Even More Than the “Something More”: Tronick’s Dyadic Expansion of Consciousness Model and the Expansion of Child Psychoanalytic Technique

Abstract

Contemporary psychoanalysis considers itself to be a discipline fundamentally concerned with meaning and meaning-making processes. Ed Tronick’s research provides scientific support for the theoretical position that meaning making is a central process in psychological development and in mental health/illness. His work collaborating with psychoanalysts has made major contributions to the psychoanalytic literature on therapeutic action, with a special emphasis on the means by which implicit meanings are activated and modified in analytic treatment—the something more than interpretation. This article is about a different something more, the even more that psychoanalytic theory and technique can evolve through further incorporating Tronick’s important findings. Tronick’s Dyadic Expansion of Consciousness Model will be briefly reviewed—emphasizing his conceptualization of meanings as being composed of multiple commingling layers (biological, psychological, relational, and social) coming together in a nonlinear “messy” mixture of mutually influencing (both bottom-up and top-down) currents. This multilayered model of meaning opens up the reconsideration of an exciting array of technical options—traditionally considered nonanalytic—to be reunderstood as truly psychoanalytic in that they address one or more of the implicit or explicit levels of meaning that a patient makes of his or her self and world. Examples of these interventions include parent work, work with teachers and schools, as well as interventions adapted from other disciplines such as Occupational Therapy. These technical possibilities are illustrated using case material from the psychoanalytic treatment of a nine-year-old boy.

Notes

¹Looming refers to “a rapid magnification of a form in the visual field that generally signals an impending impact” (Gleitman, 1991, p. 204).

² In the remainder of the article, I focus on child analytic technique; however, Tronick’s insights into the nature of meaning have implications for adult technique as well.

³ See Cooper’s (2000) discussion of the “return of the repressed positivistic” (p. 273).

⁴ Of course, Tronick reminds us that it is even more complicated than this. A prescription of medication also influences meanings at other levels as well. For example, at the family level, the medicine might represent hope for the parents that things might change, or at least a reassuring notion that the problems are “biological” and not the result of failures in parenting.

⁵ Additionally the child analyst’s countertransference to the parents, identification with the child, and fantasies of rescue can be present even when no parent meetings occur.

⁶ Deep touch pressure describes techniques in which gentle, but firm pressure is applied to the patient’s body. Usually this is done with by using some kind of tool such as a weighted blanket that the patient can be covered in. See Grandin (1992).

Additional information

Notes on contributors

J. Timothy Davis

J. Timothy Davis, Ph.D., is a member of the faculty of the Massachusetts Institute for Psychoanalysis and the Boston Psychoanalytic Society and Institute; and Instructor in Psychology, Cambridge Health Alliance, Harvard Medical School.