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Those of us in the psychoanalytic community who are fortunate to have had experiences as performing musicians have learned to extend our musical skills to the psychoanalytic encounter. We listen to the rhythm, timing, and cadence of the productions of our patients and hear vocal inflections and pauses (rests, if you will) as important communications, often more important than the spoken words. The pattern of speech, the tempo and changes in pitch and volume are factors of vital importance in participating in and understanding the psychoanalytic dialogue. The form of the communication often reveals basic character issues more so than does the content of what is said (see Nass, 1971).
Steven Knoblauch, a former performing jazz musician, has attempted in his recent book to systematically document the musical factors in the therapeutic communication. Dr. Knoblauch is connected with the Institute for the Psychoanalytic Study of Subjectivity and filters his material through an intersubjective perspective. He includes a myriad of clinical examples in his book and comes through as an extremely empathic clinician, well attuned to his patients, honest in his approach and in revealing to the reader (and at times to his patients) the internal experiences he had when listening and reacting to the material of his patients. He shows himself to be very aware of subtleties in his patients' nonverbal communications. As he brings in the analogies to music and references to communication in small ensemble playing, be it classical or jazz, his improvisational gifts and analytic freedom present us with rich analogies between what he experiences and how they translate into musical terms. These are exemplified by some of his chapter headings, such as “Listening to the Rhythm,” “Listening to the Tone,” “Improvisation and Accompaniment,” “Play and Interplay,” and “Listening to the Dialogue of Harmony and Dissonance.”
The book is written rather unevenly in that the author's descriptive clinical