The author explores "exile" as both a migratory and psychological phenomenon, with particular emphasis on it as a state of mind-one that, by virtue of the dissociative processes by which it is characterized, forecloses the (psychic) possibility of immigration. From this point of view, an exile is not simply one who cannot (physically) return; she is someone who cannot "remember" other versions of herself, who cannot bridge the gaps between versions of self rooted in disparate times, physical spaces and relationships, who cannot "stand in the spaces" between self-states. With a view of clinical process that forefronts dissociative phenomena in both patient and analyst/therapist, and their enactment in the therapeutic relationship, the author describes various forms of exile that emerged in working with his patient, Maria. He focuses on how, over time, the enactment of negation or "not-ness" (specifically, "not-Germanness" and "not-Jewishness") in the therapeutic relationship catalyzed recognition and negotiation of exiled self-states in both patient and therapist-self-states that could themselves be understood as refractions of transgenerational exile, rooted in the respective (and respectively denied) European heritages of both patient and therapist. © 2010 American Psychological Association.

Migration Exile Dissociation Self-states Enactment

doctor patient relation human cultural factor self concept psychological aspect dissociative disorder psychoanalysis Article psychotherapy interpersonal communication mental health immigration social behavior migration