The Perfect Storm

Communications from my body that I do and do not want to hear.

By Elaine Bridge, LCSW, Psy.D.

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It is not always true that I do not want to hear what my body says to me.  I usually want to listen to pleasurable experiences, like walking into a beautiful room or looking at a particular Matisse painting.  Through a relational experience with those objects my body produces an “mmmmmmm,” an excited crescendo, followed by a calming experience that talks to me and lets me know that I have been contacted by something that knows me.  When I see particular color combinations in a room I get a “wheeeee” feeling that makes me want to sit there and become part of the environment. I cannot walk away and leave it.  I have to tear myself away.  What could be more blissful?  My eyes, my emotions and my sensibilities all blend together in an exquisite harmony that speaks to me.

I can also get images in my mind, such as pictures or thoughts, which prod me more clearly to understand what is going on between a patient and myself.  That is my mind speaking to me, as I discussed in my last paper, “Pictures that I Paint in my Head.”  I usually experience this kind of internal communication as a pleasant experience, leading to an “aha” moment.

Yet there are communications I get from my body that make me want to run away.  This happens more frequently since I have turned sixty and feel infinitely more vulnerable than I have felt in years, maybe since childhood, and since I have been told by my health professional to listen to my body.

Recently, I had a patient who engendered messages from my body that were particularly horrifying, and which I could not regulate.   A perfect storm: a patient who played out the rage she experienced emanating from the involvement with an important person who she could not control and this therapist who was hyper sensitive to rage, screaming, and grief, following the death of my own mother, the most current of several recent deaths of close loved ones.

This paper explores wanted and unwanted communications between therapist and patient, and how the unspoken becomes spoken through the therapist.  As the therapist, I became the vessel through which my patient’s major dissociative communication (her inability to grieve resulting in rage) became spoken.  In the communications that led up to the “Perfect Storm,” the patient’s insistence on my experiencing the exact state and psychological position was her “life or death” requirement for the work to remain vital.  Any verbal or nonverbal communications that did not perfectly resonate with her led to a self-righteous rage, which became the climax of her experience in treatment.

Helen was an OB/GYN, 30-year-old, divorced woman, with a young child. She came to me in a great deal of despair over her recent divorce and how unjustified she felt it was. When she entered the room, her body was set on the ‘ready for fight’ switch.  She sat down, bending the top of her body and head toward me. The rage gushed like an oil well that had just hit the wellspring.  “Well, things have not gotten any better.”   She looked at me with a demand in her body and eyes that clearly wanted something, a need for exact mirroring that forced me into a hostage position. Any of my soft or welcoming signs were disregarded, and she made an uncompromising demand to make things better and that meant now, kiddo.  She barraged me with all kinds of comments and reactions that seemed shocking.  We went from zero to ten in an instant, and there was no time for me to feel anything but her requirements: I had better do something right or else.  I was then deprived of my own autonomy, unable to experience myself in either a verbal or nonverbal sense.

My body started to move into fight/flight mode.  I could not get her to calm down, to have some sense of letting me take this in and help, but there was no mercy.  Do it now, get it now, or else.  As I showed a slight surprise at a statement she had never expressed before, she turned toward me with the heavy artillery and began blasting: “You have done this, and you have done that,” and she proceeded to characterize me as if I were directing a play and she had no part in it, and there was no room to talk about it.  I had to be slandered, hogtied, and shamed, and that was that.  I felt the fear and panic.

I could not take on her attributions and explore them calmly with her even though I attempted.  She now became the director of the scene, and she wanted to be rageful, and I had to defend myself, and I did.  I found myself finding reasons and rationales for my behavior. I so wanted to calm down and be rational, but she or my internal state was not having any of it. I was cold and frightened.  I wanted to tolerate this rage of hers and not retaliate, but she would not relent.

The consequence of this is that we moved into an emotional life and death struggle. If I did not comply with her demands to join her in the destruction she was crafting, she then wanted to destroy me in a way that I sometimes feared my body might want to destroy me. I had been taken from rage to the underbelly of my grief.  I did not want to go there, but she had to kill me off in order for some part of her to live.   I could feel the approach of her death blows, and I became very sad, the deep kind of sadness that accompanies efforts to save someone that are rendered futile.

In our next session, I was even more acutely aware that if I did not address her exactly the way she required, she would become increasingly destructive of the therapeutic process.  To avoid this, I told her that I thought my words were disrupting her too much and that I thought she was actually in an acute state of grief.  She relaxed and momentarily went into a calmer state. In the following session, I found myself asking a question that I immediately regretted.  She had never been able to talk about the signals and sensations her own body produced in her emotional life, and was not about to now, propelling her flight.  In response to my question, she said she had to leave.

I never heard from her again. The perfect storm had happened.  I had expressed a hope and held it for safekeeping.  The hope was that we could stay connected through the storm, but she had to abandon it at the door.  I spoke the hope, and she  could no longer dissociate from her own hope. She wanted to attack it in me as well as within herself and everywhere else.

I felt as if I had been sitting with Medea, a patient scorned by her husband, a patient who tried to exact vengeance at my expense.  Her only solution was emotionally killing him, since the actual act would be too dangerous for her.  She not only wanted me to join in this emotional murder, but also to underwrite it.   All of my understanding of her rage, her justification for despair and sorrow was to no avail.  The only solution was emotionally killing something, and since I could not be a satisfactory accomplice, the victim would be me.

I must add that we had had other incidents of her protests against me, which I not only tolerated but internally experienced in a painfully affective way, as well as times when I willingly expressed my vulnerability in not understanding her correctly, or knowing the pain she experienced.  She had gratefully accepted these exchanges.  We repeatedly needed to return to a configuration of her knowing more than I, with me submitting to her knowledge.

The unspoken became spoken through our bodies, and I was left to pick up the trash.  What happened to the blissful state of affairs that characterized the beginning of her treatment and took also took place through our bodies: the ease and flow of the good enough mother responding to the catastrophic baby through a very attuned state? Somehow when we most needed to, we lost the baby because we couldn’t talk about the baby as a self-state who carried catastrophe inside of her.

As she demanded that I join her in her self-righteous rage, I was fighting to restore my vitality through a different channel, not rage.  I did not want to repeat a lack of repair, which appeared to be a trauma in my patient’s history, as well as my own.  Instead, my mind was attempting to let in what I call my “muse” to help us, and that attempt became unforgivable. I detailed in my previous paper, “Pictures that I Paint in my Head,” how my muse, this creative capacity, leads me to think about one person, situation, object, or experience that then leads me to see clearly the struggles being played out in the treatment. In this case, I searched for my muse instead of saving the baby her way, by murderous rage. My patient’s caring self was dissociated and ended up disconnecting from me.

Thomas Arizmendi (2008), in his “Nonverbal Communication in the Context of Dissociative Processes,” described how a patient’s subsymbolic information may be converted to the verbal symbolic via the analyst’s use of evoked images. Jody Davies and Mary Frawley (1994), quoted in Arizmendi’s article, stated that, “Dissociated experiences are not symbolized and communicated by ordinary language (p. 444). Arizmendi also cited Bromberg (1996), saying that dissociation paradoxically allows for the intactness and coherence of one’s self.  Arizmendi quoted Bromberg,      ”Under extreme conditions, such as those associated with trauma, however, it can evolve from a normal process into a defense in which the person becomes, not me” (p. 444).

As an analyst who continues to develop a more autonomous and authentic voice, along with my growing empathy, I was caught in the crossfire. My “autobiographical self” could not abide (see Vida, 2005, p. 255-278).  For me, the process of dealing with dissociated affect is a complex endeavor and involves the use of my muse. In such a situation as the one with this patient, my muse directs me away from a dissociated piece of experience toward a way of understanding what has been transpiring in the process between us. Yet, this time, I was doing it alone.

What might my muse tell me now?  It seemed awful, ugly, and thoroughly unpleasant.  I thought about the work that the poet Naomi Lowinsky (2009) described in her new book, “The Sister from Below.”  I found my muse for this case in Lowinsky’s description of one of her possible muses as being a” Banchee” (p. 3).  A screeching monkey that is relentless.  A different kind of muse, a negative catalyst reflecting despair. The “Banchee” in my patient was telling me to mirror her self-righteous rage and carry it. If I didn’t become her muse in that way, she would leave me.  What a contrast to my previous muses who were so decorative and pretty, particularly not screeching, who enhanced the bonds to my patients because they directed me back from what I had dissociated.

This muse, the “Banchee,” expressed my patient’s grief and loss in relationships in order for her to survive. On the other hand, her “Banchee” also seemed to be directing me forward. Which road could I take to support my continuing processing of this work I was left to do on my own?  I began by falling back on the comfortable road of theory to explicate my thoughts

My mind turned to Daniel Stern (1985) and his “Interpersonal World of the Infant.”  Stern directed us to the notion that developmental tasks are not experienced in the linear way Freud, Klein, and Mahler have stated, but that they are dynamics held in a dialectical tension across a lifespan (p. 10, 18).   Stern stated that rather than autonomy being a process of individuation emerging from conditions of merger, developing infants can assert their independence and say a decisive “no” with gaze aversion at four months, gestures and vocal intonation at seven months, running away at fourteen months, and with language at two years.

Following Stern’s ideas, I noticed that my patient expressed her displeasure with me by showing her profile. I was particularly struck by the way she turned her head away from me at certain junctures, exhibiting her aversion to me when she wanted to disagree with me. She also shifted her tone of voice in a recognizably emphatic manner.  Her intolerance of my remarks not matching hers was poignant.  She used her posture and stance in order to assert herself.  Her entire body was involved in explicating her negative experience or her need to differentiate from my remarks.  

Connie Lillas (2009) in her new book, “Infant/Child Mental Health,” discussed the dance between responsive (mirroring) behaviors and directive (rupturing) behaviors between parents and children: “The child experiences distress as he or she bumps into the boundaries set by the parent…A ‘dance’ now emerges between directive behaviors,

which are needed to assert the self and guide the other, and responsiveness behaviors, which are needed to connect and reconcile with the other.  The give and take of responsive and directive behaviors leads to more secure relationships that can negotiate a full range of emotions within the self and other” (p. 276).

As my patient attempted to elicit responsive behaviors from me in her attempts to connect, she bumped into my unconscious and conscious directive behaviors, but the give and take of both behaviors could not be achieved.   We were clearly not going to transform into this more highly developed cycle, but only to repeat specific historical and defensive dynamics that could be left only with me. I could not understand this with her, because she cut off any historical exploration.  Talking was too disruptive, yet silence and exploration were too abandoning for her.  My muse is still screeching at me and pushing me forward toward further thoughts about autonomy and mutual recognition.

Jody Davies (2004), in “Whose Bad Objects Are We Anyway,” referred to Jessica Benjamin’s description of mutual recognition as a difficult, unconscious, potentially hurtful, collision of two subjectivities.  Such parties collapse into a self occupied territory despite any desire to do otherwise.  This collisions alerts one or both parties on a visceral level of body heat, chest pounding, face flushing, way of feeling annihilated.  The hope is either the patient or the analyst can find the language and the play so that they can discover each other anew. The process of becoming a “we” broke down with my patient when I could not, and would not, join in the literal manifestation of her murderous rage state.

Benjamin’s description of a tortured struggle to create a two-person experience exemplified the struggle my patient and I lived through.  Working in the context of this collision is a difficult place to work from and quite tricky, with unforeseen consequences, such as the patient’s profound resistance to grieving and the presence of the analyst’s necessary grieving.

To have a mutual recognition that is more benign, becomes more conscious and facilitative, and is smoother in its emergence, what is required is a tolerance for difference in order to trust in an emerging dialogue. If an analytic couple can shift to this creative, playful state, a new opportunity may be created without the experience of re-traumatizing both partners and recreating the damaging aspects of early parent/child

experience.

Such difference can lead both to autonomy and reciprocity, and growth for each partner in the analytic dyad.  As painful as it has been for me to process this analytic experience alone, what could not be processed together with my patient, I have been able to process with colleagues, consultants, and in the writing of this paper, and so I have still learned and grown.

REFERENCES

  • Arizmendi, T. (2008). Non verbal communication in the context of dissociative Processing, Psychoanalytic Psychotherapy, 25(3), 443-457.
  • Bromberg. P. (2003). One need not be a house to be haunted: On enactment, dissociation   and the dread of “not me”: A case study. Psychoanalytic Dialogues, 13, 689-709.
  • Bromberg, P. (2006). Awakening the dreamer: Clinical journey. New Jersey: Analytic Press.
  • Davies, J. M. & Frawley, M. (1994). Treating the adult survivor of childhood sexual abuse: A psychoanalytic perspective. New York: Basic Books.
  • Davies, J. M. (2004). Whose bad objects are we anyway? Psychoanalytic Dialogues, 14, 711-732.
  • Lowinsky, N. R. (2009). The Sister from below: When the muse gets her way. In Fisher King Press.com, Retrieved October, 2009, from http://fisherkingpress. com/zencart/
  • Lillas, C. & Turnbull J. (2009). Infant/child mental health: Early intervention and relationship based therapies. New York: W. W. Norton.
  • Stern, D. N. (1985). The interpersonal world of the infant: A view of psychoanalysis and developmental psychology. New York: Basic Books.
  • Vida, J. E. & Molad, G. (2005). The autobiographical dialogue between analysts: Introductory notes on the use of relational and intersubjective perspectives in conference pace.  In J. Mills (Ed.), Relational and intersubjective perspectives in psychoanalysis: A critique (pp. 255-278). New York: Jason Aronson.


Elaine Bridge, Psy.D, LCSW is a member, supervising analyst and instructor at the Institute for Contemporary Psychoanalysis.  She is in private practice in Encino specializing in individuals and couples.  Her clinical work is informed by attachment theory and development of parent/infant communication, as well as relational theory.

2 Responses to The Perfect Storm

  1. Judy Kann says:

    Hi Elaine,
    I really enjoyed your article. You are talking about a situation that I think happens more often than is generally discussed. When this happens with particular clients, the dilemma for me is what is the therapy when I am being so utterly rejected and there is no room to move. It’s the experience of hitting a brick wall with an angry, attacking, unyielding presence. Finding a new voice – or muse – as you put it, is the challenge.
    Thanks again.

    Judy

  2. M. Bridge says:

    I saw your artichoke. You should be very proud
    Mike

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