Languages of trauma; towards a phenomenological response

In this article, I explore the possibilities of a phenomenological perspective on trauma in psychoanalytic practice. I highlight the problem of interpretations that universalise experiences of trauma, provide explanations in terms of ‘causes’ and assume particular processes/stages of ‘recovery’ from it. The notion of trauma challenges dichotomies of ‘internal’ and ‘external’ worlds. Traumatic experiences always have a context – that of the immediate relational circumstances of the individual suffering from the trauma, including the wider social/relational context, and the person’s history. I argue for an attunement to the language and specificity of the meanings, verbal and non-verbal, conscious and unconscious, of the client’s suffering within the analytical relationship. This requires the therapist to avoid ‘ready-made’ interpretations from psychoanalytic theory and to be open to the poiesis of the speech, which emerges between therapist and client. My discussion of my reading of the Chilean documentary film, Nostalgia for the Light, which focuses on the traumatic experiences of those who survived Pinochet’s military regime (1973–1989), highlights how diverse responses to trauma are. The originality of the language of the film calls on us as therapists to discover new ways of listening and speaking to our clients’ suffering.     

Intimacies: An Integrative Multicultural Framework for Couple Therapy

Implicitly or explicitly, our ideas about intimacy are the most fundamental notions giving direction to the process of couple therapy. Yet, as a field, we have spent little time conceptualizing intimacy and even less time considering the diversity of priorities and meanings couples bring to our offices. In Part One, Varieties of Intimacy, I describe a kaleidoscope of contexts—socio‐historical, cultural, gender, life cycle, and developmental—that inform our ideas and expectations for intimacy in couples’ relationships. I highlight different spheres in which intimacy may take place such as the emotional, sexual, intellectual, or familial. I propose a starting point in which the therapist, in a collaborative manner, helps the partners articulate their yearnings and priorities in order to negotiate a shared vision. In Part Two, Conceptualizing Intimacy, I suggest an experiential definition that gives room for each partner's subjective meanings, yet consider diverse relational processes that may need to be addressed for a resilient ebb and flow of intimate experiences. In Part Three , Sexual Intimacy, I outline conditions in which sex is more likely to be experienced as intimate rather than nonintimate. Finally, in Part Four, I describe Therapeutic Principles to guide the therapist in taking couples from reactivity to dialogue to negotiations of intimacy. The integrative framework proposed here discourages monolithic a priori notions of intimacy and highlights instead: nuanced meanings, relational processes to be considered differentially, present and past emotional blocks, and a flexible clinical approach to foster conditions for the creation and resilience of intimate experiences.     

“Of Course All Relationships Are Unique”: How Co-creative Processes Generate Unique Mother–Infant and Patient–Therapist Relationships and Change Other Relationships

The question of the uniqueness of relationships is examined: How do relationships come to be unique? What are some of the features of their uniqueness? And how can relationships, be it the mother—infant relationship or the patient—therapist relationship, have unique rather than archetypical effects on other relationships? A model of relationship uniqueness is presented that argues that mother and infant, and patient and therapist, co-create dyadic states of consciousness—states of making implicit and explicit sense of the world—out of their normally messy exchanges of age-possible meanings. These co-creative processes lead to change in the infant's and child's state of knowing the world, and also change the way the patient makes sense of the world and ways of being with others. Additionally presented are (I) a critique of attachment theory's assumption that the mother—infant relationship is the prototype of later relationships; (2) a critique of models of therapeutic change that see adult analysis as working primarily in the same domain as the workings of the mother-infant relationship; (3) a brain model of co-creative relational processes, Relational Activation Patterns (RAPs); and (4) possible psychodynamic processes in infants.     

Reflexive encounters with embodied resistance to relational forgiveness

Troubling relationships with our parents may raise unanswered questions and anxieties. Over time, our bodies harbor these sensations in ways that often may go unrecognized. In this autoethnographic account, I examine memories of my childhood and recent past to understand emotionally disturbing episodes tainting my relationship with my father. Interrogating my reflective habits, I probe meanings left undetected by my preconceived sense-making routines. At the same time, I notice and voice the embodied resistance I encounter when opening up and deconstructing intimate layers of deeply rooted pains associated with my father. In doing so, I demonstrate how reflective practices summon a dialogue between embodied emotions and re-engagements with past understandings. Such dialogue generates potential for reimagining relational meanings and apprehending possibilities for forgiveness.     

The Strangeness of Passing: Commentary on Paper by Christopher Bonovitz

Christopher Bonovitz gives us a rich landscape of the theoretical, historical, and relational aspects of his work with his mixed-race patient. In my response I explore what seems missing: a stronger sense of the patient as a person, more of her own history in her family, more of the clinical back and forth with her therapist, a sense of what is being played out in the transference, and particularly what “passing” is for her. I show how his choices about how to think about her story and how to tell it are oversaturated with awareness of identity and race at the expense of the basic human relationship. In the face of such racial anxiety, there is a pull to rely too strongly on countertransference as a way to gain privileged access to knowledge about the other. I attribute many of these problems to the inescapable power of race in our culture. Furthermore, I address the themes of hatred, silence, secrecy and transgression as they relate to the history of transgenerational trauma for this patient and invite our broadening our awareness about how they play out in the therapeutic process. We are faced with the difficult, yet the essential task of holding and living out the patient's anger and outrage at the racial hatred that has been endured.     

The Unfreezing of Time in the Haunted Hours

When trauma shattered the cohesion of the self and “destroyed time” for my patient Bob, he managed to hold himself more or less together with the help of haunting ghosts. This paper is the story of how my connection with Bob deepened as I eventually learned to honor his ghosts through access to my own dissociated memories of traumatic loss that had left a ghostly presence in its wake. I hope to show how a difficult and complex immersion into haunted worlds—Bob’s and my own—created the possibility for new relational depths and the reemergence of Bob’s creativity.     

My Psychoanalytic Journey

In this article I describe the evolution of my psychoanalytic thought and my current perspective of psychoanalysis, after almost a half century of professional practice. For the most part, three ideas have guided this evolution: (1) considering the patient’s mind as the major source of knowledge; (2) my firm belief that the patient–analyst dialogue, taken from the Gadamerian point of view, is the best way to have access to the patient’s mind and also to that of the analyst himself; and (3) the notion that the mind constitutes an open, dynamic, and nonlinear system in constant interaction with the environment that surrounds it. In my writings, I have tried to show that the therapeutic action in the psychoanalytic process is formed by the therapist–patient interaction. I also propose that psychoanalysis must endeavor to be a social therapy, even as it treats individuals, and go beyond what is purely instinctual so as to emphasize what is particular to human beings and sets us apart from the other animal species.     

Getting in Tune: Songs of My Experience in Psychoanalytic Training

I use the metaphor of music and dance to explore cognitive, affective, and liminal elements of my training experiences in the New York University Post doctoral Program in Psychoanalysis. I highlight experiences with supervisors and patients, which shaped the development of my identity as an analyst, and the emergence of my analytic voice within a relational paradigm.     

Reply to Reviews of Awakening the Dreamer: Clinical Journeys by Philip M. Bromberg

I reply here to reviews by three inspiring thinkers, Ethel Person, Susan Sands, and Allan Schore who, though uniquely different from one another in their conceptual frames of reference, share a sensibility as clinicians and creative scholars that has led them to engage and appreciate my work in depth while enriching it with their individual perspectives. Ethel Person's review is meaningful to me for many reasons, not the least of which is the fact that we think very much alike about “how we are” with patients despite the diversity in our families of origin. Her thinking, which extends the boundaries established by any one school of thought, transcends doctrine, especially that of “technique.” I am equally grateful to Susan Sands, whose review stimulated a dialogue between us about the similarities and differences in our views of the analyst's personal role in enactments with severe trauma survivors and whether there is reason to distinguish between life-threatening and developmental trauma. My reply to Allan Schore's review satisfies a long-standing wish to engage with him in dialogue about what he refers to in his review as “a remarkable overlap between Bromberg's work in clinical psychoanalysis and my work in developmental neuropsychoanalysis, a deep resonance between his treatment model and my regulation theory” (this issue, p. 755). In my reply I comment from my own vantage point on how our shared commitment to an interpersonal and intersubjective perspective—my interpersonal/relational treatment model and his “Interpersonal Neurobiology” led us to arrive at overlapping views on developmental trauma, attachment, the dyadic regulation of states of consciousness, and dissociation.     

On Psychodynamic Meanings of Psychiatric Treatment: Discussion of “From Dyad to Triad”

Dr. Bar-Haim has covered vast territory in her contribution “From Dyad to Triad: On Psychodynamic Meanings of Psychiatric Treatment,” (this issue) and I welcome the opportunity to offer my thoughts on her contribution and this important topic more generally. The issues touched upon include the various meanings of psychiatric treatment for patient and therapist; factors that impact compliance; resistances to suggesting medication consultation on the part of the therapist; challenges of the prescribing therapist; the role of a “disease” model in mental suffering; the overdetermined meaning of “symptom”; and, most important, recommendations for establishing effective treatment when a treatment triangle exists. I address some of these issues and comment on two clinical vignettes to illustrate my way of thinking.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.     

My life in testing

This autobiographical essay describes my career as a psychodiagnostician, which began at the City College of New York in 1941 and ended in the late 1970s when I became a full-time psychoanalyst in Manhattan. As a green, 20-year-old psychology undergraduate, I was picked by Gardner Murphy to assist David Rapaport at the Menninger Clinic in Topeka, Kansas, who was developing new methods for using psychological tests to diagnose and treat soldiers during World War II. Our findings were presented in the classic, two volume work, Diagnostic Psychological Testing, published in 1945-1946 (Rapaport, Gill, & Schafer, 1945-1946; 1968), to which I added two clinically enriched monographs: The Clinical Application of Psychological Tests, published in 1948 (Schafer, 1948/1995), and Psychoanalytic Interpretation in Rorschach Testing (Schafer, 1954), published in 1954. After the Menninger Clinic, I continued to hone my assessment expertise at the Austen Riggs Center and Yale University, but I also sought opportunities to develop psychotherapy skills. I completed psychoanalytic training in 1960 at the Western New England Institute for Psychoanalysis and thereafter sought positions that would offer more time for treating patients. A notable highpoint in my testing career was assessing Jack Ruby, killer of Lee Harvey Oswald. I look back fondly at my years as an assessment psychologist, which produced nearly 4 decades of great memories.     

Structural Aspects of Synchronistic Moments in Psychotherapy—Findings of an Empirical Study of Synchronicities in Psychotherapy and Psychoanalysis1

Synchronicity describes a meaningful coincidence of events, which is familiar to us from treatments of our patients, but unfortunately has not yet been empirically substantiated. Adding to previous findings that point out beneficial aspects of synchronicity (Marlo, 2022; Lagutina, 2021; Connolly, 2015), in this paper I will show through a series of five synchronistic moments which happened in the context of therapy and analysis and which have been documented empirically, how synchronicities occur and can be used therapeutically. In my research I found several situational factors that can be considered structural aspects of synchronistic moments. Furthermore, I will show that synchronistic phenomena can have a positive influence if certain relational and transference-countertransference referential aspects are considered by the therapist and analyst. The concept of synchronicity brings the possibility of a further therapeutical instrument for the patient-analyst-dyad.     

“It All Comes Down to Imagination”: Reply to Commentary

In her generous and full discussion of my paper, Doris Brothers writes about patient's efforts to restore themselves following trauma and how that runs into walls caused by their “systemically emergent certainties.” She beautifully writes, “Since our capacity to hope depends on being able to tolerate uncertainty we sometimes join our patients in their hopelessness” (p. 231). Brothers emphasizes how Murakami can help us tolerate uncertainty. My emphasis is on how writers like Murakami help us restore our imaginative and empathic capacities. Frozen landscapes, as evoked by Murakami in “UFO in Kushiro,” are depictions of shut-down psychic states. Animated imagery helps to melt the ice, creating living motion in thought and affect. Both Brothers and I are looking at the crucial movement from simplified to complex shared states of mind. We seem at first to differ in our understanding of the function of rage in treatment, though I believe we may be discussing different clinical situations.     

Doing Our Work: Words,Deeds, and Presence

Group leadership is an art, with relational tools of words, deeds, and presence. We aim to take our groups to creative places that they—and we ourselves—have never been before. Something needs to happen, fresh experience needs to emerge that becomes relevant to the growth of the members, including the therapist. The therapist's work is done while we are also doing something else. It entails a dual focus, or “binocular vision,” directed to personal discovery, while also focused on the group’s realities and growth potentials. Three case examples illustrate how the work happens to us: we evolve as a person as we do the work.     

Recognising the role of emotion in the classroom; an examination of how the psychoanalytic theory of containment influences learning capacity

This paper begins with personal reflections about my work in school which began over forty years ago, outlining how the different roles of teacher and therapeutic practitioner have contributed to my interest in the role of emotion for children’s capacity for learning in the classroom. I suggest that focusing too heavily on achievement risks losing sight of the experience of the individual child and argue that a psychoanalytic framework informs us of the significance of relational aspects of teaching and learning. My aim is to alert educationalists to the complexities of the classroom context, particularly the conscious and unconscious elements at work there. I have chosen to examine containment, as one aspect of the psychoanalytic, developmental framework, as a way of thinking about relational influences in the classroom and the importance of the relational context of learning. These case studies relate to my workplace, an Infant and Nursery school with a high British multi-ethnic population, where I am employed as a teacher/therapeutic practitioner. Two brief child studies are included to illustrate this examination. The first, Hamzah, concerns a young child entering formal learning without the expected relational skills and therefore unable to connect with staff and children in any meaningful way. The second, Isa, demonstrated well developed relational skills but at times found it difficult to manage his feelings when his needs took second place to the requirements of the curriculum.     

Hybrid Identifications,Mixed Feelings: Reply to Commentaries

In responding to the insightful papers of Suchet and White I explore further my own hybrid identifications in regard to the socially constructed category of race. The paper explores the dangers of both idealization and denigration of otherness. It shows how a traumatic confrontation with otherness may destabilize later identifications in favor of earlier more archaic ones. Melanie Suchet, in her very gracious response to my paper, comments that I refuse to “reside in the comfortable.” However, any wish I may have had to reside in the comfortable was derailed by the thought-provoking comments of both Melanie Suchet and Cleonie White. Both authors prompted me to confront myself and to examine a number of painful issues. These included not only a resistance to owning my own vicarious traumatization but the fact that I was subject to the return of the repressed as the personal meanings of the signifier black shifted and changed in the course of my paper. But most significantly, both authors confronted me with the challenge of Otherness.     

Redeeming the lost voice of the ancestors

The Holocaust of the Jews in World War II involved not only the murder of 6 million Jews but also the traumatic destruction and wipe-out of whole communities, with their rich culture and tradition which had existed for centuries. In places where no one survived, it was almost impossible to reconstruct the collective memory of those communities. The voice of the ancestors was lost. As a daughter of Holocaust survivors, I have always felt the strong presence of the loss, not only of the murdered family members but also of the ancient colourful world of Eastern European Jews. I have always felt compelled to link back to that lost world. In the past three years, my journey to the pre-war past has become more intense. This article describes the double role of my journey: it is both an attempt to reconstruct, redeem and preserve the memory of the lost ancestors, and a personal journey to the echoes of my ancestors' voices within my soul.     

Creativity,Spontaneity, Impasse,and Leaps of Faith: Reply to Commentaries

In my reply to the commentaries, I address several points of convergence with and divergence from Drs. Danielle Knafo and Philip A. Ringstrom. I clarify my view that while shame can drive the creative process, the thrust of my paper is about ways in which shame can close down access to one's creative potential, as well as creating obstacles to vitality and intimacy in relationships. I expand on how it was indeed a visceral, embodied sense of my own shame which served as an “informant,” as Ringstrom suggests, of Julia's chronic experience of shame, opening a door to our exploration of the repetitive enactments between us. Grounding my understanding of therapeutic action and enactments in a relational perspective, I describe how I view enactments as inevitable and co-created, and reflecting on them collaboratively as a potentially useful opportunity in analytic work. I resonate with Ringstrom and Knafo's belief in the creativity inherent in the psychoanalytic process, and the importance of spontaneity and risk taking, particularly in negotiating impasses in treatment. Finally, I describe Julia's poetic reflections upon reading the paper.