Psychoanalytic witnessing as a prerequisite to psychotherapy with a severely sexually abused young adolescent male ex-inner city gang member

Abstract

This paper discusses psychoanalytic witnessing as the prerequisite for psychoanalytic psychotherapy with a severely sexually traumatised young adolescent boy, Dean. This form of witnessing acted as a prior stage for treatment through the psychotherapist acknowledging Dean’s trauma, without seeking to symbolise its registration in the psychotherapeutic relationship. As sexual abuse is about something done to the person, this acknowledging crucially conveys belief in the truth of what has happened to the patient at the hands of the external world. My work with Dean taught me that such acknowledgment allows for such traumatised patients to then feel more able to accept interpretations based upon what they are doing to the external world, encapsulated in the transference to their psychotherapist. Because trauma is often so deeply felt, and leaves patients dissociated or fragmented, seeking evidence of its presence needs keen observation. Here the paper discusses an experience of bodily countertransference that alerted me to the location of Dean’s trauma’s registration in our relationship. Overall, the paper seeks to demonstrate the importance of psychoanalytic witnessing as a form of containment in itself, and the essential basis for psychotherapeutic work using symbolisation and the transference.

Keywords:

• bodily countertransference
• containment
• projective identification
• psychoanalytic witnessing
• sexual abuse
• trauma

Notes

1. Dean and I worked twice weekly for just over three years. At the end of this, he gave me his consent to use material from our sessions so long as I disguised details that made him identifiable. His name has been changed and I have not given any indication of where he was placed and from which London borough. I have not described his physical appearance. His words and actions remain as observed in our sessions.

2. Freud’s (1893) comment ‘blindness of the seeing eye’ describes simultaneously knowing and not knowing something. Britton (1994) used this comment to discuss a persistent state of disavowal in which, whilst perceiving things, the individual destroys their significance. My use of it is to convey this as the state (described by Britton) I was in prior to the experience of bodily countertransference that jolted me from it. Freud (1927) described disavowal as an aspect of perversion.