Being in Rhythm: Dissociative Attunement in Therapeutic Process

ABSTRACT

Dissociative attunement is a profound rhythmic encounter in therapeutic treatment. Attunement is a synchronized awareness of implicit knowing that is nonlinear and bidirectional. Empathically attuned clinicians are like microtonal tuning forks. They resonate with a variety of emotional pitches and will resonate with nuanced shifting of emotional tone. This resonance is the basis of dissociative attunement. Concepts such as empathic attunement, affect attunement, “the unthought known,” “implicit relational knowing,” and “a two-person unconscious” help us to understand unique aspects of projective identification, transference, and countertransference within the dissociative frame. However, dissociative attunements are systemically self-emergent moments in which multiple self-states are shared by means other than projection. Using clinical vignettes, I demonstrate how dissociative attunement can paradoxically appear to be misattunement. By synthesizing scientific and theoretical concepts applied to these clinical moments, we can understand dissociative attunement as a therapeutic tool as well as a pathway to vicarious traumatization.

KEYWORDS:

• Dissociative attunement
• dissociation
• therapeutic process
• implicit relational knowing
• vicarious traumatization
• self-emergence

The author thanks Marg Hainer, Lynne Kwalwasser, and Glenys Lobban for their insights and generous effort in helping her to articulate this concept; to Rick Rossein, Donald Brown, Jenny Heinz, Jon McCormick, and Lynn Pearl, who along with the aforementioned held her steady through such challenging clinical work; and to Tamsin Looker, whose wisdom is reflected in these pages.

Notes

1. Special thanks to my friend and teacher, Layne Redmond, whose “Walking and Breathing Meditation” was my first introduction to the meaning of “Being in Rhythm,” and much appreciation to my frame drum teacher, Eva Atsalis, who patiently led me toward really getting it.