Awakening the Dreamer

Clinical Journeys

Philip M. Bromberg

• Editorial: Routledge
• Año: 2013
• ISBN:
  9781134914975
• Edición: 1
• Categoría: Psychologie
• Categoría: Klinische Psychologie

In Awakening the Dreamer: Clinical Journeys, Philip Bromberg continues the illuminating explorations into dissociation and clinical process begun in Standing in the Spaces (1998). Bromberg is among our most gifted clinical writers, especially in his unique ability to record peripheral variations in relatedness - those subtle, split-second changes that capture the powerful workings of dissociation and chart the changing self-states that analyst and patient bring to the moment.For Bromberg, a model of mind premised on the centrality of self-states and dissociation not only offers the optimal lens for comprehending and interpreting clinical data; it also provides maximum leverage for achieving true intersubjective relatedness. And this manner of looking at clinical data offers the best vantage point for integrating psychoanalytic experience with the burgeoning findings of contemporary neuroscience, cognitive and developmental psychology, and attachment research.Dreams are approached not as texts in need of deciphering but as means of contacting genuine but not yet fully conscious self-states. From here, he explores how the patient's "dreamer" and the analyst's "dreamer" can come together to turn the "real" into the "really real" of mutative therapeutic dialogue. The "difficult, " frequently traumatized patient is newly appraised in terms of tensions within the therapeutic dyad. And then there is the "haunted" patient who carries a sense of preordained doom through years of otherwise productive work - until the analyst can finally feel the patient's doom as his or her own. Laced with Bromberg's characteristic honesty, humor, and thoughtfulness, these essays elegantly attest to the mind's reliance on dissociation, in both normal and pathological variants, in the ongoing effort to maintain self-organization. Awakening the Dreamer, no less than Standing in the Spaces, is destined to become a permanent part of the literature on therapeutic process and change.

1 Introduction

When Reality Blinks

DOI: 10.4324/9780203759981-1

Are you going to tell me

none of the stars are really there? Well some are there but

some burned out

ten thousand years ago.

I don't believe that.

How can you not believe it, it's a known fact. But I see

them. You see memories.

Have we had this conversation before?

—Anne Carson, Autobiography of Red,¹

¹Excerpted from Carson's glorious verse novel that speaks to the searing pain of being "other": Carson, A. (1999), Autobiography of Red. New York: Alfred A. Knopf, p. 65. Thank you, Karol Marshall, for telling me about this book.

In 1893, Freud published a memorial essay on Charcot, in which he recalled a verbal duel between them that Charcot won with a good-humored umored piece of repartee—a "one-liner." It was an incident that Freud held in his memory with seemingly great fondness even though Charcot had the last word. Freud cited it frequently throughout his career:

Charcot... never tired of defending the rights of purely clinical work, which consists in seeing and ordering things, against the encroachments of theoretical medicine. On one occasion there was a small group of us, all students from abroad, who, brought up on German academic physiology, were trying his patience with our doubts about his clinical innovations. "But that can't be true," one of us [in fact, Freud himself] objected; "it contradicts the Young-Helmholtz theory." Charcot did not reply by saying "So much the worse for the theory, clinical facts come first" or words to that effect; but he did say something which made a great impression onus:" Theory is good; but it doesn't prevent things from existing" [p. 13].

During the two decades from 1978 to 1998, my writing, culminating in Standing in the Spaces (Bromberg, 1998c), might not unreasonably be seen as my emulating Charcot by arguing that "theory is good; but it doesn't prevent things from existing." That is to say, I have been trying to convince Freud (or at least his ghost) that even after 100 years of attempting to exclude the phenomenon of dissociation from his theory of mental functioning, it remains more alive than ever. In my view, if psychoanalysis is to remain a theory relevant to understanding the mind, and a therapeutic process relevant to healing the mind, certain concepts, such as unconscious conflict, interpretation of resistance, and unconscious fantasy, need to be rethought in light of our current understanding of self-states and dissociation.

This book continues my journey into the phenomenology of self-states that was begun with Standing in the Spaces. To reprise: Self-states are what the mind comprises. Dissociation is what the mind does. The relationship between self-states and dissociation is what the mind is. It is the stability of that relationship that enables a person to experience continuity as "I." A flexible relationship among self-states through the use of ordinary dissociation is what allows a human being to engage the ever-shifting requirements of life's complexities with creativity and spontaneity. It is what gives a person the remarkable capacity to negotiate character and change simultaneously—to stay the same while changing. And it is this relationship that determines what is meant when we speak of conscious and unconscious.

Lancelot Law Whyte (1960) observed more than 40 years ago that the "antithesis conscious/unconscious may have exhausted its utility" (p. 174). The trouble, he noted, was "not that we do not yet know the right definitions to use, the meanings of which would throw most light on the structure of mental processes. What we need is not merely words with definitions using other words, but insight into the changing structure of mental processes" (p. 15). It may be wrong, Whyte added,

to think of two realms which interact, called the conscious and the unconscious, or even of two contrasted kinds of mental process, conscious and unconscious, each causally self-contained until it hands over to the other. There may exist, as I believe, a single realm of mental processes... of which only certain transitory aspects or phases are accessible to immediate conscious attention [p. 15].

To underscore his argument, Whyte quoted Hippolyte Taine, the 19th-century French philosopher and literary historian who also questioned the idea of separating conscious and unconscious into different realms. In imagery that I find breathtakingly comparable to current thinking about the structure of the mind, Taine wrote,

One can... compare the mind of a man to a theatre of indefinite depth whose apron is very narrow but whose stage becomes larger away from the apron. On this lighted apron there is room for one actor only. He enters, gestures for a moment, and leaves; another arrives, then another, and so on.... Among the scenery and on the far-off backstage there are multitudes of obscure forms whom a summons can bring onto the stage... and unknown evolutions take place incessantly among this crowd of actors [Taine, 1871, cited in Whyte, 1960, pp. 166-167].

My own accounting of human mental processes (Bromberg, 1998c) is highly compatible with Whyte's suggestion of a "single realm of mental processes... of which only certain transitory aspects or phases are accessible to immediate conscious attention" (p. 15). When considered together with Taine's vision of the mind as a stage with a lighted apron on which "there is room for one actor only" and a further recess in which evolutions take place incessantly among a crowd of actors, Whyte's imagery is in harmony with my view of mental life as a nonlinear, self-organizing repatterning of self-state configurations that produce shifting representations of "me."

From this vantage point, normal dissociation, a mind-brain mechanism that is intrinsic to everyday mental functioning, attempts to assure that the mind selects from the "multitudes of obscure forms whom a summons can bring onto the stage" of selfhood, that self-state configuration which is most immediately adaptive within the constraints of affective safety. I see this process as an ongoing system, an evolutionarily derived psychodynamic that is mediated at the brain level by processes not yet understood, and at the level of selfhood by the need to maintain self-continuity in the context of moment-to-moment changes in the environment. There is increasing support for this view of the mind, provided not only by clinicians, but by contemporary neuroscience research. Johnson (2004), for instance, discusses the shifting dialectic of the mind in these terms. Johnson takes his neuro-scientific cue from Gerald Edelman's (1989, 1992, 2004) theory that the internal mechanisms of both the brain and the immune system run miniversions of natural selection:

Think of those modules in your brain as species competing for precious resources—in some cases they're competing for control of the entire organism; in others, they're competing for your attention. Instead of struggling to pass their genes on to the next generation, they're struggling to pass their message on to other groups of neurons, including groups that shape your conscious sense of self. Picture yourself walking down a crowded urban street. As you walk, your brain is filled with internal voices all competing for your attention. At any given moment, a few of them are selected, while most go unheeded [Johnson, 2004, p. 199].

Through the creative use of dissociation, the mind selects whichever self-state configuration is most adaptive at a given moment without compromising affective safety. The need to preserve affective safety organizes the mind's responsiveness to novelty. The heart of mental functioning is a complex interface between what is experienced as safe enough and what is potentially traumatic. The felt boundary between surprise and trauma is thus particularly sensitive. It is the relative permeability of this boundary that underlies normal personality development, its pathology, and an optimal psychotherapeutic relationship that is "safe but not too safe."

When the normal function of dissociation is enlisted as a defense against trauma, the brain uses dissociation to inhibit potentially discrepant views of reality held by different self-states, which, if "on stage" at the same time, would be more than the mind could contain without destabilizing. But this aspect of the mind's ability to use dissociation in the service of psychological survival is in another respect a Faustian bargain: survival is offered at an extraordinarily high price to be collected later. Psychological self-continuity plays a role that is as central for the survival of a member of the human species as biological self-continuity is for lower forms of animal life.

When self-continuity seems threatened, the mind adaptationally extends its reach beyond the moment by turning the future into a version of past danger. That is, the mind not only functions to preserve self-continuity in the face of immediate threat, but also underwrites a temporal sleight of mind, sometimes termed "retrospective falsification" (see Terr, 1984), whereby future self-continuity is proactively guaranteed by the creation of a dissociative mental structure—an early warning system, if you will. The linear experience of time is collapsed into itself as a protective device, producing relative amnesia for perceptual memory of past trauma but leaving bodily and affective memory intact, often horrifyingly intact. This time condensation supports the early warning system by freezing the person's image of the future and of the present into relived replicas of the past. Instead of being able to deal with "what happened to me," the person enters therapy to deal with what he is sure will happen to him and what is happening to him now.

What was formerly a fluid and creative dialectic between self-states through the normal process of dissociation is slowly replaced by a rigid Balkanization of the various aspects of self. The process of dissociation has now become enslaved to a dissociative structure that takes as its highest priority the preservation of self-continuity through turning the act of living into an ongoing reminder that trauma is always waiting around the next corner and that it will be more than the mind can handle. Self-states that were formerly parts of an overarching configuration able to alter its own patterning of "me-ness" spontaneously, while simultaneously preserving overall coherence (through each state's potential for communication with the others), become sequestered islands of "truth." Each island vigilantly protects itself from potentially disjunctive input of the others by the dissociative "gap" surrounding it. Self-continuity is now preserved within each state, but the overarching coherence among states is sacrificed. Past trauma is not allowed to enter narrative memory as an authentic part of the past; it is transmuted into affective and body memories in the form of experiences that are beyond relational self-regulation and that shape the present and the future in a way that plunders life of both genuine safety and of spontaneity.

This structure works. But it does so at a cost: the experience of intrapsychic conflict becomes highly difficult to maintain. Indeed, for some people, such experience is unachievable altogether because the capacity to experience intrapsychic conflict is dependent on the mind's ability to access and tolerate two or more discrepant self-states at the same time. Thus, a consequence of trauma as it becomes embedded in structural dissociation is to limit and often foreclose the possibility of conflictual experience.

Developmental Trauma and Enactment

Clinically, the phenomenon of dissociation as a defense against self-destabilization is observable at many points in every treatment, but it has its greatest relevance during enactments, a mode of clinical engagement that requires an analyst's closest attunement to the unacknowledged affective shifts in his own and his patient's self-states. Through the joint cognitive processing of enactments played out between the "not-me" experiences of patient and analyst, a patient's sequestered self-states come alive as a "remembered present" (Edelman, 1989). These moments allow the patient, affectively and cognitively, to construct, with the analyst, an authentically remembered past. Because the ability to experience conflict safely is then increased, the potential for resolution of conflict is in turn facilitated for all patients.

To reiterate, dissociation is not only a mental process but also a mental structure that exists in everyone—for some people more extensively than for others—a structure that hypnoidally sequesters certain self-states and limits their communication with one another as a proactive defense against the repetition of what has already happened. This proactive defense operates when massive trauma has occurred but operates equally and in some ways even more extensively when early "developmental trauma" has created areas of dissociative mental structure with or without subsequent massive trauma. The reason that developmental trauma (also termed relational trauma) is of such significance is that it shapes the attachment patterns that establish what is to become a stable or unstable core self.

A child's core self becomes internally bonded to the early parental objects through interactions that reinforce who the parent perceives the child to be and who the parent denies the child to be. The main source of power that parents have over children comes not so much out of what they tell the child to do as from "showing" him who he is. That is, by relating to the child as though he is "such and such" and ignoring other aspects of him as if they do not exist, the parents "disconfirm" (Laing, 1962) the relational existence of those aspects of the child's self that they ignore. This disconfirmation, because it is relationally nonnegotiable, is traumatic by definition and is intrinsic to the existence of developmental (relational) trauma. Such trauma is typically cumulative. If the child's sense of self is to remain intact as he matures, he has to preserve the early attachment patterns on which his core self rests by continuing to exist in the mind of each new significant other that comes along as the same "self' that was "his parents' child." As he does so he continues to dissociate those aspects of self that originally were too disjunctive with the core attachment to be contained as "me."

This is a major reason why it is so difficult for many people to change in treatment. An unreflective attachment to the early discontinuing object means having to be whoever the other person seems to see you as (in order for you to prevent self-destabilization), not simply having to do what the other person seems to want you to do. Thus, a central goal of any treatment is that the therapist enable the patient to move from experiencing his enacted patterns of behavior as the person he is, to experiencing these patterns as something that he does, and thereby facilitate the development of self-reflection. Again, for many patients characterologically, and for all patients in some areas of their personality, the development of self-reflection must precede any attempt at investigating conflict. In the areas where development has been thwarted, the analyst attempts to help a patient change what is classically called ego syntonic to what is classically called ego alien. Thus the enacted ways of being are no longer "who I am" but are gradually replaced by the cognitive perspective of "what I do." As this change takes place, a person is more able to hold, reflect on, and potentially resolve disjunctive self-experiences as states of conflict without the effort's being automatically short-circuited by dissociative processes designed to protect self-continuity.

Dissociation is a defense unlike any other. It protects the stability of the self by controlling unsymbolized traumatic affect that it cannot regulate. It is not simply a different term for the concept of repression. Repression defines a process that is designed to avoid disavowed mental content that may lead to unpleasant intrapsychic conflict. Dissociation shows its signature not by disavowing aspects of mental contents per se, but through the patient's alienation from aspects of self that are inconsistent with his experience of "me" at a given moment. It functions because conflict is unbearable to the mind, not because it is unpleasant.

In those (sometimes pervasive) areas of personality in which dissociation has significantly organized the development of mental structure, not only has the capacity to bear internal conflict suffered; the capac...