On Saturday, March 7, 2020, the Tampa Bay Psychoanalytic Society hosted James Gorney, PhD who introduced us to the delightful work of Francoise Davoine and Jean-Max Gaudilliere. In their book History Beyond Trauma we learn that trauma is a place, a crossroads much like the one where Oedipus meets Tiresias, which is opened up with the therapist as ‘therapon.’ Gorney tells us that a therapon in ancient Greece was one’s battle “buddy” who keeps the warrior spiritually and physically up for the task at hand, like the manager in the corner of the ring who attends to the boxer between rounds. [The dictionary defines therapon as “an attendant (minister) giving ‘willing service’... a faithful attendant who voluntarily serves another...in a tender, noble way.” I think these aptly apply to our work.]
In Part I ‘Lessons of Madness,’ Davoine and Gaudilliere emphasize the relationship between social trauma, intergenerational trauma, and the historical effect on the traumatized individual. Like Lacan, they see psychosis as the foreclosure of the Symbolic, existing in the realm of the Real, only able to be represented in the Imaginary’s delusions and hallucinations. What I found most intriguing was their approach to psychosis: Psychosis is the mode of investigation, claiming that trauma is at the root of ‘madness’ and lives in unrepresented states. Thus psychosis is a means of research, with its co-investigator the analyst. Madness, employed as the means of research, investigates the disavowed signifiers of trauma. Signifiers are relational and ensure entry into the Symbolic order. [According to Gorney, the “symbolon” in ancient Greece was a gesture, breaking a vessel between two allies, each fitting together a broken shard, to pledge their mutual hospitality.] The psychotic symptoms are the markers, pointing to the place of unspeakable trauma. “Trauma speaks to trauma and only to trauma.” The analyst must also be with the trauma within. [Gorney gave a lovely metaphor for projective identification: it is the hat of the patient hung on the hook of the analyst.] Davoine and Gaudilliere claim trauma must be “inscribed” to be remembered and brought into a social link. [I wonder if the Boston Change Process Study Group would agree that symbolization of any kind is always necessary, given that a change in implicit relational knowing can occur procedurally without inscription.]
Because trauma is a “war zone,” in Part II ‘Lessons from the Front,’ we learn of four principles drawn from work of WWI American psychiatrist Thomas Salmon: proximity, immediacy, expectancy, and simplicity. Proximity opens up the space for safety and trust amidst the chaotic trauma. Gorney: ‘I am here with you. We are in this together.’ It is not just the physical proximity, but the willingness to take up the battle together, side by side, and to take care of one another, the therapon. It is also the survival [Winnicott] of the analyst. Medicating symptoms, without investigation and research, is the opposite of proximity. Immediacy allows us to live in the temporal context of the patient’s urgency. Gorney: ‘I will meet you at the place of pain and anxiety.’ Gaudilliere saw madness as the potential for hope and reintegration, the place to begin. Davoine saw delusion as a way of knowledge. Expectancy “constructs a welcome to the return from hell.” Gorney: ‘I say “yes” to you.’ It is the interpersonal place with a trustworthy other of mutual respect, a “primal affirmation,” the validation that yes, something horrible happened. Simplicity refers to speaking directly without jargon. Gorney: ‘I will tell it to you like it is.’ The therapon communicates, always respectfully, without moralizing, without reassuring, without showing-off cleverness, speaking honestly and slicing through the Imaginary.
[Gorney’s rich clinical examples (not related here for confidentiality’s sake) were beautiful, poetic, and moving and I recommend you read his papers.]
Davoine, F. and Gaudilliere, J-M. (2004) History Beyond Trauma. New York: Other Press.
No comments:
Post a Comment