Forging Components Anew,Modes of Therapeutic Action: Reply to Discussions by Drs. Hirsch and Newirth

I elaborate my view of the analyst’s role as catalyst, and use of an enlivening presence, to foment the growth of mentalized thought in some patients. The need to forge certain components anew in such patients’ rendering of experience mentally is highlighted, in contrast to an emphasis on patients’ capability, expressed by Dr. Hirsch. I argue for a place for deficit in relational thought, and for a relational reframing of the concept. Compatibility is seen with Dr. Newirth’s focus on the transformation of mental processes as integral to therapeutic action and the value of Bion’s models of containment and thinking in striving toward such ends.