The TBIPS Relational Study Group meets by conference call at 2:00pm on the second and fourth Friday of the month and welcomes all clinicians to discuss interesting papers on relational subjects. Yesterday was a particularly lively discussion of Donnell Stern’s 2004 paper which asked ‘how is it possible for the analyst to see her unconscious involvement with her patient?’ In this dauntingly lengthy paper the answer was not so clear, but perhaps the answer is found in the concept of the multiplicity of selves where one self state sees another. [One ego psychologist asked, ‘How is this different from the observing ego?’ but Stern did not bridge or contrast the two concepts, perhaps because the structural theory is too differently meta-psychological these days.]
While it seems the paper was to expand and illustrate Bromberg’s ideas on dissociation and how disparate parts must be brought in relation to, in awareness of, each other before conflict can exist, Bromberg’s ideas were somewhat obfuscated by so many other ideas (such as the author’s need to debunk the idea of a core or true self, inviolate and incommunicable, in favour of self as social construction, necessary perhaps as we consider the multiplicity of selves; Stern does make a nice case for countertransference reinforcing transference). Clinically, the patient and analyst become aware of dissociated self states through enactments understood only in hindsight. Furthermore, “It is only when we can tolerate conflicts between multiple states that we can negotiate [Pizer] the disagreement between them.” (p 210). “Negotiation is an ongoing never-finished weighing of the alternatives…[W]e cannot negotiate until conflict comes about.” (p.211) and “[T]he self is healed by the creation of conflict.” (p.217)
The group argued a bit about whether everything is an enactment (the trope used to be: everything is transference). I leaned toward favoring Stern’s description of enactments as “rigid and unyielding” which leaves open the possibility that there is much unconscious involvement— such as, as Stern noted, mutual regulation— which are yielding and fluid and promote growth in both analyst and patient. Two of my favorite points of the paper had to do with love and with an analytic attitude. Referring to Wolstein, Stern said that a perquisite of love is “the capacity and willingness to know and accept one’s deepest view or sense of the other.” (p. 203) [I was reminded of Natterson’s 2003 paper; see Oct. 1, 2013 post.] Regarding the analytic attitude, Stern noted that for “reparative and facilitative unconscious involvement –accepting, loving, humorous, or playful” the analyst has to ‘mean it’…”it has to be more deeply felt than mere conscious decision…” (p. 205)
My favorite point, perhaps because I am of late preoccupied with Winnicott’s ideas on survival, was on the analytic attitude as it deals with aggression: “The analyst’s role is not defined by invulnerability…but by a special (though inconsistent) willingness, and a practiced (though imperfect) capacity, to accept and deal forthrightly with her vulnerability.” And “If the analyst characteristically denies his own aggressiveness…he is unlikely to feel empathic when the patient is feeling aggressive. Instead, the analyst is likely to identify with…the patient’s internal objects that scold or reject the patient [Racker’s complementary countertransference] for having angry feelings or behaving aggressively.” (p.216)
This dense and rich paper left more to be discussed than one one-hour meeting allowed. I look forward to revisiting it with my generous colleagues.
Stern, D.B. (2004). The Eye Sees Itself: Dissociation, Enactment, and the Achievement of C... Contemp. Psychoanal., 40:197-237.