The holding environment and intersubjectivity

The holding environment is explored in the context of the analytic dyad, where it is seen as rooted in the patient's need to be experientially known through the intersubjective interaction. In examining previous emphasis on holding as an optimally attuned empathic environment provided by the analyst, a broadened view of what constitutes a holding environment is presented, underscoring its interactional nature. A distinction is made between empathic holding based on the patient's expressed material, and holding that is generated through the analyst's intersubjective knowledge, gained via ongoing intersubjective engagements and enactments. It is argued that the unmediated connection to the patient's internal representations resulting from these intersubjective interactions, and the ensuing verbal exploration of them, can create a profound sense of being understood and thus held. A clinical process depicting the experience of holding in an intersubjective context is presented.     

Future and potentiality in the psychoanalytic process

A perspective is delineated on the dimension of the future in the psychoanalytic situation. Clinical manifestations are presented of the tension between actuality and potentiality that characterizes the treatment situation. This tension, an aspect of the intersubjective field that exists between patient and analyst, involves the analyst's hopes, expectations, anticipations, sense of purpose, and therapeutic intent, facets of the analyst's subjectivity that affect the clinical process. The question of the patient's individuality and autonomy is raised in the context of the notion of the "true self." To understand potentiality in the clinical situation, it is argued, the intersubjective emphasis on the inevitable mutual influence between analyst and patient must be complemented by a view of the self as emerging from within and gaining coherence through the unfolding of inherent dispositions and potentialities.     

Poetics in the Clinical Encounter

Amidst a mounting impasse, a patient’s startling slip of the tongue opens this analyst to a crucial awareness of her affective experience so that she can begin to reenter her patient’s. The analyst’s openness to her own vulnerability serves to free both participants from collapse into a doer–done-to complementarity. The enactive communication expands the depth of their connection and dis-connection in the moment. Just as a poem says metaphorically what cannot be said in ordinary prose, the slip jolts both participants into more imaginative intersubjective ground that transcends a sense of time and potentiates clinical momentum.     

Faith as the Fulcrum of Psychic Change: Metaphors of Transformation in Jewish Mysticism and Psychoanalysis

This paper examines the role of faith in transformation, proposing that faith, on the part of the patient as well as the analyst, is the turning point of psychic change. It uses the metaphors of transformation of the Jewish mystical tradition as an organizing framework with which to consider the transformational experience within psychoanalytic process and the evolving view within psychoanalysis of the relationship between analyst and analysand as one of asymmetry and mutuality. It posits faith as a mutual yet asymmetrical stance within the psychoanalytic relationship of intersubjective, mutual recognition. In faith, one opens to the possibility of the transcendent Third, an experience of union with a larger whole from which one emerges with a sharper sense of one's authentic truth.     

The Analysis of Preconscious Phenomena and Its Communication

Thoughts and feelings of both patients and analysis may be influenced by perceptions that remain outside of conscious awareness. A preconscious communication exists between patient and analyst. Appreciation of the preconscious elements of communication may enable a better understanding of what may be otherwise experienced as a mysterious occurrence. Transference-countertransference interactions create a place to observe the manifestation of preconscious phenomena. This paper addresses how the analytic method enables the discovery of consciously unrecognized stimuli or selective attention to certain phenomena which have created a sense of the uncanny or surprising. Both intersubjective reflection and more formal, systematic methods, which include logic and reasoning, serve to illuminate these events. The paper discusses and illustrates the role of preconscious communication in the analytic situation and its relation to the analytic process.     

The intersubjective links in perversion1

The author studies the intersubjective links which the pervert maintains with analyst or partner, attempting to indicate the differences between the investments in each case. Rather than accepting that empathy towards these patients is impossible to achieve and disturbs the countertransference profoundly, it attempts to show that these difficulties may be overcome if they are reinterpreted in the light of the theory of the intersubjective link. The author examines the theories and the practice of intersubjectivity and gives a definition of his approach to the link between two subjects. He applies these ideas to the case of a sexually masochistic female patient. The countertransference is marked successively by indifference, rejection and smothering. The analysis of the analyst's dream allows the situation to evolve. Failures in primary identification can result in domination over others and utilitarianism. The author examines the place of the challenge to the ‘Law’ and the father (in the attempt by the patient to put a theory to the test) in order to identify the figure of the witness in the pervert's intersubjective links. The desire of the transference would be marked by the figure of the witness rather than by that of the analyst as accomplice.     

Discussion of Holly Levenkron's “Love (and Hate) With the Proper Stranger”

I agree with Holly Levenkron that the value of an intersubjective perspective is pragmatic: It directs the analyst toward more effective technique. Also, I agree with her view that a successful analytic process is a negotiation between analyst and patient. However, I question Levenkron's idea that the analyst must loosen her hold on her own subjectivity in order for the negotiation to proceed. An analyst cannot and need not diminish her subjectivity. Rather, what is required for clinical analytic work to unfold is that the analyst include the patient within the analyst's subjectivity—or, in other words, that the analyst come to love the patient.     

Interior experience within analytic process

In this paper, I consider the feeling of interiority as it evolves within the treatment relationship. A capacity to access and sustain one's interiority reflects a sense of personal solidity within which the validity of subjective process and privacy is taken for granted. When this capacity is relatively undeveloped, individuals rely on the “other”; (including the analyst) to help them contact, elaborate, or manage their affective experience. Quite paradoxically, the analyst's active investigation of dynamic or intersubjective process may obfuscate rather than clarify this core difficulty. I suggest two alternative approaches to the treatment situation that stand in some tension and yet also complement each other. One emphasizes the “active”; investigation of dynamic and dyadic process, wherein the analyst works interpretively and/or around relational issues. The other is organized around the “interior”; dimension of the treatment experience, emphasizing the patient's need to develop or manage her affective process in the relative absence of input from the analyst. Two clinical situations are described, the first illustrating the use of silence with a patient whose difficulties involved affect articulation, and the second involving a patient whose need for affect regulation made her highly dependent on the analyst for soothing.     

Finding the neutral position: patient and analyst perspectives

In light of current debates between classical and intersubjective schools of psychoanalysis, the challenge posed by the latter to such basic concepts as the analyst's neutrality, anonymity, and abstinence is taken up. It is maintained that the term neutral position is today more germane and meaningful than the term neutrality, which frequently has been taken to prescribe the analyst's posture. It is proposed that for each patient the neutral position is uniquely sited and that it is incumbent on the analyst to find its location. The neutral position is defined within the context of the interaction between analyst and patient. The concept is therefore compatible with--indeed it is essential to--an intersubjective or relational orientation. The manifold reasons, conscious and unconscious, why the analyst is vulnerable to leaving the neutral position are considered. The patient's reaction to the analyst who has left the neutral position and the analyst's clinical use of this reaction are discussed.     

Discussion: On Some Contributions of the Interpersonal Tradition to Contemporary Psychoanalytic Praxis

Writers identified with the interpersonal psychoanalytic tradition are primarily responsible for initiating the relational turn in psychoanalysis: the evolution from an objectivist one-person model of analytic praxis to that of an intersubjective, two-person paradigm. The two papers discussed here focus on two qualities in the analyst—curiosity and spontaneity—and how these elements of the analyst's subjectivity have helped lead to a potential enrichment of patients’ responsivity to analytic engagement.     

How a Kleinian Analysis Also Tells a Relational and Intersubjective Story Commentary on Paper by Meira Likierman

Dr. Likierman narrates her case in ways that differ dramatically from the usual discourse of relational analysts, and she frames her work with constructs that derive primarily from contemporary Kleinian theory. Yet I believe that if we listen closely to her clinical material, we can see how she and her patient live out a deeply relational/intersubjective process—intersubjective in both Stolorow, Brandchaft, and Atwood's (1987) broad sense and Benjamin's (1995) more developmental point of view.

I suggest is that there is real mutuality in their relationship, a reciprocal, unconscious, taking in of the mind and role of the other—a mutual change in which, paradoxically, both parties seem more real and, more deeply than ever, to express themselves. Ultimately, I think we can see that analyst and patient have “enacted” a slightly subversive, yet vital, mutual dance into and through precisely the paradoxes that Likierman recognizes as “forbidden” territory in the therapeutic relationship.     

The patient's material as an aid to the disciplined working through of the countertransference and supervision

The author argues that the patient's largely unconscious observations of the analyst's functioning are, at times, communicated in the patient's material and that this can impart a sense of clinical relevance to the countertransference. The concept of 'understanding work' is used to provide a psychoanalytical model of this phenomenon. This is illustrated in a clinical case and it is argued that a selective consideration of the patient's material can provide a proper discipline which steers the analyst between the twin dangers of megalomania, on the one hand, and involvement in a symmetrical, self-disclosing relationship, on the other. The author then applies these ideas to supervision and uses them to distinguish psychoanalytic supervision from a practice that also derives from an intersubjective paradigm but which, to the author's mind, is not distinct enough from personal analysis.     

Vulnerability,Resilience, and Surviving Destruction: Discussion of “The Analyst’s Experience of Trust and Mistrust”

In this response to Danielle Novack’s intellectually astute and clinically rich paper on the “analyst’s trust,” I reflect on the valuable ways in which Novack elucidates this undertheorized aspect of the analyst’s experience and reconfigures trust/mistrust as a meaningful intersubjective dimension of the therapeutic relationship. Novack shows how attending to shifts in trust/mistrust can provide valuable clues for deciphering the transference/countertransference. While I strongly agree with her construction of trust as a psychoanalytic achievement, I question the notion that the analyst’s trust is a necessary condition for her participation. Novack’s work on the analyst’s trust joins a broader contemporary conversation about potential overreaches in the relational paradigm, which I discuss. Finally, I consider the implications of Novack’s work for specifying the factors that underly resilience and engaging a conversation about surviving destruction in contemporary relational psychoanalysis.     

Forgiveness – It Depends: A Discussion of “An Analyst Has a Birthday - Can Forgiveness Heal?”

Diane Barclay’s article (this issue) is a clear example of rich and productive clinical work and how in some contexts, both patient and analyst can benefit personally from the inherently intersubjective nature of psychoanalytic practice. Both analyst and patient spent years struggling to forgive mothers who were very deficient and who bore considerable resemblance to one another. Ultimately forgiving their respective mothers proved very helpful to both analytic partners, though I argue in my discussion that we cannot conclude that forgiveness per se, ought to be a universal value or aim.     

Making Music Together: Discussion of Gianni Nebbiosi’s “The Smell of Paper”

Finding life in our patients is a common goal for analysts. Historically this project had been defined as one of freeing unacceptable impulses from their imprisoning defenses with the analyst, via interpretation, then contrasting the patient’s internal fantasied reality with “actual” reality. Untangling fantasy from reality could free the impulses to provide energy for more realistic projects. This imagery stands in stark contrast to the fluidity of a contemporary relational conceptualization of human experience where our inner experience is now understood to be the lens through which we construct our vision of external reality, always a subjective perception. Clinical change—finding life—now depends more on the activation of a generative intersubjective process between patient and analyst, which contributes to the expansion of the patient’s subjective experience. Gianni Nebbiosi’s use of music and of mime to help him feel his way into his patient’s and ultimately into his own similarly defended experience demonstrates the creativity and idiosyncratic clinical approaches that emerge from a contemporary relational orientation. This orientation recognizes the analyst’s subjectivity as a fundamental tool of clinical change—a vehicle through which any theoretical approach will necessarily be shaped. Differing approaches to a clinical situation do not always simply reflect theoretical disagreements; they may also reflect the expression of the particular subjectivity of the analyst.     

Regression in the countertransference: working with the archetype of the abandoned child

Abstract :  The author describes briefly some experiences of his sense of non-existence as an analyst in relation to five patients. He considers the possible countertransference significance of these experiences and puts forward a hypothesis that his sense of non-existence as an analyst might be a clue to regression in the patient to the anxieties of a baby without a mother, even though other clinical evidence of regression might be lacking. Referring back to Jung's early formulation of transference and countertransference as aspects of the unconscious identity shared between analyst and patient, he further develops his hypothesis, suggesting that, in the cases he has presented, analyst and patient were relating through shared dynamic roots in the archetype of the abandoned child. He briefly demonstrates how the understanding thus achieved was of clinical use in the analyses of the patients he has presented.     

COUNTERTRANSFERENCE DREAMING: LIFE IN THE INTERSUBJECTIVE THIRD

In this paper the author asks, “How long is the life of an intersubjective field?” She proposes that it is possible for the field to remain active and instructive even after formal sessions have ended: This occurs in her case of Carla, a young woman who terminates prematurely. Carla enters treatment in a downward spiral of severe trauma symptoms that began subsequent to her rape, a decade earlier. Although Carla’s symptoms diminish and the analysis continues to be productive, it suddenly ends in an impasse, leaving the analyst perplexed and feeling professionally insufficient. Months later, she has three dreams pertaining to Carla and her rape. Largely employing Jessica Benjamin’s recognition theory and her representation of the intersubjective third, as well as contemporary Bionian thinking, the paper depicts how countertransference dreaming is one example of how the intersubjective field can carry on the psychoanalytic function—even outside of formal treatment.     

And Now For Something Completely Different: Humor in Psychoanalysis Commentary on Paper by Joseph Newirth

In this commentary, I argue that if humor is to be considered in an intersubjective context, the impact of any comment or action by analyst or patient cannot be predicted with much confidence. An interaction that is experienced by both parties as humorous depends on an unconscious confluence that is largely spontaneous. Efforts to orchestrate a particular outcome to an intervention that is meant to be humorous may well reveal more than was intended, and thus have an unpredictable unconscious resonance.     

The arms of the chimeras

This article seeks to compare the approach developed in 1974 by Michel de M'Uzan to the concept of the ‘chimera’ with Thomas Ogden's ( 1995 , 2005 ) reflections on ‘the analytic third’. This comparison shows that in spite of the different theoretical approaches, unconscious to unconscious communication – a subject of interest in contemporary psychoanalytic research – makes it possible to grasp the intersubjective data deployed in the field of the session. After reviewing M. de M'Uzan's conception of the ‘chimera’ – a product of the unconsciouses of patient and analyst alike, and which emerges during a process of depersonalization in the analyst – the author proposes her hypothesis of the chimera as a particular intersubjective third whose creation, in a hallucinatory state, makes it possible to gain access to the bodily and emotional basis of the trauma. The author describes the chimera as a mental ‘squiggle’ between the two members of the pair which finds expression in different forms; further, she considers that the chimera that seizes the analyst is underpinned by the unconscious affinities of traumatic zones in both protagonists, which permit the grounding, configuration and sharing of the territories of suffering, as apprehended in this paper.     

Mirror Neurons,Embodied Simulation,and the Neural Basis of Social Identification

The shared intersubjective space in which we live since birth enables and bootstraps the constitution of the sense of identity we normally entertain with others. Social identification incorporates the domains of action, sensations, affect, and emotions and is underpinned by the activation of shared neural circuits. A common underlying functional mechanism—embodied simulation—mediates our capacity to share the meaning of actions, intentions, feelings, and emotions with others, thus grounding our identification with and connectedness to others. Social identification, empathy, and “we-ness” are the basic ground of our development and being. Embodied simulation provides a model of potential interest not only for our understanding of how interpersonal relations work or might be pathologically disturbed but also for psychoanalysis. The hypothesis is that embodied simulation is at work within the psychoanalytic setting between patient and analyst. The notions of projective identification and the interpersonal dynamic related to transference and countertransference can be viewed as instantiations of the implicit and prelinguistic mechanisms of the embodied simulation-driven mirroring mechanisms here reviewed.