Beyond the Word in Psychoanalysis: The Unspoken Dialogue

The practice of psychoanalysis, traditionally, has privileged verbal communication. In relational theory the therapeutic significance of unconscious, semantically unformulated, but nonverbally encoded communications has been recognized. While patients are understood to generate significant nonverbal material for use in the treatment process, similar nonverbal productions from analysts rarely have been acknowledged as useful for treatment. In this paper, I demonstrate a way to recognize and use the nonverbal productions of analysts as well as of analysands within the analytic process. A brief review is offered of contemporary authors who have conceptualized the importance of the nonverbal realm for psychoanalytic treatment. An approach is then described that builds on process conceptualizations derived from the infant research literature. The model, illustrated with two clinical examples, provides a way of conceptualizing “process contours” on a nonverbal level of exchange between analyst and analysand that becomes the medium for catalyzing the transition from presymbolic interactions to symbolic language. Working on this level, analyst and analysand coconstruct scenes from both the dreaded past and the hoped-for present/future, which, when reflected on in a joint process of narrative construction, provide a new context for accessing previously dissociated affective experience.