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.     

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.     

A Warrior's Stance: Commentary on Paper by Terry Marks-Tarlow

This commentary highlights specific aspects of a psychoanalytic complexity perspective in considering and discussing Terry Marks-Tarlow's article, “Merging and Emerging: A Nonlinear Portrait of Intersubjectivity During Psychotherapy.” The advantages of a complexity theory sensibility reside in the areas of (a) providing a robust theoretical framework for understanding the sources and phenomenology of complex emotional life and (b) understanding the clinical implications of thinking through a complexity theory lens. The latter involves examining the attitudes that emanate from such a revolutionary perspective and their impact on the therapeutic relationship and on therapeutic action and change. Special emphasis is placed on the distinction between two vital dimensions of psychoanalytic discourse: the phenomenological and the explanatory. This distinction is used as a lens through which the author considers the essential themes of understanding the complexity of the multiple sources of personal lived experience and their concomitant meanings, personal situtatedness (or “thrownness”), emotional responsibility, and personal freedom.     

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.     

Apparitions in the Fog Commentary on Paper by Adrienne Harris and Barbara H. Gold

Although an intersubjective analytic approach reflects postmodern concerns about the problems associated with authority and influence, it does not altogether escape them. Interpreting subjective states invokes a veiled analytic authority, and labeling them as dissociative creates a pathway for the influence of questionable assumptions about the origins of dissociation as a defense against trauma. Harris and Gold's paper can be used to illustrate these ideas.     

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 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.     

Psychotherapy Research and Psychoanalytic Practice: Commentary on Papers by Lester Luborsky and Hans H. Strupp

I discuss the views of Lester Luborsky (quite optimistic) and of Hans H. Strupp (less so) concerning the accumulating evidence for the favorable impact of psychoanalytic therapy research, as it has grown over recent decades, in shaping clinical psychoanalytic activity. I offer my perspectives on their views of the issues of (a) the effectiveness of psychoanalytic (psychodynamic) therapies vis-à-vis the varieties of nonanalytically based therapies; (b) long-term (time-unlimited) vis-à-vis short-term (time-limited) therapy, (c) the call for empirically supported treatments (ESTs), (d) the call for randomized clinical trials (RCTs), (e) the trend toward “manualization” of therapy approaches, and (f) the light that all these considerations can cast on the extent to which, and how, psychoanalytic therapy helps.     

Putting Imagination to Work: Commentary on Papers by Kenneth Eisold and Marc Maltz

Writing as one engaged in the enterprise, the author discusses critically the possibilities and limitations of psychoanalytic and post-Jungian theorizing in connection with consultancy work in the field of organizations and corporations. Slippage between the individual and more collective perspectives is inevitable and, though intellectually inadequate, may turn out to be useful. Often in such work, the paucity of many approaches to leadership available to consultants becomes apparent. The author contributes some ideas of his own concerning the “good-enough leader.” In the next section of his response, the author discusses whether these consultancy interventions are of any use or not, and concludes, broadly speaking, caveat emptor. Finally, specific ethical challenges inherent in psychoanalytic consultancy work are identified and explored.     

Context Matters: Commentary on Papers by Aschieri,Chudzik, Evans,and Fantini

This article discusses articles by Aschieri, Chudzik, Evans, and Fantini (this issue) that address cultural considerations in Therapeutic Assessment (TA). The importance of the cultural context in which a TA is conducted is highlighted. Among the themes highlighted are the conceptualization of psychology, and more specifically psychological assessment, as a culture in and of itself and the importance of shame (Aschieri), the way the cultural values influence the practice of assessment (Chudzik), the importance of understanding the meaning of one's experience within their culture (Evans), and the role of subcultural differences (Fantini). The role of culture is seen as an important variable across these articles that explore varied conceptualizations and influences on assessment psychology. Cultural sensitivity and responsivity is seen as a crucial factor in the avoidance of misalliances. The articles in this special section are viewed as important contributions to the TA literature and demonstrate how the TA paradigm can help assessors overcome potential cultural influences that could affect the benefit of a psychological assessment.     

We: Commentary on Papers by Trevarthen,Ammaniti & Trentini,and Gallese

In my discussion of papers by Trevarthen, Ammaniti & Trentini, and Gallese, I situate their work within an emerging paradigm of intersubjectivity. This new model finds philosophic grounding in the work of the phenomenologists (Husserl, Merleau-Ponty, Nancy) as it draws from the multiple sources that come together to comprise the new field of cognitive and affective neurosciences. These papers hold the potential to make relational psychoanalysis more relational by providing new foundations for rethinking the biological, developmental and clinical. What emerges is an intersubjective theory based in motor action and perception that serves as the embodied basis for human culture and community, a shared “we” space of basic human affinity. I extend this conception into the analytic setting with a brief introduction to enactive participation in clinical process.     

New Windows on Understanding Addictive Vulnerability: Commentary on Papers by Lisa Director and Noelle Burton

The author discusses papers by Director and Burton, placing their work in a context of contemporary psychoanalytic models for understanding addictive behavior. Whereas early psychoanalytic models stressed drive theory and a topographic model of the mind, the contemporary models discussed here emphasize themes of dissociation—integration, helplessness—omnipotence, self-organization, and relational therapy. The author considers how these modern themes resonate with psychoanalytic formulations of addictive vulnerability that have considered disturbances in affect recognition/tolerance, self-esteem, relationships, and self-care. The author concludes by suggesting that the dyadic paradigms advanced by Director and Burton likely have implications for psychodynamic group treatments.