A Reply to Marita Torsti-Hagman

Dear Marita

Thank you for your reply to my paper. As I feel you have given a somewhat distorted picture of my position, I have to start by making some corrections: (1) I do not claim, as you seem to think, that psychoanalysis leaves the so-called developmental failures untreated. That is the position of Anna Freud. On the contrary, in my opinion, modern psychoanalysis has long ago included developmental failures (deficits) within its therapeutic scope. (2) The aim of my paper is not to discuss “traditional” psychoanalysis. My purpose is to raise a fundamental question: How can we come to grips with the isolated experiential states in those patients where affective arousal is not linked to some kind of symbolic representation in the first place? (3) I do not place the search for unconscious meaning in “opposition” to the patient's need for experiencing a quality of being. My focus is to distinguish between different layers and modes of psychic functioning. In fact, this is the essence of the paper.

Having made these clarifications, I fully agree with your point of view that the analyst, listening to the patient's associations, also includes those which are not expressed in words, but rather in gestures, tone of voice and mood. I think my paper contributes precisely to this by elaborating the intonation in the voice of the analyst as a means of responding to the patient's wordless speech. I am also on a par with your statement that the interpretations of the analyst do not operate simply on the level of words, but include affective and kinaesthetic symbolisations as well.

So, what is the difference between us, if any? Maybe we have different conceptions of what constitutes “analytic work”? To my mind, analysing is to relate to the patient in a shared mode of finding out something. This mode constitutes a specific experiential quality and is not linked to expressing something in words. My point is that affirmation is relevant and appropriate when the patient, due to defic