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As we consider the central theme of this fascinating clinical paper, the long analysis of a severely traumatised patient, we feel that our main task is to understand why the same situation repeats endlessly, with almost no chance of movement, and to explore how to conceptualise this in relation to the “incurability” of the trauma.
T had made several attempts at psychotherapy before he came to Heinz; these ended in failure. He has had a different experience with Heinz; analyst and patient are devoted to continuing their very difficult work, even though for a long time the conversation between them took place mostly in a negative atmosphere of confrontation, persecution, and stasis.
Patient and analyst were locked in despair, unable to get through to each other. Surrounded by an atmosphere of violence, caught up in a tragic, fundamental misunderstanding, each trying and trying, repeating and repeating, each feeling provoked, attacked, lonely and abandoned. Each felt defeated in his efforts to communicate; good efforts were met by provocation, projections of anger and guilt. The result was a mutual tragedy: analyst and patient were repetitively being re-traumatised.
We believe that such a repetition of the trauma is not only inevitable but is a necessary condition for the psychoanalytic treatment of patients suffering from traumatic experiences. It is the defining characteristic of psychoanalysis uniquely to be able to elicit, and eventually to understand, deeply believable confrontations within the analyst of the traumatic experiences of the patient. Heinz’s clinical paper demonstrates this in a convincing way.
T feels, indeed knows, that his survival depends on his analysis, even though his experience is often mostly of confusion, disappointment, and the invasion by dangerous projections. He continues to try to get through to the goodness of his object, which he seems to sense is there to be found, and which Heinz communicates to him through the quality of his own engage