Context is defined in manifold ways in coparticipant psychoanalytic inquiry. Patient and analyst together develop new ways of working as new themes of inquiry or new clinical foci such as, moving from a clinical focus on the extratransference to a new emphasis on transference analysis or urgent new clinical issues emerge in the inquiry. For instance, lust only takes on clinical significance when seen in dynamic relation to the interpersonal self, that is, when lust becomes suffused or interpenetrated with concerns about social acceptability and shame, guilt, or anxiety. Stern never considers the analyst or the patient alone; all clinical events take place between them and involve them both. In examining this change, I raise the question of what constituted ethically sound, professionally acceptable behaviours and efficacious therapeutic relationships, particularly in the historical context of the emerging collaboration between psychoanalysis and social psychology.
This dimension of the work is 64 coparticipation essential because the most radical forms of coparticipant inquiry, the most truly two-way coparticipant processes, require a concept of a personal self, or unique individuality. In modern psychoanalysis this form of inquiry is most closely approximated in the work of some contemporary analysts with an interpersonal and intersubjective orientation. In participant-observation the analyst and patient are seen in a superordinate-subordinate hierarchical relationship with each other. And that is because it contains a therapeutic truth—people get better when they are related to in new and healthier ways. This challenging and exciting book merits wide readership among analysts representing all schools of though and all levels of clinical experience.
What is the role of dream analysis? Fairbairn's central defense mechanism, splitting, is the fast shift from central ego dominance to either the libidinal ego or the antilibidinal ego-a near perfect model of the borderline personality disorder. The patient is not seen simply as the suffering, transferential hurt child—the victim of unempathic circumstances—as many would have it. The concept of coparticipant inquiry, with its dialectical focus on both the personally unique and the interpersonal, has affirmed and informed my clinical experience. It is because of papers such as these that interpersonal psychoanalysis has been described as the origin, at least in North America, of the contemporary clinical interest in psychoanalytic subjectivity. Anxiety is the human and also animal reaction to potential sensory overload. And their life reflects this background—they are strikingly unapprehensive. Consequently, the coparticipant analyst strongly encourages his or her patient to explore the personal roots of his or her anxiety, even if it makes for an uncomfortable analytic experience.
When the analyst is a participant-observer rather than the classically defined nonparticipant mirror, this has clear implications for the interpersonal view of the psychoanalytic process, including the analysis of transferential phenomena. For Freud, however, the anxiety of loss of love or of any other hypothesized danger situation, e. In my opinion, the dynamism of narcissism represents a core dimension of all psychological disorders—a kind of master neurosis— rather than a discrete diagnostic entity. Similarly, on a macroscopic level, these dimensions may be seen as phases of the overall process of any particular psychoanalysis. Nevertheless, in the coparticipant experience formed by the two copartners, as noted earlier, each inevitably brings all of himself or herself into the analytic situation, whether or not this is recognized and worked with. A full appreciation of the radical possibilities of coparticipant inquiry requires a concept of those creative and proactive psychic processes and potentialities that I call the personal self. North American psychoanalysis has long been deeply influenced and substantially changed by clinical and theoretical perspectives first introduced by interpersonal psychoanalysis.
Implicitly, they de-emphasize working with the personal self, that is, the self-subject or proactive self. The therapeutic importance of immediate experience is emphasized as opposed to the traditional focus on the curative primacy of formulative interpretation. When a person grows up in a home where obsessional omniscience, narcissistic grandiosity, or paranoid vigilance and fear of spontaneity are necessary defenses. In other words, transference and countertransference are jointly generated: they are inevitably field processes, reciprocal aspects of an interactive, experiential field. Despite their many differences interpersonal analysts share a common clinical emphasis on the interpersonal self and on the field properties of the analytic situation.
Therapeutic Processes in the Analytic Working Space 155 169 viii Contents 12. The broadening of psychoanalytic theory to include a self-actualizing dynamic has clinical as well as theoretical implications. The psychoanalytic study of the self and the answers to questions such as these has been an open project, reflecting evolving and differing conceptions of human nature. No matter how hard they try or how well-intentioned or therapeutically talented they may be, analysts cannot cure patients; they can only help patients cure themselves. It is difficult, or perhaps impossible, to determine an answer in the abstract since there is great individual variation. One simply needs to be secure with others, not because to be so means relief of a physiological drive. .
However, the therapeutic role of new relational experience has always, particularly among conservative traditional analysts, been rejected as nonanalytic. Every patient has harmed both himself or herself and others, whether they were loved or hated. Radical coparticipation, which represents the consistent and comprehensive use of coparticipant principles, views the analytic relationship as a remarkably complex process whose therapeutic course and findings results are inherently unpredictable. Instead, it gives political weight and theoretical legitimacy to the social philosophies and clinical concepts of the seminal figures of the various broadly relational schools; in this way it provides a needed counterbalance to the historical exclusiveness of Freudian analytic orthodoxy. Thus, coparticipant inquiry, in its emphasis on unique individuality, is marked by an improvisatory approach, rather than a literal following or methodical adapting of a prescribed canon of analytic technique. In its salient features coparticipant inquiry does not, as many historical new forms of psychoanalytic treatment do, represent the creation or discovery of a new metapsychology from which a new technique or psychoanalytic method is then derived.
Their contextual view of the analytic situation as an intersubjective experiential field evidences a coparticipant sensibility that is, in some ways, radical 62 coparticipation for example, their theoretical emphasis on a relativistic and constructivistic post-Cartesian epistemology. The analyst creates the personal freedom for both regressive and progressive elements of his or her own psychic being to emerge as appropriate for therapeutic understanding by both coparticipants. This search for order and authority, while perhaps pacifying some fears, inevitably forecloses the therapeutic promise of a deeply personal coparticipant inquiry: the possibility of true self-knowledge and its profoundly transformative potential. According to the progressive view of human motivation, shared by humanistic personality theorists and by the major heterodox psychoanalytic theorists, the individual is essentially forward-moving and inherently seeks to expand or realize himself or herself. The psychoanalytic process is, in other words, essentially three-dimensional in nature—at once relational, narrational, and experiential. A Relational Psychoanalytic Approach to Couples Psychotherapy balances a great range of ways to work with couples, while also providing the means to authentically negotiate their differences in a way which is insightful and invaluable.