Bassat: Linking Immunology with Psychoanalytical Psychotherapy

The groundbreaking metaphor of “the body keeps the score,” found in trauma research, aligns seamlessly with Bassat’s article exploring the profound impact of embryonic experiences on human development. Her work underscores the convergence of modern biological research with earlier theoretical and clinical insights into primitive mental anxieties, explored by pioneers like Tustin in the 1980s.

Bassat emphasizes that from conception, the human embryo faces a biological challenge: overcoming the mother’s immune system to implant in the uterine lining. This process lays the foundation for what Bassat terms a “neuro-immuno-psychoanalytic” discourse, revealing how the formative experiences of embryonic life shape both our psychological and physiological makeup.

Building on this concept, Bassat references authors like Wilfred Bion, who posited a link between autism and immune system dysfunction during early pregnancy. She further explores the idea that adverse environmental factors in the prenatal period can evoke unbearable states of dread within the fetus, disrupting psychological development and leading to the formation of autistic defenses.

Bassat redefines autistic states as psychophysical protective reactions rooted in bodily sensations rather than solely psychodynamic defense mechanisms. The overwhelming sense of vulnerability and threat experienced in the pre-verbal stage can lead to profound anxieties: a dread of annihilation, disintegration, a sense of boundlessness, or the absence of a safe, containing presence. This bodily experienced terror is not susceptible to rationalization.

Consequently, the autistic infant may resort to clinging behaviors, fixating on autistic objects or shapes. They experience a profound terror of separateness, which equates to a fear of death in their perception.

The author describes how the immune system, with its function of recognizing and responding to ‘self’ vs. ‘non-self’, mirrors the mental processes that determine our sense of individuality and connection with others.

As a psychotherapist with a background in biochemistry and microbiology, I find Bassat’s work both fascinating and deeply resonant. Her writings illuminate the profound impact of prenatal development on psychological wellbeing. Clinically, we frequently encounter clients with deep-rooted anxieties, dread, emptiness, irrational fears, and uncontrollable compulsions – states resistant to rationalization or traditional talk therapy.

These psychophysiological states defy cognitive resolution because their origins lie in pre-verbal trauma. Such experiences, occurring before language acquisition, cannot be consciously recalled. Many psychotherapists recognize the importance of physical presence, movement, and aesthetic connection alongside verbal processing. Metaphors and imagery often prove more potent than purely rational problem-solving in talk therapy.

The Podcast

Episode 129: From Immunology to Psychoanalysis: Reflections on Primitive Mental States with Shiri Ben Bassat (Tel Aviv)

MARCH 4, 2023 00:45:21

The Psychoanalytic Case study

This podcast case study @26:42 is compelling for several reasons. Firstly, it documents the author’s initial case as a psychoanalyst, highlighting the challenges and rewards of working with a child diagnosed with autism and psychosis. The dedication of both the analyst and the child’s adoptive mother to persisting through the child’s violent reactions to therapy demonstrates remarkable commitment. Additionally, the therapist’s innovative use of movement as an embodied mode of communication aligns with psychoanalytic theory, showcasing a thoughtful and adaptable approach within this framework.

In her paper, Bassat (2021) writes: “

  1. I created a stable, consistent setting of five sessions a week at a regular hour – a
    concrete action- needed to rebuild a functional container that would hold her, while
    also remaining flexible and changing, allowing her to take objects from the room
    (Quinodoz, 1992).
  2. I cultivated an accepting and total presence – offering the room, my body, and my
    internal objects so that they could be invaded and even destroyed. I thus enabled her
    to destroy my books, scrawl on my walls, bite me, dribble, and leave behind a
    destroyed, chaotic room – only to re-encounter it in a clean, orderly state upon her
    return. My internal objects had similarly been attacked and injured by evoking
    unbearable memories of my own personal traumas. I understood to what extent Yael’s unrepresented traumas were destructive and painful, in need of a mother-analyst womb to be contained in as Klein’s notion that our consulting rooms are equated, in the unconscious, with the maternal body (1961)
  3. An extensive use of a live, active presence and reparation in action (Alvarez, 1992,
    Pollak, 2009) aimed to distinguish and connect bodily functions, inside and outside,
    self and object, and different emotional states. So, by standing behind the wall to
    concretely separate myself from her, darkening the room, remaining silent, averting
    my gaze, and attempting not to breathe, I was trying to prevent the exterior world
    from intruding while she was still unready. Later, I helped her to envelop herself in
    tape so that she would feel less disintegrated.”

Further reading on Immunology and Psychotherapy

This podcast covers the following topics that warrant specialization and inspires further study:

Epigenetic link to Object Relations

Martin, S. (2014) R. Yehuda, N.P. Daskalakis, A. Lehrner, F. Desarnaud, H.N. Bader, I. Makotkine, J.D. Flory, L.M. Bierer, & M.J. Meaney (2014). Influences of maternal and paternal PTSD on epigenetic regulation of the glucocorticoid receptor gene in Holocaust survivor offspring. American Journal of Psychiatry 171:872-880.

Karla Ramirez , Rosa Fernández , Sarah Collet , Meltem Kiyar Enrique Delgado-Zayas , Esther Gómez-Gil , Tibbert Van Den Eynde , Guy T’Sjoen , Antonio Guillamon , Sven C Mueller , Eduardo Pásaro (2021) Epigenetics Is Implicated in the Basis of Gender Incongruence: An Epigenome-Wide Association Analysis. Front Neurosci Aug 19; 15:701017

Primitive Anxieties

Durban, J. (2019) ““Making a person”: Clinical considerations regarding the interpretation of anxieties in the analyses of children on the autisto-psychotic spectrum” The International Journal of Psychoanalysis 100:5, 921-939.

Prenatal and Postnatal Influence on the Psyche

Meltzer, D. & Williams, M. H. (1988) 2. Aesthetic Conflict: It’s Place in the Developmental Process. The Apprehension of Beauty: The Role of Aesthetic Conflict in Development, Art, and Violence 146:7-33

Bion, W. R. (1976) “On a quotation from Freud.” In Clinical Seminars and Four Papers, Ed. F. Bion. Abingdon: Fleetwood Press, 1987.

Joanna Wilheim (2004) The trauma of conception. Presented at a Meeting of the Brazilian Society of Psychoanalysis of São Paulo (SBPSP) on October 7, 2004.

Trnsformation of the mother’s immune system. Mandelboim, O. et al’ (2006). Decidual NK cells regulate key developmental processes at the human fetal-maternal interface. Nature Medicine 12: 1065 – 1074.

Bibliography

Bassat, S.B. (2021). “War in times of love”- Prenatal cell relations as a prototype of
autistic anxieties, defenses and object relations. Paper that won the 24th Frances Tustin Memorial Prize, 2021. Tel Aviv University, November 5th, 2021. Download pdf.