Judicious Self-Disclosure by the Psychoanalyst

One of Sándor Ferenczi's greatest contributions to clinical theory and method is his pioneering concept of analyst self-disclosure. First introduced in his famous paper ?The elasticity of psycho-analytic technique? (1928), analyst self-disclosure changed the nature of clinical interaction between analyst and analysand, from the Freudian model of a surgeon to the responsiveness of an empathic mother. Ferenczi's clinical work with the so-called ?difficult cases? (narcissistic, borderline and psychotic disorders) moved him to discover the ethos of activity within an empathic method. Analyst self-disclosure is one of those responsive measures he developed to address the deficits in communication and interpersonal functioning in trauma survivors. An outline is presented of the ?Confusion of Tongues? which is the model from which self-disclosure is derived. A contemporary extension of this idea is offered in the clinical and theoretical distinction between judicious vs. conspicuous self-disclosure.     

Carl E. Schneider,The Practice of Autonomy: Patients,Doctors, and Medical Decisions

Theoretical Medicine and Bioethics -     

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.     

Motor intentionality and the case of Schneider

I argue that Merleau-Ponty’s use of the case of Schneider in his arguments for the existence of non-conconceptual and non-representational motor intentionality contains a problematic methodological ambiguity. Motor intentionality is both to be revealed by its perspicuous preservation and by its contrastive impairment in one and the same case. To resolve the resulting contradiction I suggest we emphasize the second of Merleau-Ponty’s two lines of argument. I argue that this interpretation is the one in best accordance both with Merleau-Ponty’s general methodology and with the empirical case of Schneider as it was described by Gelb and Goldstein.

The Elusive Homosexual: A Reply to Stone and Schneider

Summary: In a rebuttal of the Stone and Schneider validation study of the Wheeler signs of homosexuality in the Rorschach, it was argued that (a) homosexuality is not a proper clinical diagnosis, (b) homosexuals do not differ in psychological functioning from hetereosexuals, and (c) the Wheeler signs represent an atomistic approach of use only to those defensive clinicians unwilling to encounter the unique character of their clients.     

The elusive homosexual: a reply to Stone and Schneider

Summary: In a rebuttal of the Stone and Schneider validation study of the Wheeler signs of homosexuality in the Rorschach, it was argued that (a) homosexuality is not a proper clinical diagnosis, (b) homosexuals do not differ in psychological functioning from hetereosexuals, and (c) the Wheeler signs represent an atomistic approach of use only to those defensive clinicians unwilling to encounter the unique character of their clients.