Like a Bridge Over Troubled Waters
I sit across from our patient with my carefully chosen words. He sits next to our patient with raw, drooling emotion. I sit back in my chair with crossed legs, the epitome of personal boundaries and social convention. He lays on his back, paws up - the embodiment of childlike trust and innocence.
The relational magic that a dog brings to the psychoanalytic consulting room has a unique influence on the quality of the analytic relationship - a relationship which underlies the analyst’s ability to bring about intrapsychic change and interpersonal healing. A dog in the consulting room can function like a bridge over troubled waters, helping patients and analysts reach the unconscious and dissociated and helping them reach each other. As the unabashedly needy dog, often complete with his own history of early trauma, warms the analytic space, he elicits feelings of acceptance and belonging that relax the chains of emotional guardedness and encourage more spontaneous and authentic relatedness. Case examples will demonstrate how this furry creature functions as a third in the treatment room, infusing the air with currents of primal need and basic trust and eliciting preoedipal and oedipal longings. The dog as a magnet for projections, identifications and dissociated self-states, as well as an emotional barometer for many patients, will be examined as well via case examples.
The relational magic of the dog
What enables a person to share her deepest shame, to experience and give voice to feelings that she has had to tuck away in the attic of her being? What gives someone the courage to put aside a lifetime of feeling misunderstood and test the waters of emotional closeness? What is the ‘unleashing’ influence of a dog in the room on the psychoanalytic process? For me, the answer to these questions involves the unique quality of the analytic relationship and how this relationship lives in the analytic space, both of which are influenced by the presence of my dog in the room. 1 have considered what helps me to be my most emotionally available, authentic self with my
Like a bridge over troubled waters 141 patients and what creates an analytic space which encourages this unique kind of relationship to take hold and flourish? With these concerns in mind, 1 have a bright red leather chair in my office for an infusion of vitality, gold and brown sconces on the wall for the warm glow of filtered light and a candle burning in the corner for the relaxation that the sight and the scent of the single flame evokes. Most importantly, I add a dog to the room for the unspoken promise of relational magic that dogs so often bring.
As 1 began my analytic training several years ago, 1 informed my supervisor that I often had one of my dogs in sessions with me. ‘Who is he there for’ she asked, ‘your patients or you?’ ‘Both’ was the answer 1 eventually was able to offer. I was beginning to understand how this extra body in the room could be instrumental as an agent of change for my patients and greatly facilitated my work as an analyst.
Dogs have always had a central place in my emotional world. They exert a gravitational pull that has made me feel loved and balanced throughout my life. Dogs warm the air that 1 breathe and relax the bones of my conscious mind, allowing thought, emotion and words to flow more freely. Interacting in the presence of people can be like navigating a busy street for me, filled with instructions, prohibitions and rules that taunt my contrary nature. Interacting in the presence of a dog feels like a beach in the early morning -open, with endless possibilities and hints of promised joy. As an analyst, my dog’s centering, calming presence helps me be more relaxed, focused and emotionally present with my patients.
My first dog, Jenny, was my best friend throughout my childhood and adolescent years. She offered the unconditional love and acceptance that I didn’t always find in the two-legged world, as well as companionship and an adventurous spirit that I grew to rely upon. The summer before my senior year of college and a year after Jenny passed away, I got my own dog. It was Winston, my very feisty Welsh Terrier who helped me select a husband, survive graduate school and taught me about the value of a dog as a co-therapist.
I began including a dog in my pre-graduate schoolwork as a crisis counselor at a residential facility for adolescent girls. Winston and I worked twenty-four-hour shifts in the crisis house where I was called to intervene when a resident’s behavior was out of control. I was tasked with calming or ‘physically managing’ the upset teen and then somehow, bringing her to the crisis house where Winston and I were the only staff.
Truth be told, I was terrified of more than a few of these girls. Winston was my ambassador, always walking into the room first, disarming the battle-ready teenager with his wet nose and wagging tail. I saw how he relaxed them and how I gained credibility in the adolescent world by being his second in command.
Years later, with a Ph.D. in hand, I set up a pet therapy program at the Children’s Day Hospital where I was working. These behaviorally challenged, oppositional children would work their behavior modification programs and achieve impressive levels of behavioral compliance to earn group time with the therapy dogs. The most aggressive children were calm, even tender with the dogs and often briefly, with the staff as well.
As a seasoned clinician in private practice, my dog Justin is frequently in session with me. Justin is a seven-year-old, brown and white poodle mix with bright hazel eyes and floppy ears. He typically greets each patient as they walk in and, if encouraged, will sit with them for much of the session. Justin’s presence influences the analytic space and the analytic relationship in a myriad of ways, as I’ll demonstrate late on. He offers an infusion of warmth and a hint of spontaneity, and is both a magnet for patients’ projections and identifications and an emotional barometer in the treatment room. An extension of me and an object of my love and care, Justin becomes a third in the room, stirring old longings and conflicts and intensifying the transference. Justin wields a subtle but important influence on my internal experience in the room as well.
Having Justin in the room slows time down for me by the slightest measure. As my pace slows, silences can incubate, words can linger, and feelings can fill the air in a less hurried way. I tend to feel more relaxed in his presence and better able to stay emotionally present in the room. My nonverbal ability to connect and resonate with my dogs is channeled in the consulting room. The calming influence of Justin’s presence helps me to stay open to the nonverbal, often to what both my patients and I are not allowing ourselves to feel, never mind put into words. This sensitivity for the unarticulated and the dissociated that my relationship with dogs has helped me hone has been instrumental in my gaining a deeper, fuller understanding of my patients and the unique selves that live within them.
Having a dog in the treatment room has not been without its conflicts for me. While I find the presence of my dog in the room to be personally soothing, some patients find Justin to be a distraction, even an annoyance. In such cases, my attention may be divided, concerned that Justin may meander over and pay unwanted attention to a patient. Some have felt that Justin’s presence is evidence that, like the narcissistic mother of their childhood, I prioritize my own needs at their expense. He is felt to take away from my ability to focus on them rather than to facilitate it. I have, in fact, found myself distracted by Justin’s occasional scratching or roaming or by his unique reaction to certain patients.
Sometimes, Justin has wanted to sit with me when clearly, he could better serve the analytic moment by sitting with my patient. If I let Justin sit with me, I risk becoming the self-serving mother, addressing my own needs while I leave my child hungry and wanting. If I give Justin cues to stay down, I may become the cold and dismissive mother, as they identify with Justin’s rejection as the needy, annoying child. At the very least, a dog in the treatment room is a draw for my attention and inevitably adds a dimension of unpredictability within the analytic space which may not always be in the service of the patient’s agenda.
Like a bridge over troubled waters 143
Finally, with the presence of a furry other in the analytic space, both the room and I become profoundly less ‘blank’. 1 am a person who has a dog and chooses to bring this dog to work. Just as my wedding ring offers personal data and my casual style of dress and penchant for bright colors suggests other qualities, my wish/need to bring my dog to work may spark questions about my emotional makeup. Am 1 one of those ‘crazy therapists’ saddled by my own anxiety disorder or barely contained eccentricity? Do I struggle with a rebellious nature or a narcissistic preoccupation in which my desire to have my dog with me trumps my patients’ needs and desires? Or, does the dog’s presence suggest to patients that 1 share with them basic needs for closeness, comfort and connection that feels more accessible in the presence of a dog?
The relational magic of the dog feels related to the sense of comfort and belonging that they generate, facilitating the risking of trust and closeness between patient and analyst. The dog’s presence in the treatment room can stir needs and longings that are often fiercely guarded against in human interactions. Justin’s reactions are not shackled by human defenses or preconceptions about what is appropriate and therapeutic. Rather, as his presence seems to exude a sense of unconditional acceptance, a mutuality organically emerges between him and those with whom he engages. As the dog comforts and relaxes a patient, previously avoided or dissociated feelings such as longings for closeness, rivalry, envy and rage may be stimulated and left very alive in the analytic space.
I’m with him: the dog’s influence on the development of the early therapeutic relationship
The influence of the dog in the room can first be felt in how his presence affects a patient’s initial comfort with me and the decision to pursue treatment. Josh’s parents sat nervously in my office during our initial consultation. His father spoke in a slow, controlled manner and told me that it was possible that his fifteen-year-old son had an eating disorder. Furthermore, he went on, it was possible that Josh had questions about his sexuality. Josh’s mother sat quietly, head down as her husband spoke, stroking Justin methodically with both hands as he sat on the couch next to her. She said little throughout the session but when I asked her if she had any questions, she responded, ‘No, you will be fine. You’re a member of the tribe’.
‘The tribe?’, I asked, sure that she was referring to her assumption that 1 was Jewish, as were they. ‘A dog person’ she clarified and then added ‘Josh will be able to talk to you.’ And so, one of the most memorable treatments of my career began. Over the next few years, Josh’s parents struggled in and out of sessions to understand their son’s very serious bulimia, his bisexuality and his need for antidepressant medication to combat significant feelings of depression. Throughout my work with Josh and at times his parents, Justin was there as a quiet presence who breathed comfort into the room and reassured them that as members of the same tribe, I would understand and not judge them.
The feelings of warmth, acceptance and comfort that many patients describe in the presence of a dog are certainly not universal. One young woman comes to mind who walked by Justin with barely a glance during her first session, announcing smugly that she is a cat person. Not surprisingly, she did not come back for a second session. 1 too felt the match was not a good one and felt some measure of relief that I would not be tasked with bridging this interpersonal divide.
Working with a dog in my office seems to have a more conscious and apparent influence on my work in the initial, rapport building phase with teenagers than with adults. Having a dog work with me seems to suggest to adolescents that I might be an adult with a small ‘a’ rather than with a capital ‘A’. For many teens, dogs connote trust, acceptance, spontaneity and warmth; antidotes to their view of adults as critical and unable to understand their emotional experiences. Certainly, having a playful, comforting figure in a place that feels alien, where they are charged with a frightening task, seems to be a helpful surprise. This surprise often buys me an opportunity to show what kind of adult I am.
Leah is a highly anxious sixteen-year-old girl who has tolerated but eventually rejected three therapists in six years. According to Leah, one just played games with her and ‘it was useless’. One talked about herself too much and had Leah’s mother in the room half the time. The third therapist didn’t speak enough, appeared too formal and seemed to be put off by Leah’s edgy ‘adults suck’ attitude.
Leah’s mother warned me in our initial consultation that their relationship was quite strained and that her daughter saw therapy as her mother’s ploy to better control her behavior. I had the sense that I would come to agree with Leah on this one and began to resonate with her wish to rebel against her mother’s efforts to use her as a means to quell her own anxieties.
When Leah entered the office for her first session, I introduced myself and then the poodle who was excitedly wagging his tail at her feet. She fell to her knees to greet Justin with equal enthusiasm, abandoning her armor of adolescent indifference. I quickly fell within the shadow of the instant connection Leah felt toward Justin and was deemed worthy of a chance.
Leah spoke at length about her highly conflictual relationship with her intrusive and controlling mother who, Leah was certain, preferred her younger brother. She professed indifference to this but quickly agreed that her constant anger toward her mother might suggest that this was painful to her. Leah described lifelong struggles with anxiety, sadness and an exquisite sensitivity to separation. Throughout this very powerful first session, Leah sat with Justin on her lap. She stroked his shoulders with both hands, a gesture that served to both soothe her and help her pace herself.
For Leah, like many adolescents, the dog was felt to be a good object, understanding and accepting. Adults represented the promise of being many kinds of objects; the nurturing and holding mother, the anxious and intrusive mother, the critical and rejecting mother to name a few. Relationships
Like a bridge over troubled waters 145 with adults raise the likelihood of bumping into a combination of these internal mothers and as such, are both longed for and fiercely guarded against. Justin, on the other hand, sits by them as they rant, cry or shut down; a quiet, comforting object who reaffirms that they are lovable and not alone.
For most patients who have sought treatment with me, Justin’s presence has been a welcome surprise. While each patient forms his own relationship with him, most respond to Justin’s warmth and affection, experiencing it as a welcome balance to my analytic reserve. They appear touched by his enthusiasm at seeing them as he wags his tail excitedly and follows them from the door to the couch. They can hold him, pet him and often receive the comfort of a cold nose sniffing them should they appear visibly upset. He notices, he cares and he acts - in sharp contrast to my often ineffectual world of words.
The dog as a third in the treatment room: eliciting pre-oedipal and oedipal longings
A dog in the consulting room can transform the analytic space in ways which facilitate the deepening of the analytic relationship. The dog can become a third (Benjamin, 2012) in the room, functioning as a bridge from the unconscious to the conscious and from the intrapsychic to the interpersonal, stirring longings from childhood that might remain more difficult to access within the strictly two-person analyst/patient dynamic. As wishes for the merger, issues around separation and individuation and feelings of competition come alive with the dog’s emergence as a third, they become available for processing and integration.
Freud (1920) focused on the concept of the third in the parents/child relationship, as he placed the oedipal triangle in the center of a young child’s psychosexual development and a central theme revived in transference configurations. Issues related to rivalry, competition and aggression are stirred by the oedipal dynamics and feelings of arousal/rejection and specialness/ exclusion may emerge as connected to primal scene issues. Freud considered oedipal issues, i.e. developmental challenges related to the child being the third with his mother and father, to be important for healthy psychosexual and emotional development and successful adult functioning. It is worth noting that Freud often had a dog with him during sessions.
More recently, Thomas Ogden (2004) suggested that the construction of the analytic third is a function of the subjectivity of both the patient and the analyst. While the patient’s subjectivity is the focus of concern and inquiry, the analyst’s examination of her experience in and of the analytic third is used as a bridge to understanding the internal world of the patient. In his discussion of the creation and influence of the analytic third, Ogden writes, ‘experiences in and of the analytic third often generate a quality of intimacy between patient and analyst [and] these experiences in the analytic third may hold particular importance to the analysis in that they may be the firstinstances in the patient’s life of such healthy, generative forms of object relationships’ (Ogden, 2004, p. 237).
Jessica Benjamin (2012) speaks about the third as the potential relational knowing that can emerge and inhabit the psychoanalytic space in the room and in the analytic relationship, such that each can temporarily surrender their own view and consider the view of the separate other. Given the dog’s widespread experience as an object which offers unconditional love and acceptance, one could suggest that this generates a sense of interpersonal recognition and knowing in the other. Might both patient and analyst project their need to feel seen and known onto the dog, utilizing the furry other as a third in the psychoanalytic space? While relational theorists have focused on the creation of an analytic third in the analytic encounter, this chapter explores how the physical presence of a third, in this case a dog, may act as a repository for projections from both participants’ subjectivities.
The nature of the dog’s embodiment of the analytic third is, in part dependent on the developmental needs of the patient. Some patients struggling with pre-oedipal concerns use Justin as an extension of me and as such, as an object with which to merge. Others use Justin as a transitional object of sorts, merging with him while making early attempts at tolerating separation from me. This has often been the case when patients make early, anxiety-laden attempts at expressing anger at me.
Patients with more primitive ego development are often not able to tolerate even a whiff of separation. The presence of Justin as a third may interfere with their symbiotic transference needs. Such patients have an inability to tolerate experiencing the analyst as a separate whole object, with her own needs, experiences and especially with her own ‘other’. As living proof of the analyst’s separateness and therefore the patient’s aloneness, the dog puts the patient at risk of being exposed as vulnerable and unformed, a fledgling chick, unable to fend for himself and unable to fly away. The presence of a dog in the treatment room may be difficult for these patients as feelings of envy, rage and a need to destroy the good object to which they don’t feel they have sufficient access, may dominate their experience (Segal, 1964).
My work with Warren, a severely depressed, highly intellectualized and obsessional forty-year-old man offers an example of a patient with debilitating pre-oedipal struggles and of how having a dog in the room influenced our work together. 1 treated Warren in two times weekly psychoanalytic treatment for seven years. Warren sought analysis to help him manage overwhelming feelings of depression and crippling panic attacks. As the oldest of three boys, Warren described the feeling that he was never smart enough, popular enough or handsome enough for either his vain, narcissistic mother or extremely intellectual and emotionally limited father. He was particularly self-conscious about his height, as he stands five feet, six inches tall. Our relationship was marked by his need to demean me as paid help who was obligated to listen to the obsessional details of his life. He would deliver his longwinded monologues with a painfully monotonous tone and become
Like a bridge over troubled waters 147 enraged at any attempt on my part to interrupt with a question, clarification or even an empathic response. As with the prostitutes he hires, I was expected to meet his needs, absorb his rage and have no feelings or needs of my own, especially as he routinely let me know how unhelpful I was and what a disappointment I had become to him.
Justin was experienced by Warren as an intruder and a rival, the favored baby while he was the despised and burdensome oldest child. As such, Justin was the ‘other’ that stood in the way of his merger with me and triggered a rage that helped fuel his weekly destruction of me. Warren would glare at Justin with disdain as the dog lay equidistant between us on my office rug. He was focused on my quickest glance in Justin’s direction and would become enraged if my attention splintered for even a second.
Warren was quick to comment that I wasn’t giving him my full attention and he wasn’t paying me to look at my dog. We talked about what it meant to him that I had something, someone of my own in the session with me. This led to an outpouring of rage toward his mother, as he described how his hyperactivity and poor social skills left him in a near-constant state of being criticized by his rejecting, self-centered mother. He also talked about his disdain for his brothers, both of whom he felt got the love and encouragement that he was denied.
Thus, as feelings of envy and jealousy emerged toward Justin, we were able to gingerly reflect on Warren’s internal experience growing up in a family where he felt despised and emotionally abandoned. His hatred toward me as the self-involved mother of his childhood was facilitated by Justin’s presence in the room.
Unlike most patients, Warren never spoke to Justin or allowed himself to receive any of the warmth and affection that Justin would offer. As the favored child, Justin was the recipient of Warren’s disdain, usually manifested in his frequent scowling at the dog and complaints about his presence. After seven years of twice a week treatment, I can remember suddenly having the fantasy in the middle of a session, that Warren was going to viciously kick Justin. Several weeks later, he precipitously ended what had been a long and difficult treatment for both of us, by unleashing a series of highly aggressive, threatening voicemails, declaring that he was firing me. While I will never know exactly what the guilty match was that torched our treatment, my separateness as evidenced by my having an ‘other’ in the room, was undoubtedly part of his torment.
Justin served the vital function of keeping me alive in my sessions with Warren. His suffocating need to consume me, to focus on my every move, always attributing petty or self-serving motives to my offerings, was barely tolerable as a steady diet during our twice-weekly sessions. The depth of his loathing of me, of himself and of the few others in his small world, was toxic. Perhaps most of all, his inability to let me join him in any way was deadening and left survival as the only goal for all three of us.
For me, Justin’s presence felt like an island of good in a sea of bad objects that flooded the treatment room. When 1 felt erased by his dissociated.
obsessive soliloquies or overwhelmed by his venomous verbal assaults, Justin was a centering force whose presence helped me keep my analytic footing through the worst of Warren’s storms.
For Ava, a thirty-five-year-old young woman with anxiety and depression, Justin was the preferred sibling but unlike Warren, she could tolerate the intrusion between us and the rivalrous feelings that emerged. Ava desperately wanted more closeness and nurturance from me and experienced the limits of the therapeutic relationship as an indication that I didn’t care about her. She seemed to wish that like Justin, she could curl up in my lap, be scratched behind the ear and be taken home at the end of the day. Ava alternated between patting Justin and talking to him as he sat by her side and questioning how I would feel about her if she didn’t like dogs or complained about his presence in the session. This led us to talk about how hard it was for her as a child to ask directly to have her needs met or give voice to her anger and resentment lest her barely engaged mother detach completely.
Early anxiety around attachment has made authentic relatedness very difficult for Ava. Her overwhelming wish for closeness and experience of boundaries and limits as rejection precluded engaging in age-appropriate competition with her younger siblings. Ava resorted to splitting off many of the more challenging, impressive facets of her personality in favor of the superficial, people-pleasing persona which was congruent with the role assigned to her within her family. Ava used her relationship with Justin as both a way to seek approval and closeness from me and as a way to test out my responsiveness to her anger and fledgling self-assertiveness. Must she continue to be, like Justin, and her longstanding role within her family, there to meet the needs and fulfill the expectations of others? By both identifying with Justin and competing with him, Ava was learning to give voice to her sadness and anger and pay attention to her own very impressive intellect.
For Ava, Justin has significant transference implications. Ava has struggled throughout her thirty-five years to get the warmth, attention and nurturance that she needed from her very reserved, intellectual mother. Her reactions to Justin and what emerged between the three of us brought core interpersonal issues to the forefront for Ava.
Ava studied my interactions with Justin during sessions. Was 1 the loving, longed-for mother with Justin, holding him and comforting him as we talked? Did I ignore Justin and in doing so, become the emotionally distant mother of her childhood? She would often muse about the kind of mother she thinks I am, identifying with Justin’s longing and seeing me, much like her own mother, as cold and withholding. More recently, Ava has been able to experience me as more loving and actively struggles with the sadness and anger that the tender nurturance that she has always longed for routinely went to a younger, in her eyes, preferred sibling.
Justin’s presence in the room seems to have facilitated Ava’s experience of a negative maternal transference that has allowed her to experience an angry, ignored, emotionally starved self-state, an internal experience that
Like a bridge over troubled waters 149 she has fought to sequester since she was a young child. By stimulating early needs and sibling issues, Justin facilitated the unfolding of a rageful part of herself that she has sacrificed in the service of staying close to important others in her life. Simultaneously, he provided warmth and comfort and represented a connection to me that allowed Ava to tolerate these terribly uncomfortable feelings.
In my work with Ava, Justin served as a bridge for me to gain access certain split off parts of myself. Justin helped me travel in sessions back to my own rivalrous experience with preferred siblings. In his relaxed, soothing presence, I could identify with her split off rage and understand the price exacted in terms of ego development, that this ongoing accommodation has cost her. Not only did she abort the development of her very keen intellect, she painstakingly cultivated a beautiful shell that encased a self with troublesome pockets of emptiness. Ava’s bubbly, people-pleasing persona was her interpersonal offering that was always at the expense of feeling truly known and authentically connected to the other. Thus, as Justin helped me gain access in sessions to the underbelly of my own attempts to cope, he helped me connect with what was split off and sacrificed by Ava.
The dog as a third invites spontaneity
The dog’s unscripted presence in the analytic space suggests that spontaneity and unpredictability are welcome. Dogs bring movement to the room and hint that we do not need to stay locked in the traditional world of words. While the therapeutic experience is traditionally a verbal one, spontaneous action can break through what may feel like impenetrable resistance, a sense of deadness or intractable symptoms.
The focus on the potential mutative impact of the dog’s unpredictability in the treatment room is supported by the work of the Boston Change Process Study Group. The Boston Change Process Study Group (2005) looked at the process of change in psychotherapy and focused on the nuances of the moment to moment interactions between patient and therapist. They talked about noninterpretive factors, the ‘something more’ that brings about change in the therapeutic process and focused on an indeterminate ‘fuzziness’, ‘sloppiness’ and ‘unpredictability’ (p. 693) as being instrumental in clinical change.
My work with Dee, a painfully depressed and extremely isolated twenty-two-year-old woman exemplifies how spontaneity, fostered by the presence of a dog in the room, filled the analytic space and rescued a stagnating treatment. After two years at a residential treatment facility following many years of school refusal, Dee was severely depressed and rarely left her home. The sick parent she sacrificed her adolescent years to care for, had passed away. Now, the smallest of tasks felt unmanageable and day and night were interchangeable. While Dee’s connection with me was strong, her ability to work in the treatment ebbed and flowed, as her depression and anxiety fluctuated from moderate to severe.
One particular session stands out in my mind when Dee uncharacteristically would not make eye contact and muttered under her breath rather than spoke to me. We sat in what felt like a toxic silence for many minutes, a silence which felt like it was smothering the last tendrils of hope in the room. Finally, feeling somewhat lost, I reflected that Dee seemed to be in a darker place than I had seen her in a long time. After another long silence, I said, ‘That’s ok, I’ll just rest there with you’. We sat quietly for what again felt like an eternity. Searching for my footing in this depressive abyss, I mused about the dark area in what I shared was my favorite picture in my office. I told her that this area looked like isolated, distant mountains to me and made me think of the part of her that felt so far away and terribly alone. Dee spoke quietly, still not looking at me and said that those were not mountains but rather, they were rocks with the ocean’s waves crashing all around them. I leapt out of my chair and examined the picture in question up close. Within a second, Dee and Justin were up too, and Dee was pointing out where she saw the rocks and the water. She acknowledged that she could see how I might see them as mountains, but she maintained her view that it was waves crashing around the rocks. There was eye contact. There was animation in our voices. There was affect in the air. There was life. A month later, Dee enrolled in community college, and a month after that, she began classes.
I am not suggesting that Justin was responsible for this surprise moment in Dee’s treatment. While he did not lead the charge toward the painting, his uninhibited, action-oriented way of being in the room made both my jumping up and Dee’s jumping up, feel less out of place. The three of us created this moment which fused movement with the unchaining of Dee’s self-imposed isolation.
The dog as a barometer in the treatment room
Justin influences the analytic space by acting as an emotional barometer for my patients, helping them experience, appreciate and manage the intensity of their affect. While I do my level best not to fall out of my chair or appear rattled when a patient begins to rage at me, Justin feels no such need for this limitation. He might look up in a startling way or jump down from their side in response to unusual yelling. Often when a patient would cry or appear visibly upset, he might park himself next to her as a source of comfort, as an affect regulator. My concern initially was that patients would be soothed and quieted, receiving an implicit message that strong affect is discouraged. In fact, however, the opposite seems to happen. Patients seem to feel that they can unleash less comfortable feelings such as anger and deep sadness, with Justin literally by their side.
Philip Bromberg (2008) suggests that fear of emotional dysregulation drives the tendency for dissociation. He focuses on the presence of both safety and risk in the analytic relationship as key factors underlying the mutative impact of the analytic relationship. The dog’s ability to enhance
Like a bridge over troubled waters 151 feelings of safety in the consulting room for patient and analyst alike seem to result in the patient’s feeling contained and accepted such that they are then able to risk experiencing and expressing painful affect.
Alan is a forty-five-year-old man with a long history of substance abuse, tumultuous interpersonal relationships and severe irritability. Alan grew up with an alcoholic father and bore witness to his father beating his mother for the smallest perceived slight. Alan despised himself for his inability to protect his mother, a betrayal made worse by the feelings of love he still felt for his father. As an adult, Alan experiences his father’s extreme sensitivity to slights and frustrations and has relied on drugs, high-risk behaviors and physical aggression to manage his rage and feelings of vulnerability.
As Alan became sober and worked in therapy, he began to experience and eventually manage his kaleidoscope of emotions. He is driven by a determination to be ‘nothing like that prick’ and sees himself as a fierce protector of his mother, sister and girlfriend. Though he works tirelessly in therapy, has daily workouts in the gym and is on antidepressant medication to help with his irritability, Alan is still hobbled by his volatility. What used to be holes punched in the wall or bouts of verbal abuse that cost him past relationships, has been whittled down to an angry raised voice, with clenched teeth and balled fists. Alan is incredulous when his girlfriend complains about his aggressive behavior as he feels he is turning himself inside out to not release his rage. While he challenges his girlfriend’s experience of his outbursts as well as my own as threatening, he is moved by Justin’s startled reactions to his anger in sessions. He believes that the women in his life overreact to his admitted ‘temper’ but Justin’s jumping off his chair and scurrying halfway across the room is experienced as the gold standard of the truth.
As Alan became able to register the reaction of the ‘other’ to his rage, he became increasingly able to experience and reflect upon the waxing of irritability into anger and anger into fury. Feelings of shame and helplessness emerged as Alan could see the shadows of his father’s rage coming alive within him but seemed easier for Alan to tolerate with Justin’s steady presence by his side.
Alan’s developing ability to tolerate his rage and connect childhood feelings of powerlessness to his present-day explosions has helped him stay sober, function better in the work world and has transformed his ability to be a partner in his intimate relationship. I believe that Justin’s accepting, calming presence in the room was one of the special ingredients that has enabled his growth in our work together.
Working as a bridge from the unconscious to the conscious and from the intrapsychic to the interpersonal, the presence of a dog in the analytic space can enhance a sense of safety in the analytic relationship, encouraging the unfolding of progressive communication and unconscious processes. As amagnet for projections and identifications, the dog triggers early memories, wishes, needs and fears. As such, the dog sometimes falls within the shadow of the transference, stirring feelings about the therapist as a parent and feelings of sibling rivalry. The presence of a dog encourages the experience of strong affect and provides a comfort that facilitates the experience of split off affects and self-states. Finally, the dog sometimes is used as a self-object, providing the holding, comforting and mirroring functions that are typically reserved for the two-legged therapist.
Jen, a sixty-five-year-old recovered alcoholic, struggled with severe depression and isolation so profound, it chilled me to the bone. She felt emotionally abandoned by a narcissistic mother who lacked the patience or inclination to focus on Jen’s emotional needs. Jen was the youngest of three children and was seen as difficult and demanding by the adults in her world. She focused on her attractiveness as her only source of narcissistic supplies. Jen became an impulsive teenager, with little sense of self and even less ability to self-reflect or self-regulate.
As an adult, Jen could not succeed in a career as a model, was unable to engage in meaningful work and failed in her three significant intimate relationships. She blamed years of substance abuse and depression for the many disappointments and failures in her adult life and exuded a sense that she saw herself as inherently damaged and unredeemable.
Jen seemed torn in treatment, desperately inhaling the contact and interest that was taken in her, while feeling hopeless that anything could temper the depth of her resentment, isolation and self-hate. Jen identified with Justin, responding to him as one unfortunate stray to another. She would pat him while talking and almost seemed to be speaking for the two of them. Jen would talk about feeling that she didn’t have a home or a family, just a studio apartment and no one in the world who truly cared about her. She watched a world of people with lives that seemed filled with love and purpose but felt unable to have even crumbs of either in her life.
Jen talked about feelings of helplessness and futility. She felt unable to sustain a relationship, manage her very labile mood or find an interest to fill her many empty hours. Unlike other emotional outcasts, Jen couldn’t even find a home in the twelve-step programs. While she held onto a vague, unarticulated hope of being rescued, this hope was made all the more unlikely by her irritability and desperate, off-putting interpersonal style.
Earlier in treatment, Jen identified with Justin as an abandoned stray and talked about feelings of loneliness, rejection and helplessness. As her depression worsened and the transference deepened, Jen related to Justin as the preferred, more lovable sibling who was cherished in a way that she would never experience. Anger and resentment accompanied her desperate sadness, as Jen struggled to stay connected to me and battle the dragons of despair that lived inside her.
During one session, Jen was staring at me silently. After several moments I asked, ‘What are you thinking?’ ‘I’m wishing I was you.’ Jen responded
Like a bridge over troubled waters 153 with a melancholy voice and piercing stare that left me speechless. As this mixture of despair and envy filled the room, I slowly regained my ability to use words and quietly said, ‘Tell me more’. ‘Oh, Dr. Feldman’ she sighed, with an intensity of feeling, ‘to be you. To have a home and a family and a dog and a life. To be you’.
As a good object in her world, Justin embodied the twinning selfobject properties of unconditional acceptance and identification as an abandoned emotional stray. Wolf’s (1988) description of the twinship selfobject transference as ‘[t]he need to experience the essential likeness of the selfobject and to be strengthened by its quietly sustaining presence’ (p. 58) highlights one facet of the supportive function that Justin provided. In the end, however, both he and I were inadequate as selfobjects, our tepid offers of caring and concern like the offer of an umbrella in the midst of a tsunami.
As a bad object, Justin became the victor in her world of sibling rivalry, appropriating the lion’s share of the maternal attention and affection that she so desperately needed. Both he and I indulged our emotional greed, excluding her from the heart of our world and sharing only forty-five-minute scraps of our lives with her. As such, we gave form to the rage and envy that swirled through her internal world and became key players in Jen’s tragic enactment. Seeking revenge against the mothers who would never love her enough and the siblings who lived gluttonous lives of emotional (and financial) plenty, Jen’s suicide was her silent scream, ‘Look what you made me do!’
In the end, Jen felt condemned to a lifetime of interpersonal homelessness. While I had hoped that Justin and I could offer her something, someone to hold onto, our real-world presence offered far too little, far too late. Depleted by decades of swimming in the muck of profound isolation and despair, Jen ultimately used Justin and myself as the recorders of her tragic history. In the end, she counted on us to be witnesses and the lone souls who might miss her after she took her own life.
Dennis, a thirty-seven-year-old single man entered treatment six years ago seeking help for a paralyzing struggle with anxiety and depression. His symptoms left him socially isolated and though he spoke about desperately wanting to make changes in his life - change jobs, lose weight and go back to school - he felt he could not initiate, never mind sustain any of these pursuits without the presence of a supportive other.
Dennis talked about his relationship with his parents and spoke warmly about how caring they have always been. As he discussed his work in the family lighting business, he gave example after example of times he would become angry and frustrated with both of his parents. As we focused on his difficulty asserting his needs with his parents or expressing his anger, Dennis became acutely aware of how uncomfortable he was in the face of confrontation and conflict. Eventually, we talked about how he sacrificed his authentic responses, in fact, whole parts of himself, in the service of protecting important others from his rage and maintaining an emotional connection with them.
Dennis used the therapeutic relationship with me and Justin to provide the selfobject functions he needed to experience and gradually began to integrate uncomfortable affects such as rage, shame and frustration. He talked to me with Justin by his side, patting him and often remarking that he needed to get a dog as soon as possible. The unconditional love and acceptance that Justin offered was a balm for Dennis as he gingerly began to explore threatening feelings of anger toward the parents he still depended on for much of his emotional sustenance. With Justin’s steady supportive presence in the room, Dennis was able to contain his anxiety and give voice to his anger and frustration. As he became more in touch with his rage, Dennis felt seen and valued in the analytic relationship for his ability to experience this thorny affect, rather than for his self-defeating ability to keep his anger under lock and key.
Dennis gradually became significantly less depressed and anxious, enabling him to work consistently and enter into his first intimate relationship with a woman in over twenty years. He began dating via an online site and quickly met Maggie. Unlike his usual easy going, adolescent, somewhat passive social persona, Dennis assumed an adult, almost parental role with his new girlfriend. He supported her financially, counselled her about improving her vocational situation and bemoaned the fact that she was extremely self-involved and unsupportive of his needs.
The paternal, conservative self-state which emerged, an identification with his father, was a new and surprisingly rewarding one for Dennis. While he eschewed most of what smacked of adulthood, i.e. responsibility and commitment, he was beginning to confront his fear of the feelings that both stirred in him. Dennis looked for support and validation as he tentatively stepped into more adult roles. We spoke about the different selves within him, each with his own style and set of priorities and Dennis soaked in the recognition and acceptance that he felt from both Justin and me. With these feelings of approval around his new interpersonal abilities, a more adult Dennis became significantly more engaged in his work and started taking graduate classes in the evening.
As Dennis became able to verbalize his anger and feel empowered and worthy of having a truly intimate, mutual relationship, he ended the relationship with Maggie. This very difficult act reflected his burgeoning ability to embrace conflict and champion his own needs. While he still longs for a significant other, he relies on Justin and me in the treatment to fulfill the mirroring selfobject needs of emotional support, validation and acceptance that his anxious mother, emotionally distant father and impulsive and self-absorbed girlfriend could not provide.
Dennis would come into sessions, saying ‘Hey Buddy’ as he patted Justin with energy that Justin seemed to enjoy. While he related to me via a maternal transference, he and Justin enjoyed a mutuality that was beneficial to both of them. Dennis was able to give to Justin and to receive from him. This mutuality seemed to be a precursor as well to the shift in his ability to
Like a bridge over troubled waters 155 relate from a more adult vantage point and develop more symmetrical and gratifying interpersonal relationships.
Conclusion: a room with a dog
1 recently walked into a bakery and grinned knowingly as 1 read the following sign, ‘Chocolate Doesn’t Judge, Chocolate Understands’. 1 believe the dog, like chocolate, induces a visceral sense of understanding, acceptance and belonging. The influence of the quietly powerful dog in relational psychoanalytic treatment is felt in our work’s most transformative dimensions: the authenticity and quality of the patient/analyst relationship and the ability of both patient and analyst to access and share the conscious and unconscious intrapsychic experience. As the case examples in this chapter indicate, the dog’s accepting and loving presence helps patients feel truly seen and valued, with all of their deficits and demons. Many patients need this feeling of acceptance before they can risk exposing their shame or voicing their split off rage before they are capable of the liberating and empowering experience of authentic emotional relatedness. Similarly, the dog’s soothing and holding qualities enhance the analyst’s ability to use her own internal experience to navigate the hidden crevices of her patient’s internal world. Like a bridge over troubled waters, the dog in the treatment room provides the necessary, if not sufficient ingredients for the unfolding of trust; an unfolding which allows dissociated or buried feelings to reach the restorative shores of the patient/analyst relationship.
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