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.     

Finding the Lost Girls: Multiplicity and Dissociation in the Treatment of Addictions

Relational perspectives on the nature of self and the unconscious have transformed how we can understand addictions and substance use problems. Addictions have received little attention in the contemporary literature and therapeutic approaches outside of psychoanalysis have been skeptical of psychoanalytic approaches. It is my contention that viewing substance use problems through the lens of a relational/multiple self-state model offers new clinical possibilities resulting in greater success in treating these patients. In this model, addictive behavior is seen as embedded in dissociated self-states. Therapy focuses on helping the patient to move from dissociation to a true multiplicity and a decreased dependence on substances.     

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.     

Relational Psychoanalytic Perspective on Couples Psychotherapy

ABSTRACT

This places Relational Psychoanalysis within the pantheon of models of couples psychotherapy in psychoanalysis including those from Freudian, Object Relational, Self Psychology, and Intersubjective Systems Theory. Following a brief overview of key ideas pertinent to Relational Psychoanalysis, the article discusses the author’s Six-Step version of a relational psychoanalytic approach to couples psychotherapy.     

“Hall of Broken Mirrors”—Enactment in an Analytic Group of “Difficult Patients”

This article focuses on the transformation of dissociated self-states as a curative factor in an analytic group of “difficult patients.” Foulkes (1964) referred to the analytic group as a “curative hall of mirrors.” I would like to integrate group analytic theory with relational psychoanalytic concepts. I propose that when dissociated self-states are expressed in a group, this creates a “broken mirrors” experience that is sometimes expressed through enactment. I develop this idea, and argue that the group mirrors to the patient his image—distorted and defective—and forces him to cope with his “not me” states. I demonstrate, through three clinical vignettes, how dissociated states hinder the reflective space and create a “hall of broken mirrors” experience. I would argue that in a safe space, the patients’ “not me” states can be transformed, and the hall of broken mirrors can turn into a curative hall of mirrors.     

The session of the two dreams

Abstract :  Through the discussion of the clinical material the author tries to show how numerous aspects of traditional Jungian analysis are close to several theoretical and clinical developments of Relational Psychoanalysis. A short introduction about relational psychoanalysis is given. The relational aspects of Jungian theory and praxis are underlined. If we refer to these theoretical constructs, it becomes possible to work in an original way and think of the clinical setting as different from the classical Freudian one, without abandoning Jungian tradition.     

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.     

The Return of the Dissociated: Discussion

Psychoanalysis and politics intersect variously. Some psychoanalytic writings have critiqued society, whereas others have applied socially critical insights about class and race to illuminate transference—countertransference enactments and other clinical matters. The hegemonic politics of psychoanalysis, less intentional but equally influential, define maturity and mental health by idealizing of some psychological and behavioral traits and some clinical stances (especially authoritarianism), and by demonizing of certain categories of persons (notably nonheterosexuals and people of color), certain types of practice (e.g., social work), and certain sorts of ideas (e.g., that clinical and theoretical practices are political practices, too). One way to redress these problems is to reclaim the marginal—homosexuality and queerness, affect's presence in politics, and the political in the psychical (in which instance, the concept of multiple self-states may be useful). Any such effort requires recognizing and articulating one's own subject-position, that is, one's own class, race, gender, or sexual location.     

Metaphoric structuring: understanding time through spatial metaphors

The present paper evaluates the claim that abstract conceptual domains are structured through metaphorical mappings from domains grounded directly in experience. In particular, the paper asks whether the abstract domain of time gets its relational structure from the more concrete domain of space. Relational similarities between space and time are outlined along with several explanations of how these similarities may have arisen. Three experiments designed to distinguish between these explanations are described. The results indicate that (1) the domains of space and time do share conceptual structure, (2) spatial relational information is just as useful for thinking about time as temporal information, and (3) with frequent use, mappings between space and time come to be stored in the domain of time and so thinking about time does not necessarily require access to spatial schemas. These findings provide some of the first empirical evidence for Metaphoric Structuring. It appears that abstract domains such as time are indeed shaped by metaphorical mappings from more concrete and experiential domains such as space.     

Daniel Stern: Microanalysis and the Empirical Infant Research Foundations

ABSTRACT

Daniel Stern changed the face of psychoanalysis, as well as that of infant research. He was a brilliant, innovative, and playful thinker. Psychoanalysis particularly values his contributions on the relevance of infant research to adult clinical practice and theory, for which he is best known. But this work has its foundation in his early empirical infant research, which is less well known. I believe that a better appreciation of the original empirical basis of his work using microanalysis will deepen our appreciation of his later thinking.

In this article I return to the beginning of his work, using frame-by-frame microanalysis of film and, particularly, his first paper published in 1971. I sketch out some of the important findings and ideas emerging from this paper that continued to influence his thinking throughout his career. This research was conducted in the 1970s, the period in which I worked with him directly.     

Regression,Dissociation, Self-States,and the Developmental Dimension in Therapeutic Action

The concept of regression is at the core of psychoanalytic accounts of what goes on in analysis. It is, however, so “in our bones” that we are tempted to overlook it. In its justifiable enthusiasm of theories of self-states and dissociation, Relational psychoanalysis may be underemphasizing how much regression—both to earlier developmental stages and less organized modes of experiencing—is central in our approach to therapeutic activity and mutative action. In responding to Rina Lazar’s analysis with Sheli, I call for enhanced attention to the most powerful Freudian ideas from the new intersubjective perspectives.     

Framing Further Considerations: Reply to Commentaries by Philip Bromberg and Glen Gabbard

This response to discussants Philip Bromberg and Glen Gabbard explores the relevance of a self-state perspective to my reflections (2007) on the benefits of reconsidering traditional recommendations regarding an analytic frame. The clinical and theoretical implications of Bromberg's view that the shifting choreography of a multiplicity of self-states of analyst and patient, in collision and negotiation, are implicated in the structuring and resructuring of an analytic frame, are considered. I also explore Gabbard's perspective that analysts' reliance on traditional, rigid constructions of an analytic frame no longer characterizes most contemporary work. Although I agree that relational contributions to psychoanalysis have become increasingly well established and that our more traditionally trained colleagues are beginning to grapple with and even integrate them to some degree, I nevertheless suggest that many of the traditional ways of defining and structuring a psychoanalytic frame continue to exercise a strong atavistic influence on training, practice, and the very definition of psychoanalysis.     

Neuroscience,mind and meaning: an attempt at synthesis in a Relational Affective Hypothesis

This paper sets out a falsifiable Relational Affective Hypothesis, describing a neurological and relational pathway, through which affect and sensations arising from the interior of the body are translated, in a relational context, into language and a capacity for symbolisation. It describes the role of psychodynamic defences in narcissistic disorder, which can result in collapse in the function of this pathway. The hypothesis arose from clinical psychodynamic work with patients with severe and complex narcissistic disorders. They are characterised as severe, because they are at high risk of completed suicide and so are commonly treated in locked units, and complex because of their anorexic and bulimic eating patterns, tendency towards somatisation and the co-occurrence of autistic difficulties. A more or less profound failure of symbolisation is a feature common to these presentations. This interdisciplinary thinking offers a perspective on brain and psychological development, taking into account the complex interplay between genetic, environmental, relational and dynamic influences. It can be tested empirically and has implications for psychoanalytic thinking, psychiatry and neuroscience.     

Data In Search Of A Principle: A Review Of Relational Frame Theory: A Post-Skinnerian Count Of Human Language And Cognition.

Responding to derived relations among stimuli and events is the subject of an accelerating research program that represents one of the major behavior analytic approaches to complex behavior. Relational Frame Theory: A Post‐Skinnerian Account of Human Language and Cognition (Hayes, Barnes‐Holmes, & Roche, 2001) offers a conceptual framework for this work and explores its implications for verbal behavior and a variety of other domains of complex human behavior. The authors dismiss Skinner's interpretation of verbal behavior as unproductive and conceptually flawed and suggest a new definition and a new paradigm for the investigation of verbal phenomena. I found the empirical phenomena important but the conceptual discussion incomplete. A new principle of behavior is promised, but critical features of this principle are not offered. In the absence of an explicit principle, the theory itself is difficult to evaluate. Counterexamples suggest a role for mediating behavior, perhaps covert, thus raising the question whether a new principle is needed at all. The performance of subjects in relational frame experiments may be a mosaic of elementary behavioral units, some of which are verbal. If so, verbal behavior underlies relational behavior; it is not defined by it. I defend Skinner's definition of verbal behavior and argue that an account of relational behavior must be integrated with Skinner's analysis; it will not replace it.     

Commentary on “Night Cries: A Rural Tragedy” by Tracey Moffatt and Discussion of “States of Exile and Marginalization” by Gillian Straker

This is an excerpt of the work that I presented in Sydney last May at the International Association for Relational Psychoanalysis and Psychotherapy Conference “From the Margins to the Centre: Contemporary Relational Perspectives” in my capacity as discussant of Gill Straker’s work, which included the viewing of the film Night Cries by Tracey Moffatt. I focused on the relationships that are characterized by abuse of power, by inequalities that define interpersonal relationships, and by the type of trauma that ensues from them and on the ways and possibilities to find a way out, a method to reconcile with the victims.     

The relational tradition: landscape and canon

This essay charts the origins, influences, and evolution of the relational tradition in contemporary psychoanalysis. Considering the theoretical and philosophical influences from nineteenth-century Americans like William James and C. S Pierce, and noting the seminal modern work of Steven Mitchell and Jay Greenberg in opening a critique of one-person focused drive theory, the essay follows developments over a quarter century. Hallmarks of the relational approach-social construction, two-person psychologies, multiple self-states, social regulation and construction of identities like gender and sexual orientation, and an evolving theory of clinical practice-are reviewed. New developments in clinical theory, in the study of identity categories, in the work on embodiment and enactment, and in developmental models are also reviewed.     

Truth and Consequence: Alternative Facts and Discordant Realities

The following is an essay in applied psychoanalysis delivered to the International Association of Relational Psychoanalysis and Psychotherapy in June 2018.* In this essay I attempt to apply what we know about the psychological sequelae of childhood abuse and what we know about the conditions necessary for secure attachment to our current political situation.     

Getting in Tune: Songs of My Experience in Psychoanalytic Training

I use the metaphor of music and dance to explore cognitive, affective, and liminal elements of my training experiences in the New York University Post doctoral Program in Psychoanalysis. I highlight experiences with supervisors and patients, which shaped the development of my identity as an analyst, and the emergence of my analytic voice within a relational paradigm.