A Review of “Relational psychoanalysis V: Evolution of process”

2008

The International Journal of Psychoanalysis, 2009

Relational psychoanalysis has emphasized that the analyst's awareness of her failures in recognition and hurtful reopening of old wounds requires of her an internal struggle with self-regulation, with her own shame and guilt. This struggle takes place in the watchful presence of someone who is (sometimes hypervigilantly) listening to and monitoring the signs of the analyst's internal state. If, in response to the patient's hyper-arousal, the analyst retreats from the 'music' of mutual regulation (Knoblauch, 2000) into a dissociative use of observation in order to calm down, the patient can feel it. If, however, we are mindful of our failures, gradually we will learn together to recover from ruptures in attunement, and thus become sensitive to and use more effectively the inexplicable gaps created by the patient's unintegrated or warring self-parts and the analyst's failure to contain them. Thus moments of excess that fail to evoke a mirroring knowledge can serve instead to signal the unformulated, undifferentiated malaise, despair or fear. This perspective on ruptures represents an amplification of my original articulation of the process of mutual recognition as one of breakdown and restoration of intersubjective space (Benjamin, 1988). This expanded relational perspective includes the awareness of multiple self-parts that create different dyadic pairings within the same relationship and a view of intersubjectivity that emphasizes not just the fact of mutual influence (Stolorow and Atwood) but the consciousness that that there is a bi-directional dance between patient and analyst that each person registers differently-a cocreated dance governed by what we call the third (Ogden, 1994). In previous discussions of the intersubjective third I have distinguished between 'a primordial third', which refers to the musical or rhythmic exchange of gestures between caretaker and child as well as the procedural principles of lawful relating that underlie it, and a 'symbolic third', which makes use of more developed narrative elements and involves procedural rules based on consensus, negotiation, and recognition, especially recognition of the other's separate subjectivity (Benjamin, 2004). Because of the inevitability that things will sometimes go wrong, that we will enact frightening and shameful aspects of our internal world that both

Contemporary Psychoanalysis, 2003

Within the many streams of thought contributing to this effort, we single out systems views as providing a critical dimension of this expansion. The "dyadic systems view" is our particular contribution to the relational turn in psychoanalysis. Although systems views have been evident in both psychoanalysis and infant research, each field has come from the opposite bias (Beebe & Lachmann, 1988, 2002). Centrally concerned with interactive regulation in the dyad, infant research on face-to-face interaction has only in the past decade seriously begun addressing self-regulation (Beebe, Jaffe, Chen & Cohen, 2002; Gianinno & Tronick, 1988; Fox, 1994; Thompson, 1994; Tronick, 1989). Similarly, originally centrally occupied with the organization of inner states, psychoanalysis has only in the past decade accorded interaction in the dyad a central place. Mitchell (1993, 1997, 2000) was a key player in this shift within psychoanalysis. However we believe that currently there is a discernible theoretical shift away from inner processes toward relational processes, both in relational psychoanalysis and child development research (see Miller, 1996; Overton, 1997, 1998; Ghent, 2002), perhaps as a reaction to an historical over-emphasis on inner processes (see Beebe & Lachmann, 1998). In contrast, in our dyadic systems view, inner and relational processes are co-constructed and equally important (Beebe & Lachmann, 1998). Self-regulation processes, and otherregulation processes, emerge together in a reciprocal, inter-penetrating way (see Overton, 1997, 1998). Inner and relational, or self-and other-regulation, are "points of view" on the same whole (Overton, 1997, 1998). A dyadic systems theory of interaction must specify how each person is affected by his own behavior-that is, self-regulation-as well as by the partner's behavior-that is, interactive regulation (

The Psychoanalytic Review, 2008

Relational psychoanalysis has emphasized that the analyst's awareness of her failures in recognition and hurtful re-opening of old wounds requires of her an internal struggle with self-regulation, with her own shame and guilt. This struggle takes place in the watchful presence of someone who is (sometimes hypervigilantly) listening to and monitoring the signs of the analyst's internal state. If, in response to the patient's hyper-arousal, the analyst retreats from the 'music' of mutual regulation into a dissociative use of observation in order to calm down, the patient can feel it. If, however, we are mindful of our failures, gradually we will learn together to recover from ruptures in attunement, and thus become sensitive to and use more effectively the inexplicable gaps created by the patient's unintegrated or warring self-parts and the analyst's failure to contain them. Thus moments of excess that fail to evoke a mirroring knowledge can serve instead to signal the unformulated, undifferentiated malaise, despair or fear.

My aim in this paper is primarily to present a view of the nature of the psychoanalytic setting. I shall begin by reviewing briefly the idea of the psychoanalytic setting as invented by Freud, which is largely unchanged in the current practice of psychoanalysis with adults; then I shall discuss in some detail an attempt by the Argentinian psychoanalyst José Bleger to elaborate this idea in his 1967 paper, and his use of concepts developed a few years earlier by his colleagues Willy & Madeleine Baranger; I shall then go on to consider the idea of the 'internal setting' in the mind of the analyst or therapist; finally, I want to try to open a discussion about the relevance of these ideas for child psychotherapy, by considering a case which has been described recently by Brian Truckle.

Language and psychoanalysis, 2017

Psychoanalytic Psychology, 1995

The special section entitled "Contemporary Structural Psychoanalysis and Relational Psychoanalysis," in Psychoanalytic Psychology 12(1) was a fertile, highly informative collection of papers dedicated primarily to explicating, comparing and contrasting, and often defending the views of the contributors who, for the most part, would designate themselves as classical, in opposition to relational. Although the volume was an exciting, interesting, and important contribution, it raised far more questions for me than it answered. Above all, it highlighted a problematic tendency much too prevalent in our field, among clinicians who would rigidly encamp themselves around particular claims of allegiance in variously defended quarters, declaring (either explicitly or implicitly) exclusive possession of the genuine article of psychoanalytic knowledge in toto. In presenting this ongoing observation, my criticisms lay not with one particular group or another, but rather with our field as a whole. As psychoanalysis undergoes continued assaults upon its integrity as a bona fide intellectual discipline and practice, by persons and forces largely outside our field, it seems that we continue to induce a greater ongoing trauma upon ourselves from within. For however fruitful the genuine exchange of psychoanalytic ideas may be when undertaken with the open mind that Freud considered the sine qua non of any psychoanalytic endeavor, we seem as individuals and as a group to be constricted dialogically by the most primitive forms of defensive splitting and infantile rivalry that make true exchange an impossibility. Many of the "classical" contributors unfortunately betrayed such tendencies along with an arrogant dismissiveness, a contentiousness that Requests for reprints should be sent to Anthony Christiansen, MA,

Journal of Analytical Psychology, 2002

The current debate over the conflicting interpersonal and intrapsychic views of the analytic process may or may not help us to distinguish between psychoanalysis and analytic psychotherapy. A comparison of psychoanalysis in the English-speaking world-especially in the United States-with French psychoanalysis reveals the features that unite and at the same time divide these different psychoanalytical tendencies, both of which are the heirs to Freud's thought, in terms, in particular, of the setting (couch and chair) and of technique (interpretation, transference analysis and technical neutrality). Whereas all psychoanalytic work belongs within the framework of an interpersonal relationship, that relationship becomes meaningful only when linked to the intrapsychic dimension, which alone can open the way to the unconscious and to infantile sexuality.

Psychoanalytic Psychology, 2013

The first aim of this article is to report a newly developed measure of therapeutic process, the Dynamic Interaction Scales. When combined with the Analytic Process Scales (Waldron, Scharf, Crouse, et al., 2004; Waldron, Scharf, Hurst, et al., 2004), the two instruments permit a reliable and fine-grained assessment of technical and relational aspects of psychoanalytic and psychodynamic psychotherapeutic process. The Shedler-Westen Assessment Procedure and Psychological Health Index (Westen & Shedler, 1999a, 1999b; Waldron et al., 2011) permit a reliable and fine-grained assessment of the changes during treatment. The second aim is to demonstrate how combining results from these instruments permits exploring the relationships between processes and outcomes of treatment. We illustrate the utility of this approach by a demonstration project, applying the instruments to two treatments started 21 years apart. The results show different relational and classical approaches of the analysts and different outcomes. Both patients had a similar level of psychological functioning at the outset of treatment, but one made a much more extensive recovery than the other. The difference in outcomes may reflect different patient pathology, in spite of their initial level of functioning, but it may also reflect the impact in the better outcome case of a more relational approach, combined with a more extensive use of classical analytic interventions judged to be of higher quality. We then present quantitative results applying the same instruments to 11 additional patients. Technical and relational differences are found between good and poor outcome cases in this group, similar to those found in our two demonstration cases. Ongoing evaluation of an additional 18 cases will permit further study of these differences