Analytic listening as a holding function of the dissociated parts of the patient

Abstract

In this paper, the author develops some remarks on analytic listening, dwelling upon the somatic-sensory communication of patients with a dissociated self who have “incorporated” a traumatic history. The author, taking into account a kind of transference in which the dissociated parts act through the bodily and sensory “materiality,” argues in favor of the importance for the listening analyst of focusing on the sensations he feels touched by and that resound inside him, a listening that tolerates the “disturbance” of somatic-sensory aspects of the patient's communication and creates a sort of “grip,” which the author intends here as a form of holding function that provides a tacit physical and psychic support to the patient's dissociated parts and to his need to exist. The author presents two clinical vignettes: the case of an adult patient whose somatic-sensory communications referred to fragments of an unrecognized history and that, in transference–countertransference dynamics, created a sort of “role reversal;” and the case of a child severely traumatized by sexual abuse, who was unable to symbolize his trauma and whose communications were conveyed through painful screaming.

Keywords:

• listening
• holding
• dissociation
• trauma
• nonverbal communications

Notes

¹Naturally, the words of the analyst have a “physical” impact on the patient too. A teenage patient used to turn his head away when I was about to talk and, as we would discover later, it was his tangible perceiving as if my words were touching him to distress him deeply. In work with deprived or traumatized children, it is common to see how, even before the content of the words, it is the sound of the voice – felt as something that enters deeply – that is not tolerated. Lack of space prevents me delving into this subject here.

²Translator's note: the verb “to tell” in Italian is “dire,” which is etymologically close to the Latin “dicere.”