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In states of severe attack, the mind needs protection from the impact of massive affect: a move from psyche to soma. The body can take over in providing the contours of associations but is detached from a mental capacity to free associate and emotionally feel. Thus, one finds a patient who adopts particular positions on the couch — a certain rigidity of limbs or never moving — as a means of concealing and revealing earlier traumatic states and keeping a distance from what threatens to be some terrible knowing. Such positional structures when noticed allow for the possibility of movement away from the somatic register and towards mental curiosity. Putting into words moves psychic energy from the thing (body) presentation to word presentation, enabling affect to move from body attachment to that of the clinical dyad. As with the rest of an analysis, this requires time to work through the newfound memories in terms of past relationships. The patient in his psychosomatic place is alone and does not expect, nor often even wish for, the intervention of the other. The unconscious expectation is the other is not there to help, and often there is a historical truth to this as the adults had not protected the infant from trauma and may even have caused it. Very often the traumatized analysand has not had an early history of being held, cuddled, and loved by the mother, such that in adult life being touched becomes an ego alien idea and perceived as the harbinger of further assault. This leads to the possibility that only self-holding is possible (rocking, masturbating, disturbances of feeding, etc.).
Analysis opens up a new possibility in the telling, in that the listener, who may be experienced after a while as benign, can hear, and the patient registers, perhaps for the first time, being heard. The patient may begin to know that the other is listening and can also listen to him/herself.
A mother has to be able to tolerate hating her baby without doing anything