Psychic Song and Dance: Dissociation and Duets in the Analysis of Trauma

Abstract

The author offers observations on the nature of pathological dissociation, emphasizing the compartmentalization of unsymbolized affective experience. The irrelevance of personal agency and intentionality in the pathogenesis of dissociative psychopathology along with the deficiency in symbolization that is a sequela of trauma present special problems for traditional as well as for Relational approaches to technique. To a significant extent, “technique” must be replaced by the analyst’s way of being. The author posits, as metaphor and model for this way of being, a notion of “psychoanalytic duets” occurring in the realms of both prosody and action—song and dance. An extended clinical vignette is presented to illustrate these ideas and to point toward a transformational effect of this kind of duetting.

Keywords:

• Dissociation
• trauma
• technique
• pre-symbolic
• pre-intersubjective
• duets
• following
• enactment
• non-verbal communication

Notes

1 The Relational “school” is a major exception to this assertion; much has been written (e.g., Bromberg 2011) about technique by members of this group. But I believe that their emphasis on working with the here and now relationship and their grounding in an intersubjective conceptualization of experience can lead implicitly to a focus on formulated experience and, therefore, to a relative neglect both of unrepresented affect (Grossmark 2012a) and also of the foundational experience of isolation (McGleughlin 2015) in all traumatized patients.

2 I am distinguishing pathological dissociation from the distraction achieved in hypnoid states, which are reversible forms of self-hypnosis and, as such, do imply important elements of agency, intention, and defense.

3 I am using the term “traditional” to highlight differences between interpretive approaches and other ways of working with traumatized patients. I mean the term “traditional” to refer to techniques designed to serve goals of treatment when issues of intrapsychic conflict and hidden meaning are fundamental. Important among these latter techniques are transference, defense, and “resistance” interpretation. I realize, of course, that no technique exists in a pure or monolithic form and that any technique must be flexible enough to allow adaptation to individual need. In addition, while I am also referring to traumatized patients as if they might somehow be members of a homogeneous category, of course, they are not. There are as many different kinds of traumatized patients as there are traumatized patients, who function simultaneously and alternately at multiple levels of psychic organization and with varying ability to symbolize experience.

4 Enactment is, of course, simultaneously an important medium of impasse and re-traumatization.

5 Bromberg (2011) suggests that we are probably in the midst of a major paradigm shift. He describes this, in part, as a shift “…from the primacy of cognition to the primacy of affect, and a shift away from (but not yet an abandonment of) the concept of technique” (p. 126).

6 The reader can hear this duet at https://www.youtube.com/watch?v=QMM3UVLEjY4.

7 I am grateful to Dr. Adam Blum for this “reading” of the vocal performance and for his help in understanding certain aspects of music theory and musical dynamics related to my clinical notion of “duetting.”

8 I encourage the reader to listen to this song, focusing, not on the lyrics per se, but on the relationship of Harris’ voice to Parsons’.

9 It is not clear to me if John was aware of my dawning realization that I had killed him. I think he was not; if I am correct this supports my argument for the importance of non-symbolic communication. It is, of course, possible that he was aware of it and that the observed therapeutic effect also had something to do with an implicit communication (interpretation) of meaning, not only with a sharing of pre-symbolic experience. The activities of “duetting” and interpreting are not mutually exclusive and each is necessary at different times with traumatized patients. I have emphasized the role of duetting because of analysts’ inclination to overvalue symbolic functioning.