Heart to Heart: The Associative Pathway to Therapeutic Growth
Language is constitutive of who we are as people. Play between infant and carer has a strong influence on how language is acquired and the way it becomes generative of self. It is the communicative exchanges of life that create one’s sense of self and significance. When individuals enter into “free play” in therapy, they embark upon an associative pathway where distinct associations, emerging from what has been considered the “id”, form the basis of an emergent self, probably mediated by right-hemispherically determined communication. A case vignette illustrates a transition involving a moment of emotional connection, followed by a realization, at a later point in therapy, with discussion of both patient and therapist perceptions of these moments and an illustration of underlying physiology. The importance of right-hemispheric regulation in the psychotherapeutic setting calls for a revision of Freudian notions of primary and secondary process. The affective basis of associational life needs to be seen in a normative, integrative way rather than as an unruly process to be overcome by a rational ego.