Bion and binocular vision

The author describes his contact with Bion over a twenty-year period, from Bion's supervision of his control case in London in 1960 to the period from 1968 to 1978 when they were both working in Los Angeles. He outlines Bion's views on the use of 'instinct' and intuition in patient observation, the depressive position in patient and analyst, and memory and desire as impediments to knowledge of 'ultimate reality'. Some case material is presented, illustrating how Bion's ideas, particularly concerning attacks on linking, informed the course of the treatment. The author then discusses Freud's, Klein's and Bion's approaches to the problem of resistance, Bion's expansion of some of Klein's ideas, his definitions of psychosis and his formulation concerning thoughts that develop before thinking. The author then argues how essential it is for the analyst to differentiate between primitive projections from the patient that are pre-verbal attempts to communicate a state of mind and those that are an expression of hostility or control. He then discusses the importance of understanding idealizing projections and differentiating these from a healthy positive transference. He concludes by characterising Bion's way of working in terms of his humility, his courage and, fundamentally, his use of his intuitive binocular mind.