Commentary on Papers by Burton and Bonovitz

The author probes bastions in Noelle Burton’s and Christopher Bonovitz’s patients’ unsymbolized experience. Bonovitz and his patient were involved in a mutually created phallic collapse, one in which they are unable to use their minds aggressively and vitally to make sense of things together. Bonovitz gained purchase on a set of conspiratorial feelings he had held toward his two analysts, feelings that were enacted with his patient. For Burton and her patient there was a different kind of bastion in which Burton’s wish to know her patient couldn’t be experienced as something other than impingement. The author argues the value of our openness to reverie not only when patients’ have poorly developed capacities for verbalization and symbolization but more generally as a clinical sensibility to cultivate with all patients.     

We: Commentary on Papers by Trevarthen,Ammaniti & Trentini,and Gallese

In my discussion of papers by Trevarthen, Ammaniti & Trentini, and Gallese, I situate their work within an emerging paradigm of intersubjectivity. This new model finds philosophic grounding in the work of the phenomenologists (Husserl, Merleau-Ponty, Nancy) as it draws from the multiple sources that come together to comprise the new field of cognitive and affective neurosciences. These papers hold the potential to make relational psychoanalysis more relational by providing new foundations for rethinking the biological, developmental and clinical. What emerges is an intersubjective theory based in motor action and perception that serves as the embodied basis for human culture and community, a shared “we” space of basic human affinity. I extend this conception into the analytic setting with a brief introduction to enactive participation in clinical process.     

Psychoanalysis and Nature: Commentary on Papers by Bodnar and Santostefano

This is a response to papers by Sebastiano Santostefano and Susan Bodnar. The response argues that the psychoanalytic view of constitutive conflict makes any assimilation of analysis and ecology very problematic. Patients may benefit from being in pleasant surroundings outside urban areas, but this is not psychoanalytic work. Psychoanalysis would entail them coming to understand why they are fueled by desires they do not recognize as their own. It would entail them working through how these desires have come to belong to them. Calling these desires natural or unnatural is not helpful, and it may be pernicious.     

Originality,Dread, and Object Usage: Commentary on Papers by Sarah Mendelsohn and Deborah Dowd

Both Deborah Dowd and Sarah Mendelsohn capture the fraught experience of staying near a patient’s dread. I discuss dread as an engagement with unrepresented trauma. With each case I interpret a critical clinical moment as an instance of Winnicott’s object usage, by which the patient leaves omnipotence and finds externality. I introduce a crucial meaning of object usage that I find only implicit in Winnicott’s text: Not only must the analyst survive the patient’s destructiveness, but the analyst also must be disrupted by the patient’s unrepresented trauma. Their patients’ experience of this disruption positions each of these analysts as an other who can be used.     

Whiteness Uncovered: Commentary on Papers by Melanie Suchet and Gillian Straker

In this discussion of papers by Gillian Straker and Melanie Suchet, the author draws some links between the two papers in the interest of expanding analysts' understanding of the nature of whiteness as part of a racist discourse.     

Reminiscence,Ritual, and Beyond Working Through: Commentary on Papers by Joyce Slochower and by Laura Impert and Margaret Rubin

The author examines, contextualizes, and elaborates upon Slochower's psychoanalytic exploration of commemorative rituals and, more specifically, the Jewish tradition of Yitzor as well as upon Impert and Rubin's understanding of embodied nostalgic reminiscences, considering them within a therapeutic context for the mourner entering into the clinical situation. Slochower's experience with commemorative rituals as facilitating environments for the restoration or support of potential space and memorial activity suggests that they can aid in the re-construction and re-shaping of emotional memory, going beyond a notion of “working through.” Impert and Rubin suggest that generative nostalgic reminisces, a soma-sensory based form of memory that holds the potential for activating arrested mourning, may be clinically usefully in awakening dormant or dissociated grief so that patients can access mourning. Extending upon these contributions, the author further considers the possibility that mourning might be more usefully conceived as processes of transformational work for which a fixed resolution or outcome is neither proscribed nor prescribed. This transformational work may be seen, in part, as ongoing cycles of self-surrender to the mourner's swirling constructions of attachments lost, re-found, re-remembered, and re-conceived.     

Putting Imagination to Work: Commentary on Papers by Kenneth Eisold and Marc Maltz

Writing as one engaged in the enterprise, the author discusses critically the possibilities and limitations of psychoanalytic and post-Jungian theorizing in connection with consultancy work in the field of organizations and corporations. Slippage between the individual and more collective perspectives is inevitable and, though intellectually inadequate, may turn out to be useful. Often in such work, the paucity of many approaches to leadership available to consultants becomes apparent. The author contributes some ideas of his own concerning the “good-enough leader.” In the next section of his response, the author discusses whether these consultancy interventions are of any use or not, and concludes, broadly speaking, caveat emptor. Finally, specific ethical challenges inherent in psychoanalytic consultancy work are identified and explored.     

Age Differences in Affective Well-Being: Context Matters

The study of emotion across the adult lifespan requires an understanding of how life circumstances change with age. With this knowledge, we can predict when age is related to increases in affective well-being and when age no longer confers such benefits. In the current paper, we review research that finds age-related stability and even increases in affective well-being, as well as age-related strengths in several emotion regulation strategies. We introduce the theory of Strength and Vulnerability Integration to predict age-related patterns in emotional experience across the adult lifespan, and to identify situations when age will no longer be related to improved emotion-related outcomes. We suggest that only by understanding the context of daily life can we predict when and how age is related to affective well-being.     

Religious Context Matters: Exploring the Relationship Between Religious Context and Underage Alcohol Consumption

Previous research has demonstrated that individual religious beliefs and practices may reduce the likelihood of underage alcohol consumption, but less is known about how the overall religious cultural influence of a religion may influence individual alcohol consumption behaviors. Using multilevel analyses on two waves of the National Study of Youth and Religion merged with county-level variables from the U.S. Census and the Religious Congregations and Membership Study, we find that a county’s higher Catholic population share leads to more frequent underage drunkenness even after controlling for a wide range of individual and county-level variables. Contrary to other studies’ findings discovered at individual level, a greater population share of conservative Protestants is also linked with higher level of underage drunkenness. This study highlights the importance of viewing religious influence on health behaviors as a contextual, cultural force.     

Visibility and the Stigmatization of Cancer: Context Matters1

Few experimental studies have been conducted to investigate the effect of disease characteristics, such as visibility, on the stigmatization of cancer. The current study tested the reactions of undergraduates to vignettes that manipulated the visibility of cancer and the context in which help was needed by an individual with cancer. Results showed that participants were less willing to help the target individual when the cancer was visible and the context allowed stigmatization to be subtle. Further research should consider the relationships among disease attributes, the specific context where help is needed, and the stigmatization of individuals with cancer.     

Dances of Desire: Commentary on Papers by Dianne Elise and Jonathan H. Slavin

The richness and creativity of early classical work with dreams became narrowed through doctrinaire obedience to Freud's brilliant hypotheses. Interpersonal psychoanalysis, though originally little interested in problems of mind and private mentation, may be well suited, in part due to its lack of a comprehensive dream theory, to a clinical approach to dreams that is relatively open‐minded, pluralistic, complexly layered, collaborative, and playful. Multiple possibilities for the meanings of dreams and multiple ways of approaching dreams in analytic therapy are suggested. Although many therapists for complex reasons shy away from working on dreams, an interpersonal approach recognizes that several wishes of both patient and analyst may be significantly fulfilled in the pleasures of working together on dreams. If it is mindful of what is unfortunately a growing tendency to project into all dreams a single‐minded preoccupation with transference and countertransference, and if it respects the world of dream imagery in its own right, interpersonal psychoanalysis can make a genuine contribution to our understanding of dreams and dreams can lend an important dimension to interpersonal concepts. Several clinical examples are presented in an effort to highlight an approach that “stays with the image”; and allows the dream images to make their way into the psychoanalytic dialogue.     

New Windows on Understanding Addictive Vulnerability: Commentary on Papers by Lisa Director and Noelle Burton

The author discusses papers by Director and Burton, placing their work in a context of contemporary psychoanalytic models for understanding addictive behavior. Whereas early psychoanalytic models stressed drive theory and a topographic model of the mind, the contemporary models discussed here emphasize themes of dissociation—integration, helplessness—omnipotence, self-organization, and relational therapy. The author considers how these modern themes resonate with psychoanalytic formulations of addictive vulnerability that have considered disturbances in affect recognition/tolerance, self-esteem, relationships, and self-care. The author concludes by suggesting that the dyadic paradigms advanced by Director and Burton likely have implications for psychodynamic group treatments.     

Respecting Context to Protect Privacy: Why Meaning Matters

In February 2012, the Obama White House endorsed a Privacy Bill of Rights, comprising seven principles. The third, “Respect for Context,” is explained as the expectation that “companies will collect, use, and disclose personal data in ways that are consistent with the context in which consumers provide the data.” One can anticipate the contested interpretations of this principle as parties representing diverse interests vie to make theirs the authoritative one. In the paper I will discuss three possibilities and explain why each does not take us far beyond the status quo, which, regulators in the United States, Europe, and beyond have found problematic. I will argue that contextual integrity offers the best way forward for protecting privacy in a world where information increasingly mediates our significant activities and relationships. Although an important goal is to influence policy, this paper aims less to stipulate explicit rules than to present an underlying justificatory, or normative rationale. Along the way, it will review key ideas in the theory of contextual integrity, its differences from existing approaches, and its harmony with basic intuition about information sharing practices and norms.     

Disruption and Desire Discussion: Commentary on Papers by Dianne Elise and Jonathan H. Slavin

Dr. Slavin's and Dr. Elise's paper are discussed, with reference to clinical theory.     

The Wisdom of Sharing a Frame: Commentary on Papers by Anthony Bass and Ilana Laor

In this discussion I agree with Anthony Bass, who shows how the analytic frame has properties that involve both the process and the structure, and I suggest replacing the term structure with the term constraints. Bass considers analytic frames as contexts: Different frames organize different contexts of experience. He says that the frame is cocreated by patient and analyst and evolves over time. I think that Dafna's case presented by Ilana Laor is a good example of this aspect. I agree with Laor, who shows how the frame reflects the negotiation process between patient and analyst, emphasizing that this process itself is therapeutic. Following Bass I emphasize that a polarization between stability versus flexibility should be replaced by the dialectic between stability and flexibility. I conclude wondering how Bass's and Laor's “wisdom” regarding flexibility and elasticity can be passed over to younger psychoanalysts who are beginning their clinical work.     

Pina Bausch and the Interweaving of Trauma,Memory, and Creative Transformation: Commentary on Papers by Sarah Mendelsohn and Deborah Dowd

In her “dance-theater” (Tanztheater), Pina Bausch famously instructed her dancers with almost no language, encouraging her dancers to feel their way into the dance, to get in touch with their deepest vulnerabilities. In their papers, Sarah Mendelsohn and Deborah Dowd share with us, their audience, ways in which they, too, struggled to get in touch with their most vulnerable selves. Caught in an unending present with their challenging, traumatized patients, their struggle to locate themselves, and their own vulnerabilities in their patients, to experience the shame of their own childhood trauma, allowed for enlivened creative movement and profound psychic change.     

Psychotherapy Research and Psychoanalytic Practice: Commentary on Papers by Lester Luborsky and Hans H. Strupp

I discuss the views of Lester Luborsky (quite optimistic) and of Hans H. Strupp (less so) concerning the accumulating evidence for the favorable impact of psychoanalytic therapy research, as it has grown over recent decades, in shaping clinical psychoanalytic activity. I offer my perspectives on their views of the issues of (a) the effectiveness of psychoanalytic (psychodynamic) therapies vis-à-vis the varieties of nonanalytically based therapies; (b) long-term (time-unlimited) vis-à-vis short-term (time-limited) therapy, (c) the call for empirically supported treatments (ESTs), (d) the call for randomized clinical trials (RCTs), (e) the trend toward “manualization” of therapy approaches, and (f) the light that all these considerations can cast on the extent to which, and how, psychoanalytic therapy helps.