Field of Vision: Radical Uncertainty and the Analyst's Conduct: Commentary on Paper by Donnel B. Stern

There is a relationship between biography and theory. The analyst's ideas or formulations about his patients—theories really—must be determined, to some degree, by the certain and uncertain impact of his own history. Harry Stack Sullivan brought psychoanalysis squarely into the ambit of the relational/historical world by insisting that the mind is thoroughly and inherently social. In doing so, he staked a claim for the link between history, that is, social experience, and personhood. Our personalities and our theories are social-historical constructions. In relation to this, some differences between the interpersonal/relational and Bionian concepts of field theory are provided. One important difference pertains to the role of the analyst's conduct. Two meanings of conduct—to behave or to organize behavior—are at the center of what distinguishes the interpersonal/relational view of the analyst's position in the field from the Bionian view. For the relational analyst, action in the analytic field, including enactment, is conduct, and conduct is always bidirectional. The analyst, then, is a medium to alter, to reconstruct the self. He does not provide experience, he is experience. The form of an analytic exchange gives shape to the field and its content.     

Field Conditions: Discussion of Donnel B. Stern's Field Theory in Psychoanalysis

In this discussion we applaud Donnel B. Stern for undertaking his rigorous comparison of the “field” concept in interpersonal and relational psychoanalysis (IRP) and Bionian field theory (BFT). Stern offers a balanced presentation of similarities and differences between these two conceptual models, but we focus primarily on certain differences, starting with what we perceive as differing notions of the nature, purpose, and clinical function of the field itself. We distinguish the interactional view of an essentially relational model of the field in IRP (where the clinical aim is to enlarge the domain of the interpersonal dialogue and the capacity for mutual recognition) from the BFT model of a field viewed in terms of emergent phenomena, realized in multiple modalities of experience (here the clinical aim is to expand the scope of contact with unconscious life and to facilitate the capacity to transform emotional, psycho-sensory and proto-emotional experience). We also take up the differing relationships to external reality and authority within these two models, with special reference to the role of the frame in the function of the field.     

Day,Night, or Dawn: Commentary on Paper by Steven Stern

It was in the years immediately following World War II and through the 1950s that the psychoanalytic establishment officially defined psychoanalysis as a subspecialty of psychiatry, and it was in that context of the professionalization of American medicine that they codified the distinction between psychoanalysis and (psychoanalytic) psychotherapy. In this commentary on Steven Stern's “Session Frequency and the Definition of Psychoanalysis,” I deconstruct a series of binaries that was built into the analysis/therapy distinction and that has plagued our discipline. It is argued that psychoanalysis identified itself with the culturally “masculine” and heterosexual values of autonomous individuality (the intrapsychic), while it split off all that was relational and social (interpersonal), marked as “feminine,” homosexual, and “primitive,” onto psychotherapy, which it then devalued. The paper then examines the implications for practice and psychoanalytic education.     

With Respect to the Analytic Frame: Commentary on Paper by Steven Stern

In this discussion of Steven Stern's paper, support is expressed for the position that analysis should not be defined simply by external criteria such as four-times-a-week frequency, but should get its definition from intrinsic criteria. This raises the question, however, of what the intrinsic criteria are understood to be, and what status to accord the fact that certain extrinsic or objective aspects of the clinical framework (a fixed setting, ground rules, prohibitions, and social and legal sanctions) seem non-negotiable, indispensable, and even constitutive of the therapeutic process, as is the analyst's unilateral application of analytic techniques. Note is made of how the paper lacks a rigorous approach to the actual phenomenology of the frame, thus forfeiting a conceptual appreciation of its distinctive structuring role and its complex functionality. In lieu of an adequate exploration of how the frame works in its own right, the paper superimposes a theory-driven and highly partisan position regarding the necessary malleability of the frame, deriving from the belief that everything in the clinical encounter is co-created and negotiated. A critique of this approach is offered, centering on what is seen as an inadequate distinction between structure and process in this model of the clinical encounter.     

The Coparticipant Field: Commentary on a Paper by Juan Tubert-Oklander

Psychoanalytic field theory is integral to relational praxis. In his study of the analytic field and its interpersonal complexities and relational intricacies, Tubert-Oklander emphasizes its clinical promise. Tubert-Oklander's field orientation, however, is a conservative and limited one. This commentary proposes a new, more radical coparticipant theory of analytic praxis.

As a unique form of clinical participation, coparticipant inquiry is marked by an emphasis on patients' and analysts' relational mutuality, coequal analytic authority, and dyadic uniqueness. Coparticipant inquiry represents both a one-person and two-person psychology—an integral of classical individualism and the social emphasis of the interpersonal/relational viewpoint. Coparticipant analysis calls for a new, multidimensional concept of the self that reconciles the seeming paradox that we are simultaneously communal and individual beings—from birth embedded in a series of social field, yet always uniquely individual. This psychoanalytic dialectic between personal, nonrelational selfic “I” processes and an interpersonal “me” pattern brings into relational play such concepts as will, self-determination, and agency. Coparticipation promotesatechnically freer, more self-expressive, and spontaneous inquiryandemphasizesthecurativeimmediacyofnewrelationalexperience.

I have believed for a long time that human

nature is a reciprocity of what is inside the skin

and what is outside; that it is definitely not

“rolled up inside us” but our way of being one

with our fellows and our world. I call this field

theory.

—Gardner Murphy     

Reply to Commentary by Daniel N. Stern

I respond to Stern's largely affirming discussion by fleshing out a few points, for example, improvisation is more than just being spontaneous, it is ensemble work that plays off and with patterns emergent in the personalities of both parties. These patterns illuminate something about the unconscious of each from which blossom things heretofore unimagined or unarticulated. Several principles are then emphasized: First, improvisational moments arise when the “characters” in the moment draw from something real within themselves along with who they are inducing one another to become. Second, the cultivation of play in improvisation lends itself to putting to rest the myth of the perfectly analyzed analyst as not only impossible but as being both unnecessary and undesirable—a seminal point to the entire relational canon. Third, improvisation is a means for putting live flesh on the sterile bones of a host of theories now informing the contemporary psychoanalytic perspective such as chaos and complexity theory, along with dynamic systems theory. I also note that improvisational moments exhibit an emerging sense of vitality and a deepened sense of connection between the partners. Their work obtains a greater sense of focus, though not a deliberate focus as that their relational unconsciouses are “directing” them. Improvisational work feels liberating, playful, as well as affirming and recognizing what what each is bringing to their coauthorship. By contrast, when the improvisation fails, it devolves into negative thirdness or one-upsmanship, the qualities of which reflect deadness, avoidance, confusion, constriction of play, and a misrecognition of one another that devolves into a mutual sense of defeat. Responding to Stern's question about posi-traums, I affirm there is a phenomenon in which an entrenched emotional conviction of a patient's can be dramatically altered. This happens when something positive occurs that cannot be assimilated within the patient's intransigently negative belief system such that she must accommodate a new organizing principle, that is, a new emotional conviction to make sense of it. I concede, however, that it may be too soon to tell how much such phenomena penetrate the more physiologically encoded elements of trauma.     

Commentary on Paper by Lawrence J. Brown

Brown's historical overview of post-Kleinian psychoanalysis traces key steps in the evolving and diverse practice of working in the psychoanalytic situation while regarding it as a two-person field. The Barangers' “The Analytic Situation as a Dynamic Field” is central to his narrative. I develop my understanding of the originality of their contribution in theorizing a situational unconscious, and of their continuing relevance for thinking about analytic listening and intersubjective collaboration. Brown presents a countertransference dream of his own along with the dream of a patient as an example of the Barangers' concept of the “shared unconscious fantasy” of the analytic couple. A detailed alternative reading of Brown's clinical vignette reveals an absence of fit with the Barangers' views on collaboration in the analytic situation. Some uses of Bion's “dreaming” and “becoming” are implicitly questioned as they risk encouraging the idealization of special states over process.     

Commentary on Paper by Philip A. Ringstrom

When we feel overwhelmed by an inescapable threat, we “identify with the aggressor” (Ferenczi, 1933). Hoping to survive, we sense and “become” precisely what the attacker expects of us—in our behavior, perceptions, emotions, and thoughts. Identification with the aggressor is closely coordinated with other responses to trauma, including dissociation. Over the long run, it can become habitual and can lead to masochism, chronic hypervigilance, and other personality distortions.

But habitual identification with the aggressor also frequently occurs in people who have not suffered severe trauma, which raises the possibility that certain events not generally considered to constitute trauma are often experienced as traumatic. Following Ferenczi, I suggest that emotional abandonment or isolation, and being subject to a greater power, are such events. In addition, identification with the aggressor is a tactic typical of people in a weak position; as such, it plays an important role in social interaction in general.     

Commentary on Paper by Ellen F. Fries

In Perchance to Sleep: Minding the Unworded Body in Psychoanalysis, Ellen F. Fries masterfully articulates the complexities of right-brain to right-brain, body-to-body interactions between herself and her patient. Her work highlights the dominance of the nonverbal implicit self over the verbal, explicit self and provides an excellent example of clinical work in which she thoughtfully attends to the unspoken, bodily based communication that takes place within the therapeutic dyad. In this discussion, I offer perspectives from Sensorimotor Psychotherapy on the impact of early attachment on the procedural organization of action sequences that reflect and sustain the implicit self, and embody unconscious relational expectations. The following topics are addressed: (a) Physical actions that provide avenues of exploration into the implicit self, especially actions such as reaching out, making eye contact, or maintaining an upright posture that are abandoned or distorted when they are ineffective in eliciting the desired response from attachment figures; (b) Body-oriented interventions that target the involuntary physical spasms that Fries' patient experiences, which are associated with unresolved physiological arousal originally stimulated in the face of trauma; and (c) The nonverbal manifestation and negotiation of enactments that emerge from the body-to-body dialogue between the implicit selves of patient and therapist.     

Search Yourself: Commentary on Paper by Kenneth A. Frank

This commentary has as its point of departure essential questions about selfhood, self-knowledge, and therapeutic action. Frank's contemporary redefinition of “mutual analysis” and its impact on the clinical surround are examined, with a special emphasis placed on the willingness of the analyst to change and grow. The vital role and theme of the analyst's emotional honesty are explored with an eye toward the clinical impact of contextualism, psychoanalytic complexity, and the personal attitudes that inevitably permeate the analytic relationship and its trajectory. This commentary, in concert with Frank's paper, encourages clinicians to embrace a more collaborative, mutually analytic posture in their clinical endeavors.     

Between Subjects: Commentary on Paper by Robert P. Drozek

This commentary on Drozek's paper outlines its key points under 10 headings, looking at various aspects of the intrapsychic and intersubjective elements involved in understanding motivation. There is discussion of issues of autonomy and dignity based upon Kant's philosophy that underpin the paper's assumptions about unconditional valuing of the other as a universal element of intersubjective motivation. In the commentary attention is paid to the role of desire in motivation, as well as some of the psychoanalytical literature on motivation, including papers by Sandler, Loewald, and Winnicott, some aspects of which connect up with the paper's theses. At various points, some of the clinical relevance of the paper's proposals are brought to light, in particular how the patient may be in a position to use the analyst's interventions as a source of intersubjective motivation.     

Commentary on Paper by Michael Parsons

A range of clinical psychoanalytic approaches in the United States is considered as they may parallel Parsons's presentation of an “independent” orientation in Britain.

Attention is paid in particular to the analyst's sense of outsiderness and concern for otherness, along with their moral implications for clinical work. In addition, the limitations of theory and defensive misuse of theory are also addressed.     

Commentary on Paper by Hilary Hoge

In this discussion the author raises the question of the analyst's freedom to sustain paradoxical viewpoints, specifically with regard to dream interpretation and related links to internal objects and the self as they appear in the transference. Paradox allows for the creation of multiple, coexisting meanings that can be played with by patient and analyst. Paradox also makes possible an experience of decentering and destabilization pursuant to Bion's catastrophic change. The risk inherent in the emotional experience of catastrophic change may limit and at times foreclose both patient's and analyst's freedom to tolerate and sustain the effects of paradox.     

Commentary on Paper by Danielle Knafo

The author discusses the importance of Knafo's rich paper on the often neglected subject of solitude but argues for a clearer demarcation of the multifarious states of aloneness, solitude, loneliness, and isolation. While solitude constitutes a state of plentitude, demonstrating an ability to be alone in the company of an Other, loneliness, in contrast, conjures up a sense of dread and despair, foreseeing no link to an Other. Hence, an artwork can fulfill radically different aspects of the various states of aloneness, it can be a product emerging out of a full sense of solitude, or it can function as a forceful shield against the unbearable sense of loneliness.     

Commentary on Paper by Terry Marks-Tarlow

This discussion of the paper merging and emerging: A nonlinear portrait of intersubjectivity during psychotherapy focuses on how the original paper demonstrates the usefulness of the concepts of nonlinear dynamics systems theory (NLD) to clinical psychoanalysis. Diagnosis conceptualize in NLD terms successfully resists the pressure to reduce complex situations to overly simple few word phrases. The phenomena of transference and repetition are redescribed as resulting from an iterative process that is evident in complex adaptive systems. The model of psychoanalysis in terms of coupled oscillators is demonstrated to be clinically useful as is the concept of emergence which overcomes some of the less useful aspects of the reductionist program. The idea of studying boundaries per se, as opposed to their function of separating individuals, arises naturally from the study of fractals and promises to clarify the oversimplified discussions of these matters in the psychoanalytic literature. The original author has successfully demonstrated how useful NLD conceptualizations can be to the clinical psychoanalyst.     

Commentary on Paper by Debra Rothschild

In my response to this paper, I begin by appreciating Debra Rothschild's relational approach and pointing to the links with our work at the Clinic for Dissociative Studies. For example, we all respond differently to child alters/states than to adult ones, consider the attachment relationship to be the crucial tool, do not like to see distancing mechanisms privileged by abusing the original concept of “neutrality,” and consider honesty and authenticity are essential when working with extreme trauma. In this we agree with Bass (2007) Bass, A. 2007. When the frame doesn't fit the picture. Psychoanalytic Dialogues, 17: 1–27. [Taylor & Francis Online], [Web of Science ®] , [Google Scholar] that one size does not fit all. We consider patients need to choose between integration or separateness. Where integration is sought we speak of “merger not murder.” I express concern at the prevailing idea that a person with Dissociative Identity Disorder needs safety, stabilisation, and symptom reduction initially when the most needy clients are those who will never be safe. I also raise issues around secondary traumatisation to the therapist, the meaning of self-injury, and the language used to describe the angry alter.