in these energies, which I will elaborate below in a section on the subtle body. Vajrayana practice works explicitly with these energies, harnessing their fraught potential to unravel a fixated self.

To some extent, the body is enjoying renewed focus in psychoanalytic theorizing (Elise 2017; Goldberg 2004, 2012; Knoblauch 2000, 2005; Lombardi 2017; Markman 2020; Miller 2018; Orbach 2009; Sletvold 2014). Frequently this literature references infant research (Fonagy and Target 2009; Beebe et al. 2005) and neuroscience (Damasio 1994, 1999; Schore 1994, 2011) to support the need for analytic work to attend to embodied experience. There is a growing body of literature that emphasizes the analyst’s embodied receptivity/responsiveness as in itself a communication to the patient. Elise (2017), Miller (2018), and Markman (2020) each describe the potential for intercorporeal communication between patient and analyst. Markman says “the patient’s painfully disrupted and at times dissociated state is primarily and often forcefully conveyed through the language of the body”; he suggests that his “somatosensory reactions turn out to be a gauge of the patient’s disembodied experience” (p. 819). Miller describes a potential permeability in which “the analyst’s bodily ego sometimes has access to the analysand’s bodily ego” (p. xxi) and suggests that this potential requires the analyst to bear working at a “formally regressed level” (p. xvi). Elise (2017) takes another angle on the potential for intercorporeal communication, emphasizing the libidinal matrix that is needed to connect patient and analyst, particularly with patients whose symbolic representation is restricted: “our bodily selves engage,” she writes; “. . . Now a relational space opens for us to develop the dance of embodied relation to each other, supporting our continuing quest for affective meaning. . . . much is taking place kinesthetically in our unfolding relationship” (p. 44). These contemporary descriptions are adding dimension to theorizing the body-to-body communication at work beneath the surface of analytic dialogue.

Marion Milner has much in common with nondualistic traditions in her descriptions of a wide and unfocused embodied attention, which she contrasts with the narrow attention needed for discursive verbal thought. She points out that when directing her attention to “the whole internal body awareness” without seeking after any particular understanding, she notices “astonishing changes in the quality of one’s perceptions” (1987, p. 236). She writes that such attention and the accompanying states of being “are often rather loosely talked about by psychoanalysts as auto-erotic and narcissistic” (p. 238). Such an assumption carries with it the notion that attention to the body would be by definition a narcissistic withdrawal from the world rather than an engagement with it. Particularly in her narrative of her long treatment of Susan in The Hands of the Living God (1969), Milner emphasizes her fundamental reliance on intuitive capacities that she roots in this internal body awareness. This mode of being allows her a way of apprehending something of the encapsulated states of her patient.

The Standpoint of Shunyata

Vajrayana Buddhism posits that the body that we have from the standpoint of the conceptual mind is not the body we are. The body that we are is known as the Vajra body. The Vajra body is certainly a body and is connected to the five senses (Ray 2002; Simmer-Brown 2002). Yet it is a body that upsets distinctions between subject/object and internal/external. It involves embodiment from the standpoint of shunyata, ⁴ or emptiness. Before exploring the Vajra or subtle body in greater detail, I first need to describe shunyata.

Shunyata refers to the lack of inherent existence in the self or any phenomenon. Phenomena and the self do exist, but they do so dependently. There is no abstract knower of an experience that is separate from the experience itself. They co-arise and are empty of concrete, findable essence. Within Buddhism, emptiness is not a theoretical matter. It begins that way, but through meditative practice it is possible to experience emptiness directly with one’s full, speechless attention. It is a visceral experience that changes the lived experience of the practitioner, heightening a sense of being inextricably embedded in the world with others. Rather than being an experience that belongs to observation of a private internal world, recognition of emptiness allows a skillful knowhow for relationally embodying certain mind-body states (Klein 1995; Ray 2002; Simmer Brown 2002).

The experience of emptiness reorients subjective experience in several ways. First, experiencing emptiness requires and strengthens one’s capacity for nonconceptual clarity and expansive attention. Second, though a practitioner will return to conceptual states of mind, there will be less of a sense of using conceptual states in a reified way. As Varela, Thompson, and Rosch (1991) write,

the progressive development of insight [into shunyata] . . . expands the space within which all experiential arisings occur. As the practice develops one’s immediate attitude (not simply one’s after the fact reflections) becomes more and more focused on the awareness that these experiences cannot be pinned down. Our habitual clinging to them is itself only another disposition of mind [p. 80].

Keiji Nishitani (1982), a Japanese Zen philosopher who was a student of Heidegger’s, argued that Western philosophy expounds on reality from within a dualistic, subject-centered point of view, which is the standpoint of an ordinary position of consciousness:

This standpoint of separation of subject and object, or opposition between within and without, is what we call the field of consciousness. And it is from this field that we ordinarily relate to things by means of concepts and representations. On the field of consciousness it is not possible really to get in touch with things as they are, that is, to face them in their own mode of being and on their own home ground. On the field of consciousness self always occupies center stage [p. 9].

He argues that this standpoint breaks down in twentieth-century Western philosophy into a nihility in which there is a collapse of fixed reference points. He suggests that Western nihilism does not go far enough and stops short of transforming its partial realization of groundlessness into the experiential possibilities of sunyata. ⁵

He contrasts this standpoint with the standpoint of sunyata, in which experience and realization take epistemological authority concerning reality over cognition and intellect. When perceiving the world from an ego-centered point of view, the world is known through abstractions. From a Buddhist point of view, once emptiness of self and all phenomena is realized experientially, reality discloses itself without self-reference, literally without a thought. He writes of this shift from the standpoint of ordinary consciousness to the standpoint of sunyata, in which “the question that asks about reality . . . become[s] something that belongs to reality” (1982, p. 6).

Within the standpoint of shunyata, the boundaries between self and other are dissolved. This mode of perceiving would not be a pathological denial of separateness, as psychoanalysis tends to view such an experience. It rather involves a simultaneous recognition of both relative separateness and simultaneous embeddedness in the world and with others. Witihin Vajrayana, and some schools of Zen, this recognition is discerned in the body and is inseparable from embodied energetic shifts.

The Subtle Body

Like Freudian drive theory, Vajrayana Buddhism views the body as coursing with energies and considers sexuality as primary. However, the Vajrayana view has different implications. The Vajra body is an example of what in various nondualistic traditions is called the subtle body, known as manoyama, which literally translates as body made of mind. Changes in consciousness are intimately conflated with shifts in the energy currents in the body, which are indistinguishable from knowing itself. These energy currents are known as winds or subtle breath (lung or prana in Vajrayana and ki or chi in Zen). From this point of view, transformation comes both from a shift in ideas and, simultaneously, from a rechanneling of the body’s deepest energies. Once the visceral and the cognitive are separated, one is in a mode of perception characterized by a reification of conceptual knowing (Klein 2013, 2014; Ray 2002, 2016; Simmer-Brown 2002). From the Vajrayana perspective, the psychoanalytic view that the body is primitive and requires the transformative capacities of the mind impacts the body we have. It distorts modes of sentience that are bodily, while not coterminous with the literal body in a flat or straightfoward way. It also locks in an overreliance on the conceptual mind that is self-perpetuating.

Vajrayana contends that there is a level of intelligence in the body that is not available to ordinary dualistic states of consciousness but is there to be developed. Such development leads to a psychophysical integration that can increase sensitivity and that is easily disrupted by too much cherishing of the discriminatory mind. For example, Shigenori Nagatomo (1992), a Japanese philosopher who draws on Zen, outlines three potential relationships between mind and body that have attendant implications for thinking and being. The first, which he calls tensionality, describes a dualistic relationship between mind and body. From this position, the mind continually surges forward to name and represent. It overrides different dimensions of embodiment that he characterizes as providing an “affective sensorium” (p. 229). In tensionality, one attends self-consciously, with a reified self as its dominant parameter. In this mode, a kind of intellectualized attunement is possible. It is a knowledge that “circumscribes its object, incapable of becoming one with the object” (p. 253). From the Buddhist perspective this position involves an awkward coordination between mind and body. In the second position, detensionality, there is an intentional effort to bring mind and body into more fluid coordination, often through the kind of somatic awareness that develops through meditative practices. The third position, known as nontensionality, does not involve intention and would be an experience of shunyata. Within this mode, there is a more sensitive coordination between mind and body that has accompanying psychophysical energetic dimensions.

From the position of nontensionality there would be a release from an intellectualized mode of knowing to one in which “knowledge gained through the body” is possible, (p. 253) and this shift would be intertwined with a transformation in the subtle body. When one has realized emptiness, with the accompanying experiential knowing free of dualistic habits, simultaneously one’s subtle energy moves into a corridor along the spine known as the central channel. Once one’s subtle breath is in the central channel, Klein writes in “Seeing Mind, Being Body” (2014), “information comes directly to the energetic sensibility without an intervening conceptual latticework”; this movement in the subtle body “leads to an increase in intuitive capacities” (p. 580). This increase occurs because, at least temporarily, there is a release of the dualistic sense of experience in which there is an experiencer, an object experienced, and a relation that binds them together that is good, bad, or indifferent for the experiencer. There is nothing reified or extra on the side of mind or the side of the world to grasp at or fend off. This shift is a different mode of knowing, known as prajna in Buddhism, and it is visceral as much as it is psychic. In the example with which I began this paper, when Martha uses “her body as an engine to get out of the small dim room” of her mind and is consequently submerged in a visceral experience of Lynda’s state, this is a moment of prajna (Lessing 1969, p. 519).

From the standpoint of emptiness, my body is emphatically not mine. This body is embodied and yet impossible to definitively locate in either its materiality or its extensions into the world. From a Vajrayana perspective, once the experiential possibilities of emptiness are realized, the distinction between subject and object breaks down. While this does not mean that the other is no longer other, this realization does imply, as captured in Anne Klein’s description above, an increase in intuitive capacities. In this view, rather than something becoming knowable only when it is psychically represented, bodily experience might intuit an experience of the other. Formal thought would be secondary and would flow from this intuitive recognition. ⁶

While this way of conceiving of the body is already quite foreign to a Western, dualistic sensibility, Vajrayana goes further. Although emptiness is not locatable, there are places in the subtle body that are particularly receptive to its discernment. These are the central channel, along the front of the spine, the lower dan t’ien, which is in the low belly, and the upper dan t’ien, a space in the head just behind and above the soft palate (Klein 2014; Ray 2016). In the Zen tradition, the focus is on the hara, which is the same space as the lower dan t’ien in Vajrayana (Kasulis 1993; Shraner 1985). These spaces of particular receptivity are available once the grasping, conceptual mind is temporarily relinquished. Yet they also are spaces that can accelerate the realization of emptiness (Klein 2014; Ray 2016). Once a practitioner becomes experientially aware of them, they are increasingly a part of one’s embodied experience. ⁷

Clinical Implications

The Vajrayana view of the body is relevant to psychoanalysis in several ways. First, it adds dimension to analytic explorations of embodied experience. Vajrayana Buddhism and other nondualistic traditions coming out of Tibet, India, Bhutan, China, and Japan have spent centuries exploring the territory of the subtle body through intensive meditative practice. They see a level of sophistication and intelligence in the body that psychoanalysis has sometimes reserved for the mind. In this view, there is a potential for an energetic transmission between bodies, a kind of intercorporeal communication that could be generative for psychoanalytic work. This actual energetic transmission is not fully captured by concepts such as projective identification or unconscious fantasies of fusion with the object. ⁸ From a Vajrayana perspective, while this level of intercorporeal communication happens to some degree regardless of its being consciously registered, it is obscured by habitual dualistic modes of thinking and perceiving.

Second, the Vajrayana view suggests that the body/mind relationship, rather than being linear and vertical, is more circular, with each mutually elaborating or stagnating the other. Clinically, for both patient and analyst, shifts in embodiment would impact representation and vice versa. One of the implications of sexual energies in Vajrayana is that they imply an animated leaning out toward the world, a description that would resonate with psychoanalysts. Drive theory suggests that we cannot have unmediated access to the soma. In the Vajrayana view, while there is nothing solid to have unmediated access to, these subtle embodied energies are not only referred to by an image, fantasy, or other representation. They are lived in the body in a way that can potentially be experienced, though below the level of conscious thought.

Third, while realization of the subtle body requires cultivation and practice, some recognition of these potentials could be available to sensitive beginners. Marion Milner’s work demonstrates this. Like Martha Quest in Lessing’s Four-Gated City, Milner experimented with body-based modes of attending but did not have formal training in a nondualistic tradition. In Hands of the Living God, Milner (1969) gives an account of a twenty-year treatment with her patient Susan, in which she developed many of her ideas about the analyst’s use of her body awareness. Susan, a deeply traumatized and disturbed patient, felt she had discovered a meditative attention to her body that led to a vitalizing connection with the world. She entered treatment in despair that she had lost access to this awareness after submitting to electroconvulsive therapy. Milner initially pursued a Kleinian line of interpretation of this loss. She spoke of Susan’s “body experience in terms of the fantasy of a good or bad mother or part of a mother taken inside” (p. 53). Susan found that this way of representing her body experience left her feeling even more divorced from the embodied awareness she had lost. Milner began to agree.

She shifted her technique in various ways. She began to experiment with “a kind of deliberate filling out of one’s whole body with one’s consciousness so that one perceived with . . . a whole body attention” (p. 55). She writes that psychoanalysis tends to view such ways of attending as a form of narcissistic withdrawal. She found, however, that this mode of attending helped her more radically open to her experience with Susan and to avoid premature formulations. Some of Milner’s discoveries have affinities with nondualistic traditions. Milner refers to her shift in technique as finding “an empty center” and contacting an emptiness that is “in you but also outside and it has to work through you” (p. 418). She describes increasingly orienting toward the dyad’s intercorporeal communication and refining her sensitivity to it. As Milner employs this “change in technique,” their exploration, which includes Susan’s many drawings, becomes denser. There is a less reductive focus on “What does this mean?” although Milner states that she continually was pulled into this kind of focus when “impatiently seeking to bring about changes in her” (p. 332). Milner is a good example of how psychoanalysts may become sensitive to increasingly subtle dimensions of embodiment and intercorporeal communication, even without the more extensive training in discernment of this territory that nondualistic traditions offer.

Finally, mind/body dissociation has emerged as a topic of conceptual and clinical focus in psychoanalysis (Goldberg 2004, 2012; Lombardi 2017). Buddhism sees a mind/body dissociation that is more subtle than pathological states of dissociation. This more subtle dissociation is characteristic of ordinary states of consciousness. From this perspective, there is a tendency to know about, to represent, that is meant to manage a more groundless state of being. Such a stance involves a narrowing of attention that seals one off from an embodied recognition of one’s interdependence with the world and others (Klein 2013; Ray 2002, 2016; Simmer-Brown 2002).

Certain trends in psychoanalysis are focusing on embodied experience and attempting to correct a tendency in certain schools to privilege the mind, language, and symbolic representation. A Vajrayana view of embodiment could be helpful in addressing lingering assumptions that may too radically divide mind and body, internal and external, and the sociocultural and the intrapsychic. Buddhism suggests that these oppositions are interrelated and problematic. They mask the complex ways in which we are inextricably entangled with each other and with all aspects of the natural world. Nondualistic traditions, including Vajrayana, suggest that our breathing bodies are open to, and are potentially in, energetic, sensuous communication with human and nonhuman others. Perhaps this view can help us continue to make adjustments in our theories to respond to the historical moment. Faced with tremendous suffering and destruction ecologically, socially, and politically, we need ways of thinking, feeling, and responding that wake us to our interconnection with others and with the natural world. From a Vajrayana point of view, once we are in a subtly disembodied state a perceptual shift encourages a tendency to objectify phenomena and set ourselves radically apart from others.

Rethinking O

O is the sign that Bion (1970) used to denote “ultimate reality, absolute truth, the godhead, the infinite, the thing in itself” (p. 26). In Bion’s view, this constantly evolving ultimate reality of the psychoanalytic experience is what a psychoanalyst must orient toward. The analyst must renounce already acquired thought and perception, which Bion refers to as saturated, full of conceptual understanding, in order to access a state of mind that is receptive and unencumbered by previously discovered material. Such a description is very much in line with nondualistic modes of thinking.

The analyst cannot know O; he can only become it. In this sense O points to similar territory as sunyata. ⁹ Like Nishitani’s standpoint of sunyata, O is nonconceptual. It can be realized but cannot be known by way of the thinking mind. Bion contrasts transformations in O with transformations in K, which are about knowledge (Bion 1965). In transformations in K, analyst and patient know about the patient, which Bion views as distinct from being at one with psychic reality. In order to become at one with the patient’s psychic reality, the analyst must eschew memory, desire, and understanding, which keep the analyst anchored to what he already knows (Bion 1967).

Bion (1970) emphasizes that in order to realize O the analyst must “ignore sensuously derived experience” (p. 18). Here we can see the influence of dualism and the tendency to divide and oppose dimensions of experience that are interrelated. According to Bion, the sensory is the realm of memory and desire, and it must be transcended in order to enter the psychic domain, where O is realized.

Bion is borrowing from Kant and his idea of the “thing in itself.” Kant postulated the dualistic notion that noumena are fundamentally separate from phenomena. Noumena are events that are separate from and unknowable by human sense or perception. Phenomena are anything that can be apprehended by the senses. This concept implies a disembodied transcendental realm and suggests that in order to realize ultimate reality one would need an ontological category distinct from bodily being (Hass 2008).

Vajrayana Buddhism suggests that the problem lies not in sensory experience itself but rather in a concretization of it. There is a deeply embedded tendency to grasp too tightly to sense-mediated experience. If one looks at something or hears something and is reflexively engaged in a process of lining up sense perceptions with already known perceptual categories, this engagement with the senses will indeed block a perception of ultimate reality. From a Vajrayana perspective, as well as that of other nondualistic traditions that work with the subtle body, concretization of the senses must be released in order to access more subtle dimensions of sensory experience. For example, in the subtle body ears are linked to the interior breath and to space. To realize this link, one must refrain from grasping after a sound and attempting to make sense of it. The eyes are identified with form, and visual experience is regarded as even more subject to concretization. This realm is more associated with desire that tantalizes and distracts, and we are more likely to take our visual images as real in a reified way. This possibility is not the only one, however (Ray 2016).

A Vajrayana perspective would agree with Bion’s overall suggestion that all experience, including sensory, must be engaged without memory or desire in order to realize subtle dimensions of experience that the conceptual mind shaves off in its compulsion toward mastery and coherence. Yet the idea that this grasping is a problem of the sensory implies that once the sensing body has been ignored, one is less vulnerable to reification and abstraction. From a Vajrayana perspective, the opposite is true. Vajrayana descriptions of the body suggest that there are ways of attending to the body that involve an emptying out of saturated information. It is possible to root one’s attention in the body in such a way that is consistent with Bion’s views on disciplining oneself with regard to desire, memory, and understanding. Then whatever arises from the body could be valuable to the analyst, just as other forms of knowing arising out of O are potentially meaningful and relevant (Bion 1970, p. 33). Far from being an obstacle to be transcended, the body potentially enhances Bion’s overall view of analytic work in which intuitive thinking is central.

Hell Realm and Absence: Finding Molly

A hell realm is a description of a realm of suffering beings in Vajrayana cosmology, and it can refer to a state of being within an individual. The Vajrayana teacher and scholar Chogyam Trungpa was once asked by a student what he does in response to a hell realm. The student asked about transmuting the hell realm into something else. Trungpa responded that when he senses a hell realm in himself or someone else he tries to find a way in, rather than out. He added that the intensity of a hell realm develops in a kind of space, so there is an absence in the intensity. The absence is not an escape from the intensity. Rather, he said, “You are completely immersed in it. You are completely submerged in that kind of experience. It is so living and so real” (Trungpa 1992, p. 32). The space that Trungpa is referring to is the nonconceptual, radical openness that is shunyata.

Trungpa’s description of finding a way into a hell realm captures the analytic work of being at one with a disturbing or traumatic experience with a patient. Vajrayana suggests that both the hell realm and the absence are discerned in the body. An embodied becoming requires bearing with the experience rather than maiming it with preemptive intelligibility. Yet it also at times requires a willingness to be less coherently and viscerally oneself. Psychoanalysts are accustomed to having their sense of self called into question through transference, and this activity, although disturbing at times, does not typically stir annihilation anxiety. Corporeal becoming of a psychic reality, by contrast, is potentially more destabilizing and can feel like being engulfed. Having described Vajrayana views of embodiment, I will illustrate how these ideas influenced my work with my patient Molly.

I began seeing Molly when she was eight, during the last six months of her mother’s life. ¹⁰ Though it was clear from the beginning that her mother was dying, Molly completely denied this reality and felt until the very end that there would be a last minute cure. Elizabeth, Molly’s mother, had been diagnosed with aggressive onset MS when Molly was eighteen months old. The mother’s condition proved refractory to treatment and by the time Molly was three, Elizabeth was in a wheelchair. At the start of her daughter’s treatment she was in the final stage of the disease.

Before meeting Molly, I had several meetings with Elizabeth and Luca, Molly’s father. From the first meeting it was clear that Elizabeth and Luca hated each other. Elizabeth was almost completely paralyzed in her wheelchair, and she clung to Luca, both emotionally and physically. Luca has a large family in Italy. He and his family had been occupied for several years in a complicated lawsuit, and he frequently traveled to Italy as a result. Elizabeth felt he used his involvement with his family and this lawsuit to distance himself from her as she was dying. It was also clear within the first meeting that Molly was far too engaged in their fight, and both Elizabeth and Luca used her as a prop in their sadomasochistic dance. I attempted to structure our early meetings around helping them set boundaries between Molly and their fight. Yet by the third meeting, things escalated between the two of them, and Luca declared he could not talk about their conflict together. He asked if he could meet with me separately. I agreed, and he stormed out of the room.

Elizabeth was crying at this point, with tears, hair, and mucus on her face. I realized suddenly that I was now in charge of her physical well-being, as Luca had been, and I asked her if she wanted me to help her with some tissue. She did. As I cleaned up her face and got her hair in a more comfortable position, I saw how emaciated she was. I am accustomed to being physically close to child patients and to occasionally wiping the noses of very young ones, but I had never needed to attend so directly to the body of an adult patient. I could see the outline of her skeleton beneath her sweatshirt and pants. I felt claustrophobic, as if I too could be trapped in her paralyzed and abject body.

After this meeting, I met Molly for the first time. When I went to get her in the waiting room, she was draped over her mother’s lap and looked at me warily. She slid off her mother, passed me, and walked into my office. She sat on the floor with crossed legs, began bouncing her knee, and looked at me with raised eyebrows as if to say, “Now what?” I asked her if she knew why she was here. “My parents think I don’t know how to pay attention.” “To what?” I asked. “To whatever they’re telling me to do.” “What do you think?” She shrugged, “I guess it’s true.” I said to her later in the hour that I think she sees and hears a lot of their fighting. She said, “No. They only fight after I go to sleep.” I privately wondered what she meant by “go to sleep.” I also began to notice that, although she appeared to be relatively engaged, some part of her body was almost always moving. She would pull on a thumb, wiggle a foot, shift from one leg to another.

In that first hour I had noticed her near-constant, though subtle movement. As we settled into a four-times-a-week treatment, I increasingly felt that she was cloistered in a fortress of self-generated sensations. Some part of her body was always moving, and her ratcheted-up nervous system seemed to keep her suspended above an abyss. I imagined that past that frontier of sensation she would have to feel the despair of being a little girl with a mother who was dying and whose parents continually used her as ammunition in their fight. At this point in the treatment, I felt this corporeal stance was geared toward evacuating unbearable feelings.

Her play at that point consisted mostly of child characters who tricked their “clueless” parents. Sometimes there would be an earthquake, and everyone would be thrown from the house. Then, the next day, the parents would send the children to school with no acknowledgment of last night’s disaster. I was cast frequently as one of the child characters. I would protest and wonder why everyone was pretending nothing happened. Her character would claim that the earthquake had been an “April fools’ joke” that I had been gullible enough to fall for. She was creating a faithless world in which she could omnipotently undo any catastrophe under the oblivious gaze of the adults around her. I felt overwhelmed, with a desperate sense of needing to reach her, and would think of her frequently outside of sessions. She was completely unprepared for the tidal wave that was fast approaching, and she was very clear that there was no need to worry. Her mother would be saved.

Although I continued to meet with Elizabeth, I was finding these meetings increasingly difficult. I initially thought that I was reacting to her jealousy of my growing closeness with Molly. I was trying to help Elizabeth feel included where I could, and to contextualize Molly’s closeness with me as a natural outcome of the therapeutic process. I could certainly empathize with how difficult it was for Elizabeth to see her daughter attaching to a female therapist her own age as she was dying. At the same time, I felt disturbed by the intensity of Elizabeth’s possessiveness. She seemed unconsciously committed to keeping her daughter tethered to her and had strikingly little capacity to think about what Molly would need in the face of her impending loss. While Elizabeth would speak quite openly about the inevitability of her death, I began to sense that she had not begun to digest that reality and needed Molly to maintain her staunch denial. I worried that Elizabeth would interrupt the treatment.

In addition to these dynamics, which, though difficult, were thinkable for me, I became aware of a more visceral aspect of my aversion. When Elizabeth would ask me to help her with a stray hair or to give her a sip of water, I realized that being near her felt like being pulled into her hungry and claustrophobic body. I sensed a slight smug pleasure in her requests for help. I would bristle as I complied and would then feel guilty for my lack of compassion. After meetings with Elizabeth, my body would feel tight and my breath shallow. I found myself closing the door to my office after helping her to the waiting room and realizing that my stomach had been clenched. I would often try to shake the experience out of my body, which reminded me of Molly’s frenetic body.

About four months into the treatment, I began to develop muscle twitches. I realized, on one level, that this was likely somatic countertransference. Yet, in Chogyam Trungpa’s words, the experience was “so living and so real.” “Somatic countertransference” seemed an inadequate explanation. The twitches persisted, and I began to worry that they could be the beginning signs of a neuromuscular degenerative disease. Elizabeth had described them as one of the early indicators that she had tried to ignore before she began to have falls that drove her to investigate. I would find myself ruminating about the chances that I would start working with Molly and Elizabeth and soon after find out that I too had a neuromuscular disease.

This somatic experience and attendant destabilizing anxiety persisted for several months. In the beginning, I wondered if I was in too porous a state and needed to find a more differentiated space. Through continued exploration of my body awareness, including rooting my attention in my lower dan t’ien, I realized that I needed to let this be and see what would emerge. Although Molly was representing aspects of her experience in her play, sometimes with clear genetic and transferential links, over time I realized that putting these into words was having little impact. I increasingly felt that the only thing that led me somewhere with Molly was to tune in to our nonverbal communication. Often I felt I was propioceptively leaning forward, desperate to reach her. She would respond to such a move by backing away, walling herself further in her raw and overstimulated body. Sometimes, after rooting my attention in my lower dan t’ien, I would feel myself fall more into my own interior and simultaneously feel more in touch with her.

During this period with Molly, I had been thinking of her use of her frenetic body as a means to offer a pseudo-containment by evacuating feelings of rage and despair. I began to sense that I had been focusing on the unbearable feelings buried behind this blanket of sensations rather than opening more fully to her unstable body. As I struggled with my own body’s response to Elizabeth and to Molly, my previous way of being with Molly started to feel too conceptual and two-dimensional. I wondered if I had been missing a more direct experience of her body and its history, a dimension that was not captured by thinking of her body as a defensive shield for unacceptable feelings and conflicts in her mind. A child learns to move in and understand the world, to live the ontological struggle of how to be embodied, from the bodies of others. Psychoanalysis offers rich descriptions of this process, ¹¹ though they tend to emphasize fantasies and identifactory processes rather than addressing how these thread together with comportment. Molly began encountering Elizabeth’s bodily instability just as she began to walk. By the time she was three, Elizabeth was in a wheelchair. Elizabeth’s breakdown coincided with significant developmental moments in which Molly would have been moving out into the world, and she would have needed Elizabeth to be capable of a receptive and unobtrusive presence. I imagined Elizabeth’s physical breakdown and the terror it provoked in her had left her clinging to Molly in a parasitic way. This situation would have been transmitted in multiple dimensions, including the corporeal.

Molly’s bodily sense of herself would have been imprinted with her mother’s reaction to her mobility, exploration, and nascent capacity for separation. Molly’s frenetic embodiment was not simply a rebellion against her mother’s paralysis in a linear way. During this developmental period, Molly’s venturing out into the world would have been a crucial dimension of her evolving embodiment. In a more generative picture, her sense of her body’s extension and agency would give her a sense of her body’s contours and capacities. In this way, extending out into the world would give a body back to her. Ideally, she would have developed a sense of where she begins and ends as well as some of the risks and pleasures of reaching out. This story was not hers. Given conscious and unconscious bodily dimensions of her relationship to her mother, Molly was left with a profound incapacity to sense where her body begins and ends at a corporeal level.

The phenomologist Maurice Merleau-Ponty, whose resonances with Buddhism many have observed, ¹² suggested that the body has an intentional arc toward the world. Like the subtle body, the body’s intentionality is more primary than the intentionality of consciousness. ¹³

The life of consciousness—cognitive life, the life of desire or perceptual life—is subtended by an ‘intentional arc’ which projects round about us our past, our future, our human setting, our physical, ideological and moral situation. . . . It is this intentional arc which brings about the unity of the senses, of intelligence, of sensibility and motility. And it is this which ‘goes limp’ in illness [Merleau-Ponty 1945, quoted in Nagatomo 2008, p. 232].

This precognitive grip on the world, this bodily intentional direction toward the world, is more basic than unconscious fantasies, though it would interpenetrate them. I suggest that Molly’s arc had not “gone limp.” Rather, it had become disorganized, as if she had one foot on the gas and one on the brake at all times. To reach out she would have needed her mother’s generative absence. She would have needed to be able to let her go while implicitly trusting that she could find her again. Because her mother had claimed her so obtrusively, Molly’s bodily reach out toward the world would have involved an intensification of her mother’s absence and invasiveness. While there are clearly psychic dimensions to this, it was also lived in her body.

I had been reaching, dualistically, toward Molly’s mind buried behind this body. Arising out of my own struggling body, I began to sense that her corporeal instability could affect her mind as much as the reverse. This shift allowed me to open further to a widening of communication between us. Her body was not a primitive shield that needed to be transformed to access more verbal dimensions of her mind. It was the ground of her being, and thus far it had been profoundly unstable.

As I continued to root my attention in my lower dan t’ien, I could sometimes feel my more expanded bodymind state impact her. Whereas previously I had felt that she walled herself off in self-generated sensations, I now began to sense her body as engaged in an energetic call-and-response with mine. In the month before her mother’s death, I sensed something loosen in Molly’s frenetic embodiment. She seemed to feel some nascent trust in her experience and in the possibility of being meaningfully taken in by me. Her body did not calm, but I felt more of a pulse in the surge of her charged movements and cadence. Occasionally there were also still points. These moments were striking, as if a whirling dervish suddenly came to a complete stop before resuming her dance. I felt more freedom and fluidity in her embodiment and in my own with her.

During this period in her play, one animal puppet character would frequently take another character’s skin. She would enact this by shoving one puppet inside the other. Sometimes the inside character would then claim to be the outside one. I had thought of this as her expression of being in the middle of her parents fighting and then being consumed by her mother, with both being merged inside her mother’s skin. I also thought that she was struggling with where her mother would be after she died. While both of those ideas still felt true, as I began to register that I had missed the level at which she concretely could not feel her body’s relation to another at a corporeal level, this play began to feel more jarring. I realized I was managing a sense of disorientation. I could not figure out who was on the outside and who was on the inside or even if there was an outside and an inside. Was her body separate from her mother’s, and would her body hold together? I kept bouncing back to these questions during the play but felt that the questions were not holding together.

This experience was unsettling, and I was tempted to pull myself together. I felt that to do so would impose an order on what was happening and would block a deeper registering of her troubled body within my own. I also sensed that she would experience such an attempt to orient on my part as a kind of possession—a quest to override her and pull her into my own language. She often seemed to register that I was disturbed and would sometimes taunt me with my confusion. This move was her attempt to organize what was unfolding into a sadomasochistic register. She knew this domain well from her experience with her parents. Had I interpreted this move to her, it would, I think, have kept us in known territory and stabilized the more elusive communication that was evolving in our body-to-body resonance. At other times, she, as one of her characters, would express real despair and begin to ask if a person can take another’s essence. This painful question was new. I felt it could only emerge once she sensed that I had somatically resonated with her without possessing her with my understanding. This evolution allowed an opening of rigid dimensions of her being, which in turn began to allow new meanings to gather within her.

Molly was present for her mother’s death. Witnessing her mother’s final hours completely flooded her. After this, we lived for months in a chaotic soup. Characters would be tied up and violently flung about. At times she would dissociate as the play became too violent and clearly portrayed her mother’s death. At other moments, as things became overwhelming in the play, I would back up and try to represent what was happening. These were my attempts to calm things down, and more often than not she seemed to feel contempt for these efforts. She sensed, accurately, that I was resisting the violence and terror that were ripping through her.

In the midst of this oscillation between dissociation and defensive representations, I continued to bring my attention to my lower dan t’ien. Depending on my own state of bodymind, this space might feel cloudy, cramped, or frenetic. When I could sense an opening, my grip on whatever I was thinking or pushing for would sometimes relax. I felt there was no need to angle for less chaos. In the following hour, after play in which she and I had both dissociated, I directed my attention in this way. I felt we were suddenly very present after our familiar swing between struggle and oblivion.

In this hour, she had put playdough over the eyes of a Peter Rabbit jack-in-the-box character. This character, who she always assigned me to play, was in an imaginary wheelchair. She had also covered his nose and said that he could not breathe. I realized in looking at his covered eyes that the playdough over his eyes might represent her mother’s eyes at death and also her own dissociation. This play continued for some time, and I could feel both of us begin to slip away. I said, as Peter Rabbit, that “this is feeling like too much. I think I’m floating away.” She went on, now putting playdough over his mouth, which would fall off, and she would put it on again. After a minute or so, she looked at the clock.

(I was not conscious of this at the time, but, looking back on these drawings, she and I alternated between seeing a self-enclosed being and seeing a being reaching out with her body, uncertain if there would be another there to meet her. We seemed to be on the boundary between self-encapsulation and tentative expansion. Then––)

(She shrugs).

Early on in my work with Molly, I had viewed her chaotic body as being deployed to ward off unbearable experiences that her psyche could not contain. I was attempting to put her unconscious communications into words, often through her play. My body began to register a level of communication that my dualistic way of representing Molly’s body as a defensive shield was thwarting. My experience with Vajrayana view and practice allowed me to follow this evolution, rather than override it and regain a more differentiated stance. Molly’s body was emanating a level of communication that she needed my body to receive and become. This bodily registration began to transform a rigidity in her embodiment, and this transformation was intertwined with her capacity to represent her conflicts and fantasies. This evolution also enabled her to form meanings that had not previously gained organization.

In asking “how people came up with words,” she was in effect asking, “How do words come to matter?” Reaching her was not initially a question of putting something into words but rather had more to do with what was happening in our embodied intercorporeal communication. Like Martha in Four-Gated City, I needed to use my “body as an engine to get out of the small dim room” of my mind. Before that, I was very much the clueless paleontologist/analyst in her reverie, thinking I had a useful map when in fact my map bypassed the actual situation. She needed my embodied recognition that she had no sense of whose body she was living and that this reality had corporeal as well as psychic dimensions.

In this vignette, although I was not aware of this at the time, we are on the cusp of fragile expansion in the bodies of these drawings. Out of this she moves to questioning why people use words. In the scene that we construct, first words grow out of bodies that are living in a world that is more than they can bear. These are bodies that jump, grunt, and gesture, attempting to synchronize some of the excess of what they are living. Words are an extension of this embodied reach.

She then symbolizes why this has not been possible for her. She can use words, but these words rarely speak because her body cannot be lived as hers. All of our bodies are bound up with the bodies of others—both those of early objects and those of the cultural milieu in which we are bathed. For her, though, her body had been mistakenly viewed as having a ground and coherence when it did not. The chaotic rigidity in her mind and in her body were intertwined, and she needed to be met in both dimensions.

Conclusion

Milner writes in her preface to Hands of the Living God of her work with Susan: “Certainly one of the main practical things I learnt from her was . . . how deeply the emergence of some of the most primitive levels of psychic and body ego experience in the patient can depend on the body ego perceptions in the analyst” (p. xlviii). In order to realize this, she had to reach a limit in her work with Susan. Milner began to relinquish her own fixation with articulating unconscious meaning and to sink into the experience that was being evoked in her bodymind with Susan. I needed to go through a confrontation with a limit in my work with Molly. In my case, my body began to register a level of communication that pulled me out of dualistic frames that, because they are so embedded, are tenaciously difficult to shed. They are also protective. Due to the intensity of the analytic relationship, the level of intercorporeal communication that one is potentially more available for once the conceptual mind is relaxed can feel like being temporarily taken over by the body of another. When I experienced sensations that felt intense and alien, I felt as if I were losing a visceral sense of my identity even if, on another level, I had the concept “somatic countertransference” to categorize the experience.

Bion suggests that in order to reach deeper levels of traumatic experience and mental catastrophe, the analyst must temporarily suspend a differentiated position and become the experience rather than know about it. He describes attempting to create a state of mind that can be open to unbearable experiences in the patient. I am suggesting that this opening can include bodily dimensions and that other traditions may help psychoanalysts shake free of dualistic assumptions that limit our clinical experiences and theoretical imagination. Bion said toward the end of his life in one of the Italian seminars (1998), “Perhaps we should then have to extend . . . our knowledge of the central peripheral and central nervous system. . . . we have to become aware of the possibility that there are other receptor organs of which we are not aware . . . allow ourselves to recognize the meaning which lies beyond” (pp. 64–65). A Vajrayana perspective would resonate with this description.