The Dissociative Mind in Psychoanalysis: Understanding and Working with Trauma elucidates the latest theory, practice, and research on trauma and dissociation within psychoanalysis. The volume contains meditations on the linkage of complex trauma and dissociative problems in living, different modalities for the treatment of trauma and their theoretical underpinnings, as well as reviews of important new empirical research. Purling through all these essays is a clear explanation of how pathological dissociation is caused by trauma, and how this affects psychological organization. The Dissociative Mind in Psychoanalysis is essential reading and should take pride of place on the bookshelves of psychoanalysts, psychoanalytically oriented psychotherapists, trauma therapists, and students. To find out more, read the passage below, from Philip Bromberg’s “It Never Entered My Mind”.

“It never entered my mind”

Once you warned me that if you scorned me I’d sing the maiden’s prayer again

And wish that you were there again

To get into my hair again.

It never entered my mind.

( Rodgers and Hart, 1940)

This chapter is about “secrets,” so let me begin by telling one of mine. I’ve always felt an oddly satisfying self-contradiction in my having become a psychoanalyst, given how much I hate change. I was the last kid on my block to have a new bike because I felt such loyalty to my old one, and I was also the last kid on my analytic block to buy a computer, because I couldn’t bear to part with my yellow pads and my typewriter. Even after I capitulated, my friends who couldn’t easily open my attachments or who stumbled over my formatting, talked about the outdated version of my word processing program as if they had just run into Norman Bates’s mother — I wouldn’t admit she died and I was refusing to bury her. I’m not arguing that this is a good way to be; it’s just the way I am. The most flattering account of it I’ve heard is from a patient from whom I can’t seem to hide anything: She has referred to it as my “retro approach to modernity.”

Attachment to what I know, even with its limitations, is part of my comfortable familiarity with my ways of being in the world. From one vantage point I’m talking about “procedural memory” (Bromberg, 2003b); from another, I’m talking about fidelity to my different selves as I live them.

The same attitude can inform my work. I remember an initial consultation with a man who came to me only because he was in a state of total desperation. His marriage was falling apart, and he couldn’t “get” why none of the things he did to improve it seemed to help. But even as he was saying this, I could feel the presence of another part of him that was being dragged unwillingly into my office, a part that felt it was being required to obliterate its existence for the sake of learning some “better” way of being — a way that it knew in advance would feel irrelevant. My heart went out to him and I found myself saying, “I want to share a secret. Even though I’m an analyst I hate change; so, don’t worry, you’ll be the same when we end therapy.” He didn’t laugh, and I could see he didn’t exactly know what I meant, but I could also see that his eyes were teary. I could see that a part of him could feel what I meant. He cried even though he had no conscious awareness of why he cried. That moment became a watershed that helped us during future moments when we were struggling to stand in the spaces between different self-states with different agendas. As the poet and scientist Diane Ackerman (2004), in An Alchemy of Mind, has put it, “consciousness is the great poem of matter.” Conscious awareness, she writes, “isn’t really a response to the world, it’s more of an opinion about it” (p. 19).

Life feels continuous, immediate, ever unfolding. In truth, we’re always late to the party . . . Part of that delay [is] so that the world will feel logical and not jar the senses . . . All that happens offstage. It’s too fussy, too confusing a task to impose on consciousness, which has other chores to do, other fish to fry . . . Instead, we feel like solo masters of our fate, captains of our souls, the stuff of homily and poetry.

(2004, pp. 20–24)

What Ackerman is describing as the “stuff of homily and poetry” I have tried to capture in my concept of “staying the same while changing” (Bromberg, 1998), a phrase that itself contains a secret. The secret is that “staying the same while changing” is logically impossible. It embodies two phenomena that can’t coexist, even though they do. Somehow, the process of “change” allows a negotiation between different internal voices, each dedicated to not changing, that is, dedicated to “staying the same” in order to preserve self-continuity. This impossible coexistence of staying the same and simultaneously changing is why trying to track “change” in psychoanalysis (Bromberg, 1996) calls to mind Gertrude Stein’s (1937, p. 298) comment that when you finally get there, “there’s no there, there.” The direct experience of “self-change” is indeed a secret that eludes conscious awareness. It seems to be gobbled up by the relatively seamless continuity of being oneself, which necessarily includes parts of the self that remain secret from what is “me” at any given moment.

Robert Frost (1942, p. 362) wrote: “We dance round in a ring and suppose, / But the Secret sits in the middle and knows.” (Every therapist knows the truth of this, particularly when developmental trauma has been a significant issue in a patient’s early life. The therapist can feel the inadequacy of words as a means of reaching his patient, and often experiences a growing sense of futility about “really” knowing her. This feeling of futility is a small sample of the abysmal hopelessness felt by his patient at being unable to communicate in language from the place that Frost calls “the middle.” Therapist and patient “dance round in a ring and suppose,” but their dance of words does not unite them within the place of the secret because the secret that “sits in the middle and knows” is a subjective form of reality that is incommunicable through ordinary human discourse. It is organized by experience that Wilma Bucci (1997, 2001, 2003, 2010) has termed subsymbolic, and is communicated through enactment.

Enactment is a dyadic dissociative process — a cocoon within which the subsymbolic communication taking place is temporarily inaccessible because it is deadened to reflective functioning. In a human relationship, no person’s capacity for aliveness can be sustained without an alive “other,” so if the other is a therapist, and is for too long listening to the “material” without being alive to his own internal experience of the relationship itself, a dissociative process often begins to develop in the therapist that may have started in the patient but quickly becomes a cocoon that envelops both patient and therapist. Typically, the sequence of events is more felt than cognized by a therapist because the therapist’s self-state almost always switches dissociatively so soon after the patient’s that the switch is usually not perceived by the therapist until it becomes noticeably uncomfortable to him — what Donnel Stern (2004) calls “chafing.” Until then, a clinical process that may have been experienced by the therapist as alive at the outset of a session subtly diminishes in aliveness, typically without the therapist’s cognitive awareness. This change in the therapist’s state of mind eventually compromises his ability to retain his focus on the “material.” Why? Because when one’s affective need for an alive partner is being disconfirmed by another mind that is dead to it, a therapist is no different than anyone else. Through dissociation, he escapes from the futility of needing from an “other” what is not possible to express in words. What begins as “material” evolves into empty words.

Because therapist and patient are sharing an interpersonal field that belongs equally to both of them, any unsignalled withdrawal from that field by either person will disrupt the other’s state of mind. The disruption, however, is usually not processed cognitively by either person, at least at first. It becomes increasingly difficult for the therapist to concentrate, and only when this experience reaches the threshold of perceptual awareness by becoming distressing will the therapist’s struggle to concentrate become the pathway to perceptually experiencing the deadening power of what is taking place between them in the here-and-now. Invariably, the therapist’s own response to this (some might say lack of response) contributes, interactively, to the construction of a communication process that both acknowledges the recapitulation of the patient’s past experience and establishes the context for a new form of experience at the same time.

Just a pebble in her shoe

The relationship between dissociation and enacted “secrets” is best grasped clinically, so I’m going to present a vignette from my work that shows me in the middle of an enactment as well as showing how I was thinking about it while in it.

A bulimic patient, whose dissociated acts of purging were starting to become more emotionally recallable by her during therapy sessions, began to have flashbacks of abuse at the hands of her parents. At first, she couldn’t let herself think clearly about these images, describing them as like “having a pebble in my shoe that I can’t get rid of.” But as she began to talk about what the pebble felt like, she recognized that the part of herself holding the memories of abuse was keeping them secret and that the pebble substituted for having to relive her actual emotions. Moreover, the experience during her sessions of feeling something so painful about her vomiting was making her past pain feel “real” rather than something she was never sure existed. Her pain was becoming increasingly complex and more intense the more she relived it with me. The more real the experience felt the more its existence threatened to betray those who had hurt her, and betray the parts of herself that identified with them. For all these reasons the possibility of ever talking about the abuse “never entered her mind.” But the pebble, which was supposed to remain no more than a pebble, was starting to feel like a boulder. The session I’m going to describe was in some ways the same as those that preceded it, but in other ways it was memorably different. “Why would I want to hurt the people I feel closest to just because I need someone to know?” she agonized. At that moment I began to feel some of her agony, and I also began to experience shame attached to my desire to help her reveal her secret. The shame was about inflicting what felt like needless pain upon a person to whom I felt close at that moment — I was hurting her just because I wanted to know. Until that moment I had been ignoring, personally, the extent to which she was vulnerable to dissociated pain inflicted upon her by another part of herself, for allowing “longing” (I need someone to know) to become “desire” (I want to tell you). The only part of her that had come to feel worthy of being loved existed by protecting the family secrets. By starting to remember and disclose them because she wanted to, she became vulnerable to internal attack by other parts of herself. I had not wanted to experience the degree to which she was being punished and denounced, internally, as evil. In this session, which followed a particularly violent night of purging, she screamed angrily at me, “You’ll never get me to stop vomiting. I’ll never spill the beans.”

At that moment I became painfully in touch with my own dissociated feelings of shame about hurting her, and decided to “spill the beans.” I shared with her what I was in touch with, including my awareness and personal regret that I had been leaving her too alone with her pain because I was so enthusiastic about our “progress.” I then asked if she might be aware of feelings of her own about what I had just said to her, including feelings about my having said it. After a pause, she allowed that she was feeling two ways at the same time, and that they were giving her a headache to think about: She could feel herself furious at me but at the same time she knew she loved me and didn’t want to hurt me. I said that it was only when she got openly angry at me and said, “You’ll never get me to stop vomiting. I’ll never spill the beans,” that I woke up to what was there all along under her anger — her pain and shame in having to go through this so alone.

What I had been seeing as my therapeutic “success” in bringing about the reliving of her past had finally triggered within me an affective experience of her unmet longing for me to know, personally, what this was like for her, and to care. I had been dissociating the part of me that could feel it most personally. My “spilling the beans” and sharing the experience of how I awakened to her pain connected with her longing for me to know it personally. Her longing could not be put in words; it had not reached the level of cognitive awareness that would allow it to become conscious “desire.” Yet, as longing, it remained operative; it remained true to that self-state. When dissociation is operating, each state of consciousness holds its own experientially encapsulated “truth,” which is enacted over and over again. The secret that is being revealed through an enactment is that while your patient is telling you one thing in words, to which you are responding in some way, there is a second “conversation” going on between the two of you. Buck (1994, cited in Schore, 2003, p. 49) refers to this as “a conversation between limbic systems.”

As my patient and I continued to put our dissociated states into words, her longing, a somatic affect that possessed her, began to be expressible as “hers,” and evolved little by little from an affect into an emotion, an emotion we know as “desire.” By sharing and comparing our respective experiences that took place during the enactment and finding words for them that had consensual meaning (Bromberg, 1980), she was able to move from being the secret to knowing the secret that had only been “supposed” by us until then. Until this moment we had, in Frost’s words, been forced to “dance round in a ring and suppose.” Now the doubly shameful secret was out, and we could both “know.”

To read the complete chapter, click here.

This excerpt from Dissociative Mind in Psychoanalysis: Understanding and Working with Trauma is published with permission from, and thanks to, the Taylor & Francis Group.

Purchase a copy of the Dissociative Mind in Psychoanalysis: Understanding and Working with Trauma on the Routledge website here, or on Amazon here.

Philip M. Bromberg is a psychologist and psychoanalyst who is actively involved in the training of mental health professionals throughout the United States. Bromberg is most widely known as the author of Standing in the Spaces: Essays on Clinical Process, Trauma, and Dissociation(1998), Awakening the Dreamer: Clinical Journeys (2006), and The Shadow of the Tsunami: and the Growth of the Relational Mind (2011).