Some Thoughts on Psychic Retreats

Abstract

This paper explores connections between psychic retreats, particularly of the kind described in Richard Carvalho's 2002 paper, and certain other defences rooted in early relational trauma (Schore 2001). After distinguishing between Carvalho's theory and John Steiner's (1993) original formulation, the paper describes Schore's (2002) work on infantile dissociation and draws attention to the pre-symbolic processes that could form the basis from which the symbolic content of the psychic retreat develops. The paper underlines the connection between psychic retreats and secondary dissociative states of which psychic retreats constitute a distinctive class. It investigates the relationship between psychic retreats and Bick's (1968, 1986) concept of the second skin defence. The paper goes on to explore theories that suggest that understanding the level at which patients are functioning is the key to the level of work we engage in. It provides clinical examples to illustrate some of the points made.1