Therapy in Creative Spaces. A way to Catalyze the Unconscious in Resymbolization

The International Association for Relational Psychoanalysis and Psychotherapy, Psychoanalytic Institute, New York, NY, U.S.A.

Abstract: Art and language are powerful tools for self-expression and understanding. In therapy, they can help individuals process and make sense of complex emotions and experiences. Visual art, writing, or spoken word allow individuals to communicate their feelings in a more comfortable or meaningful way. Psychoanalysis was born out of a praxis that eases access to the unconscious. Ferenczi opened the clinical possibility of full involvement of the therapist in the dyad, questioning his presence and practice. We collaborate with a Portuguese Cultural Association (Manicómio - https://www.manicomio.pt/) that recently started using different therapeutic settings. Our practice occurs in museums and ateliers, where contact with art enables understanding primal tongue confusion by creating a new tongue. The analyst-patient dyad is built upon a communal space without the walls of mental disorder stigma. A new paradigm emerges from associating the open space (open space sessions) and art, and building a different therapeutic setting where the unconscious is resymbolized.

This presentation follows our clinical experience as collaborators of the project Consultations without Walls, which began in 2019, integrated in the Manicómio Association based in Lisbon. This project is essentially characterized by the use of creative spaces as settings for the analytic process. By creative spaces, we mean exhibition spaces (museums and art galleries), or ateliers of artistic production in open space.

0. Clinical vignette (first session)

I meet M. in the museum, and discomfort occupies a space between us.
There are some people in the museum. Not so many that the space is constricted, not so few that the place is deserted.
M. chooses to walk and halts at times, choosing points close to corners. Standing there, fearful between going or staying, I try to guess her steps and accompany her.
The confluence of angles seems to appease a growing anxiety. The low voice, the primary discomfort gives way to a more fluid breathing, as a person who is revealing herself.
She tells me about herself, about her difficulty in talking about herself. And of her difficult relationship with the world. I sense a hiatus: between the silence and the crying that wants to come out. The blunted affection.
M. walks towards a picture of a man with a hood in a defeated posture. He sits on a chair that has a chair on top of it, trapped in his lethargy, unable to see or be seen. M. looks at the painting and sketches a smile. “This is how I feel.”
Creation resymbolizes the unconscious and allows affection to take a name, between silence and scream (Levine, 2021).

The synergy created between the dynamics of movement and the contemplation of what we can absorb from the environment finds deep roots in psychoanalytic thought.
If we go back to Anna Freud (play therapy), already in 1928, she postulated that walking while talking could be an interesting therapeutic catalyst (Hays, 1999).
The reflection that we propose to make (without wishing to putting up a defence for this as the only practice in psychoanalytic psychotherapy) is to think about how art may exist as a metatongue, a catalyst of non-conscious contents that lead us to follow the footprints that the unconscious leaves in the other, learning to follow their path (Monteiro, 2023).
In the same way in which Hansel and Gretel return to the place that traumatizes them, we want to find the tongue that precedes the confusion of tongues: empathy (Bettelheim, 2011).

1. From the sameness to the hypnotisation of the self

The place where the dream is manifested, as a creative process, presents itself as the possibility for a cure without knowing for sure what the cure itself might be. The assumption is that to play again opens the possibility of dreaming/being a child again. In this perspective, the setting fixes this place as the site where space and time meet, being also the result of the creation of the tongue. However, it will be difficult to imagine an analyst’s consulting room as an aseptic laboratory, without life, without marks, or, if we would rather, without a soul (anima).
The invitation to the encounter is also made within the safety of the walls, sometimes lined with analyst’s cues, invoking his own existence, the books lined up on shelves up to the ceiling, laden with knowledge, sofa rooms appealing to a stereotypical comfort. The setting is the analyst’s stage, where he presents, where he shows and where he makes himself safe, where he irreducibly takes possession of his place. This whole scenario may contribute towards an analytic numbing, preventing, in some way, the return to the naturalness of time suspended.
What this brings about is that sameness in which the other blurs the boundaries with the self that the other is, in a kind of undifferentiated and closed continuity that does not allow to deepen in the process. We know that it is in the assumption of differences that we differentiate ourselves and that it is truly in the differences that we can separate ourselves and, at the same time, find ourselves, in order to create an identity of ourselves. We know that it is in this discontinuity, between what is inside and what is outside, that we define our existence and identity. It is through the expression of difference and through language that we seek the encounter, trying to unravel the mystery of existence (Gutiérrez Peláez, 2018).
Can there be room here for the assumption of neutrality, analytic naturalness, and transferential asepsis? The need for the analyst’s internal appeasement makes the countertransference possible, in order to have access to what is there, as if it were a matter of observing a scene of wild life, in which in order to see the intimate reality of the other, the observer has to disappear from the scene itself.

In truth, there is neither analytic neutrality nor asepsis of the setting. There is creation. In this context of psychoanalytic psychotherapy, to return to what is simple and basic is also a proposal to construct a setting outside the classic context, which may be translated by the access to the material of analysis, brought to consciousness, by invoking the physical space of the process.
Ferenczi defends tact as a form of access to what is different, as the basis of the relationship, and proposes that the settings should be built around the therapeutic relationship, in the dyad (Ferenczi, 1928).
The creation of the common symbolic world, that in which analyst and patient share a will to access, is mediated by language, the language which creates the sufficiently good analytic temperature and which allows the birth of something created in the therapeutic relation. It is in this environment, where the imaginary and the symbolic come together around the construction of the setting, that access to the real can emerge (Zizek, in Gutiérrez Peláez 2018, p.105).
Access to what is radically different from me.

2. Our Ferenczian awakening

“In a word, I would simply wish to acknowledge here that, of us two, I am now the one who has not abandoned the ranks of those who awaken.”
“Science that lulls and science that awakens.” in a letter to Frigyes Karinthy ((Ferenczi (1924), in Gutiérrez Peláez, (2018), p. 6))

Ferenczi, in dealing with difficult cases, questions his position in the relationship and thus questions himself. In this way, he opens the possibility of accessing what is real, creating wisdom from his doubts.
We feel that by working in creative spaces, the space does not imply an active posture of the therapist, in fact, it is the analysand who chooses the real path he is taking, and the therapist follows his or her footsteps. There is a path that we follow again, footprints of the real that we follow towards an understanding of language prior to the confusion of tongues. It is as if they were the footprints of the return to trauma (Gutiérrez Peláez, 2018).
In the same way that Hansel and Gretel return to their parents’ home, the analyst accompanies those who need to make their way following the crumbs that were left behind.
The countertransferential space is in analysis within the analysis itself, in which the analysand is the counter-scene of the transformation of the analyst. It is in this field of the construction of an intersubjective language, which translates a time of encounter, and from which results a new relationship as a product felt and thought, close to what Ogden later presented to us as being the analytic third (Ogden, 2001). The discovery of new neuronal pathways, coming from pleasure, and the discovery of that language, will now be the elected elements to the detriment of the unbearable and, therefore, separate lie.
The lie is what covers up the shame and what makes the denial credible. The confusion of tongues is the confusion of rules, for the one who should present himself as the mediator of that rule, places himself beyond the reach of the rule created.

For Ferenczi, the denial is the cause of the trauma, generating pathological defences such as autotomy, splitting and depersonalizations (Ferenczi, 1932).
Ferenczi’s proposal in the face of trauma is that the analyst should fulfil the function of not repeating the traumatizing figure. The analyst will have to ensure that his presence is reparatory and that he supports the relationship in such a way as to avoid the risk of domination, without resorting to pedagogical postures (Ferenczi, 1932). Ferenczi, concerned with the question of cure, questions himself about the criteria for the termination of analysis. This should be natural, with the total elimination of the marks of the analyst in the analysand. Thus, nothing would remain of the traumatic occurrence.
Experience shows that the price of autonomy is very high and always higher than it is often expected; and it is all the greater, the deeper the relationship between analyst and analysand is, often presenting itself as difficult and even dangerous. This threat contains all the early and more or less split traumas which may have escaped analysis (Bégoin 2005).
Ferenczi’s proposal for the termination of analysis does not find an echo in Freud’s response in Terminable and Endless Analysis (1937). For Freud, Ferenczi was asking too much.
The art of the new relationship is that which allows the gaze of the analyst to exist and to be rather the encounter that inaugurates existence, the art of the dialectical construction of the language that undoes confusion, that uncovers the unspeakable (Coimbra de Matos, 2016).
When we come across this way of accompanying people and their stories, we find Ferenczi was on a path headed to a therapeutic awakening, towards the possibility of choosing not to remain in the analytic/oneiric dream. This can reveal itself to be a place of stagnation and sameness that sets in when the symbolic satisfies the difficulties of growth in the analytic relationship.

3. New settings, creative space or deconstructing Babel

From verbal cacophony to empathic essence - creative spaces as places where symbols meet.

Our experience, primarily and experientially founded in spaces where artistic creation is happening (ateliers) or is being exhibited (museums), makes us perceive these venues as privileged spaces where the confusion of tongues can potentially happen. Also, space, by its nature, makes the return to primal tongue possible.
Several languages, several nationalities come together to form a conglomerate mass, a soft, almost hollow and imperceptible buzz, making us wonder if the building we are in is not challenging the laws of gravity, of what it means to be human, just like Babel.
We think of the Pompidou Museum with its entrails inside out and imagine how much of what is inside may also be outside, how the buzzing transforms into a faceless melody, a force that lulls into an almost hypnotic trance, which favours the contemplative lethargy of the passers-by and at the same time refers to the representation of the internal buzzing, for now still indecipherable. It is the possibility of translating this sonorous mucus into the analytic dyad that may guarantee that the existence of the self will be resumed (Kohut, 1977).
The invitations are fluid, because in the exhibition space, the randomness of the objects and of the route to be taken has no script, they are the result of the moment. This is the time to go through the space of what is physical and mental. The space-time, the space of encounter, where the elements are recombined in order to have access to what is there, is the unique dimension of each person. What remains is the created possibility, the human matrix, of the encounter, and giving meaning to what apparently has no meaning.
What is intimately human, or that which speaks to us and reveals the human essence, is the capacity to create. By create, we mean that which results from the action of thinking. Intimately, we may question whether in this assumption we would be regarded as the same as minor gods that through creation aspired to some heaven. We will abandon this hypothesis for the moment, because what brought us here is human nature and perhaps the need not to go mad with the absence of understanding the world.

We can speculate that science is art, it is the capacity and the creation of a language that will be able to translate and to describe what is there (Nabais, 2019).
It will be able to describe through language what already exists, and that, by way of this logic, creation will be the description of what already exists with a new presentation, with a new language. Science would then be the creation of the intelligible, an access to nature, to the essence through something that brings up the repressed, the unimaginable, the incomprehensible and/or the unthinkable, the matrix of trauma. We would be, therefore, the architects of the mental space and would make visible what is not visible.
As in the symbolic world, by recombining elements, new environments are created, new possibilities arise of translating what comes into contact with the real.
However, the human comes up against the dimension of time, against its own finitude, against that living imperative that points to death itself (Heidegger 1988).
Our clinical experience in this context seems to favour this recombination, since the environment is loaded with symbolisms which derive from representations of the non-conscious, as if we were always facing expressions of the oneiric universe and which frequently pass the barrier of the individual’s active critical defences, and may favour the access to mental material, less accessible and capable of being thought, catalysing the alpha-analytic function (Bion 1994).

4. “Dis “confusion of tongues

The traumatic event (trauma) is presented as a violent and disruptive intrusion in the sense that it breaks with daily experience and inaugurates another time, that of the trauma that can be described as operating in two steps. On the one hand, the caregiver infringes its translation in the other, and on the other hand, the caregiver hinders the baby’s activity of decoding and future understanding. Here, we are faced with the prototype of the creation of the confusion of tongues (Laplanche, in Reading, 2023, pp.18-19).
Psychoanalysis, founded on doubting about what is visible, formulates the hypothesis of the return to what remained suspended, from that time. In seeking the inaugural meeting, based on the interest, motivation and enthusiasm of the analyst over the analysand (like the mother over the baby), it brings the formula that interrupted it to the here and now, a kind of rescue of what was lost, of what is and remained incomprehensible in the other, as if the analyst acted from the position of the archaic incomprehension of the other, seeking to make the path of his own analysis within the analysis of the other, knowing that the deeper the analysis is, the deeper my analysis of the analyst is. The intimacy that arises from this encounter, from the encounter of the non-conscious, takes place in a proper time, because the time of analysis and the time of what has not been thought about, what has been interrupted, is a time to be taken up again with tact and in a loving way (Coimbra de Matos, 2016).
Ferenczi, brings us tact as that form. Tact in the place of gentleness. “But what is “tact”? The answer is not very difficult. It’s the capacity for empathy” Ferenczi, S. (1928, p. 89)
Empathy, the tongue that was remained suspended at the moment of trauma (Bégoin 2005).
How can we access empathy by penetrating the confusion of tongues?
How can we listen to what is not said, move beyond the verb, knocking gently at the door of what is so radically different from us?
The new relationship, thought from the interpretation of transference, proposes going back, returning to the beginnings, to the place before the trauma, and following the footprint that the real leaves (Gutiérrez Peláez, 2018, p. 105), finding the primal tongue of empathy, as the return, not to the repressed, but rather to the moment before the trauma, a moment before Babel, which creates the new language and attempts the impossible (Bégoin 2005).

The access to the horrible thing (Zizek, 2004 in Gutiérrez Pelaez, 2018).
The access to the Real.
It is important to assume it as part of what the relationship between humans is, as an expression of language.
It can be in the gaze of the analyst — just like the gaze of the mother on the baby and in which the baby sees himself and can find himself within — that the analysand-baby discovers his existence. In this place where the word does not yet have a face. The dreaming of the analysand in a speculative narrative, made silently within the analyst, launched by the gaze, like pieces of an invisible puzzle. The announcement of the rehearsal of the analytical pair is begun by the enthusiasm of the analyst, the enthusiasm of the childish interest and curiosity, which seeks the initial wordless play. This is a summons to play, to discover, where now in adult life words take their place, the place of the gesture, the place of the fingers that are placed in the mouth, in the rehearsal of the discovery of the world, which explores and discovers the entrails. It is now the analyst’s hands, made up of glances, touches and words, which, in an enthusiastic wandering, accompany the fingers of the baby, of the child who walks, sits or lies down with a large body, in the cradle of the analyst’s arms, in that resting place, touched and possible, now able to dream slowly again (Winnicott, 1960).
We are trying to integrate in the same time/space, desire and need, that which was suspended in a time without space back there, where tongues were confused, and to be able to access the suspended tongue that unites us, empathy, as the place from which we all came. The capacity of maternal reverie, the primal dictionary, which appeases the doubt, is re-edited as the analytic dyad, as the decoder of the confusion installed and which clarifies and unites. We are then able to dream of the construction of the psychological building capable of having access to and express the authentic self, to dream of the construction of the new relationship which repairs the gesture, the gaze and the word (Ferenczi, 1933).

5. Conclusions

(Art as another tongue)

We are made of matter that emerges from time, and the impossibility of respecting that time in all its dimension translates into the time of becoming ill. The moment of the failure of language, incapable of translating, of giving meaning to meaning, when confusion is established as the territory of the relationship, a kind of cloud of smoke arises. It covers what cannot be seen. Art, another form of sublimation of time, that stronghold of language made from what emerges from the dream, from the oneiric juice, that is, the supreme expression of the human, of the human “being” (Kameniak, 2009).

Art as the expression of a process of thinking about the perceived reality that cannot be translated or is unspeakable in words. Artistic production as an expression of what is intimately human. The return to the primitive expression of man, when he takes possession of his history and can write it on the walls of caves, through paintings that illustrate the process of thinking. The proposal is to return to what is the primal tongue of the baby, to its ancestry, to the moment of disagreement, to that time, to that instant of accident, of failure and on the edge of mental illness. The return to empathy.
Artistic spaces are ultimately the symbolic translation of the dream, of what, before the word, appears in what is mental. They are the mental portfolios, and they are also the permanent invitation to the elaboration of what is not present, of the memory that had to be covered up. The reverie (Bion 1994) acting without plan or design. The therapist is always free and at the mercy of the circumstance in the creation of the space for thinking. The whole process tries to symbolize the non-conscious, to create a common prosody, in this resuming of the matrix that was suspended in another time.

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