On Saturday October 5 2013, the Site held a conference on the topic of trauma adding the question: ‘Can’t we just let the past BE the past?’ and then elaborating ‘Why we need to talk about trauma and what might happen if we don’t’. The question of speaking or not speaking about trauma arose throughout the conference, raised in different ways by different speakers, from the therapist whose circumstances led her to tell her patients about a personal trauma, to the image evoked of the space on the wall where a picture used to be. In the first discussion following the first two papers and then again in the plenary at the end, the point was made that there had been perhaps an absence within the conference itself, a lack of the speech of our patients, of case studies, of clinical material.


As someone who prefers my theory with an abundance of clinical application attached, I was pleased to hear this raised, especially as it touches on a particular concern of mine about writing or speaking about clinical practice in general, which is how to do it without it being an expropriation of the patient (an issue alluded to in one of the first papers), and a breach in the confidentiality of the clinic. And yet not to speak of the work is to risk rendering psychoanalytic conferences a predominantly academic discourse stripped of the very thing that most of us are spending our working lives doing – hearing the voices of human suffering and in very different language from that used in a conference setting.


This is a problem of ethical practice and is true of all psychoanalytic conferences. But it is also worth wondering whether it was a particular feature of this particular conference, and its topic of trauma, as was suggested by the questioner at the end who thought this conference was particularly lacking in clinical material. The sub-title said that we need to talk about trauma but maybe we didn’t quite, and the question is what might happen if we had done.


So part of my response to the conference is a desire to speak from a more clinical perspective. I have worked with people who have experienced prolonged childhood trauma which is re-experienced through flashbacks and nightmares – not uncommon phenomena of trauma. What I have noticed, and often only retrospectively, has been a reluctance on my part to bring this work to supervision, or even to my own therapy, to speak of it to anyone outside the room, despite being aware of it having quite a profound impact on me, leaking into my psyche (to appropriate a metaphor used by Dorothee in her paper). On one occasion, having finally brought a piece of work to supervision, I was advised to focus more on the guilt, the sense of agency that my patient felt with regard to what happened, rather than getting too caught up in the horrific dynamic of powerful adult and powerless child. This proved a particularly difficult but also fruitful direction for the work. Whereas the initial speaking about the experience had allowed it to be witnessed, this had actually led to an increase in the symptoms – as if the guilty part was asserting itself as it encountered a listening, and perhaps sympathetic ear. I feel somewhat ashamed as I write the word “sympathetic” as it is not part of my analytic training to be sympathetic but it had been my response nonetheless and a very powerful one. A good reason to avoid the supervision session then, to avoid exposing my own sense of shame and guilt at my un-analytic response.


This sense of guilt was referenced several times in the conference – a subject on which Klein has much to say so perhaps it was not as surprising as it first appeared to have a keynote speaker at a Site conference speaking in Kleinian language. The funny thing about guilt is that whereas Klein may put it together with the notion of reparation; in everyday language it is often spoken of with the notion of pleasure – “guilty pleasures”, naughty but nice, something enjoyed but forbidden, or perhaps enjoyed because it is forbidden. This point was alluded to in the introduction to the conference by Val, speaking about the public appetite for trauma, in the days of rolling 24 hour news. And if it is part of the public’s appetite, why not ours too, the guilty pleasure of the consulting room, to be privy to the worst of human depravity, whilst protected by the boundaries of the clinic and of course by language? Because whilst Lacanians will speak of the trauma that is language, they also acknowledge that by always missing the mark, by never being able to symbolise the Real, language could also protect us from trauma, from encountering it too much.


To imply by my questions and responses to my patient that I was accepting their sense of guilt in the matter felt profoundly uncomfortable, but his sense of relief that it could be heard was also profound, more so I think than the relief at being able to speak of the events in the first place. So the past events may be in the past, but what haunts the psyche is the guilt and shame associated with trauma, the shame of what it exposes, the guilt that we are not who we want to be, and that our pleasures can be very guilty indeed is what makes them so unspeakable. As so often in the clinic, maybe it was as much what was not said as what was said that calls our attention.