Psychoanalytic Social Work

ISSN: 1522-8878 (Print) 1522-9033 (Online) Journal homepage: http://www.tandfonline.com/loi/wpsw20

Intergenerational Transmission of Violence:

Shattered Subjectivity and Relational Freedom

Yaakov Roitman

To cite this article: Yaakov Roitman (2017): Intergenerational Transmission of Violence:

Shattered Subjectivity and Relational Freedom, Psychoanalytic Social Work, DOI:
10.1080/15228878.2017.1369439

To link to this article: http://dx.doi.org/10.1080/15228878.2017.1369439

Published online: 22 Sep 2017.

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 PSYCHOANALYTIC SOCIAL WORK
2017, VOL. 0, NO. 0, 1–19
https://doi.org/10.1080/15228878.2017.1369439

Intergenerational Transmission of Violence: Shattered

Subjectivity and Relational Freedom
Yaakov Roitman
Private practice, Rehovot, Israel

ABSTRACT KEYWORDS
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This article considers a relational perspective regarding the reverie; trauma;

intergenerational transmission of the trauma of violence. The intergenerational
psychoanalytic literature suggests that parents often transmit transmission; violence;
the trauma of violence to their children in the form of projected intersubjectivity
nameless dread and unmentalized states that interfere with the
children’s emotional needs and support. The offspring absorbs
the trauma, which manifests itself in the form of disorganized
attachment and in turn leads to the development of a
predisposition toward cocoon-like dissociative states. This study
considers two clinical cases that examine the interpersonal
dynamics of dissociative processes. The therapist’s reverie
about his ancestors’ survival of depersonalizing violence and
Winnicott’s concept of the survival and the use of the object
help the therapist find his or her identity and gain the relational
freedom needed to overcome the dissociative state, thereby
becoming an alive subject who is able to help the child patient.

General outline
How can the therapist find relational freedom when working with the children of
war survivors? How can the therapist find relational freedom to experience for
himself—and help the patient be alive—to restore a subjectivity that has been
shattered by trauma (Aron, 2006; Stern, 2015)? When working with traumatized
patients, the therapist is subjected to depersonalizing states of dissociation from
unmentalized, uncontained experiences of homicide, dehumanization, emotional
numbness, and loss. The literature demonstrates that working with intergenera-
tionally transmitted war trauma requires the therapist to address dissociative
cocoons in the form of disorganized patterns of attachment. In this work, I empha-
size the subjective experience of a therapist’s reverie about being the child of a war
survivor. This type of reverie can become an alive object and an analytic third
(Benjamin, 2004; Ogden, 1997). The aliveness of rediscovering an identity helps
the therapist overcome his own dissociation and can facilitate relational freedom
for the child patient. A therapeutic relationship based on the mutual recognition of

CONTACT Yaakov Roitman, PhD roitmany@gmail.com Kalman Byaler, 6, Rehovot, Israel.

© 2017 Taylor & Francis Group, LLC
 2 Y. ROITMAN

being the child of a war survivor can help a child patient return to an age-appropri-
ate course of development.

Introduction
The first generation of survivors: The dissociated horror
The transmission of trauma from one generation to another, particularly trauma
caused by violence, is a multifaceted subject that involves the complex relationship
between the intrapsychic and the intersubjective in psychoanalysis. The belief in
the concept of trauma as an exclusively intrapsychic phenomenon existed until the
onset of World Wars I and II (Laub, 2013; Stolorow, 2007). The lethal violence
that emerged during those wars changed our understanding of the nature of
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trauma. Because the way of conducting war changed to the annihilation of the
masses, including civilians, trauma has become a social trauma for the masses.
Therefore, not only the individual’s subjectivity (his or her personal vital forces)
but also the entire community’s vital forces are under attack.
The therapist is also part of this community. According to Twemlow (2004),
when therapists encounter the trauma of extreme violence, they fear for their own
safety and are subjected to survivor’s guilt. This fear challenges the therapists’ usual
capacity to maintain analytic functioning. Twemlow finds that “several psychoana-
lysts tended towards over self-disclosure and adoption of a tough-minded survival
mindset and worried what this might do to their capacity for empathy and their
awareness of countertransference. Perhaps most startling was that many analysts,
despite their training in self-analysis, seemed stymied when dealing with their own
needs” (2004, p. 715).
When working with cases of trauma involving extreme violence, I also faced sig-
nificant difficulties, such as preoccupation with my own needs for safety at the same
time that I needed to provide a basis of secure attachment to my patient. In addition,
I doubted my ability to use countertransference. The most interesting reaction for
me was a preoccupation with my identity. I am from a family of war survivors.
I think about how it might be helpful for therapists to use their self-preoccupations
to become a live witness to their patients’ traumatic experiences rather than allowing
these self-preoccupations to overwhelm them. Volkan (cited in Twemlow, 2004,
p. 713) states that “culture is a reservoir for externalization that holds self and object
images in a network of safety, or in Fonagy’s terms, in a set of attachment systems
that contain aggression.” Here I attempt to present the conceptual framework of
therapy for trauma as a complex system of attachment containing violence.
Intersubjectivity, which finds its roots in humanistic philosophy (Mitchell,
1993), alleges that there is a basic human need to find one’s own self in another
person. Intersubjectivity emphasizes the crucial role that the dialogue between the
individual and his or her significant others play in the formation and consolidation
of the self. This dialogue is believed to be internalized in the course of development
as a dialogue among the various parts of the self. While maintaining diversity and
 PSYCHOANALYTIC SOCIAL WORK 3

creative self-expression, the self preserves a needed measure of continuity, but

sometimes in a close relationship, one part of the self becomes dominant. Although
one side of the self becomes dominant and the other is less expressed, it is still
adaptive as long as the individual retains the ability to manage conflicts. Contact
between people involving the mutual creation of dynamic and interpenetrating
ideas that are shared consciously or unconsciously is also defined as part of the
interpersonal or relational fields (Stern, 2015). In these fields, people share, strug-
gle, and co-create unconscious fantasies (Greenberg, 1995).
Violence and death resulting from war are direct threats to human relatedness.
People experience fear of annihilation, loss, and the urge to survive, which polarizes
the self. Therefore, war initiates dissociative processes in the self. Many psychoana-
lytic studies have examined the various psychological consequences of war trauma
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(e.g., combat, holocausts, and war atrocities). Phenomenological studies have

described the serious damage to a person’s ability to manage a relational dialogue.
Among the relational difficulties, the studies describe a “lack of witnessing” the feel-
ing of impossibility of finding another person who can help share the horrors in
order to contain and symbolize the utter horror of death and loss (Laub, 2013).
For Gampel (1998), the basic condition for the child to survive is not to ask for a
witness but to remain silent. For a child at war, crying, shouting, or calling for a
parent is not an option. Being a child is fraught with danger, not only for the child
but also for the relatives. Therefore, children’s needs are abandoned, and children
learn to detach from their own feelings. The ability to be detached from one’s own
feelings, to be transparent, invisible, and foreclosed, becomes dominant. This dis-
sociated state is unconsciously projected to the next generation in the form of
unmentalized, unsymbolized aspects of the needy and abandoned child.
For Kestenberg (1993), intergenerational transmission is defined by a first-gen-
eration inability to mourn and a second-generation preoccupation with persecut-
ing feelings and thoughts. The horror of war erodes the parent’s ability to think
metaphorically and thus diminishes the capacity to provide adequate care for the
child. The lack of metaphoric thinking creates a state of timelessness of the horror
in the parent’s mind. The everlasting horror is transmitted to the child as a name-
less experience that has no witness to share it. Faimberg’s (1988, 2014) work
focuses on the narcissistic identification of children and grandchildren with paren-
tal nameless horrors or the telescoping of experiences from generation to genera-
tion without the ability to reflect upon them.

The second generation: Disorganized attachment

According to the theory of attachment introduced by Bowlby (1969), beginning in
infancy, we seek emotional contact with a parent, especially when experiencing
stress. For a child, the most important need is not instinctual gratification but
instead parental psychological availability. Children who are securely attached to
their parents know that they can rely upon them when they are under stress, and
 4 Y. ROITMAN

they therefore openly communicate distress. Following a reunion with a parent

after a stressful separation, the child effectively returns to play and explorative
behavior. This implicit knowledge of attachment security, shaped over the course
of development, is internalized in the form of working models that the child suc-
cessfully activates to cope with stress.
According to Fonagy, Gergely, Jurist, and Target (2002), attachment-related secu-
rity also provides the interpretive interpersonal mechanism, which is defined as the
capacity for self-regulation, mentalization (the ability to perceive others’ emotional
needs and intentions in the form of mental states), and intimacy. In a less favorable
environment, children who display no signs of distress and avoid or ignore their
caregivers after considerable stress and a subsequent reunion with them are defined
as exhibiting non-secure avoidant attachment. Children who cling to their caregivers
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in an inconsolable state, remain under stress, and who are unable to return to their
former state of exploration are defined as exhibiting non-secure anxious attachment.
In their seminal article, Main and Goldwyn (1984) defined disorganized/disori-
ented behavior as contradictory or undirected behavioral responses to signs of
frightening parental behavior arising from the trauma or abuse experienced by the
parents. According to Hesse and Main (1999), the “‘parent’… sporadically alarms
the infant via the exhibition of frightened, dissociated, or anomalous forms of
threatening behavior” (p. 483). Acquired in childhood, this internal working model
affects parenting and is transmitted to the next generation. Other studies argue that
this association is not direct and that the internal working model is influenced by
new experiences. Main claims that children adapt to the parent’s disorganized
models of attachment. A child under stress attempts to regulate the patterns of
parental behavior to establish emotional contact with the parent. Dismissing, fail-
ing to resolve, and ignoring parental reactions stimulate non-secure patterns in
children. Particularly striking is the association between parental unresolved loss
and infant/child disorganized behavior. This association generally becomes signifi-
cant in the transmission of traumatic experiences from the parent to a child who is
not necessarily naturally combative (van Ijzendoorn & Bakermans-Kranenburg,
1997). “Being frightened by the parent places the attached infant in an irresolvable,
disorganizing and disorienting paradox in which impulses to approach the parent
as the infant’s ‘haven of safety’ will inevitably conflict with impulses to flee from
the parent as a source of alarm” (Hesse & Main, 1999, p. 484). The intermittently
disorganized child may behave in the opposite manner, over-controlling and
harshly ordering the parent to meet his or her wishes.

Integrating attachment and relational psychoanalysis

According to Fonagy and colleagues (2002), disorganized attachment is associated
with the intergenerational transmission of trauma. Patterns of disorganized attach-
ment can be traced even in the generally secure protocols of adult attachment
interviews. The cause of these disorganized patterns is frightening parental
 PSYCHOANALYTIC SOCIAL WORK 5

reactions to an infant’s distress. Empirically, maternal frightening, dissociated, and

unpredictable behaviors in response to the infant’s distress are associated with
children’s disorganized patterns. The psychoanalytical frame of thought is inte-
grated with attachment theory at the point where dissociated and frightening adult
reactions in response to the distressed child cause the child’s predisposition to
dissociate (Fonagy et al., 2002; Main & Goldwyn, 1984; Main & Solomon, 1986;
Stern, 2013). Generally, dissociation is a disturbance or alteration in the normally
integrative functions of identity, memory, or consciousness. Although minor disso-
ciations are normative, the phenomena of dissociation include trance states and
ideas of possession, experiences of depersonalization and derealization, fugues, dis-
sociative identity disorder, freezing, stilling, and slowed movements and expres-
sion. The child might begin to perceive his own distress as a “bad” aspect of the
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self and perceive himself as “bad” and therefore be prone to detach the unwelcome
self-state. Consequently, the self splits into idealized and negative states.
Interpersonal theory helps to better understand the association between intergen-
erationally transmitted trauma and dissociation. According to Bromberg (1994,
1996), relations with significant others in which different parts of the self become
consolidated are crucial. Significant others who are empathically attuned to the child
participate in his or her co-regulation as primary supporting participants. This
co-regulation implicitly structures the child’s self. It provides the self with relational
opportunities to achieve structure, to co-regulate affect, and to symbolize the differ-
ent aspects of the self. This intersubjectivity exists in the interpersonal field of secure
attachment. Bromberg states that security is based on the mode of parent-child
synchronicity (Trevarthen, 2001), the contingency of emotional reactions (Gergely &
Watson, 1996), and mentalization (Fonagy et al., 2002). This background of emo-
tional safety consolidates various aspects of the self and creates an implicit represen-
tation of the self-other in times of distress. A securely attached caregiver is
responsive in times of danger. However, in cases of adverse or emotionally negative
and/or disorganized parental reactions to a child’s distress, the child perceives his
own signal of fear/distress as unacceptable and enters a quasi-hypnotic stressful state
that shatters parts of the self, thus beginning the dissociation process. According to
Bromberg (2009), this process creates a dissociative “cocoon,” and the child-self
forecloses the dialogue with another part of the self. The threatening aspects of the
relationship remain in an unmentalized and unsymbolized form. Hence, the child is
not able to regulate or diminish the distress.
According to Bromberg, overly disjunctive self-experiences are adaptationally
held in separate self-states that do not communicate with one another, at least
temporarily. A dissociative mental mechanism is designed to prevent cognitive
representation of what may be too much for the individual to bear. However, a
dissociative mental mechanism is also formed to enable enacted communication
of the intolerable affective experience. Through enactment, the dissociated
affective experience is communicated from within a shared “not-me cocoon”
(Bromberg, 2009) until it is cognitively and linguistically resolved through
 6 Y. ROITMAN

relational negotiation. The first dissociative parts exist separately: “In the early
phase of an enactment, the shared dissociative cocoon supports implicit com-
munication without mental representation. Within this cocoon, when the
patient’s self-state switches, the therapist’s self-state also switches equally and
dissociatively to a state that can receive and react to the patient’s dissociated
state switch” (Bromberg, 2008, p. 337). Bromberg stresses that during episodes
of intergenerational transmission of attachment trauma, the infant adapts to
the rhythmic patterns of the mother’s dysregulated stressful states. Alexithymia
(i.e., the inability to possess emotional awareness in the appropriate social con-
text and the incapacity to identify and describe emotions, thereby impairing the
identification of emotions in others and diminishing empathy, which eventually
impairs an adequate emotional response and social relations) and anhedonia
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(i.e., the incapacity to find pleasure in usual activities; Krystal & Krystal, 1988)
are the products of this deterioration.
The analytic situation involves periods of enacting a shared cocoon structure. In
this situation, the therapist’s own child-parent representations of the self are under
“lethal” unconscious attack. In the transference, an unconscious fantasy of the
parent is created in which the parent is forced to kill, not to feel, and not to know
fear and loss. There is a fantasy involving a parent who denies the child’s needs,
such as the need for soothing when the child feels fear. On the other hand, a
mutual fantasy of a child who does not have the right to desire his or her father is
co-created. The protective cocoon provides an opportunity to rediscover the
important forsaken relations. For the therapist, it is important to be safe but not
too safe. For Bromberg (2013), a genuine, empathic co-regulation may provide a
reliable response to a child’s trauma. This point when the therapist looks for safety
in his or her cocoon should be further explored because war trauma places the
psychoanalytic dyad in a “minefield.” These cocoons will persistently foreclose the
opportunity for a genuine relationship that promotes growth. In a state of impasse,
the patient needs someone who can recognize the cocoon in himself (Benjamin,
2004; Stern, 2015). Therefore, in a moment of dissociative turmoil that robs one’s
identity, the therapist needs an inner “witness” for himself or herself to cope with
his or her own cocoon. This inner witness is the way to overcome the dissociative
experience and resume the internal dialogue with the different part of the self. The
resumed dialogue provides what Stern (2013) defines as the opportunity for
therapists to newly identify themselves as welcome to an unbidden experience. If
therapists recognize something new about themselves and the patient, a new
opportunity for relational freedom arises.

The role of the therapist

The therapist experiences the trauma together with the patient and thereby needs
to recognize (Benjamin, 2004) the effects both in himself and in the patient before
he can create the safe space needed. The therapist’s ability to survive in the
 PSYCHOANALYTIC SOCIAL WORK 7

relational field becomes an act that supports the relational freedom to relive the
violent experience. This act may provide developmental scaffolding for the child
patient.
According to Stern, dissociative enactment is not overcome by insight but rather by
new, unpredictable, spontaneous perceptions by the therapist of himself and the
patient. There are moments that force the therapist to behave as a stranger to himself
and openly admit the mistake of believing that he had contributed to the impasse
(Aron, 2006; Benjamin, 2009). This type of alienation requires strength on the part of
the therapist to ask what is truly happening regarding his relationship with the patient.
The relationship can never be predictable, and unexpected changes often occur.
Stern states that a new understanding of the relational state should not necessar-
ily relate to the dynamics of transference-countertransference but can come from
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different spheres of experience. He explains:

the novel experience that becomes explicitly available may be fantasy or memory not
obviously related to the current unfolding analytic situation. It may be some kind of
insight about other, seemingly irrelevant matters, such as the sudden appearance in the
mind of one of the partners of an understanding of some aspect of own or the other’s
character; the novel experience may even be a new observation or grasp of some part of
the patient’s history or current life outside the treatment. (2013, p. 11)

This ability to embrace new experiences is also elaborated in the receptive

capacity for reverie. According to Bion (1962), the maternal capacity for reverie is
a complex function. First, reverie is defined as the maternal capacity to experience
love for the infant and the infant’s father. Second, it is defined as the maternal
receptivity to the infant’s preverbal sensorial states and the maternal ability to
understand what the infant is experiencing. The mother provides containment and
the alpha function, which is associated with the ability to transform raw sensorial
elements into symbols and dream-thoughts, the ability to mentalize generally, and
the capacity to think. The beta elements (i.e., the infant’s raw sensorial unmental-
ized and unsymbolized perceptions of the most primitive states) are contained by
the mother’s alpha function.
Ogden (1997, 2004), following Bion, argues that reverie may be defined as the
analyst’s capacity to pay attention to the most narcissistic preoccupations, rumina-
tions, and daydreaming fantasies, which, in the intersubjective field, may help the
analyst better understand what is happening unconsciously to the patient. These
preoccupations are co-created analytic objects, or the analytic third. The analytic
third is co-created by the shared unconscious dynamic. It is never solely an
intrapsychic process; rather, it is the sharing experience between two subjects. The
therapist, who is in a state of reverie by paying attention to the shifts in his own
subjectivity, may ask himself if such shifts may correspond to some particular state
in the patient’s subjectivity. This is always a mutually shared and co-created pro-
cess in which shifts in the analyst’s mind may provide insight into the patient’s
unconscious internalized object relations.
 8 Y. ROITMAN

Following in the footsteps of Stern and Ogden, I believe that the reverie can
become a living unbidden presence when facing the trauma of war violence. As the
literature warns, the therapist may rely on “common knowledge” about a war
(Gampel, 1998). This common knowledge can hinder his understanding of the
patient’s individual, idiosyncratic relationship to war. Therefore, one must
vicariously live and survive through that particular patient. The dehumanization of
war violence conflicts with the humanism of the freedom to be alive—to have a
reverie. To have a reverie is to undergo experiences without being subjugated to an
enormous effort to remain human. According to Winnicott, to be alive, one must
use real objects. By real, Winnicott means objects that “really survived destruc-
tion.” Otherwise, successful survival of the disaster is only a fantasy. What is real
survival?
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Winnicott’s survival of the object

According to Winnicott (1971), destructiveness and love are interconnected.
Infants’ ability to become alive fully depends on the mother’s ability to survive the
infant’s ruthless love and on her capacity not to retaliate. Ogden (2016) interprets
this aspect of mother-infant relations as the maternal ability to withstand infants’
very demanding, pressurizing, and exhausting hunger for love and care. In order
to survive, the mother has to contain her genuine pain associated with the feeling
of the failure to provide adequate care for her very demanding baby. In addition,
her survival depends on her ability to recuperate (i.e., to unconsciously and
consciously process this pain of failure and find new strength to continue on). Her
ability to continue on with her love and care means “not retaliating.” When this
process of survival occurs, the mother becomes alive and real for the infant, and
the infant can use her for personal growth. Eigen (1981) stated that the endless
cycles of a child’s ruthless love and maternal survival create an “area of faith” in
the reliability and reality of the relational human world. Therefore, it is a facilita-
tive process of the infant’s ego maturation. The infant’s immature ego emerges
from the zone of enmeshment in its own projections. When the mother survives
and does not retaliate for the infant’s ruthless love, the infant’s internal world will
not be perceived by him or her as destructive and “bad.” The child will be able to
differentiate between his or her healthy aggression and the violence of the outside
world. Due to the mother’s survival, the child can securely use the objects as living,
nurturing carriers of growth potential. As a result, the child can better reclaim his
or her needs—to recuperate from dissociation.
According to this theoretical point of view, the therapist survives by maintaining
the psychoanalytic technique. In Winnicott’s (1971) sense, the therapist becomes the
object to be used and “must necessarily be real in the sense of being part of shared
reality, not just a bundle of projections” (p. 80). “The analyst must consider the
nature of the object not as a projection but as a thing in itself” (p. 81). For Benjamin
(2004), it means that the therapist recognizes a child of a war survivor in himself.
 PSYCHOANALYTIC SOCIAL WORK 9

To summarize, when the therapist relives violence with the patient, there is a
question of how to survive and how to maintain relational freedom. On the one
hand, this involves identifying a cocoon and the disorganized emotional patterns;
on the other hand, it involves maintaining the ability to serve as a secure base that
contains violence. In the clinical cases described next, I will describe how the
therapist, in moments of subjectivity shattered by violence, is able to rediscover in
reverie the elements of his identity as a descendant of survivors. This unbidden
presence helps to restore the therapist’s analytical function and relational freedom.
This process of recognition helps to overcome depersonalization because of the
trauma.

Clinical presentation
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Case 1: Aron
Aron, a 7-year-old boy, was referred to my private practice by a psychiatrist who
diagnosed him with severe depression. During the initial evaluation, Aron’s
parents explained that both grandfathers had been exposed to killing, one as a
soldier when confronting the enemy and one during the Holocaust when he
witnessed his younger brother being choked to prevent the Nazis from discovering
the family’s hiding place. His grandfathers were described as violent and emotion-
ally shut down. The parents themselves admitted to having serious difficulties
regulating their anger and were barely able to restrain themselves from physical
aggression toward their son. The mother emphasized that she felt rejected by her
father throughout her childhood and adolescence, which led to difficulties in her
relationships with men.
Aron was the older of two children in a middle-class family. His parents were
highly educated. His father worked as a mathematician, and his mother ran a suc-
cessful independent art enterprise. The parents complained that Aron was violent,
sometimes extremely violent, toward his mother and his younger brother, and that
he was undisciplined, disorganized, and out of control. He was unable to function
at school (the counselor also complained about his complete isolation in class) and
was shy, friendless, and uncommunicative with teachers. Furthermore, he
expressed little interest in his surroundings. Following his evaluation, Aron began
attending therapy sessions twice per week.

Segment 1
In the initial stage of therapy, it was difficult to be in the room with Aron. He
explored games and asked to play a board game. His play was rather mechanical,
monotonous, and robotic, void of all human contact or relations. My voice, my
words, and my very presence were painful for him. I tried to be present in the
most unobtrusive of ways, remaining as silent as possible. My few responses and,
at times, even my gaze seemed intrusive to Aron. He often tried to leave the room
after making brief eye contact with me in an effort to escape my presence. Once,
 10 Y. ROITMAN

he looked me in the eye, and I felt his gaze become extremely violent and filled with
rage, as if my meeting his eyes was a sharp knife attacking him, from which he
required protection. I felt intimidated and frightened by his possible reactions, and
I tried to cling to the need for this meeting for both of us. I felt his rage intensify
when he felt particularly disappointed during the simple board game that we man-
aged to play. Although I attempted to maintain my composure, I experienced a
feeling of self-preservation while attempting to communicate with this child.
In some sessions, Aron appeared to be desperately trying to assemble the perfect
Lego model. Every attempt, move, and mistake was disappointing and aroused a
destructive and compulsive impulse. When disappointed, his glances at me and his
movements became violent; he dropped and threw objects and ran around the room;
once he even attempted to throw a cupboard. I struggled to survive while protecting
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him from his own physical violence. I was preoccupied with the need to be strong
without retaliation while willing myself to be as still and as silent as possible.
In one session, precious calm moments occurred during which Aron was busy
building the perfect model, and I was able to think about what constitutes my true
identity as a therapist in these sessions. I felt sadness and was filled with sorrow for
those individuals who have the capacity to be authentic rather than robotic. As I was
recovering from this reverie, I began to understand that Aron had most likely lost his
authentic childhood feelings. I willed him to successfully assemble a Lego model.
When he did eventually succeed, I initially felt excited and hopeful. Aron also seemed
to relax for the first time. The fact that his internal connections were broken, tough,
and sharp and that he refused to connect with me now appeared clearer to me.
In subsequent meetings, his unusual presentation and difficult behaviors contin-
ued. I found myself thinking about his mother’s closeness and concern for him
when my own subtle hostility and surreptitious feeling of rejection appeared. I felt
as if an aching wound appeared inside of me. In the reverie of the moment, I had a
feeling of recalling Aron’s mother’s gaze, which was full of pain and rage as she dis-
cussed the violent silence of her father (Aron’s grandfather). Her voice was full of
pain when she described being rejected by him and the failed romance of her ado-
lescence. Suddenly, I was fantasizing about the rage regarding her bond with Aron,
which most likely felt threatening to him because of his wish to be accepted by his
mother. The image of an Oedipal failure occurred to me. Simultaneously, my asso-
ciations returned to my relationship with Aron and his feelings of violence that I
denied. I thought about Aron’s projected wishes to both kill his father and to be
loved by him. The wish to have a strong father may supersede these urges. I
remained silent, but it felt as though I had made a genuine connection with Aron
because I stopped being defensive and accepted the burden of harsh paternal trans-
ference onto myself.
A temporary lull in the room was followed by Aron’s violent looks, and I
thought of the genuine and undeniable difficulty of being the target of his murder-
ous rage. I thought of my own father, a son of Holocaust survivors, and his feelings
of blame. I thought about my fantasy of unconscious death, which I foreclosed,
 PSYCHOANALYTIC SOCIAL WORK 11

along with the feeling that my father bore the blame of being alive and the protec-
tive shields and disconnections that we both constructed so that our bond would
survive. “It is all about a loving father,” I said to myself while looking at Aron. This
helped me to calmly bear Aron’s furious gaze.
In subsequent sessions, Aron became markedly less violent and restless. His
mood also improved. He showed me a cartoon with monsters that appeared gran-
diose, ruthless, and somewhat omnipotent. I felt his need for violent, sadistic con-
trol over me in his effort to feel powerful and strong. He wanted me to play a
violent game. I felt anxious that this game might stand between us, and I said “no,”
as if I were saying no to violence. Surprisingly, Aron responded positively with
laughter and joy and suggested that we watch the first episode in a series. Aron
told me that this episode was released 12 years ago (I thought Aron’s response
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reflected a longing for some past experience and that this connection was a victory
over the violent disconnection and isolation).

Segment 2
Following a two-week break, Aron came to a session with his mother. He and his
mother were engaged in an aggressive quarrel near the entrance for a long period
of time. Eventually, Aron threw his jacket on the floor and went into the room. His
mother said, “See… let him tell you what is happening. He is angry.” In the room,
Aron took a plastic toy from the shelf and began to bend and break it, muttering,
“Phew! I want to break it!” I thought that he did not seem to be feeling the total
extent of his anger for reasons that were not clear to me, nor did I feel that his
anger was directed at me. As if to include me in his inner drama, Aron threw the
toy on the floor and began to trample it, saying, “baby toys…” and leaving me
wondering about the meaning of his vicious trampling of the toy. My mind drew a
picture of an Indian trampling defeated enemies. I asked myself why this image
arose in my mind and how it was connected with what was happening to Aron. I
tried saying to myself that maybe he was having a very difficult time. I was quite
unsure as to what he needed, and leaving him alone in this situation was difficult.
Uncharacteristically, Aron said, “I cannot give up the anger.” I asked why. Aron
said that he needed his anger in order to be physically strong enough to defeat me.
His statement did not incite any further anger or fear. I began to think about the
game that I had once started with my son when he began to fight with me, saying,
“I will destroy this giant.” I could not determine how it could be linked to Aron’s
anger. I did not know the cause of Aron’s quarrel with his mother, but I guessed
that Aron had a strong desire for his father to be strong and powerful. I decided to
join in his game and to express paternal strength and masculinity without the
explicit desire for murder but rather with the desire for a typical fight between
father and son. Improvising, I said that a card game could reveal whether Aron
was sufficiently strong to sustain a loss. Aron gladly sat down and opened the
cards, saying, “Enough with your pathetic attempts to cheer me up. I will not stop
being angry.” He calmed down, and we played the game. Later that week, his father
 12 Y. ROITMAN

asked for a special appointment, and he confessed that he grabbed Aron by the ear
early that morning because he was angry that his son had not met some school
obligations. He talked about his fear of becoming violent.

Segment 3
Aron brought comics and asked to look at the pictures while telling stories of the
adventures of the hero, who soaked in the mud of a river, rudely mocking the
weak. It was difficult to hear this pseudo-macho-masculine omnipotent bravado
and sadism. I began to fantasize about men’s brotherhood and a son joining his
father on a fishing adventure for the first time while trying to maintain an inter-
ested enthusiastic gaze and a solid sense of inner strength. During later sessions,
Aron asked me to play a game with small and large toys. While exploring the toys,
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he asked me to take the largest one. I felt honored by his offer to be the most pow-
erful and embarrassed by my desire to possess this power. I understood it as an
unconscious desire to be with his father, and I gratefully accepted this toy, saying,
“I gladly accept this force.” In the subsequent session, Aron told me that I looked
like a famous linguist, Eliezer Ben-Yehuda, the reviver of the Hebrew language,
who had a son who became a successful journalist. In my reverie about the son
who was forced to learn and speak Hebrew, I realized that I was revisiting a previ-
ous pattern with my young patient.
Aron subsequently caught the flu and regressed. Similar to his nasal congestion,
his autistic withdrawal affected his ability to breathe, to live, and to relate. I said
quietly that a blocked nose was a sad condition. Aron cheered up and said the cold
was worse than the noise of his classmates. I understood that he was speaking
about the difficulty of sensory regulation and the fragility of the skin-ego that did
not protect him.
He returned to the following meeting withdrawn and lifeless once again. He still
had a runny nose and had to stop himself from sneezing. I told him that there was
nothing wrong with blowing his nose and breathing. Aron blew his nose and said,
“See! Could you see the snot?” I helped him clean it. Aron recalled a game that he
could not find for a long time; the more time that passed, the less likely he would
find it. I was sad, feeling his sadness, and I wondered if it was possible to perceive
what was happening as an unconscious question of surviving childhood. Moreover,
in my reverie, the father said, “live.” I said breathe and gave life to the child left
behind in the hiding place that should have protected him from the Nazis.
Aron’s therapy is ongoing, and he has made progress in all areas of functioning.
He is no longer violent at home or at school. He is also no longer depressed, and
there has been significant improvement in his academic functioning and in his
relationships with his parents and brother.

Case 2: Saul
Saul is eight years old and the youngest son in a family of two siblings. His father, a
former Marine, fought twice in Iraq and Afghanistan. Despite the opportunity for
 PSYCHOANALYTIC SOCIAL WORK 13

demobilization, he returned to the front. Both grandfathers fought in the military.

Following demobilization, the father suffered from dissociative outbursts of anger
and violence that led to divorce. The father never spoke of the war. For a long
time, he was a workaholic, compulsively—almost maniacally—engaged in ridding
himself of memories of the war. During quarrels and attacks on his wife, he would
enter into a dissociative trance in which he would become aggressive. He treated
his sons cruelly. Consequently, the mother took her children and left the United
States.
During the initial phase of therapy, we did not play but instead compulsively
engaged in the game of Monopoly. Saul encouraged me to earn money, then begged
me to lose my fortune and to manically try to recover it. I felt like a slave to my for-
tune with no opportunity to think or feel. I felt like a cog in the hands of a cruel boss
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who could do with me whatever he wanted. Saul’s demands became increasingly

sadistic and violent, causing me to feel increasingly dehumanized, aggressive, and
despised. I mentally destroyed my enemy in response to his offenses.
This process continued for a while—Saul as the aggressor and me as the brutal-
ized man. Then, I had a reverie (Ogden, 1997). I remembered my father recalling
my grandfather, who fought against the Nazis after the concentration camps were
liberated. He was the first to cross the front line and enter the Nazi trenches. He
received the “Order of Glory” for his actions during the battle. His words about
the Nazis were particularly brutal. This taste of brutality resonated with the brutal-
ity of my thoughts. I assumed that this type of brutality was some sort of homicidal
state of mind. A little later, I also remembered the St. Crispin’s Day speech from
Shakespeare’s Henry V, when the king mercilessly prepares his soldiers for death,
saying, “If we are mark’d to die, we are enow [enough].” In the vividness of the rev-
erie, I felt compassion for my grandfather, who was forced to become brutal; he
had to fight to survive. In this reverie, I also identified for the first time with Saul. I
felt like a father saving his son from the threat of violence and death. I also felt that
Saul was immersed in a homicidal environment and that he needed the father.
I calmly stopped the game and demanded to play together according to the
usual rules, persistently refusing to comply with his cruel indications. Saul stopped;
he went to the toy boxes and asked me to sit with him on the floor. Sad and lost, he
began to play with toy soldiers in a game of war. One of the soldiers was seriously
wounded and vomited blood. Saul staged incredibly vivid and violent battles dur-
ing which we were preoccupied with the soldier vomiting blood.
The game turned into an endless war in which the soldiers returned to the front
and died. Noteworthy was how the game repeated itself from session to session.
Saul would turn away from me and imitate the sounds of battle. It was possible to
make out the terrifying sirens and explosions during which soldiers were merci-
lessly destroyed. I listened to the sounds. In my reverie, they reminded me of mili-
tary sirens and the noise of medical devices in an intensive care unit in a hospital.
The general atmosphere was one of violence, chaos, and annihilation. I tried to
comment on Saul’s experience, but he did not react. With each meeting, he
 14 Y. ROITMAN

complained that I did not play with him and that I was passive. I tried to accom-
modate him, but Saul did not respond to any of my attempts to show that I was
with him; he distanced himself from me physically and emotionally. “You do not
play with me,” he would say, and he turned his back to me as he played out the
sounds of war. I felt helpless and desperate.
I proceeded by relying on the philosophical principle of relational psychoanaly-
sis (Gadamer, the belief that the other in dialogue is truthful and knows what he or
she is talking about), which proposes that the therapist learns from the patient.
Saul had said that I “did not play with him.” I decided to listen to him and to trust
him while evaluating my own aliveness and authenticity regarding my presence
and reverie. It was incredibly interesting to suddenly feel that I wanted the session
to end and for Saul to leave.
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What is the sense of annihilation, the fear of losing one’s father? How does one
cope with this horror of loss? What father must I be so that the child will feel alive
again and will overcome his own loss? Interestingly, the reverie regained traces of
fantasies and memories of how my grandfather experienced destruction and loss
and of how he survived, how he loved me and I loved him. I also needed to
respond in my own way, openly and honestly, not hiding in the shelter of any pre-
supposed knowledge. I decided that the state of “not playing with me…” may indi-
cate my dissociative cocoon that Saul may have sensed. It likely reflected my
detachment from horror and loss. Therefore, it is possible that in the transference,
I scared him with my disorganized response. I unconsciously withdrew and fled
the room. I was not surviving the destruction; I was retaliating. We negatively mir-
rored each other’s disorganized state. The moment of rediscovering the love for
my grandfather, a survivor, was a moment of feeling love for a paternal figure in
Bion’s sense: a genuine reverie and identification with surviving destruction and
loss while continuing to survive.
Saul distanced himself when I approached. I decided to insist: “Saul, come here;
I want to play with you.” I persistently called him, in a warm and paternal fashion,
and felt a dramatic shift in my relationship with him. He approached me and said
(with anxiety in his voice), “I cannot stop the war; everybody… will die.”
Perhaps I was slightly impulsive, but adopting the voice of the toy figures in the
game, I said that he needed a break and that I would care for them all. Atypically,
Saul obeyed and sat down, and I began to protect the figures from the chaos and
the atmosphere of death that prevailed in the room. My actions must have seemed
funny to him, but they were not rejected by him. Saul changed; he went to the box,
removed two swords, and asked me to fight with him. I was deeply touched by his
manner; he fought slowly, with dance-like movements. Unlike his previous violent
play, this new game felt as if it was gradually unfolding. He performed all kinds of
brave, quasi-samurai movements: slow, thoughtful movements that reflected a
strong, brave, and resourceful child.
While the war was not completely over, Saul began to express tender feelings
toward me and toward his mother, and his anxieties diminished. In addition, his
 PSYCHOANALYTIC SOCIAL WORK 15

obsessive need to harm someone diminished, and he started to behave more

appropriately at school.

Discussion
From the first moments of Aron’s therapy, the trauma involving the child’s need
for his father was repeated through transference. Aron’s need for a father triggered
homicidal feelings, erasing his ability to create a connection with his father. I think
of how my gaze, which carried the desire for emotional contact with Aron (and
possibly the unconscious desire to find the father), made him very anxious and
caused disruption. There was no room to accommodate this wish, neither in the
mental space of the gaze, nor in the child’s body, nor in the external reality. Aron
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attempted to throw a cupboard (an act of violence) to stop (to defend against) the
child’s need of the father and to escape. In this act, the therapist’s ability to provide
something human—an emotional bond, some analytic functioning—was under
attack (Ogden, 2016). Aron compulsively repeated the impossible and conflicting
situation of being a child and having living relations. For him, it was necessary to
be aggressive and destructive in order to survive. How should the therapist survive
in order to restore for a child a belief in an emotional bond? I will attempt to
address these questions in more detail. For now, in Aron’s case, I can say that it
begins with the very basic elements of the therapist’s unconscious and conscious
processing of Aron’s tremendous anxiety. I thought about what constitutes my
true identity as a therapist during these sessions. I think that it may begin with my
ability to survive by maintaining my psychoanalytic functioning. I understand the
therapist’s survival as intimately linked to the ability to perceive an act of ruthless
love within Aron’s destructiveness. In order to survive the pain and restore my
capacities (Ogden, 2007), I had to rediscover some new elements in my identity
(Stern, 2013). I had to relive my own dissociated aspects of the son-father relation-
ship, my own elements of dissociated need for the father and the painful feelings
associated with it. These elements of intersubjectivity allowed the process of the
reverie to address Aron’s traumatized need for attention and positive feelings from
his father.
The encounters with Saul placed enormous demands on me to be a genuine living
witness to his trauma. The therapist must, in Winnicott’s (1969, p. 88) sense, “neces-
sarily be real in the sense of being part of shared reality, not a bundle of projections.” In
addition, “The analyst must take into account the nature of the object (the therapist
must consider himself) not as a projection but as a thing in itself” (p. 80). I think that
Saul’s ruthless love taught me about the process of recognition (Benjamin, 2004): how
to rediscover the painful feeling of being a descendant of a survivor and continue being
a therapist. The therapist is unconsciously being destroyed by violence but continues
the reverie. This intersection, a state of paradox in the Winnicottian sense, may be
defined as a pathway to recognition of the traumatic experience that helps to establish
a secure dialogue between the disorganized and dissociated parts. The reverie about
 16 Y. ROITMAN

the grandfather that emerged in the session with Saul can be understood as an unbid-
den experience (Stern, 2013). This reverie created oneness in otherness, or what Benja-
min defines as thirdness (the co-created realness of the shared reality of war and loss).
Therefore, the reverie might be considered a process that creates hope in the ability to
be truly alive (Ogden, 1995) and to exit the vicious cycle of violent, dissociated
relationships.
When Saul unconsciously hungrily longs for his father in the transference, he
puts tremendous pressure on the therapist’s perception of himself. In order to
become a genuine, alive, and secure supporting figure for Saul, the therapist under-
goes a process of surrender to the process of creating thirdness (Benjamin, 2004,
2009). The process of surrender consists of the creation of a mental space in which
the therapist frees himself from any intent to control or coerce any dynamic
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unfolding in an analytic situation. The therapist frees himself to consider the

other’s point of view. The surrender is a process of recognition: the ability to con-
tain and to remain bonded to the other’s mind while accepting any separateness
and differences. The surrender needs the third that mediates between the one and
the other. These dynamics contrast with two-dimensional do-and-done-to pro-
cesses in which one coerces or submits to the psychic reality of the other in an
interlocking relationship, as in the first parts of the described cases, the pseudo
“securely attached” therapist and the scared child, a pseudo sharing of the experi-
ence of what it is like to be together under the intimidation of violence and tremen-
dous loss instead of co-living. For Benjamin, thirdness arises from surrendering to
the patient’s experience. For example, in Saul’s case, it could be observed in my
surrender to his plea, “You are not playing with me…”. I began to recognize that I
was either fleeing from Saul in a state of dissociation from the fear of loss or retali-
ating by unconsciously killing him for the sake of maintaining my own security.
Due to the encounter with Saul and his trauma, I become a real subject with a
real history. For Saul, the reverie about three generations articulates both verbally
and nonverbally the hope for survival. When the therapist has a reverie of love for
his ancestor who is a war survivor, he finds within himself hints of a real experi-
ence (in the Winnicottian sense) that can benefit the patient; the therapist feels
that parent-child love can truly survive the destruction and dehumanization of
war. Through this reverie of love for his forefather, the therapist can truly recog-
nize—in the transference—the child patient’s need for his father, who is trapped in
the dehumanization inherent in the trauma of war. The appeal to love for an ances-
tor who survived war helps contain the child patient’s needs and thus facilitate the
development of his ego. To me, the idea that an appeal to prior generations facili-
tates the development of the ego is based on Freud’s thought about the significance
of intergenerational processes in formation of the ego. Freud stated, “Thus in the
id, which is capable of being inherited, are harbored residues of the existences of
countless egos; and, when the ego forms its super-ego out of the id, it may perhaps
only be reviving shapes of former egos and be bringing them to resurrection”
(Freud, 1923, p. 40).
 PSYCHOANALYTIC SOCIAL WORK 17

The aliveness of memory for three generations becomes a vector of life as

opposed to war and annihilation, formulating survival and hope. Relying on
three generations of one’s personal family history creates a reference point, an
intersection, which allows the therapist to address an overwhelming experience.
This intersection also helps to determine whether the countertransference
serves as a living reverie or a protective cocoon. Perhaps an actual identity is
created by the intersections of the social relations between survivors and their
subsequent generations.

Summary
The trauma of violence unfolding in the therapist-patient relationship becomes a
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destructive attack on the therapist’s core of subjectivity as a person who is capable of

reverie. The destructive attack calls into question the therapist’s ability to hold onto
elements of extreme violence in the context of secure attachment. The destructive
attack creates in the therapist elements of psychic deadness in the form of a dissocia-
tive cocoon and disorganized patterns of attachment that must be resolved. These
elements of disorganized attachment are split-off traces of a threat to life and the loss
of emotional security for the child. The therapist who experiences the child patient’s
psychological problems must give in to an interpersonal process to find and resolve
these traces. Reintegrated, the traces of a threat to the child’s life may be helpful in
finding new meaning in the form of a new element of identity: being the descendant
of survivors. This process of recognition creates relational freedom to transfer to the
child patient an ability to positively experience life while feeling the pain of the loss
of a loved one. The reverie about being the descendant of survivors may become a
process involving the therapist’s survival in Winnicott’s terms. This survival can
become a focal point that provides an attachment base within which violence is con-
tained or reduced.

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