Mutuality*

Ferenczi’s striving for mutuality, a call which Freud didn’t take up, let him explore this concept with his analysands. He thus became the originator of mutual analysis, although with caveats, and of the concept of introjection, another important Ferenczian notion. The analyst’s attitude of knowing the ‘objective’ and independent Truth is changing its orientation into that of a co-construction in the analytic work; here the analyst and the analysand build a third internal world, which they share and which remains their own. Clinical vignettes illustrate the implications of these views.     

The Evolution of Mutuality in the Resolution of Transference

The American Journal of Psychoanalysis -     

Mutuality Relations,Observation, and Intentional Constraints

This commentary focuses on the implications of Stoffregen's (target article, this issue) theory, as they apply to current research on human biological motion. We take up his suggestion that affordances, not events, are perceived and that data generated within event-perception research may reflect conversion of affordance-based perception to "event-based scales." Research on point-light walkers has been classed with event perception; however, results from our current research on perception of point-light sports displays suggest that accurate detection of humans and their actions in these displays may be controlled by complex relations better explained within an affordance-based account. We report the results of an experiment that controlled the presence and absence of relations between biological motion and a discrete environmental object. Detection was best when these affordance-relevant relations were available. Finally, we consider the utility of Stoffregen's ontological distinction as it may inform our understanding of past, current, and future research on perception of point-light walker displays.     

Mutuality of commitment in romantic relationships: Exploring a dyadic model

On the basis of the interdependence and interpersonal perception literatures, this article advanced and tested a dyadic model of mutuality of commitment. It is argued that mutuality of commitment is composed of 4 perceptions (i.e., A's self and other perceptions, and B's self and other perceptions) and 4 types of interconnections among the perceptions (i.e., actual, assumed, empathic, and reciprocal mutuality). Evidence for the presence of the 4 types of mutuality of commitment was found in a sample of 121 romantically involved couples. Furthermore, in several situations the perceptions and types of mutuality had significant associations with people's perceptions of relationship quality. Each of these results is discussed, as well as the utility of the new conceptualization of mutuality of commitment.     

Mutuality and reciprocity in the psychological contracts of employees and employers

The authors assessed the joint perceptions of the employee and his or her employer to examine mutuality and reciprocity in the employment relationship. Paired psychological contract reports were obtained from 80 employee-employer dyads in 16 university-based research centers. On the basis of in-depth study of the research setting, research directors were identified as primary agents for the university (employer) in shaping the terms of employment of staff scientists (employees). By assessing the extent of consistency between employee and employer beliefs regarding their exchange agreement, the present study mapped the variation and consequences of mutuality and reciprocity in psychological contracts. Results indicate that both mutuality and reciprocity are positively related to archival indicators of research productivity and career advancement, in addition to self-reported measures of Met Expectations and intention to continue working with the employer. Implications for psychological contract theory are presented.     

Evaluating pediatric psychology consultation services in a medical setting: An example

We examined the nature of referrals to a health center-based pediatric psychology service from 1990 to 1993 and assessed the satisfaction of health professionals with these services. Archival evaluation of 1467 records showed that over half of the consultation requests came from general pediatrics, pediatric neurology, and surgical services and that 70% of the psychological services were delivered on an outpatient basis. The most frequent referrals were for cognitive/neuropsychological evaluation and externalizing behavior problems. Pediatric psychology trainees were involved in 94% of the consultations. Survey of health professionals (n = 143) indicated very high overall satisfaction with the quality of services delivered. Presenting problems yielding the greatest likelihood for future consultation requests were behavior problems, child abuse, coping with illness, and depression/suicide. Results are discussed in the context of previous evaluations of pediatric psychology services and recommendations for future evaluation research.     

The co-therapy relationship: Mutuality,agreement and client outcome

This project, utilizing a pretest and posttest design, studied interactions between co-therapists and the relationships of their interactions to client outcome. Six co-therapist pairs at a counseling center saw two clients in multiple treatments yielding twelve cases. The study investigated co-therapist relationships in regard to: (a) their level of mutuality or caring for their partners, (b) their ratings of the quality of their relationships, and (c) their agreement as to perceptions and behavior during sessions. Also investigated were: the relation of co-therapist interaction to client outcome and the personal growth of the therapists over the course of therapy. Results supported success claims of the literature concerning co-therapy.     

Mutuality: Clinical and Metapsychological Potentials of a Failed Experiment

Ferenczi's experiments with mutual analysis are often dismissed, without acknowledging the results obtained from them and his own cautionary remarks about their limits. Though ultimately failed, Ferenczi's experiments with mutual analysis were a source of clinical and metapsychological knowledge, despite the fact that he was unable to elaborate them in his lifetime. In this paper I connect mutuality to the development of the psyche, especially to the constitutive core of the intrapsychic. To understand the latter, it is necessary to take into account, among others, issues such as the common attribute, the mutual flux between the unconsciouses, the dialogue of unconsciouses, the maternal profundity, the primal relationship with the mother, and, above all, the primal unity between mother and child, which are fundamental for the emergence and development of the primary psychic forces. Incidences of rupture, distortion of the core of mutuality in the psychic life, its loss and disadjustment, by means of external traumatizing forces, and some clinical implications are described.     

Somatization, psychiatric disorder, and stress in utilization of ambulatory medical services

Examined the prediction from Mechanic's (1972) attribution theory of somatization that somatizers who are under stress will overuse ambulatory medical services. Two hundred fourteen volunteer patients from university ambulatory care clinics completed the Diagnostic Interview Schedule and the Life Experiences Inventory. We examined somatization, psychiatric diagnoses, and life stress-and the interaction of these factors-in predicting frequency of medical visits during the preceding year, after controlling for need (active medical problems) and predisposing factors. As hypothesized, life stress interacted with somatization in predicting number of medical visits; somatizers who were under stress made more visits to the clinics than did nonsomatizers or somatizers who were not under stress. Although stress affected somatizers most, stress was predictive of increased medical utilization for all patients. These results suggest that psychological services intended to reduce overutilization of outpatient medical services might best focus on stress reduction and be most beneficial to somatizers.     

How Change Happens: Controlling Images,Mutuality, and Power

SUMMARY

Change is inevitable but it can go in a positive direction toward growth or in a negative direction. Extending Patricia Hill Collins' concept of controlling images (2000), we can see how these images interact with relational images and strategies of disconnection to obstruct growth on both the societal and the personal level. In therapy, change is defined as movement-in-relationship toward better connection; and increased connection leads to growth. Several aspects of therapy that lead to deeper and wider connection are explored, especially increasing the patient's power. Prior versions of parts of this article were presented at the Jean Baker Miller Summer Training Institutes in 2001 and 2002 and at the 2002 Learning from Women Conference sponsored by the Jean Baker Miller Training Institute and the Harvard Medical School/Cambridge Hospital in Boston, Massachusetts.

As therapists, we're “in the business” of change–change for the better. That's our goal. Another word for change for the better is growth. Change is the essence of life. It is most obvious in children but it is a necessity through all of life. Change will occur inevitably but it can go in a positive or a negative direction. Further, I believe change toward growth creates pleasure. We feel most alive and zestful when we are engaged in this expanding activity.     

Innovation by a family medical practice to provide infant mental health services

The authors suggest that infant mental health principles have practical applicability to the daily lives of families with babies, and they offer one approach to making such application in a private practice. It is suggested that combining psychiatry, family medicine, psychology and nursing may make for a particularly well integrated team that has greater capability than each of its members has alone. Finally, thoughts are offered about the usefulness of research in a private setting, and the economic viability of this kind of practice is discussed.     

Gender Symmetry and Asymmetry in Violent Relationships: Patterns of Mutuality Among Racially Diverse Women

Three patterns of mutual intimate partner violence (IPV) are proposed, based on frequency and severity: Male primary perpetrator (MPP), female primary perpetrator (FPP), and symmetrical (SYM). Patterns and effects of ethnicity were examined with 445 African American, Euro-American, and Mexican American low-income women experiencing mutual IPV. More relationships were classified as MPP (54%) than SYM (35%) or FPP (11%). Comparing women's and men's perpetration of several types of IPV (e.g., threats, severe physical) indicated MPP-pattern women experienced all IPV types more often and were more likely to sustain injury than their male partners. Fewer gender differences were found in the FPP pattern. Racial/ethnic groups were more similar than different; previously reported differences may be explained by variation in socioeconomic status. The larger part of the study was funded by grant R49/CCR610508 from the National Center for Injury Prevention and Control of the Centers for Disease Control and Prevention, awarded to the third author. This article was also made possible by grant 2001-WT-BX-0504 from the National Institute of Justice awarded to the first and third authors. These agencies are not responsible for the results. Portions of this paper were presented by the first and third authors at the International Family Violence Conference in Portsmouth, NH, July, 2003.     

Hope and Dread in Mutuality and Asymmetry Regarding the Analytic Setting: Reply to Commentaries

The challenging commentaries to the discussion on the analytic setting help to clarify the various meanings this concept have to us as analysts, supervisors, theoreticians, and members of the analytic community. This sharing of our thoughts, experiences, and feelings helps refine the dilemmas we share as relational analysts regarding the setting as structure or as process. As I see it, the challenge of being a relational analyst lies in the tension between affording mutuality while retaining the asymmetry that enables a deepening of the mutuality regarding the analytic setting.     

The Mutuality of Change and Personal Growth in Analytic Relations: Commentary on Paper by Lauren Levine

This discussion explores the ways in which the multiple roles that analysts assume in their training years and beyond (analyst, patient, supervisor, supervisee, student, and teacher) are complementary and mutually enhancing. I suggest that our patients' personal growth, expanded and enhanced sense of self, and healing of old wounds are integrally linked to our own. Our work with our patients informs our personal analytic work, which expands our work with patients, deepening our capacity for knowing ourselves and others, in a continuous mutually enriching loop of psychoanalytic exploration.     

Group identification and self-efficacy associated with quality of life in emergency medical services volunteers: A cross-sectional investigation

Volunteering in emergency medical services (EMS) plays a fundamental role in the improvement and maintenance of collective and community health. However, this work often requires rescuers to deal with very stressful situations with consequences in terms of decreased quality of life and psychological well-being. The aim of this work was to analyze the resources that can be positively associated with volunteers’ quality of life. In particular, based on social identity and social cure approaches, we tested the effect of self-efficacy and identification with a volunteer category on both positive and negative aspects of the volunteers’ professional quality of life. A self-report questionnaire was administered to 203 EMS volunteers (53.7% men) from a large nonprofit volunteer association. Results are mostly supportive of predictions from the social identity (and specifically the “social cure”) approach, and show that professional identification and self-efficacy were differently linked to the dimensions of the volunteers’ quality of life. More precisely, professional identification was negatively associated with burnout and positively associated with compassion satisfaction, and both effects were mediated by self-efficacy. On the contrary, self-efficacy and volunteer identification were not associated with secondary traumatic stress. Practical implications for volunteers’ wellbeing are discussed in the light of the policies of volunteer associations to improve collective resources.     

A Meta-Analysis of an Implicit Measure of Personality Functioning: The Mutuality of Autonomy Scale

The Mutuality of Autonomy scale (MA) is a Rorschach variable designed to capture the degree to which individuals mentally represent self and other as mutually autonomous versus pathologically destructive (Urist, 1977). Discussions of the MA's validity found in articles and chapters usually claim good support, which we evaluated by a systematic review and meta-analysis of its construct validity. Overall, in a random effects analysis across 24 samples (N = 1,801) and 91 effect sizes, the MA scale was found to maintain a relationship of r =.20, 95% CI [.16,.25], with relevant validity criteria. We hypothesized that MA summary scores that aggregate more MA response-level data would maintain the strongest relationship with relevant validity criteria. Results supported this hypothesis (aggregated scoring method: r =.24, k = 57, S = 24; nonaggregated scoring methods: r =.15, k = 34, S = 10; p =.039, 2-tailed). Across 7 exploratory moderator analyses, only 1 (criterion method) produced significant results. Criteria derived from the Thematic Apperception Test produced smaller effects than clinician ratings, diagnostic differentiation, and self-attributed characteristics; criteria derived from observer reports produced smaller effects than clinician ratings and self-attributed characteristics. Implications of the study's findings are discussed in terms of both research and clinical work.