Abstract
I would like to look at the question of the senses in psychoanalysis not so much from the standpoint of how the analyst listens and takes in data (which is generally taken for granted as the natural role of sensory perception in the analytic situation) as from the standpoint of the active uses of sensory perception. Attention to the domain of sensory perception, especially in working with patients who suffer from what might be described as disorders of the sensorium, reveals the importance of the analyst and patient’s engagement at the sensate level and the significance of active perception in the analyst’s technique.
Attention to sensory perception in the analytic situation illuminates certain phenomena that otherwise remain obscure and that invite conceptual elaboration. Of particular interest is the way in which immediate sensory experience seems to lend itself naturally to a shared consciousness of the world and how this affects a kind of functional symbiosis between analyst and patient at the sensate level.
This has implications for our understanding of clinical theory and technique. I will propose that the analyst’s sensory participation serves a quite specific function, namely, to initiate or catalyze a shared framework of sensate experience in the analytic situation. This I will refer to as the analyst’s inductive function, inasmuch as it entails an active dimension of technique that constantly, if unconsciously, seeks to establish a shared sensory state. Automatically and implicitly, we search for a kind of perceptual communion: when we take up a certain psychic posture, turn our attention to particular things, speak in a certain tone of voice, we are not simply being receptive and opening up lines of communication; implicitly we are engaging in a kind of sensorial-symbiotic strategy, reaching out through our sense organs to form a framing hold and symbiotic bond. Without knowing it, we are always making the patient notice what we are noticing, and vice versa. This is by no means a deliberate or conscious part of technique, but it is crucially woven into what we do.
I will try, in just a few words, to say something about this essentially inductive, performative dimension of the analyst’s sensory participation. The things the analyst pays attention to, how the analyst speaks, the modes of psychophysical embodiment and ambient states of consciousness of the analyst—these are the modes of induction, the ways in which the patient is inducted into the “common sense” of shared sensate experience (and these, too, are the ways in which the patient unconsciously seeks to recruit the analyst into a shared sensory framework). I will conclude by suggesting some possible implications for an expanded model of technique, especially the idea that the analyst’s technique should logically include active experimentation with altered states of perception, attention, and body consciousness, as well as improvisations in the analyst’s modes of speech. But I will begin with a brief vignette, to frame some of the ideas I will tackle.
Hugh
The patient, Hugh, amiable, attractive, and highly successful in the world of design, could not comprehend his alienation from ordinary human affairs, and had found every attempt at therapy utterly futile. I could tell that my formulations and interpretations were useless to him, since they were aimed at his internal experience, which he simply could not perceive or make sense of. One day he walked into my office and paused for a moment, looking at a photograph hanging on the wall, before taking up his appointed seat and continuing the futile exercise of trying to communicate with a foreign object. I took this as a cue, and pointed to the photograph. Thus began a strange new activity in which, instead of talking to me, he spent time looking—not so much gazing at but, rather, examining—patterns in the weave of the rug and in the shadows thrown on the wall by the plants or by the light coming through the blinds. Few words passed between us, but I found myself mesmerized by the experience of being in a pattern-world for whole sessions at a time. Tortuous attempts at verbal communication subsided, and there was now a sense of contact. It was a situation of noticing, attending to things together, conjointly occupying a world of sensory experience—not yet communicating and articulating the separate psychic realities of two people, certainly not yet an experience of an interpersonal relation with its hidden layers of transferential valence and affective identifications passing back and forth between us, but a shared location of attention. The challenge at this point was to allow this experience of a sensory/perceptual identity to take hold and develop.
I offer this description as an example of a kind of patient who obliges us to shift our attention to the sensory domain, and who will sooner or later require of us a corresponding shift in clinical technique. Psychoanalysis, of course, provides unique tools for the illumination of the psychic interior; so it is natural that the analyst, when confronted with this kind of dissociation from internal life, would look for its causes on the terrain of unconscious conflicts (via dreams, associations, symptom formation, countertransference data, splitting in the clinical field, and so on). But I think it is also sometimes necessary to do the opposite—to pay special attention to the surfaces, the sensory experience itself, and to actively seek a way of engaging at the level of sensory perception.
Sensory Perception in Clinical Theory
Freud (1895), from the outset, highlighted the role of perception in the formation of the system Cs. 1 But since clinical technique was to be harnessed so emphatically to the task of observing and analyzing unconscious processes, the workings of perception-consciousness in its own right received far less attention in clinical theory. Indeed, the analytic setting and analytic technique were designed to minimize external sensory stimulation, the better to facilitate observation of data originating at the level of unconscious wishes and conflicts. It was thus assumed that the patient’s sensory experience reflected unconscious wishes and conflicts displaced onto the body. Likewise, the tools of analytic technique would ensure that the the analyst would be shielded from a barrage of extraneous sensory stimuli, so that he might focus and hone his attention to the data of the unconscious. To this end the analyst sought to effect a peculiar state of evenly suspended attention, a neutral-receptive hovering that would optimize his ability to pick up the drift of unconscious communications, and make it less likely that he get caught up in the noise of conventional conscious thought and the ordinary perception of things.
Following the logic of its own inception as a technique of listening and analyzing, psychoanalytic clinical theory traditionally found little to say about the active components of technique. Always alert to the possible taint of suggestion, the highest value was placed on abstinence and neutrality. Much has now changed: in the wake of a paradigmatic shift in recent decades toward intersubjective models of clinical process, modern psychoanalysis has grappled anew with the question of the analyst’s neutrality, and the analyst’s contribution to the clinical process has been extensively explored and described (in terms of models of countertransference, of enactments, of reverie and co-created constructions in the clinical field, etc.). But while the analyst’s receptive, responsive functions are richly documented in these models, the analyst’s inductive or initiating functions—the way he actively engages the patient—have received less systematic attention, and the phenomenology of sensory engagement in its own right remains sparsely described in clinical theory.
To be sure, the domain of sensory perception does not easily lend itself to analytic models of description and explanation, since sensing and perceiving are phenomena that take place subsymbolically, 2 at the level of presentation rather than representation. The quality of active sensory engagement is not registered in the realm of wishes and fantasies and representations, but takes the form of a concretely shared event, undifferentiated at the level of self/other. This is because sensory perception implants us directly in the world of things, “before” accruing meaning and significance to the self. 3 Its effect is radically synchronic—it occurs in the ephemeral present, not yet captured by systems of representation. Its effects are felt but not known in thought, experienced but not categorized in self-awareness. This is a mentality where the relevant activity is not psychic transformation (through interpretation, containment, affective attunement, working through, and so on), but engagement (i.e., engagement with the world of perceptual objects). It is a psychic domain where what matters is what we do rather than what we think, imagine, or say. For all of these reasons, the essential characteristics of sensory perception place it outside the usual purview of our clinical theory.
The question to be addressed here is, how are we to think about the particular role of sensory perception in the clinical situation? How are we to conceptualize the specific function of the analyst’s active sensory engagement, and what are the implications for technique?
I will suggest that sensory engagement constitutes a distinctive, continuous, active dimension of the analytic encounter; that its vicissitudes deserve attention in their own right; and that dysfunction at the level of sensory engagement requires attention specifically at the sensate level.
Isolated Experience vs. Shared Phenomenon: Access to the Sensory “Commons”
The act of perceiving an object—sensing something anew—is not necessarily or essentially an individual act; on the contrary, it naturally evokes a shared or communal experience. Central to my thesis is the idea that a crucial distinction is to be drawn between perception as shared phenomenon and perception as the isolated experience of an individual. The implications of this distinction are many, but for our immediate purposes I will focus on two highly significant ways in which shared perception effects individual development, and hence potentially affects our clinical models. In summary form, I will outline the role of shared sensation and perception in (a) transcending the contours of the self and expanding consciousness; and (b) linking the inner and outer worlds (“common sense”).
Transcending the Contours of the Self and Expanding Consciousness
Experience in the sensory domain has the potential of instantly expanding and transforming the contours of the self. This can be ascribed to the direct transmuting effect of renewed perceptual contact with the world of objects (external or internal), wherein the self “becomes” the object (as described by phenomenologists) or temporarily “melds” with the object. But it is also because the immediacy of perception in the presence of another momentarily extinguishes the boundaries of self and other. Even where there is a clear consciousness of the presence of others (and there is probably always a rudimentary awareness of their presence), the distinctive effect of shared sensate experience is that it momentarily dissolves the difference: in the act of jointly perceiving an object, one is rendered experientially indistinguishable from the other.
In this domain of shared or communal perception lies something inherently transformative, something not found in the act of individual perception alone, or in the context of relating to an object. The distinctive thing about being jointly alive in the act of shared perception is that one is, in a sense, sharing the sensorium—the body—of the other, free of the demand to relate to the other as object.
What is at stake is the expansion of individual consciousness, the ability momentarily to transcend the limits of individuality, to find a bridge to worlds (both external and internal) beyond the restricted sphere of ego consciousness.
Linking of the Inner and Outer Worlds (“Common Sense”)
Of great significance is the role that this kind of shared experience plays in raising individual perception to the level of common sense—the feeling of being able to momentarily match the inner and outer worlds, and thus link and marry them. 4 The individual’s sensory experience serves as a gateway to the experience of “common sense,” but we need the participation of another to actually make it so. 5 Where shared experience falters, and especially when it is systematically obstructed, a change takes place wherein sensation and perception begin to be deployed in as a different way—less as a gateway to the the sensory “commons” than as a gatekeeper or barrier to shared experience. Sensory perception now becomes the province of the individual’s guardedness and control over external and internal objects. Now a bastion against impingement and communion alike, the sensorium falls under the mastery of the individual ego.
Another way of putting this is that sensory perception opens us up naturally to a potentially sharable domain of experience, a kind of perceptual “commons.” Entry into the sensory commons allows the outside world to become “usable” to the self in new ways (fresh food for the psyche, to adopt a phrase of Bion), in a way analogous to how dreaming allows the internal world to become usable to the self. In this sense, shared perception provides the basis for a kind of “communal dreaming” of the external world, bringing the patterns and rhythms of the object-world under the sway of apperception, and thus into the precincts of self-experience.
The Function of Sensory Symbiosis
I have proposed that the shared experience of sensory perception effects a kind of sensory symbiosis between analyst and patient. This is not the emotional symbiosis of the parent-child dyad, but the symbiosis of a shared consciousness of the world. 6 Symbiosis in the sensory domain is not founded on the need for emotional attachment, on libidinal gratification, or on regressive wishes for safety in merger with the object; instead, it represents a progressive (forward-looking) drive to “discover” the world beyond the self or, more accurately, to meld the self into the world. This drive for an expansion of self through active perception of the world stands in opposition to the tendency of the ego to limit and constrain consciousness, and thus keep the contours of the self defined and unchanging.
With a few exceptions (e.g., Milner 1952), the wish to fuse symbiotically or to transcend the self have generally been viewed by psychoanalysts as defensive strategies; and indeed, the clinical treatment of pathological narcissistic organizations is barely possible without an understanding of the ways in which omnipotent and intrusive merger strategies are employed to forestall separation and deny the reality of dependency along with its effects, such as envy and possessiveness (Rosenfeld 1988; Meltzer 1992; Steiner 1993). But insofar as the yearning for shared experience at the sensory level also reflects a vital psychic drive to become part of a larger world, it would be important to recognize the therapeutic need for sensory symbiosis in its own right, as distinct from defensive pathological merger strategies, and as distinct also from autistic strategies of self-isolation. 7
It is evident that fusing with something larger than oneself is of immense importance psychologically, its relative absence from psychoanalytic clinical theory notwithstanding. 8 Contrary to the automatic assumption of defensive regression, we should keep open the possibility that certain troubled patients, in their yearning for transcendence and sensory communion, are searching for a way to refind themselves through making contact with the immediacy of the object world (a search that may also be understood in terms of a universal striving to populate a vast nonhuman world with human forms: to invest the world of objects with personal feeling). Failure to recognize this striving in the patient may itself lead to clinical impasse, because it may blind us and limit our grasp of how passionately, even violently, the isolated individual might be driven by the hunger to escape the prison-house of ego consciousness, and might implicitly seek our urgent aid, through shared experience, in finding new life in the world of objects.
Object-seeking has generally been understood in terms of the ego’s executive functions, whether in terms of procuring suitable satisfactions for unconscious wishes, or in terms of meeting object-relational needs for identity, or for recognition or regulation of the self. The hypothesis of sensory symbiosis suggests another, more impersonal dimension of object-seeking: that in being drawn to the object world (for example, in the gravitational pull exerted upon our senses by the natural world, or our often insatiable and ruthless attraction to cultural objects), it is not necessarily the purposes of the individual ego that are being served, but the need to satisfy a fundamental drive for transcendence and union with the world beyond the contours of self. This impersonal drive may, however, manifest itself in confusing and troubling ways (for example, as an urge to break free of attachments, or to dissolve or destroy boundaries between individuals).
If there is merit to this depiction of a basic tendency to transcend the boundaries of ego consciousness—a drive to meld into the forms of objects, to become coextensive with a larger world—then it will surely manifest itself everywhere, and not only in the clinical setting. Normal expressions of this drive to marry the world are myriad, woven so completely into everyday life that usually they do not stand out; nonetheless, they are critical to psychic life. It is obvious, for example, that a special psychic value is to be found in those heightened sensory experiences that take place in communal contexts. Shared perceptual and sensate experience (the public viewing of art, dance, and music; the urge to move one’s body and to use one’s voice in unison) afford a distinctive alteration of consciousness: the collective or group framework seems to facilitate entry into a sensory commons that is of immense psychic value in its own right (beyond the identificatory processes described by Freud [1921] in “Group Psychology and the Analysis of the Ego”). Whatever else is entailed in these communal activities, they seem to transport the self beyond the ego’s individualistic constraints, and in this respect appear to express the drive to lose oneself in the world, to temporarily dissolve the limited boundaries of ego consciousness.
Of clinical interest, then, are individuals unable to partake of the sensory commons in this way, people impaired in their capacity to enter or make use of states of sensory symbiosis. Here a very different picture of sensory hunger emerges, one in which faith in the communal experience of self has been replaced by solitary obsessions, compulsive and lonely forms of autostimulation and self-regulation. Should we make more room in our clinical models for recognition of the troubled patient’s attempts to find renewed contact with the world, as manifested in the drive to transcend the boundaries of self? The hunger for self-transcendence and sensory communion is taken up in innumerable religious, spiritual, and cultural discourses and activities. The question is whether there is a way to depict this powerful drive in a distinctly psychoanalytic way, and apply it to our clinical theory.
Clinical Implications
I have tried here to focus attention on the function of sensory perception in the clinical encounter. Beyond shaping how we listen to and take in the clinical material, our sensory engagement, without our usually being aware of it, serves to initiate an essential (prereflective, subsymbolic) kind of contact with the patient. We join the patient in a kind of perceptual symbiosis that provides a sensory frame within which things can emerge in the analytic process. I would like to examine some implications of this for clinical technique.
The Sensorial Dimension in Clinical Technique: The Analyst’s Inductive Activity
Recognizing the importance of sensory symbiosis between patient and therapist raises a number of questions concerning technical approach. It brings to the fore those activities of the analyst—which I will refer to as the inductive dimension of technique—that catalyze an engagement at the sensory level, forming a vital substrate of shared experience. We can distinguish these inductive activities, which usually operate at an entirely implicit level, from the more familiar receptive/interpretive activities described so extensively in the contemporary literature (in terms of the empathic, containing, reverie, and symbolizing functions of the analyst, as well as the analyst’s countertransferential participation in enactments and intersubjective co-creation of clinical facts). In contrast to these symbolizing, interpretive functions of the analyst, which move the patient in the direction of self/other differentiation, enhanced self-reflection, and individuation, the inductive activities of the analyst move in an opposite trajectory, toward the formation of a symbiotic union with the patient at the sensory level. 9 Here the analyst operates in the domain of de-differentiation, where consciousness of the world effaces the boundaries that demarcate separate identities, and where the psychic necessity of shared sensory experience takes precedence over intersubjective object-relational dynamics. Clinical technique at the level of sensory symbiosis eschews the search for symbolic meaning and self-reflectivity in favor of experiencing the contours, movement, and impact of objects in and of themselves. Insofar as the inductive dimension of technique operates as a counterpoint to the receptive/interpretive/symbolizing dimension, the analyst is involved at all times in a kind of dual movement between differentiation and de-differentiation, between symbolization and symbiosis. This entails perpetual micro-adjustments in consciousness—a constant experimental shifting of attention back and forth between, on one hand, immersion in the perceptual qualities of objects themselves (whether external or internal) and, on the other, apprehension of self/other relational demands. 10
Implications for an Active Experimental Technique
This ability to engage the patient at the level of a functional sensory symbiosis is a dimension of the analyst’s activity that, despite its fundamental role in securing a basis for therapeutic contact, is little conceptualized in our clinical theory. Instead, it tends to go unrecognized as an implicit, nonspecific aspect of the analyst’s “skill,” or the “fit” between patient and analyst. Occasionally the breakdown of shared experience forces us to abandon the receptive/interpretive position in favor of a more active approach to reviving the therapeutic framework of contact—when, for example, it becomes necessary to awaken a sleeping patient, or to reclaim the attention of a patient trapped in a fugue or trancelike state.
These extreme instances, however, merely bring to the fore a dimension of our activity that is operative at all times, albeit in an automatic, implicit form, namely, our need to secure a common sensory and perceptual framework with the patient as a fundamental feature of our clinical work. We constantly seek to effect contact and communion at the psychophysical level of shared experience, by means of unconscious shifts in our own psychophysical states, variations in the tone, patterning, and rhythm of our speech, adjustments in what we choose to pay attention to in the clinical exchange. In all these ways, we induce and renew the sensory symbiosis that forms the framework within which therapeutic exploration of the internal world and of intersubjective phenomena can take place. In the absence of this kind of contact there will emerge, sooner or later, a troubling sense of isolation and futility in the therapeutic encounter (though the disturbing realization of sensory isolation is very often obscured by well-developed pseudoengagements (false-self strategies) not infrequently involving the fetishization of the therapy relationship itself as an adaptive disguise to deny the underlying impasse caused by sensory miscommunion. The question is, would our clinical theory benefit from a more explicit recognition of the inductive role of the analyst?
Especially, then, in cases where the patient suffers from what may be called a psychosensory disorder (which I would define as psychophysical isolation resulting from impediments to sensory symbiosis), it may be necessary to shift the emphasis to the inductive dimension of our work, to make more explicit and deliberate use of the inductive elements that usually remain implicit and unrecognized in our work with patients. This would entail the analyst’s (a) increased attention to the sensory domain in its own right, to the perceptual qualities of things, and to shifts in consciousness and psychophysical states (to what Sekoff [2012] refers to as the textural qualities of what goes on in the clinical encounter); and (b) adopting an innovative approach to technique, including a willingness to experiment with states of attention and modes of speech.
Since speaking remains a primary means of making contact in the talking cure, the analyst’s patterns of speech (especially improvisations in modes of speech) play an important role in the search for sensory symbiosis. Here the performative (in contrast to the semantic) function of speech comes to the fore: it is not the symbolic function of words that counts here, but the embodied (and shared-bodied) quality of speech that induces a shared perceptual awareness of things. This is a dimension of speech that is not yet dominated by the deconstructive (interpretive) use of words, but remains deeply embedded in sensate experience, permeated by the sensibility of symbiotic experience. One might say that in the search for sensory symbiosis, the analyst speaks first and foremost in order to establish sensory contact (using speech to depict and draw attention to objects that can be perceived and experienced in common); secondarily, the analyst speaks “generatively” (Sekoff 2012), in the sense that the words begin to parse meanings and build symbolic connections at the intersubjective level, while remaining embedded in the shared patterns of sensory symbiosis.
The following vignette offers an example of innovation in technique involving a form of descriptive speech whose effect is primarily performative (formative of shared sensory experience), before the words begin to take on the function of intersubjective symbolic communication.
Penny
Like Hugh, Penny could make no use at all of the verbal-symbolic associative processes on which psychoanalysis was initially premised. Like many of our contemporary patients, Penny had a successfully functioning social ego but was unable to make sense of internal psychic states. With considerable surface acumen, she could well follow the patterns of behavior involved in attending sessions, but could not communicate anything other than surface niceties, because nothing interior or buried or conflicted could be represented; all she could do was adhere to one physical sensation or obsessional thought process after another. My interpretations and attempts to make something of the encounter, while acknowledged politely by her, were like so many dried leaves carried off in the wind. The meaning of my words evaporated, while her mind remained inextricably mired in the detailed patterns of painful muscular tension, obsessive repetitive thoughts, and compulsive checking of the sensory surround.
I will not attempt to document the assortment of inquiries into her inner conflicts, and the differently angled interpretations that I tried out concerning her hostility, aggression, and sadism, none of which found the slightest corresponding echo in her mind or emotions. Penny did find a way occasionally to indicate that she understood the dilemma she posed for the psychotherapist: occasionally she would leave me a competent phone message or a well-written note expressing the hope that I would not give up on her, and explaining that she knew she did not think like other people, could not make sense of emotions or relating to others. These insights were of no use to her in the sessions, but they helped me to gradually let go of my quest to make sense of her mental and emotional life, and to enter a more experimental mode in my own mind.
I had begun to notice that Penny would regularly mumble something perfunctory and offhand—something like “loose door handle” or “the lamp is high” or “nice shoes”—that seemed like non sequiturs, and which I took to be residues of her competent social self. Inquiring into the meaning of these comments predictably led nowhere. Now I endeavored to situate myself more fully on the physical terrain of sensory experience, and to allow myself as much as possible to hear the word-shapes as she mumbled these strange phrases, and to focus my attention intently on the objects—the shoe, the door handle, the lamp. Soon I found myself speaking in a new way, describing the objects that Penny had drawn attention to, without attempting to make any symbolic links to her internal states, past events, or unconscious conflicts or defenses. I found myself depicting the objects as if sketching them in words. One object in particular, a plant that we could both see at the end of the room, became the focus of our attention for some time, as Penny posed a series of oddly concrete questions. So, responding to her prompts, I described the extended spoonlike leaf shape of the rather peculiar plant; how the design of the leaf allows drops of water to be funneled toward the semi-exposed bulb below, and how the papery netting surrounding the bulb acts like a spongelike sleeve, drawing the moisture down and allowing it to seep into the soil at the base of the bulb, where the roots can get the benefit, and so on. But if I did not wait for her prompts, and went too far afield in the urge to explain, then I would sense her slipping back into her obsessive-somatic cocoon.
In evaluating this phase of my work with Penny, I think above all that the descriptions (or, more accurately, depictions) of the plant facilitated and embodied a joint sensory experience, one in which her prompting and my speaking served the performative function of forging an experience of perception-in-common. The important factor here is not the content of the description, but that the depiction speak for both of us as we perceive the object together. One may do exactly the same thing depicting an object in the internal world that is “visible” to both parties, but in cases where there is an impairment of the capacity for sensory symbiosis, the work often has to start in the perception of objects in the external world.
In my judgment, then, the main benefit in this phase of Penny’s treatment arose not from associative or symbolizing activity but, on the contrary, from the forging of a shared perceptual and sensory experience.This required, first, a technical approach of experimentation on my part, an attempt to forgo my usual state of ego consciousness and seek out fresh sources of data at the sensate level. Then, once some level of perceptual communion had been established (which owed as much to Penny’s seeking out objects in the environment as to my technical innovations), I began to speak in a new way, in a mode that may be described as generative speech, in that it remains embedded in the experience of a sensory symbiosis, and does not yet attempt to interpret the dynamics of intersubjective relations or intrapsychic processes. In terms of clinical theory, the discovery of a suitable mode of generative speech always relies on an experimental approach. One must learn how to speak anew in the presence of the patient.
When working in the terrain of sensory symbiosis, the urge to make explanatory connections and to suggest symbolic correspondences is often prominent, reflecting the strain and difficulty for the analyst who must remain for prolonged periods in a shared sensory-based state, without recourse to the security of one’s established ego consciousness. On the other hand, the advent of shared perceptual and sensory experience in the therapeutic situation, especially where it has been absent or lacking, is capable of bringing about a unique transformation in the analyst’s state—a sense of liberation from the strictures of the self and a new experience of the world.
Beneath her socially skilled surface, Penny was chronically overwhelmed by interpersonal contact. Habitually driven into an almost autistic retreat, she was unable to secure a basic kind of contact—at the level of sensory immersion with others—that would allow her to escape her sensory isolation and the tyranny of a constricting ego (autistic defenses against a useful symbiosis). When, later on, Penny developed a series of humorous sketches of a kind of Whole Earth Catalog of things for the analyst’s office, to make it more pleasant and to work better for the patient, I came to think of the plant descriptions as not only the critical forging of a shared state of consciousness, but also the genesis of a workable contact barrier (a usable psychic boundary marking the contours of self in relation to inner and outer worlds). The literalness of the plant-as-object was gradually supplanted by other uses: it became an object perceived from multiple angles, brought alive at different moments for different uses, attracting new words, thicker description, a site for puns, associations, and representations of inner states. On the basis of a shared sensate experience, the object now became a vehicle for “common sense”: gradually the plant took on the qualities of an intermediary or transitional object, something the patient could use to begin thinking and imagining self and other, inner world and outer. This marked the emergence of the possibility of intersubjectivity in the clinical encounter (the intersubjective third [Ogden 1994a,b]). The object became available for symbolic use and communication, in the mode of “play” or creative illusion, between patient and analyst, between conscious and unconscious layers of experience, between private inner worlds and the sphere of interpersonal or public communication (“common sense”). But these uses of the object, and the development of an intersubjective mode of symbolic communication, could not have taken place in the absence of a satisfactory communal perception of the object, and the accompanying experience of sensory symbiosis. What I want to emphasize here is not primarily the achievement of separation (Penny, after all, suffered from a kind of distorted overseparateness from herself and the world of objects), but the achievement of a satisfactory symbiosis, a useful de-differentiation between self and other, by means of finding a shared perceptual experience. Thus Penny could escape her isolation and imprisonment within the strictures of the obsessive-compulsive strategies of her ego. For a patient like this, expanding the possibilities of self through shared sensate experience is a necessary condition for establishing emotional and interpersonal communication.
In the case of Penny, the work of founding a sensory symbiosis through the joint perception of external objects opened up, in turn, the possibility of a generative mode of speech and communication, leading gradually to new capacities for thought and communication, so that slowly it became possible to symbolize and think about internal states, memories, and the sense of self in relation to others. Only on the basis of symbiotic contact, carried out in the absence of relational demands, could a basis be found for her own exploration of the world
Modes of Induction: Posture, Psychophyical Habitus, Grain of the Voice
There are many modalities through which sensory and perceptual contact is made, notable among them the varieties of attention the analyst employs in the clinical situation, and the analyst’s psychic posture and ways of speaking. All of these, of course, usually make their effect subtly, without our deliberately manipulating them.
By posture I am referring to a usable somato-psychic form in relation to a specific task. We take it for granted that a certain range of postures are fitting for specific practices; that skiing, for example, or playing the violin, meditating, wrestling, or writing each requires an inhabitation of the psyche-soma that sets in motion the activity. Freud specified the postural requirements for the patient undergoing analysis (recline on the couch, etc.), but in fact the analytic process probably relies more on the posture of the analyst. 11 In speaking of the analyst’s posture, I am focusing on a kind of psychophysical readiness to engage the patient at the level of the sensorium. I have recently become aware that the chair I sit in during sessions is placed slightly differently with each individual patient. An even greater variability, of course, pertains to the voice. Roland Barthes (1977), in writing of “the grain of the voice,” refers not simply to timbre, tone, volume, or accentuation; rather, he describes something like the way one’s voice is used. How the analyst’s voice inhabits his body, and the task the voice is aimed to accomplish, is always a matter of clinical significance. In the peculiar emanations of posture and voice, the analyst is never simply responding to the patient’s communications, but is actively creating a psychosensory framework within which communication might take place.
Communion and Miscommunion: Sensory Dislocation and its Repair
If it is true that analyst and patient are constantly engaged in unconsciously establishing a shared perception of things, then it is equally true that we are always dealing with some degree of miscommunion. In the sensory encounter between patient and therapist there exists a natural flux and variability, rather than a fixed symbiotic engagement. But where there exists a more thoroughgoing miscommunion, a systematic inability to sense things together, we find ourselves confronted by more far-reaching obstacles to therapeutic contact. While the implicit striving for sensory symbiosis usually lies largely unrecognized in the background of our clinical encounters, it is forced to the foreground in cases where dissociative and adhesive processes predominate. When a particular patient (or analyst) has become incapable of shared experience of the world, we often find ourselves in the territory of certain kinds of psychic disability (variously described in terms of pathological narcissism, disorders of self-regulation, autistic syndrome disorders, dissociative states, alexithymia, and attention deficit disorders). Sometimes the block to communal perception—the inability to see things or sense things together—is blatant, as when obsessional mechanisms or autistic features are prominent. But more frequently the stratagems of sensory disengagement operate in a well-disguised fashion, under the auspices of a well-adapted “false self.” Behind this, however, we will eventually find a solitary mode of being in the world, and a signal inability to profit from the experience of sensory symbiosis. The outcome, which typically presents itself as a kind of narcissistic fortification, is a psychic organization that rests on strategies of pathological autonomy. In these cases, it is imperative that we recognize the patient’s inability to partake of the shared sensory framework, and that this sensory isolation is a crippling obstacle to therapeutic engagement.
As regards technique, I consider it axiomatic that repair of the damaged or dysfunctional sensory framework takes place not at the level of psychic representations, unconscious fantasies, or transference interpretations, but at the level of sensory and perceptual engagement—through sensing and perceiving. Repair of the damage to the sensory framework will require active efforts by the analyst to find a point of engagement at the sensory level. 12
Summary
Communion in the perceptual sphere takes place in a domain that is, conceptually speaking, different from the more familiar terrain of transference-countertransference phenomena, enactments, and other clinical processes that take place between patient and analyst. Indeed, what is distinctive about the domain of sensory experience is that it does not depend on the distinction between self and other but, on the contrary, is the place where the relational requirements of communication between subjects may be momentarily set aside. In the act of perception, self and other are effaced, and the restricted boundaries of ego consciousness temporarily transcended, in favor of a more immediate sense of being in the world.
I have suggested that the analyst’s sensory participation is a matter not only of receiving the patient’s communications through one or another sensory modality, but of forging a sensorial basis in the treatment situation—a functional symbiosis (Bleger 1967) or shared psychic framework. It defines an inductive and performative (in contrast to a semantic and deductive) dimension of analytic work, insofar as this work of securing a shared psychic matrix involves an engagement of perceptual/sensory experience at a subsymbolic level. Thus, the analyst does more than establish a secure holding environment or static symbiosis: in addition to providing holding, containing, and interpretive functions, the analyst also plays an initiating, inductive role, finding and refinding a functional symbiosis at the sensorial level.
Footnotes
Acknowledgements
The author thanks Adam Blum for help in researching the concepts discussed in this paper.
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Speaking conceptually, engaging through the senses is a subsymbolic activity (
), insofar as it involves a concrete medium that is not represented by symbols—i.e., it does not essentially entail a fantasy or representation of engaging an object (though these qualities of fantasy and object representation will usually be appended at other levels of psychic organization), but takes the form of mimetic union or fusion through sensory contact (Cartwright [2010] uses the term proto-containment to describe aspects of this pre-representational domain.) At this subsymbolic level, objects are sensed and perceived but not related to, and the self becomes coextensive with its surroundings (de-differentiation). On this terrain of subsymbolic engagement, patient and analyst enter into various permutations of perceptual identification and aggregations of sensory involvement. Obviously, this level of sensory/perceptual engagement does not lend itself to secondary process awareness, but it is not part of the dynamic unconscious either.
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Phenomenologists may differ with my characterization, insofar as they see meaning as arising from, or embedded in, perception itself. My approach in this paper shares a great deal with the insights (and even some of the terminology) of phenomenology. I am thankful to Michael Levin (personal communication) for bringing my attention to Merleau-Ponty’s ideas about perception and the “body-subject.” Strikingly resonant, moreover, is Merleau-Ponty’s use of the term symbiosis (1945) to describe how perception is always shared with others. Also relevant is Heidegger’s definition of human being (Dasein) as being-with-others (1927), and his description of the world as always already shared with others. Despite the striking concordance of these concepts with my own efforts to describe the function of perception in analysis, my view remains somewhat oblique to a phenomenological view of ontology, since I continue to hold that unconscious psychic life has its own distinct reality, and that the self is constituted bidirectionally, as it were, in relation to internal and external realities simultaneously. While from the point of view of phenomenology my approach is undoubtedly dualistic, I think the question of how psychoanalysis can benefit from the insights of phenomenology is of ongoing significance (see, e.g., ).
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I am proposing that useful apperception (the rendering of perception as meaningful to the self and its history) depends on the entry into the sensory symbiosis with others, and that failure of this symbiosis impairs the individual’s ability to transform perception into useful apperception. Winnicott’s conception of transitional space () provides a model of this phenomenon.
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Finding an understanding, in theoretical terms, of this kind of shared sensory experience is a large question, one that cannot adequately be addressed here. Beyond the psychic phenomena that have been studied extensively in clinical theory (the domain of wishes, defenses, fantasy, identifications, transferences, etc.), is there a proto-psychic domain where mental and affective elements begin to aggregate in shapes, begin to move toward something with a usable form and shape? (Tustin1980; Ferro 1999; Cartwright 2009). Is there a not yet separated-out mentality where things are not yet objects, something like a “glischrocaric position” (Bleger 1974) where we are not yet differentiated, or where de-differentiation is a vital part of psychic life? (Milner 1952). Should we conceive of this in terms of “primitive” ideation or incipient mental functions, the terrain of “ideographic” images (Bion 1962) or “pictograms” (Aulagnier 2001)? The work of Meltzer (1975), Tustin (1980), and Alvarez (2006) provides another conceptual anchoring point for thinking about a sensory modality in psychic life, where autistic or adhesive processes (the insistence on sensory contact in lieu of other modes of psychic engagement with the world) becomes a tyrannical organizer of existence. recasts this as an autistic-contiguous mode, a fundamental component in a dialectical relation with other (schizo-paranoid, depressive) modes of psychic organization.
If we accept the idea of a kind of “rudimentary consciousness” (), a mode of being aware of things that is nevertheless prereflective, presymbolic, preindividualistic, and inherently communal, then we face the question of how to conceive of the formative role in psychic life of sensory perception in its own right. While Bion emphasized the role of “alpha function” in transforming beta elements (raw sense data) into alpha elements (psychic material useful for thinking, dreaming, etc.), I think it might be useful to consider something like a “beta function” (i.e., a sphere of psychic functioning where sensory experience operates not just as a something to be worked on and transformed by the mind, but performs distinctive psychic functions in and of itself). From this standpoint, the “beta function” may be seen as expanding consciousness into the world of objects, interweaving self into a psychic community (making “common sense” of the world, making use of “communal dreaming”). In this model, sensory perception would be viewed not simply in terms of proto-mental precursors in need of psychic elaboration and transformation, but as itself formative of psychic life in the world.
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The hypothesis of therapist-patient sensory symbiosis rests on the assumption of a prerepresentational level of psychic experience, which entails a prereflective perception of the other (Merleau-Ponty 1945), or a rudimentary consciousness (Bion 1962) of the other that does not entail a registration of individual identity and separate selves. This perception-based mode of psychic life, insofar as it naturally invokes shared experience, activates a symbiotic relation—symbiotic because its realization depends on the presence of the other experienced as undifferentiated, even though self and other exist objectively as separate entities. This brings us closer to a description of the domain of “being,” in contrast to “doing” (Erlich 2003), and what described in terms of “at-one-ment” and going-on-being. However, the implication for clinical work is that the possibility of going-on-being rests on the ongoing provision of a facilitating environment, which entails the active catalyzing work of the analyst (which I will describe as the inductive dimension of technique). In this sense, it is doing that precedes the possibility of being.
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Referring to the inherent “shape-making propensity” of the mind, conceptualizes the isolationist use of perception in autistic states as follows: “In normal development, this shape-making propensity will soon become associated with the actual shapes of actual objects. This will result in the formation of percepts and concepts which facilitate a working relationship with objects in the outside world which can be shared with other people. . . . In autistic children, their shape-making propensities have taken an atypical course which seriously hampers on-going psychological development. Because their ‘shapes’ are unshared with other people, they become entirely personal and peculiar” (p. 280). “Of course, we all create our world in that, in terms of our modes of perception, we construct a working simulation which helps us to function in what we quaintly call the ‘real world.’ . . . The trouble with autistic children is that their ‘creation’ is unduly ‘quirky.’ They have used the shape-making propensities of the human mind in their own idiosyncratic way. The evolution of their construction had not been modified by co-operative interplay with other people” (p. 281).
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The oceanic feeling, of course, was a matter of some interest to . While the urge to boundarylessness was eventually consigned to the workings of the Death Instinct, I think it is reasonable to consider the drive to sensory symbiosis as an alternative hypothesis—the urge, that is, to have boundaries dissolve in the service of refinding the world through sensory perception.
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Germane to the description of the “inductive” level of technique are the seminal contributions of Searles (1975), who identified a fundamental symbiotic dimension of the clinical encounter; Kohut (1971), who recognized the importance of the analyst’s provision of self-object functions; and , who described the provision of holding functions. My own emphasis is on seeking out the sensory level of symbiosis.
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This echoes Bion’s recommendation (1967) to the analyst to relinquish “memory and desire” when approaching the analytic session, and his further description () of the necessary oscillation between O and K, between knowing and experiencing, which forms the dynamic of learning from experience.
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, of course, opened up a vast new terrain of the analyst’s mental functioning in clinical technique when he outlined the elements of analytic technique in terms of the analyst’s mental state, in particular the capacity for receptivity and reverie that places the analyst within reach of the patient’s projections and proto-mental communications. I am extending this to the domain of the analyst’s sensory readiness to engage the patient.