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intersubjective systems theory

This column also appears in the January/February, 2011; Volume 23, Issue 1 of The Therapist, published by the California Association of Marriage and Family Therapists (CAMFT).  Abstract page 90.

Abstract:

This two-part series examines the psychological origins and antecedents of terrorism.  Object relations, intersubjective systems theory and contemporary relational psychoanalytic theories are used to define and highlight the constellation of specific dynamics implicated in terrorist enactments, particularly the ways they replicate salient interactive patterns of early mother-infant communication.  This resonant, harmonic unit, characterized by interactive modes of touch, gaze and projection, establishes the creative sphere wherein an infant comes into selfhood and begins to develop nascent capacities for relationality, empathy and morality.  Emotional terrorism begins when a mother is unable to contain and modify her infant’s projected anxieties or, in reverse, projects her own, initiating a repetitious cycle of terrorist-victim or “doer and done-to.” Clinical and cultural implications of sadism, the perversion of empathy, are also considered.

Terrorism, that shapeless haunt of latent danger associated with unpredictably nihilistic provocateurs and paranoiac agitation, is as readily identifiable as the plot of a Cold War spy thriller, yet not as easily understood.

What is terrorism, we might ask, and what, if anything, distinguishes it psychologically from other forms of violence.  What makes it so, well, terrifying?

As psychotherapists, how do we begin to think creatively about terrorism and its origins in ways that might disrupt the futility of rancorous recriminations and swift retaliation?  What can we learn from theory of mind and the psychological antecedents of terrorism to relieve the persisting and polarizing impasse of victim and victimizer, what Jessica Benjamin (Benjamin 2004) described as doer and done-to?

Can we use our theoretical knowledge and expertise to expand the narrow scope of conceptual thinking that delimits conventional understanding of terrorism?  Might we then redefine terrorism in ways that generate more enduring solutions than those provided by political and military pundits?  Are there ways to formulate less intrusive and more durable interventions to manage the amorphous dread and collective vigilance that suffuses the atmosphere like toxic vapor?

While preemptive or retaliatory militaristic actions successfully manage discrete acts of terrorism, they do nothing to dismantle the terrorist-victim dynamic that drives intimidating violence, leaving us mired in impasse and stalemate.  The antecedent psychological dynamics informing terrorist violence must be considered with gravitas equal to that of the disruptive behavioral discharge.  Lasting success will be more difficult to achieve if we obstruct the latter without concurrently understanding the former.

To loosen the conceptual stricture and rigid dialectics that dominate civic dialogue and circumscribe public policy, it is crucial to understand that the cycle of terrorist violence begins in the mind.

Psychoanalysis, with its richly diverse theoretical compendium, might illuminate the psychological dynamics of terrorism with a crispness and precision other paradigms lack.  Certainly, it would contribute a thoughtful dimension to a serious dialogue.  Psychoanalytic thinking posits that behavior reflects mentation and understands that mental life begins in infancy.

Therefore, it is imperative to examine the intersubjective sphere in which the budding infant mind begins to develop.  The early interactive modes of mother-infant communication and the projective processes crucial to early mental life represent the prototypical dynamics for those that subsequently galvanize the emotional terrorist.

The vitality of mutually regulating infant-mother communication

Projection denotes a normative, in fact, essential mode of infant communication.  Along with touch and gaze, it is one of the primary, post-natal emotional languages characterizing rudimentary mother-infant communication long before a child acquires the capacity for verbal discourse.  Winnicott (Winnicott 1963) proposed the phrase “maternal preoccupation” to describe the immense emotional and relational changes occurring in new mothers as they care for infants.  This heightened state of attentive focus insures infant survival, because only a mother (or father or primary caretaker serving maternal functions) is sufficiently identified with her infant’s needs to meet them fully.

The Newborn

The newborn

An empathically attuned mother receives her baby’s emotional projections like spoken language.  Organizing and returning these bits of sensory affect in ways her infant experiences as regulatory and containing, he is comforted.  An infant may think he has magically fulfilled or hallucinated his own sensory-affective needs, when it is his mother who has perceived and gratified them seamlessly.

Creating an environment in which her infant can safely mature, he begins to establish a nascent sense of himself as an individual whose unencumbered development was best described by Winnicott (Winnicott 1963) as “going on being.” Within this exquisitely cultivated surround, the unfettered infant is free to grow and begin to develop mental and relational capacities.

Bion (Bion 1962) referred to this rhythmic interpersonal dynamic intended to reduce infant fears as “container-contained.”  During communicative exchanges, mother and baby establish a mutually resonant and harmonic unit.  The subtlety of these early communicative interactions creates a sense of “thirdness,” a co-created, trusting intimacy that relieves the solipsistic isolation of the intrapsychic mind and brings the infant into relationality.  As Winnicott (Winnicott 1960) wrote, “There is no mother without a baby, and there is no baby without a mother.”

If the mother is unwilling or unable to contain and organize her child’s sensory-affective experience or, in reverse, projects her own unmetabolized anxiety onto her child, the overwhelmed infant has few options for deliverance.  Feeling his very existence at risk, he will either split himself off from this undigested emotional matter or use projection to rid himself of what he cannot yet tolerate.

It is this disorganized, unmetabolized emotional experience and the means by which it is kept out of awareness that ultimately pose a threat.  Lacking linguistic symbolization and eluding conscious awareness, it can only be acted out or discharged behaviorally.

The psychologically undeveloped maneuvers of the vulnerable infant grasping for survival eventually become the emotional propellant fueling terrorist enactments.  We are terrorized and scorched by the exploding fragments of projected traumata.

Projection, empathy and morality

Projection – the movement, shifting or sharing of sensory-affective experience in the absence of spoken language – is really a neutral dynamic having psychological implications well beyond infancy.  While it most often recognized as a defensive method employed to rid the body-mind of intolerable sensations or affect, projection may also be used in the service of creating experience-near, interpersonal bonds.

Projection used to locate a part of oneself in another to share or understand that person’s subjective experience constitutes the intrinsic basis for empathy and subsequently, ethical and moral life.   The acquisition of empathy is a developmental achievement, a byproduct of the healthy projective exchanges between mother and infant.  An infant must experience empathy before he can express or return it.

Clinical psychotherapy might best be defined as a science of empathy distinguishing it from the empiricism of research psychology.  Empathic attunement is the singular clinical feature common to all psychotherapeutic modalities.   As practicing psychotherapists, whatever our theoretical orientations, we routinely rely upon empathy as a point of departure to approach and convey understanding to clients and patients in ways that facilitate trust and evoke change.

Empathy is a two-person interpersonal dynamic not a one-person act of benevolence.

In fact empathy guides ethical conduct throughout life.  Moral choices reflect not simply the religious or secular laws that demand them but the earliest moments of flickering consciousness when a mother’s gaze, touch and responsiveness communicated safety and welcome.

Laws exist to regulate behavior when empathy and ethics have failed.

Sadism – the perversion of empathy

Conversely, sadism represents its perversion.  It is well known that the Nazis employed whistling bombs during the Blitz of London, because they knew empathically that the shrill crescendo of approaching incendiaries would terrify people below.  Theirs was a well-crafted mode of emotional terrorism.

Empathically attuned children know just how to injure their parents.  Nothing wounds more acutely than hearing an angry toddler shriek, “I don’t love you anymore.” The father who regards himself as his child’s best friend will cringe every time he hears his enraged offspring declare, “You’re not my best friend anymore.”

In our current mass-media surround, sadism is frequently exploited for cheap entertainment by pop-culture “therapists” who use brutality to shred the fragile defenses of vulnerably desperate client-participants by attacking their exposed psychological viscera most cruelly.  Rather than working to build psychic structure, they use empathy to shame and humiliate.  To amuse and entertain.

Televised “reality” or talk show programming is the bloodsport that has replaced the coliseum as the purveyor of vicarious sadism in the contemporary milieu.

Slathering at the celebrity slag heap, fans project their vicious envy, delighting in the public humiliation of the inconsequential and accomplished alike, often the same people they had idealized as demigods the day before.   John Lennon’s murder thirty years ago might be attributed to the terrorizing enactment of one such emotional fan who idealized then vilified a celebrity-stranger.

Externalization and projection of unmetabolized envy and murderous rage was followed by an actual murder in an ineffectual attempt to kill off unformulated, dissociated experience.  The media delivered death like episodic soap opera melodrama, unable to distinguish the significance of actual murder from the base sexual voyeurism permeating its customary medley of mindless tattle.

Dissociation and unformulated experience

The mind is very adept at devising creative tactics to manage unbearable feelings and traumatic experience.  Sometimes they are defensively and selectively kept out of awareness by avoidance.  Existing as content without form, they have yet to be sculpted by thought and language (Stern 2003).  For a vulnerable infant, these defenses insure survival, which is why they are often extremely difficult to modify later in life.

Dissociation and projection permit the temporary evasion of anxiety, but emotional stasis is maintained at the expense of learning and change.  Though evacuation removes or minimizes the psychological irritant and often leaves the emotional terrorist feeling vigorously self-righteous, serious problems arise when the disavowed attributes are attributed to someone or something else and attacked.

In futile Sisyphean style, the proverbial scapegoat must carry away communal guilt sins of “badness” each successive year, because the shameful feelings they evoke are never claimed and examined.  They can only be split off and dispatched.  The disavowed traits are psychologically transferred ritually to a neutral animal, preferably one young and untainted.  After carrying collective contamination into the wilderness of the unconscious mind, the young animal is destroyed, pushed off a cliff, ostensibly taking the badness with it.  Banished but not vanquished, the badness exists as unsymbolized, dissociated experience that can only be enacted.  This emotional content without symbolic form (Stern 1997) requires increasing degrees of defensive vigilance to circumvent its emergence into consciousness.

Consider for a moment that the one-way transfer of existential terrors from one body-mind to another might be construed as emotional terrorism.  Terrorist enactments, as we have come to know them in both secular and religious configurations, have their origins in the breakdown of communication between a mother and her infant.

Attachment to primary caregivers teaches an infant how to experience and manage feelings of love and hatred.  The qualitative reliability or deficiency of these early relationships forms the emotional substrate of our relational template.  If an infant’s defensive repertoire isn’t modulated by parental care, psychological maturation is hampered, and existential terrors remain unmetabolized, intolerable and unmanageable.

In these instances, unbearable feelings of envy, longing, desire and rage do not remain simply unformulated and emotionally shapeless within the intrapsychic mind.  They are externalized and cast out.  Once ejected, they are located elsewhere just as an infant projects unbearable feelings of distress onto his mother who can (hopefully) better tolerate and organize them.  No military engagement or body of law can assuage the unmediated, existential terrors of infancy and early childhood.

Reciprocity and Mutuality

Ideally, an infant’s archaic projective communications are part of a two-pronged interpersonal dynamic defined by mutual acknowledgment and reciprocity.  Received by his mother who organizes and returns them in digestible and titrated doses to help him develop increasingly differentiated psychic structure and relational capacities, they transpire within a mutually regulating intersubjective field.

Projections associated with terrorism are missing the regulatory and clarifying half of the exchange.  In this configuration, distressing affect is evacuated from the body-mind like a painful gas bubble but remains devoid of clarifying thought or symbolic language that might render it meaningful or psychologically useful.  Without the reparative and integrating response of an attuned parent or therapist, unbearable experience or affect is simply jettisoned like shrapnel and located elsewhere.  Unable to be used for learning, it can only be projected and attacked repeatedly.

Without the completing circle of communication, the “bad” qualities of these emotional projectiles are attributed to the external objects where they have been lobbed and are subsequently attacked “out there.”  While rage and envy may be temporarily subdued, enduring change is precluded, because the attack-retaliation cycle presents no viable opportunity for emotional refinement or growth.

Paradoxically, terrorism is less about hatred of others and more about self-hatred aged into vindictiveness that has been defensively misattributed to someone or something else and then attacked.  An individual with a developed sense of personal agency and only benign degrees of envy has no psychological need to destroy others.  We must distinguish clinically and politically between gratifying terrorist enactments and acknowledging the subjective realities of others in an attempt to promote mutuality and collaborative solutions.

Working with children

Board game imbroglios with young children offer wonderful opportunities to observe and modify defensive projection in action.  Because luck rather than skill is too often involved, a child who is not winning quickly grows frustrated and resorts to cheating.

My nephew and I were playing such a game one afternoon when he happened to select a color card that sent him back to the beginning square of the game.  I could see his entire body collapse with disappointment and downcast, he began to peek furtively at the underside of the cards to his best advantage.  His usual habit was to decide mid-game that he wanted to do something else.

I observed him for a while, weighing options, and finally remarked that he seemed very interested in winning and was very clever about doing so.  He responded with a crafty smile.  As we had played this game together many times, I risked going further, adding that this was a game of luck, and that winning wasn’t always possible.  Was it?  He smiled again and skillfully shifted a card or two.  “He cheats all the time,” his friend proclaimed from the kitchen where he was enjoying a snack, and at that moment, my nephew reached emotional saturation.  Quickly externalizing and projecting his frustration, he shouted, “You cheat!  You cheat!” and fled the room.

Object devaluation accompanies the psychological assault.  One of the first things the mind does to relieve the disappointment of being deprived of something it wants but cannot possess is to devalue as part of the attack.  This is an attempt to “sour the milk.”  The bad feelings of deprivation, envy, lack or loss are projected and superimposed on the unavailable or lost person or object of desire and then attacked vindictively.

For an hour or so after our rupture, my nephew said he didn’t want to play “that stupid game” ever again.  The game had been temporarily personified with projected badness.  After spending some conversational time together outside, he felt able to resume our engagement with enthusiasm and an increased tolerance for the vagaries of Candy land.

The Emotional Terrorist Part II examines theory and case material in depth, offering clinical examples with couples, families, children and individuals.

WARNING! This text is printed for the personal use of subscribers to The Therapist Magazine and Inside Out Journal and is copyrighted by Mauri-Lynne Heller.  It is illegal to copy, distribute or circulate it in any form whatsoever without the author’s permission.

Benjamin, J. (2004). Beyond doer and done to: an intersubjective view of thirdness. Psychoanalytic Quarterly, 73:5-46.

Bion, W.R. (1962). Learning from Experience. London: Tavistock

Stern, D.B. (1999).  Unformulated experience: From dissociation to imagination in psychoanalysis.  In: Relational psychoanalysis, the emergence of a tradition. Hillsdale, HJ: Analytic Press. (Original work published 1983)

Winnicott, D.W. (1960). The theory of the parent-infant relationship.  International Journal of Psycho-Analysis, 41:585-595.

Winnicott, D.W. (1963). Dependence in infant care, in child care, and in the psycho-analytic setting. International Journal of Psycho-Analysis, 44:339-344.

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This column also appears in the online edition of the July-August, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists.

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this third in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring the intersubjective matrix of transference-countertransference engagement, specifically the various modes of therapist-client communication, readers will begin to think innovatively about the shared psychological space in which we work.

Part III

Enactment is the language of lived experience, that which has not yet been mentalized and articulated linguistically.

In Part II of this three part series, we explored the use of the analytic third and therapist reverie as specific ways of accessing and understanding the unconscious communication transpiring in the transference-countertransference milieu.  In this final column, various modes of client-therapist communication will be explored.

Spoken Language:

Spoken language, its idiomatic usage and accompanying vocal sounds are modes of communication that convey much more than simple content.  By paying very close attention to these elements, we gain significant clues to unconscious processes.

Jacques Lacan, the French psychoanalyst, proposed that the unconscious was actually structured like a language (Lacan 1973) and that only language could promote psychological change.

Poet's Dream

He also suggested that we are impacted by language before we are born, and this is certainly an accurate assessment of the ways familial organization or beliefs and cultural schemata embedded within our environmental surround begin to sculpt and impress our identity long before we have the capacity to begin to define ourselves.

The following clinical example explores the meaning behind the use of a common idiom.  A patient recently used the phrase “threw me for a loop” several times during the course of a forty-five minute session.  The first time she said it, I simply noticed that she selected that particular idiom instead of a number of others she might have chosen.   When she used it a second time, I began tracking it seriously.

She was describing a distressing recurrent dynamic in which she found herself once again unwittingly embroiled and caught off guard.  “It just threw me for a loop,” she said emphatically and paused briefly before continuing with her narrative.

The third time she used the phrase to describe her subjective experience of surprise, I understood what she was telling me and interpreted, “I think you are telling me that you are going in circles and are caught in a loop that you feel you can’t escape.”  By linking a commonly used idiom to a very personal aspect of her inner world, we arrived at a new understanding that shifted us to a place in the session where we could speak more consciously and precisely about the feelings of circularity and constriction that were deeply embedded in early childhood dynamics.  In that shared moment, unformulated content that had existed on the edge of consciousness had acquired linguistic form.

Another patient arriving for our first session sat in the waiting room filling out forms.  Blah, blah, blah, he read quietly until he reached the paragraph about fees and panicked.  I’d left my inner office door open and invited him to come in when he’d finished.

Anxious that his narcissistic defenses wouldn’t contain his shame, he bleated out to me, “How much are you going to charge me?”  Finding out shortly thereafter that he had been in the military, I decoded his remark to mean that he was really asking are you going to charge at me?  Will you wound me (like my mother)? Will you hurt me? This became an ongoing theme of his year-long, four times a week analysis in which withholding of fees predominated.

Somatic language:

Very early, infantile experience is preverbal, unformulated and encoded somatically.  The capacities to think and use language are developmental achievements acquired over time.

The psychoanalyst Wilfred Bion (Bion 1962) suggested that infants begin to think in order to cope with thoughts, the nascent, unformulated impulses that constitute early mental life.  The infant has not yet learned to use his thought-impulses for thinking.  They are, therefore, encoded and subsequently communicated somatically via projective processes that replicate one of the primary modes of communication used by a mother and her infant.

In a state of maternal preoccupation (Winnicott 1963, 1965), when a new mother has adapted herself entirely to her infant’s needs, she is in a state permitting her to be exquisitely attuned to her baby’s projections.  Decoding them as only she can, she responds empathically by making necessary environmental adjustments, providing the desired warmth, food, holding, touch or gaze.  As the baby develops and acquires more direct means of communication, maternal preoccupation concomitantly subsides.

The Mona Lisa

Maternity

The most profound clinical example of somatic communication that conveyed infantile annihilation anxiety occurred during the analysis of a functionally psychotic and autistic young man.  Imprisoned in his own solipsistic mental isolation, he was capable only of incorporating others into his own tortured mental schema.  My reveries in the analytic third enabled me to gather his (preverbal) imagery and projections, organize them and return them to him in explanatory bite-sized pieces that he could ingest and assimilate.

As he lay supine and still on the couch, speaking in flat, unemotional monotones about superficial concerns, I often found myself filling with unspeakable and wordless dread and terror.  After one such session, I went to the restroom and, as I was washing my hands, felt the building begin to roll and shake.  Recognizing an earthquake, I grabbed the counter edge to steady myself until the temblor passed.  When I regained my balance and could walk, I went directly outside expecting to see other folks congregating.  But I saw no one.

There had been no earthquake, other than the somatically projected transmission of abandonment, the non-verbal communication of what it had been like for this individual to have been discarded at six months of age.  His world fell apart.  Whatever developmental balance or stability he had initially achieved rolled out from beneath him.  My next step was to find ways to articulate this shattering experience that reverberated through every moment of this young man’s life, so that we might speak of it directly, so that we might arrive at new ways of being together.

Dream language:

Freud’s royal road to the unconscious is still paved with gold.  Dreams have always permitted us to clothe the invisible man of the mind in accessible, meaningful and personal ways.

Some patients have more access to dreams than others, and it’s interesting to track the arc of dream content and meaning across the period of treatment, observing how they shift.  With my patient’s permission, I will recount one of her dreams as an example.  What follows is a nearly verbatim record of her dream narrative:

I was in L.A. in a house. It was more a shelter.  A man was there with me.  There was a tornado in the desert –and strong winds.  I was trying to keep the door shut.  My foot is in it.  And then we were blown to smithereens.  I wasn’t afraid, though.  There was a huge light and everything evaporated.  I was very calm.  Like I ended up in a different place and time.

As she spoke, I tracked my own feelings, thoughts, images and reveries in the third.  As she alternated between present and past tense, I was aware that this dream had retained its potent sense of primary process immediacy.  We shifted back and forth in time and dream space.

My first spontaneous idea was that this dream used birth trauma imagery to convey the dreamer’s transition from one psychic space or place to another, from a desiccated and dry place to somewhere else.  I also considered that the desert might symbolize her emotional desertion and neglect as a young child.  Her foot in the door represented a feeble attempt to defend against retraumatization and the emergence of strong affect and memory.

Her quiet response to this interpretation was that the light was calming.  I ceased to exist on one level.  I existed in the light but was invisible. This was the way she described what it felt like to step into psychological space and engage unformulated experience.  Expecting a repetition of past trauma, instead she found calm.  She hadn’t quite yet created a new symbolic form to represent her unformulated content but was in transition and able to tolerate the uncertainty and necessary of creative disorder (Stern, 1983) whipped up and represented by the tornado.  This was also a dream about finally surrendering to authenticity while releasing stringent defenses.  Her foot in the door was an insufficient defense against the more compelling need to give birth to herself.

Because the man in her dream was familiar but mostly unseen, an accompanying entity, we imagined that he represented a deeply held transitional object (Winnicott 1953) supporting her during her psychological travels.  A transitional object, often a blanket or toy, is designated by the young child as the talisman that will accompany her during nascent and experimental forays into transitional (psychological) space.

Helping her individuate from the mommy-baby unit status of early infancy, the baby creatively imbues this object with sustaining elements associated with the nurturing mother.  This is why these poignantly tattered and beloved objects manage to find their way into college dormitories years later.  It is regarded with esteemed affection by parents and children.  Recognized by the infant as not-quite-me and not-quite-mom, it represents transition.

Transferentially, this image might also have represented the active (male) strength our relationship has provided for her in addition to the more feminine aspects of empathy.  Dream images are frequently condensed, and these represented aspects of self that she was beginning to integrate.

Her narrative continued, and she spoke of feeling stuck as she prepared for the state bar exam, dejected that she had lost meaningful direction and purpose.  Tired of giving her talents away, she experienced this dream as a means of redirecting herself.

This patient dreams of houses and rooms frequently, and these are symbols of mind, self and object world.  Transferentially, these motifs may also symbolize my office and her analysis and my capacity to hold and contain her affect, to provide ego strength when needed, to inspire curiosity and help her self-regulate.

My final interpretations were based on my reverie in the analytic third in which I envisioned the scene in the Wizard of Oz when Dorothy and her house are flying through the eye of the tornado, also a metaphor for vaginal birth contractions, in this instance auguring psychological birthing.

I shared my image with her, adding that this leitmotif also illustrated how she was looking for a psychological home.  Someplace to land without killing someone beneath her as a result.  In fact, outworn elements of her inner object world would, indeed, have to die.

Because she has worked with criminals, I added that she was trying to escape her internal prison.  This is a potent dream we’ve revisited several times and will continue to reexamine over the course of her analysis.

Enactments:

Enactments represent the behavioral language of lived experience dramatically expressed within the therapeutic dyad.  They represent unmentalized experience that has yet to be linguistically articulated where it can be examined, understood and altered.

The classical analytic position holds that enactments are indicative of poor treatment or the therapist’s inability to maintain her stance as neutral observer, while more contemporary thinking conceptualizes enactments as not only inevitable, but necessary and creative opportunities for growth.  They portray with immediacy exactly what is transpiring within the therapeutic dyad and are the road maps to mutative interventions.

The blue circus

From an intersubjective position, enactments in the clinical setting represent the co-constructed participation of both therapist and client.  Raymond Friedman and Joseph Natterson (Friedman, R., Natterson, J. 1999) suggested that enactments are “intersubjective inevitabilities” with the therapist as an active participant-observer rather than a more remote neutral observer.

While enactments represent the continuous living out of mostly unconscious fantasy within the therapeutic relationship, they can be identified as brief or extended (Friedman, R., Natterson, J. 1999).  An example of an extended enactment might crystallize around a client’s unconscious need for sponsorship and a therapist’s unconscious wish to be helpful.

The therapist’s contribution represents much more than a simple countertransference response to a client, but the activation of the therapist’s own unconscious material.  As the therapist begins to understand the meaning of the specific dynamics unfolding dramatically, they become useful elements employed in the service of furthering the clinical work.

Deleterious enactments lead to therapeutic impasse and the cessation of relational generativity that facilitates change and growth.  They often have a repetitive and stagnant aura, a scripted feel, and both therapist and client feel like they’re being acted upon by the other.  Reciprocity feels absent.   Jessica Benjamin (Benjamin 1999) described this coercive clinical stalemate “complementarity.”

Within the dyad, impasse enactments are often identified by the mutual feelings of misunderstanding, isolation and frustration they produce.  They can, however, be equally stimulating, as they reveal the near-conscious aspects of the analytic experience that can be more closely examined and interpreted.

Working to access, decode and understand the meanings conveyed by even the most rigid enactment permits the unfolding of significant growth and change.  Irwin Hoffman (Hoffman 1983, p. 73) suggested that enactments may be “paradoxically integral to the emergence of new understanding and of new ways of being in the analytic relationship and in the world.”

However, all enactments unfolding within the clinical setting between therapist and client or patient share in common a subtle blending of old and new features, old because they draw upon unconscious elements from both the patient’s and therapist’s unconscious histories and lives and new because the current dramatization being enacted is unique to them and a specific moment in their relationship.

The patient who had been abandoned as an infant reenacted his lethal rupture scenario in every relationship he ever had.  None had ever lasted more than a few months, and that included work relationships.  This individual was unable to hold a job and was frequently unemployed, impoverished and homeless.  He was dramatizing and communicating that an infant without a mother is homeless.

The salient and tragic feature was that he was reliving the scenario, not changing it.  Living in his truck was a metaphor for mother loss.  He had no psychological or actual home.  Psychological space was for him a terrifying psychic void; he had no inner mother there to support him.

Within a few weeks of beginning a year-long analysis, he began his malignant enactment by canceling or missing appointments, making excuses and arriving late.  His unconscious need for mothering and my unconscious need to fulfill those needs set the stage for the enactments that followed, as he prepared to leave me before I could leave him.

Had I simply pitted my will against his within a rigid dialectic about frame, I would have created a therapeutic impasse, a situation of complementarity from which he would have fled, once again trying to leave mother before she could leave him.  Instead, I used the dramatization as an opportunity to comprehend and convey my empathic understanding of his experience, his terror, his loss and grief.  Enactments permit us to say, “Oh, now I see what happened to you.  Now I understand.  You’re showing me what your life has been like.  We’re experiencing it together, and now we might change the outcome.”

Countertransference:

We are made aware of these unconscious elements by tracking our own feelings, sensations and thoughts.  Our sensory awareness responses are clues to what our client’s are experiencing within themselves and within the shared psychological space of the intersubjective matrix.  The psychoanalyst, Avedis Panagian, once remarked at a conference that we access our patient’s lives and traumas by activating our own.  This is why our reveries, feelings and thoughts, even when they seem unrelated are so vitally important to our work.  They represent an overlapping experiential juncture in the third “we” space, the analytic third (Ogden 1994).

Copyright Warning: This text is printed for the personal use of the subscriber to InsideOutJournal.com.  It is illegal to copy, distribute or circulate it in any form whatsoever.

Benjamin J (1999). Afterward. In: Mitchell S, Aron L, editors. Relational psychoanalysis: The emergence of a tradition, p. 201-10. Hillsdale, NJ: Analytic Press. 496 p.

Bion, W.R. (1962). The Psycho-Analytic Study of Thinking. International Journal of Psycho-Analysis, 43:306-310.

Friedman, R., and Natterson, J. (1999).  Enactments, An Intersubjective Perspective.  Psychoanalytic Quarterly, 68:220-247.

Hoffman, I. (1999). The patient as interpreter of the analyst’s experience.  In: Relational psychoanalysis, the emergence of a tradition. Hillsdale, N.J. The Analytic Press.  (Original work published in 1983.)

Lacan, J. (1973) The four fundamental concepts of psycho-analysis. New York. W.W.  Norton & company.

Ogden, T.H. (1994). The analytic third: working with intersubjective clinical facts. International Journal of Psycho-Analysis, 75:3-19.

Stern, D. (2003).  Unformulated experience: from dissociation to imagination in psychoanalysis. The Analytic Press, Inc. Hillsdale, N.J.

Winnicott, D.W. (1953). Transitional objects and transitional phenomena—a study of the first not-me possession. International Journal of Psycho-Analysis, 34:89-97.

Winnicott, D.W. (1963). Dependence in infant care, in child care, and in the psycho-analytic setting. International Journal of Psycho-Analysis, 44:339-344.

Winnicott, D.W. (1965). The maturational processes and the facilitating environment. London: The Hogarth Press and the Institute of Psycho-Analysis.

{ Comments on this entry are closed }

This column also appears in the online edition of the May-June, 2010 issue of  The Therapist Magazine, the publication of the California Association of Marriage and Family Therapists (CAMFT).

Abstract:

Adapted from a presentation to the CAMFT Orange County chapter, this second in a three-part series examines the ways applied contemporary psychoanalytic theory, particularly Intersubjective Systems Theory, with its focus on recognition and mutuality, has refined and expanded our understanding of mental processes and clinical interaction, modifying therapeutic dynamics in ways that promote therapist-client resonance.  Exploring the intersubjective matrix of transference-countertransference engagement, specifically the co-created space identified as the analytic third and the use of reverie, readers will begin to think innovatively about the shared psychological space in which we work.

Part II

Christopher Bollas: In order to find the patient, we must look for him within ourselves.

Preverbal Experience:

Given that much of what transpires in psychological space is unconscious (because after all, as Donnell Stern suggested (Stern 2003), all thought originates unexpectedly from somewhere beyond consciousness, distinguishing what is kept out of awareness defensively and volitionally from what has simply not yet taken form is axiomatic), we can work on both these levels.

There is a difference between not wanting to know something and simply not knowing it yet.  Donald Winnicott (Winnicott 1975/1945) distinguished between unorganized and disorganized mental configurations.  The individual whose mental life is unorganized has yet to congeal whereas the disorganized individual’s mind was once organized and has come undone.  The former may be ego-syntonic, while the latter ego-dystonic.

These unconscious elements existing as unformulated experience are often preverbal, meaning that they are linguistically inaccessible.  The patient struggling to formulate verbal constructs for affective experience has hit such a preverbal pocket.  This material does not exist as a fully developed notion waiting simply to be discovered like a vein of gold within a mountain.

Preverbal elements have yet to be articulated and are generally experienced as amorphous affects – impulses, feelings, urges, fears, shadowy elements, etc.  They are the sensory bits like Lego pieces that are yet to be consciously molded and integrated linguistically.  Wilfred Bion (Bion 1962) called these unformed elements “beta bits.”  He also proposed that thinking is a way to deal with thoughts – these sensory, inchoate impulses that require formulation and linguistic articulation.

Artists are extremely adept at making use of unformulated experience, though all of life is essentially a work of art.  The poet, Sharon Olds, begins writing when “a poem has formed itself, or its beginning, within me, and it’s time to get a pen and notebook and sit over there on the rocking chair next to the window and try to bring forth that which is within.”

It’s not that the poem was hiding in its complete form in her unconscious; it began as an amorphous, inchoate impulse that she then mentalized and shaped into linguistic form.  The awareness of this urgent sensation represents the welcome but often inconvenient inclination that initiates every act of creative generativity.  It’s a stirring that compels creative action.

Shared Experience:

When we work clinically in psychological space, we are talking about co-creating a shared mind-body experience, a conjoint psychological space wherein we overlap in an attempt to access and understand each other’s subjective world.

This is another feature that distinguishes contemporary psychoanalysis from its more traditional relative.  Rather than simply adhering to a doctor-patient hierarchy, where the latter has all the questions and the former all the answers, we now conceptualize two subjectivities involved in the act of co-creation.  Ideally this relationship is defined by bi-directionality and mutuality, though it necessarily remains asymmetrical.  This interactive dynamic defines the intersubjective matrix or field.

The Analytic Third and the languages of psychological space

The body-mind speaks many languages from the behavioral to imagery to words.  Within the intersubjective sphere of the transference-countertransference milieu, we work to access and decode the many communications that we receive in the service of our clients and patients.

Thomas Ogden (Ogden 1994) defined this working, overlapping “we” space as the “analytic third.”  In his seminal paper, Ogden described how he tracks the moment-by-moment interplay of the oscillating therapist-patient engagement in this intersubjective matrix.  Its prototype is the mommy-baby unit of infancy described by Winnicott (Winnicott 1960) and the emergence of transitional space, yet it is more nuanced and complex, because while we are interacting with what we call the “analytic baby,” the more archaic components of self, we are also with the more intellectually developed adult.  We have to track on all levels.  There is no such thing as an analyst apart from the relationship with the analysand (Ogden 1994).

Beginning to work in the transference-countertransference milieu

We begin to work by attuning ourselves to the paradox our clients and patients bring to us, primarily the hopeful longing for some new relational experience appended like a barnacle to the dreaded expectation that nothing and no one will ever really be different.

The hope that maybe this person will understand is quickly quashed by the fear that the therapist will be just as disappointing as everyone else has been.  And this often includes prior therapists.  And so the transference-countertransference dance begins to develop in psychological space.

Our goal is to decode, organize and clarify the unformulated bits and pieces we receive, to apprehend in our well-trained nets the clues that help us begin to understand and formulate interventions.  We sit with a client, listening and observing with all our sensory organs until we begin to grasp something.  What we experience isn’t yet fully formed; in fact, it may be as unformed as our client’s subjective experience.  In truth, as Bollas suggested (Bollas 1994), we find our client within ourselves, within the greater context of the intersubjective field.

We scroll through the session without knowing what we will find, without preconceived expectations, as Bion (Bion 1970) suggested “without memory or desire,” until we begin to form our own associations.  We have an impulse, a strong feeling, an aversion, a sensation.  And this is how we begin to work in psychological space, the place where you and I overlap and become “we.”  This is the transference-countertransference milieu.

Accessing psychological space

It is impossible to know the unconscious or unformulated directly.  We can only access its derivatives, as they are like clothes on the psyche’s invisible man.

The analytic third is the overlapping psychic sphere wherein discrete subjectivities mingle and exchange communications.  It is the realm where unconscious meets unconscious.

Louis Aron (Aron 2006) has also written about this third space extensively: “What is meant by ‘the third’? The third is a concept that has become popular across a variety of schools of psychoanalysis. It has been developed and extended by some of the leading theorists of psychoanalysis, including Ogden, Green, Benjamin, and a variety of Lacan-influenced writers, but it is often defined ambiguously and inconsistently across schools. For some, the third refers to something beyond the dyad, a context within which we emerge; for others, the third is an emergent property of dyadic interaction, and yet for others, the third is a dyadic achievement that creates the psychic space necessary for reflexive awareness and mentalization.”

Jessica Benjamin (Benjamin 2004) wrote: “My interest is not in which “thing” we use, but in the process of creating thirdness—that is, in how we build relational systems and how we develop the intersubjective capacities for such co-creation. I think in terms of thirdness as a quality or experience of intersubjective relatedness that has as its correlate a certain kind of internal mental space; it is closely related to Winnicott’s idea of potential or transitional space.”

So the third is many things, a space in which communications are exchanged and reformulated, a function of relationship-building and a theoretical concept open to diverse interpretations.

Elements of Intersubjective communication

Reverie and Imagery:

Reverie and imagery give visual, if not palpable, shape and form to elements that swirl in this dynamic and interdependent field of intersubjectivity, particularly crystallizing communication that drifts from unconscious to unconscious, bypassing awareness.  This is the live edge of clinical work, the place where analyst and patient, therapist and client intersect, clothing the unseen communications in ways that make them accessible and amenable to articulation in language.

Mother and child in a boat

This kind of communication best describes the ways a mother intuits the needs of her baby.  Receiving her baby’s projections, she organizes and returns them in tolerable and digestible doses.  Did you ever have to put on a sweater because your mother was cold?

The focus is less on what originates where but on interpersonal co-creation of elements in the overlapping psychological space of the analytic third.

An example from my own practice is my awareness of surrounding airport sounds.  My office is very near the runway, so the sounds of jets taking off are generally background noise.  I only become aware of them distinctly when I sense that my patient’s thoughts or feelings are defensively taking flight, or perhaps they don’t yet have a (linguistic) place to land.  At those moments when I envision planes lifting off the runway, I may ask what thought or feeling just took off, and I will invariably receive a germane answer.  If the answer is “I don’t know,” we collaborate to discern what it might be.  I attempt to put words to mental pictures I receive, and we try them on for size together.

A more imagery-laden example of processing in the third derives from my work with a man who grew up in an Eastern Block country, though has lived in the States for many years.  He’s lost the fluidity of thinking and speaking in his native language yet struggles to express himself precisely in English.  Not only is this frustrating, but it pushes him back to a more archaic means of image-laden, unconscious communication.

Therefore, I experience lots of imagery in the third when we’re together.  On several occasions, I’ve “seen” a winter scenario of cold earth, frozen beneath soggy, fallen leaves and bare trees.  Translating this into emotional language, I offered him the interpretation that he felt like his feelings were suspended in permafrost.  Indeed, they were.  He has always identified himself as being emotionally cold.

Therapists often confuse their random but meaningful thoughts or countertransferential reveries with intrusive distractions that should be discarded, and sometimes they very well may be.  But even that is significant.

The question begging an answer is why did I need to distract myself at that particular moment?  What didn’t the client want me to know or what did he want me to avoid?  What couldn’t I bear to witness?  What must always be left unacknowledged, unformed, unsaid or isolated as dissociated material?  What was too painful to feel?  What really longed to be understood?  Most usually those very thoughts and images have something to do with what is going on within the client’s mind-body.

Recently while sitting with a patient, I beheld in my mind the image of a child prostitute and asked her if she felt like hooker in her marriage.  Indeed, she did, but that was the first time she’d been fully aware of her feelings.  She had communicated this unthought known (Bollas 1987) to me via imagery.  Now we speak of it explicitly, and it is amenable to change.

I frequently tell patients that split off aspects of themselves have lives of their own outside awareness revolving like isolated moons with no way to reconnect.  Our job is to set up a linguistic satellite system so that the moon can communicate with the mother ship.  You can’t enact a lunar landing if you don’t even recognize that a moon exists.

What makes this way of working with unconscious material contemporary are the ways in which it differs from Freud’s schema of the unconscious as the return of the fully-formed repressed, conceptualizing that insight and awareness were sufficient to illuminate the issues and produce change.

More current schemata suggest that unconscious elements are not simply inaccessible as a result of defenses, but unformed.

While insight is valuable, it is equally imperative that we attempt to access and comprehend what is unformulated, thereby facilitating the creative process whereby mental Lego pieces can be assembled and used.  Reverie and the analytic third provide a means for us to achieve that goal.

Aaron, L. (2006). Analytic Impasse and the Third: Clinical implications of intersubjectivity.  International Journal of Psycho-Analysis, 87:349-368.

Benjamin, J. (2004).  Beyond Doer and Done To: An Intersubjective View of Thirdness.  Psychoanalytic Quarterly, 73:5-46

Bollas, C. (1987). The Shadow of the object: psychoanalysis of the unthought known. Columbia University Press, N.Y., N.Y.

Bion, W.R. (1970). Attention and interpretation: a scientific approach to insight in psycho-analysis and groups, 1-130.  London: Tavistock.

Bion, W.R. (1962). Learning from experience. London: Tavistock.

Bion, W.R. (1962). The Psycho-Analytic Study of Thinking.  International Journal of Psycho-Analysis, 43:306-310.

Ogden, T.H. (1994). The Analytic Third: Working with Intersubjective Clinical Facts. International Journal of Psycho-Analysis, 75:3-19.

Winnicott, D.W. (1960). The Theory of the Parent-Infant Relationship. International Journal of Psycho-Analysis, 41:585-595.

Winnicott, D.W. (1975). Primitive emotional development. In: Collected papers:

through paediatrics to psycho-analysis. (pp. 145-156). (Original work published 1945). Basic Books. Locale unknow

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