ABSTRACT
A patient’s dissociation in session is at once absorbing and deadening. The therapist is swept into what Loewenstein (1993) named the “dissociative field”—the transitional space between patient and therapist that activates the dissociative capacities of both. Within the dissociative field, the therapist is held captive by the intoxicating and hypnotic quality of the patient’s dissociation and is susceptible to concomitant shifts in states of consciousness and emotional tone that often manifest as a dissociative countertransference reaction-moments of feeling dazed or disconnected (Gill, 2010; Howell, 2005). Rappoport (2012) wrote about her internal experience in the face of a patient’s dissociation, describing a sense of “psychic and physical freezing” (p. 379) and a “physical woodenness and numbing” (p. 380). Similarly, Arizmendi (2008) described his own “paralyzed retreat” subsequent to his patient “fad[ing] away into a dissociative state” in session. Perlman (2004) framed such instances of dissociative countertransference as an intersubjective phenomenon that occur frequently in work with survivors of chronic trauma; he named this phenomenon “mutual dissociation” (p. 106). Both patient and therapist retreat to an inner world to achieve distance from the horrors of trauma the patient has experienced, including the frightening traumatic affect that arises in the course of therapy (Davies & Frawley, 1991). The result of this mutual dissociation is what Ogden (1995) described as the ambience of “deadness” (p. 699). There is a subjective sense that nothing is happening, seemingly reflective of a mutual retreat by the patient and therapist from that which is overwhelming and unbearable-that which compelled the dissociation in the first place.
