On the Royal Road Together: The Analytic Function of Dreams in Activating Dissociative Unconscious Communication

Resonance in the Dissociative Field: Examining the Therapist’s Internal Experience When a Patient Dissociates in Session

“…These findings provide support for the relational analytic stance that the therapist's internal experience constitutes an important way of knowing, especially in work with patients traumatized in early life. This perspective further supports Hopenwasser's (2008) and Sands' (2010) constructs of dissociative attunement and dissociative unconscious communication, that a kind of implicit, nonconscious and psychobiological knowing occurs in the midst of the patient's dissociation in session. This knowing is an experience of resonance and communion between therapist and patient in the midst of the withdrawal of one or both parties.…”

“…Of the many valuable contributions from relational analytic trauma literature, Hopenwasser (2008) and Sands (2010) most clearly elucidated this process of implicit knowing from within the dissociative field. Hopenwasser used observations from clinical work with chronically traumatized patients with dissociative symptoms to define the theoretical construct of dissociative attunement-the therapist's nonconscious and psychobiological attunement to the dissociated parts of the patient's self that become manifest in the therapist's subjectivity.…”

“…Episodes of dissociative countertransference, which often look and feel like a misattunement, can instead be understood as the result of attunement to the patient's shifting dissociated states, resulting in resonance and ultimately the sense of "seeing someone deeply" as Siegel (2010) suggested. Sands (2010), using the language of dissociative unconscious communication, described a similar process of nonverbal and nonconscious attunement to traumatic affect and dissociated states of chronically traumatized patients. Sands defined this implicit communication as "a powerful and visceral resonance between patient and analyst, as something dissociated in the patient grabs hold of and enters into deep communion with something dissociated in the analyst and opens up a channel of unconscious empathy" (p. 365).…”

“…In these moments, the patient is most in need of an attuned other to promote a sense of safety and co-regulation of traumatic affect, however, dissociation intrudes upon the therapy dyad, foreclosing intersubjectivity. Emerging theory and research from the intersecting fields of interpersonal neurobiology, trauma and dissociation, and relational psychoanalysis suggest that even in a dissociative state there is a capacity for interpersonal resonance and attunement (Hopenwasser, 2008;Howell, 2011;Sands, 2010). Accordingly, the therapist's painstaking presence and willingness to enter into a patient's dissociation can promote states of resonance and understanding in the dyad, strengthening the working alliance rather than leading to withdrawal and disconnection.…”

Listening to the Body and Feeling the Mind

“…The majority of writers on body-countertransference have been women (e.g., Mathew, 1998;Sands, 2010). Lombardi has a vivid body-countertransference reaction with Vittoria.…”