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Stanley Coen oriented the audience for this engaging panel with opening remarks that focused on the enduring impact of trauma and the sequelae of “unbearable affects.” If not sufficiently “metabolized,” these affects will find their way into the analytic situation and lead to severe disruptions in the treatment process: transference/countertransference disturbances, impasses, severe regressions, and psychotic episodes. However, Coen stated optimistically, analysts (and therapists) who expect that such unmetabolized feelings will indeed create chaos in the treatment will be better prepared when the chaos inevitably arises. In other words, disruptions in treatment may not be a failure of affective regulation on the part of the therapeutic couple, but rather may signal the necessary emergence of difficult material, and in this regard can be viewed as a positive sign, presaging the potential integration of previously intolerable affects. Using examples from both his clinical work and his work as a supervisor, Coen illustrated how severe disturbances in the treatment indeed reflected the emergence of intense feelings referable to early traumas from which patient and analyst wanted to flee. Self-analysis allowed the analyst to become less resistant to the patient's unmetabolized feelings such that analysis could proceed.
Coen reviewed some of the literature that describes how therapists of traumatized patients need to “feel and live through” versions of the patient's earlier trauma within the treatment; such traumas are expressed as “crises” that threaten to “overwhelm the relationship.” The therapist's capacity to bear the affects as they emerge in the treatment becomes the path to healing. Thus, rather than decrying failure, Coen suggested there is