A young woman who had been repeatedly sexually abused by her father when she was a child began psychotherapy with a young female therapist who consulted with me on the case.* Early in the treatment, whenever the patient began to remember and describe the sexual abuse, or to recount analogously invasive experiences in her current life, she would display emotional reactions that consisted of two distinctive parts, both of which seemed entirely bodily. One was a trembling in her arms and upper torso, which sometimes escalated into violent shaking. The other was an intense flushing of her face. On these occasions, the therapist was quite alarmed by her patient’s shaking and was concerned to find some way to calm her.

I had a hunch that the shaking was a bodily manifestation of a traumatized state and that the flushing was a somatic form of the patient’s shame about exposing this state to her therapist, and I suggested to the therapist that she focus her inquiries on the flushing rather than the shaking. As a result of this shift in focus, the patient began to speak about how she believed her therapist viewed her when she was trembling or shaking: surely her therapist must be regarding her with disdain, seeing her as a damaged mess of a human being. As this belief was repeatedly disconfirmed by her therapist’s responding with emotional understanding rather than contempt, both the flushing and the shaking diminished in intensity. The traumatized states actually underwent a process of transformation from being exclusively bodily states into ones in which the bodily sensations came to be united with words. Instead of only shaking, the patient began to speak about her terror of annihilating intrusion.

The one and only time the patient had attempted to speak to her mother about the sexual abuse, her mother shamed her severely, declaring her to be a wicked little girl for making up such lies about her father. Thereafter, the patient did not tell any other human being about her trauma until she revealed it to her therapist, and both the flushing of her face and the restriction of her experience of terror to its nameless bodily component were heir to her mother’s shaming. Only with a shift in her perception of her therapist from one in which her therapist was potentially or secretly shaming to one in which she was accepting and understanding could the patient’s emotional experience of her traumatized states shift from an exclusively bodily form to an experience that could be felt and named as terror. It is in the formation of such somatic-linguistic unities, the bringing of emotional experience into language within a holding context of human understanding, that a sense of being can be born, restored, or consolidated (Trauma and Human Existence, Routledge, 2007: http://www.amazon.com/Trauma-Human-Existence-Autobiographical-Psychoanalytic/dp/0881634670/ref=la_B001IXOF6S_1_1?ie=UTF8&qid=1338738119&sr=1-1).

* This clinical vignette is a fictionalized composite.

Copyright Robert Stolorow

About the Author

Robert D. Stolorow, Ph.D.

Robert D. Stolorow, Ph.D., is one of the original members of the International Council for Psychoanalytic Self Psychology, which stems from the work of Heinz Kohut.

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