The Relevance of Poetic Language for the Revitalization of Psychotherapy

Abstract

This article addresses the problems associated with language in the therapeutic setting that is stale, overly rigid, or too reliant on jargon, and therefore inhibits the full and open exploration of clients. Instead, the author suggests that psychotherapy learn from and borrow from the field of poetry. Specifically, the use of poetic language—defined as language that is rooted in images, pictures, and metaphors and that is spontaneous, associative, and informal—can improve therapists’ tracking of the somatic-emotional-mental experiences of clients and create a rich and textured holding environment that is better fit for the transformational process. The article explores observations and statements by both poets and psychotherapists, examines the overlap and parallels between them, and describes a means for using poetic language to revitalize therapeutic language and the process of therapy.

Keywords:

• clinical practice
• co-regulation
• metaphors
• poetic language
• psychotherapeutic language

Introduction

It would be a relief if scientific papers could somehow remind us of real human beings so they were not such a pain to read.

W. Bion

In order to do justice to the exploration of using poetic language and metaphor to invigorate therapeutic language, this paper will be more associative and less linear than traditional psychological papers. Like the process of the poet at work, metaphors that are co-created within the patient-therapist relationship are developed through a creative process that allows surprise and the rise of the unexpected and unknown, but also follow intrinsic patterns that are neurobiologically-based and developed within a cultural and social environment.

Metaphors and images are one way of exploring the unconscious and unknown, helping to contain, shape and form them so that they can be of use to the patient’s growth. Supporting this inventive potential within the therapist-patient relationship can facilitate the emergence of self-models that align with the patient’s reality and encourage the empowerment and self-activation necessary to achieve a more fulfilling and vital life.

This paper attempts to make connections between the emergent process of poems in the mind of the artist and the emergence of metaphors and images in the mind of the patient. It also seeks to demonstrate that the emergence of these metaphorical vehicles is to a great degree dependent on the quality of the therapeutic relationship and the development of a co-created space that can be compared to Winnicott’s “potential space”—the space that does not belong to mother/therapist or infant/patient but is the result of a safe and well-attuned relationship. The movement and fluctuations in this space can be explored, explained, and expressed using psychological concepts, but my contention is that somato-based metaphorical dynamics cannot be fully apprehended or grasped through professional language and research. The very nature of the unconscious, unknown and unsaturated, is that it has open borders, is in flux, and is necessarily paradoxical and multifaceted.

Poetic Language and Psychic Processes

Psychotherapy is about change and transformation, about finding meaning in our relational world as well as coming to terms with our human condition in an impersonal cosmos. Psychotherapists continually search for new ways to initiate and facilitate change. Language, in the form of the spoken word, plays a significant role in this process. Since Freud’s invention of the psychotherapeutic hour, interventions involving understanding, empathy, and guidance have been expressed predominantly through words. For French psychoanalyst Jacques Lacan, a human mammal “is before all else a speaking subject, a subject of language” (Richardson, 2001, p. 335), and in a radical move, Lacan went as far as proposing that “the unconscious is language” (J. S. Hendrix, 2015, p. 261). “For Lacan, the unconscious is language, the Other, so unconscious thought can only be conceived with the same linguistic structure as conscious thought. Unconscious thought is present in conscious thought as an absence. The mechanisms of the transition from the unconscious thought to the dream image in Freudian dream work, condensation and displacement, are the linguistic mechanisms of metaphor and metonymy” (J. S. Hendrix, 2015, p. 261). Our extraordinary human capacity for thinking, mentalizing, and creating images and ideas allows us as therapists to capture the somatic-emotional-psychological experiences of the client. By using what I refer to as poetic language, I believe we can reflect the true process of the psyche.

In recent decades, an increasing number of therapeutic approaches have used a bottom-up process of spontaneous, unintentional, and raw expression (Weiss & Daye, 2019). At the same time, the field of psychotherapy has also been undergoing a revolution through contact with evolutionary concepts from other fields, including neuroscience, biology, physiology, and computer sciences. The expressive arts, dance, sculpture, and painting have also influenced how psychologists think about possible remedies for the human condition. Harnessing the capacity for poetic language in treatment also adds to the enrichment of the field. While professional psychological nomenclature (e.g., terms such as narcissistic and paranoid) has been fully integrated into pop psychology and even daily conventional speech, for true personal and relational transformation to take place, newness, freshness, and spontaneous discovery through language must be part of the analytic process.

Both poets and psychotherapists know that words count, and that every word counts. Context, intonation, ambiguity, clarity, and opaqueness are of utmost importance. Poets do not have pages and pages to make a point. Neither do therapists. Words cannot be easily stripped of their textural and sensuous origin; they owe their power and vitality to their origin in a world of senses that perceives and processes a living cosmos, but also point beyond what we know, see, touch, or smell. Through its resistance to being completely known by the logical mind, a poem retains its elusive power. Ogden (1997), building on this idea, summed up the relationship between poetry and therapy as follows:

At its core, poetic language rejects ideological, academic, or stereotypical language that is saturated with the known and therefore unfit to portray the vitality of experience. Similarly, in psychotherapy, analytic language that is ideological is no longer alive because the answers to the questions being raised are known by the analyst from the outset and the function of language has been reduced to the conveying of that knowledge to the analysand. (p. 219)

Ogden further said that for the therapist not to talk about experience but “to capture something of the experience of being alive in words, the words themselves must be alive” (p. 4). Like Ogden, I argue that therapists must capture the living language of poetry, “the analyst’s only escape from dry ‘therapeutic’ rhetoric, or dead language” (p. 12), which inherently preserves multiplicity of meaning and an element of the unknown, if they are to truly reach their patients and create psychological change.

In this paper, I will explore observations and statements by poets and psychotherapists that can help in our quest to invigorate therapeutic language and the process of therapy. I will discuss how poetic language, with rootedness in images, pictures, and metaphors, can support the never-ending quest for improvement, renewal, and exploration of our psychotherapeutic task. I propose that the imperfect, multivalent, and often paradoxical metaphors that are closer to our associative mind than our sequential mind can best facilitate our encounters with the unknown and unprocessed. As Greer (1995) stated, “Poetry exists partly to undermine the certainties of an accepted intellectual system, by opening a fissure of awareness at which the reality of the unconquered world may enter”(p. 3). By using spontaneous, associative, and informal language, we can improve our tracking of the somatic-emotional-mental experiences of clients and create a rich and textured holding environment that is a good fit for this transformational process. Therapists, like poets, can reach and elevate the hearts and minds of their clients, waiting for connection to the words and phrases that will touch and stir them to action. Using a fresh approach to communicating ideas also offers clients a path to fresh experience that scholarly jargon cannot.

Poetry and Embodiment

Mankind owns four things

That are no good at sea:

Rudder, anchor, oars,

And the fear of going down.

Alberto Machado (1979)

The tension between logical, sequential, and rational thinking on the one hand, and irrational, emotional, and associative thinking on the other, is detectable throughout much of Western inquiry and canon. Plato, for example, wanted poets to be banned from the republic because they posed a threat to civility: “If ‘epic or lyric verse’ is allowed into the state ‘not law and reason of mankind … but pleasure and pain will be the rulers in our state’” (Blasing, 2007, p. 76). This attempt by Plato to run the world with the rational and sequential left hemisphere of our brains, and to eliminate the associative and emotional right hemisphere, is really an attempt to deny the evolutionary reality that our bodies are the foundation of our existence. Body, emotions, and irrationality—and with that, often the feminine—are partially perceived as a threat to rational social living and interpersonal relationships.

When we say poetry is deeply embodied, and that metaphors are somatically based, we not only rely on phenomenological data but also on research accumulated over the last 30 decades that supports this notion. Embodied concepts are built upon a variety of hypotheses, among them “the embodied cognition hypothesis” (Varela et al., 1991) and “sensory-motor simulations hypothesis.”

These approaches have in common that we navigate and interact with the world with our bodies: that our bodies are the vehicles that perceive and shape our communication and that this communication is to a degree a metaphorical language. Lakoff and Johnson (1980), in their groundbreaking work regarding the “conceptual metaphor hypothesis,” established convincingly that people think metaphorically across various conceptual domains, although they might not use metaphorical language per se (Casasanto & Bottini, 2014; Landau et al., 2010).

Lakoff and Johnson identify “primary metaphors” such as “happy is up, sad is down, closeness is warmth, future is ahead, cold is distance” that are grounded deeply in our sensory-motor existence. For Casasanto and Gijssels (2015), these expressions:

are implicit associations between two analog continuums: the “source domain” continuum which is typically more concrete and can be experienced directly through the senses (e.g., touch for warmth, vision for proximity or height), and the “target domain” continuum which is typically more abstract and can only be experienced through introspection (e.g., affection, similarity, happiness). These examples, like many other mental metaphors, are typically referred to as “embodied metaphors.” The notion that mental metaphors are embodied is deeply entrenched in growing literatures spanning linguistics, philosophy,psychology, and cognitive neuroscience, and theories of metaphor and embodiment often appear mutually inextricable. (Gallese & Lakoff, 2005; Gibbs, 2003; Lakoff, 2014; Lakoff & Johnson, 1999; Shapiro, 2011)

The embodied cognition concept challenges Cartesian concepts that assume that mental processes are largely independent of physical processes and are solely neural phenomena. Cartesian models are also models of dualism of body and mind that run counter to modern research of the complex and interrelated processes that constitute a human living in the world. The conceptual framework of embodied cognition gives the utmost importance to physiological, sensory, motor, and emotional processes in the development of cognitive functions. Bodily experiences shape how we think. Francisco J. Varela, et al., describes embodiment in this manner: “By using the term embodied we mean to highlight two points: first that cognition depends upon the kinds of experience that come from having a body with various sensorimotor capacities, and second, that these individual sensorimotor capacities are themselves embedded in a more encompassing biological, psychological and cultural context” (pp. 172–173).

Using this perspective, we can account for interior and exterior factors determining the development and use of metaphorical language. We can account for intero- and extero-perception and processing. This sensory processing is in focus in the sensory-simulation hypothesis that postulates that the use of metaphorical language is accompanied by activation in our neural and physiological systems. Expressions such as “grasping an idea” are accompanied by sensory-motor activation in certain brain areas relating to hand movement. “Thinking outside the box” is enhanced when people are in a large room instead of a small cubicle. Countless research exists that explores these phenomena by putting people in an FMRI machine and recording the activation of various brain regions when the subject is given metaphors that relate to motion, spatial movements, verbs vs. nouns, color, or valence. Action-oriented nouns and verbs in general lead to more activation of motor areas whereas color-related metaphors lead to activation of the visual cortex. These activations are highly complex, due to the enormous complexity of the human brain and its multifaceted and multilayered dynamic system.

In general, we could say with Gibbs (2006) that our making sense of the meaning of metaphors and images depends on our senses, and that this process “resides in the automatic construction of a simulation whereby we imagine performing the bodily actions referred to in these excerpts” (p. 435). The interaction between body processes and language is now supported by an increasing volume of research, although there is controversy surrounding the influence of external variables on this interaction. According to Littlemore (2019), “there is increasing evidence from behavioral psychology to suggest that areas of the brain that were formerly thought to be purely sensorimotoric play important roles in language processing, and that language processing makes significant use of spatial, perceptual, and visual imagery (Buccino et al., 2005; Coslett et al., 1998; Hauk & Pulvermüller, 2004).

Sigmund Freud tried to establish psychoanalysis as an accepted science, and therefore tried to distance himself to a certain degree from mystic traditions and culturally laden irrational concepts, although he was steeped in mythology, art, anthropology, and literature, and his writing is deeply influenced by the use of metaphor, though he did not directly address this in his work.

The technique of free association was for Freud a means to discover the underlying structures of human behavior and explore them in a way that made psychoanalysis acceptable in scientific circles; yet without mentioning the use of metaphor, Freud (1913/1966) explained his technique in a metaphorical manner to his patients: “Act as though you were a traveler sitting next to the window in a railway carriage and describing to someone inside the carriage, the changing views which you see outside” (p. 135). Free association allows the spontaneous eruption or spontaneous emergence of all kinds of content, and is thus similar to poetic and metaphorical language. Starting with Freud, then, we could consider poetic and metaphorical language to be a fitting container or facilitator for the process of therapy.

Bion, who some consider the most influential psychoanalytic thinker since Freud, was especially interested in a theory of thinking which he developed by expanding and changing Klein’s concept of infantile phantasy, which, in its focus on images and symbols, can itself be seen as a kind of poetry or poetic thinking. Bion focused on the process through which thoughts become available to the patient for thinking by enhancing the capability of the patient to metabolize the “beta-particles,” unprocessed affective elements, into “alpha-particles,” which can become thoughts and used for thinking. In order for this transformation to take place, the ability to mentalize—without which the patient is stuck in a concrete world—must be developed. Bion theorized that this capacity was facilitated during infancy via a “container” consisting of the mother’s capacity for “reverie” and, later, by the analyst by creating a container-contained dynamic in the analytic hour. The mother/analyst’s capacity to reflect on the bits and pieces of the infant’s affective experience, to put them into words, can be seen as paralleling the poet’s attempt to create meaning through the translation of affective experience into poetry.

Bion (1967) placed great emphasis on the aesthetic dimension in the exploration of the self and reality. In his view, “the aesthetics of the real” allows profound emotional experiences that can open up reality, which Bion named “O.” He expanded Freud’s evidenced-based paradigm toward an aesthetic paradigm, which he saw as better equipped to hold, metabolize, and facilitate deep emotional experiences. According to Casement (1990) “it is this capacity for playing with a patient’s images that Bion encouraged” (p. 37).

Bion also put great emphasis on the creative aspects of the psychological process. In contrast to the Kleinian view that emphasizes the destructive nature of the “paranoid-schizoid position,” Bion points toward the necessary disintegration before integration can happen. So that new thinking can arise, old thinking has to disintegrate. In the container/contained relationship of mother and child, and later in the container/contained relationship between patient and therapist, seemingly destructive processes, such as projective identification, can be used in a creative way for the maturing process. Nicola Glover states that, “According to Bion (1970), the creative, adaptive individual is one who has ‘negative capability’ (Keats, 1958), or, in Winnicott’s terms, [is] able to hold the paradox without resolving it through a ‘flight to split-off intellectual functioning’” (1971, p. xii). For Bion there is “an aesthetic dimension which is an essential part of the analytic encounter. The love of knowledge, together with the love itself are seen to be one and the same” (Glover, 2018). My suggestion is that metaphor and poetic expressions, with their potential for openness, unpredictability, and transformation, align with Bion’s thinking that rupture contains the possibility to gather again, not just the present, but also the past.

Bion (1990) and Lacan (1989) understood the metaphoric language that can be used in therapy in a deconstructionist way, to undermine the certainty of knowing and to open up the exploration with a patient toward an underlying mystical reality. Whereas I agree that this is the dimension of metaphor and poetry, I disagree with their turn toward the ethereal and mystical and instead view poetic language as also a deeply grounding force, a movement toward solidity, maturing, and anchoring. Poetic language in this way resembles a Latin dance, which emphasizes the movement of energy into the feet and into the ground. It counter-balances the upward push of energy, such as in a waltz, where energy moves toward the arms, hands, and head. The bi-directionality of these movements—both toward a solid somato-sensory dimension as well as toward an undefined, unsaturated unknowing that requires imagination and curiosity—allows the patient to move along a path of true self-activation.

In contrast with Bion’s (1990) turn to the mystical and obscure, I suggest that poetic language is capable of combining logic and emotions, as well as the body. In this way, it embraces both science and art. Such a use of poetic language is based on our somatic existence and rooted in our somatic experiences; it is nourished and facilitated within the body by a multitude of interoceptive signals. According to Modell (2009), “Metaphor represents a biological property, a capacity of mind that is probably uniquely human” (p. 6). With this in mind, the task of contemporary linguists and scientists is to free metaphorical language from the stranglehold of philosophers who conceptualize it as a trope, a figure of speech that can infer meaning or transfer meaning from one mode to another. In this view, “metaphor is fundamentally an expression of a neuro-physiological process that has been co-opted by language” (p. 6). In their fundamental re-conceptualization of metaphor, Lakoff and Johnson (1999) put metaphors on their feet by defining them as an embodied process. In fact, Lakoff and Johnson view metaphors in two ways: as arising from sensations and feelings in our bodies but also as expressions of unconscious but neuro-biologically based processes.

This view corresponds with contemporary neurobiological research that the base of human existence is our organism, and that memory capacity and thinking developed as a survival tool for the mammalian organism. The ability of neural networks to detect patterns aids in this survival and metaphors have the potential to, at least, partially, contain and facilitate this complexity. By applying these concepts of metaphorical language to our therapeutic communication with patients, the process of “dreaming a session together” can become an embodied process that allows the solidification of the self, rather than its escape into an ethereal or amorphous realm. Whereas Freud did not use the term metaphor in his conceptualizations, Modell (2009) pointed out that Freud’s use of “libidinal sensations” to refer to various bodily openings and sensations (e.g., anal for the anus, oral for the mouth) was his attempt to anchor fantasy in somatic experiences.

If we follow the bridging between metaphor, poetic language, and neuroscience, we can understand metaphors and poetic images as attempts of the mind and body to organize experiences into a meaningful whole. It serves the survival of the organism by trying to predict the optimal response to the challenges at hand. Yet our ability to create new patterns is limited; evolution created an optimal compromise between necessary complexity and necessary simplicity. Metaphors and images can be simplification templates that allow the brain to assess and understand myriad data coming in from the outside, as well as the inside, in a speedy and effective manner; they are the natural language in which the brain makes sense of the world and its best blueprint to predict the most appropriate response to immediate challenges. This includes their use as part of the transferential field within the relationship between patient and therapist, as well as their potential to facilitate what is possible in human relationships, the healing and repair of ingrained patterns, and the creation of a life that is no longer determined by developmental trauma or adaptation to unhealthy and threatening environments. Poetic language can create new options that have not been established in the neuro-physiological reality of the patient. One might even say poetic language can cause new circuitry to grow.

Case Example: Using Metaphor with a Couple

A couple in their forties who have two children, and have complained about frequent arguing and fighting and an increase in distance and disappointment in each other, argue in our session. Using an intervention that can be called a symmetrical insult—or according to Tatkin (2014), “going down the middle”—I say to both of them, while looking at the space between the two, “You are so good at racing each other to the bottom, where you find yourselves miserable together and lonely.” This metaphor depicting their argument as a race to the bottom resonates with them. It describes, in a simple manner, a process that has been going on for years and has pushed them further and further apart, almost to the end of their marriage.

Tatkin (2012), whose approach to couple therapy is founded in part on Attachment Theory, sees these dysregulations between partners as engrained responses to severe stress that were developed in early childhood in insecure attachment situations. We can also use this racing metaphor to refer to relevant neurobiological functions, such as a rapid increase in neural processing speed, activation of the sympathetic nervous system, increase in arousal, and rising blood pressure. The dynamic between the couple is an automatic process that leads to the opposite of what their intentions and dreams are. Kahneman (2011) spoke of “the fast brain” (in contrast with the “slow brain”), which involves the prefrontal cortex and its bidirectional wiring to the limbic system, and which is designed to detect threat and danger. In moments of misunderstandings, blame, anger, or withdrawal, partners can easily see one another as primal threats. By using this metaphor, I allow myself to be precise and pointed, without blaming or pathologizing a common couple process. The couple are free to make use of it and respond in a manner that shows increased solidarity between them. The processing that follows over the next few sessions grounds their error-prone processing of each other in somatic experiences as well as biological, physiological, and neurological data.

During our sessions, the couple also make use of the metaphor by exploring its opposite—that is, rather than a race to the bottom, the use of slow and reflective processing, the ability to be prosocial, and keep track of the partner while speaking. The couple chart an upward course, learning to bring out the best in each other and to hold onto the true self-image of their partner. The racing metaphor also emphasized the importance both of a collaborative process to repair their deep sense of loneliness and of an acceptance of the underlying dependency that is part of a realistic primary relationship.

Research has shown that the use of metaphors can facilitate the process from concrete thinking to abstract thinking. Jamrozik et al. (2016) point out that “metaphors allow us to draw on concrete, familiar domains to acquire and reason about abstract concepts. Additionally, repeated metaphoric use drawing on particular aspects of concrete experience can result in the development of new abstract representations” (p. 1080). In the case of this couple, the concrete situation of their negative interaction that resulted in a fracturing of their connection and a “race to the bottom” allowed them to generalize their dynamic, based on a concrete interaction that unfolded in our session.

Dwelling Poetically and Our Acceptance of Interdependency

In his seminal work, Being and Time, Heidegger (1993) situated poetry at the foundation of life rather than as an ethereal art or craft with little relationship to the struggles and tribulations of daily existence. In his view, language speaks first, we respond to language, and the most truthful response to language is poetry. Therefore, poetry is primary in our existence and has a special relationship to truth and being. Through poetry, through being in contact with the deep strata of life, we as humans can find our home and learn to dwell on this earth.

Heidegger’s dwelling is more than an occupying or lodging; it refers to finding oneself in relation to heaven and earth. In dwelling, we grapple with our mortality, with our place in the great circle of beings, between the great forces of existence. As we are always born into a humanized cosmos that was developed by sapiens communities, so the poetic dwelling is always also a communal dwelling. People are not isolated islands in vast oceans, but interconnected beings that walk the earth. This constructed world is always also a world of interdependencies that must be confronted, acknowledged, and managed. As clients in session with a therapist confront their relationships and dependencies as well as their defenses against these dependencies, so the poet is confronted with the reality that aesthetics are not an escape from reality into an imagined dependency-free space, but a confrontation with our limits. In the words of poet Berry (2011), “The autonomy of aestheticism is a fantasy. Reality is in the study of dependencies” (p. 81).

Berry’s assertions are as applicable to psychotherapy as they are to poetry. The tension between our experiences of freedom and choice has to be reconciled with our experiences of dependencies. Metaphors and poetic naturalism can be the vehicles in the dynamic of patient and therapist that allow tensions and fractures to appear and to be repaired, restoring integration and cohesion. If the concept of autonomy dominates and the multiplicity of dependencies is denied in poetry or psychotherapy, then we remain locked in the realm of phantasy. It is within the matrix of mutual dependencies and our attempts for attunement that the fissures of differences and failures of optimal attunement reveal themselves. The possibility to repair these necessary failures is the essential ground on which truly human relationships can develop. I would postulate that only a repaired relationship is truly safe and secure. A repaired relationship has overcome rupture and breaks. The perfect container of naive illusion has been fractured, and the tensions and complexity of a relational life can now enter. This is the process in which the differences that have been covered over in the physiologically supported honeymoon state emerge more clearly. With this development, the work of true relating and deep connectivity can begin. Many authors, among them Klein and Riviere (1964) and Winnicott (1965), have commented on this important process. The child’s attempts to repair the imagined damage done to the loved object facilitates the emergence of empathy and concern and the recognition of difference. Metaphoric and poetic language are suitable containers to hold this process, because they allows both the repair of the concrete hurtful behavior and the overall holding environment of the relationship. The hurtful behavior has to be understood in a somatic felt-sense and needs to be redeemed in a renewed sense of concern for the other and the relationship.

We can observe the struggle with dependency in the anxious-avoidant attachment type (Bowlby, 1969). Attachment theory postulates that we are primed and hardwired to need a caregiver for safety and security. We are essentially other-seeking. We cannot survive alone. Insecurely attached individuals structure their needs for the other in characteristically self-protective ways that grow directly out of early experiences. Anxious-avoidant individuals defend against the reality of needing others and instead create the fantasy of an unrealistic independence and an insular self. The anxious-avoidant does this out of a deep fear of getting close, because the self is poorly developed and therefore connection with the other holds the potential for loss of self. Similarly, the anxious-ambivalent individual protects against disappointments, the fear of being dropped, by applying clinging defenses that keep the deep-seated abandonment and depression at bay.

In a similar vein, the unquestioned belief in certain words can be understood as a clinging to a concrete world that empties itself of feelings and meaning. To understand the world, we undergo a process of mentalizing the object, of developing the capacity to use symbols and images that are internalized. The inability to develop this capacity leads to the defense against our interdependence and the fantasy of self-reliance. The concrete-thinking strategist often has diminished abstract-thinking capacity and cannot conceive of the world as a construct of their mind. The emotional-somatic-psychological reality of experience is denied. Psychoanalytically, this overreliance on the concrete world can be understood as an outcome of insufficient safety with a caregiver. The individual is anxious and insecure in relationship and has difficulty mitigating the presence or absence of the other because the necessary internalization of the other has not developed. In this sense, the adherence to literal thinking is the manifestation of an insufficient or faulty mentalization, which leads to a denial of our common existence and our need for the other.

Heidegger believed careful and attentive listening to language and to the structure that shapes our experience and interaction with others and the world brings us closer to truth. Following this concept, we can say that poets do not simply carve words out of themselves; they find them through careful listening and attention. Similarly, therapists find words to express what is happening in a session by carefully listening to both the client and themselves. We could say the client leads the therapist toward the right words. In Winnicottian (1971) terms, through mutual attunement, client and therapist co-create a “potential space” where the right words can emerge. Finding the right words can position the therapist, in a Heideggerian way, in the realm of poetic dwelling. From this authentic perspective of dwelling, the therapist facilitates two important processes: connecting with new possibilities, and confronting life’s limitations. These existential limitations also give us the motivation to seek each other out, ask for help, and collaborate. In this experience, the client learns to receive care, give care, love and be loved, as well as to face the inherent mortality underlying all life.

When Freud developed psychoanalysis, he conceptualized many of its principles in his seminal work The Interpretation of Dreams, which was published in 1900. The term talking cure that captures the importance of language in psychoanalysis is actually attributed to Anna O., a patient of Freud’s early collaborator Joseph Breuer. He believed that through the free association of the client and the capacity of the analyst expressed in the “right interpretation,” the client could experience a kind of homecoming and reside more fully in their body and life. Through the deepening process of mirroring interpretations, the client in relationship with the analyst can access the unconscious and defended aspects of his psyche. Thus, Freudian dwelling was made possible through an interpretation that brought unconscious material into contact with consciousness. His conceptualization corresponds with Heidegger’s position, which regards the poet’s capacity to bring thought into contact with the unthought as the process that makes dwelling possible.

Heidegger’s unthought is being—that which we already understand before we think it. It is our basic phenomenological experience of being in a world that is cosmos, not chaos. It is our evolutionary hardwired first-person perspective, that the world is around us and we are in the center. It is the process of using attention and becoming aware of ourselves in the world of other beings and things, of consciousness, that can overcome separations, disconnections and phantasy. Heidegger regarded the poet’s ability to step between the thought and the unthought as “the greatest gift that thinking can bestow” (Wood, 2002, p. 28). In other words the poet has the opportunity to mediate the unconscious with the conscious, play in the realm of the pre-conscious without destroying either realm. The poet’s language does not violate the unthought but makes it present. When the therapist can voice the right words, unconscious material can be accessed. The client feels recognized but not violated, seen but not stared at. The poetic response allows the client to manifest the thought and also recognize that the unthought, over which the therapist has no jurisdiction, is still present.

The poetic response is not concerned with rhyme and meter, but allows unconscious and preverbal material to emerge into language. It requires activation of the self. We also find this struggle for self-activation and authentic response in therapy with couples. The partners don’t want to be listened to passively but rather in an active and coregulatory process that allows each partner to be understood by the other. In this way, misunderstandings, misconceptions, and misappraisals can be revealed, reworked, and repaired.

Trauma, Defense, and Metaphors

Wurmser (1977) differentiated between a metaphorical process and the metaphor proper. The metaphorical process is biologically and somatically based, while the metaphor proper is based on verbal and linguistic aspects. Still, in his view, the basic concept of metaphor as a somato-sensory-based process is valid, and the metaphor proper points toward a greater capacity to move along a continuum of literalness and abstractness. We know that patients who have a trauma background are often significantly impaired in this move toward greater abstraction. They often have difficulty with mental associations or symbol formation due to the severity of the neglect and abuse in their childhood, which keeps them preoccupied with safety issues. When this occurs, metaphors can be instrumental in shifting the defensive process toward a process of growth and the development of a true reality testing function.

Walking the line between literal and abstract, metaphors allow for the abstraction necessary to fully process traumatic events; they lessen the emotional charge, thereby allowing the traumatic memory to settle in the hippocampus and other memory-processing areas in the brain instead of being kept alive in an amygdala-dominated system. For patients with borderline or narcissistic features, in particular, their lack of symbolization often results in the deployment of more primitive defenses, such as splitting, projective identification, or severe disassociation. Unfortunately, patients who have a more disorganized internal structure cannot make good use of the relief and the organizational help that non-literal thinking can provide.

Botella and Botella (2005) contrasted this metaphorical approach to the unconscious processes examined through a Freudian stance which cannot be contained by language, and therefore is not fully usable for a patient. They argue that Freudian language is insufficient to translate the internal catastrophic state of the mind. For the Botellas, psychological development is a dreamlike or hallucinatory experience that gives a sense of continuity and partial integration, which is projected onto the sensory realm. Following Lakoff and Johnson’s (1980) concept that metaphors are embodied processes that underlie mental and scientific discoveries, this proposal of projection onto the sensory realm is a misconstruction of the process of metaphoric mentalization. Metaphoric processing is deeply rooted in the sensory motor experience of the person and in their bodily experience. In this way, metaphors become a grounding and solidifying vehicle instead of a process that leads to excessive mentalization.

Borbely also emphasized vagueness as an important aspect in the development of self. If our experience is too clarified and precise, it will not lend itself easily to processing the vastness of our experience. In contrast, the vagueness and even vagaries associated with metaphor and poetic language invite open processing; they allow us to connect various experiences loosely, but also solidly enough to become part of our internal organization of meaning and relating. The openness required to live in an expansive and complex universe is often severely undermined by traumatic events in the development of a person. Drawing on the work of Bartsch (2002), Borbely (2008) wrote, “Psychological trauma, which leads to severe anxiety, impairs or destroys the possibility of registering an experience with appropriate ambiguity. It thus diminishes an experience’s metaphoric potential regarding the formation of, and inclusion by, new perspectives” (p. 417). Use of poetic language can help patients with a traumatic background express past and current experiences. It can help them feel safe as they engage with their therapist in a process of co-creation and co-regulation to explore these issues.

Emergence—Integrating Passive and Active Modes

Oceans

I have a feeling that my boat has struck,

down there in the depths, against a great thing.

And nothing happens!

Nothing…Silence…Waves…

–Nothing happens? Or has everything happened,

and are we standing now, quietly, in the new life?

Juan Ramon Jimenez (1995, p. 246)

Stern (1997) repositioned dissociation over repression as the primary defensive process in psychoanalysis. In dissociation, certain unconscious content can be accessed through a creative process. Consciousness is not a passive container but rather can be actively worked with by letting unconscious content appear. Stern proposed that effusive and overused interpretations run counter to this process of emergence. In this way, he was close to the process of “found poetry,” derived through the creative function of embodied thinking. The process of the emergence of latent content and dynamics is important when we regard the therapeutic process as one in which defensive maneuvers need to be interrupted and new unfamiliar patterns of thinking, feeling and behaving can appear. Learning is always, especially in therapy, a two-fold process: first it needs the disruption and unlearning of restrictive and antiquated defenses and, second, the development of new neural networks and behavior that allow vitality and curiosity to replace compliance and duty so that the real self can be found.

The recurrent use of interpretation carries the risk of stifling the creative emergent process as well as the creation of a fresh language that reflects the patient’s emerging mindfulness. Interpretations often unnecessarily create a disparity between the therapist’s power to understand and go toward weaknesses and the patient’s insufficient understanding of the world. Metaphoric and poetic language, however, can facilitate the empowerment of the patient as well as the non-catastrophic disappointment of the patient in the therapist.

Case Illustration: Drew

Drew is an intellectual, cerebral man in his late sixties who has a long-term successful marriage but suffers from a sense of disconnection with others and feelings of emptiness he describes as “going through the motions like a ghost.” Over the last year, as we have explored both his past and his present, we have slowly discovered that the “wonderful” childhood he had described was starkly different from his earlier conclusion. In the free-flowing exploration of our work together, aspects of parental neglect and misattunement emerged, as well as a lack of parental acknowledgment of, or protection from, his older brother’s aggression. The connections and interpretations I made were received, but the emotional impact was often lacking.

For several weeks our sessions felt somehow flat and I could see that his dissociative process took over when he began talking about a visit with his brother. He described how he had barricaded himself behind the door of his room as his brother banged against the door trying to get in. His face was relatively motionless and I commented that in this moment I felt that he was shutting the door in front of me and that perhaps he was feeling that he had to barricade himself against my words. As we slowly explored his memory of the episode with his brother and his experience of relating it to me, I said, “I will never try to push the door open; you are totally in charge here of how much you want to open it.” As we processed his continued uncertainty and sense of unsafety, I said “I am happy to sit here in front of your door and we can talk to each other through it,” (We are using Borbely’s (2008) notion of “temporal metaphor as a defense” by working with the metaphor “door” and moving between present and past back and forth to access repressed fear. The image of a door allows safety by its property to create a barrier but also movement toward openness by its property to have hinges).

He appeared both relieved and enlivened at these words, and over the next several sessions we used and developed this image. He had “found” a key that he could use now to lock the door and thus could move away the chair that he had pushed against the handle. We envisioned that I was pulling my chair up on the outside of the door and we could talk more easily through it. We discussed how long his door both had been, and had to be, barricaded and that it was difficult—almost impossible—to feel safe. Over the next two or three sessions he chose to “unlock” the door, but not to open it. All the while we focused on the changes in his voice as well as his self-report about changes in his body and level of tension. (We are making use of Wurmser’s concept that the metaphorical process is a body-based process as well as of Borbely’s (2011) proposal that we can shift the negative metonymy toward a positive one).

I used a line from Rumi’s poem that “I was knocking from the outside but then I realized the door was locked from inside”; that the most effective way to progress was the use of our relationship, my tracking of his facial expression and his ability and fascination to use my emotions visible on my face to locate and feel his emotions. Ultimately, Drew decided to give me a key with the caveat that I would use it only with his permission. (Putting Drew in charge of the key allows the activation of diminished self-activation templates and creates more agency which is then used to feel more agency in relationships by handing me a key. In this way we can co-regulate the process of opening and closing, of connection and disconnection, that can enhance relational safety).

Opening the Door to Refreshed Therapeutic Language, or Going to the Farmer’s Market

When we as therapists open the door of the consulting room and let in the light and dust of the real world, the language of our profession has the opportunity to be de-purified. The renewal and growth of our craft does not come predominately by further sanctification of our psychological language but by dipping our words in the common rivers of life, exposing them to the bustling marketplace and the simplicity of everyday conversations, and in the changing nomenclature of non-experts and non-specialists. Professional psychological language obviously has a valid function in research, diagnosis, and professional communication but less so in the consulting room with the client. When psychological language is overused, it creates the risk that it conceals rather than reveals, closes communication rather than opening it. By using the footprints created by poets, we can give our therapeutic language the grit and traction it needs to take hold in the minds and hearts of our clients. This is not an attempt to transform every psychotherapist into a lover of poetry but a suggestion to open and sensitize to the power of images and metaphors used in poetic language. This kind of grit or tension allows new aspects of meaning to emerge that defy intellectualization and lead to a fuller body-mind integration.

Dialogue created between client and therapist through the modification of therapeutic language in the way just described alters the therapeutic relationship, which is at the core of the therapeutic process. The trust, care, and challenge embedded in this relationship are the essential agents of therapeutic change. Sounds and words that are fresh and saturated with real empathy can mirror and locate the client. The essential therapeutic work of supporting the real self of the client, as well as challenging the protective-defensive structures, can be made easier by using fresh and vital language. These kinds of therapeutic words do not obscure differences or similarities but facilitate necessary autonomy and differentiation. Stereotypes and clichés are left behind, and the potential of a more truthful and meaningful existence fills the room for a moment.

Like a poem, the words of the therapist (and those of the client) should have an impact. They should speak to the profound questions of our existence, should plumb the depth of our anxieties, and acknowledge the pain that is part of our existence, as well as our searching for meaning. Words spoken by a therapist, like those of a poet, should not be random and meaningless. The conversation in the therapy room, even if it is at times humorous, is work. It is not distraction or avoidance but the calling forward of the real self.

Stafford (1978) talked about “found poems,” meaning poems that already exist and can be plucked from the unknown when we develop the requisite listening and response skills. When we are deeply attuned to our interoception, to our world of sensation, feelings, and thoughts, poems can appear and be manifested in words by the poet. This listening and responsive position does not diminish the act of individual creation in writing or in the process of therapeutic interventions, but it gives another important dimension to our function as therapists. It establishes that we are not the sole authors, originators, or doers of the therapeutic process; rather, we are listeners with a passion to respond. Just as a poem has to be found by the poet, and an infant has to be found by its mother, so also does the client have to be found at times by the therapist. When Stafford (1978) said, “The only real poems are found poems—found when we stumble on things around us” (pp. 67–68), he indicated that it is necessary to stumble in order to find.

A good poem, with its simplicity, power, and beauty, leads us to the edge of words and points to the beyond. In this sensibility toward words and meaning, it carries the humility necessary to look toward the territory that is still unknown but also acknowledges and respects what we know. In all the seriousness of the tension between knowing and not knowing, there is also a playfulness that makes it possible for the reader or patient to follow the same surprising path the writer or therapist has taken. It is the playful authority of words that seduces us to tolerate getting lost. Writing that “only has at heart your getting lost” (Frost, 1949, p. 341) ensures that “we will never get it right in any final way, and we don’t mind” (Ogden, 2001, p. 303).

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No potential conflict of interest was reported by the author(s).

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Hans Jorg Stahlschmidt

Dr. Hans Jorg Stahlschmidt, PhD, received the foundation of his education and training as a psychologist in Germany and received his PhD in clinical psychology from Pacifica University. He is Senior Core Faculty as well as Senior Trainer at the PACT Institute, developing curriculum and training therapists in a specific couple therapy approach, the PACT model. He also maintains a private practice in Berkeley and is a widely published poet.