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“Constitutive-intervention”– structuring primal psycho-physical space

ABSTRACT This paper describes a specific type of therapeutic intervention relevant to therapeutic communication with patients exhibiting non-symbolic autistic defenses or traumatic characteristics. The paper focuses on clinical manifestations of developmental deficiencies and communication problems that stem from a primal psychophysical space that is unmatured, traumatized, deformed and/or chaotic. The concept of the body-container is presented as a proto-scheme of primal psychophysical space, organizing the intersections of one's anatomical structure and potentials for intersubjectivity. This conceptual context allows the therapist to conceive the patient's non-representational and non-communicative physical actions in the therapeutic setting as presence-in-action. Such presence is discussed as a crucial invitation for the emergence of the therapist's intuitive pre-symbolic creativity, which may eventually crystallize into a perceptually-presented 'constitutive intervention'. This unique kind of intervention is designed to support the patient's creative capacity for pre-symbolic realization of this multi-dimensional psychophysical proto-scheme. Various constitutive interventions, utilizing concrete gestures that involve the therapist's body and the physical aspect of the therapeutic environment, are examined theoretically and illustrated through clinical vignettes.