This is an original manuscript / preprint of an article published by Taylor & Francis in Psychoanalytic Inquiry, Volume 39 2019, Issue 3-4, available online: https://www.tandfonline.com/toc/hpsi20/39/3-4
Emotional Communication and the Unconscious
in the Analytic Setting
Paul Geltner, DSW
In 1912, Sigmund Freud enjoined the analyst to turn "his own unconscious like a receptive organ towards the transmitting unconscious of the patient” (pp.115–116) and later suggested that thoughts linked to wishes could be transferred from one mind to another without language (Freud, 1921). But if this process exists—and many analysts (e.g. Reik) have agreed that it does—how can we know which of the analyst's thoughts have been transferred from the patient's mind into the analyst's mind, and which are simply products of the analyst's own mind?
Consider the following: (1) the patient describes a childhood birthday party, and the analyst anxiously remembers an intense sexual fantasy from her childhood, (2) the analyst is filled with tenderness for a patient as he obsessively describes plans for a dinner party and (3), the analyst feels outrageously invaded when she hears a patient talking on a cell phone in the waiting room.
In this paper, I propose a framework for identifying and understanding possible unconscious communications between patient and analyst. One form of unconscious communication can be conceptualized as a particular manifestation of emotional communication (Bucci, 2001), the channel of communication that evolved prior to symbolic language (Darwin, 1872), and the only channel of communication available to pre-linguistic infants. Emotional communication conveys information about a person's emotional state through the expression of feeling through the non-symbolic aspects of speech, such as tone and prosody and non-symbolic vocalizations, gestures, facial expressions, and silence.
After language is acquired, emotional communication is usually intertwined with cognitive communication—the channel of communication that conveys information through symbolic language. Although both channels operate simultaneously in speech, the experience of receiving each channel is different: Cognitive communication is experienced as thought; emotional communication is experienced as feeling. The experience of listening to spoken language melds the two channels of communication with the feelings aroused by the emotional communication often in the background. However, a complete understanding of any communication requires an understanding of both channels.
When an emotional communication is successful, the person who receives it experiences an attuned feeling that meaningfully corresponds to the expressed feeling: A bit of information has been accurately conveyed from the expresser's subjectivity to the receiver's subjectivity. When the receiver's feeling does not meaningfully correspond to the expresser's emotional state, the response is disjunctive: an emotional interaction has taken place, but there has been no emotional communication between subjectivities. (The term disjunctive is derived from Atwood and Stolorow's (2014 pp. 38) intersubjective disjunction, which I believe describes the same situation, although defined in different language.)
We can never know, with certainty, whether a receiver's feeling is attuned to the sender's feeling, but we can hypothesize that a feeling might be attuned if there is congruence between the analyst's feeling and some aspect of the patient's material that provides the clinical basis for thinking that a feeling is an unconscious communication from the patient. In other words, the analyst's feelings seem to have a meaning within the context of the patient's subjectivity.
An operational description of emotional communication expands the analyst's ability to apprehend unverbalized dimensions of the patient's experience by allowing the analyst to identify the meanings of feelings attuned to emotional communications. This significantly increases the analyst's ability to empathize with multiple dimensions of the patient's experience.
Brief history of the concept of emotional communication
The term emotional communication was first used in the psychoanalytic literature by Ackerman (1955), but it was first used in the sense that I have defined it by Spotnitz (1963). However, the concept is closely related to a number of other concepts in psychoanalysis, including thought transference (Freud 1921), complimentary and concordant identifications (Racker, 1957) empathy (Greenson, 1960; Kohut, 1959; Kohut, 1971; Basch, 1983), projective identification (as described by Bion (1959), not Klein (1946)), reverie (Bion, 1962; Ogden, 1997), coenestheic functioning (Spitz, 1945), the infantile nonverbal affect system (Krystal, 1988), role-responsiveness (Sandler, 1976); countertransference enactment (Jacobs, 1986), interactive regulation of affect (Schore, 2002), affective attunment (Stern, 1985), intermodal matching of affect state (Kumin, 1996), emotional engagement (Maroda, 1991), the implicit mode (Beebe, Knoblauch, Rustin, & Sorter, 2005), and implicit relational knowing (Boston Change Process Study Group, 2008) and many others. Although the exact relationship of all of these concepts to emotional communication is beyond the scope of this paper, I will use emotional communication as an overarching concept that encompasses aspects of all of these other concepts and the phenomena they describe.
Despite Freud's (1912, 1921) suggestions about unconscious communication, the classical tradition argued that the analyst's the feelings should be understood only as products of the analyst's own personality. Deutsch (1926) began a minority tradition, however, when she suggested that some of the analyst's feelings provide information about the patient, an idea linked to the idea of unconscious communication. Ferenczi (1932) explored the analyst's feelings as a dimension of the transference in his clinical diary, but the idea that the analyst's feelings could be used to understand the patient was expressed more explicitly by his student, Hann-Kende (1933). The idea of unconscious communication was elaborated in greater detail by Reik (1948), who devoted a book to the phenomenon. Over the next decade, a series of papers by Winnicott (1949), Spotnitz (1949), Heimann (1950), Racker (1957), and Searles (1959) addressed how the analyst's feelings should be used to understand the patient. Their work forms the clinical basis of the concept of emotional communication as presented in this paper.
The idea that some of the analyst's feelings can be understood as unconscious communication from the patient became a fully integrated part of the theory and practice of many Klienians (Rosenfeld, 1988) and Object Relationalists (Bion, 1961; Ogden, 1979), the Modern Analysts (Margolis, 1978; Marshall & Marshall, 1988), and some classically oriented analysts (Kernberg, 1965; Giovacchini, 1979).
Contemporary theorists have worked with more limited versions of this idea in the context of theories that emphasize the mutual, bidirectional influence of the patient and analyst upon each other. Stolorow, Atwood and Ross (1978), make an unelaborated (but recurrent (Atwood & Stolorow (2014)) positive reference to the idea. It appears frequently in the Relational literature on enactment (Maroda, 2001; Davies, 1994; Aron, 2003), to name just a few. Lichtenberg (1989) presented detailed case studies of how the analyst can experience effects related to a patient's model scenes (pp. 253) and Lichtenberg, Lachmann, & Fosshage (1996) further developed these ideas, integrated into a self-psychological perspective enriched with findings from infant observation. Bucci (2001) offers a sophisticated theoretical framework for understanding emotional communication within her fusion of cognitive and psychoanalytic concepts.
Although the foundational theorists described the clinical phenomenon, their underlying theories were incomplete. With the exception of Spotnitz (1969), who posited continuous two-way unconscious communication between patient and analyst, they often wrote as if the patient created the feelings in the analyst—as if out of nothing—without any contribution of the analyst's own subjectivity. Furthermore, they did not provide well-reasoned grounds for differentiating feelings that illuminated the patient's subjectivity and from those that were simply manifestations of the analyst's subjectivity. For example, Winnicott (1949/1975) wrote that the "truly objective counter-transference" was related to "objective observation" of the patient's actual "personality and behaviour" (p. 70). This suggests that the analyst's feelings serve as an objective standard of normalcy—an idea that is objectionable to many contemporary analysts (Lichtenberg, Lachmann, Fosshage, 1996).
When Freud (1921) first proposed the idea that a thought could be transferred from one mind to another (which was only a tentative suggestion), he declined to offer an explanation except to say that any explanation would have to have a materialist basis. We must do the same with emotional communication: We don't know how or why emotional communication or any of the related concepts actually work. Nevertheless, Altenmuller, Schmidt, and Zimmerman’s (2013) research from animal observation and Stern’s (1985) and Beebe & Lachmann’s (2005) (and many others’s) research from infant observation underscores its existence and importance as a channel of communication. This discussion will focus on various aspects of unconscious emotional communication between the patient and the analyst as they appear in the psychoanalytic relationship without attempting to explain them further.
This psychoanalytic epistemology shares a similar underlying view of the analytic relationship posited by Intersubjectivity (Atwood & Stolorow, 2014) and Relationality (Mitchell, 1988), which views the analytic relationship (and all relationships) as being two-way, mutual, and co-constructed by the analyst and patient. In particular, it assumes that feelings are not just internal, subjective emotional experiences but are also behavioral expressions that communicate aspects of this subjective experience to others. In practice, it fosters a greater degree of attention to how the patient’s unconscious communications are experienced through the analyst's feelings in a way that tends to recreate the patient's past relationships in the psychoanalytic relationship than is usually found in either Intersubjective or Relational literature. I believe that a focus on identifying unconscious emotional communication can extend and enrich both of these perspectives.
Although this approach to psychoanalytic epistemology highlights the receptive/reactive qualities of the analyst's subjectivity, it also recognizes that the analyst's subjectivity is not purely receptive: It can distort or misinterpret the relationship of his feelings to the patient. For this reason, this theory posits that attuned feelings have two meanings: One linked to the analyst's subjectivity and one linked to the patient's subjectivity; differentiating these two meanings is ta major focus of this clinical epistemology.
Elsewhere (Geltner 2013), I have presented a synthesis of the many ideas that have contributed to the theory of emotional communication and offered an extensive description of its phenomenology. Here, I will discuss the role of emotional communication in unconscious emotional communication. Then, I will present two case studies: One that illustrates how the analyst's feelings can illuminate the patient's unconscious repetitions and model scenes and another that illustrates how the analyst's feelings can lead her to misunderstand the patient.
Emotional communication in psychoanalysis
In psychoanalysis, patient and analyst engage in unconscious emotional communication with each other constantly, spontaneously, and unconsciously, as all people do. Emotional communication is not something that the patient does to the analyst or that the analyst does to the patient. It is something that every person does with every other person—in every moment of relatedness—from birth onward.
However, one type of emotional communication is central to understanding the patient: Emotional communication that the patient expresses unconsciously to the analyst that is linked to the patient's repetitions. These emotional communications repeat intersubjective dynamics from the patient's emotional past in the emotional present of the analytic relationship. When the analyst's feelings are attuned to these communications, the analyst experiences feelings linked to the patient's repetitions. These feelings often form a part of model scenes that encapsulate aspects of the patient's most basic relationships.
Unconscious emotional communication linked to the analyst's repetitions also flows from the analyst to the patient; there is nothing privileged about the subjectivity of the analyst in this regard. In a well-functioning analysis, most unconscious emotional communication flows from the patient to the analyst, but there will always be unconscious communication emanating from the analyst's repetitions as well.
Differentiating attuned feelings from other feelings
Although feelings that are strikingly at odds with what the patient is talking about or consciously feeling often suggest a response to emotional communication, there is nothing about the purely subjective experience of an attuned feeling that differentiates it from the analyst's other feelings. For this reason, the analyst cannot determine whether a feeling might be attuned by looking at it in isolation from the patient. Rather, the analyst’s feeling is hypothesized to be attuned if it is either 1) analogous to what the patient has reported feeling, i.e., patient’s own self-state; or, if it is analogous to what the patient has reported someone else has felt towards the patient (Racker 1957). These two basic types of attuned feelings largely correspond to the self-object and repetitive dimensions of the transference respectively (Attwood & Stolorow, 2014).
Attuned feelings are identified by areas of congruence between the analyst's feeling and the patient's material (Heimann, 1950). Suppose the analyst is angry with the patient for coming a few minutes late: Her anger might be attuned if the patient's father became furious when the patient broke minor rules. Suppose the analyst is feeling hopeless about being able to successfully analyze the patient; the hopeless feeling might be attuned if the patient describes despairing about succeeding in her career.
Congruence is the clinical evidence that suggests the analyst's feeling is attuned to the patient's unconscious emotional communication. In the absence of congruence, the analyst may speculate about the meaning of their own feeling—a practice that is often indispensable in guiding the analyst's exploration of the material with the patient. But the feeling shouldn't be used as the basis of an interpretative or other non-exploratory intervention unless it has been meaningfully linked to the patient’s material.
Although analysts often note similarities between their feelings and their patient's material in the course of their associations, I have found that the simple approach of deliberately comparing their feelings to the material in a structured manner often yields surprising congruencies almost immediately. In other cases, however, the material emerges more slowly, over months or even years.
This approach does not, of course, provide any certainty about the meaning of the analyst’s feeling in the patient's subjectivity: None is possible here, at least no more than in any other area of psychoanalytic understanding. It does suggest when the analyst's feeling is an unconscious communication conveyed through emotional communication, however.
In addition to it's possible meaning within the patient's subjectivity, an attuned feeling always has a meaning within the analyst's subjectivity. It is rare for the analyst to experience an attuned feeling that is completely unrelated to their own repetitions because feelings that are problematic for the patient are problematic for most people, including the analyst.
Thus, each attuned feeling has two meanings: One linked to the patient's subjectivity and the other to the analyst's subjectivity. The first helps the analyst to understand the patient; the second helps the analyst to understand themselves. Each clarifies a different aspect of the analytic relationship. However, they do not have the same epistemological value. The meaning linked to the patient's subjectivity allows access to dimensions of the patient's unconscious repetitions. The meaning linked to the analyst's subjectivity, on the other hand, leads to an understanding of the analyst's own repetitions, not the patient's. Nevertheless, understanding the analyst's repetitions is important because it helps the analyst to decenter (Piaget through Attword & Stolorow (2014, p. 38)) from their own subjective context and grasp the meaning the feeling may have within the patient's subjectivity.
Case #1
The patient described his seventh birthday, a high point of his childhood. He had been allowed to invite a huge number of friends, and his mother made tray after tray of his favorite macaroni and cheese. Everything seemed right in the world. The analyst, however, associated to fantasies that she had when she was a child about a friend who had, in fact, been abused by his mother. One image that had stuck in her mind was that he had been forced to sit in a very hot bath and then pulled out and left naked in a cold basement. She felt identified with the boy and often fantasized that she was him, lying naked, cold, and exposed. She remembered feeling proud and heroic—with an unmistakable element of sexual pleasure in the fantasies. She thought about these fantasies obsessively as a child, never mentioning them to anyone until her analysis. But they all came back in a flash again when her patient described his birthday party. She also felt that the patient—a slight, vulnerable looking man—reminded her of her abused boyhood friend. She resolved to ponder this after the session and went on listening to the patient.
Reflecting later, the analyst's first thought was that her fantasy was a contrast between her own miserable childhood with the patient's apparently happy childhood memory. But she also noticed an important difference between her childhood fantasy and her fantasy in the session: As a young girl, the analyst had masochistically identified with the boy; but now, she enjoyed the image of the boy's suffering, not as the masochistic twin but as the sadistic perpetrator.
She thought, perhaps, that her fantasy enviously punished the patient for having a happier childhood than she had. However, she was struck, as she had been previously, that it was odd that the patient's conscious childhood memories were so consistently good while his adulthood was so tortured. Perhaps this was a defense against remembering what actually happened.
She associated to her patient's long history of victimization, including being exploited and treated cruelly by lovers and employers, always by people who seemed to care for him. Her primary emotional response to this history had been sympathy and empathy. But her association of the patient with her childhood friend, combined with the change in her emotional position in her fantasy, made her realize that, in that moment, she had felt a sexually sadistic feeling toward him.
She also realized that the week before, she had even enjoyed telling him that she was charging him for a missed session. This feeling was completely uncharacteristic of her. She was usually too lax on fee and attendance issues and had forced herself to set firmer limits with all of her patients. At that time, she assumed that her pleasure was about accomplishing this goal. Now, she wasn't so sure.
How can we understand the emergence of the analyst's fantasy within the treatment? Let’s first consider the meaning the fantasy has for the analyst. Her childhood fantasy was clearly related to her life at the time. Her mother had violent emotional outbursts that alternated with times when her mother was gentle and loving. It was not surprising that she identified with another child who had been abused, defensively focusing on his suffering rather than her own. She had discussed the fantasy early in her analysis and concluded that it had become eroticized as a way of integrating the love and affection that she felt from her mother with the violence that she also felt from her. She had not thought about it much since then. The analyst was also well aware that her anger at her mother became attached to sadism that found an outlet in her radical political views: She became easily enraged at oppressors of all sorts—real and imagined—and could revel in revenge fantasies, including torture. But apart from her fantasy, her sadism had not taken further sexual forms. Conversely, she recognized her tendency to identify with victimized patients. The pleasure she took in the sadistic feelings about a victim—her patient—was a completely new experience.
Clearly, the fantasy connects to a rich web of themes within the analyst's subjectivity and is derived from her own model scene. But the shift from the masochistic to the sadistic position in the fantasy is a significant change from both the original fantasy and from how her sadism has been expressed in her life. It is possible, of course, that this shift has a further meaning in her unconscious—an identification with the aggressor, for example—and that material might still emerge and further clarify other meanings within her repetitions. But for the moment, that is speculative.
Now, let's consider the meaning her fantasy might have within the patient's subjectivity. When the analyst first had the fantasy, its congruence with the patient's material was not immediately apparent to the analyst: It seemed disconnected from what the patient was talking about and completely at odds with the analyst's conscious feelings about the patient. But the analyst did see that it was congruent with the patient's history of being abused by people who cared for him. Her fantasy may have been an analogue—however distant—to how the patient may have experienced his abusers’ feelings toward him.
More congruent memories emerged over time: Shortly after his seventh birthday party, the event discussed in the session, the patient's mother sank into a withdrawn depression, and his aunt took over his care. His aunt treated him strictly, in an angry, humiliating manner. She inspected him naked, spanking him when she decided he wasn't clean. Despite the harshness, she gave him more attention than his mother had, and he was strongly attached to her. As the memories arose, he realized that these interactions were compelling and pleasurable even though they were also painful and humiliating. He was still extremely attached to her and loved her deeply. This relationship formed the basis for the masochistic repetition that threaded through his life, nearly always occurring in contexts in which he felt cared for, in which he felt tortured but also in which he felt that strangely compelling attraction to the person who abused him.
These memories were congruent with the analyst's fantasy and clarified the meaning of the fantasy within the patient's repetition. We can hypothesize that the fantasy and its pleasurable sadistic feelings were attuned to the patient's unconscious emotional communication because they were clearly congruent with the memories of his relationship with his aunt. Her fantasy may have signaled a shift in the unconscious dimensions of the transference: Initially, he may have experienced the analyst as more purely nurturing; later, his experience included the sadomasochistic dynamics that characterized his relationship to his aunt. Her fantasy could be viewed as condensed image of a model scene that encapsulated his relationship with his aunt expressed within the symbolism of the analyst's personal memory.
What initiated the shift in the transference? It’s possible that the analyst triggered it when she charged him for the missed appointment – or perhaps because she unconsciously communicated that she enjoyed it. It is also possible that her pleasurable feeling, like the fantasy itself, was an attuned reaction to an unconscious emotional communication from the patient. We can't know who initiated what within the relationship, but we can say that the dynamic was congruent with a significant pattern of relatedness in his life.
Let's look more closely at the role that the analyst's subjectivity plays here. Although the meaning of the analyst's feelings can be understood in the context of the patient's subjectivity, the analyst can only experience the feelings within the context of her own experiences. The sadistic feeling that the analyst recognized as her own may be attuned to the patient's communication, but the details of her fantasy are her’s alone. Different analysts would experience the unconscious emotional communication differently, within the context of their own ways of experiencing sadomasochistic relatedness. This analyst's particular memories served as analogues of the patient's experiences. If the analyst did not have the potential to feel these feelings, this emotional communication from the patient would not have gotten through to her. Her subjectivity served as the medium through which the patient's communication was received and experienced in the present. In the process, her personal fantasy changed form and acquired a new meaning that was shaped by the patient's repetitions. This experience allowed her access to dimensions of the patient's feelings that he unconsciously repeats, in exquisitely subtle behavior, instead of remembering them (Freud, 1914).
In this case, the analyst's fantasy about the patient had two sets of meanings: One within the context of the analyst’s subjectivity and the other within the patient's subjectivity. Neither meaning obviates the other; each leads to an understanding of a different dimension of the analytic relationship. Although they are intricately interwoven, they can be differentiated from each other by making use of the patient's material.
This case also makes it clear that the analyst should not prematurely conclude that a feeling is not attuned if areas of congruence are not immediately visible. Although there was an initial degree of congruence in this case, it can take months or years for the congruence to emerge. Analysts will not necessarily identify an attuned feeling the first time they experience it if they do not see, or are not looking for, any congruence with the material—a situation that occurs quite frequently. Often enough, the material that reveals the congruence is deeply unconscious and has not yet recognizably broken through into the patient's conscious material. Obviously, not all of the analyst's feelings in the session are attuned to the patient's emotional communications, but to assume too quickly that a feeling is not attuned risks losing an essential element in the patient's relatedness to the analyst.
Case #2
The analyst had an intense and trying session with a patient who was going through a particularly difficult time. Near the end of the session, the next patient entered the waiting room, speaking loudly on his cell phone. The analyst heard his voice—although not his words—through the office wall, became distracted from the work at hand, and felt quite irritated. The patient in the waiting room frequently complained about difficult relationships with his extended family, and the analyst had a theory that he was controlling and invasive toward them. Now, the analyst thought irritably, it was her turn to be invaded by him. She felt that the patient in the waiting room was intruding on her present session, perhaps enacting his demand for immediate attention. In quick succession, the analyst felt annoyed at herself for not placing a “no cell phone” sign in the waiting room and for not putting better soundproofing on her office wall.
However, when the loud patient started his session, he spoke in his normal voice. She wondered to herself why the loud voice had disappeared. The analyst felt that her ideas about the patient’s motivation were further validated. The patient told the analyst that he had once again had a very tense and troubling phone conversation with his sister. "She and the rest of the family—I tell them loud and clear what I'm feeling—but they just don't listen!" She silently noted his use of the word "loud" and decided that an enactment was taking place: It was time to intervene, but it was too early in the treatment to directly interpret the transference. Instead, the analyst suggested that the patient might not be aware that his behavior might seem to his controlling to sister at times and that she may be experiencing him as trying to forcibly take over without considering the impact he had on her. The patient seemed surprised, and the analyst saw a flash of hurt feeling on his face. But he quickly appeared thoughtful, reflective and appreciative of the analyst’s comment, which she thought was more significant. She decided the hurt feeling was only the necessary pain that so often accompanies learning something new about oneself. The analyst was pleased with the patient's response, and she considered her comment to have been insightful, productive and contributing to the patient’s growth.
At the very end of the session, the patient mentioned casually that when he was going straight to the hospital. When he had spoken to his sister in the waiting room, he learned their father had had a serious heart attack that morning and was now in intensive care, and he was going to meet her there.
The analyst felt stunned and confused. She thought of herself as empathic and attuned, but she realized that she had missed something very important in the session and didn't know how. When the patient returned for his next session, no mention was made of what had occurred during the previous session. Instead, the patient talked about his father’s sudden death. And no material emerged in later sessions that supported the analyst’s theory that the patient’s family experienced him as invasive. His problems with them stemmed from different dynamics.
What happened here? On one hand, the analyst was conscious of her anger, and she attempted to use it to understand the patient. She felt that it was under control when she made her intervention.
But the information at the end of the session reveals that her understanding of the session had been far from complete. Although she was aware of her anger, she wasn't self-reflective. If she had been, she might have remembered that she was hyper-reactive to feeling controlled and intruded upon due to her own father's behavior towards her. While this wouldn't obviate the possibility that her anger was an an attuned reaction to an unconscious communication, it would have been a warning that her anger had an important meaning within her own subjectivity and that she should be especially careful before interpreting. She did the opposite: she speculated that the family felt the way she did—a reasonable possibility—but then felt confirmed in her speculation when her own angry feeling intensified instead of waiting for more congruent material from the patient. She had unconsciously used her own subjectivity as the context for understanding her feeling, not the patient's—a clear example of a disjunction (Atwood & Stolorow, 2014). This prevented her from understanding why the patient spoke so loudly, despite his having essentially explained it when he said that he felt that nobody in the family listened to him. More importantly, it prevented her from realizing that her interpretation was, at least in part, a rageful and punitive reaction linked to her repetition to her intrusive father. In the process, she enacted what the patient was complaining about: That his family didn't listen to him.
Although the patient seemed to appreciate the intervention, and it may have had a therapeutic impact, we can't ignore the unverbalized hurt feeling the analyst saw, nor can we know the long-term term effect of the intervention. But we do know that the analyst missed something important in this session and that both the analyst and the patient enacted their repetitions together. It seems likely that in this case, most of the unconscious emotional communication, in that moment, flowed from the analyst to the patient.
This case illustrates the complexity involved in using emotional communication to formulate interventions: The analyst can enact either their own repetitions or the patient's if a) the analyst doesn't understand it broadly enough within the context of the patient's subjectivity based on sufficient congruent material or b) if its meaning within the analyst's own subjectivity is so intense or unexamined that it prevents the analyst from reflecting upon and decentering their feeling and understanding its meaning within the patient's subjectivity. While it is impossible for analysts to analyze all of their feelings about the patient, it is certainly worthwhile analyzing any that are striking, or are seemingly understandable but particularly intense, as was this analyst's angry fantasy of sound-proofing her office wall combined with her intense feeling of being invaded.
Conclusion
We have focused on striking examples, been analyzing even seemingly mundane feelings—repetitive moments of fleeting irritation, desire, or boredom—often reveal significant and specific congruence with the patient's life story. Unconscious emotional communication is a ubiquitous part of the analytic process, just as it is in everyday life.
Although an understanding of emotional communication can reveal information about the patient that cannot be apprehended through language, the analyst's ability to experience attuned feelings does not automatically lead to therapeutic interventions, just as accurate empathy does not necessarily lead to therapeutic relatedness (Kohut, 1981). Many attuned feelings reinforce the repetitions if they are communicated or enacted. Although the relationship of emotional communication to technique is beyond the scope of this paper, one general idea can be offered at this point: Interventions informed by emotional communication are potentially more powerful than interventions related solely to the patient's verbal material. While this can lead to greater therapeutic impact, it can also lead to more toxic enactments, more intense disjunctions, and greater re-traumatization. While nothing can make the psychoanalytic relationship risk-free for the patient, analysts who make use of emotional communication must strive to function at even higher levels of self-reflection and self-control than analysts who limit the scope of their epistemology to the purely verbal dimensions of the analytic relationship.
This is why deliberately comparing the analyst’s feelings to the patient’s material can helpful in differentiating the meanings within the patient’s subjectivity from the meanings within the analyst’s subjectivity. The analyst can use of this approach on their own, in silent self-reflection, but it is much more effective when used in discussion with another analyst—a supervisor, consultant, or peer—who listens, questions, and directs the analyst's attention alternately between their feelings and the patient's material. The attitude of the listener must be the opposite of what has all too often been the norm in psychoanalytic supervision, in which material that seems to be related to the analyst's own subjectivity is excluded from the process and referred out to the analyst's personal analysis. There is simply no way of knowing which of the analyst's feelings may be related to the patient's emotional communications and which ones may be related more directly to the analyst's own subjectivity unless the analyst can discuss all of their thoughts, feelings and fantasies about the patient and compare them to the patient's material.
Within this open environment, putting the analyst's feelings into words—out loud—can allow unconscious or preconscious feelings to emerge and make the congruencies vivid—as if they had been hidden in plain sight until the analyst emerges from their reflective solitude and communicates to another person. A group setting, in which all members of the group are invited to freely discuss their feelings about the case, without fear of being told that their reactions are inappropriate, is often the most effective of all. Group members are often sensitive to subtle areas of congruence and emotional communication missed by the both the analyst and the supervisor.
Some of the effectiveness of this approach is obviously related to the structuring function of language in human experience: As Freud (1923) wrote, material becomes conscious and pre-conscious through "by being put into connection with the verbal images that correspond to it (pp. 20) But some of it is probably due to the inherently communicative nature of human thought and experience: Through talking to another person, the non-verbal channel of emotional communication rises to consciousness in a way that is often impossible in isolation. No matter how self-contained our individual experience might feel, most analysts of all contemporary orientations agree that we can only really know ourselves through our interaction with others.
Reference List
Ackerman. N. W. (1955) Trends in the terminal phase of a student analysis. Journal of the American Psychoanalytic Association, 15:107-115.
Altenmuller, E., Schmidt, S., & Zimmermann, E. (2013). Evolution of emotional communication: From sounds in nonhuman mammals to speech and music in man. Oxford, United Kingdom: Oxford University Press.
Aron, L. (2003) The paradoxical place of enactment in psychoanalysis: Introduction. Psychoanalytic Dialogues, 13, 623–631.
Atwood, G. & Stolorow, R. (2014) Structures of Subjectivity (2nd ed.). Hove & New York: Routledge.
Basch, M. F. (1983). Empathic understanding: A review of the concept and some theoretical implications. Journal of the American Psychoanalytic Association, 31, 101–26.
Beebe, B., Knoblauch, S., Rustin, J., Sorter, D., (with Jacobs, T., & Pally., R.) (2005) Forms of intersubjectivity in infant research and adult treatment. Hillsdale, N.J.: Analytic Press.
Beebe, B. & Lachmann, F. (2005) Infant Research and Adult Treatment: Co-Construction Interactions. Hillsdale, N.J.: The Analytic Press.
Bion, W. (1959) ‘Attacks on Linking’, International Journal of Psychoanalysis, 40: 308–315; reprinted in Second Thoughts: Selected Papers On Psycho-Analysis (1967). New York; Jason Aronson.
Bion, W. (1961) Experiences in Groups, and Other Papers, New York: Basic Books.
Bucci, W. (2001). Pathways of emotional communication. Psychoanalytic Inquiry, 21, 40–70.
Boston Change Process Study Group. (2008). Forms of relational meaning: Issues in the relations between the implicit and reflective-verbal domains. Psychoanalytic Dialogues, 18, 125–48.
Darwin, C. (1872). The expression of emotions in man and animals, London: John Murray.
Davies, J. (1994). Love in the afternoon: A relational reconsideration of dread and desire in the countertransference. Psychoanalytic Dialogues, 4, 153–170.
Deutch, H. (1926). Occult processes occurring during psychoanalysis. In G. Devereaux (Ed.), (1953). Psychoanalysis and the occult. New York: International Universities Press.
Freud, S. (1912). Recommendations for physicians practicing psychoanalysis. The standard edition of the complete psychological works of Sigmund Freud, (Vol. 12, pp. 111–120). London: Hogarth Press.
Freud, S. (1914) Remembering, repeating and working-through. The standard edition of the complete psychological works of Sigmund Freud (Vol. 12, pp.145-156). London: Hogarth Press.
Freud, S. (1921). Psychoanalysis and telepathy. The standard edition of the complete psychological works of Sigmund Freud (Vol. 18, pp. 173-194). London:Hogarth Press.
Freud, S. (1923) The ego and the id. In The standard edition of the complete psychological works of Sigmund Freud. (Vol. 19, pp. 1-66) London:Hogarth Press.
Fliess, R. (1942). The metapsychology of the analyst. Psychoanalytic Quarterly, 11, 211–27.
Geltner, P. (2000). The evolutionary and developmental origins of patient induced countertransference. Psychiatry, Fall (63), 253–263.
Geltner, P. (2013). Emotional communication: Countertransference analysis and the use of feeling in psychoanalytic technique. New York, NY. Routledge.
Giovacchini, P. (1979). Treatment of primitive mental states. Northvale, NJ: Jason Aronson, Inc.
Greenson, R. (1960). Empathy and its vicissitudes. International Journal of Psychoanalysis 41, 418–24.
Hann-Kende, F. (1933). On the Role of Transference and Countertransference. In Devereaux, G. (Ed.). (1953). Psychoanalysis and the occult. New York. NY: International Universities Press
Heimann, P. (1950). On counter-transference. International Journal of Psychoanalysis, 31, 81–84.
Jacobs, T. J. (1986) On countertransference enactments. Journal of the American Psychoanalytic Association, 34:289-307.
Kernberg, O. (1965). Countertransference. Journal of the American Psychoanalytic Association, 13, 38–56.
Klein, M(1946). Notes on Some Schizoid Mechanisms. In envy and gratitude and other works (1975), New York, NY: Delacorte Press/S. Lawrence.
Kohut, H. (1959). Empathy, introspection, and psychoanalysis: An enquiry into the relationship between mode of observation and theory. Journal of the American Psychoanalytic Association, 7, 459–483.
Kohut, H. (1971). The analysis of self. New York, NY: International Universities Press.
Kohut, H. (2010). On empathy. International Journal of Self Psychology, 5, 122–131.
Krystal, H. (1988). Integration and self healing: affect, trauma, and alexithymia. Hillsdale, NJ: The Analytic Press.
Kumin, I. (1996). Pre-object relatedness: Early attachment and the psychoanalytic situation. New York: Gilford.
Lichtenberg, J. (1989). Psychoanalysis and motivation. Hillsdale, NJ: Analytic Press.
Lichtenberg, J., Lachmann, F., & Fosshage, J. (1996). The clinical exchange: Techniques derived from self and motivational systems. Hillsdale NJ: Analytic Press.
Margolis, B. (1978). Narcissistic countertransference: Emotional availability and case management. Modern Psychoanalysis, 3, 161–77.
Maroda, K. (1991). The Power of countertransference: Innovations in psychoanalytic technique. Chichester, NY: Wiley.
Maroda, K. (1999). Seduction, surrender, and transformation: Emotional engagement in the analytic process. Hillsdale, NJ: The Analytic Press.
Marshall, R. & Marshall, S. (1988). The Transference-countertransference matrix: The emotional-cognitive dialogue in psychotherapy, psychoanalysis, and supervision. New York, NY: Columbia University Press.
Mitchell, S. (1988). Relational concepts in psychoanalysis: An integration. Cambridge, MA: Harvard University Press.
Ogden, T. (1979). On Projective identification. The International Journal of Psychoanalysis, 60, 356–53.
Ogden, T. (1997). Reverie and metaphor: Some thoughts on how I work as a psychoanalyst. International Journal of Psychoanalysis, 78, 719–732.
Racker, H. (1957) ‘The Meanings and Uses of Countertransference’, Psychoanalytic Quarterly, 26: 303–57; reprinted in Transference and Countertransference (2001), New York: International Universities Press.
Reik, T. (1948). Listening with the third ear. New York, NY: Farrar and Straus.
Rosenfeld, H. (1988). Contribution to the psychopathology of psychotic states: The importance of projective identification in the ego structure and the object relations of the psychotic patient. In Bott-Spillius, E. (Ed.). Melanie Klein Today (Vol. 1, pp. ??-??). London: Routledge.
Sandler, J. (1976). Countertransference and Role-Responsiveness. International Review of Psychoanalysis, 3, 43–7.
Searles, H. (1959). Oedipal love in the countertransference. Journal of the American Psychoanalytic Association, 3, 19–66.
Schore, A. N. (2002) Advances in Neuroscience, Attachment Theory, and Trauma: Implications for Self Psychology. Psychoanalytic Inquiry, 22:433-484.
Spitz, R. (1945). Diacritic and coenesthetic organizations. Psychoanalytic Review, 32, 146–52.
Spotnitz, H. (1949/1976). Emotional induction. In Psychotherapy of Preoedipal Conditions, New York: Jason Aronson.
Spotnitz, H. 1(1963/1976). The toxoid response. Psychotherapy of Preoedipal Conditions, New York: Jason Aronson.
Spotnitz, H. (1969). The modern psychoanalysis of the schizophrenic patient: Theory of the technique. New York, NY: Grune & Stratton.
Spotnitz, H. (1976). The psychotherapy of preoedipal conditions. New York, NY: Jason Aronson, Inc.
Stern, D. (1985) The Interpersonal World of the Infant, New York: Basic Books.
Stolorow, R., Atwood, G., & Ross, J. M. (1978). The representational world in psychoanalytic therapy. International Review of Psycho-Analysis, 5, 247–256.
Winnicott, D.W., (1975). Through paediatrics to psychoanalysis. London: The Hogarth Press. (Reprinted from International Journal of Psychoanalysis, 30, 69–74)