The Sleepy Analyst Struggles to Awaken: Dissociation, Enactment, Regression, and Altered States with Trauma Patients

Abstract

I assert that embarrassment, shame, and concern for professional reputation have inhibited analysts from discussing their struggles with countertransferential sleepiness, a phenomenon presumably more widespread than is generally acknowledged. Analysts may thus be insufficiently armed with understanding of this vexing predicament to which our work can leave us so vulnerable—its causes, trajectories, and even, potentially, its usefulness. Building on McLaughlin’s 1975 paper on the topic, I acknowledge the analyst’s sleepiness as a defense against affect in the patient and analyst, and explore it as an enactment of parental unavailability and abandonment and a primitive communication from the patient about early states of psychological deadness and unintegration. Noting a recent trend in the relational literature toward valorizing engaged and enlivened registers, I consider the problems and potentials of dwelling in a distanced and deadened intersubjective field.

Keywords:

• countertransference
• sleep
• enactment
• companioning
• dwelling
• dead third

Acknowledgments

I express my gratitude to Rachel Altstein, LP, April Feldman, LCSW, Robert Grossmark, PhD, Marisa Hansell, LCSW, Peter Kaufmann, PhD, and Hilary Offman, MD, for their valuable comments on early drafts of this paper.

Notes

1 I’m here using “relational” in a wide sense for convenience, collapsing significant differences of orientation among these varied writers.

2 Though I wrote this article prior to reading S. Stern’s (2019) formulation of “airless worlds,” I find concordance with his description of airlessness in the clinical setting, and I appreciate his problematizing analysts’ erroneously assuming that a patient’s toxic identification with parental negation will resolve on its own in the context of a good-enough therapeutic relationship (p. 440).

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Notes on contributors

Matt Aibel

Matt Aibel, LCSW, is Faculty and Training Analyst at National Institute for the Psychotherapies (NIP), Submissions Editor of Psychoanalytic Perspectives, and Editor of The IARPP Bulletin, the International Association for Relational Psychoanalysis and Psychotherapy newsletter. He practices in Manhattan and Northport, Long Island.