A procedural theory of therapeutic action: Commentary on the symposium,Interventions that effect change in psychotherapy

Operating largely outside of awareness, the procedural mode of processing has been neglected in psychotherapy and psychoanalysis, and yet it is critical to our understanding of therapeutic action. This group has made an outstanding contribution to a procedural theory of therapeutic action, integrating some of the most important current concepts in infant research, cognitive psychology, systems theories, and adult psychoanalysis. The procedural mode of “implicit relational knowing” is placed within the context of a moment-by-moment, mutual regulation model of co-constructed exchanges. Nonlinear dynamic systems theory has greatly influenced their theory of change. The centerpiece is Louis Sander's concept of the “moment of meeting.” Although the concept of intersubjectivity is central in all the papers, the multiple uses of the term suggests that a careful re-examination of the definitions of intersubjectivity is sorely needed. We must now integrate the work of this group with other current procedural theories of therapeutic action. © 1998 Michigan Association for Infant Mental Health