From switch‐words to stitch‐words

Abstract

During the course of treatment with some patients a word or phrase reappears that functions to connect layers of fantasies and to identify a history of conflicts and defenses. These stitch‐words are compared to the switch‐words proposed by Freud as points of condensation in dreams, as well as to other forms of idiolectic evidence (e.g. metaphors) that inform therapeutic listening. Stitch‐words expand on Freud's concept by taking into account syntactic aspects of language that function to hold together layers of unconscious fantasies. A description of the grammatical type of words (syncategorematic) best suited to function as stitch‐words is presented and illustrated by their use in two clinical examples (‘normal’, ‘fair’). The therapeutic value of listening to, as well as through, the surface of patients' language is discussed.

Von Wechsel‐Wörtern zu Stichwörtern

Im Laufe der Behandlung tauchen bei manchen Patienten wiederholt bestimmte Wörter oder Formulierungen auf, die mehrere Schichten der Phantasie miteinander verbinden und eine Geschichte von Konflikten und Abwehren identifizieren. Diese Stichwörter werden mit den „Wechseln” verglichen, die Freud als Verdichtungen in Träumen erläutert hat, sowie mit anderen Formen idiolektalen Materials (zum Beispiel Metaphern), die für das therapeutische Zuhören aufschlussreich sind. „Stichwörter” erweitern Freuds Konzept, indem sie auch den syntaktischen Aspekten der Sprache Rechnung tragen, die verschiedene Schichten der unbewussten Phantasie zusammenhalten. Die Autorin beschreibt, welche grammatikalischen Wortarten (synkategorematische) als Stichwörter am besten geeignet sind und illustriert dies anhand ihrer Verwendung in zwei klinischen Beispielen („normal”, „fair”). Der therapeutische Nutzen des Hörens auf die Oberfläche der Sprache des Patienten – und durch sie hindurch – wird diskutiert.

De las palabras‐puentes a las palabras‐costuras

En el transcurso del tratamiento con algunos pacientes una palabra o una frase reaparecen y funcionan para conectar capas de fantasías así como para identificar la historia de conflictos y defensas. Se compararán estas palabras‐costuras (stitch‐words) con las palabras‐puentes (switch‐words) que propuso Freud como puntos de condensación en los sueños así como de otras formas de evidencia de idiolectos (e.g. metáforas) que informan la escucha terapéutica. Las palabras‐costuras expanden el concepto de Freud tomando en cuenta aspectos sintácticos del lenguaje que funcionan para sostener juntas capas de fantasías inconscientes. Se presenta una descripción del tipo gramático de palabras (sincategoremático) que mejor funcionan como palabras‐costuras y se ilustra con dos materiales clínicos (‘normal’, ‘justo’). Se discute el valor terapéutico de la escucha de, así como a través de, la superficie del lenguaje de los pacientes.

Des mots‐aiguillage aux mots‐couture

Pendant le traitement de certains patients surgit un mot ou une phrase qui sert à relier de différentes couches fantasmatiques et d'identifier une histoire de conflits et de défenses. Les mots‐couture sont comparés aux mots‐aiguillage proposés par Freud comme points de condensation dans le rêve, ainsi qu'à d'autres formes d'évidence d'idiolectes (ex. les métaphores) qui entrent en jeu dans l'écoute thérapeutique. Les mots‐couture ici proposés étendent le concept de Freud par la prise en compte des aspects syntaxiques du langage dont la fonction est celle de relier les différentes couches du fantasme inconscient. Nous présentons une description de la catégorie grammaticale (syncatégorématique) des mots les mieux adaptés à la fonction de mots‐couture et deux exemples cliniques (‘normal’ et ‘juste’) sont donnés. Nous discutons de la valeur thérapeutique de l'écoute de, ainsi que de l'écoute à travers, la surface du langage du patient.

Dalle Switch‐words alle Stitch‐words, ovvero dall'ambivalenza alla multivalenza

Nel corso della cura di certi pazienti, si incontra spesso una parola o una frase che sembra dover funzionare come collegamento fra vari strati di fantasie e indicare una serie di conflitti e difese. In questo lavoro, si confrontano queste parole con funzione coagulante (stitch‐words) cone le parole ambigue (switch‐words) proposte da Freud nella sua teoria del sogno; parole quest'ultime che costituiscono punti nodali nella condensazione onirica, e che appaiono anche in altre manifestazioni idiolettiche (per esempio nelle metafore). È nostra intenzione ampliare questo concetto freudiano di switch‐words, importante nell'ascolto clinico, proponendo le stitch‐words che si fondano sulla considerazione di aspetti sintattici del linguaggio e che saldano insieme diversi strati di fantasia inconscia. Viene presentata una descrizione del tipo grammaticale di parole (sincategorematica) che meglio si presta a funzionare come stitch‐words, illustrate poi con il loro uso nella prassi clinica (per esempio ‘normale’ e ‘giusto’ nei due casi clinici presentati). Viene quindi discusso il valore terapeutico di un ascolto non solo del livello intrinsico del linguaggio del paziente, ma anche di quello estrinseco.

Key words:

• representability/figurability
• semiotics
• unconscious

Notes

1. A Lacanian perspective views the point de capiton as an essential developmental step in moving from dyadic to triadic relations, created by the paternal ‘no’ that symbolically anchors words and things, or at least provides the necessary illusion that such an anchoring is possible. The temporary stopping of the signifier's sliding, or glissement, enables the illusion that meaning can be fixed and establishes faith in language, thereby avoiding the constant slippage seen in the psychotic's distrust of language (Fink, 1997, p. 94). One listens for the breaks (hesitations), interruptions (gaps), distortions (parapraxes) in speech as opportunities to punctuate the patient's discourse, revealing underlying structural configurations (Evans, 1996; Fink, 1997).

2. The considerable literature on syncategoremes by semioticians, linguists and philosophers is too detailed and technical to review here, but see Eco (1984) and Klima (2006) as examples.

3. These illustrations are not intended to represent complete cases or demonstrate clinical process.

4. Similarly, as noted, I have found that attending to types of negation used by patients can indicate how the patient is experiencing or using the therapist's interventions (Litowitz, 1998, 2011).

5. “It's not fair” is a common retort by children expressing feelings of exclusion and impingement in their interactions with others.

6. There is a research tradition of mining the surface of language for deeper or evolving meanings (e.g. Spence and Lugo, 1972). Langs et al. (1993) created a coding system to trace ‘referential activity’, i.e. processes of bringing nonverbal feelings, sensations and memories into verbal expression. Such coding systems have been used to track therapeutic change over the course of treatments (Bucci, 2003; Halfon and Weinstein, 2012); and increased use of metaphors is rated positively.

7. It is worth noting that in German Stichwort is defined as ‘key‐word’ or, in a theatrical context, as ‘cue’.