Over the years of working as an analyst, Bion saw something beyond the prevalent theories and usual range of clinical practice: ‘something’ that led to a transformative insight. This ‘something’ was not discernible, rather a psychic reality that couldn’t be seen, or touched, or easily put into words. It was not to do with knowing about it, but rather a becoming, something ineffable, and of a non-verbal nature. Perhaps in that way, similar to a spiritual reality, also felt in the psyche as an experience of peace or Presence. Bion was not ‘religious’ in the traditional sense, but he certainly read about Western and Eastern mystical experiences.

Bion thought that to reach this state of O in therapy, he needed an open mind and to sit with ‘not knowing’. Bion saw this as negative capability and a letting go of theories and assumptions. O could not be looked for or planned, but might manifest if both people were open to raw emotion, and so emerge as a flash of insight, a shared emotional ‘impact,’ or a non-verbal realization bringing a sudden, new sense of reality. A glimpse or a moment of O transformed both the analyst and the patient leading to a new authenticity that was previously inaccessible to conscious thought. The truth revealed was an emotional truth, rather than a factual one.

This example is taken from the work of another analyst James Grotstein who was influenced by Bion’s work. Grotstein describes analysis with a young depressed woman, who had recently emigrated from a central European country to the US. They were about 4 months into their meetings when one day she appeared in the session almost as if in a trance. Grotstein describes her demeanour as ominous and uncanny, and she was silent; he became increasingly anxious – then terrified without knowing why.

‘I then began to feel that I was dying! I knew that I wasn’t, but I really felt that I was. When the feeling became almost unbearable, she broke the silence and uttered, ‘You’re dead!’ What emerged was a significant part of her past history and the emotional truths she had been evading.’

Her parents divorced when she was 3, and her father took her to live with his parents until she was 7, when she was to be sent away to school.

‘When the analysand told me that I was dead, she then related this story: she recalled the railway train, the station platform, and both her and her grandparents tearfully waving goodbye. She never saw them again. She claimed that they both died soon after of broken hearts. The date of this analytic session was an anniversary of that fateful train departure.’

Once the woman spoke, Grotstein regained his composure and found himself unexpectedly saying

‘I believe that, when you waved goodbye to your beloved grandparents on that fateful day, you “died” as a self and have remained emotionally dead up until this time. The anniversary of its happening seems to have brought the event back to life for you. You gave to me your intolerable feelings of your emotional death and the loss of your grandparents because you could not bear to experience the truth about your separating from them, but now hoped that I could bear it for you and ultimately with you’. She then exclaimed, ‘Yes! Yes! Yes!’ and cried. This session became a turning point in her treatment.’

For Grotstein the powerful experience they shared was O – the Truth. The repressed truth of the trauma was dramatically freed up, and allowed to become owned as personal truth.