If you are unable to access this, or any other video, because your country will not let you get Youtube (I’ve had the problem with China, for example) or for any other reason, feel free to write to me at dr.paulgeltner@paulgeltneranalyst.com, and I will arrange a different way for hear it.

This following section is a supplement to the podcast above, Joining, Mirroring, and Modeling

(The following is from the pre-publication manuscript of Emotional Communication: Countertransference Analysis and the Use of Feeling in Psychoanalytic Technique, described in more detail on the home page of this site.

Although mirroring can be used in differentiated narcissistic states, it is most effective when the patient is either in an extroverted narcissistic transference in which she experiences the analyst as a twin, with or without blurred ego boundaries, or in self-directed introverted narcissistic transference in which there are blurred ego boundaries creating a feeling of merger. On the countertransference side, the analyst must experience the same feelings as the patient, both toward herself and toward the world and must also view the patient as a twin. Even more so than in joining, the feelings must be genuine. While there is always a risk that the patient will feel mocked by mirroring this reaction is almost guaranteed if the feelings are fake.

As with joining, mirroring can be syntonic or dystonic. We will consider syntonic mirroring first.

Syntonic mirroring. In syntonic mirroring, the analyst expresses feelings that are consistent or syntonic with the patient’s sense of self. Like syntonic joining, the emotional communication is intended to validate and strengthen the patient’s sense of self. However, the analyst is more explicit that he feels the same way the patient does. The patient sheepishly mentions that he is afraid of flying. The analyst responds, “Ugh, flying. Scares me to death.” Or the patient says he feels isolated at the office because he’s so much smarter than everyone else. The analyst responds, every bit as haughty as the patient, “I know what you mean. Most of the analysts I meet are absolute dumbshits. I’m just luckier than you because I don’t have to see them every day.” The patient complains that her boyfriend leaves his socks all over the place, and the analyst chimes back, “Don’t you just hate it when they do that!” As with syntonic joining, both the cognitive and the emotional communications are addressed to the afflicted ego but with even more emphasis on the emotional communication that conveys the sameness of patient and analyst. They are two peas in a pod, united in nourishing harmony.

Mirroring (again more than joining) usually reflects the patient’s tone, speech rhythms, and vocabulary as well. This must be done with subtlety and real feeling; otherwise the patient is liable to feel manipulated, demeaned, or mocked through sarcastic imitation. When done correctly, however, it is both stabilizing and validating, and the impact on the patient’s sense of self is powerful.

Mirroring can work with discrete moments and feelings, but it is often most powerful when the analyst mirrors the patient’s whole mode of thinking, feeling, and relating. This is can be done deliberately. What is fascinating about mirroring, however, is how often it develops spontaneously and preconsciously out of the narcissistic transference/countertransference.

The patient and analyst often move in synchrony when they are in states of twinship or merger. The analyst’s voice automatically tends to fall into the same cadences as the patient’s. The analyst has similar interests, similar reactions, and similar curiosities as the patient. They may have similar weaknesses as well. For example, the patient loses the check, while the analyst loses the bill, and nobody is upset because they understand each other. Patient and analyst seem to hum along in perfect attunement. These moments of syntonic mirroring can be intensely intimate and satisfying.

On the other hand, they can be extremely unpleasant as well. Take the analyst who finds that she is unable to formulate a clear sentence when she is with a patient who can’t collect his thoughts or the analyst whose voice begins to tremble in harmony with the patient’s freely expressed anxiety as examples.

A kind of spontaneous mirroring often occurs when the analyst is in a state symmetrical narcissistic countertransference. For example, in cases where the patient and the analyst each become the object of an identical paranoid suspicion of each other, each can begin to relate to the other as if they were a threat to be managed and avoid.

Strictly speaking, this sort of unplanned, unconscious mirroring is an acting-in rather than an intervention. This isn’t to say that it can’t be deeply curative, but it also may not be. A patient in the twinship or merger transference frequently requires the analyst to engage in this sort of mirroring, at least initially, in order for the environment to be similar enough to be compelling. But what the analyst doesn’t immediately know is whether the spontaneous mirroring will also be different enough to be curative. If the patient is experiencing the narcissistic transference because her narcissistic needs were not adequately met in childhood, then she needs them to be met now, and the spontaneous mirroring will be a curative emotional communication. On the other hand, it is also possible that the narcissistic transference and its accompanying countertransference are a repetition of an earlier interpersonal relationship and that what is needed now is a different sort of emotional communication.

For example, a supervisee described a patient who felt completely helpless and induced similar feelings in the analyst. The patient and the analyst both feel helpless, and the analyst fumbles around just as much as the patient in an effort to understand what is going on. It is possible that the emotional communication the patient needs is an anaclitic one, requiring the analyst to pull herself out of the induced hopelessness and into the role of active parental caretaker to the helpless patient.

When mirroring that is supposed to be syntonic misfires, the results can be disastrous. I once did an initial session with a teenager who was paranoid and threatening in a covert sort of way. He described a number of situations in which he said that he had to be very careful because he might get in trouble. He then asked me to tell the psychiatrist, who he was supposed to see after me, that I didn’t think he had anything wrong with him and that he didn’t need to see him. I told him that I too had to be very careful about what I said to the psychiatrist because I was afraid that I might get in trouble. I was attempting to mirror his paranoia. Furthermore, this was not really a fabrication because I actually did have to be careful about what I said to the psychiatrist, and so it seemed, in my inexperienced state, that this was also genuine. In any case, the intervention had the effect of inflaming him. “Hell, if you can’t do anything around here without getting in trouble, then what do I need you for?” he shouted and stormed out, slamming the door. I had inadvertently made a dystonic mirror, which prematurely released an uncontrolled outburst of aggression.

Dystonic mirroring. Like dystonic joining, the purpose of dystonic mirroring is to reverse a state of pathological self absorption created by self hatred or self-directed aggression. And the purpose of both types of dystonic emotional communications is to draw the patient’s aggression away from herself and toward the analyst. However, they are applicable to slightly different types of narcissistic transference/countertransference configurations in which the analyst experiences different aspects of the patient’s feelings.

In dystonic joining, the analyst experiences the feelings of the part of the patient’s mind that is critical or hateful toward the patient, such as a sadistic superego. The purpose of the intervention is to both externalize the self-attacking part and to stimulate a rebellion against its tyrannical hold on the patient’s functioning. In mirroring, on the other hand, the analyst experiences the patient’s feelings of being attacked and criticized. When she communicates to the patient that she is just like her, she is attempting to draw the fury of the attacking part of the patient’s mind toward her for being as deficient as the patient’s own ego.

I once worked with an eight-year-old girl who constantly criticized herself, for example. She would color in a drawing and then attack herself for making a bad drawing, calling herself stupid. I felt extremely stupid as I witnessed this because her drawings were actually much better than anything I could do, and I didn’t seem to be much of an analyst for her either, as none of her problems seemed to be getting any better. I mirrored her by also coloring a drawing and doing the same thing she did - attacking myself for making a bad drawing and calling myself stupid. In other words, I was just like her - except maybe a little worse. Over a period of a couple of sessions, she began to tell me that I was even more stupid than she was, and that her drawings were better than mine. I felt just terrible when she did this. Her criticisms really hurt. But it was worth it; this eventually led to a lowering of her anxiety and getting along better with her mother.

Dystonic mirroring, like dystonic joining, is a complex intervention to use. It is important that the analyst genuinely feel the negative feeling that the patient is attacking and also accept the feeling. For example, if the analyst is mirroring the patient’s feeling of incompetence, the analyst must be able to tolerate the feeling of incompetence without becoming swept away in self attack herself, either as a result of her own feelings or after having been criticized by the patient. In other words, the analyst’s message must be “Yes, it’s true, I’m incompetent. Feel free to attack me, but as far as I am concerned, I don’t object to being incompetent, and I will not crumble under your attack.”

This is important for a number of reasons. First, and perhaps the most basic, the analyst must not allow herself to be genuinely harmed by the patient. She owes it to herself, to her other patients, and to the people in her life to practice in a way that preserves her emotional and physical health.

Second, the patient cannot safely release the rage that is bound up in self attack unless she is sure that the analyst will not be harmed by it. The whole function of one form of self-attack - the narcissistic defense - is to protect the object. Thus, if the object can be harmed, then helping the patient to direct the rage outward may work in the short term, but it will leave the patient feeling horribly guilty and convince her that she is genuinely dangerous and must keep her aggression directed inward.

Third, even those patients who would not be immediately harmed by hurting the analyst are liable to be harmed in the long run by learning from the analyst that it is acceptable to hurt other people with their aggression. While there is a measure of truth in this - all people hurt each other to some extent and must learn to tolerate it - devastating other people with whom they are involved is another matter altogether.

Fourth, the patient may lose confidence in the analytic process as a whole if the can’t withstand the emotions that she has unleashed. The analytic relationship is a partnership, and the analyst must be the driver. It is acceptable for the patient to take over from time to time but not at a moment as intense as this. The patient is liable to leave the analyst in disgust, or stay in treatment out of pity, and neither of these options will do either of them any good.

For all of these reasons, the analyst must be in a strong state of self acceptance and self resilience to weather the storm that may be unleashed by a successful dystonic mirror.

Finally, there is one more way in which dystonic mirroring is related to the patient’s well being. By feeling, expressing, and accepting the feelings that the patient so strongly objects to, the analyst conveys that the feeling, however contemptible it may be, has its place in the spectrum of the human emotions, and this usually allows the patient to integrate it into her own personality in a different way than before.