Relational ideas, a smattering

First year courses at TBIPS have finally reached their emphasis on theoretical contributions from relational authors and so I am pleased to present a few concepts that have so informed our way of being in relation to our patients. They include the paradigmatic shifts from intrapsychic to interpersonal and intersubjective, from one-person to two-person, from drive-conflict model to relational [Mitchell], and from a unified self to a multiplicity of selves (in health, held together by a sense of continuity, cohesion, and coherence) [Bromberg]. Also important has been the shift from the analyst as objective authority [Sullivan] and all-knowing blank screen to flawed subject inevitably implicated in the relational dyad [Levenson] and a co-creator of the patient's transference. The mind, the self emerges from the matrix of social relationships.

Relationships and their 'internalization' are primary motivators [Bowlby] and are the organizers of psychic life. Early experiences are encoded in the brain in such a way as to become the 'default' way of being with others. Until subsequent experiences (including psychoanalytic therapy) over time reconfigure neuronal dendritic branchings, we may reenact either side of earliest complementary ways of being. Infant research [Beebe and Lachmann] gifts us with three salient principles: ongoing affect regulation, timely and consistent repair of ruptures, and shared moments of heightened affect. Schore concludes that attachment is affect regulation. Schore also notes another major paradigm shift: from left brain (interpretation, insight, explicit,) to right brain (emotional, perceptive, procedural) where dissociated self states [Bromberg] are brought to the conversation through their enactment and what was once unformulated [Donnel Stern] and implicit can then be made explicit.

In the therapeutic space of the analytic third [Winnicott, Benjamin, Ogden], greater than the sum of its two participants, spontaneity, play, and co-creativity can take place. Negotiation of differing agendas from each participant foster an intersubjective [Benjamin] way of being together as each member of the dyad contributes her/his respective perspectival reality. Uncertainty, fluidity, and unpredictability are lived as analysts no longer take cover behind dogmatic theories and technique. This fluidity includes contributions from feminism, queer theory, gender studies, linguistics, social constructivism, and Hegelian dialectics as we let go of linear dynamics.