A JAPA Vignette: A Moment with Matt

Matt and I were not communicating. I was often unclear what he meant. If asked for clarification, he would reply, “I don't know, I don't know.” My way of speaking confused him. I noticed his long pauses after I spoke. He might then say, “I don't know what to say,” or “Why did you say that? I don't know what you mean.” He told me the problem was that I jumped around and made links he could not follow, including connecting what he said to our relationship. The words I used for his emotions did not resonate. We were cut off from each other.

Several times Matt suddenly entered terrified states, curling up in a ball, saying, “I don't know, I don't know what is real!” sobbing and hyperventilating. This was usually preceded by an agitated state that escalated the more I tried to understand and help. I felt especially off balance, disoriented, and cloudy-headed. When I tried to put words to his experience, he would say, “I know that already,” or “That doesn't help.” If I could gather myself up during his panic, I might try to help him by simply calling his name several times, telling him I am here with him, suggesting he breathe slowly with me. I was not sure if this helped, though he seemed to listen, and over several minutes he gradually calmed down and remained silent for the rest of the session.

These episodes deeply disturbed me: the intensity of his out-ofcontrol suffering and my terrible feeling of uselessness. It bordered on something traumatic for me as well. I didn't know why I was so thrown off and where this was coming from in me. These emotional states are something I've faced before many times, as most analysts have. I understand

my tendency to dissociate when overwhelmed or when I am triggered by specific moments, but this felt unusually forceful.

As I mentioned, my feeling lost and estranged had an i