Minding the Dissociative Gap

I offer the view that the source of therapeutic action in psychoanalysis is a shared minding of the dissociative gap—a process that simultaneously decreases the mind's fear of otherness and the vulnerability of the brain's neural networks to potential affect dysregulation. Through a patient's “me” and “not-me” self-states becoming more at home with each other, the automatic neurosynaptic warning signal that triggers immediate dissociation as a protection against potential hyper-arousal becomes more selective at the brain level and, through a feedback loop, allows the patient's mind to support increased development of intersubjectivity. Little by little, the patient's capacity to bear internal conflict is increased by easing the mental struggle to hold it cognitively. For a classical psychoanalyst, taking this seriously does not lead to abandoning Freud, but it does lead to a different listening stance. It requires listening to clinical process not only dyadically, but listening to it as an inherently confusing affective event to be processed together, rather than as content to be “understood”; that is, organized by the analyst into something he deems cognitively conceptual and then made available for potential interpretation. Clinical examples are provided for consideration.