Spotlight on Psychoanalytic Psychology, V. 27 No. 4

By Louis Rothschild, PhD

For the Spotlight of Volume 27, Issue Number 4 of Psychoanalytic Psychology, I wish to comment on Andrew Harlem’s article, "Exile as a dissociative state: When a self is “lost in transit”" . Harlem sets out to elaborate our understanding of the word exile. His thesis is simple and clear: exile is a state of mind in which dissociation forecloses on the process of immigration. Here he draws upon interpersonal and relational work on pathological dissociation. Exile is shown to be a specific type of psychological immigration in which departure is forced and return is impossible. A crisis of betrayal may be considered characteristic of such an upheaval. Although not referenced in this paper, there is I think a link between what is here and Davoine and Gaudillliere’s  (2004) idea that the exiled exist outside of time, and that this presents a risk for both parties in treatment as it is through crisis that one fights to enter time.

Harlem focusses on a case that he inherited from a therapist who became ill. He describes his own agenda of wanting to bridge disjuncture for this patient. In a Homeric spirit that reminds me of the forgetfulness of Ulysses (Shay, 2002) in Hades, we are shown how his patient’s ease of moving on without comment or apparent attachment is an absence that highlights the work ahead. Here, his therapist’s awareness begins to collide with an additional awareness that his patient who had been living in the United States for ten years does not appear to engage the culture. He describes feeling that she lives in a bubble. Tension mounts as therapist attempts to remember in the face of his patient’s forgetting. He begins to conceptualize an anxious girl starving in this bubble. Further, that the bubble began to form before she was born, with parents who left Germany for another culture, and raised her in a dislocated space. During the course of treatment, she returns for a period to this other country where she was a child and an enactment between German and Jewish selves takes place between therapist and patient over a dropped Internet connection. Soon after, following her return to his consulting room the patient learns that her therapist is Jewish. This leads to a discussion of opposites meeting. In such a meeting, therapy is characterized as an immigration process in which the establishment of links affords migration.

This paper highlights the conceptualization of absence. I am left thinking that although Bion has had much to say on the subject, that Harlem is correct in calling attention to our tendency to listen only for conflict and that the danger in doing so is that we may miss an important silence. This article warrants attention for just this sort of commentary and a well-written and informative case presentation. As I read it, I see different patients that I’m working with. A native New Englander exiled by class and trauma, and two others with roots in other countries one of whom I now meet electronically are in the foreground. There is much here for any clinician working with the dissociation and disavowal that co-occur in trauma, so I recommend clicking on the PDF file in the upper right hand corner of this screen, and spending some time with the article itself.


Davoine, F. and Gaudilliere, JM. (2004). History beyond trauma. S. Fairfield (Trans.). New York, NY: Other Press.

Shay, J. (2002). Odysseus in America: Combat Trauma and the Trials of Homecoming. New York, NY: Scribner.