Correspondence: Etty Cohen, Ph.D., 113 University Place, #1004 New York, NY 10003. e-mail: etty.cohen@nyu.edu

¹Etty Cohen, Ph.D., Faculty and Training and Supervising Analyst at The American Institute for Psychoanalysis of The Karen Horney Psychoanalytic Center and an adjunct professor at NYU Ehrenkranz School of Social Work.

^†A version of this paper was presented at the Division 39 Spring Meeting, Miami Beach, Florida in March 2004 as part of the panel on the traumatizing impact of culture, chaired by Dr. Robert Prince. Theoretical concepts of this paper are discussed in my book (Cohen, 2003).

Abstract

Cultural differences between the analytic dyad can foster powerful transference-counter-transference feelings and potentially promote traumatic re-enactments. Those patients who are more directly affected by traumatic experiences may be able to verbalize what has happened to them only if they are convinced that their analysts are "taking in their horror, holding it for them, responding to it emotionally (reenacting) and giving it back in more modulated and containable" manner (Davies, 1997, p. 24). These mutual enactments that emerge in patients and their analysts can be understood as dissociated self-states. Clinical material is presented from the treatment of an African-American inner-city teenager and an Israeli teenage soldier to illustrate the emergence of enactments and dissociation in patient-analyst dyads.