Analytic Listening and the Five Senses

During the spring of 2011, just a month before the panel “Analytic Listening and the Five Senses,” I attended a symposium at the Boston Psychoanalytic Institute—three distinguished poets brought together to discuss Freud’s “Creative Writers and Day-Dreaming” (1908). Each poet spoke about writing and the artistic process, and each read one of their poems. During the first reading, by Gail Mazur, a listener could detect, along with the poet’s voice, a loud rustle of turning pages from the audience, as Mazur moved to the second part of her poem. I myself was not reading but listening intently to Mazur’s voice and picturing the images from the poem in my mind. One of our panelists-to-be, Jonathan Palmer, seated next to me, was sketching—it seemed automatically and as if without noticing his own activity—whoever was speaking.

Reading, listening, drawing: this was serendipity. Members of the audience seemed to filter differently both the poem being read and the reader. As the discussion continued, my observations turned to the poets themselves. Louise Glück noted that for her, a poem belongs on the page: poems have shape, and their lines have size and chosen fonts. Pages contain the poem, and you lose that containment when you don’t see it. Robert Pinsky took another point of view. For him, the medium of poetry is not visual but vocal. The sounds compose the words, phrases, and lines. In fact, he added, he wishes he could have been a musician, since music is the most immediate of all the arts and the most collaborative.

In both cases, as it can be with each of us, the personal view was taken to be universal. Poems are poems only when they are seen on the page; poems are poems only when they are listened to as they are read aloud. In neither case is poetry simply a matter of words, sounds, and their combinative construction: poetry is something you see, or poetry is something you perform and hear. Mazur did not weigh in on this particular discussion. The poem she chose to read is a meditation written in the period when the death of her husband—the painter Michael Mazur—was imminent. “Figures in a Landscape” (2011) describes visual experience and expresses affect, thus putting into perspective, literally, through a portrayal of figures in a landscape, her immediate emotional situation at the time of writing.

“Analytic Listening and the Five Senses” asks whether and how we find similar variation among analysts and how such specificity of sensory predilection infuses clinical work. Freud bequeathed us the talking cure, and we all use words. Yet, just as a few poets can tell us how, or imply that, they experience words through different sensory modalities, we can also wonder how differential sensory prisms might be experienced by each analyst. We explore the place of the senses in analytic work—how individual analysts filter their listening, their noticing, their analytic presence through differently developed, or inborn, sensory modalities and predilections. ¹ We ask how these modalities, so basic to psychoanalytic theory, affect our work—how they may be employed by different analysts and how we respond to these modalities as they are brought out in patients. We wonder how these features of the analyst’s individuality—if she is visual, musical, tactile, or sensitive to the sounds, rhythms, and meanings of words and the spaces between and among words—affect her listening. We explore how sensory modalities shape our clinical identity outside the consulting room and then reenter it, creating what McLaughlin (1993) has called “transference sanctuaries” (p. 378)—for him, specifically, working in his woodshed and garden, and painting eggs. As the “creative writers and day-dreaming” morning progressed, Jonathan Palmer continued to sketch. I found myself in a familiar mode of my own, thinking about this panel and writing ethnographic notes.

Contributors to our literature give us a rich sense of how the analyst’s person (Bonaminio 2008), character (Baudry 1991; Kantrowitz 1993; Kite 2008), mind (Jacobs 1991, 1997), personal history and vulnerabilities (McLaughlin 2005), mortality (Pinsky 2002, 2012), and personal idiom and personal internal setting (Parsons 2007; Coltart 1992; Balint 1993; Milner 1950) are constitutive features of each individual analyst’s presence and activity. According to these writers, we cannot not bring our character, person, mind, vulnerabilities, personal internal setting, or mortality to our work.

In a similar vein, this panel considers how such particularity inheres not only in qualities of mind and character but also in different modalities of sensory filtering. We wonder what developed and undeveloped senses we bring to our work. We hear and see, but we also smell, taste, and touch. In everyday parlance we say we have “blind spots,” are “mis-attuned” to the patient, that a patient is “difficult to reach.” We may feel that we are left with a “bad taste” in our mouths after a session, or that we are “touched” by something a patient says or does. Most American analysts do not touch their patients directly, but many Europeans shake hands before or after sessions. We all touch and feel our chairs, pens, notepads, and appointment books; we change the napkins on the couch cushion, and we straighten the magazines that patients have thumbed through in our waiting rooms. We make minor adjustments after particular patients—after some (a smoker, a perfume wearer, someone who sweats or doesn’t wash) we may open the windows or use air freshener, and in this context we can note that some clinicians, just as some patients, notice personal and other odors more than others do.

As we endeavor to investigate analytic listening and the five senses, we remember that we do not begin from a level sensory playing field (or empty canvas). We picture Freud’s consulting room, filled with small sculptures from antiquity. We know that Freud wrote on da Vinci and on the Moses of Michelangelo and that in other works he often drew on poetry and literature. Our folkloric wisdom contrasts Freud’s passion for these arts with his disavowal of interest in music. He writes, confirming our expectation, that he is “almost incapable of obtaining any pleasure” from those arts, like music, whose effects on himself he cannot explain:

Nevertheless, works of art do exercise a powerful effect on me, especially those of literature and sculpture, less often of painting. This has occasioned me, when I have been contemplating such things, to spend a long time before them trying to apprehend them in my own way, i.e. to explain to myself what their effect is due to. Wherever I cannot do this, as for instance with music, I am almost incapable of obtaining any pleasure. Some rationalistic, or perhaps analytic, turn of mind in me rebels against being moved by a thing without knowing why I am thus affected and what it is that affects me [1914, p. 211].

Sterba, discussing Freud’s claim, challenges our assumption. Freud, he remarks, loved Mozart’s operas and knew them well. He notes further that Freud occasionally used musical metaphors in his writing: Adler and Jung, Freud asserts, “have picked out a few cultural overtones from the symphony of life, and have once more failed to hear the mighty and primordial melody of the instincts” (quoted in Sterba 1965, p. 97). ² Following Sterba’s lead, I found an early letter from Freud to Martha Bernays, in which he reports to his “sweet little Princess” about having seen Beaumarchais’s The Marriage of Figaro. He loved the production, finding it brilliant and witty, but, he says, “Now and again I missed the wonderful music” (Freud 1886, p. 192). Freud mentions particular passages of Mozart’s music that he missed, and he knows just where opera and play do not coincide.

Sterba points out that Freud favored artistic forms that involve the visual or the verbal (i.e., manifest representations of reality). These he could interpret in the fashion of dream interpretation, working toward finding latent unconscious meanings and unpacking condensations, displacements, and transformations. Music, Sterba points out, simply is what it is, not a traceable transformation of anything. ³ The problem when it comes to music, Sterba claims, is that “the intellectual, interpretively searching approach to works of art—which was Freud’s approach—has to fail. . . . In general, works of the other arts are copies of reality. . . . psychoanalysis attempts to draw conclusions as to the latent, i.e., unconscious, content of the work of art. This method cannot be applied in the realm of music, where the work of art is not a copy of reality” (p. 97). With dreams, we might notice, Freud insisted on their final form as visual and pictorially representational, as “copy.”

Analysts may themselves participate in artistic creativity, and thereby in an interchange between their creative and their analytic work. Marion Milner’s classic On Not Being Able to Paint (1950), perhaps inspiring Winnicott’s squiggle game, must certainly have been written by an analyst for whom the visual, or acts and represented acts of drawing, played a greater role than the musical in her listening. As we have this in her writings, Milner’s internal analytic setting and image of free association and its blocks are metaphorically linked to free-drawing on the page. Consciousness, the unconscious, and their expression are found through drawing, which may also use the whole body and body activity, representing, in what is then found, mind and body. ⁴

As I mentioned earlier, I have observed Jonathan Palmer at meetings. He does not listen without sketching, or perhaps he listens through sketching. We may wonder how he is using his mind here: Is his sketching representational, as it can seem to the observer, perhaps like our attempts to capture process, or the points of presentations, in verbal notes? Is he attending to his countertransference, as others notice through their body, their mind’s wanderings, or the images or music that come to mind? Does sketching foster evenly hovering attention? (Jonathan points out that my own, less sense-driven process of listening is cerebral: I take notes and have organizing ideas, notice turns of phrase and things said and not said.)

We find a contrast to Milner and Palmer in Gilbert Rose and Julie Jaffe Nagel (Nagel 2010). In Between Couch and Piano, Rose (2004) tells us that his couch shares office space with the same baby grand that gave him comfort when he was a child. He claims that nonrepresentational, nonverbal arts, and especially music, “generate feelings and help to process them” (p. xxvii). For Rose, the tempo, the time, the implicit motion of repetitions and changes, all these call particularly upon and evoke layerings of affect that accompany words. Nagel (2010) reports that specific music came to mind during her analysis and that she would often wish she could communicate the rush of thoughts in her head in music, rather than being limited to one word at a time (p. 650). In contrast to words, Nagel implies, music enables one to hear or produce many notes at the same time: it is synchronic as well as diachronic.

My own curiosity about sensory modes began in the mundane. I had puzzled over discussions with colleagues about phone analysis, which became a regular feature of my own work, as student and young professional patients relocated, and after I made a cross-country move. As I discussed this work with colleagues, I found some who could not imagine phone work but who were completely at ease doing clinical work through Skype, which I, by complement, found unimaginable. Others could imagine neither. The ear, the eye, and the body: analysts vary in their comfort with Skype and phone work, and one differentiating feature seems to be how much the visual, the tactile-visceral-bodily, or the tonal, rhythmic, and auditory, guides their listening presence.

My observations led me to think further about my own sense predilections and how these affect my work. I do not have a strong innate visual sense, have no artistic capabilities, am (germane to the Skype-phone discussion) more than electronically challenged, and something of a cyberphobe. Consciously, I had noticed in myself a visceral reaction to our field’s relative neglect of music, in contrast to the other arts, until quite recently. I love music and, though in no way an accomplished musician, have, generally, musicality and a good ear. Whether with patients in the office or on the phone, I am attuned to rhythm, voice, and timbre. I notice a tonal index, as my patients’ voices get slower or more speedy or go up and down octaves, depending on what is being felt, thought, or said. I pick up on and remember patients’ musical memories, hearing and entering imaginatively into their musical associations. Is a patient associating to a particular aria in an opera or to Long Black Veil as it evokes for her the 1960s? Is another hearing music in the clinical moment as he reports hearing, over the weekend, moving renditions of Shenandoah and “that song from Casablanca,” as I am hearing both music and words (“Oh Shenandoah, I long to hear you . . .” and “You must remember this, a kiss is just a kiss”)? As we are talking about his deep sadness, despair, and hopelessness, and a patient says, “I think, somehow, if I could understand music. . . . If someone would sing to me as I was dying,” I am moved, and I think immediately of the lullaby the patient remembers from his early childhood. I name, internally, another patient’s dream as his “Tamino dream.”

I remember and respond to patients’ associations to art and the visual surround, but I do not, I think, myself as immediately imagine or associate to these: they do not resonate internally in the same way (indeed, I do not myself find a visual word in the way that “resonate” comes naturally to mind). They seem more—well, visual. They are not as felt in my mind, affective state, inner ear, and body. And though I attend carefully and can place myself imaginatively into visual scenes described by patients who are more visual, I do not have as easy a time as with music in imagining, being moved by, or sometimes even knowing particular artists or works of art. As we learn from our panel, other clinicians experience differently.

In my mind for some time, consciously or preconsciously, was another observation. While working in the Bay Area, I was involved in a peer group with our panelist Forrest Hamer and another colleague. As we moved, under Forrest’s guidance, from discussing clinical cases to reading and discussing poetry, I found that the effect on my clinical work—on my listening, hearing, noticing, feeling, and sensing—was equally profound and useful, and in no way lessened. Somehow, the rhythm, sounds, and tones, along with the meaning of words, when read and thought about with colleagues, provided clinical deepening, in terms of both meaning and affect.

All of these sensory modalities take us directly to the body, and we find differences among analysts, as we listen to our colleagues and read the literature, in how much their clinical listening involves observations of body in their patients or of direct bodily experiences in themselves. The body itself—its size, shape, posture, movement, smell, how it is noticed—seems to figure more immediately and in the present for some analysts and patients than for others, and this must itself emerge from some specific aspect of the analyst’s own being-in-the-world. Balsam (2012), Chasseguet-Smirgel (2005), Dimen (2003), and McDougall (1989), among others, notice bodily sexuality in the consulting room, as well as bodily presence more generally—their patients’ bodies (and their own) as maternal, fecund, anorexic, drawn, over- or underexcited. Jacobs (1991) and McLaughlin (2005) make us aware of the continual workings of the autonomic nervous system, the relaxation or tension of heart and chest, the clenching of the stomach, and other bodily distractions, as they observe these in patients and experience them in themselves. These practitioners all attend carefully to and query their patients about bodily experiences and sensations. Similarly, all our panelists, each immersed in particular modalities of expression and experience, notice the body. Peter Goldberg, especially, has focused extensively on the psychophysical body and bodily experience. He explores compulsive exercise, bodily being or not-being, and bodies experienced as alive and not alive. He describes bodily pseudovitality, fabricated bodies, and the somatic false self, as patients bring such (non)experiencing into the consulting room and affect themselves, the analyst, and the analytic field (Goldberg 1995, 2004).

Individual analysts, then, may be more attuned to the visual, the musical, the tactile, the bodily-visceral. Meanwhile, we no longer think of words themselves as exclusively or primarily cognitive, and some, more than others, will be sensitive to the sounds, the rhythms, and the meanings of words, and to the spaces between and among words. We note the presence in our community of enough analyst-poets that there is a poetry section in each issue of The American Psychoanalyst and poetry workshops and symposia at several institutes. Several colleagues, focused on rhythm and tone as well as on meaning, conceptualize free association as a melding of the words and sounds of poetry into music. Ogden (1999) writes of “‘the music of what happens’ in poetry and psychoanalysis,” Seiden (2004), in “On the Music of Thought,’” about metaphor in poetry and psychoanalysis, and Jones (1997) of the missing “orchestration” (p. 694) of words, tone, timbre, and emphasis in many case reports. Jones, like Hamer a poet and psychoanalyst, claims that “as analysts, we attune ourselves to the overlap of meaning and music in words. . . . We not only use tone and melody, but choose words with particular rhythms” (p. 694). She points out that both analysis and poetry approach the unsayable, giving voice to experience and fantasy that has not yet been recognized: “experience that is in its intensity or its oldness beyond words” (p. 684; see also Parsons 2007).

My citations are sparse and selective, and they can be drawn on only heuristically, yet they also must capture sensuous reality in some way. Developmentally, sounds and rhythms (the music of what happens), experienced as they are in utero, precede vision, yet this does not mean that, universally, seeing is an advance. For some, the visual is a sensory filter, whereas for others, it is the ear, words, the tactile, or the visceral (literally, in the viscera). Schachtel (1947) characterizes seeing and hearing, as compared to taste, touch, and smell, as distal senses, but seeing is not distal for those, like painters and potters, who live with their eyes and creative hands and for whom touch and smell, the most proximal senses, also enter the studio. Nor is hearing distal for those who hear “melodies in the mind” (Nagel 2010). For one patient, saying what comes to mind enables an avoidance of what have been, since childhood, her deepest terrors, which are always experienced in visual form—immediately, viscerally, and in detail. Further, when we parse things in our ordinary language of the senses, we bypass the cross-modal sensory perception that we learn about from infant developmentalists like Stern (1985): loud sounds and bright colors have common experiential presence and intensity. ⁵ Loewald brings such observations to the clinical consulting room, noticing that language, the ostensible primary medium of communication in analysis, always partakes of the undifferentiated, global, affective, visceral, tonal, bodily, and relational resonances initially developed with the mother, from whom language is first learned. He describes these as the “undifferentiated ingredients of the total situation. . . . the sounds, tone of voice, and rhythm of speech . . . fused within the apprehended global event” (1978, pp. 185, 187). Loewald also tells us that in a good analytic hour, patient and analyst “become both artist and medium for each other,” and he specifically does not differentiate between modalities, as he says, “the progression in such an hour is quite similar to the progression of a work of art, a poem, a musical composition, a painting. . . . propelled by . . . directional tension” (1975, p. 369). ⁶

Beginning from Loewald, Schachtel, and infant developmentalists, we retain our sense of cross-modality and individual specificity, asking further, What if the global apprehended linguistic-psychoanalytic event involves patient or analyst with particular sensory listings? We wonder how we can expand our understanding of the ways sensory predilections consciously and unconsciously infuse each clinician’s presence in the consulting room, what difference it makes if the medium is by predilection more verbal, visual, tonal, rhythmic, or rooted more in global or specific bodily being. These are questions our panel hopes to illuminate. The participants each consider how their own particularized sensory modality or modalities enter the consulting room and make a difference in their work, just as other aspects of the analyst’s personhood make a difference.

We know structure, Freud told us, by observing how the crystal shatters. So also, we can understand facets of everyone’s sensory experience by listening to those who are aware of and accomplished in one sensory mode or another. Each of the panelists has dual or multiple identities, backgrounds, or interests—creative vocations or avocations that draw on different sensory modalities and sensitivities—and each has also written or taught about bodily presence and bodily states in patient and analyst. Their contributions draw on these dual identities. Jonathan Palmer is a painter who writes that painting is “particularly well-suited to revealing feelings” (2008, p. 481). Forrest Hamer is a poet who has also written about psychically and bodily experienced race and racism in the consulting room (2002, 2006). In “Listening with Both Ears,” he describes how his two careers complement and reinforce one another: “the poems I author are written by a psychoanalyst, and the psychoanalysis I practice is conducted by a poet” (2008, p. 86). Peter Goldberg observes and writes about bodily states with particular acuity and focus; he also plays rhythm and blues piano and is a serious gardener whose palette is his backyard. Susan Yamaguchi is a potter who has written about the relations between her states of mind when throwing pots and when doing clinical work.

Such a range was designed to provide audience members, and now readers, with evocative ways of thinking about themselves in their own clinical work. We have wanted to help ourselves and others to notice what predilections of sense, sound, voice, seeing, word, body, may shape our clinical work. The panelists write about their own sensuous-creative modality in relation to the clinical encounter and their clinical stance, about what they notice themselves noticing, observing, or feeling, and each presents illustrative clinical material. Susan Yamaguchi comments on the panel and conveys something of the alive and engaged tone of the meeting panel itself.

“Analytic Listening and the Five Senses” works toward understanding the role of sensory and somatic modalities in analytic work. We consult colleagues with specifically developed identities and practices in different creative arenas, or with particularly notable grounding in somatic experience and representation. Our goal is to provide an associ-ative basis through which readers, like those who attended the panel, can locate themselves and think about themselves in their own clinical work.