Epiphany: The Poet's Art, the Analyst's Instrument. Formal Structure as a Vehicle for the Expression of Primary Experience

Psychoanalysts have long relied on primary sensory experience as a means for encountering, metabolizing, and integrating nonverbal communications. Slower to develop has been a language for discussing these more primary ways of knowing. We tend to valorize rational understanding, and yet the very difficult work of psychoanalytic psychotherapy demands our ability to coexist in both primary and secondary-process realms, and also to tolerate the inevitable moments of disequilibrium. What may feel like an empathic or interpretive failure is often an opportunity to obtain, at the level of personal experience, a sense of where the patient may be stuck. The feel of these ungrounded, seemingly unbounded moments is inevitably regressive, resonating with the primitive moments of disequilibrium and dedifferentiation linked to traumatic memory (Charles, 2007; Krystal, 1988).

We begin life as sensory beings, in a world not yet informed by the language that will eventually categorize, organize, and thereby supersede our more primary ways of knowing. Before language is acquired, parent and child communicate, often effortlessly and seamlessly, through patterned exchanges of touch, gesture, and tone (Trevarthen, 1989, 1995). Many primary experiences have never been encoded into verbal memory but rather become