The Unsayable: The Hidden Language of Trauma


Buy It Now!

‘Remarkable’ work could prompt healthy debate
(March 2008 Issue)

“The Unsayable:
The Hidden Language of Trauma”
By Annie G. Rogers, Ph.D.
Ballantine Books
New York, N.Y., 2007

By Paul Efthim, Ph.D.

One of the most important books about psychotherapy to come along in recent years, "The Unsayable" dares us to hear what our patients cannot find the words to say.

Annie Rogers, a professor of clinical psychology at Hampshire College in Amherst, Mass., writes from a unique perspective: after several psychiatric hospitalizations in her late adolescence, she became an acclaimed writer ("A Shining Affliction"), child psychotherapist and Harvard developmental researcher. Her latest book weaves together her hard-won insights from years struggling to recover from her own traumatic past and how these experiences helped her understand and treat sexually traumatized children.

"The Unsayable" somehow manages to do several things remarkably well: Rogers presents a number of stories illustrating how trauma leads to the fracture of language and the encoding of signs and symptoms in the body; she illustrates how a particular form of listening can help patients gain access to what has been unsayable; and she provides a lucid introduction to the obscure terrain of Lacanian psychoanalysis, which grounds her approach.

According to Rogers, the problem with trauma is not so much the abuse itself, no matter how horrible, but the way in which "terror marks the body and then becomes invisible and inarticulate." The unsayable can be found in enactments, in speech, in dreams and in physical symptoms. Even when patients have memories and can relate stories of trauma, there is always something unsayable. The task of the therapist is to help decipher the coded language of the unsayable so that people can use language to make conscious linkages between present and past rather than repeat destructive enactments.

It is a rare treat to encounter such an accessible account of Jacques Lacan's views of language, the unconscious and psychoanalysis. We learn how certain sounds, words, and phrases that are embedded in patients' speech - called "signifiers" by Lacan - can point the way to connections between bodily symptoms and unconscious emotions or beliefs.

Rogers follows Lacanian practice by not interpreting the content of what is said, but rather underscoring signifiers so that patients themselves can make the necessary connections. Rogers uses her personal compelling story of psychosis and recovery through psychoanalysis to begin and end the book. The main chapters present clinical tales of her work with numerous girls and young women who had been sexually abused. The centerpiece of the book is the story of the seven-year therapy of a girl called Ellen, in which Rogers' dedication to the case verges on over involvement but ultimately leads to an astonishing and positive outcome.

Along the way, Rogers illustrates a number of technical traps in therapy, such as answering patients' questions for them or offering reassurance about an unknowable future. Psychoanalysis is presented in an exciting, positive light, as a way of listening to the patient's unconscious without the promise of love, healing, expert interpretation or preventing a crisis.

She argues that the outcomes of Lacanian psychoanalysis are, in many cases, superior to those from more contemporary approaches, including not only CBT but also relational psychotherapies. This could lead to some healthy debate in a field that is deeply ambivalent, if not frightened of working with the unconscious in any direct way.

At once brilliant and vulnerable, Rogers is a master storyteller and teacher. "The Unsayable" was written to be accessible to a general audience but is more directly addressed to those involved in the enterprise of psychotherapy. This book is a treasure that will provide ample stimulation to a broad readership.

Paul Efthim, Ph.D. is a licensed psychologist in full-time practice in Brookline, Mass. He holds faculty appointments at the Massachusetts School of Professional Psychology and the Boston Institute for Psychotherapy.