Commentary on Philip Bromberg's “On Knowing One's Patient Inside Out”

I am pleased to have been asked to take part in the dialogue arising out of Philip Bromberg's paper. I enjoy reading his papers because they are so clearly based on clinical experience and because his theories arise out of this. Both the analyst and the patient are experienced when one reads his papers, and the reader does not feel that he is intruding on the analysis but, rather, feels himself to be part of a dialogue that he can understand and with which he can identify. The words that the reader chooses in his comments have to be the right words, as do the words the analyst and patient use when they talk to one another.

I can comment on only a few of Bromberg's ideas and choose those that resonate with my own. Bromberg talks about unconscious communication as a transferential enactment of unsymbolized experience and about how, for certain patients in particular, past experience is not so much unconscious as frozen in time. I like the expression “frozen in time,” and I take it that Bromberg sees this as belonging to the unconscious part of the mind, not as a process in the unconscious but as a state of the mind. Such states may be able to be linked with states in the analysis in which associations are not possible and that have to be tolerated by the analyst, whose aim, indeed, is to bring to consciousness parts of the patient that had never been associated with his core, or the part he thinks of as himself. With regard to the term “self,” I would like to add here that for me the patient has a “self” but also an “I,” which can say “this is me” or “this is not me”; and so I see the self as owned by the patient rather than as the core of the patient, which I think of as “I and me.”

It is important to keep in mind that what is remembered by the patient but has never been thought—has never had words—must have been experienced by the patient in a different way from other events, the occurrence of which has perhaps been wiped out by the patient and so