Somatic Experiencing: In the Realms of Trauma and Dissociation—What We Can Do, When What We Do, Is Really Not Good Enough

Abstract

We know that the deepest disturbances must be reached to foster the deepest changes and growth. But what do we do when some of our patients suffer relentlessly through dissociated, dysregulated states of catastrophic proportons, when these states are repetitive but not generative, when our psychoanalytic forms of holding, provision, and containment are just not good enough? After a number of years in psychoanalytic practice, the author trained in Somatic Experiencing (SE), a non-psychoanalytic, bio-psychological model for treating trauma. He presents a psychotherapy case that began before his SE training and continued during and after. He illustrates how SE perspectives and approaches can inform and enrich our psychoanalytic ways of looking, listening, and responding. He emphasizes how SE can supplement and enfold into psychoanalytic processes of intersubjective regulation, crucial for patients who are exquisitely vulnerable to severe overactivation (overwhelming anxiety, panic, terror, agitation, rage, explosiveness, etc.) and/or underactivation (freeze, numbness, emptiness, deadness, etc.). He discusses the relationship between SE and major psychoanalytic paradigms (Classical, Kleinian, Winnicottian, Relational, and Self Psychology), looking at points of convergence, divergence, synergy and tension. He shares a professional and personal journey of interweaving SE into psychoanalytic treatment.