Therapeutic Action in the Work of a Playful Clinician: A Reflection on Dr. Silber’s Reimagining of Humpty Dumpty

ABSTRACT

In my discussion of Dr. Silber’s paper, Reimagining Humpty Dumpty: The Therapeutic Action of Play, I mirror Dr. Silber’s playful posture in her use of the Humpty Dumpty fable to talk about children and their care by society. My reflections on Dr. Silber’s therapeutic work with her two young patients focus on her co-creating meaning with each child’s parents as well as with the child. I discuss that by holding in her mind both the subjectivities of the child and his parents, Dr. Silber is able to practice a fundamentally relational therapy. I would have liked to have heard more about her emotional reactions in her work with both cases as another important dimension of her work. Finally, I emphasize through my play with Humpty Dumpty several ways that society can support children and families that are essential for their development: parental leave, developmentally approptiate expectations for children in school, and the facilitation and protection children’s open ended time and ability to play.     

The Analyst as Catalyst: Cultivating Mind in the Shadow of Neglect

I describe an effort to cultivate mind and deepen relatedness in patients who exhibit rudimentary thought and constricted forms of object contact, due to the effects of certain neglect or serious disturbance. Some of these patients require the analyst to serve as a catalyst, who takes proactive steps to summon a psychic realm to the patient’s experience and to forge components of the dyadic bonds that promote such function. The insights of the object relations tradition into foreclosed development are noted. I argue that such insights can be optimally applied with the benefit of the relational school’s emphasis on forms of dyadic engagement and use of the analyst’s subjectivity. In some cases of neglect, and others in which serious developmental challenge is the result of disturbance, priority is placed on the patient’s growth. Similarly, in my case illustration, my goal in using my subjectivity, as a catalyst, is for my patient to take his own emerging mind and psychic self with interest.     

IS JOHN ZIZIOULAS AN EXISTENTIALIST IN DISGUISE? RESPONSE TO LUCIAN TURCESCU

This essay responds to Lucian Turcescu's article, “ ‘Person’ versus ‘Individual’, and Other Modern Misreadings of Gregory of Nyssa”, Modern Theology Vol. 18 no. 4 (October, 2002) in which he argues that John Zizioulas's relational ontology of trinitarian personhood is indebted more to modern personalism and existentialism than to the Cappadocian Fathers. Turcescu's focus on Gregory of Nyssa does not warrant the claim that a relational ontology of personhood cannot be found within the thought of the Cappadocian Fathers. More substantively, Turcescu never addresses Zizioulas's interpretation of the Cappadocian affirmation of the monarchy of the Father, which, I argue, is central to Zizioulas's relational ontology insofar as such an ontology attempts to express the realism of divine‐human communion.     

Relational Psychoanalysis and the Inner Life: Commentary on Cooper,Corbett, and Seligman

Relational analysts know that their experience feels private and contemplative during a significant portion of their working hours. A consideration of the inner life, both the analyst’s and the patient’s, is part of relational praxis. Yet relational analysts also recognize that they are continuously involved with their patients, even at those very same quiet moments. Cooper, Corbett, and Seligman recognize both these parts of relational clinical work and argue that both are necessary. Making this argument explicit is important for its own sake, but also because analysts from other schools sometimes write as if there is no place in relational clinical practice for a quiet consideration of the inner life. Two examples of such criticism are offered, in both of which relational analysts are described as being too focused on social interaction and too little on the inner life. I offer my own version of the kinds of arguments about privacy and contemplation offered by Cooper, Corbett, and Seligman. I then make the case that all psychoanalytic theories come with risks of excess. Relational and interpersonal theories come with the risk of an overenthusiastic embrace of clinical interaction, whereas more intrapsychic theories carry the risk of attending too little to the impact on their patients of present-day relatedness—which is just as likely to have unconscious roots as the inner life.     

An Independent Theory of Clinical Technique Viewed Through a Relational Lens: Commentary on Paper by Michael Parsons

This discussion of Michael Parsons's exposition of the Independent Tradition's clinical theory of technique compares and contrasts the British Independent and American Relational perspectives in regard to their approach to technique. In this discussion I will consider the question whether, given strong object relational influences on relational psychoanalytic theory, we are able to locate systematic differences in the way that Independent and Relational analysts attempt to work, to be with, and to relate to their patients in the psychoanalytic situation. Overlapping historical roots of the two traditions are considered, along with apparent differences in the ways in which the contributions of common ancestors, such as Ferenzci, are applied. I suggest that the integration of American Interpersonal School ideas with Object Relations theory in American Relational Psychoanalysis led to a different therapeutic sensibility, different ways of thinking about and participating in the analytic process from those that are reflected in the Independent Tradition as Dr. Parsons describes it. The discussion includes an imaginative reconsideration of clinical process along relational lines, in an attempt to clarify different emphases in technique between the two schools.     

Vulnerability,Resilience, and Surviving Destruction: Discussion of “The Analyst’s Experience of Trust and Mistrust”

In this response to Danielle Novack’s intellectually astute and clinically rich paper on the “analyst’s trust,” I reflect on the valuable ways in which Novack elucidates this undertheorized aspect of the analyst’s experience and reconfigures trust/mistrust as a meaningful intersubjective dimension of the therapeutic relationship. Novack shows how attending to shifts in trust/mistrust can provide valuable clues for deciphering the transference/countertransference. While I strongly agree with her construction of trust as a psychoanalytic achievement, I question the notion that the analyst’s trust is a necessary condition for her participation. Novack’s work on the analyst’s trust joins a broader contemporary conversation about potential overreaches in the relational paradigm, which I discuss. Finally, I consider the implications of Novack’s work for specifying the factors that underly resilience and engaging a conversation about surviving destruction in contemporary relational psychoanalysis.     

A Journey Toward Wholeness, a Journey to God: Physical Fitness as Embodied Spirituality

Physical fitness expressed through exercise can be, if done with the right intention, a form of spiritual discipline that reflects the relational love of humanity to God as well as an expression of a healthy love of the embodied self. Through an analysis of the physiological benefits of exercise science applied to the human body, this paper will demonstrate how such attention to the optimal physical fitness of the body, including weight and cardiovascular training and nutrition, is an affirmation of three foundational theological principles of human embodiment: as created in the “imago Dei”, as unified body/spirit, and as part of God’s creation calling for proper stewardship. In a contemporary climate where women’s bodies in particular are viewed through the lens of commodification—as visual objects for sale based on prescribed notions of superficial esthetics and beauty—as well as the consistently high rates of eating disorders such as anorexia, bulimia, and obesity, authors Greenwood and Delgado offer a vision of how women and men can imagine a subjective relationship with their own bodies that reflects the abundant love of God for God’s creation. Spoken from the lived experience of professional fitness competitor and trainer, as well as trained biokineticist, Dr. Greenwood presents the most current scientific data in the field of biokinetics that grounds the theological analysis offered by Dr. Delgado, whose personal journey through anorexia and scholarly emphasis on Christian theological anthropology inform this work. Taken together, Greenwood and Delgado suggest a response to God’s love for humanity, including our physical bodily humanity, which entails a responsibility to attend to the physical fitness of our bodies in order to live into the fullness, flourishing and love of God’s creation as God intended.     

Psychoanalytic Companioning

In this paper I offer an integration of object relations and relational conceptions of clinical interaction and suggest a register of psychoanalytic companioning. I suggest that when working with patients and states where there is no self-other definition and therefore no mutuality, the path to healing and growth is via companioning the patient into the darker, more regressed and unformed states of illusion and merger rather than via the promotion of separateness and relatedness, which, I propose, will accrue from within the companioning register. The analyst works from within an unobtrusive relational position. I offer a case example of my work in this register and suggest that this offers a different register of the use of the analyst’s subjectivity: one that is receptive, “cooperative” (Trevarthen) and responsive to the patient’s internal world and objects, rather than analytic and knowing. I consider the dimensions of intersubjectivity that cohere with the dimensions and levels of the patient’s mentalization as outlined by Leciurs and Bouchard (1997).     

Contexts,Polarities, and Pluralism. Discussion of Slochower’s “Going Too Far: Relational Heroines and Relational Excess”

In her searching paper “Going Too Far: Relational Heroines and Relational Excess,” (this issue) Slochower finds the potential for excess as inherent in any psychoanalytic theory. I argue that context is key in understanding this phenomenon within relational psychoanalysis; what she describes may not be the case for other theories. The beginnings of relational theory as a movement, generational and radical, could lead to therapeutic overconfidence or certainty around countertransference insights and disclosures. Slochower sees an abundance of certainty in this stance, as well as pressure for premature mutuality. As a complement or balance to this intense mode of interpersonal engagement, Slochower elaborates her own work on holding, wherein the analyst “brackets” her experience and respects the patient’s need for privacy and nonimpingement. Uncertainty is an affirmative stance in letting the patient’s inner life come into being. There are a number of polarities in Slochower’s paper—between mutuality and privacy, certainty and uncertainty, and in the origin story of relational psychoanalysis between relational and classical theories. I argue that pluralism offers a path forward from polarities to a rich complex world of multiple possibilities and recognition of different minds and theories.     

Egalitarians,sufficientarians, and mathematicians: a critical notice of Harry Frankfurt’s On Inequality

This critical notice provides an overview of Harry Frankfurt’s On Inequality and assesses whether Frankfurt is right to argue that equality is merely formal and empty. I counter-argue that egalitarianism, properly tweaked and circumscribed, can be defended against Frankfurt’s repudiation. After surveying the main arguments in Frankfurt’s book, I argue that whatever plausibility the ‘doctrine of sufficiency’ defended by Frankfurt may have, it does not strike a fatal blow against egalitarianism. There is nothing in egalitarianism that forbids acceptance of the moral platitude expressed in sufficientarianism's positive thesis, (viz., it is morally important that everyone have enough). Nor is there anything in egalitarianism as such that makes it impossible to recognize the banal truth that there are many important things besides equality, and that many dimensions of human affairs are improperly appraised from a relational or comparative point of view. The fact that a relational or comparative point of view is sometimes out of place, however, surely does not mean that it always is. I conclude with the suggestion that egalitarianism is most compelling when it is understood as a normative conception of social relations (rather than, as Frankfurt seems to assume throughout his book, a thesis about the equal distribution of something) and thus presides over precisely those aspects of human affairs for which that relational or comparative point of view is germane.     

MEMORY ALTERING TECHNOLOGIES AND THE CAPACITY TO FORGIVE: WESTWORLD AND VOLF IN DIALOGUE

I explore the impact of memory altering technologies in the science fiction drama (2016–2020) in order to show that unreconciled altered traumatic memory may lead to a dystopian breakdown of society. I bring Miroslav Volf's theological perspectives on memory into conversation with the plot of Westworld in order to reveal connections between memory altering technologies and humanity's responsibility to remember rightly. Using Volf's theology of remembering as an interpretive lens, I analyze characters’ inability to remember rightly while recalling partial memories of their trauma. In virtue of this examination, I contend that memory altering technologies may inhibit individuals from relational processes of healing, such as forgiveness. Consequently, I argue that this study leads to a richer understanding of the potential that memory altering technologies have for undermining humanity's ability to interact in a relational capacity, specifically in terms of forgiveness.     

Porous skin: Breathing through the prism of the holey body

The skin is a body's largest organ and both a metaphor and a materiality. It constitutes a person's exteriority through which and on which social meaning is negotiated and constructed. My contribution challenges the modern idea of the skin's imagined solidity and fixity by returning to an older set of ideas that approach the body as porous, relational, ambiguous and atmospheric. The thought of a body that is open, holey from both the inside and the outside, atmospheric, strikes against culturally constructed and carefully policed myths and norms of groundedness and boundedness. Porosity, however, has not always been feared in that way. My paper explores the ways in which older, speculative thought celebrated the skin's ability to mingle corporally with air, wind and world. This radical openness affectively and materially ‘ungrounds’ seemingly familiar feelings and expectations of order, sense and stability. I wish to retrieve some of this original thinking, which approaches the body not as surface but through its glands, crevices, pores and holes that blur dichotomies of inside and outside. The purpose is to offer an embodied and relational politics that starts from a breathable skin that makes emotion and affect more contingent on the body's holey relationship to air and atmosphere.     

The Analyst’s Generous Involvement: Recognition and the “Tension of Tenderness”

I define the analyst’s generous involvement as inherent to human encounter and a necessary element of therapeutic process. When the analyst’s generous involvement goes missing, it can be read as a sign of disengagement and disconnection. Using as metaphor H. S. Sullivan’s concept of the “tension of tenderness,” I argue that the analyst’s recognition of a need or affect state in the patient evokes an internal tug constituting the analyst’s need to provide for what has been recognized. I elaborate on what the analyst’s generous involvement is, and what it is not, including countertransference pitfalls and corruptions that may masquerade as generosity. I engage a relational conversation with the radical ethical ideas of Emmanuel Levinas. An extended clinical vignette illustrates the challenges and conflicts entailed in the analyst’s finding an analytically useful form of expressing the tug of generous involvement in the immediate moment.     

Psychoanalytic Engagements With Death: Discussion of Martin Frommer’s “Death Is Nothing at All: On Contemplating Non-Existence”

In this discussion, I reflect on some historical, theoretical, and clinical implications of Martin Frommer’s thesis that death anxieties are best navigated via reaffirming attachments with that which is beyond the self. Frommer’s examples of active engagement with his patients in personal modes of discourse about shared existential concerns are considered in terms of the ethics and responsibilities of self-disclosure and the therapist’s own subjective reactions to the death anxieties. Frommer’s contribution is applauded as an exemplar of relational psychoanalytic therapy that incorporates and goes beyond Freud’s formulations of internal processes of identification with the deceased.     

Introduction to Panel: When Relatedness is Damaged or Undeveloped: A New Consideration of the Link between Relational Psychoanalysis and the Object Relations Tradition

In this panel, we introduce two new conceptualizations of the analyst’s role and function designed for work with patients outside the reach of customary modes of engagement. Our approaches to the challenges of such patients draw on the insights of object relations theorists but rely on the relational school’s emphasis on the analyst’s subjectivity and differing forms of engagement. We believe that together our approaches contribute to a broadened bandwidth of relational practice.     

Being and Doing in the Concept of God

In this essay I use the notion of divine values, those values analytically assigned to the concept of God, as a means of understanding replies to criticisms of open theism. I begin by orienting open theism according to the divine values open theist’s embrace within the larger context of relational theology. I then present three criticisms, a theological criticism, a practical criticism and a philosophical criticism and an open theist reply to each. Finally, I attempt to show the underlying motivation which unifies the open theist’s responses and points out where progress can be made in such discussions. This paper was delivered during the APA Pacific 2007 Mini-Conference on Models of God.     

Revisioning Fordham's ‘Defences of the self’ in light of modern relational theory and contemporary neuroscience

This paper explores the evolution of Michael Fordham's ideas concerning ‘defences of the self’, including his application of this concept to a group of ‘difficult’ adult patients in his famous 1974 paper by the same name. After tracing the relevance of Fordham's ideas to my own discovery of a ‘self‐care system’ in the psychological material of early trauma patients (Kalsched 1996 ), I describe how Fordham's seminal notions might be revisioned in light of contemporary relational theory as well as early attachment theory and affective neuroscience. These revisionings involve an awareness that the severe woundings of early unremembered trauma are not transformable through interpretation but will inevitably be repeated in the transference, leading to mutual ‘enactments’ between the analytic partners and, hopefully, to a new outcome. A clinical example of one such mutual enactment between the author and his patient is provided. The paper concludes with reflections on the clinical implications of this difficult case and what it means to become a ‘real person’ to our patients. Finally, Jung's alchemical views on transference are shown to be useful analogies in our understanding of the necessary mutuality in the healing process with these patients.     

A Confucian in Buddhist clothing? – Interpreting Nishida’s conception of the good as a realisation of the Mandate of Heaven

ABSTRACT

In this study, I examine the Confucian influence upon An Inquiry into the Good, the first publication of Nishida Kitarō. Nishida’s student Kōsaka Masaaki depicts his mentor’s conception of the good in terms of realising the 'Mandate of Heaven'. Taking this to be indicative of the importance of Confucianism for Nishida’s early thought, I compare his philosophy of pure experience and ethical project of ‘self-realisation’ with corresponding ideas found in the Confucian corpus. I especially focus on the Great Learning and Doctrine of the Mean as interpreted by the Neo-Confucian Wang Yang-Ming. This study builds upon the pioneering work of Michel Dalissier, Dermott Walsh and David Williams on the Kyoto School and Confucianism. My portrayal of Confucianism is indebted to the ‘philosophical’ translations of Roger Ames, David Hall and Henry Rosemont, Jr., which bring into relief the tradition’s ‘relational ontology’ that Graham Parkes teaches is shared by the Kyoto School.