Psychotherapy as the Growth of Wholeness
The Negotiation of Individuality and Otherness
My one regret in life is that I am not someone else.
—Attributed to Woody Allen
We may still tremble, the fear of doing wretchedly may linger, but we grow. Flashes of inspiration come to guide the soul. In nature there is no outside.
When we are cast from a group or a condition we have still the companionship of all that is.
—Theodore Dreiser, Jennie Gerhardt
LIKE MOST EPIGRAPHS, those above were chosen for their implicit relevance to the perspective that organizes what is to follow. For me, it is their relevance to the power of the patient/therapist relationship as the medium through which a conceptual subtitle becomes a personal experience—The Negotiation of Individuality and Otherness. Sometimes, however, epigraphs seem to have a mind of their own, as did mine. They insisted in participating in the writing of the chapter, not just introducing it and then politely disappearing. In the following section, you are about to see what I mean.
Unbidden
I’ve never before used an epigraph in this way, much less two. Normally, after choosing an epigraph that appeals to me, I then forget about it and concentrate on writing. But in composing this chapter, I wasn’t able to do that, and as I wrote, I couldn’t keep myself from returning to the epigraphs as if they were beckoning me—almost as if I kept reading and rereading them, they would somehow show me the meaning of my irrational behavior. In fact they did, but not in a nice, self-contained, rational way. What I received was not a “meaning” but a feeling of strangely pleasurable surrender to something new that was even more unbidden: The words of these two epigraphs, my reason for choosing them, kept changing experientially in unexpectedly personal ways while I was writing. Their words, the thing that carries the meaning in an epigraph, gradually became part of a previously unimaginable relationship with a human being I am imagining saying them.
I, of course, ask myself if this might be similar to what takes place while I am being a therapist—that the words of the stranger called “patient” begin as more real than the person who speaks them—and that the meaning of the words evolves as part of my growing relationship with the person speaking them. My answer is that it did feel very similar, and I am offering the opinion that, like the relational evolution of my epigraphs, the dyadic evolution we call “psychotherapy” begins as an unimaginable relationship that becomes increasingly imaginable because the author of the words, through the continuity of the relationship, is becoming real in new ways as shifting self-states revisit “old” things.
As I began to write this chapter, I first experienced my epigraphs only through the lens that led me to choose them; they seemed to represent a polarity of self-experience in dealing with the challenge of living life, and they also seemed to evoke the complexity of meaning with regard to the concept of “change.”
In the first epigraph, the concept of change is evoked as a fantasy—the fantasy of being “someone else.” In the second epigraph, the idea of change is transmuted into “growth.” It is relationally transmuted through the evolution of fantasy into imagination.1 In the psychoanalytic relationship, the evolution takes place as an interpersonal/relational phenomenon in which the negotiation of selfhood and otherness transmutes the concept of change into the experiential paradox I call “staying the same while changing” (Bromberg, 1998e). In this spirit—get ready for the “unbidden.”
The First Epigraph
There were quite a few revisits! In my initial ones I could “imagine hearing” the dissociated not-me voice of a self-state who is speaking about who he feels he really is—a person without hope. These first revisits were sort of “Ho-hum” because I wasn’t able, affectively, to experience him speaking from that self-state. But I could at least imagine hearing him say that he truly wishes he were “someone else.” I also could “imagine hearing” him confessing that he wraps this in humor—humor designed simultaneously to express its truth (i.e., his “one regret”) while masking it in the fact that because he is actually saying it, he is unlikely to mean it. I then had the thought that he cannot “change” who he feels he really is, because for him it is the truth about who he feels he will always be. That thought led to another, and this one was more unbidden. “If he should enter psychotherapy,” I said to myself, “it will not be with the hope that change means growth, but with the possibility that he might at least make the most of the fantasy of being a different self—someone else.” I then said to myself, a bit self-consciously and only partly with humor, “He’s not even real and you’re already looking at him as a potential referral.” As I said these words to myself, I ended my first revisit. But my epigraph wasn’t yet through with me.
There was something about hearing myself say that line that enabled me to continue the unbidden “madness” of my revisits to the epigraph even though I kept telling myself, “Enough is enough.” I am pretty sure the main source of my willingness was that even while I was saying, “He’s not even real and you’re already looking at him as a potential referral,” I could feel that my own use of humor was at that moment close enough to his that I knew “enough wasn’t enough.”
So I return! What happens is different but not totally. I am trying less hard to “figure him out” conceptually through the words of the epigraph. And without knowing why, I am now feeling personally engaged with him as a human being. I am with a person who, in giving up hope, found a way of bearing his internal state of nonending aloneness. I am feeling bad for him. But strangely, I am also feeling bad for myself. I’m feeling deprived. Once again comes the thought that none of this is based in reality—but this time it feels like just “words.”
I’m then aware of an unbidden emotion, and I recall that I had been vaguely aware of it in my first revisits but that it didn’t feel personal. Even though I had known it was mine, it didn’t feel like me. This time it is unpleasant, and I tell myself that it’s about feeling deprived. I say, “I’m now able to feel close to him and know that he can’t feel it.” The unbidden emotion gets even bigger. With mixed feelings I recognize what it is: loneliness! Suddenly I’m not sure that my closeness to him is authentic. My loneliness is taking up all the space, and it does not feel like unreciprocated closeness to him. It is a not unfamiliar pain. With increasingly greater certainty, I recognize the experience as one I have from time to time with certain patients: the loneliness of being with such an internally alone person and feeling the helplessness of it.
As I began to recognize the affective source of my loneliness, the recognition becomes exciting because I am now feeling authentically close and I can experience the difference. Even though he can’t experience it because he has given up hope, he doesn’t have the power to deprive me of it. Through my loneliness I could feel close to the person I am with—close to the person who has given up hope. But in order for it to happen, I had to surrender myself to the reality of my unbidden self-awareness in a relationship with a stranger—in this case a stranger, who, one might realistically say, isn’t even “real.”
If this had taken place as part of a “real reality” in which I had been his therapist, could I have found a way to help the two of us use it by sharing my experience of it and inviting him to do the same? I think so, but what matters most to me here is not whether our relationship was one-sided, whether his existence was real or imaginary, or that it was derived from an epigraph. The experience I share with you is created by something affectively alive between myself and an “other” that became alive despite its uncertainty. What took place for me during my “revisiting” led to an affective recognition that the person I was “with,” in addition to his living with an unshareable state of hopeless aloneness, might also be alive to a therapist whose loneliness in being with him is potentially sharable and could lead somewhere unforeseen because of its joint uncertainty. In my being able to feel the personal excitement of what was taking place, I knew that I wanted to share with my readers that I not only could experience this person as a “difficult patient,” but also could experience a deepening awareness of something I already “knew”: that I enjoy working with difficult patients such as him.
The Second Epigraph
I began by discussing my choice of these two epigraphs as representing a conceptual polarity with regard to how I think about things. In the second epigraph, what I could not anticipate was that the experiential polarity that emerged during my relationship with the speaker would be personally discrepant with the conceptual polarity of the words. The quotation from Dreiser’s novel at first seemed like a windfall. I imagined it as the voice of a person who feels secure in the internal experience of hope, and who can speak passionately about wholeness as a gift that transcends the pain of struggling with life’s challenges. Hope is presented not as a place that one finally “arrives at” but as the lifelong challenge it truly is. I continue to love the epigraph; what I feel toward the speaker, however, is unexpected.
It was a bit startling to find that the quality of my relational experience during the course of my revisits, though in one way reprising my revisits to the first epigraph, did so in reverse.2 My relationship with him did not deepen the meaning of my initial assumption that the speaker is someone for whom individuality already includes “self–otherness” and thereby allows this person to live life with “the companionship of all that is.” It challenges my assumption. As I begin to feel more affectively related to Dreiser’s speaker, I find myself thinking that if I were to have a relationship with this person as a patient, I might initially feel admiration but would soon be fighting against my own cautiousness and perhaps boredom.
“What an odd thing to feel,” said I, once again. “Those wonderful words represent a perspective on growth that I totally share—and it is so beautifully expressed.” So beautifully expressed that, even in the earliest revisits, I can recall wondering why the person who spoke these words would ever need anything he doesn’t already possess.
Yet, something in the revisits makes me now think the opposite—as well as feel shut out from direct experience of what I’m thinking. Why? Unlike the revisits to the first epigraph, I am not coming to feel personally close to the speaker at any point. No unbidden affect, no evolution in the relationship. Only my thinking is changing. I am wondering whether his magnificent prose and seemingly personal insight might be an alternate version of the use of humor by the creator of the first epigraph. Oh, hell! If true, it would make this person, too, a difficult patient. But I’m also aware that if I were his therapist in “real reality,” the felt difficulty would be different in a way that was upsetting to me. Even though I didn’t at all enjoy recognizing it, I had a strong sense that it would likely take longer and be more arduous for a relationship to develop in which I would be contributing my own genuine aliveness. It would be hard for me to enjoy being with him. It is the kind of insight that has an immediately “personal” downside as well as the potential for a more satisfying and enduring upside.
The upside, as with the speaker in the first epigraph, was a heightening of personal awareness, but with this speaker, it was, in an even more personal way, also the downside. What was most vivid was not about him, but my recognition that the “me” as analyst/therapist had feelings about him as “patient” that I didn’t like looking at explicitly—in this instance, reminding me that my ability to enjoy being with a patient “like him” does not come as easily. I realized that although in one way I was blaming him for failing to be the “good” patient I thought I was getting, the hard part for me to accept was that I was blaming him for being who, in my eyes, he is. The person I am feeling myself to be at that moment is most definitely a “not-me.”
But, happily, what made it less painful was the unbidden (and uncharacteristic) appearance of a conceptual revisit to something that I had offered in a piece of writing 20 years ago (Bromberg, 1998a)—an idea that we might do well to abandon the concept of “difficult patient” and replace it with “difficult dyad.” I am pretty sure if he and I had been in my office as patient and analyst/therapist during the first few visits of an initial consultation, I would have been less quickly aware of my dissociative self-protection that was provided by the conveniently insightful use of a less critical concept—as you will see later in the chapter when you experience it in action with an actual patient.
State-Sharing and Self–Otherness
Having now introduced you to how my mind works, I am ready to begin what I suppose could be called the “chapter proper.” The foundational perspective that shapes my thinking is enriched by, and, in an ever-expanding way, intertwined with Allan Schore’s groundbreaking contributions to the fields of both psychotherapy and neuroscience—particularly some of his major work during the past two decades (1994, 2003a, 2003b, 2011, 2012). As you read, you will see that in addition to the key importance of affect regulation and dysregulation, both Allan and I place special emphasis on the phenomenon and concept of “state-sharing” (Schore, 2003a, 2011, 2012)—that is, the right-brain to right-brain communication process through which each person’s states of mind are known to the other implicitly.
The interface between my own thinking and his, when linked to the centrality we each place of the mind–brain–body interface, provides the core context that I believe will allow psychoanalysis as psychotherapy to become most genuinely therapeutic. My wish to start with our twosome is not quite as unselfish as it might appear because it allows my experience of its shared pleasure to then recede enough for me to equally enjoy the individual pleasure of meandering around on my own—which I shall be doing before long.
All in all, I will be reflecting on how the human relationship between patient and analyst/therapist enables an individual self to heal and simultaneously co-creates a dynamic link between healing and growth that allows the relationship to evolve into a source of sustained growth that most justifies the name psychotherapy. Let me restate this last sentence in terms of the idea that people change—the broad concept that organizes the book’s overarching coherence. I will not be trying to elucidate how they change, because I have trouble using the word change when applied to people. I will instead be devoting my efforts to thinking about what makes psychotherapy possible. With any given patient, no matter how much we value our concepts, the “answer” to what makes psychotherapy therapeutic is for me not definable as a concept. It is a relational experience that is shaped by two specific people, and what makes it therapeutic is its uncertainty—the very thing that makes it conceptually indefinable. I am especially referring to the experience I call “safe surprises” (Bromberg, 2006a, pp. 10, 23, 95–99, 198–199) that take place between the two individuals as they are struggling with relational uncertainty—and “hanging in” anyway, more or less together.
In addition to his scientific contribution, Allan Schore’s interpersonal/relational sensibility as both a neurobiologist and clinician has been a major force in rebuilding a bridge between psychotherapy and psychoanalysis. The body of his work has systematically provided evidence that personality growth is interpersonal/relational at the mind and body levels. One objective in this chapter is to show how the phenomenon of state-sharing allows the extraordinary phenomenon of self-state communion to take place in a way that allows both partners to include their own and the other’s subjectivities within their individual perceptual contexts of what takes place between them in their ongoing relationship.
This current era also happens to be one in which two remarkable things have happened simultaneously: quantum physics has lost its self-consciousness about accepting the existence of things seemingly impossible at the same time that the psychoanalytic focus of attention has shifted from the idea of an “encapsulated mind” to openly exploring the nature of self. This concurrence, though not by design, certainly plays a role in why data have been accumulating so rapidly, indicating that mental functioning is inherently relational, and especially so in the link between minds. One consequence is that as we are perceiving the scope of the link between minds, it often feels so staggering that it generates the word uncanny3—just because it is.
I mention this because I believe that no theory of psychoanalysis is relevant unless the praxis upon which its psychotherapeutic relevance depends delivers surprises—and in continuing to expand the surprises, furthers the discovery of new human capacities that are even more uncanny.
State-Sharing, Dissociation, and Enactment
As Schore puts it in describing the dissociative communication process that links state-sharing and psychotherapy: “Dynamically fluctuating moment-to-moment state-sharing represents an organized dialogue occurring within milliseconds, and acts as an interactive matrix in which both partners match states and then simultaneously adjust their social attention, stimulation, and accelerating arousal in response to their partner’s signals” (2003a, p. 96, emphasis added). The relationship between dissociation and right-brain to right-brain state-sharing has a complex interface with the therapeutic process that Schore (2003b) writes about as the paradoxical dual role of dissociation. He offers the view that the use of dissociation as a last-resort defensive strategy represents the greatest counterforce to effective psychotherapeutic treatment, while paradoxically serving on its behalf as a communication process. It allows right-brain to right-brain state-sharing to endow the patient–therapist relationship, through enactment, with the power to use itself as an interpersonal/relational medium that weakens the role of dissociation as a counterforce to self-growth. In other words, in its function as a nonconscious communication process, dissociation opens the way to enactment, which I believe is the most powerful therapeutic context of state-sharing—the coexistence in two people of differing versions of “reality”—the realities of their relationship, and the realities held by one’s own states and those of the other. State-sharing is thus more than the sharing of the states themselves. It underwrites the sharing of affectively organized “truths” that have been dissociatively unshareable and thus unknowable to either person in the way the mind of the other experiences them. This is why it plays such a singularly robust role in the processing of enactments. By the analyst/therapist’s sharing of his or her experience as it takes place with the client/patient, without having to first be conceptually “certain” of what it means, the patient–analyst relationship is allowed to become what psychotherapy is all about: facilitating the negotiation between self and other as it is played out for patient and analyst/therapist, with another person and between other parts of each of their selves.
I further suggest that the inability to negotiate otherness “out there in the world” is most frequently a result of the capacity having already been sacrificed in its internal role of negotiating otherness between one’s own self-states—and that this in turn has compromised the person’s capacity to be fully him- or herself in the world with a reasonable degree of affective safety. To successfully negotiate self-state differences with those of other people, there must be enough internal self-state coherence and enough capacity for internal conflict to bear the inevitable collisions between the subjectivities of one’s own self-states.
Affect Tolerance From a Self-State Perspective
In his book The Science of the Art of Psychotherapy, Schore (2012, pp. 91–92) establishes that therapeutic effectiveness depends on the patient’s being able to reexperience dysregulating affect in affectively tolerable doses. In agreement with Pat Ogden (Ogden, Pain, Minton, & Fisher, 2005), he links the neuroscience element (the fact that the affect-focused work occurs at the edges of the regulatory boundaries of the windows of affect tolerance) with my formulation that the therapeutic relationship “must feel safe but not perfectly safe. If it were even possible for the relationship to be perfectly safe, which it is not, there would be no potential for ‘safe-surprises’ because it would never be surprising that the analyst/therapist was not behaving, as expected, like a bad early object” (Bromberg 2006a, p. 95).
What makes this link especially important, Schore (2012, p. 92) goes on to say, is that when the mind is experienced from a self-state perspective, what we call windows of affect tolerance are state-dependent and not, as we have long believed, capable of being assessed simply by the degree of dysregulation taking place without knowing more about the particular self-state of the person that is most prominent in the relationship at that moment. Ignoring the state-dependence of affect tolerance leaves an analyst/therapist no means of confronting a phenomenon in which, as Schore discusses, the right brain’s self-states have a wide range of arousal tolerance to support the unique, nonconscious psychobiological functions of each state. The term affective safety thereby refers to an individualized range of tolerance for different self-states. It is this fact about the meaning of “arousal tolerance,” Shore adds (p. 92), that dovetails especially powerfully with my assertion that “the phenomenon of dissociation as a defense against self-destabilization . . . has its greatest relevance during enactments, a mode of clinical engagement that requires [a therapist’s] closest attunement to the unacknowledged affective shifts in his [or her] own and the patient’s self-states” (Bromberg, 2006a, p. 6).
Collisions, Safety, and Authenticity
Here is where I begin meandering around and ruminating about different things more or less on my own, among them the meaning of the words safe and authentic from a self-state perspective. We already know that affective safety is a key element in what makes psychotherapy a healing process as well as a growth process—a healing process that is identifiable in a patient’s increasing ability to distinguish safe surprises from potential trauma. But in examining what enables the patient–therapist relationship called psychoanalysis to be most genuinely effective as psychotherapy, both words invite being reconsidered from a self-state perspective with regard to the issue of whether we know to whom they refer.
Relational Authenticity
In a pioneering article written over 40 years ago, Edgar Levenson (1974) stated that the meaning of intimacy has undergone great change in the patient–analyst relationship. In Levenson’s words, it has come to denote “a very ambiguous felt state, difficult to formulate and, even more confusing, undergoing a continuous shift in its meaning” (p. 359). Levenson argued that the reality of this ever-shifting context of relational meaning demands a redefinition of what makes psychoanalysis therapeutic:
Authentic therapy begins by admitting the chaos, plowing ahead, falling on one’s face, listening for the feedback, and delineating the patterns of interaction as they emerge from one’s mutual experience. A feeling of intimacy, an intense personal commitment, may emerge at the most stormy or unpleasant moments. One risks one’s own identity in every real therapy. That’s enough basis for authentic relationship. (Levenson, 1974, pp. 368–369, emphasis added)
Ah! But is the idea of an authentic relationship in itself enough of a basis for psychotherapeutic growth to take place? Levenson believes that the answer is yes, and so do I, but only when looked at from a self-state and dissociation perspective. Without this perspective, the recognition of who feels the authenticity and who doesn’t is confusing and difficult to deal with in the here and now. This issue, in fact, makes it especially clarifying as to why I believe that psychoanalysis as psychotherapy is the utilization of an ever-shifting self-state context. As the basis for an ongoing “safe but not too safe” negotiation of individuality and otherness, it is this that allows paradox to exist—“self–otherness” without being “someone else.”
From my point of view, what makes an analyst/therapist’s response to a patient feel “authentic” is how closely it matches an individual self-state’s experience of its own “me-ness.” Each self-state in a person has its reason for existing as the “me” it is, and will not rewrite its personal reality simply to suit an analyst/therapist’s “belief system” about what defines personality growth. There is no way that a self-state narrative of “who I am” ever changes directly; it cannot be cognitively edited and replaced by a better, more “adaptive” one. Only a change in here-and-now perceptual reality can alter the self-state reality that defines the patient’s internal world at a given moment, and this process requires an enacted collision of personal subjectivities between patient and therapist.
This is why the analyst/therapist’s open struggle with his or her uncertainty plays as much of a role in the therapeutic process as an “analytic stance” based on either empathy or cognitive clarity derived through “understanding.” Each self-state comes to attain a relational clarity about its personal significance that gradually alleviates the patient’s previously held sense of entitlement about who he or she “really” is and his or her confusion about how, historically, he or she came to be this person. And for the therapist, it is not necessary to work so hard to “figure out” what is going on, what has gone on in the past, and what things “mean.” In the course of knowing each other through their relationship, both people come to know themselves more and more intimately, and this is why the thing we call treatment evolves. As an “interpersonally personal” therapeutic milieu, it replaces an analytic stance, and regardless of which particular stance it replaces, what is diminished is the intrinsic problem created by the analyst/therapist’s belief that eventually, albeit slowly, his or her patient will somehow “take in” what the analyst/therapist is offering because the patient will come to see that it will lead to a “healthier” reality. The word see is what is most important here because if its meaning is not to be taken simply as a synonym for understanding, it will be valuable if I speak at this point about the difference between “seeing” and “perceiving,” and why the mind–brain–body process of perception underlies everything in the psychoanalytic relationship that allows it to become psychotherapy.
Perception
Let me begin by underlining what you already know: (1) As a psychoanalyst I hold that the patient–analyst relationship is itself the source of therapeutic action. (2) I hold that what takes place in the relationship must be “perceived” in order for what is “talked about” to exist in a therapeutic context. That said, I’m going to now address what perception is, and while so doing will clarify why “simply” by enabling the relationship to be inescapably personal, it supports the ability to make what takes place in the relationship therapeutic.
So, what is perception, and how is it different from seeing? Perception begins at the brain level as sensory input, but sensory input is not perception. It is when sensory input to the brain becomes personal experience to the mind that the “self” becomes involved. Perceptual experience exists because of what the person’s subjectivity makes out of sensory experience. Registration on the senses does not provide meaning. But when the neurological impact at the brain level is experientially shaped by interaction with the individuality of a given person’s subjective experience, what Jerome Bruner (1990) calls “an act of meaning” takes place. Perception, in other words, underlies the creation of an “act of meaning” because personal meaning comes into existence when, in any given individual, the brain’s sensory neurology engages with his or her mind’s subjectivity as it interacts with the otherness of what is “out there.”
Perception and Verbal Language in Relation to “Acts of Meaning”
As analysts/therapists, when we participate through our own aliveness in increasing a patient’s capacity to symbolize experience perceptually, those areas of selfhood that have existed only as internal experience without self-agency become relationally personal because the meaning is being shaped interactively. Through each person communicating his or her own subjectivity to an “other,” an “act of meaning” takes place. Bruner puts this point right out there: “The child’s acquisition of language requires far more assistance from and interaction with caregivers than Chomsky (and many others) had suspected. Language is acquired not in the role of spectator but through use. Being “exposed” to a flow of language is not nearly so important as using it in the midst of ‘doing’” (1990, p. 70, emphasis added). Bruner then goes on to address, indirectly, the special status of working therapeutically with attachment-related interaction, including its seeming inability to access, experientially, the trauma associated with it: “It is only after some language has been acquired in the formal sense, that one can acquire further language as a “bystander.” Its initial mastery can come only from participation in language as an instrument of communication” (p. 73, original emphasis). Bruner writes that the initial mastery of language “can come only from participation in language as an instrument of communication.” In this developmental phase, however, verbal language as an instrument of communication is either barely present or nonexistent. So, although in an overarching way I agree with Bruner, it must be kept in mind that during the early attachment phase of development, there is a special complexity that is, for better or worse, life altering: Even though this phase lacks “participation in language as an instrument of communication,” it must nevertheless be able to underwrite the core sense of selfhood that is coming into being through procedural interaction patterns. When it fails, the outcome is tragic. But the fact that it can even succeed as well as it does makes my mind float between admiration and awe just in describing its task.
In analysis or therapy, each patient thereby brings with him or her the residue of his or her negotiation between individuality and otherness in early development—a negotiation that, to one degree or another, was affectively fraught. This requires that the patient and analyst/therapist engage with each other in a way that does not, for a prolonged period of time, dissociatively sidestep the fraught areas of experience from being played out in their relationship—and this includes what both Levenson (see above) and I acknowledge as the “messy” parts of the relationship. But for the relationship to be therapeutic, what is enacted as repetitive must include what is not repetitive—its authenticity—which, from my perspective, is initially most shaped by an analyst/therapist’s ability and willingness to be open to a mutually personal process of relational self-reflection that includes the analyst/therapist’s perception of his or her own participation. As Levenson famously put it in his critique of psychoanalysis as fundamentally asking the wrong question, analysts/ therapists should be asking, “What’s going on around here?” rather than the more usual psychoanalytic inquiry into “What does it mean?” (1989, p. 538).
Over time, through an increasingly broad range of each person’s self-states, the relationship becomes a source of self–other aliveness. It endows a patient with ever-increasing capacity of his or her own to hold in a single state of consciousness the safe participation of “other” self-states—both his or hers and the analyst/therapist’s—a capacity that formerly had held alternative versions of his or her own self-state truth, and were thereby incompatible, adversarial, or a source of fear. How can perception make this possible?
Let’s Get Personal
I’ve now gotten one step closer to a main point that is rarely discussed in detail because it leads to something that makes an analyst/therapist uncomfortable for various reasons, especially in its challenge to the convenient fiction that the patient/therapist relationship is something we can “allow” or “not allow” to be personal. The analytic relationship, like any relationship, is inherently personal, and all we can do is either use that fact in as creative a way as possible or believe that we are able to make it less so by a “stance” that we tell ourselves defines the relationship as something we call professional. By accepting its personal nature, psychoanalysis as psychotherapy becomes a process of healing and growth that is openly mediated in a perceptual context. Because the personal nature of this process evolves perceptually for both partners, it evolves individually for each. So now to the harder question, about which I will have something to say a bit later: How does perception, by making the context personal, enable the patient–analyst relationship to utilize what takes place in it as a negotiation between subjectivities that is so deeply therapeutic?
Perception and Self-Narrative
I ask you to pay particular attention to the next sentence: The patient–therapist relationship becomes an activity that shapes an ongoing and evolving dialectic between seeing and being seen rather than an ideational process in which one person is being seen “into” by another. Every clinician finds out the hard way that when you try to see into someone, all you get is one or another of the person’s “self-narratives.” Our collection of self-narratives is what we all use to experience ourselves as staying the same. It is what gives all of us something solid to hold onto while our self-states are shifting, so that “change” isn’t equivalent to loss of personal existence. In this sense, self-narratives in a context that disregards the absence of perecption are just words that have different “user value” for each particular self-state. But the main user value for all states is to conceal the core mistrust in human relatedness through relying on “just words” to assure they are always in “safe hands”—the only safe ones being their own.
In areas of the personality where trauma has left its mark, many self-states define not simply points of view of their own, but narrative truths of their own, which, as I’ve described earlier, are non-negotiable and protected by a dissociative mental structure. The function of this structure is to assure that certain of the person’s self-states remain unbridgeable islands, allowing each to perform its function, without conflict, by using only its own truth. Within this structure, what is “me” to one state will automatically be “not-me” to another. Part of our work as therapists—at times our sole focus during the initial part of treatment—is participating in the restoration of fluidity between the dissociated self-state gaps—what I call the capacity for “standing in the spaces” (Bromberg, 1998c, 1998d). During the early phases of this process, “safety” is not an authentic relational experience, nor are “hope” and ”trust”. The more therapists try to demonstrate their trustworthiness, the more they fail. The patient’s self-state narratives thus become a central part of the paradoxical dual role of dissociation that Allan Schore (2003b) has described, in this case serving as a counterforce to growth because personal narrative cannot be “edited” by accurate verbal input.
This situation is personally frustrating to most analysts/therapists, and in my opinion is thereby one good reason that, most simply put, the analytic/therapeutic relationship must be allowed to provide an experience that is perceptually (not just conceptually) different from the patient’s pre-established self-narratives. Furthermore, the perceptual context, while it is bridging the gaps within a patient’s fixed set of self-state narratives about who he or she “really” is, will also be addressing the patient’s dissociated mistrust of the analyst/therapist. How? Because of the challenge that is presented to the patient’s lifeless and inauthentic form of “safety” as they increasingly participate together in an alive relationship that is perceived to be safe, even though not perfectly (Bromberg, 2006a, pp. 4, 189–192).
It is in this way that authentic psychotherapy breaks down the old narrative frame (the patient’s “truths”) by evoking perceptual experience that doesn’t quite fit it—which means that the analyst/therapist must be open to being seen personally, and this includes the patient’s perceptual awareness of the analyst/therapist’s efforts to wear a “professional mask” when he or she feels in need of one.
Seeing and Being Seen
I cannot overemphasize the importance of the analyst/therapist’s openness to being perceived. I have been making this point for over 20 years (even though in the early days I used the word see instead of perceive). It started with a 1994 paper titled “Speak! That I May See You” (Bromberg, 1998b)—a line that has been attributed to Socrates. When my final draft of that paper was almost completed and I was about to close the file, I knew I wasn’t completely happy with the title, but I liked it enough to keep it, and I wasn’t about to mess around with Socrates. So I negotiated with him. I added a last line to the text, asking Socrates if I could be allowed to wish that he had said, “Speak! That I May See Both of Us,” and Socrates generously agreed—as long as I didn’t change the title.
Aside from my enjoyment in revisiting the zaniness, I am underscoring my strong and long-standing conviction that when perception organizes our way of relating, our patients are therapeutically freed (though not necessarily “free”) to actively “do” unto us what we are “doing” unto them. When patients are freed to recognize and actively engage their analysts/therapists as a center of their own subjectivity (see Benjamin, 1988, 1990, 1995, 1998), rather than dissociatively hearing their words without physically embodying a perception of the person who speaks them, psychoanalysis becomes a process in which affective access to new self-meaning is not “resisted.” It is negotiated among self-states because affective meaning must feel authentic to each state in its own terms. Cognitive meaning will find its natural place later—and equally through the relationship. All this is to say that personal meaning is not birthed by the “right words,” but by a two-way perceptual context that slowly includes the cognitive meaning provided by the personally negotiated affective physicality of its experiential meaning (see Ogden, Minton, & Pain, 2006; Ogden, 2015)
The Developmental Phase of Early Attachment
The early attachment phase intrinsically lacks participation in language as an instrument of communication. During this period, the mother and child are bonded in a special cocoon of oneness that is developmentally normal. The word symbiosis is not accurate because there is always a physically organized experience of separateness no matter how early—but psychologically, the mental quality of the child’s experience of reality overlaps with what Peter Fonagy and his colleagues (e.g., Target & Fonagy, 1996), in their work on the developmental evolution of reality, call the psychic equivalence mode. Experientially, the child’s reality is “I am that which you know me to be, and I am not that which you do not know me to be.” The normality of this phase is that the child has no self-experience that is not organized through being the child of this mother. It is a phase of reality that is especially ripe for trauma because nonrecognition is communicated as procedurally as the rest of attachment experience.
The special affective state of “oneness” between mother and child that is the hallmark of this phase must be nourished. That in itself is, at least for a while, most frequently a source of enough pleasure for both mother and child to mitigate against serious nonrecognition trauma, but this same phase is also required to make room for a transition that allows the oneness of attachment reality to now include self–other negotiation as an instrument of communication. It is the latter through which the representational expression of self-existence can evolve without losing the pleasure of oneness that, if things go reasonably well, continues to be a treasure of its own.
But things do not always go reasonably well and when they don’t, the developmental transition that enables a child to communicate his or her subjective existence as a self can be a nightmare—at times even leading to the phenomenon known as selective mutism. However, the bigger tragedy is that the initial relationship that is supposed to provide the basis for a safe and robust adult experience of individuality and self-agency as well as assuring continuity in the unique pleasure of oneness, frequently fails to deliver, and its failure impairs further self-development, the source of which has always been confoundingly inaccessible to analysts/therapists.
The child continues to need relational help in making the transition, but if the attachment period has been too infused with the trauma of nonrecognition, relational help is most often too little or too late. In later stages of development, the internal struggle to negotiate “me and not-me” has already been abandoned as hopeless, but sometimes, even against the odds, the act of living may lead to a relationship that feels alive to the challenge—and once in a while that relationship is with a therapist who stumbles his or her way around in new and “unbidden” ways.
Because the early attachment relationship is, at different points, required to facilitate developmentally diverse things, some of which the child will experience as affectively in opposition, it is not difficult to understand why, in a relationship that cannot be negotiated through language, it inevitably will be difficult later in life for a therapist to identify a phase-specific relational source. As complicated and affectively dysregulating as it often may be, the therapist’s task is to allow the relationship to heal the impaired areas of self in which the expression of individuality and self-agency has been injured, while simultaneously nurturing the continuing pleasure of oneness so it is able to evolve into the self–other wholeness I have called “the nearness of you” (Bromberg, 2011a)—a phenomenon I will shortly discuss in greater detail.
Not Simply “Neglect”
Despite the connotation of the word neglect that the term nonrecognition may impart, it is trauma in every respect, and arguably the most devastating aspect of every other form of relational trauma, including those that are assaultive.
Trauma is not intense anxiety. Anxiety is something you have. Trauma has you. Trauma is a flooding of dysregulated affective experience that, if it cannot be relationally processed, destabilizes a person’s perceptual experience of his or her own existence and creates an escalating dread of depersonalization that must be stopped at any cost. The brain then takes over. To avoid the escalation of what is an indescribable threat to survival, the normally fluid dissociative gaps between self-states are hypnoidally rigidified, making self-reflection and in turn intrapsychic conflict impossible, not simply difficult—possibly in the total personality, but inevitably in certain areas of the mind.
Trauma may imitate neglect, but it is a dissociatively co-created form of “socialization.” Why do I place the word socialization in quotation marks? Because the best way to turn one’s child into what you need him or her to be is not by telling the child what he or she should do but by showing the child who he or she is. In the early attachment phase, reality does not achieve meaning through whatever words may be said by the parent. In the face of a mother’s dissociative nonrecognition of her child’s self-states that hold aspects of the child’s subjective experience that are incompatible with what she is able to recognize in herself as this child’s mother, the child’s experience of reality is destabilized. The “oneness” in their pattern of relating that allows the child to feel known by the mother as her child is traumatically ruptured. It is an affectively traumatic destabilization of reality, and as such, is not subject to thinking or relational mental representation.
For some children, the experience escalates into what adults may call a tantrum, but whatever it is named, when it happens too frequently, the brain will not let it happen again. The dissociatively anticipatory self-state structure that I described earlier replaces self-state fluidity and becomes the brain’s fail-safe survival solution. Even though this anticipatory structure “works,” it is similar to living in a haunted house. As therapists, when we allow our patients to remain too long alone in that haunted house, something begins to feel “wrong.” No matter how hard an analyst/therapist tries, words do not make it better. On his or her own, the analyst/therapist doesn’t know what to do. Neither does the patient.
As analysts/therapists, we have reached a place in which our helplessness is not due to something present that we can’t figure out, but to the absence of something we don’t necessarily perceive when it is present, much less as a loss of that “something.” It is a loss that is emotionally unsettling enough for the analyst/therapist to dissociate, not only because it involves both analyst/therapist and patient, but at least as much because it involves a “not-me” self-state of the analyst/therapist that holds affect toward the patient that the analyst/therapist would much prefer to keep “not-me.” The content of the “not-me” affect varies, but for an example of it, go back to my discussion of my second epigraph in the initial section titled “Unbidden.” The loss, however, is what needs the most attention here, because I’m speaking about the sudden loss of a special aliveness being tentatively created by the tendrils of an emerging but risky experience of shared pleasure that was precipitously and nonconsciously terminated—a lost, shared pleasure that more often than not signals the emergence of what I call “the nearness of you.”
The Nearness of You
What do I mean by “the nearness of you?” Even if you already know what I mean (Bromberg, 2011a), equally to the point is why I don’t simply call it “the capacity to have an intimate relationship?” Some researchers in mother–infant interaction have been extraordinarily illuminating here. Consider what Ed Tronick (2003) has to offer in referring to it as “a dyadic state of consciousness” that, when achieved, leads to what he felicitously calls “feeling larger than oneself:”
When mutual regulation is particularly successful—that is, when the age-appropriate forms of meaning (e.g., affects, relational intentions, representations) from one individual’s state of consciousness are coordinated with the meanings of another’s state of consciousness—I have hypothesized that a dyadic state of consciousness emerges. Though it shares characteristics with intersubjective states, a dyadic state of consciousness is not merely an intersubjective experience. A dyadic state of consciousness has dynamic effects. It increases the coherence of the infant’s state of consciousness and expands the infant’s (and the partner’s) state of consciousness. Thus, dyadic states of consciousness are critical, perhaps even necessary for development.
An experiential effect of the achievement of a dyadic state of consciousness is that it leads to feeling larger than oneself. Thus, infants’ experience of the world and states of consciousness is determined not only by their own self-organizing processes, but also by dyadic regulatory processes that affect their state of consciousness. (p. 475)
It is no easy job for the patient–analyst relationship to restore a patient’s trust and joy, and especially trust and joy in the attachment-based wholeness of self that I call “the nearness of you” (Bromberg, 2011a). The capacity for it is part of our endowment, but it is not a gift that becomes usable just by our being born. We are born. We are raised. We develop. During the process of development, we are exposed to the impact of early relational trauma. When the shadow of early trauma of nonrecognition reduces the capacity to safely trust oneness, then future ability is compromised to negotiate the relational transition to self–other wholeness. The success of the transition requires that it carries with it the pleasure that originated in the oneness of early attachment. Without it, each developmental effort to surrender to the experience of “the nearness of you” is aborted by the vigilance of a self-state whose job is to prevent the repetition of past trauma. For some patients, what I have just described is all-encompassing, but for everyone, at least in certain areas of self, it exists in a form that, though “hidden,” is always whispering its name.
At the time I wrote the final chapter of The Shadow of the Tsunami—the chapter I titled “The Nearness of You”—I was uncertain about the conceptual meaning of the name I gave it, even though I knew I was speaking about something experientially alive. I did the best I could by writing about the inherent relationship between the process of early attachment and the development of what attachment theorists consider to be a core self, but I wasn’t able to write in detail about what I meant by the word core because I was uncertain. I let it stay uncertain and allowed it to seem as if I meant it simply as the beginning of selfhood in whatever way “beginning” might be conceived.
Happily, I am now able to take this a step further. My view is that “the nearness of you” is the core self of early attachment—the core capacity of an affectively organized self to surrender safely, as an adult, to the exhilaration of dyadic oneness. When self–otherness has been well enough negotiated relationally to assure that individuality will not be compromised, there is no difference between wholeness and the robust self-coherence that facilitates “standing in the spaces” between self-states. In other words, I am saying that the attachment-derived core self is in fact the affective state of oneness that, little by little, evolves from Tronick’s “larger than oneself” experience into a wholeness that endures through life—as long as early attachment experience was not ruptured and left unrepaired.
When a patient’s anticipatory hypervigilance created by a dissociative mental structure seems to coexist with attachment instability, the source of both, I have found, is most often located in the trauma of nonrecognition during the early attachment phase of development. This may in fact be especially strong evidence that the early joy of oneness became so unsafe that it could not evolve. The subsequent development of wholeness could not take place, leading throughout life to an unreflective, repetitive behavioral pattern: tentative efforts to give birth to a shared experience of “the nearness of you,” followed by an inevitable need to abort it. Because the link between self and other was traumatically ruptured early on, and the felt risk of revisiting it triggers the brain’s “survival structure,” the patient is unable to feel the affective existence of otherness without it becoming automatically a source of potential harm. The brain, supported by certain self-states, attempts to make sure that “other” remains alien to selfhood rather than part of it.
It finally seems time for me to answer the self-inflicted question with which I ended the Section Let’s Get Personal: I’ve presented a viewpoint that psychoanalysis as psychotherapy takes place in the relationship through an interpersonally/personal process that evolves perceptually for both partners, dyadically and individually. Can I now provide some minimally conceptual overview of therapeutic action that accounts for how the relationship accomplishes its task pragmatically? My answer is yes and no. First the yes: The structural dissociative protection that is automatically dictated at the brain level is voluntarily surrendered, little by little, while in the outside world primacy of self-survival at any cost diminishes. The surrender is not automatic. It is earned as the relationship evolves. It is earned through the interpersonally personal quality of the relationship; it is earned through the inherently interpersonal neurobiology of brain structure and function; and it is earned through the body’s somatic “mind of its own” being the essential stronghold of selfhood. These together allow the miracle of state-sharing to permit self–other wholeness to be achieved. It is a miracle that takes place in the relationship, and as a miracle, it doesn’t explain how it works.
What takes place pragmatically and explicitly that makes the analyst/therapist a good therapist? What does he or she do that enables the patient to grow and heal in a relationship with him or her that is perceptual? I don’t know. I believe I will never know. And I’m glad to believe I may be right. If I wasn’t glad, I would use fewer words like unbidden, nearness, wholeness, and personal, and I would not want to do that because I believe in the meaning of those words. But I also know that sometimes my nonlinear soul takes time off and I catch myself sounding as if I believe there must be empirical answers, as in the notion of enabling patients to do unto their analysts/therapists what their analysts/therapists do unto them. But don’t let this “confession” fool you. This paragraph is the “no” part of the “yes and no.” But now comes something that may help you forgive me.
Claudia and Me
State-sharing between author and reader is a reality (Bromberg, 2006b), but sometimes it can use a little help. So in hope of making it a little easier to experience what I mean by “it takes place in and between both partners or it takes place in neither,” what follows is the “here-and-now” experience I mentioned earlier. The vignette, excerpted from The Shadow of the Tsunami (Bromberg, 2011b, pp. 110–120), was chosen because I believe it captures both the uncertainty and the personal aliveness I’m talking about.
Self-states do not exist because of trauma. They are what the self is, and if they didn’t exist, we would wish they did. It is the normal affective vitality of our self-states as they dissociatively shift while communicating with each another and with the self-states of another person that is the essential energy source fueling our pleasure as we participate in everyday life. In the patient–analyst relationship it is the essential energy source that embodies state-sharing with the physical “chops” that makes the relationship affectively robust enough to be the context in which psychotherapy is co-created. Let me introduce the patient I call “Claudia.”
Claudia was in her late 30s when she began her analytic work with me. She had been sexually molested at age 5 by her psychologically impaired older brother, but unlike what is more typically observed in the aftermath of such experience, Claudia still retained a clear visual memory of it—not “snapshots” or flashbacks. As we began to work together, it became quickly clear that in Claudia’s childhood the invalidation of her selfhood had a scope much larger than sexual abuse per se—so much larger that her wariness about looking into her past for a single “obvious” cause of her current problems made rational sense, even though it also served a protective function against my otherness that was “dissociatively rational.”
My perspective on Claudia’s childhood was more or less the following: Her normal developmental need for an interested mother who wished to help and support her in coping with the routine challenges of growing up had been responded to as invalid. In effect, she was shown again and again by her mother that her desire for such attention was a sign of selfishness because, unlike her handicapped older brother, Claudia was not “defective.” Only if there was a serious crisis that she was unable to handle could she put forth a claim for help, but this could not happen without great shame. As “crises,” they were rendered relationally “nonexistent” ahead of time. As a burdened but proudly “nondefective” child, she grew up with the cumulative trauma of expecting that each “next thing” to come along—always something she was determined to handle alone—would be too much for her, but it was this very determination to carry the burden without complaining to her mother that had become the key ingredient in the procedural attachment pattern that shaped her core sense of self. Claudia lived, most visibly, in a self-state of “good little soldier,” kept in line by an internal voice denouncing the “not-me” part of her that yearned to communicate her inner despair. From the time she was 5 years old she escaped from this inner torment by using her capacity to dissociate.
Claudia eventually married, had a child, and functioned fairly well at a job that entailed considerable responsibility, but, as you might expect, she was always putting out brush fires and felt constantly on the edge of everything falling to pieces. Despite her own early developmental trauma of nonrecognition, Claudia was a pretty good parent in most ways, but for years had been terrified that if she relaxed her maternal vigilance for even a moment, she would be placing her daughter, Alice, in great danger (including, of course, from some other parts of Claudia herself). Alice, who was getting older, was increasingly demanding more freedom, and this was not easy for Claudia. The issue of her hypervigilance in “protecting” Alice was something that Claudia and Alice were dealing with together with some interpersonal success, but when Claudia talked to me about their relationship, this progress was never acknowledged. I was not yet responsive to the degree that the adversarial collision between Claudia’s dissociated self-states was being enacted in our relationship, and for a long time I experienced her as more embedded than she actually was in the single truth of “I must protect my child or disaster will strike.” I therefore felt her as more dependent on my input to help her sort things out than she was. I was so busy trying not to relate to her as her mother did—as the “nondefective child” who didn’t need help—that I failed to recognize that we were enacting a version of the way one part of her related to Alice: making sure that I protected my child lest disaster should strike, while ignoring another part that was “holding out” on me about her increased growth. But the part of Claudia I was ignoring, as it turned out, was doing something more complex than simply “holding out” on me. Here is where the fun starts:
Claudia had indeed grown profoundly, and a central part of her growth was in discovering the joy of using her own mind as a “private space.” I sort of knew about her joy, but the joy in using her own mind as private space was the development about which I consciously knew nothing because it was the development that she, at least for the time being, wanted to keep just for herself. In other words, keeping it from me wasn’t inherently an act of “withholding.” In that regard, and notwithstanding my dissociative obliviousness to the enactment, I was at least uncertainly aware of a shift that seemed to be taking place in her mental functioning: Periodically, the concreteness of her thinking seemed to diminish, allowing the shadowy presence of something almost like humor to briefly appear. But because this came and went without any shared trajectory, the power of our ongoing enactment was strong enough to keep me from looking at it as something to take seriously, and as you will observe in what follows here, I am seeing Claudia through a glass darkly, not only with regard to her capacity for mothering but also with regard to her capacity for sophisticated thinking—and I am being set straight on both counts.
The Session
This particular session was preceded by a voicemail message from Claudia that she had left for me earlier in the day. In it she stated only that since she had not been able to get me on the phone and she would be seeing me for a session in a few hours anyway, she would wait till then to tell me the reason for the call and that it wasn’t important for me to call her back.
I did not retrieve the message until just 2 hours before she was due to arrive for her appointment, and although I wasn’t “certain” that there was something in it beyond her apparent emotional indifference, I was left with an impersonal but nonetheless nagging sense that she had wanted me to call her back.
Notice that I here use the word wanted. If I were to be more open, I would also admit that I really felt she “needed” me to return her call—a difference so important that I am underlining the nature of the dissociative process in me that led to my failure to affectively “know what I knew.” Why did I not want to feel her need? One reason was that I didn’t WANT to return her call. I was busy and didn’t feel like interrupting what I was doing. But there was more to it than that: I also didn’t want to admit to myself that a part of me felt uncomfortably like her mother. It was too disjunctive with my self-state that was dedicated to making sure to “protect my child” lest disaster should strike. So, because I told myself that she was being “mature” and that I should heed the explicit content of her message, and ignore the implicit message conveyed by her affective ambiguity, I felt almost no conflict about not returning her call. Like most examples of unilateral clinical judgment, my decision was based on a “truth” that was at least partially self-serving, and it is this aspect that I, of course, dissociated.
When Claudia arrived for her session, she began by casually mentioning that she had left me a voicemail message earlier in the day. In a calm voice she then stated that she had had a “strange and disturbing experience” the night before, which was why she had called me. Then, without elaborating on her feelings about the phone call itself, she began to tell me about the “unimportant” reason she had called. She said that she was feeling overwhelmed by everything caving in on her all at once—work, marriage, and motherhood—and that it was all more than her mind could handle.
This time, however, Claudia did not completely give herself over to her old dissociative solution. Even though her brain initially responded dissociatively to the potential for attachment rupture, her mind seemed able to deal with a level of cognitive complexity that transcended her brain’s need for automatic protection at any cost. Claudia’s use of her cognition was now robust enough to master the difference between being scared and being scarred. Indeed, Claudia was frightened and affectively dysregulated, but unlike what would have been characteristic of her in the past, when she “awoke” she telephoned me. Furthermore, the message she left wasn’t as much dissociatively ambiguous as it was an attempted solution to resolve an internal conflict between two self-states that were present simultaneously rather than alternately. One could say that her dissociative response was more against potential dysregulation rather than destabilization of self-continuity. I think this is accurate, but what was dissociatively taking place in me is as informative as what I saw taking place in her, and to get to it we are about to look at what was happening between us.
Claudia could hold the experience of conflict! Sounds hopeful, RIGHT? Yeah, it was, but my part in the ongoing enactment was to enlist my hopefulness as a means of securing my own dissociation. I told myself how wonderful it was that regardless of experiencing psychological overload and in spite of her dissociative symptom, Claudia’s ability to hold a state of conflict would enable her to come to her session “fully” present—or so I chose to believe. My preferred definition of fully present was at that moment shaped by my relief that she came ready to “work on her problems” and didn’t seem to be bothered that I had not called her back.
It was when she began talking about how much worse her relationship with Alice was becoming, and how awful she felt about having to talk to Alice’s therapist about her bad mothering, that the following exchange took place—an exchange that left me breathless.
PB: You may need to give Alice more room to breathe. Your worry that something bad will happen to her if you leave her by herself for even a minute still makes you feel that you would be neglecting her.
CLAUDIA: (primed for confrontation) Are you saying that I’m an overprotective mother?
PB: (nondefensively, because that was in fact what I was saying) I suppose I am.”
CLAUDIA: (emphatically) Well, you got it wrong! I’m not an overprotective mother to my child. I’m just a normal grandmother.
PB: (bewildered) Grandmother? What do you mean by grandmother?
CLAUDIA: Grandmothers were mothers once already. So with their grandchild it’s the second time around—being a mother. They know what to look for before it happens because they’ve been there before.
PB: (totally bewildered) What does that have to do with you? You are not a grandmother.
CLAUDIA: Neglect is what it has to do with me. I had to mother myself when I was a child, so this is my second time around. I know what to look for before it happens, so I’m just a normal grandmother.
Claudia was clearly enjoying her ability to play with my innocence. But beyond that, she was also enjoying her own mind. She was in what before would have been dangerous territory, but her attachment was not threatened—certainly not enough for her brain to trigger automatic dissociation. A new capacity for ironic wit suddenly showed itself through an interpersonal directness that I had not recognized existed—a directness that was both an unmistakable challenge to my narrow image of her, and also a clear source of pleasure to Claudia. She could see I was bewildered by this change in her, but she knew me well enough to know that I was also enjoying this delightfully clever person, even if I wasn’t certain “who she was.” She experienced our bond still very much in place, and as it then developed, it was on the threshold of becoming even stronger.
It was then that she said it: “I needed you to call me back. You should have known that, and you should have called—even though I said it wasn’t necessary.”
I could feel my head spinning. Everything that came to mind I discarded, because I could feel my defensiveness and I wanted to hide it from myself as well as from her. Was what she said true? How could it be? How was I supposed to know what she “really” wanted? Almost as if I had asked that question aloud, Claudia continued: “Sure—you’re telling yourself you were in a no-win situation, but maybe what I am blaming you most for is that you didn’t think about what I was feeling when I left that weird message.”
To use my own language, Claudia had given me a “safe surprise.” She was implicitly inviting me to join her in creating a shared space in which we might explore together what she might indeed have been feeling when she left the phone message—an invitation that, as it turned out, would lead to open exploration not only of Claudia’s feelings, but to what I might myself have been feeling that made me put the issue of what she “really” wanted out of my mind.
It was not easy. Claudia wasn’t being mean, but neither was she keeping anything unsaid. Because she had helped me become aware of how personally distant I had been from her, I was hesitant to look for any more things to say to her that, even if some might be true in the abstract, would feel as experientially inauthentic and empty to Claudia as they now felt to me.
What to do! It was clear that my cupboard was bare. There was nothing left in it that would “work” any better. The problem was ME, not my ideas. So I stopped searching. Strangely, it didn’t feel so bad to give up. And even more strangely, it was at that moment that I could feel an option that I had not felt earlier: I could share my experience of what was going on in my mind. I could share it just because I wanted her to know it, not because it was supposed to lead somewhere. And so I did; I shared my “formulation,” and I also shared my feelings about my formulation—my private awareness that I kept repeating my formulation because I needed some credible concept that I could offer her so I didn’t have to face how hard it was to find a way of just being with her. I told her that even though my formulation still seems plausible to me, I have no reason to believe that understanding its logic would be in any way useful to her. She listened attentively, obviously thinking about what I just said, and then tried restating the formulation on her own, after which she declared, quite thoughtfully, that she agreed it isn’t useful but “it’s at least useful that both of us now know it isn’t useful.”
The humor in this moment didn’t escape me. I had given up searching because I had run out of ideas, and the result was that we ended up agreeing that my ideas weren’t useful anyway. Though it wasn’t exactly a gold-medal performance, there was something about what we just did that brought us together experientially in a way that hadn’t been possible until that moment. I was no longer feeling disconnected from her despite the fact that the only thing we agreed on was the lameness of my ideas. I was feeling not only close to her, but along with the closeness, I could feel a sense of freedom that was, dare I say it, JOYFUL.
One of the things that became clearer as we compared our respective experiences of what was being enacted in our relationship was the powerfully new meaning contained in her “grandmother” story—a meaning that was there to see when she was ready to put words to it, and was willing to invite me to the party. She had constructed a delightfully impish metaphor in which the complex interrelationship among daughter, mother, and grandmother was not only witty but also a form of self-representation. At this latter level, Claudia was proudly sharing that, unlike the manner in which her self-states manifested themselves in the phone message, she was experiencing a relatedness among them that felt more natural than the times they became, and might yet again become, “not-me” to one another. Mother, daughter, and grandmother felt more than just separate entities. They felt not only interrelated, but the fluidity of their relatedness was now safer. In playing with metaphor while playing with me, Claudia was simultaneously telling me and showing me that she felt a greater sense of wholeness. And she was having fun doing it. She didn’t mind that her pleasure, which was being expressed just because she was feeling it, was dysregulating my state of mind.
By the time the session ended, the phone message no longer seemed weird, and Claudia didn’t feel alien to me. The “Claudia” I had been experiencing as having hijacked our relationship was no longer an alien “other.” The boundary between selfhood and otherness had become newly permeable for both of us.
Over time she got in touch with the self-state in her for whom it didn’t make sense for me to call back, and she then recognized she had not been able to make that explicit because she was protecting another part of her that felt very differently. This was why the message that she left, although it was supposed to be “sort of” a compromise, was actually on the boundary between conflict and dissociation. Because there was not enough self-reflective negotiation with the part that did need to speak with me immediately, the message lacked the hallmark of ambivalence that comes with sharing internal conflict with someone else. The needs of each part were, at that moment, still not negotiable enough to be held as openly shareable conflict in a phone message, so even though the presence of each self-state could be felt in the message, the synthesizing of conflict resolution with the processing of dissociative enactment awaited the relational context of the session to take place. And it was through what took place in this session that dissociation was most allowed to not only demonstrate what Schore (2003b) writes about as its paradoxical dual role, but also demonstrate that, as with any enactment, there are always “not-me” self-states of the analyst/therapist that are likewise enacting their dissociated presence. So it was with an analyst/therapist named Bromberg who was then fortunate enough to meet a twosome named PB and Claudia.
We stopped trying to figure out the psychoanalytic truth. We freed ourselves from our dissociative cocoon when Claudia could feel what she needed from me, and I could feel my own need. And it was not about whether I should have returned her call. It was about each of us needing something from each other—something that transcended concrete behavior. Claudia needed me to experience an urgency to which she could not yet claim the right—an urgency that her need for me to return her call would be felt by me and thus have relational legitimacy—regardless of whether or not I did return her call and regardless of whether I “wanted” to do so. The issue with which we were struggling was in “feeling into” one another (state-sharing) while feeling co-equal legitimacy in having minds of our own—each mind holding and expressing its own reality without experiencing as “alien” the reality of the other.
Let it be clear, however, that the co-created relational space that we came to share was not, nor could it ever be, identical for each partner because individual self-state truths continue to contribute to self-experience. What mattered was that the self-state subjectivities of neither person were alien to the self-state subjectivities of the other.
I hope I have been able to convey the strength of my conviction that in psychotherapy, the freeing of joy in being “all of one’s selves” is an accomplishment of its own. Claudia’s private joy was a needed aspect of what enabled her to share it with me, but for her to undertake such a public journey of her private self, Claudia and I had to discover together the unspoken parts of her phone message as they existed in the subjectivities of one another. What we discovered was that the message only indirectly had to do with her brother’s abuse and her mother’s indifference. Although as time passed, both of those experiences became more and more emotionally vivid and consciously discussible, the “message” that mattered most was not to her mother but to me.
Why so? Because accessing early trauma is, at its heart, personally relational: It does not free patients from what was done to them in the past, but from what they have had to do to themselves and to others in order to live with what was done to them in the past. This is why I argue that the therapeutic context for Claudia was in her relationship with me, and only indirectly with her mother or brother, and that the affective and cognitive access to her childhood trauma of nonrecognition became a useful addition, but not a prerequisite, for what took place.
Ultimately, the most salient message was what Claudia became more and more able to communicate to me in a variety of ways: “You have the right to not always give me what I need. I have the right to have all parts of me recognized. I now claim that right without feeling flooded with dread.”
Because Claudia was attuned to my right-brain self-state processes while I had access only to my dissociated left-hemisphere verbal channel, what she was affectively communicating about her experience of me was making me increasingly uncomfortable because I could not experience my own “strange” feelings and thoughts as part of what was taking place between us.
I had been experiencing myself as the all-accepting “doctor” and was connected to Claudia by my earnestness to deliver the “right” formulation. The problem wasn’t that I believed my formulation was a good one, but that I needed to experience myself as only “the good doctor” in order to remain dissociated from my own “not-me” self-states that held the negativity in my experience of Claudia—a person I was there to “help.”
In Claudia’s piece of the enactment, she was procedurally communicating her “not-me” negativity, making me increasingly uncomfortable because it became harder and harder for me to dissociate my discomfort—which was being generated by my reciprocal negativity toward her, even though the source of my discomfort remained dissociated. Yes, we were in what I call a dissociative cocoon, but what makes this vignette especially interesting, especially with regard to Allan Schore’s work on state-sharing, is that Claudia’s evolution of self–otherness had already made room for enough healing and growth to use the cocoon not only more flexibly, but in a joyous and robust way of which I did not know she had become capable. She herself was in charge of it, and my pleasure in her pleasure may have been the most powerful part of what led to the “nearness of you.” Our relationship continued to develop in newly evolving ways, but I especially like sharing this vignette in this chapter because it allows me to revisit the experience of how state-sharing comes about: not as a burst of extraordinary mutuality that has always been there and eventually is “uncovered,” but through being earned together in a process of healing and growth that belongs to both of us.
The words with which I ended “The Nearness of You” (Bromberg, 2011a) as the final chapter of The Shadow of the Tsunami will serve, in an equal way, as a personally warm goodbye to my readers here:
The link between the legendary 1937 song, “The Nearness of You,” and what some now call implicit relational knowing needs few words to explain it. And even though I love Allan Schore’s concept of conversations between limbic systems, I prefer the wording of Hoagy Carmichel and Ned Washington. When they wrote the “The Nearness of You” they already knew that “It’s not your sweet conversation / That brings this sensation, oh no/ It’s just the nearness of you.” (p. 186)
Notes
1. Winnicott writes that as a “patient begins to become a whole person and begins to lose her rigidly organized dissociations, she becomes aware [because] she has a place from which to become aware—of the vital importance that fantasying has always had for her” (1971, p. 27). He then goes on to offer what I feel is one of his most brilliant insights. He states that at the same time this is happening, “the fantasying is changing into imagination . . . [and that] the big differences belong to the presence or the absence of a dissociated state. In the fantasying, what happens, happens immediately, except that it does not happen at all” (p. 27, emphasis added). In other words, the person that is being experienced while fantasying is dissociated from the “me” that is having the fantasy, and is essentially “someone else.” It is to this “someone else” that, just as Winnicott says, what is happening is happening immediately, except that it is not happening at all. It is “not happening at all” because the self that is having the fantasy at that moment cannot imagine it as “me.”
2. To reduce the possibility that I may be misunderstood as if I were speaking about the cited authors of the epigraphs, I wish to clarify that such is not the case and that any perceived similarity is unintended. The words in the second epigraph, a direct quotation from Jennie Gerhardt, are spoken in the novel on behalf of the title character whose wisdom and loving generosity are being misinterpreted as naive innocence. Could Dreiser personally have identified with Jennie? Possibly. The first epigraph is attributed to a celebrity. As such, its sensibility as well as its language are inseparable from public image, making it not simply possible, as with my marginal knowledge of Dreiser, but almost unavoidable that it would have a degree of influence on my imagination. However, for me to draw upon this issue in either epigraph would take the chapter too far from its purpose, an outcome which is indeed avoidable.
3. My most explicit foray into the topic of the uncanny (Bromberg, 2011a) was in the context of a phenomenon I call “the nearness of you,” to which I return in greater detail later in this chapter. Right now, I want just to mention an article to which I had given special attention: “Beyond Intersubjectivity: The Transpersonal Dimension of the Psychoanalytic Encounter” (Tennes, 2007). In it, the author links the therapist’s internal experience of uncertainty to “a model of selfhood that resists the need for certainty,” and proposes, as do I, that “self and other, subject and object, both are and are not separate” (p. 514). Most centrally, Tennes argues that “as our clinical technique takes us further into intersubjective territory, we are encountering realities for which we have neither language nor context” and that “we discover that they deconstruct in profound and perhaps destabilizing ways, our notions of self and other” (p. 508). Citing research by the biologist Rupert Sheldrake (1999, 2003), Tennes states that Shedrake developed “a theory of the ‘extended mind,’ which he links to already existing field theories in physics, mathematics, and biology. Our minds, he proposes, are not confined inside of our heads, but stretch out beyond them through morphic fields” (2007, p. 508n).
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