Affective Relatedness in Stance and Process: Commentary on Papers by Stuart A. Pizer and Barbara Pizer

Although these papers by Stuart and Barbara Pizer might initially seem unrelated, I find in them a deep complementarity, presenting an interlocking approach to analytic stance or attitude and analytic process. Both papers are responses to the totalizing nature of knowing that can reduce our ineffable subjectivity to chattel, to be used as spare parts in the service of avoiding the existential agonies of our own vulnerability in the face of death. I see generous involvement as a contemporary formulation of neutrality and as a necessary foundational stance for an analytic process captured eloquently by the notion of moving feeling forward, a process of de-totalizing, of opening a generous experience of the other as an irreducible mystery.     

The Last Time: Commentary on Paper by Stuart A. Pizer

Pizer presents poetic details of his patient's complex therapy and analysis. This commentary examines one moment in the treatment that may have violated the potential in potential space. The question is raised as to the impact of such a moment.     

Of Innocence and Experience: Commentary on Paper by Stuart A. Pizer

In providing the background to a pivotal session, Stuart Pizer reveals his clinical work as an unsupervised neophyte, prior to his own analysis and analytic training. These early therapeutic efforts were flawed, leaving Pizer at times “grimacing with mortification 26 years after the fact.” But they were also extraordinarily helpful to the patient. Schaffer discusses the challenge of supervising similarly talented beginners: how does one teach psychoanalysis without desiccating a treatment? How does one teach a relational approach, with no “basic model” and few rules, to a beginning analyst infused with an unformulated, yet often passionate, sense of what is “curative”? Pizer recognizes that were he to meet the same patient today, he would not conduct the same treatment. Now trained and analyzed, not to mention more cautious and “worldweary,” Pizer would not do what he did then. But what if he were the supervisor then? Schaffer concludes her discussion by asking Pizer how he, now a seasoned analyst, would supervise his early therapist self.     

About Starr and Aron's Women on the Couch: Commentary on a Paper by Karen E. Starr and Lewis Aron

Karen E. Starr and Lewis Aron's new study of primary sources shows that the idea of the importance of sexuality at Freud's times was broadly promoted by the neurological and medical (hydrotherapeutic, electro-therapeutic, etc.) establishment. This fact opens important new perspectives in the study of an underlying substructure to psychoanalytic thinking (especially the economic discharge model). Many details in this paper make us rethink the factual history of psychoanalytic theory in a new light.     

Narrative Writing and Soulful Metaphors Commentary on Paper by Barbara Pizer

The author posits that Pizer's use of both narrative and lyrical style is not typical in psychoanalysis, whose scholarly tradition tends to favor a denser, more academic style of writing. The ways in which psychoanalysts read these two forms of writing are mirrors of one another. Both kinds of reading are forms of discipline; both forms of writing are necessary in psychoanalysis. The author also writes that Pizer's “nonanalytic third” does not have to be a “good” thing like a poem; it can be almost anything important to the analyst. The nonanalytic third is a soulful metaphor that can be used to create alternatives to rigid experience. Because rigidity in psychoanalytic relatedness is usually the result of problematic unconscious involvements between analyst and patient, the nonanalytic third can be significant in the negotiation of enactments.     

Love Will Do the Thing That's Right: Commentary on Paper by Stuart A. Pizer,Ph.D., A.B.P.P.

In this paper, hope is explored as a motivating force in analysis. To see the patient's and the analyst's hopes in terms of changes they expect the treatment to accomplish emphasizes the cognitive aspect of hope. While touching on these cognitive expectations, this paper focuses on the emotional, rather than the cognitive, function of hope in treatment. It addresses the question of how hope can inspire analytic participants to have the strength and stamina that analysis requires.     

The Sleeping Analyst,The Waking Dreams: Commentary on Papers by Richard A. Chefetz and David G. Mark

The discussion applies the basic psychological concepts of emotion schemas and the referential process to the case material presented by Drs. Richard Chefetz and David Mark. Emotion schemas are types of memory schemas that develop in an interpersonal field. They include subsymbolic processes, symbolic imagery, and linguistic codes, integrated to varying degrees. In treatment both participants come in with their emotion schemas, developed in the course of their lives, activated in the events of the day; communication between analyst and patient occurs on all levels in subsymbolic somato-sensory and symbolic verbal forms. The discussion of Dr. Chefetz's presentation emphasizes the relationships among multiple schemas of self and others, within the patient and between patient and analyst. The discussion of Dr. Mark's three cases focuses on connections and disconnections within the schemas as well as between them and emphasizes the pivotal role of imagery in connecting subsymbolic experience and words, and in the reconstruction of dissociated schemas in the context of the therapeutic relationship.     

It is All Personal: Further Thoughts on Therapeutic Action: Commentary on Paper by Noelle Burton

This paper evolved from an earlier panel presentation on conceptual tributaries to relational thinking at the 2015 International Association for Relational Psychoanalysis and Psychotherapy Conference in Toronto. Representing the place of Object Relations theory in the DNA from which Relational Psychoanalysis emerged, I emphasized—and provide here an abbreviated review of—the contributions of Fairbairn, Klein, and Winnicott. Then, as now, believing in the communicative power of clinical examples, I offer an extended clinical narrative in which the medium is the message and clinical phenomena such as multiple self-states, enactments, negotiation, play, and the residue of internal object relations (in both patient and analyst) are brought to life. Also, as the Toronto Plenary overview paper by Jody Davies has developed into its current substantial elaboration of distinctly relational issues (multiple self-states, co-creation, and the interplay of process and insight) and serves as the capstone paper for this published version of our panel, I respond to Jody’s conceptual contributions and her perspective on Relational thinking.     

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.     

Commentary: Critical Reflections on the Ethical and Professional Considerations in Writing About Clients

From the standpoint of a journal editor and researcher, this commentary critically reflects on some of the primary notions addressed in the 4 featured articles of the special section, discussing areas of agreement and divergence. As a way of further exploring these ethical and professional concerns, the contentious issue of using school children as case studies in publications and in graduate counseling courses is briefly examined.     

Commentary: Writing About Clients: Ethical and Professional Issues in Clinical Case Reports

From the standpoint of a former journal editor and long‐time professional, this commentary challenges the direction of the profession as demonstrated in this special section. The ongoing creation of more and more ethical constraints not only harms the profession but also loses sight of fundamental ethical principles.     

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.     

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.     

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.     

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.     

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.