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Jeanine M. Vivona

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PSYCHOANALYSIS AS POETRY
Like psychoanalysis, poetry is possible because of the nature of verbal
language, particularly its potentials to evoke the sensations of lived experience. These potentials are vestiges of the personal relational context in
which language is learned, without which there would be no poetry and
no psychoanalysis. Such a view of language infuses psychoanalytic writings on poetry, yet has not been fully elaborated. To further that elaboration, a poem by Billy Collins is presented to illustrate the sensorial and
imagistic potentials of words, after which the interpersonal processes of
language development are explored in an attempt to elucidate the original nature of words as imbued with personal meaning, embodied resonance, and emotion. This view of language and the verbal form allows a
fuller understanding of the therapeutic processes of speech and conversation at the heart of psychoanalysis, including the relational potentials of
speech between present individuals, which are beyond the reach of
poetry. In one sense, the work of the analyst is to create language that
mobilizes the experiential, memorial, and relational potentials of words,
and in so doing to make a poet out of the patient so that she too can
create such language.

It is difficult
to get the news from poems
yet men die miserably every day
for lack
of what is found there.
William Carlos Williams,
from Asphodel, That
Greeny Flower (1955)

Professor of Psychology, The College of New Jersey; adjunct clinical faculty,

Department of Psychiatry, Pennsylvania Hospital.
A version of this paper was presented at the Winter Meeting of the American
Psychoanalytic Association, New York, January 18, 2013. Submitted for publication
June 28, 2013.
DOI: 10.1177/0003065113513639
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A layman will no doubt find it hard to understand how pathological disorders of

the body and mind can be eliminated by mere words. He will feel that he is
being asked to believe in magic. And he will not be so very wrong, for the words
which we use in our everyday speech are nothing other than watered-down
magic.
Sigmund Freud (1905, p. 283)

sychoanalysis1 is carried out through words, yet we lack cogent

explanations of the therapeutic action of the verbal and linguistic
processes that are at work in talking and listening. To a regrettable
degree, belief in psychoanalytic treatment still requires belief in words as
watered-down magic because we have not fully explicated the therapeutic properties and potentials of the language in speech. We tend to
consider speech primarily as a medium of psychoanalysis and less as a
mechanism that participates in therapeutic action. On the one hand, when
we conceptualize speaking as an interpersonal action with therapeutic
power, we often overlook the role of language in speech. On the other
hand, when we explain the therapeutic value of interpretation and insight
with appeals to the Enlightenment notion that insight leads to change
because knowledge sets one free (see Eagle 2011), we invoke a tautology
that renders explanation unnecessary.
Yet there are oases in our literature where insights about the therapeutic action of language can be found. To my mind, some of the richest
discussions of language in psychoanalysis today are those in which we
allow poetry to reveal the action of the verbal therapeutic process. Poetry
is nothing but words. Yet the undeniable power of poetry to evoke feelings and alter understandings invites comparison with the action of psychoanalysis. For instance, Ogden (1999) and Parsons (2007) identify a
source of therapeutic action in the analysts ability to listen to the
patients speech as to a poem, remaining open to its multisensorial reverberations as sources of meaning. Seiden (2004) understands the therapeutic value of metaphor as an instrument for both discovering and creating
new meanings. Charles (2010) elaborates the importance of the verbal
form, particularly its use of symbols at once personal and communal, for
giving shape to senses and meanings that may be inchoate. Shaddock
(2010), a poet and psychoanalyst, believes effective interpretations draw
1

I believe that the therapeutic contributions of language I explore here are

similarly active in both psychoanalysis proper and psychoanalytic therapy. I therefore
do not distinguish between these modes of treatment in this paper.

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on the same language skillsconcision, clarity, allusivenessthat

inform the best poems (p. 244). Caston (2007) likens termination of
psychoanalysis to the poetic closure that both reader and writer may
experience at the conclusion of a poem.
In her commentary on Castons notion of poetic closure, the poet
Irene Willis (2007) notes that Caston uses the word poetic in a colloquial
rather than precise sense; by contrast, she asserts, Words are what we are
talking about when we speak of poetrywords as they move through
space, making their own music (p. 44). From among the many points of
connection between poetry and psychoanalysis, I focus narrowly on the
nature of words that poetry reveals to us, particularly their evocative and
active potentials, without which there would be no poetry and no psychoanalysis. Indeed, the words the poet elevates to art are at work in psychoanalysis all the time as a source of therapeutic action. Using clinical
examples that are not manifestly poetic or remarkable, I attempt to show
some common yet important contributions of words to therapeutic action,
made possible by the embodied and evocative nature of language that
poetry reveals.
I begin with a discussion of a poem by Billy Collins as a basis for
considering the sensorial and imagistic potentials of words. I then explore
the interpersonal processes of language development to elucidate the
original nature of words as imbued with personal meaning, embodied
resonance, and emotional tone. This developmental view of words and
the verbal form allows a fuller appreciation of the verbal therapeutic
processes that are at work in the speech and conversation of psychoanalysis, not only the sensorial underpinnings of words revealed by
poetry but also the relational potentials of speech between individuals,
which are beyond the reach of the written poem.
S O M E T H I N G I A M U N L I K E LY E V E R T O D O

To see what language is doing in poetry, I ask you now to read Billy
Collinss poem, Fishing on the Susquehanna in July, which appears
below.2

2
Fishing on the Susquehanna in July from Picnic, Lightning, by Billy Collins,
1998. Reprinted by permission of the University of Pittsburgh Press.

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I have never been fishing on the Susquehanna

or on any river for that matter
to be perfectly honest.
Not in July or any month
have I had the pleasureif it is a pleasure
of fishing on the Susquehanna.
I am more likely to be found
in a quiet room like this one
a painting of a woman on the wall,
a bowl of tangerines on the table
trying to manufacture the sensation
of fishing on the Susquehanna.
There is little doubt
that others have been fishing
on the Susquehanna,
rowing upstream in a wooden boat,
sliding the oars under the water
then raising them to drip in the light.
But the nearest I have ever come to
fishing on the Susquehanna
was one afternoon in a museum in Philadelphia
when I balanced a little egg of time
in front of a painting
in which that river curled around a bend
under a blue cloud-ruffled sky,
dense trees along the banks,
and a fellow with a red bandanna
sitting in a small, green
flat-bottom boat
holding the thin whip of a pole.
That is something I am unlikely
ever to do, I remember
saying to myself and the person next to me.

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Then I blinked and moved on

to other American scenes
of haystacks, water whitening over rocks,
even one of a brown hare
who seemed so wired with alertness
I imagined him springing right out of the frame.

I am interested here in Collinss use of words to create lived

experience. Through the plain language of this poem, Collins creates for
the reader, and for himself, an experience he has never lived. We hear the
oars sliding under the water as we row up the river, see the glittering
drops fall from the oars as they rise, feel the gentle sway of the boat on
the river. No less do we see the paintings in Philadelphia and through
them to the experiences they depict, perhaps especially that brown hare
springing right out of the frame. Once we have read this poem, we have
been fishing on the Susquehanna in July. Collinss poem enacts the vivid
lived experience through words.
Yet from the first line, denial is the manifest content of this poem:
I have never been fishing on the Susquehanna
or on any river for that matter
to be perfectly honest.
Not in July or any month
have I had the pleasureif it is a pleasure
of fishing on the Susquehanna.

Psychoanalysts are familiar with this kind of denial, in which the

semantic content of words conveys one message and the tone or feeling
conveys quite another, as happens with the patient who states, I am not
angry with you for going on vacation, and then shows with tone of voice
just how angry she is. It is a denial that calls attention to itself, to be
perfectly honest. Collins proclaims his utter ignorance of the experience
of fishing; it is unknown to him; it could not be more different from what
he actually does in his quiet room. Yet the cadence of his poem conveys
the rolling rhythm of the boat, where we sit, waiting for the fish to bite.
This rhythm infuses the stanzas about writing as well as those about
fishing, asserting an affinity the semantic content belies.
I am more likely to be found
in a quiet room like this one
a painting of a woman on the wall,
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a bowl of tangerines on the table

trying to manufacture the sensation
of fishing on the Susquehanna.

This rhythm is briefly broken in the middle of the fourth stanza with
trying to manufacture the sensation / of fishing on the Susquehanna.
This gets our attention; we trip over its awkward rhythm and hard
syllables. Why manufacture? Of course, it is another denial, but not only
that. Manufacture announces the work of the poet and calls attention to
the poem in part by interrupting the experience it has begun to create in
the reader. Perhaps Collins wants us to experience the distance of these
four syllablesmanufacture. Even when we have worked our way
through them, we have made it only to the sensation. We are still so
many syllables from the Susquehanna. He continues:
There is little doubt
that others have been fishing
on the Susquehanna,
rowing upstream in a wooden boat,
sliding the oars under the water
then raising them to drip in the light.

When we finally arrive at the river, it is through the proxy experience of

the others who have been fishing on the Susquehanna, perhaps like the
others who would be angry about a therapists vacation, of whom there
can be little doubt. Yet the experience itself is no less palpable, no less
real, for being conveyed as if through the eyes of another. Collins
achieves this immediacy in part by putting us on the river, where we are
rowing, sliding, and raising. We are not observing the actions of
another; we are doing.
Then Collins calls us back with a jarring But (like his blink that
comes in the last stanza):
But the nearest I have ever come to
fishing on the Susquehanna
was one afternoon in a museum in Philadelphia

Collins reminds us again that we are in a poem, not on a river; we must

not forget that the reality we are experiencing is created by the poem, a
reality undiminished by the fact that the experience Collins now describes
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is triply mediated by a painting in a museum in Philadelphia. And yet,

beyond the little egg of time, there we are
under a blue cloud-ruffled sky,
dense trees along the banks,
and a fellow with a red bandanna
sitting in a small, green
flat-bottom boat
holding the thin whip of a pole.

This poem is an ironic tribute to language itself.

PHONEMES AND FEELINGS

How do words create these sensuous experiences? In psychoanalysis, we

appreciate the powerful effects a speaker brings to words though tone of
voice, as well as through facial expressions, body posture, and gestures.
We know that the act of speaking can convey meaning along with and
sometimes in contrast to the meaning conveyed through the semantics of
words. Poetry invites us to ponder the evocative power of words themselves. When we read a poem silently, there is no tone of voice to hear,
other than the one we create or remember as we read. There is no speaker
before us from whom to observe facial expressions, postures, and gestures. Yet we do hear and see and feel. Poetry helps us remember that
words are sounds that can move us, even without a voice to speak them.
Were this not so, there would be no poetry.
Sensuous experiences evoked by words arise jointly from sound and
semantics. For instance, linguistic sounds assist semantics in the creation
of visual imagery. Collinss thin whip of a pole is so thin not only
because of the redundant description (could there be a fat whip?) but also
because of the slender sounds of his words, each with its thin short i.
Similarly, we see the Susquehanna curled around a bend with the help
of the round, curling sounds of those words. Manufacture sounds like
hard work. Ruffled sounds ruffled. Moreover, as I mentioned, the
cadence of Collinss words evokes the sensation of a boat swaying gently
on the river. Alliteration contributes to this swaying effect even in Collinss description of his quiet roomwoman on the wall, tangerines
on the table. Collinss use of the continuous present tenserowing, sliding, raising, and, finally, springinggives a feeling of immediacy to
lived action that is ongoing, and also sustains the rolling rhythm.
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Although we feel the rhythm of the fishing boat and see the fellow
with his red bandanna, we may not know how Collinss words are creating these sensations and images in us. Such effects of words may be
particularly elusive when, as in this poem, the explicit semantic meaning
of the words contradicts the experiential effects of their sounds and
cadence. When such moments arise in our psychoanalytic work, we may
attribute our somatic resonances to something other than the patients
words and presume the mechanism to be something other than verbal.
Lacking the poets knowledge of these potentials in words, and his gift
for mobilizing them, we may miss the experiential contributions of words
to therapeutic action. This is perhaps all the more likely when we ascribe
to a conceptualization of words as abstract, disembodied, emotionally
neutral symbols whose connections are primarily with other symbols
(see, e.g., Stern 1985; Boston Change Process Study Group [BCPSG]
2007 [but cf. BCPSG 2008]; Bucci 1997; Damasio 1999). It is to the
nature of words that I now turn.
W H AT S I N A W O R D ?

According to the highly influential (and often critiqued) view of the

Swiss linguist Ferdinand de Saussure (1915), a word is a type of sign,
whose sound, called the signifier, designates a concept or category, called
the signified. Many words also point through the signified to a referent in
the world, though Saussure emphasized the structural rather than the
referential nature of language. For example, river denotes a large stream
of water flowing in a definite course. The word can be used to refer to
various such streams of water, including the Susquehanna River. Meanings in language are always relative; the scope of a word is determined
by the other words in the lexicon; river is neither creek nor ocean but
somewhere in between. The word both differentiates and amalgamates; it
makes more of some features of things and less of others as it gathers
things together and distinguishes them from other kinds of things. In
these ways, language constructs rather than reflects meaning.
Saussure asserted that the relationship between the words sound and
the concept it signifies is arbitrary. That is, with a few exceptions such as
onomatopoeia, the link between word and meaning cannot be perceived
because the sound of the word does not designate the signified; the sound
does not reveal the meaning, even if it sometimes contains clues, as we
see in Collinss poem (see Ramachandran and Hubbard 2001). Even then,
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the link between word and concept is established not by reason or perception but by convention, and thus language is a product inherited from
preceding generations (Saussure 1915, p. 71). Long before Saussure,
Shakespeare, that master of words, highlighted the arbitrariness of words
in Juliets famous question: Whats in a name? That which we call a rose
/ By any other name would smell as sweet. If the link between signifier
and signified is truly arbitrary, it does not matter what we call the rose or
our beloved. The name would be inconsequential in light of ones experience of the thing.
Juliet had her reasons for decrying the importance of a name, but
should we accept her logic? Certainly, the name does not determine the
thing any more than the thing determines its name, and yet their confluence in the word is consequential. For example, synonyms, different
words with the same ostensible meaning, have different senses, different
connotations that offer different shades of meaning, even when their referents are perceptibly identical. The word is more than a neutral label,
then; it tells us something we cannot perceive. Collinss fellow with a
red bandanna smells sweeter than if Collins had referred to him as a
man with a red bandanna. The fellow could be a friend; hes one of us.
We would have no similar sense about the man; who is he? Didnt Juliet
love Romeo in part because his name was Montague?
Taken at face value, the arbitrary nature of the connections between
words and their meanings seems to highlight the abstracting functions of
language and the potential resulting disconnections between language
and life. To the extent that language is a system of signs pointing to
abstract categories and to other signs, language seems more self-referential than world-referential. Indeed, for Saussure, language is a powerful
instrument of thought because it is autonomous from the lived world.
Moreover, if the presence of words in a lexicon shapes what we label
things in the world and therefore what we can think about those things
(recall that Eskimos, famously but falsely, are said to have a dozen words
for snow [Martin 1986]), then words may also misrepresent reality. That
is, the differentiations made in language may be imposed on the world
rather than derived from it. The world that language constructs may be a
false world.
Yet when we consider the implications of the fact that there is no
inherent relation between a word and its meaning, we do not find that
language is in essence arbitrary and abstract. On the contrary, the fact that
the signs of language are a product of preceding generations that must be
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learned from other people suggests that the word is grounded in experience in the world and within the relationship with the person from whom
words are learned. This implies the inherent individuality of each persons language, both the meaning of words (Loewald 1978) and the
meaning of speaking (Amir 2010; Rizzuto 2004), as a consequence
of individual relational experience, particularly in early development
(Harris 1992; Litowitz 2007, 2011). From the perspective of the individual, then, we cannot call a rose by any other name than the one we
learn through living.
That the words meaning must be learned through experience has
three far-reaching, interrelated implications about the nature of words:
(1) word meanings may be personal and idiosyncratic as well as universal; (2) word meanings may be embodied as well as abstract; and
(3) words may be imbued with emotion as well as neutral. Moreover, the
original personal, embodied, and emotional nature of words is not lost to
development but remains a source of power in language, and particularly
of therapeutic action. These potentials come into focus when we attend
to the origins and processes of language development. I now take up each
of these implications in turn.
WORD MEANINGS ARE PERSONAL
A N D I D I O S Y N C R AT I C

The first implication of the learned nature of word meanings is the highly
individual quality of each persons lexicon. The experiential context of
language development is unique for each person, and that context imbues
words with a personal sense, along with a consensual meaning, so that
the same word may have different shades of meaning for different people.
These personal senses are sometimes accessible to reflection. When you
hear the word river, which river comes to mind? For me, it is the Hudson
River, which was a central feature of the landscape of my childhood. This
is the river that river means to me, and which I bring to Collinss poem.
A patient bemoaned her habit of chewing a pack of gum each day to
manage the stresses of her demanding job; she chewed gum to prevent
overeating and putting on weight. Yet she saw this not as a reasonable
strategy, but as a lapse. Each stick of gum, she confessed, was like a shot
of liquor, leaving her with a bloated belly, a sore jaw, and an aching
head. Perhaps worst of all, it left her wanting more. She knew she was
ignoring these bodily consequences and the real problem of her dissatisfying job. Yet she had become, she asserted now, an addict who
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needs the hit of sweetness. I was struck by her agitated confession, culminating in the one-two punch of addict and hit. Her forceful tone
implied that her meaning was self-evident, yet I did not understand how
the behavior she described warranted the self-reproaching label. Dare I
ask? With hesitation, I said, An addict? She paused and looked at me
closely. Did I not understand the dangers? She is an addict, she asserted,
because she gives in to her desire; to be an addict is to be at the mercy of
desire, always in danger of being ravaged. I marveled aloud at the danger
in allowing herself a little sweetness. She then realized the implications
of her words and quipped, Maybe chewing gum isnt so bad if it keeps
me from having an affair with my twenty-year-old coworker!
Responding to my question about her words, the patient articulated
the meanings that lay within them, thoughts and feelings that were speakable yet not initially spoken. As happens often, focusing on the patients
specific words yielded a cascade of idiosyncratic meaning (see Wilson
and Weinstein 1992). Among the senses that may lurk in a word such as
addict, this exploration revealed the particular problem of desire that was
embedded in this word for this person. Moreover, this exploration initiated the ongoing work of redefining these words, with the hope of liberating desire from addict such that the patient may pursue desire free of the
burdening connotations of addiction, danger, and ravaging.
To be sure, this example illustrates a process that is typical rather
than remarkable. So often our work involves helping patients appreciate
the specific and textured senses of the words they have chosen to utter.
Yet this would not be necessary or helpful if words were devoid of personal meaning. The goal of this type of exploration differs from that of
helping patients understand the meanings of the words they cannot utter
because those words are not accessible to consciousness. It is also different from the exploration of unconscious dynamics hinted at by a word or
its sound, as in a joke or slip of the tongue where a words meaning is not
what it appears to be. Indeed, although verbal interpretation of unconscious content is the embattled star of our story of therapeutic action, a
crucial supporting role is played by the frequent task of helping patients
understand what they are saying. Exploration of the personal senses of
words makes it possible to reconsider and perhaps rework their meanings. Patients, like poets, choose their words to express a precise meaning, to communicate a feeling, or to create an effect using sense and
rhythm; unlike poets, they may be unaware of the desire to do any of
these. In this sense, spontaneous speech is unwitting poetry.
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The idea that words denoting abstract concepts, such as addict and
river, have personal, idiosyncratic resonances is inconsistent with the
widely accepted theory that memories of abstract knowledge such as
word meanings, concepts, and facts (i.e., semantic memory) are stored
separately from autobiographical memories of personal experiences (i.e.,
episodic memory; Tulving 1972). Yet theory and research dating back to
the 1980s (e.g., Hintzman 1986), in concert with current neuroscience
research (e.g., Greenberg and Verfaellie 2010), suggests that words are
not stored in a purely abstract form, even in adulthood (Goldinger 1998),
and that episodic and semantic memory are more interactive than they
are distinct (Sheldon and Moscovitch 2012, p. 1452) or even fully integrated within a single system, with the hippocampus as its hub (Battaglia, Borensztajn, and Bod 2012, p. 1637).
For example, Sheldon and Moscovitch (2012) demonstrated that
some semantic processing tasks both draw on episodic memories and
activate brain regions associated with episodic memory retrieval, specifically the medial temporal lobe (MTL), which includes the hippocampus.
While their brains were scanned with fMRI, participants made lists of
twelve items of three types: autobiographical information (e.g., names of
friends), semantic information presumed to be learned abstractly (e.g.,
positions in government), and semantic information presumed to be
learned through personal experience (e.g., items found in a kitchen).
MTL activation was greatest for retrieval of semantic information learned
through personal experience, and, for those tasks only, MTL activation
increased as the task progressed. Responses to that task were also unique
in that items became increasingly idiosyncratic as participants generated
list items; by contrast, autobiographical list entries were uniformly idiosyncratic (i.e., different across participants) and abstract semantic list
entries were uniformly general (i.e., similar across participants). Based
on this pattern of results, the researchers surmised that participants first
used automatic semantic strategies to name prototypical items (e.g.,
spoon and knife found in all kitchens) and increasingly drew on personal
memory to name idiosyncratic items from their own experiences (e.g.,
apple corer found in their own kitchen) as the task progressed. Thus, as
time elapsed, participants drew more heavily on their personal memories
as they processed a certain type of word, a finding generally consistent
with the idea that personal associations constitute the meaning of some
words and that those associations are available to emerge through the
psychoanalytic conversation.
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WORD MEANINGS ARE EMBODIED

The second implication of the fact that word meanings are learned is that
words are by nature embodied, having grown out of sensuous lived experiences, including those of the intimate relationships with treasured
others from whom words are first learned. Word meanings are not inherently abstract but potentially experiential.
No one helps us understand the earliest experiential foundations of
language better than Hans Loewald. Loewald offers us a psychoanalytic
theory of the nature of language, which takes account of the ways in
which language is interwoven through the essential developments of
early life. For Loewald (1978), language ties together human beings and
self and object world, and it binds abstract thought with the bodily concreteness and power of life (p. 204). This is because language, in the
form of the sounds of mothers speech, imbues the infants lived experience from the beginning of life. The sounds of mothers speech are part
of the infants experience of interacting with the mother, and over time
those sounds become differentiated from other sensations of the lived
world as a special kind of sound; these special sounds grow into words.
But the sounds also remain connected in memory to the rest of experience
and for that reason are a powerful way to recall ones inner experience
and communicate it to another. Indeed, the lived feeling that language can
create is a reflection of its experiential nature. Although the semantic
possibilities of words expand over development, they do not overtake the
experiential possibilities. A word is always an experiential memory.
That said, the admixture of abstractness and aliveness in the word
can vary dynamically (Loewald 1978). Much of the time, adult thinking
requires suppression of the experiential memory inherent in language, so
that language can assist with rational abstract thought without being
weighed down by experiential particulars. Over development, children
become able to understand and use words in increasingly abstract ways;
yet this common, adaptive usage of language need not be confused with
its nature. On the other hand, the experiential aspect can sometimes overwhelm the semantic, as in a kind of enactment in which words are more
like things, like part of the action, than like symbols. Ideally, the word is
neither wholly separate from its experiential foundations nor wholly
merged in it. The ability to use language in a flexible way that meets the
demands of particular meanings, with the right mix of rationality and
expressiveness, is a sign of psychological maturity, as well as of the
poets talent.
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From this point of view, a word is an auditory aspect of a lived experience that comes to represent that experience; because the word emerges
from the experience, it can later evoke it in a multisensorial way. Moreover, individuals differ in the sensory modes through which they experience and process words, carrying forward specific aspects of the original
experiences that inhere in words; correspondingly, the type of sensory
experience evoked by words may reflect ones characteristic way of taking in the world, perhaps starting with the early relational world. Just as
poets experience specific perceptual relationships to the poem, as words
on a printed page to be seen, as the sound of spoken words to be heard;
many analysts have a primary sensory modality through which they experience the words they hear: visual, tactile, auditory, kinesthetic (Chodorow
2012). I mentioned that river to me is the Hudson River. I will now add
that I carry a specific visual image that I can see, if I think about it, in
response to the word: From its high banks, I see the majestic Hudson
River coursing past rural Dutchess County on a bright day. You may bring
not only a different river to this word, but also a different perceptual
experience of that river, perhaps a kinesthetic bodily experience of floating or swimming or even drowning. Or an auditory experience, such as
hearing the river rush past the shore or gurgle over rocks.
This conception of words as entwined with aspects of lived experience is consistent with the contemporary view of language as embodied
(see, e.g., Lakoff and Johnson 1980), which allows that language can
have somatic and experiential concomitants, consequences, or both (see
also Fonagy and Target 2007; Vivona 2009). With a similar conception of
words in mind, Ogden (1999) advocates a form of listening that is
responsive to the rich reverberations of sound and multi-layered meanings that lie at the heart of both poetry and psychoanalysis (p. 989), and
contrasts this with attempts to listen through language into some presumably deeper meaning that is not in language itself (for a related argument, see Priel 2003).
WORDS ARE IMBUED WITH EMOTION

The third implication of the learned nature of the link between word and
meaning is that a word can carry with it, as part of its memorial meaning,
emotional aspects of the lived experiences within which the word is
learned and used. Emotion in speech does not come exclusively from the

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tones of the speakers voice. Words themselves may carry feeling reminiscent of the tone of voice in which they were originally spoken and the
lived relational contexts in which they were originally heard and used.
Words can carry emotion because they were spoken, not only when they
are spoken. Words, then, are potentially emotion-laden rather than inherently emotion-neutral.
When we consider the origins of language in the intimacy of interpersonal relationships and of language as speech sounds woven through
the infants sensuous world, we see that emotional tone of voice and
semantic meaning are not at first separate aspects of words. Rather, vocal
tone and semantic meaning are entwined in the infants aural experience
because people speak to infants with an exaggerated emotional prosody
known as infant-directed speech, in which the melodies of speech are
consistent with the semantic message, and help to carry it along (Fernald
1989). This amplified emotional speech, in which tone and meaning are
married, is everyones first language; infants prefer it, listen carefully to
it, and derive meanings from it. Not until the third year of life are children
able to derive meanings from adult-directed speech, with its relatively
neutral affective tone (Ma et al. 2011). Thus, the ability to understand the
semantic meaning of words separate from the tone in which they are
spoken is a developmental achievement, rather than the starting point for
language. In developmental terms, emotional tone of voice is not something added to words, like the proverbial icing on the cake. Neutral
speech has had its emotional tone removed, like desalinated ocean water.
A woman entered psychotherapy with the therapeutic goal of talking,
for the first time, about the extensive physical and sexual abuse she had
experienced as a child, overwhelming yet vague memories of which
haunted her day and night. The task filled her with dread. For a long time
she began each session with a three-word sentence: I feel mad or I feel
sad or I feel bad. Usually I could not tell which of the rhyming adjectives she had spoken, so hurriedly did she say the words, in such an
anguished way, head down, eyes averted from me. Like an angry child
forced to apologize, I thought, as though the words were not an expression of her inner state but a submission to a demand. After she had produced these three words, she would fall into a tortured silence, which
sometimes lasted thirty minutes. She squirmed in her chair, her mouth
twitching violently. She dared not look at me. She was so afraid of me
during those silences that I sometimes feared myself. I watched helplessly as she suffered, anxiously searching my mind for something to say,
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wanting to offer some comfort, to bring the wretched silence to an end.

But if I spoke during the silence, the patient recoiled from me; I saw and
felt her retreat. It was as though my words caused a timer to be reset; the
silence started over from the beginning. I learned to hold my tongue and
stay silently with her until the storm had passed, until she was ready to
speak again. She had to be the one to break the silence; she could not
allow me to break in on her. Talking with me was an absolute terror for
her, and she needed time to work up the courage to say more than her
initial sentence.
I understood so much about this womans inner experience from her
body language, facial expressions, and tone of voice, which was a mixture of fury, terror, and desperation, as well as from the spasms of fear
and helplessness I experienced in her presence. What more could her
sparse words tell me? I feel mad. I feel sad. I feel bad. These are the
simple sentences a young child would use to state her specific feeling. Yet
the tone and delivery of each sentence was the same; the awful silence
that followed each sentence felt the same. For these reasons, I thought of
the sentences as synonymous, as though it did not matter which adjective
the patient spoke. Given her history of early trauma, this semantic vagueness might reflect the patients difficulty knowing and articulating her
emotional experience (Fonagy and Target 2008), as though this was the
best she could do with words. Given the intensity of the nonsemantic
communications, the semantic subtleties of the patients speech seemed
unimportant. Only slowly, as we lived this moment session after session,
did I come to realize that speaking in this way served a purpose. It
allowed the patient to avoid differentiating the meanings of her words,
while also hiding that avoidance. That is, the definitive cadence of her
statements (I feel . . .) belied her unspoken confused questions: Am I mad
or am I sad? Do I feel bad or am I bad? Did I do something bad, or did
someone do something bad to me? Over many months, we came to see
that the patient feared articulating these questions because she expected
that doing so would confront her with the full horror of her early experiences, as well as with unbearable feelings toward the caretakers who had
perpetuated them.
In moments such as this, the semantic contribution of words to
therapeutic action does not involve their usual function, the articulation
of inner experiences and ideas. Indeed, the patients inner turmoil was
revealed through her facial expressions, body postures, and vocal tone, as
well as through the countertransference, not through the content of her
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sparse words. Yet the marriage of tone and semantics in the patients
speech intimated a crucial meaning of her experience, which was not
accessible through purely nonsemantic modes. Indeed, this meaning
emerged at the intersection of semantics, grammatical form, linguistic
sound, and tone of voice and in the context of the patients body postures
and facial expressions. Specifically, disparity between tone of voice and
bodily expressions on the one hand and semantic meaning and speech
rhythm on the other betokened the patients motivated refusal to acknowledge the questions that underlay her words. The patients language was
not poetic in any usual sense, yet it conveyed meaning through a juxtaposition of semantics and sound that is also at work in Collinss poem;
however, in this case the effect was tragic rather than comic.
FORM AND MEANING

To this point I have argued that words have personal, embodied, and
emotional foundations that are mobilized in speech as in poetry. Yet even
this expanded view is not the whole story if it seems to imply that the
meaning of language lies in the meaning of words. As we see in the case
vignette, the form of a communication is an aspect of its meaning. To
give a generic example, when we phrase an interpretation as a question,
we change its meaning from an assertion (I believe this to be so) to an
invitation (What do you think?). Language is action whose meaning is
not limited to semantics, even embodied semantics, but also inheres in
the composition and evolution of verbal expression. Although
psychoanalysts have contrasted the vagaries of verbal and nonverbal
communications, we have not fully explored ways in which verbal form,
in the utterances of both patient and analyst, shapes meaning.
A brief detour into literary criticism will help to illuminate the
importance of verbal form and the limitations attendant in considering
the meaning of language in terms of content alone. For the literary critic
Helen Vendler (1988), the essence of a poem is not that it is about something but that it does something through the form and content of its
words. Consequently, the meaning of a poem cannot be separated from
the specific verbal form the poet gives it. She demonstrates the loss of
meaning that comes from ignoring a poems form through a critique of
Lionel Trillings psychoanalytic interpretation (1950) of Wordsworths
Ode: Intimations of Immortality from Recollections of Early Childhood. Trilling assumes that a poem is a discourse rather than an action
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(Vendler 1988, p. 94) and reads the Ode as an ambivalent lament for the
lost innocence of childhood. Vendler asserts that Trilling misconstrues
the poem because he focuses on what it says, and ignores how it speaks;
thus, he detaches the sentiments of the Ode from the only medium in
which they can live, the medium of their language (p. 94). Attending to
the subtle yet profound shifts in the types of metaphors Wordsworth uses
across the poem, Vendler finds the Ode to be not a lament for lost innocence but a tribute to the wondrous meaning-making of the mature mind,
a tribute to metaphor itself, which is the form, hero, and accomplishment
of the poem. The Ode is altogether a different poem when its form is
appreciated as a source of meaning.
The original form of language encountered by the infant is the emotionally alive speech of a special person with whom the infant interacts;
that speech is addressed to the infant and emerges from and gives meaning to the lived experiences they share, of which speaking, looking, and
touching are a part. This form of language conveys to the infant the
semantic meaning of words along with the speakers attitudes about the
world and the infants relationship to it (Vivona 2012). Through speaking, the speaker enacts her intention to communicate, to reach the infant
with words, and to show the infant how to do the same, intentions even
young infants have been shown to infer (Csibra 2010). Through speech,
the speakers mind becomes manifest to the infant. The infant learns
more than word meanings. Through interactions with speakers, the infant
learns the possibilities of verbal communication, in particular the potential to know and affect the mind of the other through words.
In the same way, psychoanalytic talking is not discourse, not merely
dissemination of content; it is action effected through words that cannot
be understood apart from its verbal medium. The fact that the interpretation, and often the resulting insight, is expressed in words has channeled
our understanding of the therapeutic action of speech. We have tended to
consider the interpretation primarily in terms of its content and thus as a
way to disseminate information that, when effective, expands the patients
self-knowledge (Eagle 2011). Beginning with Freud, psychoanalysts
realized that this left something out (Friedman 2002), and an expanding
array of purportedly extralinguistic processes have been proposed to fill
the gap, beginning with affect (e.g., emotional insight) and moving
toward experiential and/or relational processes, many of which are presumed to operate outside of language (see, e.g., Curtis 2012; BCPSG
2005). The importance of these other processes notwithstanding, we have
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tended to overlook the textured meanings communicated through verbal

form. Poetry brings those meanings into focus.
P S YC H O A N A LY S I S A S P O E T R Y

We are now ready to take this expanded view of language into our consideration of the therapeutic conversation, broadening our scope from
monologue to dialogue to contemplate the ways in which talking in psychoanalysis mobilizes the potentials of language that we admire in
poetry. To do so, we take account of both the memorial, embodied, affective potentials of words and the use and evolution of the verbal form
across the session and over the relationship.
A man in psychotherapy was expressing a new realization that he is
dependent on others, especially women, for his sense of self-worth. He
had not known this about himself, and he was surprised to realize that he
could not seem to enjoy his independent pursuits. He needed women to
give him a sense that he is special and loved. Yet his recent anguished
searching for validation from women had left him anxious and confused.
He was certain his friends would be scandalized by his actions; he
expected yet did not sense this judgment from me. After we talked this
over for a while, the patient paused and said, I guess my problem is I
dont love myself enough. I dont feel the self-love that other people
feel. I noticed that I felt strangely uncomfortable with the simplicity of
this statement about self-love. There was something so direct and plain
about it. For a moment, I wanted to object, as though something important was being left out. Then I realized that his usual tone of negative
self-judgment was missing. This was a statement of how he is, uncomplicated by his feelings about it being so. I realized, too, that this is the way
I try to speak to him, with a tone of empathy rather than judgment, something we had just been exploring. My strange feeling came in recognizing
the tone, cadence, and intention of my own words coming back to me
through him. An interpretation I might have made came from him: I do
these things because I do not love myself enough.
Then he asked me, Why dont I love myself? Do you know? It was
the final moment of the session. I spoke without pausing to think, We
dont come into the world knowing we are lovable. We have to learn
that. I said this matter-of-factly and as I heard myself speak, I worried
that my tone sounded didactic, perhaps even patronizing. I heard myself
say we rather than you, and became aware of making a statement that
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patently applied to me as well as to him. The patient looked at me with a

start. He said, Really? Is that true? He was taken aback. After a pause,
he added excitedly, I didnt know that. This is really important. He left
beaming. I was surprised by his delight in a statement I considered
insipid at best. In the following session, he offered a new metaphor
through which to understand his frantic efforts to feel validated and satisfied. He said, Im like a man who has lived on lentils all my life and now
Im gorging myself at the Hyatt buffet. His gorging is understandable,
even normal, he said, in light of his lifelong limited diet, which had left
him neither starving nor satisfied.
The patient began by reflecting on my nonjudgmental attitude toward
him, which I had expressed to him, shown him in words, many times
throughout our work together. Then he tried out this way of thinking
himself, on himself, creating a self-interpretation that expressed a view
of himself that I recognized as similar to mine, as different from his usual
way. His interpretation became possible as he internalized the consistent
attitude I had expressed toward him through the content, tone, and intention of my speech.
This atmosphere of receding judgment was the context for his brave
question, Why dont I love myself? In response to both the urgency of
his question and the pressure of the end of the hour, I expressed the truth
as it came to me in that moment. The patient immediately saw something
true and transformative about himself in my dispassionate aphorism
about people, including the two of us. He grasped the implications of
thinking about himself in this new way: This is important. And what of
his excited amazement? For Vendler (1988), works of art evoke a
response of aesthetic delight. She does not mean that we understand the
work of art, or that it understands us. She means that we have a special
resonance with it as a creation that, in the confluence of form and content, stirs something in us. The patients delighted amazement in this
resonant moment was not the effect of receiving new information about
the human condition but of realizing something meaningful about himself, both personal and interpersonally shared.
Both psychoanalysis and poetry depend on the ability to create new
meanings in language. Language, wrote Loewald (1960), in its most
specific function in analysis, as interpretation, is thus a creative act similar to that in poetry where language is found for phenomena, contexts,
connections, and experiences not previously known and speakable
(p. 242). Words are transformative because of the experiences they can
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evoke and create. Words can connect self to other, thought to feeling,
present to past, and present to future. The right words awaken their experiential foundations to just the right degree, in sympathy with the lived
moment. Semantics and sound are married in the word in a particular
way, evoking experience. Because language is always action, psychoanalysis and poetry foster an interpersonal sharing of both meaning and
understanding. The experience of hearing a good poem or a good interpretation is of being understood and at the same time seeing something
new about oneself that has been articulated by someone else from within
that persons own experience. The change that can happen on hearing
such language we call insight. Insight is not only knowledge, not only
content. It is an experience of resonance with another persons vision of
things.
The verbal form is both shape and substance of the interpretation, as
it is of the poem. Put another way, the interpretation resonates when its
content, tone, and form are right. Indeed, the form of my response to the
patients question was crucial. Because I expressed my thought as a general truth, I countered the patients tendency toward self-criticism by
stating indirectly that he is neither defective nor blameworthy for being
as he is. Of course, this was not something I planned. Only in retrospect
did it occur to me that this particular form of expression, a general statement delivered without discernible emotion, was the kind this man would
be likely to take in. By contrast, I recalled other moments when I
expressed my genuine emotion with words and tone of voice (How
sad) and was stunned by his vigorous rejection of such therapist talk
that smacked, to him, of generic technique. The emotion, my emotion,
often got in the way for him. For this patient, neutral desalinated speech
was more evocative, in that it left more room for his own emotional experience to emerge, than was my speech with its feeling intact.
Within a new empathic understanding of himself, the patient was
freed to relate to himself metaphorically. During the following session,
the patient used metaphor to mold the understanding of himself that we
were developing to fit better with his sense that he had been taught to love
himself, but in a limited way, for a certain way of being. Yet there is so
much more to him than a taste for lentils. Vendler (1988) asks, What else
is metaphor but a conferral of colors on the neutral world, an introduction
of pathos where before there was only fact? (p. 98). For both the patient
and the poet, metaphor is an accomplishment that allows him to move

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beyond fact and toward meaning. Such language transforms the momentary into the enduring, allowing other moments to be experienced and
lived in new ways.
This new experiencing becomes possible as the patient learns from
the analyst, as apprentice learns from poet, to use language poetically as
a way to see himself and thus to relate to himself and to others in new
ways. As we have seen, individual relational development leaves its mark
not only on the meanings of words, but also on ones sense of the kinds
of experiences, ideas, and feelings that can be expressed in words, the
things one can and cannot do with words. The child who learns that
words are empty, or that words are meant for trickery and deceit, will not
become a poet. Such beliefs about language, implicit in every utterance,
may squelch ones nascent hope in the communicative and transformative
potentials of speaking (Rizzuto 2004). Yet as the patient experiences the
psychoanalytic conversation, her beliefs about language itself can begin
to change and the potential scope of both verbal content and verbal form
can enlarge. Thus, not only does psychoanalysis bring about the possibility that the patient may speak about previously unspeakable matters; it
also enhances the patients capacity to use the potentials of language, that
is, to make use of the experiential foundations of words and to mobilize
new verbal forms, and thereby to make new meanings.
S P E A K I N G O F R E L AT I O N S H I P S

And this is where the analogy between poetry and the psychoanalytic
conversation begins to break down. Spoken language in psychoanalysis,
unlike the language of a poem, constitutes a relational act toward a specific other who is present and whose response may be wished for or
feared, elicited or thwarted, and certainly gauged. Although the poet and
her reader may have a relationship, they do not interact. Words reach their
fullest potential as speech in relationships. It is to the relational potentials
of spoken words, which are not revealed in poetry, that I now turn.
A woman struggled greatly to speak with me when we were together
in session, experiencing and expressing her intense discomfort and anxiety with fidgeting hands, jiggling feet, averted eyes. Yet after the session,
she often sent her detailed thoughts to me in an e-mail, articulating quite
precisely what kept her from talking to me and what she did not say. She
could do this because writing and being read are not the same as speaking
and being heard.
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In Loewalds writings is an exposition of the relational potentials of

language. In this passage from Psychoanalysis as an Art and the Fantasy
Character of the Psychoanalytic Situation, Loewald (1975) addresses a
controversy brewing in the mid-1970s over the relative therapeutic
importance of insight versus relationship experiences, notably Franz
Alexanders corrective emotional experience, a debate that continues to
this day:
I wish to point out that it is the very fact of the analysts ability to show
the patient the role the latter has assigned to him and the genesis of this
assignmentit is this empathic objectivity of the analyst, perceived by the
patient, that carries the potentiality for change. It is neither insight in the
abstract, nor any special display of a benevolent or warm attitude on the part of
the analyst. What seems to be of essential importance is insight or selfunderstanding as conveyed, as mediated by the analysts empathic understanding,
objectively stated in articulate and open language. . . . If defenses do not
interfere, it is experienced by patient and analyst alike as authentic responsiveness.
This responsiveness is an essential element in what we call emotional insight
because it frees the patient for nondefensive responses of his own. Interpretations
of this kind explicate for the patient what he then discovers to have always
known somehow, but in the absence of its recognition and explication by the
analyst such knowledge could not be grasped and acknowledged [pp. 360361;
emphasis added].

For Loewald, the relationship between analyst and patient fosters change
when the analyst can articulate, clearly and with empathy, the nature of
the relational experiences in which the two participate. It is not insight in
the abstract that helps, not the dissemination of ideas separate from the
emotional relational context that brings those ideas to mind. It is not
warm or benevolent actions or attitudes, not the way the analyst is or
seems, separate from what he thinks and says. It is the use of speech to
articulate, with an attitude of empathy and openness, what is being
experienced in relation to the other and the meaning that can be made of
that experience. The interpretation is the analysts authentic, empathic
response to the patient (see also Spivak 2011). It offers the patient not
only a new idea about herself but also a new way of thinking about
herself, a different coloring of the facts. This kind of speech is therapeutic
when it can be internalized by the patient so that she too can think about
herself in such ways (Loewald 1960).
In relational terms, an interpretation is an interpersonal moment of
an extended conversation taking place between two people in a special
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relationship; indeed, the relationship is structured so that this type of

conversation can take place. Interpretation is the outgrowth of the
collaborative process of these two people speaking and making meaning
together. Interpretation is part of this process, indicates the process, and
moves the process along. Consequently, though it may be clear enough
who the speaker of an interpretation is, its authorship is always ambiguous.
To return to the case material, the spontaneous aphorism was part of
a particular collaborative exchange, preceded by and founded on the
work of the hour, including the patients self-interpretation, and the work
of the relationship as a whole, including the patients repeated experience
of finding himself not judged by me for thoughts, feelings, and actions
that he believed I would criticize. Of course, the same comment would
not have conveyed the same meaning if said to a different person,
if spoken within a different relationship. In general, I suspect, a matterof-fact statement would be more likely to activate defenses than to bypass
them.
Analysts and patients alike vary in the extent to which they resonate
with and make use of the elements within speech, and within the
psychoanalytic situation generally (Chodorow 2012). Ones characteristic
resonances reveal the hopes with which speech is imbued. Indeed, poetry
shows us not only the breadth of things the word can do, but also the
scope of ones particular vision of the word. Some of us are drawn to
the breezy, wry tone of Billy Collins, whose poems belie their significance
and purpose; we delight in the clever clarity of the word. Some are moved
by the exuberance of Walt Whitman; we rejoice in the expressive vigor of
the word. Some are captivated by the enigmatic imagery of William
Carlos Williams; we are intrigued by the word that is more than it appears
to be. Some are engaged less by poetry than by music or dance; we feel
meaning coursing without words through the body. Indeed, meaning
takes many forms, and words participate in meaning in many ways.
Because language is the legacy of individual development, each
persons language is a unique admixture of the communicative potentials
of the word. Consequently, each member of the analytic pair faces the
challenge of engaging with the others ways of using and receiving
words, as well as the others accommodations to the limitations of words
as he or she conceives them. To be sure, some patients use words in a
limited way; some analysts are acutely attuned to meanings conveyed
without words. Yet an important therapeutic task is to bring meanings
into the verbal form, as happens when the analyst speaks her thoughts to
the patient.
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Just as there is no generic good poem or good art, there is no generic

good interpretation. On the contrary, for the interpretation to do its work,
the meanings active in the shared relational moment must be articulated
by the speaker in language whose precise content, tone, and form creates
resonance in the listener and thus is experienced as something valuable
and true. Moreover, for the words to foster change, the enacted meaning
must be communicated by the person with whom it has been experienced.
It is the immediacy and specificity of the experience, and of shared
understanding, that help us bypass defenses that would otherwise
undermine the therapeutic moment. To the extent that the analyst is a
poet, he is a proxy-poet, in that he attempts to bring words to or out of an
experience that may not be his own, or perhaps would not be were he not
in the therapeutic relationship with this patient. This is not to say that the
experience itself necessarily involves the therapeutic relationship or the
transference; it is to say that such moments involve the patient and
analyst experiencing something meaningful together, and that their
speech participates in, as well as reflects, that meaning. This explains
why, despite its exemplary language, a poem cannot do the work of
psychoanalysis.
Conversely, there is no speech, and no interpretation, separate from
the interpersonal relationship in which the words are created and heard.
It is not simply that both insight and relationship are necessary therapeutic
mechanisms. We cannot consider one without considering the other; they
are inseparable phenomena, each constituting the other. On the one hand,
we cannot know the meaning of the words, or the meaning of speaking
and listening and being heard, without taking account of the relationship
in which the conversation occurs. On the other hand, we cannot appreciate
the potentials of the relationship without acknowledging that it is
conveyed, powerfully even if not entirely, through speech. We cannot
take the words out of the relationship in which they are uttered and heard.
We cannot dissect the insights that emerge through this relationship from
the experience of the emotional, responding, speaking presence of
another human being. That the meaning takes the form of speech between
psychoanalyst and patient is not beside the point; it is the point.
Conceptually, of course, we can differentiate the words spoken and
heard from the feelings and experiences that make up an interpersonal
relationship. Some in our field have done just that, and have attributed
different therapeutic effects to these different aspects of the psychoanalytic
situation, new insights to the content of the speech between analyst and
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patient, and new ways of being to unspoken relational experiences.

However, at least most of the relational experiences, such as feeling
understood or important or neglected, that are attributed to unspoken
relationship factors are possible because of the kind of talking that takes
place within and thus constitutes the therapeutic relationship. Not only is
the content of that talking unique, but so is its special form and the way
that special general form is realized within each dyad and infuses each
therapeutic moment. Indeed, when we think about the therapeutic
relationship as carried out through conversation, and when we keep in
mind the many personal, experiential, memorial, and relational potentials
of words, then it becomes ironically clear that any opposition of insight
and relationship as therapeutic mechanisms is one of those false
dichotomies that language so easily depicts, despite their being untrue.
The work of the analyst is to create language that mobilizes the
experiential, memorial, and relational potentials of words, and in so
doing to make a poet out of the patient so that she too can create such
language. It is not special language that they create; it is everyday
language used in a special way, made possible by the special relationship
they share. In Freuds fabulous words from The Question of Lay
Analysis, Nothing takes place between them except that they talk to
each other (1926, p. 187). Their talk uses the fullest relational potentials
of words to evoke, convey, enact, connect, reveal, and transform. It is
hard work, indeed. This is why we, like the poet, need the quiet room.
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