The paper discusses the experience of voice in analytic listening, focusing on two vocal phenomena: vocal adhesive identification characteristic of autistic states, and the psychotic split between voice and meaning. A special attention is given to the difference between a lacuna “in the voice” and a lacuna “of the voice”, yielding two modes of intervention: interpretation of the voice, and interpretation through the voice.
This workshop will present a therapeutic process of a three-year-old child on the autistic spectrum. It will offer an integrative view into the complex therapeutic process in our multi-professional psychoanalytically oriented day care unit for young Autistic Spectrum Disorder children. Clinical observations from the therapeutic-educational environment will be presented by Orly Shalev. This part will briefly present a multi-dimensional picture of the child in the context of our psychoanalytic-developmental working model. It will be followed by clinical material from a psychoanalytically oriented psychotherapy, presented by Gal Meisels. A short theoretical discussion, reflecting on the presented clinical materials will be presented by Tami Pollak, PhD.
The paper focuses on psychic states in which living and bearing one’s vitality have become hindered or totally obstructed, either as a result of a primary trauma or of a late-onset trauma. The author relates especially to patients who have been severely traumatized and have withdrawn into encapsulated states with schizoid/autistic-like features that create complex challenges in therapy/analysis. The lecture weaves together clinical cases with theoretical understandings and with a discussion of the Kurdish movie Turtles Can Fly, in which many orphan Kurdish refugee children try to survive emotionally the traumatic life they have been going through. The author discusses the complex states of mind of the patients presented and of the orphans in the movie, who are sentenced to life, having lost all their hope and ability to tolerate their own vitality or that of others, due to extreme traumas. Consequently an encounter between themselves and another person, including a therapist/analyst, frequently becomes a flooding experience that is beyond their abilities to assimilate, being experienced as an annihilating threat to one’s emotional existence and being in danger of creating states of a therapeutic and undigestible excess for which the term toxemia of therapy is suggested.
Excerpts from work with an adult patient.
In the paper I describe a hallucination I experienced as a psychoanalyst during a session with an adult patient and search for its meaning.
I relate it to the analyst’s potential ability to experience hallucinations in the sense given by Bion, i.e. to exercise a particular kind of receptivity to the patient’s nameless, unlived experiences. Civitarese wrote that in this state of emotional sensitivity the analyst has access to the patient’s true reality.
I present how an autistic part of the patient was covered up by the well-functioning part of her personality and how I gradually became aware of the manifestations of the autistic part of the patient’s personality through contact with me. I describe how the patient’s primary fears of disappearance and confusion with the object came to be manifested through hallucinosis. I think of the hallucination as a trace of transformation, according to Tustin, an autistic shape into a shape with more psychic qualities, which is a vehicle for communication.