Pub Date : 2014-09-29DOI: 10.1080/15551024.2014.948365
L. Jacobs
This article addresses the issues of white-centeredness and racialization that are inherent in contemporary American society and culture. The aim is to develop a conceptual framework by which dominant culture therapists and analysts might sensitize themselves to the implications of their dominance in the therapeutic process. While racialization is my fulcrum, the ideas I present could as easily be applied to heterosexism and to any situation in which a so-called normative standard regarding experience and behavior reigns. The article addresses the major difficulty in recognizing white-centeredness and challenges the common wisdom that white shame and white guilt need to be removed as barriers to the progress toward racial justice. The author addresses inherent power imbalances in the therapeutic setting and offers ideas for managing white guilt and shame productively.
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917466
F. Summers
I want to thank Steven Knoblauch for his thoughtful response to my article. Steven’s discussion opens what I consider to be a crucial discourse not only in self psychology, but also in contemporary psychoanalysis in general. In my view, the evolution of self psychology has resulted in two separate but intertwining themes: The value and limits of the concept of the selfobject and the relationship between conceptualization and the concrete experience of psychoanalysis. Although I only explicitly addressed the former in my article, Steven adroitly noted that I am implicitly raising the question of how one uses theory in psychoanalysis without “draining psychoanalytic work of its vital character.” These are both important questions, but they should not be conflated. The purpose of the article is to consider the development of empathy in the analytic process and to assess whether limiting the transference to any of the varieties of “selfobject” experience can result in the ability to be empathic. Included in that concern is the issue Steven raised as to what type of concept is most appropriate for psychoanalysis. Steven and I are in agreement that any notion of the analyst as function is to wiped off the analytic slate. However, for me that is only the start. Of course I agree with Steven that we should be careful to use concepts that retain the life blood of the emotional sturm und drang that we call psychoanalysis. And that was a leitmotif in my article. But, I want to say more than that. The deeper issue is whether seeing the transference solely through the lens of the selfobject conceptualization limits the analytic aim of developing empathy. Because the selfobject is never a person with her own experience, the patient does not make contact with the analyst’s mind and, therefore, the move to empathy is problematic. So, I am concerned not only with avoiding rarefied conceptualizations that Kohut termed “experience distant,” but also, and more importantly in this article,
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917468
D. Goldin
Psychoanalytic thinkers tend to conflate addiction with the use of substances. At any moment of use, a substance can have emotion-regulating qualities and may even appear to be a symbolic substitute for a person or a function (a theory at the heart of the self-psychological approach to compulsive substance use). However, addiction—as opposed to use—is a state that happens over time and represents a loss of choice. It is my belief that far from being a symbolic act, addiction is an anti-symbolic state, plucking an individual from a narrative mode of being, which requires a human context and a broad, dynamic sense of time, to a conditioned mode or a somatic feedback mode, which relies largely on positive and negative reinforcement and tends to narrow temporal horizons. A tenet of this article is that a rigidly narrow subjective sense of time, what I call “low temporal bandwidth,” is the most prominent feature in a person’s vulnerability to addiction, a feature linked to a conditioned mode of being, as opposed to a narrative mode. This article traces some of the early relational pathways to low temporal bandwidth and explores how a new human context in therapy, centered on the elaboration of emotional states into narratives, can allow for more flexible, dynamic temporal bandwidth that often dramatically loosens the pull of addiction.
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917459
D. Orange
This discussion asks why we clinicians find holding theory lightly so difficult. Commenting on Steven Stern’s clearly successful, but also conflictual, narrative, it guesses that we hold to our central, organizing, psychoanalytic beliefs because they possess selfobject, stabilizing functions for us in the face of work that threatens to disorganize us or otherwise exhaust us. When we meet a patient, as in this instance, who challenges these foundational ideas, we may hold them ever more tightly, and thus, generate struggles and impasses like the one recounted here. Only, as Stern so well explains, when we finally surrender to the rightness of the patient, embracing our own vulnerability and unknowing, allowing ourselves to be changed by the patient, has the patient an opportunity to find a way forward. This is the difficult path of clinical humility.
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917461
S. Stern
In this reply to discussions by Donna M. Orange and David Wallin, I address both of their major concerns about my nine-year analysis with “Linda” by introducing a new organizing principle: The experience of power in our relationship. I argue that given Linda’s felt lack of personal power or agency, and the controlling, negating ways her mother had exercised power throughout her childhood and adolescence, Linda was extremely vigilant regarding the ways I used my power, and predisposed to “resisting” attachment and dependency in order to protect herself from the potentially controlling and exploitive influence of the powerful other. Given these sensitivities, much of the work in the early years of the analysis involved my trying to find a “language” of non-controlling, shared power to navigate between the shoals of retraumatizing control and facilitating therapeutic influence.
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917464
F. Summers
In Kohut’s last paper he used Odysseus as his icon of mental health due to Odysseus’ refusal to kill his son to avoid conscription. It is argued that Odysseus’ decision cannot be accounted for within the framework of a selfobject conceptualization. By using Odysseus’ decision as a signature indicator of the healthy self, Kohut went beyond the selfobject in defining mental health, albeit without an explicit acknowledgement of so doing. The thesis of this paper is that Odysseus was empathic with his son, and such empathy is inextricably linked to the development of self. Empathy being a goal of a self psychological analysis, it follows that there is a gap between such an aim and the use of the concept of the selfobject as the crux of therapeutic action. If transferences are limited to their selfobject forms, conceptual tools are lacking for the development of empathy because selfobjects are not experienced as subjects of experience. Because capacity for empathy requires making contact with the analyst’s subjectivity, analysis must go beyond the selfobject transferences to achieve the goal of developing the capacity for empathy. The clinical implications of this view are drawn out and illustrated with the analysis of a depressed man.
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917458
S. Stern
This article was first presented as a plenary paper at the Annual Meeting of the International Association of Psychoanalytic Self Psychology in October 2013. In keeping with the theme of the conference, “forms and transformations of connectedness,” the article summarizes my nine-year analysis with “Linda,” a patient who was intensely conflicted about allowing the kind of deep connection I believed was necessary for her to make the kinds of changes she ostensibly was in therapy to achieve. The clinical narrative focuses on our dialogue and struggles around this issue as it evolved through different phases and relational configurations.
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917463
Amy Joelson
C onnectedness between analyst and patient is an unpredictable, emergent process. How might the analyst nurture an experience of emotional connection while also respecting the patient’s sense of agency in how she might need to regulate that experience? In the foregoing articles, Steven Stern describes how a sense of connectedness was struggled with, how it emerged, and how it was transformed between him and his patient Linda. Discussants David Wallin and Donna M. Orange offer alternate views of the challenges that Stern and Linda faced, suggesting different clinical paths. This epilogue compares and contrasts their formulations. First, how might we understand the trajectory of Stern and Linda’s relationship? In particular, how might we understand Stern’s formulation that his patient was “connection-resistant?” Did she resist connection, or was she trying to ward off the sense of weakness and vulnerability that she expected would accompany it? In his reply, Stern formulates that Linda sought not only a sense of connectedness, but also a sense of personal power. That she stayed nine years with Stern and nine with the analyst before him suggests that she is good at connection, but perhaps not the intensity or consistency of connectedness that Stern assessed she needed and that he wanted to provide. What in their relationship might have made it difficult for him to feel connected to her? On the first day of treatment, Linda said, “I want someone who can hold my feet to the fire. I can be controlling and slippery” (Stern, this issue, p. 180). This metaphoric statement captures much of the complexity and challenge inherent in this case. It conveys Linda’s experience in sustaining connection through being controlling and slippery while also conveying her desire to give up this controlling-slippery strategy. Her statement reflects the confidence she already has in her new therapist, that he might engage in
分析师和患者之间的联系是一个不可预测的突发过程。分析师如何在培养情感联系体验的同时尊重病人的能动性她可能需要如何调节这种体验?在前面的文章中，史蒂文·斯特恩描述了一种联系感是如何挣扎的，它是如何出现的，以及它是如何在他和他的病人琳达之间转变的。讨论嘉宾David Wallin和Donna M. Orange对Stern和Linda面临的挑战提出了不同的看法，提出了不同的临床路径。这篇结语比较和对比了他们的表述。首先，我们如何理解斯特恩和琳达的关系发展轨迹?特别是，我们如何理解斯特恩所说的他的病人是“连接抵抗者”?她是在抗拒联系，还是在试图避开她所期待的那种伴随而来的软弱和脆弱感?在他的回答中，斯特恩阐述说，琳达不仅寻求一种联系感，还寻求一种个人力量感。她在斯特恩身边待了九年，在他之前的分析师那里待了九年，这表明她善于建立联系，但也许不是斯特恩认为她需要的那种联系的强度或一致性，也不是他想提供的那种联系。在他们的关系中，是什么让他觉得和她有联系?在治疗的第一天，琳达说:“我想要一个能把我的脚放在火上的人。我可以控制和圆滑”(斯特恩，本期，第180页)。这种隐喻性的陈述抓住了这种情况中固有的复杂性和挑战。它传达了琳达通过控制和圆滑来维持联系的经验，同时也传达了她放弃这种控制和圆滑策略的愿望。她的陈述反映了她对她的新治疗师的信心，他可能会参与
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Pub Date : 2014-07-03DOI: 10.1080/15551024.2014.917460
D. Wallin
That “we are the tools of our trade” (Pearlman and Saakvitne, 1995) and thus, need to address the impact of who we are on what we do suggests an omission in Steven Stern’s article—namely, attention to the role in the analysis of the analyst’s psychology. Drawing on attachment research, I theorize that we clinicians are often shaped by the unresolved trauma of parents that leaves us with (at least traces of) disorganized attachment to which we adapt with the “controlling-caregiving” strategy identified by Mary Main. This history (which is mine and perhaps Steve’s as well) welds trauma to shame, may thus have us trying too hard to be “good,” and may be part of what apparently encouraged Steve to valorize acceptance and marginalize his own subjectivity. His evolving stance was clearly healing, but the work might have been deepened had Steve explored—at times in dialogue with his patient—the impact on their relationship of his own attachment history and patterning.
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