ABSTRACT

Recently, I have observed some things that, although they were already mentioned in our founding book, were right in front of our noses and we did not see them, have completely changed the paradigm of our way of doing clinical work. Human suffering, probably that of all living beings, is a condition of the contact boundary, not just of the individual who perceives or expresses suffering but of the midline that represents contact (Goodman, 1951), and it was while reading an article by Margherita Spagnuolo Lobb (2002), in which the author insists on the concept of “Self is contact and contact is Self,” that the idea was not entirely clear to me until I concluded that the Self can only be expressed at the contact boundary; everything that happens to us as living beings, the life that surrounds us, the life that belongs to us or does not belong to us, becomes evident only at the contact boundary. So here a perspective opens in which we should ask ourselves, ¿Suffering is an injury at the contact boundary or at the boundary of contact? An interesting dilemma; if there is a contact boundary, there is a Self, if there is a Self, there is an environment, this understanding invites us to definitively step out of individuality and conclude that: “suffering as an individual experience can only be expressed in that midpoint between the organism and the environment, in the midpoint of two bodies that meet or if the contact is self and self is contact, as the experience that becomes possible in contact, that is to say, at the contact boundary that can only be shared and that never belongs to the individual alone.” “The suffering of the contact boundary reminds us of how we manifest and not just what we manifest”; “The suffering of the contact boundary reminds us that it is only there where we can be recognized by the “Environment and the others.” The value of this innovative yet not new idea lies in its clinical application, in how the therapist recognizes at the contact boundary between themselves and their patient a suffering that can be understood and shared, the emotion that emerges from the organism to become part of the clinical relationship, and with this, an expression of the boundary is perceived by both. This concept had already been explained by Frida Reichmann Fromm (2009) cited by Velasco, and more recently by the Japanese psychiatrist and philosopher Bin Kimura (2003).

Now, if we understand that is an injury to the contact boundary,and our organic contact boundary is the skin, we see in this explanation that what makes suffering at the contact boundary is not the abolition of the individual who suffers but the demonstration of how and where they suffer. How the suffering that emerges from the organism to seek the support of the environment allows the suffering self to share, enrich, and express itself in the possibility of not bearing the pain in the solitude of its own organism.“The recognition of suffering as an injury to the contact boundary also helps us understand that the greater the opportunity to express oneself spontaneously in contact, the greater the possibility of transforming suffering into growth.” It also allows us to access another fundamental concept that helps us understand the difference between suffering and psychic disturbance.” It also allows us to access another fundamental concept that helps us understand the difference between suffering and psychic disturbance.

For years I have been working on the idea of human suffering as a specificity in its expression, as a clear passage towards psychic disturbance. Specifically, I want to say that: “the possibility of developing a psychic disturbance is linked to the impossibility of intentionally declining suffering at the boundary of contact,“ with this I am saying that the greater the emotional isolation, the greater the risk of contracting a psychic condition.

But what does it mean to decline suffering at the point of contact? By this, I mean that to decline is to modulate, regulate, transform suffering into part of an assimilable experience; and with this, despite the pain experienced, to grow and help our relationships grow. I also mean that emotional isolation, as an anaerobic experience, ferments in its armoured confinement. In emotional isolation, there is no experience of the possibility of finding the ‘novelty‘ that allows the individual self to move towards the environment and relationships. In emotional confinement, there is no openness, no opportunity to contact new and possible experiences. The psychic disturbance then manifests in the evidence of a self unable to access the novelties of the environment and the relationship with others, either because the environment does not support the organism or because the individual self has not developed the necessary skills to healthily access the expression of one’s own needs, or because the doors are closed to changes and exchange with everything that is individual whether the confinement is intentional or not, physiological or social.