Awareness of trauma to children was first codified as the “battered baby syndrome” by Henry Kempe in 1962. While Accident & Emergency Departments, paediatricians and social workers remain alert to these presentations, it seems that child sexual abuse and the range of emotional abuse particularly in disorders of Attachment, have come to the fore in psychotherapy. The sequelae of physical abuse are not always highlighted in the discussions of Complex Trauma but occur, as expected, often in association with other forms of abuse.
The work of Martin Teicher in Boston in separating the brain consequences of different types of trauma and my clinical observations raised an interest in separating out different patterns. Noticing associated levels of dissociation, the frequent co-morbidity with alcohol abuse, the depth of shame and self-devaluation, the nature of further relational patterns including in therapy has led to this paper focussing on physical abuse. In presenting a small number of clinical vignettes, within a theoretical background, I hope to allow the listener to reflect on their own experience of this common aspect of trauma.
Evolutionary change can now be studied at extraordinary scales; and these scales involve increasing evidence of semiotic (or sign based) expansion in telodynamic systems – systems which appear oriented to goals and even to self-correction (Shapiro 2011; Deacon 2012). Here I wish to explore how the emergence of the human self can be understood as an expansion of meaning potential, in particular, as a product of a ‘strategy’ of doubling and differentiation. My argument reviews the role of semiotic behaviour from bacteria to the collective consciousness that underpins human language. I further argue that the ‘stages’ of differentiation – e.g.. head to tail; top vs. underneath; right to left symmetry; hemispheric brains – all employ a double with differentiated function.
Therapy requires the patient and therapist to be in a mutually aware relationship. An underlying characteristic of this relationship is that both parties aim towards ‘feeling felt’. The human necessity for ‘feeling felt’ is at the very beginning of the human journey. In a sensitive caregiver-infant relationship the infant and caregiver ‘take in’ the other’s inner state through giving their awareness purposefully to the other’s communicative gestures. This ‘taking in’ is confirmed moment-by-moment through the ‘giving back’ (mirroring) of these gestures. But for the relationship to be alive, in the giving back there must also be the addition of the other person’s inner state. In adulthood this intersubjectively shaped storytelling, created through gestures and words, characterises the space where trauma can be healed in relationship.
Suicide is a major risk in Australia. In 2007, 1,881 people died by suicide. People bereaved by suicide must construct personal meaning about the death, decode the intentions of the deceased and receive and process a range of attitudes and beliefs about suicide from their social networks, from the supportive to the stigmatising.
In our work as therapists we constantly seek to develop our patients’ capacity for relatedness. Spiritual seeking in its purest forms is the pursuit of levels of development beyond the aims of most psychotherapy patients, but is understandable as a profound extension of this capacity in relation to both humanity and the divine.
The aims and objectives of this paper are to demonstrate the underlying ‘musical thematic’ structure of embodied meaning between psychotherapist and patient and to discuss how this gives insight into the interpersonal dynamics of psychotherapeutic healing. The model of Communicative Musicality (Malloch, 1999; Malloch & Trevarthen, 2009), like that of the Conversational Model (Meares, 2004), has its origins in the investigation of mutuality in the infant-caregiver relationship. We observe in this relationship an exquisite mutually regulated interchange of embodied narratives of affect which enable caregiver and infant to spend meaningful time together.