Embodied mutual meaning unfolding through time as substrate of clinical complexity
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.
These affective narratives are structured ‘musically’ through a shared pulse and quality in gestural narratives of voice and body that allow both caregiver and infant to attune to each other. This attunement consists of the infant or caregiver ‘taking in’ the other’s inner state through close listening to and observation of the other’s gestures and then ‘giving back’ (mirroring) these gestures, but in a way that adds to the exchange because there is now something of the person’s inner state in the gestures that are offered to the other. Thus this improvised ‘musical’ gestural narrative of meaning unfolds.
A vital outcome and component of this exchange is the mutual delight of both parties as they are influenced by and create these gestures which ‘fit’ together, creating mutual warmth, value and ultimately self-esteem (Meares, 2005: 67-75). Using examples from complex clinical presentations, this same process of improvised ‘musical’ gestural narrative will be demonstrated in the psychotherapeutic relationship and its use to understand the interpersonal therapeutic dynamic underlying the complexity will be discussed.
