Int J Psychoanal 2007;88:559–74

‘Bound in a nutshell’: Thoughts on complexity,

reductionism, and ‘infinite space’1
GLEN O. GABBARD
Baylor Psychiatry Clinic, Baylor College of Medicine, 6655 Travis, Suite 500, Houston, TX 77030, USA —
ggabbard12@aol.com
(Final version accepted 28 July 2006)

Pluralism is the hallmark of 21st century psychoanalytic discourse. Nevertheless,

an unpleasant byproduct of pluralism is a tendency in some quarters to retreat into
orthodoxy, stemming from a perceived need to shore up theoretical boundaries in
the service of differentiating one theory from another. The delineation of borders
places us at a risk of losing sight of the fact that genuine psychoanalytic thinking
is fundamentally non-reductionistic. Moreover, the core psychoanalytic notion of
overdetermination, which Freud never abandoned throughout his career, has recently
been neglected as authors argue in their communications that one point of view is
better than another. Both analysts and their patients secretly are drawn to simple
formulations that eschew complexity. The need to remain open to the ‘infinite space’
of meaning, motive, and causation should be a hallmark of clinical psychoanalytic
practice. The author considers the implications for technique, and provides case
material to illustrate some of the challenges inherent in approaching psychoanalytic
work as a complex phenomenon.

Keywords: pluralism, complexity, reductionism, overdetermination, cause,

motive, meaning, theory, metaphor, countertransference

As Hamlet contemplates his fate in Elsinore Castle, he states in passing, ‘I could be

bounded in a nutshell and count myself a king of infinite space’ (1973a, II.ii.258).
I have often thought that this is an apt description of the analyst seated in his
consulting room. Patient and analyst sit behind a closed door, day in and day out,
for a period of years, both confined to their respective positions in the room. Each
inhabits a role in the asymmetrical arrangement of the psychoanalytic setting. The
analyst is constrained by confidentiality and other analytic boundaries that comprise
the architecture of the frame. Within this nutshell of constraint and confinement,
however, a frontier of infinite space opens up to the analyst. The space to which I
allude, of course, is an internal landscape. While resonating in some respects with
Matte-Blanco’s (1998) notion of the unconscious as infinite sets, I am thinking of this
particular space somewhat differently. It is a territory that includes the intrapsychic
space of the patient, the intrapsychic space of the analyst, and the ill-defined border
where they converge and overlap.
The contemplation of infinite space requires a mind that is sufficiently open to
entertain complexity, paradox, multiple causation, and alternative points of view. In

This paper was presented as the CAPS Lecture for the British Psychoanalytical Society on April 28,
1

2006 and as the Freud Lecture at the Psychoanalytic Association of New York on May 1, 2006.

©2007 Institute of Psychoanalysis

560 GLEN O. GABBARD

psychoanalysis, theory can be either slave or master. We analysts are at risk of becoming
confined within our nutshell of theory in a manner that constrains our thinking. Hence
dogmatic adherence to a theory can collapse the infinite space available to us within our
private reveries as we sit with the patient. Multiple perspectives from which to view a
patient’s symptom or transference can be reduced to a single privileged view that fits
our preferred theoretical model. As Britton (in press) has recently noted, ‘Theories not
only inform practice; they can also obstruct its development.’
A striking paradox has emerged from the contemporary scene. Pluralism is the
hallmark of 21st century psychoanalytic discourse. Dialogue across psychoanalytic
cultures fills the pages of our journals and echoes through the corridors of our
meetings. Similarities and differences between conflicting models are examined with
enthusiasm. Nevertheless, an unfortunate byproduct of pluralism is a tendency in
some quarters to retreat into orthodoxy, stemming from a perceived need to shore up
theoretical boundaries in the service of differentiating one theory from another. This
rush to certainty may close off a much-needed openness to other points of view.
The need to demonstrate how one theory differs from another does not have to
lead to a shutdown of creative psychoanalytic thinking. Comparison and contrast
may expand the borders of theory. However, when dialogue is perceived as threat-
ening the sanctity of a theoretical edifice, the result can be an ‘us–them’ polarization.
The core psychoanalytic notion of complementarity is then lost in the insistence that
one view is correct in an absolute sense. Polarizations may occur along fault lines,
such as conflict vs. deficit, depth vs. surface, oedipal vs. preoedipal, real trauma vs.
endogenous trauma, or one-person vs. two-person psychology. We should heed the
wise words of Schafer: ‘Contextual analysis defies dichotomous thinking … We
are obliged to go on and on analyzing interlocking, multifaceted transferences and
countertransferences, all of them expressed or hinted at in fantasies, and enactments,
some of them typical and expectable and some surprising’ (2005, pp. 771–2).
Delineation of borders places us at risk of losing sight of the fact that genuine
psychoanalytic thinking is fundamentally non-reductionistic. Although this idea
would probably meet with universal agreement among psychoanalysts, there is
almost always a pull within psychoanalytic discourse towards thinking of a ‘nothing
but’ sort (Schafer, 1970), i.e. a tendency to reduce complex mental phenomena to
‘nothing but’ a single determinant. In other words, a symptom, such as an inability
to finish a dissertation, is clearly a manifestation of castration anxiety. Hartmann
(1951), Schafer (1970), and others have pointed out that this mode of interpretation
does not take into account autonomy, multiple function, change of function, and
the multiple appeal of interpretations to all psychic systems. As the philosophers
Feigl and Brodbeck (1953) note, psychoanalysis is not a ‘nothing but’ science, but
rather a ‘something more’ science (Schlesinger, 2003). Analysis should expand our
understanding, not reduce it.

Overdetermination
In light of these disconcerting trends within psychoanalysis, the time is ripe, shortly
after the 150th anniversary of Freud’s birth, to revisit his fundamental notion of
 ‘BOUND IN A NUTSHELL’ 561

overdetermination and to reassert its crucial role in psychoanalytic theory and tech-
nique. The term can be found in Studies on hysteria (Breuer and Freud, 1893–5),
where Strachey comments in a footnote that the German word used in this context by
Breuer was überdeterminiert. To illustrate the meaning of the term, Breuer reported
the case of a 17 year-old girl who had her first hysterical attack after a cat jumped on
her from behind and landed on her shoulder. While those around her, including the
girl herself, had viewed the cat as the cause of the hysterical attack, Breuer stressed
that there had been a history of sexual assaults, the memory of which had been
triggered by the cat’s attack.
In defense of his paper on anxiety neurosis in 1895, Freud provided a simple
definition of the term: ‘As a rule, the neuroses are overdetermined; that is to say,
several factors operate together in their aetiology’ (p. 131). In a passage on hysteria,
Breuer noted,
In all of the cases, as in this one, there must be a convergence of several factors before
a hysterical symptom can be generated in anyone who has hitherto been normal. Such
symptoms are invariably ‘overdetermined’, to use Freud’s expression. (1893–5, p. 212)

While Freud generally used the term to describe hysterical symptoms, he rapidly
expanded the concept. Only three years later, in speaking of repression (1898), he
stressed that every psychical product was overdetermined. The term fully blossoms
in Freud’s epic work on dreams (1900), when he argues that overdetermination is at
the core of the dreamwork. The idea of overdetermination was consistently champi-
oned by Freud throughout his life. It even appears in Moses and monotheism (1939),
written near the end of Freud’s life, where he asserts that, in the case of Moses, each
event seemed to arise from convergent causes. Strachey indicates in a footnote that
Freud never abandoned the concept of overdetermination.
This core psychoanalytic concept has been appropriated widely. It has been co-
opted by the fields of art, literature, and film to refer to the idea of multiple narratives.
The playwright Tom Stoppard, for example, notes, ‘The question, “What does it
mean?” has no correct answer. Every narrative has at least a capacity to suggest a meta-
narrative’ (1999, p. 8). Nevertheless, Freud’s views are frequently misunderstood by
those writing from a perspective outside of psychoanalysis. As if anticipating future
arguments against him, Freud specifically eschewed reductionism in Totem and taboo
(1913a), where he stated there was no danger that psychoanalysis would attempt to
reduce a phenomenon as complicated as religion to a single source.
A serious discussion of overdetermination, however, leads us into murky waters
involving the distinctions between cause, motive, and meaning. Ricoeur (1977)
observed that Freud blurred the distinction between motive and cause when he
attempted to identify causally relevant factors at work. Moreover, Rubovits-Seitz
(1998) points out that one cannot separate out motives from meanings, since much
of what we refer to as meaning is understood in terms of motives. Any behavior
arises from a network of reasons or motives that are attached to meanings. A number
of authors (Friedman, 1995; Holt, 1972; Meissner, 2005; Sherwood, 1969) have
called attention to Freud’s struggle to decide whether man was a creature influ-
enced by natural forces adhering to principles of physical causality vs. someone
562 GLEN O. GABBARD

motivated by meanings. This struggle is reflected in his discussion of the Dora case
(1905), where he first asserted that motives are not involved in the formation of
symptoms and are not present at the beginning of the neurosis. Eighteen years later,
he had changed his view and added a footnote to the text in which he said that his
point of view on motives could not be maintained. He revised his view to note that
motives for an illness could be in existence before the illness appeared and were
partly responsible for it.
Freud’s complex view of the interface of cause and meaning has also been noted
by critics. Grünbaum (1984), for example, faulted Freud for drawing unwarranted
causal inferences from meanings discovered in the clinical setting. This criticism,
however, presents a rather oversimplified view of Freud’s conceptual model. Shope
(1973) noted there were at least four uses of the concept of meaning in Freud’s
oeuvre: 1) the entity for which a mental phenomenon substitutes; 2) the intention or
purpose of a mental phenomenon; 3) the significance of the mental phenomenon;
and 4) the unconscious causal motives behind the phenomenon. Freud did not view
meaning and cause as synonymous; Shope stresses, however, that he did include an
unconscious causal network in his account of meaning.
Rubovits-Seitz shares the view that Grünbaum’s critique tends to view the
Freudian understanding of cause and meaning in an oversimplified fashion. He
makes the observation:
Psychoanalytic theory conceives of latent meanings and psychic determinants as unequivocally
though complexly related, a viewpoint which is consonant with: 1) its core concept of continuity,
that is, that all aspects of mental functioning are connected; 2) its nonlinear logic of psychic
reality …; and 3) the additional concepts that subsequent experiences can influence earlier
(mental) events, that meanings can become causes, that motivations function as both causes and
meanings, and that meanings suggest the nature of their determinants. (1998, p. 187)

As a practical consideration, most analysts working today recognize the complex

interactions between causation, motive, and meaning. They would view a model of
linear causality with skepticism, and, even when such a model may appear to apply,
they would recognize that meaning is always infinitely expandable. Interpretation of
a symptom in contemporary psychoanalysis is less geared to the search for multiple
causes than the understanding of a complex network of meanings (Phillips, 1987;
Rubovits-Seitz, 1998).
Friedman (1995) suggests that concepts like cause, motive, and meaning are not
as disparate as some critics have suggested. He acknowledges differences, e.g. that
a motivational system is about impetus, and the phenomenon of impetus, such as
sexual desire, is not identical with meaning. However, he notes that, even if Freud’s
theory rests on a motivational explanatory foundation, when one is working with
an individual patient, the analyst works things out with the patient almost entirely
in terms of reasons that have to do with conscious and unconscious meanings for
the patient.
Psychoanalysis stands on the unfashionable assumption of complexity in the
understanding of human affairs. Today we swim against a current of reductionism.
Evolutionary psychology reduces human behavior to Darwinian notions of survival
 ‘BOUND IN A NUTSHELL’ 563

value and fitness. In biological psychiatry, genetic reductionism reduces the pleo-
morphic nature of psychiatric syndromes to the identification of genes, the location
of the site in the brain responsible for the condition, or the discovery of the aberrant
neurotransmitter. The idea that complex behavior is reducible to simple truths has
enormous appeal, especially in an era in which we are enamored with high-tech
diagnosis and ‘quick fix’ psychopharmacologic solutions.
It is far too easy, however, to locate the forces that imperil overdetermination
and complexity outside our field. We analysts are daunted by the complexity of the
clinical situation. We may cling to our favorite theoretical models of explanation as
a drowning man clings to the wreckage of his boat. We long for universal truths that
can be imposed on our data. When a distinguished psychoanalyst like Rangell states
that, ‘I have never failed to observe in the clinical situation that terror and horror
are castration anxiety, and not any other form of the anxiety response’ (1991, p. 8),
his certainty has a reassuring ring to it. Faced with the dread of an encounter with
primal forms of terror in the patient, the analyst can interpret with conviction about
the origins of that terror. Indeed, throughout the history of psychoanalysis, there has
been a trend to reduce the source of something confusing and frightening to a single
determinant. This trend manifests itself in a particular form of language—‘What you
really are afraid of is …’ or ‘Underlying this chaos is really a very simple wish.’
Even Freud himself (1937) seemed relieved by proclaiming that one had reached
bedrock with a female patient when finally encountering penis envy and with the
male patient when laying bare the masculine protest or castration anxiety. Frankly,
I do not think the term ‘bedrock’ is a clinically or heuristically useful concept in
psychoanalytic discourse. It may be more helpful, in my view, for analysts to assume
that, when they believe they have reached some form of bedrock, they have actually
encountered some combination of the limits of a theoretical edifice, a clinical
impasse of some sort, and a countertransference aversion to further elaboration.
Listen to Freud’s words as he describes his frustration:
At no other point in one’s analytic work does one suffer more from an oppressive feeling
that all one’s repeated efforts have been in vain, and from a suspicion that one has been
‘preaching to the winds’, than when one is trying to persuade a woman to abandon her wish
for a penis on the ground of its being unrealizable. (p. 252)

One can imagine that Freud’s conception of what a woman must do would activate
intense conscious and/or unconscious protest in female patients. When one runs up
against this apparent bedrock, it is probably more useful to view it as an impasse that
is likely to reflect a ‘false floor’ to one’s conceptualizing and to continue to listen to
the multiple meanings and functions that are inherent in the patient’s associations
and to observe the enactments that occur between patient and analyst.
We cannot ignore the implication from this passage that Freud’s support for
the concept of overdetermination was ambivalent. Indeed, like all of us, Freud
was drawn to reductive thinking at those moments when he could make no further
progress in his thinking. Careful study of his work reveals a recurrent dialectical
tension between reductionism and overdetermination. The dual-instinct theory itself
can be viewed as a form of reductionistic thinking.
564 GLEN O. GABBARD

Many patients also prefer simple, straightforward explanations to illuminate

their suffering. A patient once came to me for a second analysis and told me that
his first analysis had been quite helpful to him: ‘I learned,’ he explained, ‘that I
hated my father, and I felt a lot better after that.’ We too may find it far easier,
and certainly less messy, to avoid the ‘infinite space’ of complex causality and
meaning that converge in ways that are difficult to understand. We may be less
than satisfied when we convey these multidetermined modes of understanding to
our patients. Freud once noted that overdetermination ‘detracts somewhat from the
elegance of the interpretation’ (1913b, p. 270). Life tends to be messier than what
our psychoanalytic writing reflects. Nevertheless, Britton (in press) notes that both
members of the public and analytic practitioners themselves may demand certainty
and coherence.
We analysts can thus be bound in a nutshell of theory that restricts our vision of the
patient. Many of us may prefer premature closure to the alternative of uncertainty. We
may find it difficult to bear the countertransference anxiety of not knowing (Faimberg,
2005), as we become lost in a sea of associations, historical antecedents, memory
fragments, and transferences. A theory-driven psychoanalysis provides an illusion of
mastery that we highly value. Analysts often become narcissistically invested in a
particular paradigm of understanding (Rothstein, 1980) that we believe will supply
answers to our confusion in the midst of the chaos we confront in a difficult analytic
encounter. A half-century ago, Wheelis made the following observation:
Psychoanalysts frequently describe one or another of their colleagues as rigid, dogmatic, and
authoritarian; yet no analyst ever so describes himself. The inescapable inference is that some
of us have taken refuge in dogma without knowing we have done so. (1956, p. 171)

The psychoanalytic literature itself may actually work against the operational-
izing of the principle of overdetermination and the full appreciation of complexity
in clinical work. In my role as a journal editor, I have come to realize that analytic
authors are writing for a particular invisible audience as they compose their words
on the computer screen. They wish to make the point as persuasively as possible
that conceptualizing clinical data from the standpoint of their preferred perspective
has greater value than other perspectives. In the service of making a compelling
argument, they present a version of psychoanalytic work that, if not entirely fictive,
is at least more elegant than the real-life version in the trenches of the consulting
room. These same writers must confront space limitations established by the journal
editors to whom they submit their manuscripts. Hence they must state their premise
and present clinical material supporting that premise in relatively few pages that
can easily be digested by the typical reader. Our publication format itself then may
encourage a form of reductionism.

Implications for technique

Given that analysts and patients alike may unconsciously collude in the seeking out
of simplistic, straightforward explanations, what can the analyst do to preserve an
environment that is open to the overdetermined nature of clinical phenomena? Up
 ‘BOUND IN A NUTSHELL’ 565

to this point, I have been melding two themes that are related but not the same thing:
1) failure to recognize multiple causes and meanings; and 2) the perils of being
narrowly theory-driven in one’s approach.
A central idea links these two concepts—namely, that theory is metaphor. Our
theories are attempts to capture what psychological transformations are like. Because
psychoanalytic theories are metaphors, they must suffer the fate of all metaphors:
at some point they break down. With this view in mind, overdetermination is a
commentary on analytic theory itself. In brief, it means that every metaphor for what
happens psychologically eventually breaks down. An interpretation is a metaphor
that is breaking down even as it is uttered. Moreover, analysts may cling to dogmatic
interpretations as a defensive response to the fear that their set of metaphors has
limitations.
Theory itself is not the problem. It is an essential tool for the analyst. Without
theory, we cannot analyze. Even within one theory there is ample room to take
overdetermination into account. What I am emphasizing is that a particular relation-
ship to theory is required. Theory must be regarded as a passenger in the journey
we undertake with the patient and not the driver of the vehicle. We may carry on
an internal conversation with this passenger as we sit with our patients. From this
conversation, ideas emerge that are based on this theory, but we must view these
ideas as only one lens out of an assortment of lenses through which we can view
the material. As Waddell (2005) has stressed, theory may interfere with observation.
The point here is not that one must embrace every major theoretical perspective, but
rather what Joseph Sandler stressed in his writing—that there is value in ‘tolerating
different theories in one’s mind and trying to understand them in order to permit the
theories to interact with one another, and possibly lead to clinically useful theoretical
developments’ (1990, p. 862).
Inherent in the analytic role is a degree of skepticism about our own pat formu-
lations and the patient’s theory of pathogenesis. Analysts must always doubt. Hence
our internal dialogue with theory must be undertaken with the understanding that
the theory may or may not fit with the analytic material. In his Italian seminars, Bion
emphasized that theory must never be privileged over direct clinical observation.
Patients, after all, do not come to analysis because they suffer from an entertaining
theory:
We could say that there is one collaborator we have in analysis on whom we can rely,
because he behaves as if he really had a mind and because he thought that somebody not
himself could help. In short, the most important assistance that a psychoanalyst is ever
likely to get is not from his analyst, or supervisor, or teacher, or the books that he can read,
but from his patient. The patient—and only the patient—knows what it feels like to be him
or her. (2005, p. 3)

Thus, Bion exhorts the analyst to dare to feel and think whatever it is that
comes into awareness regardless of whether these feelings or thoughts are in accord
with one’s own preferred theories or those of others. This approach is akin to
what Chodorow (2003) has referred to as listening to rather than listening for. The
analyst’s mode of being with the patient must be one that avoids premature closure.
566 GLEN O. GABBARD

Both Winnicott (1971) and Balint (1968) caution the analyst against knowing too
much or rushing to offer a ‘correct’ interpretation to bring order to the patient’s
experience. Such maneuvers may squelch the patient’s emerging need to find his or
her own way to understand internal experience.
Ogden makes a similar point succinctly:
The analyst … must possess the capacity for reverie, that is, the capacity to sustain over long
periods of time a psychological state of receptivity to the patient’s undreamt and interrupted
dreams as they are lived out in the transference–countertransference. (2004, p. 862)

In other words, a major implication for technique is that tincture of time is a crucial
ingredient in the analyst’s approach. The multiplicity of meanings and functions will
emerge only if ‘analytic time’ is created for them, a feeling that patient and analyst
have all the time in the world. The analyst must be content to hold the complexity
of the situation and sit with it regardless of the discomfort produced in both parties.
Analysts need to live with what their patient is experiencing in all of its ramifications,
its developmental echoes, and its functions as transference–countertransference
manifestations (Ogden, 2005). This process involves both using theory construc-
tively and unlearning what one knows about theory that may lead one astray. The
result is the creation of an atmosphere where surprise is possible.
By tracking the patient’s affective state and one’s own emotional responses
without immediately explaining the feelings, one can facilitate a sense of freedom
from the shackles of theory. As Bion noted, ‘I think that what the patient feels is
the nearest thing to a fact—as I ordinarily understand it—that he is ever likely to
experience’ (2005, p. 7).
Patients will go through analysis in precisely the way they have to do it (Gabbard,
2000). We can impose our expectations of an opening phase, a middle phase, and
a termination phase. We can impose the concepts of oedipal rivalry, depressive
position, self–object transferences, or insecure attachments on the patient, but, to
our great good fortune, patients find ways to express themselves apart from these
theory-driven expectations. We analysts owe it to our patients to keep theory on the
back burner of our analytic minds, so that patients can reinvent psychoanalysis each
time they come to our consulting rooms, and so that we can share in that reinvention
as co-inventors (Ogden, 2005).
When Freud conceptualized overdetermination, he was thinking in terms of
a one-person psychology. In this second century of psychoanalysis, we are now
inclined to view psychoanalysis as encompassing both a one-person and a two-
person psychology. Hence another principle of technique is to recognize that one
determinant of the patient’s fantasies, transferences, resistances, and symptomatic
behaviors may involve the analyst’s enactments, biases, and modes of intervening
in the course of the hour. The work of Gill (1987), Hoffman (1992), Greenberg
(1995) and Mitchell (1997), to name only a few, emphasizes the continuous impact
of the analyst’s real behavior on the patient. The exploration of that impact is
another cornerstone of technique. A major component of this exploration involves
a systematic inquiry into how the analyst’s subjectivity/countertransference may be
influencing what the patient says and does in a particular way. Patients often feel
 ‘BOUND IN A NUTSHELL’ 567

they must either comply with or rebel against what the analyst expects of them and,
by implication, the analyst’s theory.
The analyst must listen in an active way that allows the patient to feel understood
without yet placing the patient’s material in a predetermined metapsychological
formula. This mode of active listening is close to what Poland (2000) has described
as witnessing. He emphasizes the need to respect the patient’s meanings while
simultaneously entertaining multiple points of view. He recognizes the paradox
of the intimate connection between self-definition and concern for the other and
identifies three relational perspectives in the analytic dyad: ‘one addresses an intra-
psychic one-person psychology; a second looks at two-person psychologies based
on the interaction of separate subjects; a third considers emotional interaction as the
outgrowth of a singular unified dyad’ (p. 30).
Another mode of enhancing the patient’s capacity to appreciate multiple
causative factors is the way in which one uses interpretation. Analysts must be
wary of closing down other possibilities by implying that one has struck bedrock.
If, for example, the analyst says, ‘The fundamental reason for your anxiety about
success is …’, ‘The bottom line in all this is …’, or ‘What all your concerns boil
down to is …’, the patient’s ears will perk up as though an oracular truth is being
spoken. The choice of words itself in such pronouncements reeks of reductionism
and monocausal theory. Schafer (2005) notes that analysands often hear such
interpretations as a sign that the analyst is dissatisfied with the narrative they have
constructed. There may thus be a coercive element perceived by the patient, who
feels as though he should be saying something else. Schlesinger makes the point
that ‘the proper general form of an interpretation is not “what you really mean
is …,” but rather, “You may also mean …” ’ (2003, p. 16). Similarly, the analyst’s
interpretations must invite the possibility of other meta-narratives than the one
on which the analyst is focusing. One might say, for example, that ‘In addition
to your insight that you fear your father’s wrath if you succeed, I wonder if you
also worry that you will decimate your father with your success.’ In this manner
of speaking, the analyst simultaneously expands the patient’s understanding of the
determinants while also paving the way for the patient to associate to still others.
We cultivate an attitude in the patient that other meanings exist in addition to
whatever meaning the patient has attributed to a phenomenon. The work is never
done. One terminates analysis but not analyzing.
The task is challenging not simply because of one’s wish to simplify. The
analyst’s countertransference to a particular patient is influenced by a host of factors
that provide even further complexity to the clinical picture. Each time analysts
set foot in their offices, they carry within themselves allegiances to supervisors,
teachers, authors, and to theories themselves (Smith, 2001). We are inextricably tied
to a host of ambivalently held identifications with those who came before us. Try
as we might, we cannot leave them at the door when we analyze. While we are all
in favor of freedom of thought for the analyst, it is a tall order in analytic work, and
the best we can hope for is maintaining these diverse connections and loyalties in
the conscious realm of our free-floating attention. All interpretations are not equally
valid, of course, and ultimately some themes and meanings are more compelling to
568 GLEN O. GABBARD

the patient than others. In their own way, patients supervise us by letting us know
which interpretive formulations can be discarded and which can be retained.
A clinical example will illustrate some of the challenges we encounter in
preserving an analytic space for the overdetermined nature of clinical phenomena
to emerge. In this case, the analysis of a simple enactment—late arrival to each
analytic session—revealed multiple determinants and multiple meanings. As noted
above, these fragments of an analysis are by necessity telegraphic and incomplete in
order to fit within the finite space required by editors.

The case of Marie

Marie was a divorced woman in her late thirties when she began analysis with me
five times weekly. Her reason for seeking analysis involved a series of unsatisfying
relationships with men that left her feeling used and worthless, contributing to a
chronic sense of loss and sadness. She linked these relationships to her hatred for
her father, who told her that no man would ever put up with her. She was a respected
professional, though, who was competent in her work and felt like she was fooling
everyone by appearing to be more intact and better off than she really was.
From the first month of analysis, Marie became intensely involved with a man
who was a generation older than her and a close friend of her father’s. At the time
that this relationship began, she settled into a pattern of coming between 5 and 15
minutes late to every session. The patient met attempts to explore the meanings of
her lateness with a pat formulation: ‘I’ve been late all my life. I like to do things
on my time—not others’ time. That’s all there is to it.’ The patient had her own
pre-existing reductive explanation.
In the early months of the analysis, the patient encountered my wife at a social
event. The following session, one in which the patient arrived approximately 20
minutes late, was filled with self-loathing comments. She felt it was impossible to
compete with someone like my wife, and she recounted the many horrific experi-
ences she had had with men, all reflecting that she could not find a good man who
would accept her.
The next day she came to the session reporting a dream in which she was making
love with her father’s friend, only to be interrupted by the doorbell. Upon answering
the door, a large angry woman shot her in the head. In her associations, she thought
of how her mother would be enraged when she had a successful relationship with
a man. She then went on to say, ‘I feel so anxious about coming to these sessions
because I feel that your wife would be jealous if she knew how I felt about you.’ I
said to her that perhaps she came late to undermine the analytic work and thereby
avoid the wrath of another woman who would be enraged by a successful relation-
ship. In response to my interpretation, she told me about a time that she carelessly
dropped an expensive new camera in a lake. Her father had given her the camera,
but she felt that her sister would be too jealous if she and her father enjoyed a special
hobby together. At this point in the analysis, I was fairly certain about what was
going on. The patient had begun the analysis by becoming involved with a man who
was close to her father, while at the same time coming late to the analysis. She feared
 ‘BOUND IN A NUTSHELL’ 569

this relationship would evoke rage in her mother. Similarly, by coming late and
attempting to defeat the analytic process, she was avoiding an oedipal triumph in the
transference that would enrage my wife. Her life was a series of ubiquitous oedipal
triangles involving formidable female rivals. I was disconcertingly complacent.

One year, nine months

Despite my theoretically solid interpretation of the oedipal configuration, the
patient’s lateness continued. She clearly was not impressed by my certainty. After
about 1 year and 9 months, the patient arrived 15 minutes late and began with an
association. She said she was taking a shower prior to coming to the analysis and
had a powerful feeling that she was once again an adolescent trapped in the shower
by her father, who would periodically come in and wash her hair with shampoo in a
harsh and sadistic way, all the time insisting that he had to be sure her hair was clean.
She said that, when she came into my office, she very much had the feeling that she
was being trapped on the couch with me in the same way that she was trapped in the
shower with her father.
She then told me a dream: she was on the edge of a cliff looking down into a
chasm, and a wild dog was trying to run up the side of the cliff. The wild dog finally
made it to the top of the cliff, and Marie kicked it back down. I asked her about her
associations, and she said the dream depicted the way she felt about herself, that
she felt intense rage that she had to keep stuffing down so it wouldn’t spring to the
surface. I encouraged her not to stop with that compelling association, but to see
what else came to mind.
Marie then told me that a new man with whom she had become involved was
partially impotent, and she actually enjoyed his sexual problem and was not interested
in his getting over it. She told me that she had an aversion to oral sex because she
would often have an impulse to bite the man’s penis. She painfully acknowledged
that part of her had a wish to castrate men in a hostile way as a kind of revenge for
the wrongs she had experienced from her father in the past. She then said that she
knew it bothered me that she always came late, but she thought she was protecting
me from the wild dog within her. So another layer of meaning emerged from further
analysis of the lateness. Not only was she avoiding the wrath of an oedipal rival by
coming late, but she was also protecting me from the wild, aggressive side of her
that might destroy me if fully unleashed in a 50 minute hour.

Three years, two months

About 2 years later, the patient still had not found a satisfying male relationship. She
had recently broken up with her boyfriend when he discovered that she was using
a vibrator. She told me that she preferred masturbating with a vibrator to sexual
relations with her boyfriend because she was completely in charge when she was
with her vibrator. She went on to say that she was reading a book about masturba-
tion fantasies in which the most arousing to her were fantasies of having sex with
machines, where she had complete control. One specific fantasy also involved tying
up a man and getting him to submit to her. I commented to her that in the analytic
relationship it seemed that I was in a somewhat submissive position in relation to
570 GLEN O. GABBARD

her because I had to wait each day for her to arrive before we could start. She
laughed and said, ‘I maintain control because I’m always the one who determines
the beginning of the session. I love to keep you guessing about whether I will come
or not—or at least when I will arrive.’ She went on to say that she played ‘hard to
get’ with me as she did with other men because she believed that, once she gave
in sexually, she would lose the man and he would have no other interest in her. I
pointed out to her that, in a similar way, she did not want to be penetrated by me but
preferred to frustrate me by coming late and having a partial session. She responded
by saying, ‘If I frustrate you, then you will continue to pursue me to see if you can
get me under control.’ She went on to say that she had a fantasy that I would try to
mold her if she collaborated with me. Working with me analytically would be a way
of subjugating herself to me. She said, ‘I know I’m frustrating you, but I’m also
assuring that you will pursue me.’ I reflected on how in fact I was pursuing her. I was
attempting to analyze her lateness with a kind of zeal suggesting that I was highly
invested in making her come to the session on time. In a sense, then, I was enacting
her fantasy that I would pursue her if she resisted complying with my expectations.
As I thought about this drama playing out between us, I was reminded of a
Fairbairn (1940) paper, in which he suggested that love is too dangerous to release
upon one’s objects. Marie had arranged it so that she was fleeing from my love while
protecting me from her own. I said to the patient, ‘You must be terribly concerned
that I will lose interest and you will lose me entirely if you give in and spend a full
50 minutes with me every time.’ This comment was followed by a long silence.
Marie then commented, while choking back tears, ‘I don’t want to need you too
much. Then I’m vulnerable. I’m afraid I’ll have such intense neediness, that I’ll
swallow you up and overwhelm you. I don’t know if you can tolerate me. You might
recoil in horror if you saw how needy I was.’
Marie was telling me that her lateness had some further determinants. She
avoided being in a submissive position in which I controlled her by keeping me
waiting and having the fantasy of being the one who had the upper hand in the
relationship. She could control and subjugate me. Moreover, she was desperately
afraid of needing me too much if she allowed herself the full 50 minutes on the
couch. She imagined that she would unleash a voraciousness that would devour me
and leave me as an empty shell. This new layer of meaning led me to a shift in my
technique—I increasingly focused on her underlying fears of her own desires, rather
than her aggressive wish to control me.

Termination
The patient spent the last year and a half of her analysis engaged in quite a healthy
relationship with a man who was patient with her and could put up with her need
to test the relationship repeatedly. As she experienced feelings of loss in relation to
me and to the analysis as termination neared, she used a sexual metaphor to convey
the way in which she felt that she had allowed me to penetrate her in the way she
had allowed her new boyfriend to penetrate her. She also felt deeply concerned
that I would resent her success and hate her for it as her mother had. She recalled
 ‘BOUND IN A NUTSHELL’ 571

that, when she invited her mother to her college graduation, her mother replied,
‘Sure, I’ll come and throw rocks.’ She thought that perhaps another reason for her
lateness earlier in the analysis was to avoid the envious attacks from me that might
accompany her successes.

Discussion
In these fragments of a 6 year analysis that I have strung together, I have sought
to demonstrate in a somewhat schematic way how multiple determinants may
emerge in the course of analyzing a particular symptom or enactment in the analytic
process. Reduction of the meaning of the symptom to one cause would be, at best, a
partial understanding of the symptom. Moreover, my capacity to entertain different
theoretical formulations allowed a fuller understanding of the various meanings of
her lateness.
Among the significant determinants of her lateness were the following:
1) An avoidance of an oedipal triumph in which she had me all to herself while
enraging a female rival who might retaliate against her.
2) An attempt to protect me from the unbridled rage within her that derived from her
anger at her father for his sadistic treatment of her. In her likening the analysis to
being trapped in the shower, she projected that sadistic aggression on to me as well.
I had become the persecuting object that her father had been, so she had to avoid my
aggression as well as her own.
3) She simultaneously enacted a fantasy in which I was under her omnipotent control
because I had to wait for her each day to start the session. I became the subjugated
figure rather than the subjugating one. She felt strongly that she would keep me
involved by playing ‘hard to get’ and forcing me to pursue her. In retrospect, my
countertransference frustration with her lateness made me an ideal target for her
projectively disavowed omnipotent control. I did indeed wish to analyze the lateness
so that it would stop. I undoubtedly conveyed this zeal to change her behavior, thus
convincing her that she was succeeding in making me pursue her. This transference–
countertransference ‘dance’ reflects how a two-person psychology may be useful
in understanding how a particular behavior is co-determined by both analyst and
patient.
4) Her conviction that her love was toxic led her to come late to avoid destroying me
with her neediness. An openness to Fairbairn’s ideas allowed me to formulate what
was going on in a way that facilitated my ability to think about what was occurring
in the analytic relationship.
5) Finally, the patient was able to acknowledge that her chronic lateness was related
to a maternal transference to me—namely, she was protecting herself from the
mother who would resent her success and enviously attack her for it.
The case of Marie illustrates an important corollary of the principle of over-
determination. Understanding of new meanings and new determinants frequently
leads to a change in direction. A partial understanding may be expanded to a more
complete, deeper understanding, and an unexpected direction may be taken in one’s
technical approach. In this regard, overdetermination is not only defined by parallel
572 GLEN O. GABBARD

meanings, but by hierarchies and branches of meaning that contain more detailed
psychic truth about the patient.

Conclusion
Analysts must strive against their tendency to be complacent with simple explana-
tions, no matter how compelling they may be. Forces in the mental health field
drive us to do our work more quickly so we can be ‘cost-effective.’ Arriving at
formulations prematurely is reinforced by these currents in the culture as well as by
our natural urge to feel a sense of mastery over the chaos of the human condition.
Finally, we must avoid the siren song of theoretical certainty leading to analytic
closure before we have fully explored the multiple meanings of the patient’s behav-
iors and symptoms.
The quotation with which I began this paper is not complete. Hamlet qualifies
his status as ‘king of infinite space’ with an afterthought: ‘were it not that I have bad
dreams’ (1973a, II.ii.261–2). As I think about the uncertain future of analysis, I too
have a bad dream—that pluralism may lead us to a retreat into orthodoxy to clarify
positions and return us to a form of reductionism and ‘bedrock’ thinking. However,
all dreams aren’t bad ones. Dreams themselves are a window into the principle of
overdetermination and the ‘infinite space’ of the unconscious. Bion might say that
a king of infinite space needs to dream up new metaphors that endlessly expand
understanding. Shakespeare seemed to anticipate Bion in this regard. After all, in
another contribution from the Bard, Bottom awakens from a dream and announces
that ‘it shall be called Bottom’s Dream, because it hath no bottom’ (A midsummer
night’s dream, 1973b, IV.i.219–20).

Translations of summary
„In aller Kürze“: Gedanken über Komplexität, Reduktionismus und „unendlichen Raum“. Der
Pluralismus ist das Charakteristikum des psychoanalytischen Diskurses im 21. Jahrhundert. Eine unan-
genehme Begleiterscheinung des Pluralismus ist die in bestimmten Bereichen zu verzeichnende Tendenz,
sich in eine Orthodoxie zurückzuziehen und theoretische Grenzen zu errichten, um klar zwischen den
verschiedenen Theorien zu unterscheiden. Die Markierung von Grenzen bringt das Risiko mit sich, dass
wir übersehen, dass genuines psychoanalytisches Denken von Grund auf nicht-reduktionistisch ist. Darüber
hinaus wird das zentrale psychoanalytische Konzept der Überdeterminiertheit, das Freud niemals aufgegeben
hat, in der jüngsten Vergangenheit ignoriert, wenn manche Autoren in ihren Verlautbarungen erklären,
dass dieser oder jener Blickwinkel besser sei als ein anderer. Unter der Hand werden Analytiker und auch
ihre Patienten zu einfachen Formulierungen verleitet, die jede Komplexität meiden. Die psychoanalytische
Praxis sollte sich durch die notwendige Offenheit für den „unendlichen Raum“ von Bedeutung, Motiv und
Verursachung auszeichnen. Der Verfasser erläutert technische Implikationen und illustriert anhand von
Fallmaterial einige der Schwierigkeiten, die sich ergeben, wenn man die psychoanalytische Arbeit als ein
komplexes Phänomen betrachtet.

‘Encerrado en una nuez”: ideas sobre complejidad, reduccionismo y ‘espacio infinito’. El pluralismo
es el sello distintivo del discurso psicoanalítico del siglo XXI. Sin embargo un desagradable efecto colateral
del pluralismo es la tendencia de ciertos sectores a replegarse hacia la ortodoxia, a partir de una necesidad
de apuntalar fronteras teóricas al servicio de la diferenciación de teorías. La demarcación de fronteras pone
en riesgo perder de vista el hecho que el pensamiento psicoanalítico auténtico es fundamentalmente no
reduccionista. Además la noción psicoanalítica central de sobredeterminación, que Freud nunca abandonó a
lo largo de su carrera, fue recientemente descuidada por autores que sostienen en sus comunicaciones que un
punto de vista es mejor que otros. Tanto los analistas como sus pacientes son secretamente arrastrados hacia
 ‘BOUND IN A NUTSHELL’ 573

esquemas simples que evitan la complejidad. La necesidad de permanecer abiertos al ‘espacio infinito’ de
significados, motivos y causas debería ser un la característica principal de la práctica clínica psicoanalítica.
Se estudian las implicaciones para la técnica y se presenta material de un caso para ilustrar algunos de los
desafíos inherentes al enfoque del trabajo psicoanalítico como fenómeno complejo.

« Attaché dans une coquille » : réflexions sur la complexité, le réductionnisme, et l’ « espace infini ».
Le pluralisme est la caractéristique principale du discours psychanalytique du 21ème siècle. Cependant, un
effet latéral déplaisant du pluralisme est la tendance dans certains domaines à se réfugier dans l’ortho-
doxie, ce qui provient de ce qui est perçu comme une nécessité d’établir des frontières théoriques afin de
différencier les théories entre elles. La délimitation des frontières nous place dans le risque de perdre de
vue le fait que la véritable pensée psychanalytique est fondamentalement non réductionniste. De plus, la
notion psychanalytique centrale de la surdétermination, que Freud n’a jamais abandonnée tout au long de sa
carrière, a été récemment mise de côté, du fait que différents auteurs défendent dans leurs communications
qu’un point de vue est meilleur qu’un autre. Tant les analystes que leurs patients sont secrètement poussés
vers des schémas simples qui évitent la complexité. La nécessité de rester ouvert à l’ « espace infini » des
significations, des motivations et des causalités devrait être la caractéristique principale de la pratique
clinique en psychanalyse. Les implications pour la technique sont examinées, et du matériel de cas illustre
quelques uns des défis inhérents à l’approche du travail psychanalytique comme un phénomène complexe.

Costrizioni del pensiero: Riflessioni sulla complessità, sul riduzionismo e sullo ‘spazio infinito’. Il
discorso psiconalitico di questo secolo è all’insegna del pluralismo. Tuttavia, quest’ultimo è causa di una
spiacevole e non rara tendenza a rifugiarsi nell’ortodossia. Tale tendenza è dovuta alla necessità di erigere
delimitazioni teoriche che consentano di differenziare una teoria dall’altra. La delimitazione di questi
confini fa però incorrere nel rischio di perdere di vista il fatto che l’autentico pensiero psicoanalitico è
essenzialmente non-riduzionista. Inoltre, la fondamentale nozione psicoanalitica di sovradeterminazione,
che Freud non ha mai abbandonato, è stata recentemente alquanto trascurata; non è raro che gli autori
sostengano nelle loro comunicazioni che un certo punto di vista sia migliore di un altro. Sia gli analisti che
i loro pazienti sono segretamente attratti da formulazioni semplicistiche che sfuggono alla complessità.
L’esigenza di mantenersi aperti allo ‘spazio infinito’ del significato, della motivazione e della causalità
dovrebbe invece essere la caratteristica principale della prassi psicoanalitica. Vengono considerate le
implicazioni per la prassi e presentato materiale clinico per illustrare alcune delle sfide inerenti al trattare il
lavoro psicoanalitico come un fenomeno complesso.

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