The Child and Adolescent Initiative hosted an online discussion of Heather MacIntosh’s paper, A Bridge Across Silent Trauma: Enactment, Art and Emergence in the Treatment of a Traumatized Adolescence. This paper, published in Psychoanalytic Dialogues in 2017, recounts Heather’s treatment of a severely traumatized, highly suicidal and self-harming adolescent girl who is virtually silent for the first two years of treatment. Through Heather’s exquisite attunement, boundless creativity and patient persistence, the young woman emerged and connected to Heather meaningfully and transformatively. In addition to an overall admiring response to Heather’s work, the discussion raised questions about working with trauma- Is it important for the discrete nature of the patient’s trauma to be known in order for it to be transformed? Can trauma actually be healed or just integrated so that the patient can move forward? How does an experience-near versus experience-distant understanding of our patients’ traumatic experiences impact our understanding of therapeutic action? Can we identify the potentially deeply painful experiences of adolescence as traumatic in and of itself? Participants remarked that the article reminded them of the importance of sitting with patients in silent, painful states while remaining engaged and present, of expanding boundaries in order to allow the patient to shape the treatment that she needs as well as using one’s own internal experience in order to connect deeply with silent, traumatized patients. Overall, witnessing deep change as the therapist holds onto hope in the face of severe symptoms and the patient’s despair, reminded all of us of the life-saving and life-altering power of human connection and empathic understanding in psychotherapy.

Denise Davis, L.C.S.W. is in private practice in Highland Park, Il where she sees children, adolescents, adults and couples and supervises and runs study groups. She is an instructor in The University of Chicago School of Social Service Administration’s Professional Development Program and also presented at the Illinois Society for Clinical Social Work’s Jane Roiter Seminar. Denise Davis is a member of the Midwest Self Psychology Study Group, the co-chair of International Association for Psychoanalytic Self Psychology’s (IAPSP) Child and Adolescent Initiative and a member of IAPSP’s Advisory Board. Denise Davis has been a presenter at IAPSP Conferences and has been a discussant for IAPSP’s online journal club. She is the author of Moments of Meeting: A Self Psychological Approach published in the International Journal of Psychoanalytic Self Psychology and is authoring a chapter in a forthcoming book entitled Moments of Meeting to be published by the Routledge Relational Perspective Series in Fall 2016.