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In the beautiful clinical material presented in this paper, we see Alexandra Harrison create an action-dialogue with her young patient Kate, containing and thereby transforming the fear-filled consequences of her patient's trauma. Harrison and her coauthor, Edward Tronick, use the material to illustrate their “dyadic expansion of consciousness model,” a model for understanding the cognitive and emotional growth and understanding that can develop when a child's inner world becomes altered and meaning gets made, not just uncovered, through the interaction with a sensitive, empathically attuned other.
The session presented here has significance as a model for understanding what can transpire, nonverbally, in analytic treatment, not only with children but also with adults. Harrison demonstrates how what is communicated implicitly by our words and actions, as the communication takes shape in the back-and-forth movement between patient and analyst, may have more mutative power than an explicit communication. What I would add is that in some instances such implicit communications lose their power to alter a patient's inner world if they are made explicit.
Harrison's first moves were directed toward engaging her patient, Kate, who had begun treatment for panic attacks, stammering, significant separation anxiety, and a sleep disturbance, all of which developed after she witnessed the televised attack on the World Trade Center. Her mother was not available during this frightening event because she had