Psychoanalyst Harold Blum on the speechlessness of acute trauma

In the traumatized patient, the capacity to tolerate frustration, to delay action in favor of thoughtful contemplation, to freely verbalize feelings and fantasies with preservation of self-observation and reflection are extremely important.

These skills are important for all analytic work, but they are particularly pertinent in the traumatized patient because the original traumatic situation is always speechless.

Speech is impossible during acute traumatization, and the frozen cognition, the strangulated affects of silence or screams, and the motor tendencies toward flight, fight, or chaotic thrashing all have to be ultimately replaced by verbalization. The fantasies in which the trauma has been embedded, embellished, elaborated, and validated have to be repeatedly verbalized as a central part of analytic work.

— from Blum, H. (1990). The influence of trauma on the opening phase of analysis. In T. J. Jacobs & A. Rothstein (Eds.), On beginning an analysis (pp. 67–81). International Universities Press.