Shrinking the Tsunami

Abstract

Developmental trauma is a core relational phenomenon in shaping human personality. It contributes to every human being's potential for affect dysregulation, which is always a matter of degree even in those for whom secure attachment has led to relative stability and resilience. We all are vulnerable to the experience of having to face something that is more than our minds can deal with, and the differences between people in how much is unbearable is part of what we always work with as psychoanalysts. Clinical and neurobiological evidence suggests that enduring personality growth in analytic treatment is interwoven with the ability of the patient-analyst relationship to decrease a patient's vulnerability to affective hyperarousal regardless of how minimal the scope of the vulnerability may be. This use of the patient-analyst relationship takes place through the nonlinear joint-processing of an enacted (dissociated) communication channel in which the patient's fear of affect dysregulation (the tsunami) is “shrunk” by the broader ability to safely distinguish the likelihood of mental shock that could be indeed affectively overwhelming from the kind of excitingly “edgy” experiences that are always interwoven with the risk of spontaneity—experiences that I call “safe surprises.” The patient's fear of dysregulation, as it is relived in the here-and-now through enactments, becomes increasingly containable as a cognitive event, thus enabling the mind/brain to surrender its automatic reliance on dissociation as an affective “smoke-detector.”I believe that the transformative process of shrinking the tsunami is fundamental to the depth of the analytic growth process itself, and that it derives its power from the coexistence in the analytic relationship of two essential qualities, safety and risk. Through the creation of a dyadic space that includes the subjectivities of both patient and analyst but is not the exclusive property of either, the patient/analyst relationship becomes a therapeutic environment by being “safe but not too safe.” As long as the analyst's ongoing commitment involves an effort to communicate his simultaneous concern about his patient's affective safety while doing the “work,” the coexistence of safety and risk becomes the essential element of therapeutic action that makes the reliving part of a psychoanalytic growth process rather than a blind repetition of the past.

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