Exploring, claiming and expanding the frontiers of an emerging self

ABSTRACTThe author discusses her evolving understanding of the growth and transformation she is witnessing in her work with one analytic patient, a young, white, cis-gendered woman with a history of profound neglect and relational trauma, a life-long struggle with severe anxiety, OCD and somatic symptoms. Steve Stern’s concept of “airless worlds” and what he refers to as a process of “re-subjectification” inform the author’s conceptualization of the therapeutic processes taking place in this treatment. The author presents clinical material, applying these and related ideas to demonstrate how she and her patient have worked together to recognize the toxic and negating identificatory structures and processes Stern refers to, appreciate these in their historical context, and being to transform some of them. This process has allowed the author and her patient to begin to illuminate the contours of her patient’s emerging subjectivity as her patient learns to explore and lay claim to a self that extends beyond the borders of familiar territory inhabited by early toxic and negating identifications.KEYWORDS: Airless worldsdeconstructionidentificationre-subjectificationself Disclosure statementNo potential conflict of interest was reported by the author(s).Additional informationNotes on contributorsAlyson KeppleAlyson Kepple earned her medical degree from the University of Virginia School of Medicine and completed her psychiatry residency at the Western Psychiatric Institute and Clinic at the University of Pittsburgh where she served as Chief Resident for Psychotherapy Training supervising and teaching psychiatry residents and medical students. She is graduating in June of this year from her psychoanalytic training at the Institute for Contemporary Psychotherapy and Psychoanalysis (ICP+P) in Washington, DC and is a recipient of the 2021 Early Career Professional Award presented by The International Association for Psychoanalytic Self Psychology (IAPSP). She maintains a private practice focusing on psychoanalytic psychotherapy and psychoanalysis treating patients in Virginia and Pennsylvania. She volunteers teaching and supervising psychiatry residents at the University of Pittsburgh and is on the faculty of the Western Pennsylvania Community for Psychoanalytic Therapies, serving on the curriculum committee and teaching for the psychoanalytic psychotherapy training program.