METAPHOR CAN TAKE MANY SHAPES OR FORMS and heralds change. Its emergence, in whatever form it takes, leads to a greater understanding of previously unprocessed feelings. It seems that such feelings may pressure the patient from within to find some way of expressing them, of putting them “out there,” so to speak, so they can be felt, processed, and integrated more easily. In an early therapy session one patient, whom I have called Peter (Wilkinson, 2007a, p. 325), brought a vivid, visual metaphor that captured his early trauma. He had managed the distress that he was experiencing over the weekend break by spending his Saturday making an Advent calendar, and he brought it to his next appointment. It was a picture of a frozen land of ice, with a few small dark pine trees, the only hint of color in the landscape. In the center of the picture loomed a huge stag, dominant and aggressive. Almost hidden behind the stag was a tiny baby deer. Such a vivid, visual metaphor both arose out of and stimulated right-brain activity concerning feelings, lodged in the implicit, as we began to think and talk about the picture together.
The picture affected me deeply as I sought to be available to the feelings that the patient wished to communicate in this metaphorical way; I felt chilled, and deadness was provoked in me by the utter desolation of the gray and white wasteland of the patient’s internal world that confronted me. As we began to talk together both of us were seeking to engage with the novel metaphor that the picture presented. I wondered out loud why the patient might have found himself choosing that image; very quickly the patient began to get in touch with sad and frightening feelings that he had not been able to explore with me before. He explained that as he looked at the picture with me he felt frightened that the little Bambi might not survive for long after losing its mother to the hunter. I immediately thought of the verbal connection with bambino or child, only to find my patient explaining that he had just that moment thought that for an Italian, Bambi must mean child. The fast unspoken processes of empathy enabled such connections in our minds, and neural integration was fostered as we were able to speak about these feeling-toned ideas together. The patient began to realize that he himself had felt quite young as he had sat making it, perhaps about 8 years old. He did not yet relate the scene he had portrayed so vividly to his own early trauma, but I began to realize that deep inside this patient there was a defensive, frozen self state and some crucial early loss.
In later sessions it became clearer that this frozen state had arisen through the very early loss of his mother and the difficult interactions that had dominated his experience of his father, who, overwhelmed by his own loss, could not allow himself to draw close to his son. It had been further compounded by the deep loneliness he often experienced when sent away at boarding school at 8 years old. Although he was told he was privileged to go to boarding school, he felt he must have done something wrong to be sent away when other children went to day school and got to live at home.
In the early session when he first brought the image, I sought to engage with my patient so that we might begin to explore what this image meant for him. In so doing I was beginning to understand my patient’s personal use of metaphor, and I began to gain insight into the dynamics of his internal world. It took much longer before the patient began to risk the pain that attaching to another might bring. Right-brain activity was dominant in so many aspects of this early exchange. In this early stage of therapy the patient was relating to early feelings, early self states; such experience was enabled through engagement in an affective relation to another. One might say that feelings dominated the therapeutic picture at this stage, but in a wholesome creative way that contrasted with the threatening stag, enabling “the processing of the nonsalient meanings of the novel metaphor” (Mashal et al., 2007, p. 115), inviting a changed sense of self through a new safe affective experience with another.
Metaphors can emerge to capture and convey our earliest experiencing. Cozolino (2006) comments: “Abstract notions are tied to our bodies through metaphor, thus connecting our minds to the world through the experience of our bodies” (p. 73) and suggests that “our ubiquitous use of physical metaphors to describe our inner experience may also betray the sensory-motor core of both our subjective experience and abstract thought” (p. 190). Pally (2000) observes that “by containing within them sensory, imagistic, emotional and verbal elements, metaphors are believed to activate multiple brain centres simultaneously” (p. 132). Metaphor stimulates brain activity and facilitates change and development in the mind-brain-body being. Levin (1980) suggests that metaphor is a particularly effective medium for the therapist to use for transference interpretation because “metaphors cross modalities: they relate one sensation to another and the various hierarchical levels of experience to one another” (as cited in M. L. Miller, 2008, p. 11). Bucci (2001) notes that affective engagement with the therapist may call forth imagery that is as yet unrealized to a patient who is still working at a subsymbolic level. It seems that metaphor has a dual role to play in therapy for at these times the sensitive use of metaphor by the therapist, as well as a careful entering into and exploration of metaphor offered by the patient, will facilitate change.
Proto-Metaphor
How does our powerful response to metaphor arise? Perhaps it may emerge from a child’s earliest experiences. Schore (2002) describes the mother’s face as “the most potent visual stimulus in the child’s world” (p. 18). Jacques was the first child of a couple in their 30s, whom I observed weekly from 6 weeks to 2 years of age (Wilkinson, 2006a). At different stages of development Jacques used a Venetian mask, a large vividly colored toy parrot, and a long-linked necklace, both to stand for his mother and to help him process difficult feelings in relation to her.
• At 2 months old I noted that Jacques tracked his mother with his eyes and that often when she left the room, he would look at a painted Venetian mask of a woman’s face that hung above the sitting-room door, seemingly as a way of holding on to her image in some way, albeit displaying some distaste for it. His eyes would meet his mother’s on her return, and he would lall and gurgle to her in delight as he “found” her again.
• Later, around the time that solid foods were being introduced, Jacques was given a large, brightly colored toy parrot. It hung on a perch just near the high chair in which he was fed. It seemed that for Jacques it was an exciting object that could also suddenly become scary. On at least two occasions it seemed that the moment at which it became scary coincided with the moment that Jacques was offered a bright green soup, which he tasted, then made absolutely clear that he didn’t like. I have wondered about the fact that the predominant color of the parrot was also bright green, and that Jacques’s mother also often chose to wear green. Was one standing for the other? Was the color a link that made this association possible in Jacques’ newly developing mind?
• At about 1 year old Jacques used to like to play with a long, silver chain that I wore often when I visited. One day his mother was called away unexpectedly and we were left alone together for almost an hour. His mother had rarely left him for that long. He played with the chain almost the whole time, so much so that I marveled at his concentration. He sucked the chain, held it up, looked at it inquiringly, and chewed on it again; he salivated copiously as he did so. When his mother finally returned, he took a long look at her, then threw the chain to the floor, no longer needing to substitute an object for Mother once his real mother had returned and was once more available. It seemed that my chain had become a link to Mother, on this occasion enabling him to allow another to stand in for Mother in her absence.
In using metaphor we are allowing one thing to stand for another, and in Jacques’ way of managing here, I felt I was seeing the beginnings of the capacity for metaphor and symbolization. It seemed to me that each of these instances might indicate the beginnings of Jacques’s ability to use one thing to stand for another, the ability to use a transitional object in the way Winnicott suggested (1975a), and the ability to think symbolically, to use what might be thought of as proto-metaphor. These instances seemed to represent a very early stage in the development of mind that becomes possible through interactive experience with another mind; interactive experience with his mother formed an integral part of Jacques’ experience in these sequences. Fosshage (2008) emphasizes the infant’s very early ability for nonverbal symbolic processing in all sensory modalities and understands this as a precursor to thinking, which he terms “imagistic thinking.”
As we observed earlier with Naja (Chapter 2), research indicates that 2-month-old infants stimulate what, in the left hemisphere, will later become their language network by looking at their mother’s face (Tzourio-Mazoyer et al., 2002, p. 460). From my observation with Jacques it seems that this interactive process also fosters the capacity to symbolize, to use metaphor, in effect, to facilitate the early development of mind.
Neurological Substrates of Metaphor
Although basic language functions are associated with the left hemisphere, a plethora of research studies is beginning to show considerable involvement of the right hemisphere in the processing of metaphor especially when novelty, creativity, and imagery are involved (Faust & Mashal, 2007; Mashal et al., 2007; Mashal & Faust, 2008). Right-hemisphere specialization in the very early stages of processing emotionally charged words has been established (Ortigue et al., 2004; Atchley et al., 2007). Mitchell and Crowe (2005) outline a bihemispheric theory of the neural basis of language, noting that some language functions, including metaphor, are mediated by the right hemisphere rather than the left (Mitchell & Crowe, 2005, p. 963). While familiar, conventional metaphors (e.g., “food for thought”) are processed as part of regular left-hemisphere language functioning, an fMRI study of the neural correlates underlying the processing of novel metaphoric expressions (e.g., revealed “stronger activity in right posterior superior temporal sulcus, right inferior frontal gyrus, and left middle frontal gyrus…suggesting a special role for the right hemisphere in processing novel metaphors” (Mashal, et al.,2007, p. 115).
The significance for the therapist is that, as Fosha (2003) reminds us, “emotional experience is not processed through language and logic; as the right hemisphere speaks a language of images, sensations and impressions…therapeutic discourse must be conducted in a language that the right hemisphere speaks” (p. 229). Of course a metaphor that is conventional for one may be novel for another. Discussing metaphors with an American friend proved enlightening; as we talked on the telephone I remarked that it was “raining stair rods,” a familiar phrase in the North of England but one that I found had not crossed the ocean to California, whereas “raining cats and dogs” was a familiar metaphor to us both. This seeming digression makes clear that in choosing what metaphorical speech to use the therapist must listen carefully to the patient’s language, for the metaphors that will be most likely to effect change in the patient are those that are developments of the patient’s own use of novel metaphor or those that are new to the patient and are therefore stimulating. Loker (2007) also points out that
a metaphor that is used in the waking state in verbal form can also be used in dreams in pictorial form, because the mode of cognition and language of the unconscious, or of the right brain, which produces dream thoughts, is believed today to be concrete-analogic and is the source of both dream thoughts and waking metaphors. (p. 44)
Evolving Symbolizations
Evolving symbolizations (such as those contained in Holly’s series of dream pictures [see Chapter 5]) often emerging in the form of novel metaphors, have long been established as indicators to the therapist and the patient of progress in the healing process. The activation of the implicit in this way requires connection at a deep emotional level. What emerges may be healthy early experience, too early to be available to explicit memory processes, but the result of healthy early dyadic experience. However when early experience has been traumatic, what emerges from implicit memory will have a very different quality to it; being born of deep uncertainly and insecurity, it will be defensive and dissociated. As the therapy develops so symbolization evolves, with damaging early experience beginning to be modulated more by deep emotional connection with another than by cognitive, linguistic processing. Inevitably, as material from the implicit emerges, the left hemisphere has a role to play in the process of putting the images into words, which then become available to the processes of explicit memory storage and retrieval. Cozolino (2002) suggests that language combined with emotional attunement is “a central tool in the therapeutic process; it creates the opportunity to blend words with feelings, a means of neural growth and neural network integration” (p. 210). Nowhere is this experienced more powerfully than in the realm of emergent metaphor, when a patient haltingly struggles to express the feelings that have emerged in a picture, dream, or image.
M. L. Miller (2008) emphasizes the importance of Levin’s understanding that emotional memories are encoded in “multiple hierarchically ordered levels of experience, with the lowest level being various sensorimotor schemas that organize sensory and motor experience.” Higher levels become more complex with “sensorimotor qualities but are also amenable to symbolization,” and the final layers are those that are “amenable to verbal symbolization” (p. 10). Defensive dissociative processes may mean that layers don’t interact easily with one another and that movement through layers becomes blocked. Two patients who suffered severe relational trauma before they were 5 years old independently described how they had, as children, developed a way of being in which they retreated into hectic motor activity whenever circumstance triggered any possibility of recalling their traumatic early experience. One told how in later life she had become a sculptor and had realized that she had chosen this field, and enjoyed it, because it was such a slow motor process that she could actually feel its calming effect. She produced work that she was later to realize was deeply symbolic of her early trauma. At the time, the pieces were made without any conscious understanding or ability to make links, far less to verbalize her experience.
Case Example: Clare
The gradual development of the ability to move more easily from primitive levels of functioning can be seen in material drawn from the treatment of Clare, a successful businesswoman, whom we met in Chapter 1. I have written elsewhere about Clare’s description of the similarities and differences in the initial transference to her therapist in her two experiences of therapy, a transference quality that emanated from her early relationship with her dominant, aggressive, and persecutory father (Wilkinson, 2007b). When we deal with the interactive regulation of implicit memory products, we are by definition dealing with material so early, or so traumatic, that it cannot easily be brought to mind, the unconscious emotional exchange within the analytic couple may be used as a means of knowing and understanding the otherwise unknowable and inexplicable.
Early Therapy: Amygdalar Terror Emerging in Metaphor
Clare’s early therapy could easily become dominated by an experience of her male therapist as the archetype imbued, hostile, persecuting, destructive monster; all too frequently the therapist carried the projection of her internalized destructive and persecuting father, or rather the destructive, persecutory aspects of her own inner being that were so hard for her to contemplate. At these times Clare would feel herself freeze; it was hard for her to hold on to the reality of the gentle, enabling person that she knew this therapist to be at other times. She remembered her father as the terrifying person who would summon her to his study to berate her for her shortcomings. In retrospect, her own anger, which she would later describe as manifesting a desire to “hammer home” her point, was as yet totally inaccessible. Clare felt that both of us worked with her in a containing way but nevertheless her first therapist, a man, could easily be experienced as “a monster,” a fearsome black beast, in a moment. At such times she would become so anxious that she imagined that she “saw” a tall, monstrous black-cloaked figure whom she felt would tear open her chest, almost like a surgeon pulling apart the two sides of a patient’s ribcage, to remove her heart. Later she felt that this image was the beginning of her awareness of the overwhelming anxiety and bodily fear that she had experienced as a child in the presence of her father. In a way the process symbolized her terror of her father’s attempts to open up her mind, her terror of him finding, yet again, that she was inadequate, that there was not enough knowledge inside her. But it also carried the knowledge that the therapist, the surgeon of the metaphor, was trying to help. Clare’s metaphor captures something of the pain involved in opening up one’s mind in this way and of the therapist trying to help with difficult early experience that is hidden inside and affecting all aspects of the patient’s functioning—just as the surgeon seeks to repair the heart, buried deep inside the patient, yet influencing every aspect of living and being.
Second Stage of Therapy: The Emergence of Shame-Related Metaphor
In the beginning of her work with me, Clare struggled with her experience of me as the condemning parent analyst. We found ourselves grappling over and over again with the effects of shame, the neural substrates of which are formed in the second year of life (Schore, 2003a, 2003b). Healthy early experiences of misattunement, permitted by the parents at a manageable level for the toddler, lead to an acceptance of difference, a growing awareness of the other, and enable the development of the capacity for socialization (Stern, 1985). However, when the rupture in attachment caused by shaming has been frequent, prolonged, and unmitigated by experiences of repair, the neuronal pathways for self-hate and fear of the other become strongly established and the other becomes a source of terror and dread rather than a source of supportive relationship.
After working together for a while, Clare gradually became able to trust me a little, and sometimes I seemed to become more human, more accessible as a real person. But nevertheless her internalized critical father was still waiting in the wings to be experienced through me as a severe critic, as the “one who often summoned her to the door of his study to berate her for her shortcomings, often adding as a veiled threat, ‘And I don’t even have to touch you to break you’ ” (Wilkinson, 2007b, p. 355). Badenoch (2008) observes that “shame-imprisoned people say that it feels intolerable to be visible, to be known, because of the hateful core they perceive within themselves” (p. 105). At this stage at the best of times it was difficult for Clare even to speak in sentences. She would begin, hear her father’s condemning voice in her head, interrupt herself; begin again, only to stop and start on a new tack. I would wonder whether to finish the sentence for her, whether this would make her feel even more inadequate or whether my silent waiting would be damaging, seeming to her like a critical, condemning father. This pattern of interrupted speech happened again and again as the internal persecutor condemned each new attempt to express herself. Her particular form of wordlessness was the most striking feature of her state of being at these times, as she became dominated by right-brain functioning, by deeply held ways of being and behaving arising out of the traumatic quality of her earliest relational experience, lodged in implicit memory. At this stage it seemed that I might be experienced as a frighteningly sadistic figure at any time. Clare, it seemed, would slide away from me, much as she had tried to slide away from her father’s summons to the door of his study. If there was anything that was too difficult to talk about, particularly if it involved a task at work in which she felt she might fail, she would begin to miss her sessions. If she did come, her body language and the sliding of her gaze away from me told me that she could barely bring herself into the room, for fear I would actually become the critical, controlling person that deep down she feared I might be. At these times the image of her father shouting at her as she stood fearfully at the study door became a metaphor for her fear of my anger, the anger of those that she found difficult at work, and most of all for her own rage, which lay buried deep within her. At such times as she sidled in, I would have almost a physical sensation of having grown very tall and that she had become someone much smaller than me. It took many experiences spread over time for her to trust that I might not want to attack her, that I might not see a failure but the very competent and pleasant woman she actually was.
One of her worst memories was of the remedial English exercises that her father forced her to do for what seemed like hours on end every evening. She always felt that her efforts fell short of her father’s standards, and each time she would feel she had failed yet again and further displeased him. As one might expect, situations at work that involved creative writing were probably the most difficult for Clare, especially when appraisal, assessment, or examinations were involved. Clare had to struggle with herself not to slide away from the task, not to leave it undone rather than risk failure. When she undertook such work, she would begin the task only to cast what she had done on one side, begin again, cast it away again and begin again, over and over, writing and rewriting, haunted by the ghost of her father standing once again at his study door.
Clare brought vivid memories of endless sessions with her father commandeering the blackboard, easel, and chalk, which her aunt, who was a painter, had bought her when she had noticed Clare’s artistic ability. Instead of providing a chance to explore her creativity as her aunt had hoped, the blackboard became associated with failure, with her inadequacy when faced with the long sums written on it for her to solve as her father attempted to improve her arithmetic. Years later she only had to touch chalk for her hands to break out in allergic eczema—a tendency that abated only after she had worked on the experience in therapy. Gradually she became more able to risk engagement with me through the shared exploration of these internal images, such as the monster, the surgeon and the angry father, which she haltingly became able to verbalize. As she did so the process helped her to understand her difficulties with both her external father as a child and her internal father, the stern critic, the one whose legacy meant that she also had to grapple with her own anger and her tendency to hammer home the point with others.
Third Stage of Therapy: A Sense of Safe Relationship
Why and how did Clare come to experience our relationship as safe? I think Clare would reply that it was the experience, over time and on many occasions, of a nonretaliatory other who sought to understand her apprehension rather than condemn her before she started. It seemed that through the medium of nondirective psychodynamic psychotherapy she was gradually able to encounter me, another person, separate but with whom she could engage at a deep affective level and with whom she was gradually able to experience a sense of safely rather than of threat. Gradually new neural pathways began to build that permitted more comfortable and comforting states of mind. I gradually found my eyes meeting not eyes that slid away but eyes that seemed to peep up at me, at first timid, and then, after a while, I became aware that I had lost the sense of a smaller person. Gradually I noticed hints of laughter and humor in eyes that dared to hold my gaze as an equal and in an adult way. The eyes have been shown to be the most direct route for recognition of mental states and emotions in others (Baron-Cohen et al., 1997, Baron-Cohen et al., 2001; Hirao, Miyata, et al., 2008). This is often particularly true for patients who have learned vigilance through repeated traumatic experience; the young child may learn early to read the mind of the abuser in his or her eyes. A child or indeed an adult patient with this sort of early experience may need to be able to look and look away, to gaze and be free to break the gaze. I have chosen here to write briefly about the eye contact that Clare made with me at this stage, about the eye talk that leads to “I” talk (Solomon, personal communication, 1999). I could equally well have written of changes in body language, changes in the content and emotional tone of the material the patient chose to bring.
Evolving symbolizations may emerge in a series of pictures or dream images, which I understand as emergent metaphor, one thing gradually being revealed as standing for another and carrying with it the capacity to enable change into a more mature state of being (metamorphosis). Such metaphors stimulate brain activity in a more thorough way; such processing, utilizing as it does brain plasticity, brings with it more possibility of change than any other form of human communication (Pally, 2000). Sometimes a series of images will emerge close together over a very short period of time. As such they seem to indicate a crucial point in the therapy, usually where a difficult emotion, previously held only in the body, is beginning to be able to be known as a recognizable feeling for the first time. Sometimes the series will be spread over time and will contain frightening images which as the therapy progresses metamorphose into something more human and accessible. In Clare’s case what started as a frightening black monster changed to the father who regularly summoned her to his study and berated her as she stood at the door, to the therapist who seemed to argue with her and finally became “the one who I can discuss difficult things with and know that my point of view is heard.”
Neural Substrates of the Metaphorical Aspects of the Dreaming Process
Emergent metaphor has long been one of the most powerful vehicles by which the self may achieve greater integration, and nowhere is this effect more marked than in work that emerges from the dreaming process. Grabner et al. (2007) note that the functioning of the right hemisphere in its more free-associative primary process (which we may associate with emergent metaphor) has much in common with the states of dreaming or reverie. Bar-Yam (1993) suggests that during sleep the mind-brain is active but is mainly isolated from sensory neurons and therefore from sensory input. He speculates that during sleep the mind further subdivides into isolated neuronal groups and that this makes possible the breaking up of experience from the waking period into pieces that become the building blocks for creative learning and enable adaptive response to future circumstance. The role of the zif-268 learning gene in rapid eye movement (REM) sleep is emphasized by Rossi (2004) who draws our attention to animal studies of REM sleep in which this gene is expressed after the animals have been allowed novel, enriching experience, and that as a result of this gene expression new neural pathways develop. In humans it seems that one result of such processing is that, through metaphor, the unconscious is conveyed to consciousness. Thus dreaming, arising from sleep that is a fundamentally dissociative state, may yet be said to revitalize the mind-brain in an associative and integrative manner.
Many researchers now adopt a stance that understands dissociation from a broader perspective, embracing not only the unusual dissociative phenomena at the extreme end of the spectrum that present in dissociative identity disorder (DID) or in complex cases of posttraumatic stress disorder (PTSD), but also understanding the sleep process as an essentially dissociative state of mind, and all dreams as dissociative phenomena. Such a view considers the dissociative strategy to be part of the normal functioning of the mind-brain as it screens out the nonessential in order to maintain optimum functioning. Our concern as therapists is often with the negative aspects of dissociation; in the dreaming process, a dissociative phenomenon, we are able to make creative use of our understanding as we work with the metaphorical aspects of remembered dreams.
As early as 1910 Prince suggested that dreams had more in common with dissociative phenomena than with repression. His views did not find favor in the Freudian community at the time and were refuted by Jones, in particular (as cited in Gabel, 1990). Jung, however, took a stance concerning dream content that was much more in keeping with current theory concerning dissociation. He understood dreams as the compensatory products of the unconscious that sought to help the dreamer to understand aspects of his or her own inner world of which he or she was not yet aware and which would be helpful. Jung (1946a) commented: “Dreams do not deceive, they do not lie, they do not distort or disguise, but naively announce what they are and what they mean…. They are invariably seeking to express something that the ego does not know and does not understand” (par. 189). He felt that dreams put the dreamer in touch with aspects of his or her inner world, which were currently unavailable to the conscious mind, through the metaphorical images that they contained. While Jung felt that initial dreams were “often amazingly lucid and clear-cut” (1934c, par. 313), he understood every dream to be essentially integrative in nature, bringing dissociated aspects of experience into conscious mind.
Hartmann (2000) has argued that a dream offers “the explanatory metaphor for the dominant emotion or concern of the dreamer” (pp. 69-70), and Mancia (2005) has suggested that the function of the dream is to create images that are “able to fill the void of nonrepresentation, representing symbolically experiences that were originally presymbolic” (p. 93). Dreams can be understood as metaphors that enrich the mind-brain, in an associative, integrative manner (Wilkinson, 2006a, 2006b).
At the early stages of life the affective experiences captured in these vivid visual and emotional “pictures” are products of right-brain activity, recorded in implicit memory. Mancia (2005) points to the very primitive origin of some dream material; awareness of implicit memory has extended the concept of the unconscious to include the place where “emotional and affective—sometimes traumatic—resymbolic and preverbal experiences of the primary mother-infant relations are stored” (p. 83). As such these will inevitably emerge in dreams. They will not have been encoded as part of an autobiographical narrative that is easily accessible because the hippocampus that tags time and place to memory would not yet have been online. Rather they will remain as part of amygdaloidal memory and will emerge when a stimulus, such as a similar feeling, tone, sight, or smell, rouses them from their long “sleep.” As such they contribute to “the formation of an early unrepressed unconscious nucleus of the self” (Mancia, 2005, p. 85).
The exact nature of the biochemical and regional differences in dreaming from waking states preoccupies many researchers who reach very different conclusions. Hobson (1999) emphasized the role of the cholinergic system in the dreaming process and argued that dreaming activity begins in the brainstem, progresses through the limbic system, finally reaching the medial frontal cortex, while the executive portions of the frontal cortex (i.e., the dorsolateral cortex and the orbitoprefrontal cortex) remain less active. His earlier understanding of the dreaming process as essentially chaotic has been rejected by some prominent critics, who argue that he underestimated the degree of cortical control over the dreaming process (Jones, 2000; Domhoff, 2005), and indeed Hobson modified this view in his later work. Solms (1999) suggested that dreaming is generated by a different mechanism from the one that generates REM sleep itself. He understands the activation of the dopaminergic mechanism to be crucial to the generation of the actual dream in all sleep states. Braun (1999) argues that neither the cholinergic nor the dopaminergic hypothesis will prove to be the sole explanation of the dreaming process but that the pattern of activity may actually be driven by differential patterns of information transfer between cortex and thalamus.
Domhoff (2005) suggests that it is most helpful to consider the features that dreaming shares with both normal waking cognition and waking hallucinatory thinking and to blend that understanding with a thorough knowledge of dream content. He examined several large-scale studies of dream content, all of which failed to find bizarreness and intensity of emotion. He concludes that dreams have more in common with stories than with psychosis (Domhoff, 2005). This approach seems to resonate with the experience of many. Be that as it may, all seem to agree that the dream is in a unique way the expression of the internal, the intrapsychic world of the dreamer (Braun, 1999).
Inevitably expression of this inner world emerges in metaphorical images, which represent evolving symbolizations that may lead to metamorphosis as they are processed in therapy. Metaphors act as windows to the psyche, to the soul, to the self as we work with our patients in the relational encounter that is special to the consulting room.
Case Example: Jill’s Dreams
Jill could not remember her father, who had died in a car accident soon after she was born. Jill was an only child and was very close to her mother when she was young. However, she learned early on that her mother was unpredictable: She might be nice or she might be cross and strike out. Much later, in her teens, she realized that her mother had had a drinking problem from early on, which was part of the reason for her frightening mood swings. When she was almost 4 years old Jill was excited to learn her mother was to marry and that she was to have a new daddy. Recently Jill, now middle-aged, had been wondering what, if anything, had happened between herself and her stepfather when she was a child and could not remember. She was aware of his unremitting hostility, and little else.
Jill arrived in the consulting room in a rather frightened state and recounted the following dream sequence:
I was staying with Evelyn, an old friend in the country, or maybe in her London house. It felt like a main home. I was beginning to lay the table. It was an old, Georgian long table, slighdy rounded at the ends. I shook out the rather pleasing new cloth that was of linen, a rather soft, loose, light weave. Its pattern was a large, slightly oblong check, in soft shades of pink, blue, and lavender. As I placed it on the table what I thought was a dry old lump of excrement was suddenly revealed. I became aware of a further lump on the floor quite near me. I noticed that a small, dark-haired Hispanic-looking man was standing at the far side of the table holding a soft broom. I thought he would clear up the mess, but he walked past me through an open doorway into another room. As he did so he stepped on the dry turd that was on the floor, denting rather than completely flattening it.
Suddenly the scene changed; I had gone onto the terrace. I was at the corner, with my hand on the balustrade, just at the point where there was a narrow, slightly curved flight of steps down into the garden. I seemed to be about to stroke the silver-gray tabby cat that was on the balustrade. Instantly, I became aware of something stuck between the fingers of my left hand, partly caught by my ring. I thought it was a wasp; I was terrified that it would sting me. I looked more closely and became aware of short, rather stiff hair-like whiskers, and then I saw its hard black back. I thought it would stick itself into me. I was horrified; I could find no way to get rid of it. I woke in terror.
Jill’s first comment as she began to explore the metaphorical language of her dream was that she had been wondering if anything had happened between her stepfather and herself when she was a child, in addition to the hostility and verbal abuse that she had suffered from throughout her childhood and had never forgotten. Jill went on to think about the checked tablecloth linking the dream to my consulting room, which had somewhat similar soft furnishings at that time, then she moved quickly back to what she felt had really frightened her in the dream. Later she realized that the table reminded her of the dining table belonging to a happy family that she had known well when she first left home, a family to which she had yearned to belong.
She went on to wonder whether there was a link between the two parts of the dream. She began by saying “I wondered about the dark Hispanic-looking man.” Then her thoughts seemed to move on and she rather tentatively likened the black, hard-backed, bewhiskered beetle to her black-haired stepfather, who had put a ring on her mother’s finger. I asked if he had had whiskers. With difficulty she articulated that the hair seemed to her to be more like genital hair. Jill became distressed at this moment and said that she remembered how as a young teenager she had walked into her parents’ room and had seen her stepfather with all revealed. When she was calm again she went on to say that when she was about 11 for a period of time she had slept in her parents’ room, probably to free a room for her aunt, who had come to stay after an operation. She wondered what she had been aware of then, what that time had been like for her. She returned repeatedly to her terror of the beetle. She thought it might be a reference to her stepfather, but it remained unclear exactly for what it stood. She noted that wasps penetrate with something in their bottom, not with a proboscis, as she had haltingly tried to describe as she explored her fear of the dream creature. Referring to the dream later in therapy she realized that proboscis was the sarcastic joking word used to describe her stepfather’s large nose by her mother. She also wondered whether the little girl she had been had become confused between two different words beginning with p. Later she came to think of the soft female things in the dream, like the checked tablecloth, as not unlike one her mother had and the silver tabby cat rather like the tabby female cat of her childhood home. They seemed to her to be reminders of the lost happy times with her mother, which had quickly become out of reach as her stepfather’s rule became the dominant force at home.
A few days after this dream, she came to a session and told of a frightening incident that had happened the previous evening:
I was in the garden last thing at night. I was aware of a winged insect buzzing fiercely near the glass door, attracted to the light in the porch. I came into the sitting room. I suddenly saw/felt this horrible gray, slug-like object fix onto my thigh; I was wearing trousers but I became absolutely terrified. I was too terrified to shake it off because then it would become loose in the room and could harm me or others. I shouted to the children to keep away. I was frightened it would hurt one of them as much as me. I took my coat and somehow managed to get it off and then stamped on the coat until I was sure I would have killed it. My feelings were panicked, frenzied, out of control rather than being in control of the situation.
Again the actual incident took on a metaphorical meaning for my patient as she returned again and again to the pain and distress of the little girl who could not emotionally withstand the hostility of her difficult stepfather. His fury had penetrated her and made her whole internal world feel unsafe and damaged. She was terrified of anger yet was often consumed with anger.
Jill tried to think what this incident might have symbolized, but the creature remained an unnamable, unidentifiable source of a terror that had fixed on her and might have penetrated her and damaged her. Over time, and through talking to her aunt, it became clear that her memories of her stepfather as verbally and physically abusive were accurate. The aunt had also feared for some while that he was also too intimate physically with his young stepdaughter. Her grandmother and aunt had spoken to her mother, who denied it vehemently, but it was about then that the stepfather’s attitude toward his stepdaughter seemed to change from inappropriate intimacy to the unremitting hostility that my patient had always remembered. The early part of the analysis was concerned with sorting out her feelings about her now-dead stepfather, grieving for the kind stepfather he had never been, while also grieving for the real father whom she had never known. Most of the later therapy and transference centered on the much more complex feelings that this patient had for her volatile and rather tempestuous mother, who loved and hit in turn, who always claimed to love her daughter but who never really managed to convey this love to her or to protect her.
In this period of the therapy, the metaphorical aspects of both dreams and real life happenings were used by Jill to help her to process difficult emotions which had remained locked in her body. The gradual transformation of emotion into feeling that is its mental representation (Damasio 1994, 2003), which was facilitated by this processing, enabled Jill to begin to think about the unthinkable in relation to her early experience and to tolerate the inevitable uncertainly that accompanies this process.
Conclusion
These case histories illustrate the importance of metaphor in helping the therapist and patient explore the quality of leftover affect and trauma caught in body memory, while not foreclosing on the uncertainly and lack of clarity that there is for such patients in terms of their earlier experience. Just as the body never lies and can put us in touch with appropriate affect, emergent metaphor helps us to understand the emotional truth of our inner experience while still tolerating uncertainly. Most importantly, emergent metaphor heralds metamorphosis, the capacity for healthy change in the mind, enabling a more coherent sense of self.