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In psychoanalytic writing, a good metaphor can be a basis for elaborating clinical techniqu and shaping alternative modes of relating in the therapeutic dyad. In The Musical Edge of Therapeutic Dialogue, Steven Knoblauch offers music as a metaphor for conceptualizing the nonverbal dimensions of communication as rhythms of relational exchange that carry the resonance of unformulated emotional experiences. In speaking of the melodic dimension of therapeutic engagement, he directs our attention to the how of speech—tone, rhythm, and cadence—and how these reverberate in body and emotion within and between patient and analyst.
Just as music renders affect by both inducing and framing emotions, so do the nonverbal nuances of interaction—breathing, body movement, tone and rhythm of speech. Knoblauch shows how an analyst attending to rhythm, volume, and tone can recognize important shifts in affect and thereby “hear” in the process the powerful unconscious representations of self and other, as well as the “dissociated affect states” that shape the interchange. The musical edge of therapeutic dialogue is a metaphor for the connections and disconnections of relatedness, as the exchange can be one of harmony and accompaniment, or one of being out of rhythm with each other. Empathy and emotional regulation in the analytic space emerge in concert as patient and analyst find one another's rhythms, harmonize, and improvise.