The day the clock stopped. Primitive states of unintegration, multidimensional working through and the birth of the analytical subject

This paper is based on one idea and built around one clinical experience that helped me to broaden my comprehension of it. The idea, underlying the work of several authors, is that when the analytic field is saturated with primitive and unintegrated mental contents, the analyst's somatic countertransference is a precious indicator of a deep, dissociated form of communication. The clinical experience concerns the difficult elaboration of a complex, multifaceted countertransference that took place during the early stages of the analysis of a sensitive patient who used to communicate in a very dissociated way and that I found hard to contain. This experience, closely described in the article, led me to formulate the clinical idea that the transference field may be made of distinct layers (psychoid, affective, verbal), and that each one of them may potentially convey dissociated, even contrasting bits of information. The corollary of this is that the analyst should be ready to accept contrasting sensations, feelings and thoughts at the same time, as they might be the basic ingredients of a complex reverie. The analyst could find himself/herself in front of his/her own internal unelaborated multiplicity before a symbolic image may emerge to link the scattered pieces of the experience. Nevertheless, the heart of this paper is not about suggesting an idea, but in the sharing of a complex working through, which fostered the birth of a new, more human relational perspective: the capacity of being together in time, in a transitional space where there is neither total separation nor fusion.

Plurality of psychic states in the field

The archetypal images of separation and dissociation are very present in Jung's model of individuation, and Jung proposed a dynamic relationship between conscious and unconscious parts of the psyche of analyst and analysand. In addition, numerous contemporary authors emphasize the multiplicity of the self and the emergence of the field created by both participants, allowing for symbolization and transformation. I describe here my attempts to reach the encapsulated psychic split of a client. Defeated in my search for any conscious, developed self-state that could readily match his, I had to nurture the field of our relationship, where a child was imprisoned and allow space for daydreaming. The field ultimately supported the emergence of a primitive part of me matching his, which he required to safely mirror his experience. In staying and dreaming within this field of longing, we reconstructed his initial trauma. The defeat of my ego and the response to the multiplicity of Mark's states through the sustained reverie of holding a child, a single archetypal image, stirred the good mother in me, forged a container for non-rational, affective somatic psychic splits, and initiated psychic changes.

Transgender medicalization and the attempt to evade psychological distress

In this paper the author argues that trans-identification and its associated medical treatment can constitute an attempt to evade experiences of psychological distress. This occurs on three levels. Firstly, the trans person themselves may seek to evade dysregulated affects associated with such experiences as attachment trauma, childhood abuse, and ego-alien sexual feelings. Secondly, therapists may attempt to evade feelings, such as fear and hatred, evoked by engaging with these dysregulated affects. Thirdly, we, as a society, may wish to evade acknowledging the reality of such trauma, abuse and sexual distress by hypothesizing that trans-identification is a biological issue, best treated medically. The author argues that the quality of evidence supporting the biomedical approach is extremely poor. This puts young trans people at risk of receiving potentially damaging medical treatment they may later seek to reverse or come to regret, while their underlying psychological issues remain unaddressed.

Race, religion and a cat in the clinical hour

Racial and religious identities are complex, often mired in dynamics of 'othering'. Such dynamics easily become a means of distancing the pain, fear and rage of intergenerational traumas, thus undermining ways race and religion can be powerful vehicles for the transference and countertransference. Drawing from a history of race in America as well as Jung's anxiety when meeting the stranger within himself, this paper focuses on 17 years of work between a black female patient and white female clinician (me). Together we encountered themes of hatred, silence, guilt and intimacy in the transference and countertransference, themes eventually symbolized by the presence of my cat which was locked into the bathroom for each session. This cat came to represent a bridge through developmental traumas and wounds of racism.