Case Response I

I want to thank the analyst and the patient for sharing this material as it offers us significant insight into the subtle and captivating ways complex trauma leaves its lasting impact on the psyche and influences the relational field of analysis. We are introduced to Alice through the analyst's reflections: “I come apart” and “the analyst in me hovers,” which I experience as different states, or complexes, that become constellated in the analyst when working with Alice. I also imagine these statements as reflections of the patient's childhood trauma, attachment disruptions and dissociation. I was pleased to see that the clinical material contains drawings, a creative method I actively and selectively use in my analytic work (Swan-Foster, 2018, 2022) so as to welcome the guidance from the unconscious, or from the perspective of the right brain, somatic, implicit memories resulting from trauma, complex PTSD, and dissociative disorders. Drawings both contain and regulate affect in important ways that make certain dissociative aspects of the analytic work visible and known (Hass-Cohen & Carr, 2008; King, 2016). In this vein, I imagine Alice's drawings as hidden private spaces, square psychic pockets that hold condensed aggressive fantasies, nightmares, and disavowed emotions such as grief. These pockets also hold content that is unknowable. As illustrations of Alice's psyche, the squares may depict split-off heretical ideas alongside lived experiences stitched into the layers of cumulative complex trauma. I imagine the drawings offer Alice the opportunity to actively excavate a visual map from which she can more lucidly share her lived reality of her traumatic past.

In an effort to explain how I relate to this material, I will briefly explain my own countertransference process. Working with trauma and dissociation has led me to keep a sketchbook to explore my post-session countertransference reactions. I include spontaneous images of clinical inquiries, such as my mis-at