不只是“谈话疗法”：精神分析治疗中的非言语维度

精神分析治疗在很长一段时间里被视为“谈话疗法”,其治愈机制是将潜意识的内容意识化,语言解释在其中发挥关键作用。自20世纪末开始,越来越多分析师强调非言语交流在治疗中的作用。非言语交流不仅能够为咨访双方提供更丰富的交流形式,还能通过互动中的“相遇时刻”,实现对患者过去经验的重组,改变其有缺陷的内隐关系知晓。非言语交流和语言交流能够在治疗中发挥互补作用,未来的精神分析心理学要继续加强对非言语领域的研究。     

不只是“谈话疗法”：精神分析治疗中的非言语维度

精神分析治疗在很长一段时间里被视为“谈话疗法”,其治愈机制是将潜意识的内容意识化,语言解释在其中发挥关键作用。自20世纪末开始,越来越多分析师强调非言语交流在治疗中的作用。非言语交流不仅能够为咨访双方提供更丰富的交流形式,还能通过互动中的“相遇时刻”,实现对患者过去经验的重组,改变其有缺陷的内隐关系知晓。非言语交流和语言交流能够在治疗中发挥互补作用,未来的精神分析心理学要继续加强对非言语领域的研究。     

Conceptualizations of the psychoanalytic process

A demonstrable psychoanalytic process involves elaborate and sustained intrapsychic experiences and phenomena for both analysand and analyst. It also includes a complex and at times subtle interpersonal relationship in which each participant is actively sensitive and responsive to verbal and nonverbal input from the other. These interpersonal experiences stimulate further intrapsychic responses which in turn may have further interpersonal effects. Within the framework of the psychoanalytic situation, these combined intrapsychic and interpersonal responses lead first to facilitative and ultimately to definitive changes in the patient's psychological organization and function. A method for demonstrating a psychoanalytic process is described.     

Learning social attitudes: children's sensitivity to the nonverbal behaviors of adult models during interracial interactions

White children show marked ingroup race preferences and a relative devaluation of Black people. The origin of these early interracial attitudes is to a large extent still unclear. The studies here test the possibility that preschool-aged children are particularly sensitive to the nonverbal behaviors performed by White adults during interracial interactions. In Study 1, children were shown a video displaying an interaction between a White and a Black adult. Across conditions, the White adult's verbal behaviors were either friendly or neutral, whereas his nonverbal behaviors showed either easiness (e.g., closeness, high eye contact) or uneasiness (e.g., distance, avoidance of eye contact). Results revealed that participants shaped their attitudes toward the Black target accordingly, independently from the White adults' verbal behaviors. Study 2 replicated the basic findings and demonstrated that the observed effects generalized to other Black targets. Results are discussed in relation to current approaches to understanding the formation of racial attitudes among children.     

Nonverbal Interactional Behavior in the Families of Persons with Schizophrenic and Bipolar Disorders

Whereas verbal interactional behaviors have been repeatedly found to distinguish the families of persons with and without major psychiatric disorders, there has been comparatively little examination of the discriminative value of nonverbal interactional behaviors. We developed the Nonverbal Interactional Coding System to measure “affiliative” and “distancing” nonverbal behaviors in 18 schizophrenic and 18 bipolar patients and their parents during 10-minute interactions conducted during a posthospital period. Bipolar patients and their parents displayed affiliative nonverbal behaviors (“illustrator gestures” or “prosocial behaviors”) for longer durations than schizophrenic patients and their parents. In contrast, parents of schizophrenic patients displayed distancing nonverbal behaviors (looking away) for longer durations than those of bipolar patients. The nonverbal interactional data added to the statistical strength of patients’ and parents’ verbal interactional data in distinguishing between these diagnostic groups. Nonverbal interactional behaviors are important variables to consider in interventions aimed at improving the communication skills of families coping with psychiatric disorders.     

Beyond the word in psychoanalysis the unspoken dialogue

The practice of psychoanalysis, traditionally, has privileged verbal communication. In relational theory the therapeutic significance of unconscious, semantically unformulated, but nonverbally encoded communications has been recognized. While patients are understood to generate significant nonverbal material for use in the treatment process, similar nonverbal productions from analysts rarely have been acknowledged as useful for treatment. In this paper, I demonstrate a way to recognize and use the nonverbal productions of analysts as well as of analysands within the analytic process. A brief review is offered of contemporary authors who have conceptualized the importance of the nonverbal realm for psychoanalytic treatment. An approach is then described that builds on process conceptualizations derived from the infant research literature. The model, illustrated with two clinical examples, provides a way of conceptualizing “process contours”; on a nonverbal level of exchange between analyst and analysand that becomes the medium for catalyzing the transition from presymbolic interactions to symbolic language. Working on this level, analyst and analysand coconstruct scenes from both the dreaded past and the hoped‐for present/future, which, when reflected on in a joint process of narrative construction, provide a new context for accessing previously dissociated affective experience.     

Panic as a form of foreclosed experience

Following a discussion of panic states and their relationship to psychosomatic illness and related disorders, the author presents an extended clinical vignette in which he initially viewed the patient's intense anxiety as a manifestation of repressed conflict and, accordingly, used verbal interpretations as the principal mode of intervention. After this approach did not prove effective, the analyst began to make use of nonverbal interventions consistent with his emerging understanding of the patient's distress as a manifestation of the foreclosure (de M'Uzan 2003) and relegation to the body of undreamable experience (Bion 1962).     

A disturbance of interpreting,of symbolisation and of curiosity in the analyst‐analysand relationship: (The patient without insight)1

The author examines the function of the analyst who may distort the unconscious communication with the patient by means of the expression of his countertransference. He studies a disturbance in curiosity and in symbolisation in a patient with a narcissistic pathology. Both problems were related to this failure in interpreting. The curiosity of the patient, which initially seemed to be non‐existent, was found to be directed towards investigating the mind of the analyst, this being his sole purpose. The disturbance in symbolisation was manifested as a constant verbal acting out, which was expressed as verbal communication empty of meaning. A change in the interpretative attitude enabled a modifi cation in the objective of the curiosity, which became focused on investigating his own inner world, and the emptiness of the verbal communication was replaced by representations. This change in communication allowed the analyst to relate the facts of the psychoanalytic relationship both with the patient's phantasy and with the events in his history. An idealised identifi cation with destructive aspects of the mother towards the father was discovered. This idealisation had been sustained by the analyst by means of his errors in interpreting. The author explores disturbances in symbol formation and in the use of symbols, and he considers the different states of emptiness.     

On the countertransference of the patient: Transformations of the psychoanalyst's 'theoretical self' and their possible articulations with the vicissitudes of the analytic relationship

In this paper the author examines one of the many levels of the analyst/analysand relationship: the possible interaction between the analyst's mental routes in relation to theories (also meant, but not only, as internal objects) and the vicissitudes of the psychoanalytic relationships with his patients. The author assumes that an important variable affecting the transformation of certain therapeutic relationships is the change that takes place in the relationship between the analyst and that part of his internal world where his theories find their place. He names this part of his internal world 'theoretical self', and 'precipitates of the analyst's theoretical self' those complex formations, akin to more or less cohesive conglomerates, that are formed by his relationship to theories and to psychoanalytic institutions, and by the various, 'personal' internalised objects. The psychoanalyst will relate to these precipitates in a variety of ways, and he will make use of them mostly at an unconscious level in his analytical work; and his patient is likely to 'react' to them, almost chemically. The author also offers some working indications: the psychoanalyst, despite his knowledge of some aspects of his own countertransference, is in fact lacking in knowledge, unless he constantly does some extra work focusing on how his mental position (i.e. the relationship with the precipitates of his theoretical self) may intervene in any of the therapeutic relationships that he establishes-not necessarily in the same way in each of them. The author also illustrates his reflections and conceptualisations by reporting dreams and excerpts from sessions taken from three psychoanalytic treatments in the course of several years.     

Preschool Children's Collaborative Problem-Solving Interactions: The Role of Gender,Pair Type,and Task

The purpose of this study was to investigate gender differences in problem-solving and conflict-resolution skills in preschool children. Children between 4 and 5 years of age completed 3 problem-solving tasks with either a same-sex or a different-sex peer. Children's verbal and nonverbal interactions were analyzed. Girls used mitigation more often than did boys. Mixed-sex dyads engaged in controlling verbal interactions more often than same-sex dyads. There were relationships between verbal and nonverbal behaviors and task success; these relationships also differed across pair types. The results of the study demonstrate that the gender differences in types of verbal interactions previously observed in preschool children's free play are also present in their problem-solving interactions and that children are able to alter the types of behaviors they use depending upon both partner gender and the type of task involved.     

The effect of nonverbal teacher approval on student attentive behavior

The effect of contingent nonverbal teacher approval on student attentive behavior was examined in a classroom with 12 retarded children. After baseline data were gathered on contingent verbal and nonverbal teacher approval and student attentive behavior, the teacher was instructed to increase her use of contingent nonverbal approval (smiles and physical contact) and to maintain her baseline level of verbal approval. After a reversal phase, the nonverbal approval phase was reinstated. Nonverbal teacher behaviors increased during the experimental phases, whereas verbal teacher approval (alone or in conjunction with nonverbal behaviors) did not increase. Attentive behavior increased for 11 of 12 students during the phases in which contingent nonverbal teacher approval increased. Correlational data suggested that nonverbal teacher approval accounted for behavior change of the students to a greater extent than did changes in the amount of teacher approval per se or in the teacher's use of verbal approval.     

Remembering to Relate: Socioemotional Correlates of Mother-Child Reminiscing

Previous research has established that mothers vary in how elaborately they reminisce with their preschool children, but explanation of these individual differences is lacking. We predicted that maternal elaborations during reminiscing would be related to mother-child attachment status, as well as to measures of verbal and nonverbal emotional expressiveness. Thirty-eight middle class mothers and their 41/2-year-old children participated in a reminiscing task and a joint art activity, and mothers completed the Attachment Behavior Q-set (Waters, 1987). Mothers who were more elaborative during reminiscing also reported a more secure attachment bond, but these variables were unrelated to either verbal or nonverbal expression of emotion during mother-child interaction. However, patterns of relations also varied by gender of child. Theoretical implications of these results for understanding joint reminiscing and attachment are discussed.     

The Role of Language in Temporal Cognition in 6- to 10-Year-Old Children

The ability to recognize temporal patterns and position events in time emerges during the preschool years and is refined in middle childhood. This study explored individual differences in temporal cognition in relation to verbal and nonverbal abilities. Children (30 boys, 32 girls; M_age = 8;2, age range = 6;0?10;8) completed 3 temporal-cognition tasks measuring estimation of temporal distance (how far events are from the present), knowledge of conventional times of events (specific days or months of events), and flexibility in using the calendar system (arranging nonconsecutive months in order), along with assessments of nonverbal intelligence, verbal short-term memory, visual-spatial working memory, receptive vocabulary, receptive grammar, and reading mastery. Controlling for age, performance across temporal-cognition tasks correlated with language abilities; nonverbal abilities accounted for little to no additional variance. The findings link language skills with the acquisition of conventional time patterns; such patterns developed alongside the ability to gauge distances of events in the past or future and form an organized timeline.     

Clinical and theoretical aspects of enactment

Enactment as a concept can serve analytic discourse through its established meaning of an act intended strongly to influence, persuade, or force another to react. We might agree to use the term in two complementary ways: Broadly, enactment can designate all behaviors of both parties in the analytic relationship, even verbal, in consequence of the intensification of the action intent of our words created by the constraints and regressive push induced by the analytic rules and frame. Patient and analyst are vulnerable to falling back on behaviors that actualize their intentions, doing so in ways motivated by and reflecting transference hopes, fears, and compromises shaped in their developmental past. Specifically, enactment can then be defined as those regressive (defensive) interactions between the pair experienced by either as a consequence of the behavior of the other. While nominally an interpersonal perspective, this concept of enactment facilitates more balanced attention to the involvement of both parties and to the intrapsychic dynamics in both that specifically shape their interactions. A clinical vignette illustrates the analyst's contributions to enactment, especially those reflecting his reactivated conflicts and their relation to his theoretical and technical preferences.     

Responses to interpersonal conflict among young adults: Influence of family of origin

This study aimed to examine the role of family environment upon responses to interpersonal conflict in young adulthood, and to determine whether response patterns differed between men and women. Behavioral, affective, and cardiovascular responses of 17 young adults from families rated extreme (EXT) on scales of cohesion and flexibility were compared with those of 21 young adults from balanced (BAL) families. Participants engaged in 2 role‐play conflicts, 1 with a male confederate and 1 with a female confederate. Measures of positive and negative verbal and nonverbal behaviors, self‐reported anxiety and anger, and heart rate and blood pressure were obtained. Results showed EXT participants exhibited more negative verbal and less positive verbal behavior during both interactions than BAL participants. EXT men exhibited greater DBP, state anger, and negative nonverbal responses than BAL men, findings not observed for women. These findings indicate that exposure to a negative family environment influences how young adult men respond to interpersonal confrontation more than young adult women.     

Mothers' adjustment to the birth of a second child: a longitudinal study on use of verbal and nonverbal behaviors toward two children

4 mothers' skillful use of verbal and nonverbal behaviors to their first and second children was examined while each mother was playing with them for about one year after the birth of the second child. Analysis showed that maternal verbal interactions with the firstborn were frequently accompanied by nonverbal interactions toward the secondborn, especially during the first few months postpartum. The concurrent use of verbal and nonverbal behaviors with the two children may be a behavioral strategy for the mother to adjust to the birth of the second child.     

Nonverbal Behaviors and Perceptions of Sexual Intentions: Effects of Sexual Connotativeness,Verbal response,and Rape Outcome

Through the exchange of nonverbal and verbal behaviors, a man and a woman on a date negotiate situated identities. However, a woman's nonverbal and verbal behaviors may reflect an identity discrepant from the one she intended to project, leading to miscommunication between men and women regarding the woman's desire for sexual activity. In Experiment 1, subjects read scenarios in which a woman, Mary, engaged in behaviors that were low, moderate, or high in the degree to which they connotated a desire for sex. In addition, they learned that Mary responded to her date's sexual advances either by saying "no," or by slapping him, or they received no information regarding Mary's verbal response. Subjects were also informed that Mary's date either did or did not force her to have sexual intercourse. Subjects perceived Mary more sexually as her behaviors increased in sexual connotation. In addition, they perceived that Mary desired sex more when no information about her verbal response was provided than when she resisted her date's sexual advances. Subjects also rated the woman more negatively when her nonverbal behaviors were incongruent with her responses to her dale's sexual advances. Contrary to previous research, little evidence of victim derogation was obtained. Results from Experiment 2 showed that men and women agreed in their perceptions of a woman whose behaviors connoted a high interest in sex, but that men perceived behaviors low in sexual connotation ore sexually than women. Implications of the data for understanding sexual miscommunication between men and women as well as reactions to rape victims are examined.     

Children's emotional reactivity to interadult nonverbal conflict expressions

The authors investigated children's responses to nonverbal expressions of conflict. Reactions of 3 groups of children (ranging in age from 6 to 16 years) to multiple forms of nonverbal conflict behaviors expressed in videotaped simulations of interadult disputes were examined. Results indicated that children make few discriminations between different forms of nonverbal conflict behaviors and that their reactions to nonverbal conflict are similar to their reactions to verbal conflict. Adults' expressions of fear elicited the most negative emotional responses from children, suggesting that children react to the meaning of conflict expressions and that expressions of fear may represent the greatest emotional security risks to children. Implications of these results for a theoretical model of the effects of forms of marital conflict on children are discussed (P. T. Davies & E. M. Cummings, 1994).     

Toward a definition of psychoanalytic neutrality

The word and concept of neutrality play an important but confusing role in the history of psychoanalysis. Does neutrality imply indifference? The origin of this ambiguity is traced to the fact that Freud himself never used the word "neutrality" (Neutralitaet) in his own writings. (His term Indifferenz was translated as "neutrality" by Strachey.) The essence of the controversy that has simmered in the psychoanalytic literature ever since is contained in the question: "Is remaining true to the concept of neutrality somehow antithetical to the analyst's genuine involvement with the patient?" In this paper, I examine the feeling and power aspects of the word and suggest that the concept of neutrality becomes clinically useful when the analyst asks himself the question, "Neutral to what?" The analyst's awareness of his motives for recognizing and addressing certain conflicts and for overlooking others is heightened. With three clinical vignettes as illustrations, I explore the role of the concept of neutrality in deepening our understanding of (1) the analytic relationship; (2) The influence, on the conduct of the treatment, of the analyst's goals and theoretical persuasion regarding how the goals are to be achieved. As examples, I use the current debates over the relative value of the analyst's focusing his attention on: (a) the patient's mind in the hour rather than his life outside the hour and, (b) transference over nontransference interpretation. Finally, I emphasize the far-reaching implications of adding an explicit concept of "external reality" to A. Freud's exclusively intrapsychic definition of the "objective" analyst's position of neutrality as equidistant from id, ego, and superego. The addition of this fourth point to the analyst's "compass" widens the analytic field toward which the analyst is neutral. The concept of neutrality with respect to specifiable conflicts is thereby also broadened to include (a) interpersonal conflict within the psychoanalytic relationship and (b) conflict within the analyst. With these explicit additions, the concept of neutrality with respect to conflict becomes congruent with the current emphasis on the nonauthoritarian two-persons aspects of the psychoanalytic relationship, without detracting from the primary analytic goal of deeper understanding of intrapsychic conflict.