Knowledge and experience of time in primitive mental states

The author proposes that time be considered an object of working through during the psychoanalysis of patients whose mental functioning reveals distinct primitive aspects. These so-called 'difficult patients' are particularly intolerant of the temporal limits of analytic sessions and often attempt to undermine the analytic setting. He presents some hypotheses about time and the mind's depth levels. A series of clinical vignettes taken from the analysis of adolescent, borderline and psychotic patients shows several ways in which the analysand's perception of and relation to time surfaces and is worked through in the course of analysis. Analyzing the relationship with time and the conflict between denial and acceptance of temporality proved a significant catalyst in the development of cases that had tenaciously impeded progress. It thus became possible to bring about important changes in the ways such patients experienced affect in the analytic relationship and in object relations, not by acting directly upon these relationships but by working instead on the formal parameters that organize the mind-and primarily on its spatio-temporal organization.