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Working with patients who have been traumatized as infants and young children can be confusing for the therapist who is accustomed to working in the symbolic order. In order to cope with traumatic, psychic overwhelm, these patients have retreated from object relations and continue to relate to others concretely as things or functions. Their relations are body relations, consisting of unconscious symbiotic union with others. Since often trauma survivors become adept in the world, often well educated and finding professional jobs, their concreteness and difficulty processing emotion may go unnoticed. There can be a display of pseudo-maturity and pseudo-object relations.
For therapists and analysts working the somatic relational process in therapeutic work with this traumatized client group can be confusing and disorienting. Analysts and therapists frequently report confusion by not being able to find meaning in a patient’s words or emotion and in their narratives. This confusion is uncomfortable and frightening, sometimes eliciting in the analyst a need for an immediate answer, an immediate understanding. When that does not appear in the analyst’s confused mind, unmediated affect such as rage or extreme maternal care, intense love or violent hate, can arise inside the analyst. These experiences contribute to the confusion and disturbance, while the violent affects and emotions seemingly create an illusion of certainty.
This seminar will offer an opportunity to think about how the therapist or analyst can learn to value this confusion as information. This challenging process can give rise to the containment of previously unrepresented experience which can result in the development of a three-dimensional analytic space and be internalized by the patient for a successful outcome. Through the seminar there will be lectures and time for Q&A with our speaker and colleagues.
In this first session Judy will offer an important talk on how normal projective identifications are disrupted due to early trauma. A patient might, in phantasy, become the person they are with. This silent and unconscious fusion enables a primitive organization to develop that provides structure and seemingly results in a capacity to function procedurally in the world. Whenever this phantasy is threatened by relationship, confusion results. Neither the patient nor the therapists can discern who is who. The confusion becomes manifest in a variety of ways, for example, in passivity, poor memory, or in a difficulty making decisions. It also appears via unconscious mimicry which includes a primal identification.
In a healthy psychic world, our identifications serve to build internal structure and create our personalities and our identities. In addition, they serve to link us emotionally with those we consciously love and admire, creating an internal and external community that is cohesive and integrated. As defenses, much like language is a defense, identifications create a background of safety. Our clients may do this by unconsciously splitting themselves and their objects into black and white categories. These can eventually become less polarized, enabling us to differentiate, categorise, and subordinate information gained from experience. When early trauma interrupts these processes, the spontaneous psychic play is restricted. With such restriction comes a disruption in body relations and object relations.
Somatic defenses isolate a person from whomever they are near. When a patient functions in a pseudo-object relations manner, the symbolic order is challenged. Words are about words and are not symbolic. Confusion can arise, for example, when the analyst makes an interpretation and the analysand focuses on the sound of the voice, the rhythm and tone, the volume and alliteration of sounds. The words become stripped of meaning and unrelated to emotional experience. Confusion and miscommunication can then arise when each member of the dyad assumes the other is using words in the same manner they are. How can we bring meaning to the words, create a three dimensional connection where fusion is no longer necessary for safety.