The body and the consulting room's materiality as a path for developing intersubjective psychophysical space

ABSTRACT

The paper explores the therapeutic importance of some structural aspects of the body and the consulting room for integrating primal psychophysical spatiality with children suffering from severe developmental deficiency (mainly autism, but not exclusively). The dominant dimension of those children available for the therapist is their non-communicative corporal organisation and behavioural involvement with physical aspects of the consulting room. The paper introduces the idea of ‘an envelope with openings’, seeing it as an innate multidimensional psychophysical schema. Such a structure fits with the child and the therapist’s body, and characterises the physical aspects of the consulting room. This structural resemblance has the potential of functioning as an intuitive pre-reflective common source for therapeutic communication. It might support the therapist’s somatic openness, crystallise into a countertransference-based corporal communication, functioning as a ‘constitutive intervention’, and thus give organised existence to the primal layer of the child’s experience. This type of intervention invites the therapist to use his body and/or some physical aspect of the room to structure fragmented psychophysical elements into this spatial-temporal embodied schema. Clinical case material from two therapies with children with ASD, and one adult therapy, illustrate this potential, gradually revealing the consulting room as a goldmine inhabited by subjective objects, ready for intersubjective meaning.

KEYWORDS:

• Consulting room
• autism
• child psychotherapy
• psychophysical space
• non-symbolic communication

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

1. Here orifices are considered to be connected vertically, since for the erected homo sapiens it is common to talk about lower and upper orifices; even the upper ones are located vertically – the eyes are above the nose, which is above the mouth.

2. For metonymic, analogical, metaphorical, symbolic or conceptual relation between materiality and phantasy, see (Pollak, 2018, pp. 155–156).

3. The vertical axis refers to the frontal spine as elaborated in Pollak (2003).

4. By ‘texture’, I refer to the fabric of the space in terms of perceptual parameters, such as intensity, quality and friction, encouraging the experiential differentiation between liquid/solid, cold/hot, hard/soft, far/near, in/out, etc.

5. The identities of both Dan and David have been heavily disguised, and the material included in this paper intentionally limited so as not to be identifiable. Mimi, the third patient included in this paper, has given explicit informed consent for the publication of this material. This included being given the opportunity to read the paper, which she accepted.

6. A shield against stimuli (Freud, 1895), a manifestation of the container function (Bion, 1962), a projection of the gathering function of skin, an acknowledgment of an intersubjective envelope (Anzieu, 1990) and more.

7. In Hebrew ‘going’ means both walking and leaving.

8. Her actions reminded me of a baby who, having gained enough motor control to crawl around, voluntarily explores the possibility of proximity and distance vis-à-vis the mother, free from being busy with her subjectivity.

9. In my experience, when therapy comes to touch on the raw level of the body-container, the hammock can be particularly useful even for adult patients.

Additional information

Notes on contributors

Tami Pollak

Mrs Tami Pollak is a clinical psychotherapist and supervisor in a private clinic and in a day care unit for children with ASD. She teaches on the ‘primitive mental state’ track of the psychotherapy programme at Tel-Aviv University, Israel, and has a PhD in integrating psychoanalytic object-relation metapsychology with French phenomenology. Mrs Pollak has published the article The body-container in the International Journal of Psychoanalysis, and four more articles in Israeli psychoanalytic journals. She has edited the book ‘Treating children with autistic spectrum disorders: A psychoanalytic and developmental approach’ (2017), in which she also contributed two chapters. She is also the author of the book ‘The BodI – psychophysical space as transitional space’ (2018), published in Israel, which is now in the process of being translated into English.