Standing in the spaces: Essays on clinical process, trauma, and dissociation.

Abstract

This work recapitulates and extends a unique creative odyssey in modern clinical theory. Advancing no overarching theoretical system, Bromberg moves in ever widening exploratory circles as he works his way into the complexities of personality change. Early in these essays, the author contemplates how one might engage schizoid detachment within an interpersonal perspective. To his surprise, he finds that the road to the patient's disavowed experiences most frequently passes though the analyst's internal conversation, as multiple configurations of self-other interaction, previously dissociated, are set loose first in the analyst and then played out in the interpersonal field. This insight leads to other discoveries. Beneath the dissociative structures seen in schizoid patients and also in other personality disorders, Bromberg regularly finds traumatic experience - even in patients not otherwise viewed as traumatized. This discovery allows interpersonal notions of psychic structure to emerge in a new light, as Bromberg arrives at the view that all severe character pathology masks dissociative defenses erected to ward off the internal experience of trauma and to keep the external world at bay to avoid retraumatization. These insights, in turn, open to a new understanding of dissociative processes as intrinsic to the therapeutic process per se. For Bromberg, it is the unanticipated eruption of the patient's relational world, with its push-pull impact on the analyst's effort to maintain a therapeutic stance, that makes possible the deepest and most therapeutically fruitful type of analytic experience.