In his 2019 paper, ‘Ontological Psychoanalysis or “What do you want to be when you grow up?”‘, Thomas Ogden describes two dimensions of psychoanalysis: epistemological psychoanalysis and ontological analysis. He is careful to point out that these dimensions frequently overlap, and neither ever exists in pure form, but that they do nevertheless involve quite different modes of therapeutic action. Epistemological psychoanalysis, as practiced by Freud and Klein, has to do with knowing and understanding; while ontological psychoanalysis, in Winnicott’s or Bion’s hands, is more concerned with being and becoming. The titular question, ‘What do you want to be when you grow up?’ is the key (but probably often implicit) question posed by the ontological analyst, and Ogden implies that the analysis is only approaching its goal once the patient is able to answer the question truthfully and wholeheartedly: ‘Myself’.
Though he never states it explicitly Ogden leans very heavily towards the ontological analysis side, which we infer from his wonderful descriptions of the ‘playing’ that both analyst and patient engage in. This conception of ‘playing’ Ogden gets from Winnicott, who describes it as a transitional experience, somewhere between fantasy and reality, whereby the child/patient and mother/analyst engage in an interaction in which it would make no sense for the mother/analyst to ask of the child/patient: ‘Did you conceive of this object or was it presented to you?’. Ogden suggests that therapeutic healing happens when the patient and analyst are able to play together from within the patient’s transference-countertransference enactments.
This is a very appealing idea, and Ogden describes some beautifully sensitive clinical cases to elucidate what he means by this joint form of playing within the analytic sessions.
I also loved Ogden’s description of the end goal of psychoanalytic therapy, what sounds to me like ideal psychological health:
“…for Winnicott and Bion, the most fundamental human need is that of being and becoming more fully oneself, which to my mind, involves becoming more fully present and alive to one’s thoughts, feelings and bodily states; becoming better able to sense one’s own unique creative potentials and finding forms in which to develop them; feeling that one is speaking one’s own ideas with a voice of one’s own; becoming a larger person (perhaps more generous, more compassionate, more loving, more open) in one’s relationships with others; developing more fully a humane and just value system and set of ethical standards; and so on.”
But I couldn’t help having the nagging thought that such a strong emphasis on ‘being and becoming more fully oneself’ might resonate more with Western audiences with their freedom- and self-actualisation-oriented moral compasses than other groups, and that it might be missing something as a result.