23

Summary: Toward a Form of Psychotherapy that Integrates Nonconscious Practices

The last chapters of this manual describe behavioral and mental practices that unfold outside of the field of consciousness, while shaping it at the same time. These mechanisms are not unconscious (in the Freudian sense), but nonconscious. The therapists of today try to find ways of incorporating these mechanisms into psychotherapeutic methods. To show the problems that the psychotherapeutic community is trying to resolve, I propose that you imagine yourself as the psychotherapist of an adult who had a mother a bit like the ones described by Beebe and Tronick and who presents symptoms that make you think of an adult version of the problems described in their studies of depressed mothers. The fact that there is not an equivalent body of research on the relationship with the father is truly embarrassing for the practitioner. In some cases, it is possible to transpose the data on the dyads with depressive mothers onto a dyad with a depressed father. This solution is sometimes useful and fruitful, but never really satisfying.

The leap between what a patient can recall and the speculations based on research carried out on others are immense. There is the risk of imposing a hypothesis on the patient, of imposing an explanation as a belief that will then grow in his intimate associative system. This is not the aim of body psychotherapists. When they describe an explanatory hypothesis, it is with the hope that it can be explored as a possibility; and that this discussion will integrate itself into the co-conscious experience that structures itself in the process of psychotherapy, by activating insights in the patient. Often the psychotherapeutic process will show that these hypotheses only become partially relevant once they have been modified to fit the patient’s experience. In other cases, the therapist and the patient may discover that they are not relevant, or at least that they cannot be integrated by the patient. One should never forget that a hypothesis, even when it is based on robust research, cannot be relevant for everyone.

Even so, it is no longer possible to ignore all of this research. It can be used by a psychotherapist to explore the nonconscious practices of a patient. I take, for example, Beebe’s model, which postulates that auto-regulation and interpersonal regulation form a single communication system. An ancient communication system of the patient can find ways of reactualizing itself in a psychotherapeutic process. Once this has occurred in my practice, I can sense the impressions that are associated to this old communication system. I then try to analyze the atmosphere that permeates the room when the patient sits down, our respiratory reactions, the gurgling in our bellies, and I remain attentive to the changes in the quality of the patient’s skin and eyes. I use dreams to integrate, with the imagery produced by the patient, what is being woven. Sometimes the patient brings me films or photos with which I shore up my hypotheses. Little by little, a certain common material is constructed with the patient. It allows us to build a network of hypotheses about the way the patient’s nonconscious practices constructed themselves in a manner difficult to identify. The infant experienced, reacted; but the infant could not build representation of the grand lines that his organismic development was designing. In hindsight, the adult experiences himself living for decades a certain number of situations that resemble one other. However, the nonconscious mechanisms take such varied forms that it is sometimes difficult to pinpoint what repeats itself. Gradually, this process progresses in resonance with the affective and bodily experience of the patient while the dreams allow the organism to generate more pertinent and illuminating metaphors. Sometimes new memories emerge. Without our truly knowing how, when such a process is pertinent to a given patient at this moment in his life, decisions are made and behaviors fluctuate, and then take on a new equilibrium. These changes also bring their share of information that allows us to calibrate the psychotherapeutic process.

I stop here with regard to these new explorations, for it consists of clinical research in progress, about which it is too early to draw conclusions. We shall see more clearly when more case analyses of this type of approaches are published.