toward an emancipatory psychoanalysis: …...2 toward an emancipatory psychoanalysis 9 3...

New York London

Toward anEmancipatoryPsychoanalysis

Brandchaft’s Intersubjective Vision

Bernard BrandchaftShelley DoctorsDorienne Sorter

http://www.psychoanalysisarena.com/toward-an-emancipatory-psychoanalysis-9780415997843


RoutledgeTaylor & Francis Group270 Madison AvenueNew York, NY 10016

RoutledgeTaylor & Francis Group27 Church RoadHove, East Sussex BN3 2FA

© 2010 by Taylor and Francis Group, LLCRoutledge is an imprint of Taylor & Francis Group, an Informa business

Printed in the United States of America on acid-free paper10 9 8 7 6 5 4 3 2 1

International Standard Book Number: 978-0-415-99783-6 (Hardback) 978-0-415-99784-3 (Paperback)

For permission to photocopy or use material electronically from this work, please access www.copyright.com (http://www.copyright.com/) or contact the Copyright Clearance Center, Inc. (CCC), 222 Rosewood Drive, Danvers, MA 01923, 978-750-8400. CCC is a not-for-profit organiza-tion that provides licenses and registration for a variety of users. For organizations that have been granted a photocopy license by the CCC, a separate system of payment has been arranged.

Trademark Notice: Product or corporate names may be trademarks or registered trademarks, and are used only for identification and explanation without intent to infringe.

Library of Congress Cataloging-in-Publication Data

Brandchaft, Bernard.Toward an emancipatory psychoanalysis : Brandchaft’s intersubjective vision /

Bernard Brandchaft, Shelley Doctors, Dorienne Sorter.p. cm. -- (Psychoanalytic Inquiry ; v. 31)

Includes bibliographical references and index.ISBN 978-0-415-99783-6 (hardcover) -- ISBN 978-0-415-99784-3 (pbk.) -- ISBN 978-0-203-88336-5 (e-book)1. Psychoanalysis. I. Doctors, Shelley. II. Sorter, Dorienne. III. Title.

RC504.B73 2010616.89’17--dc22 2009046826

Visit the Taylor & Francis Web site athttp://www.taylorandfrancis.com

and the Routledge Web site athttp://www.routledgementalhealth.com


http://www.copyright.com

http://www.copyright.com

http://www.copyright.com/

http://www.taylorandfrancis.com

http://www.routledgementalhealth.com


xi

Contents

Acknowledgments xiiiAbout the Authors xvii

1 Encountering Brandchaft 1

2 Toward an emancipatory psychoanalysis 9

3 Reconsiderations of psychoanalytic listening 29

4 Theoretical reconsiderations 39

5 A case of intractable depression 51

6 Bonds that shackle, ties that free 73

7 Whose self is it anyway? 91

8 Co-determination and change in psychoanalysis 111

9 To free the spirit from its cell 125

10 The self and its objects in developmental trauma 147

11 Obsessional disorders: A developmental systems perspective 163



xii Contents

12 Systems of pathological accommodation in psychoanalysis 193

13 Reflections on the unconscious 221

14 Brandchaft’s intersubjective vision 243

References 267Index 279



9

2Chapter

Toward an emancipatory psychoanalysis

It is with some surprise that I find myself, at the end of my career, involved in the writing of a book. It is not that writing has been foreign to me or that the business of assembling chapters and polishing arguments is unknown in my professional experience. But I had not envisioned undertaking a project of this scope at this late date or that with the encouragement of valued col-leagues and former students, I would be joining with Dorienne Sorter and Shelley Doctors in an effort to publish a book devoted exclusively to the unfolding of my ideas about psychoanalytic treatment and its possibilities. I am surprised, in short, that I have this final opportunity to recapitulate and summarize my professional experience.

As I look back on it, my professional experience has been singularly shaped by the distinctive context in which it took shape. It was, truth-fully, a time of deepening crisis in the psychoanalytic world. It was a time characterized by a clash of ideas—and passions—between the defenders of hard-won Truths around which psychoanalytic institutions had become organized and had flourished and a small, diverse, and growing band of discontents. The persistent turmoil that resulted invaded not only the realm of ideas but personal relationships as well; old, cherished bonds between colleagues were broken, and new ones only tentatively came to replace what had been lost.

It is also clear to me, as I look back, that in many ways the psychoana-lytic world was a microcosm that reflected the profound changes that were loosed in the larger world in the last half of the 20th century. A sense of deepening crisis was hardly unfamiliar to me personally, having spent the years of my adolescence and beyond in the Great Depression. I can remem-ber well the thick pall that hung over life, the gloom that we dispelled in our games only to have it descend again when we returned home. I remem-ber, too, how my curiosity took me, in the summers of my 15th and 16th years, to the roads and to the rails, freight cars, and hobo jungles of 1930s America where I encountered whole families of dispossessed and solitary souls all lost in a culture in which alienation had become institutional-ized. But the avalanche of history did not stop there. Following the Great



10 Toward an emancipatory psychoanalysis: Brandchaft’s intersubjective vision

Depression and the Second World War, our society lurched onward to the precipice of nuclear holocaust in the Cuban missile crisis, to Vietnam, to the Nixon debacle, to the horrors of 9/11, and to the invasion of Iraq and the war on terrorism.

The personal story of my professional career is thus intertwined with a background context of a culture increasingly torn apart by a succession of traumatic events. In each of these recurrent crises, and silently at work in the interim between them, one could discern the escalating consequences of failed attempts to deal with painful and complex realities building to the immanence of disaster. Each new development was met with massive denial and avoidance—or else by an antiquated understanding that deteriorated into simplistic talking-point, sound-bite nostrums even as the plain facts of everyday life argued eloquently that there was, as John Updike recorded, beneath the events, “a flaw in the mindless system.” It was a society, it is now clear, in which no one was answerable and every sector was desper-ately in need of fresh understanding and radically different solutions.

The uncertainty and turbulence of the period, as could be expected, reached as well into the minute details of developmental relationships as caregivers, themselves inadequately prepared for life in a rapidly changing world, struggled with, and too often simply avoided, the massive problems of how to prepare their children for a life in a world that had become almost totally unpredictable and at times perilously close to extinction. Inevitably these sounds of disintegrating change came to be heard in our offices and consulting rooms.

Psychoanalysis, as I experienced it over the course of my career, reflected this turbulent context. Its foundations, embedded in the authority of another day, began to crumble. The ensuing crisis reflected the unbearably heavy uncertainty and anxiety of an underlying belief in our patients, and in ourselves, that existence itself might be at stake. Such was the back-ground in which new paradigms began to emerge, with radically trans-formed perspectives of what it meant not only to be an analyst but also to be a person.

The assault on the citadels of psychoanalytic tradition initially took the form of assertions that the doctrine of intrapsychic determinism, upon which the discipline had been founded and upon which its bona fides had come to rest, was inadequate to explain the basic disorders analysts were attempting to treat. In the process, new concepts came to be employed that appeared at first to advance enlightenment but then had to be discarded or reconfigured as their limitations become apparent. The chapters of this book, to some extent, recapitulate the reexamination of some of the pillars of conceptual thought upon which the received wisdom had rested together with remedies that were at the time proposed to deal with their flaws. But it is important to articulate at the outset that the narrative behind the indi-vidual chapters binding them together involves the personal struggle of an



Toward an emancipatory psychoanalysis 11

analyst in the last half of the past century to break through the restraints imposed by psychoanalytic tradition while at the same time striving to retain what seemed empirically to have continuing value.

I have come to be particularly associated with one of the new paradigms that emerged in psychoanalysis within the past quarter of a century—the intersubjective perspective. To my thinking, it has proved invaluable in illuminating the process of human psychological development and pathogenesis and in extending the analyst’s ability to influence outcomes beyond the bounds within which it had previously been constrained. The perspective, like a number of others, initially arose in reaction to dissat-isfaction with Freud’s metapsychological theories and their picture of the mind as an isolated “mental apparatus” fueled by drive energies striving for expression and in conflict with each other. In that vision, which domi-nated psychoanalytic thinking and training for more than half a century, the study of human experience was focused on conflicts between love and hate whereas basic and complex human relationships were relegated to a secondary position, determined by processes of instinctual discharge, and mediated by such auxiliary processes as introjection, projection, and pro-jective identification.

By contrast, the essentials of the new intersubjective perspective consti-tuted an attempt to escape the constraints of traditional theory by a radical reconceptualization of the analytic field in terms of continually and recipro-cally interacting subjectivities. The outlines of this approach were proposed in three major collaborative works undertaken by myself, George Atwood, and Robert Stolorow. Atwood and Stolorow had begun to articulate the intersubjective perspective prior to our collaboration, having arrived at it in part from an academic background; for myself, I had come to the essen-tials of a similar perspective from a background of clinical experience in psychoanalytic practice. The foundational work on intersubjectivity then took place in a close collaboration extending more than 15 years, result-ing in Atwood and Stolorow’s (1984) Structures of Subjectivity, to which I contributed, Psychoanalytic Treatment: An Intersubjective Approach (Stolorow, Brandchaft, & Atwood, 1987), and The Intersubjective Perspective (Stolorow, Atwood, & Brandchaft, 1994), as well as numerous articles and presentations.

In our initial work, we sought to extend Winnicott’s (1965) tradition-breaking observation that “there is no such thing as an infant” (p. 39) and to place intersubjective (relational) interaction at the center of the psycho-logical world—and at the center of psychoanalytic treatment (Atwood & Stolorow, 1984, pp. 41–42). We contended that mother and infant form an irreducible psychological unit and that “both psychological development and pathogenesis are best conceptualized in terms of the specific inter-subjective contexts that shape the developmental process and that facili-tate or obstruct the child’s negotiation of critical developmental tasks and




successful passage through developmental phases” (p. 65). We thus saw specific intersubjective contexts of child and caretaker, whether benign or pathological, as shaping affective experience and generating the recurrent patterns and schemata or organizing principles through which subsequent experience would be understood and felt. An impressive body of research in support of this perspective has since emphasized that the organization of the child’s experience is indeed a property of a child–caretaker system entailing mutual regulation (Beebe & Lachmann, 1988, 2002; Lichtenberg, 1983, 1989; Sander, 1988; Stern, 1985). We also contended that patient and analyst likewise formed an indivisible psychological unit and that the emergence in analysis of the patient’s invariant unconscious organizing principles would be affected by the kind of field that analyst and patient created together. We concluded that this conceptualization dictated a focus on the “evolving psychological field constituted by the interplay between the differently organized subjectivities” of analyst and patient as the “fun-damental methodological basis for psychoanalytic investigation” (p. 65).

A critical hallmark of the intersubjective approach was that, following Kohut’s lead, we insisted that the mode of observation be consistently framed within a disciplined and sustained empathic approach to the patient’s sub-jective experience, including the patient’s experience of the analyst. The stance of empathic-introspective investigation we adopted placed a new emphasis on the analyst’s recognition and monitoring of his co-contribution to the patient’s experience, especially when a shift occurs from harmoni-ous to disjunctive or aversive reactions. Sustained investigation into such interactions led to a conviction that a patient’s need to wall himself off from the impact of the analyst and the analyst’s interpretations, and to dissociate from his own affective experience of the interaction, is “always evoked by the patient’s perception of qualities or activities of the analyst that lend themselves to the patient’s fears, anticipation or experience of a repetition of developmental trauma” (Stolorow & Atwood, 1992, p. 59). This observational stance entailed a decisive departure from the traditional psychoanalytic one, which had seen the patient’s response as emanating from endogenous forces within the patient, so that virtually every concep-tual and preconceptual basis upon which psychoanalytic metapsychology had previously stood now came under question, to be abandoned or recon-figured as new evidence might indicate.

In recent years, my own particular field of interest within the larger field of intersubjective phenomenology has increasingly focused on the specific intersubjective contexts that obstruct the child’s negotiation of critical devel-opmental tasks and successful passage through developmental phases. The result has been an intensive study of configurations I have termed systems of pathological accommodation and their manifestations in treatment. These systems of pathological accommodation, arising out of skewed and traumatizing intersubjective contexts and perpetuating their effects, had




been recognized by earlier investigators, by Ferenczi, Winnicott, Fairbairn, and Bowlby in particular, but their writings, for whatever reason, did not bring about the dramatic transformative changes in analytic inquiry and understanding that I felt these configurations warranted.

The recognition and examination of systems of pathological accom-modation and the exploration of their treatment in psychoanalysis via an emancipatory approach constitutes the essential subject matter of this book. My emphasis rests on a belief that the extent to which the phenom-ena of pathological accommodation can silently permeate every aspect of the personality and influence all human relationships has remained insufficiently appreciated. This is especially true of the relationship estab-lished in psychoanalytic treatment. In addition, the disturbing and wholly unwelcome recognition that pathological accommodative influences also have continued, from a metacognitive standpoint, profoundly to shape the development of psychoanalytic theory and practice itself has additionally convinced me that it is time for a closer look and fresh perspective.

There are personal roots to this latter emphasis. My own history in psy-choanalysis took place in the turbulent period when the profound critiques that led to the crisis were initially germinating. I was fortunate to have been in a position that enabled me to witness and benefit from some of the most important changes and from contacts and interchanges with many of the leaders of innovative thought. Yet, I was struck by the pervasive and tenacious influence of authority as a system of metacognition that tended, sooner or later, to drain the process of change of its vitality, however origi-nally promising its beginning. I also became aware of the extent to which the lifeless quality I had come to recognize as symptomatic of the imprison-ing influence of pathological accommodation on the lives of my patients had come more generally to infiltrate and permeate the field of psychoanal-ysis, even though this trend was not infrequently broken by particularly gifted analysts. These impressions of the vitality-stripping influence of an “adherence to the dictates of antiquity,” as Thomas Browne phrased it long ago, were strengthened as I found a similar influence in the attachments to divergent belief systems in the ranks of innovative schools of thought that were gathering influence.

Meanwhile, the burgeoning in recent decades of attachment-related research and of a systems view of development, although broadly sustain-ing the intersubjective view of development, offered a complementary basis for approaching the phenomena of pathological accommodation. This research offers new insight into the enduring consequences that result when the infant’s attachment–caregiver–developmental system is not a benign one but in fact, to a greater or lesser degree, a traumatizing one. In this context, it does not matter so much whether the traumas take the form of discrete, dramatic events that go unremediated or consist of more subtle “impingements” (Winnicott, 1949), repetitively injured narcissism (Kohut),




“cumulative traumas” (Khan), or the like. The consequence in every case is that the immature self-structures of the child yield to the overriding man-date of maintaining attachment to the caretaker, which for the child ensures survival. We cannot be reminded enough that infants and children become attached and obstinately maintain their ties to even the most abusive care-takers. Thus the new developmental perspectives allow us to envision the origins of systems of pathological accommodation as a complement to what can be observed empathically in analytic treatment, namely, the persistence of pathological invariant organizing principles constructed in earlier inter-subjective fields and manifested on cue in the current one.

The problem of how to treat patients who present with structures of pathological accommodation has been with us from Freud’s time on. The essence of the problem may be highlighted in the following terms. An insol-uble dilemma is introduced into the life of the patient by a psychic event, whether outside or inside the treatment. He or she is then thrown into a comfortless and preoccupying perturbation. This may be manifest, as it was in Freud’s early patients, by a system of double-tracking dissociation (Breuer & Freud, 1893–1985, p. 12) or by competing identificatory systems (Freud, 1923, pp. 30–31). Or the resulting perturbation may take the form of a montage of oscillating and competing mental images and affects mani-fested as a state of tormented and ceaseless doubt (Freud, 1917a). Sometimes the perturbation is signaled by the onset of a deepening, intractable depres-sion. Sometimes the patient is engaged in warding off a threatening internal state through acts of sustained, ever-mounting rebellion. Sometimes the perturbation is made worse, not better, by the first signs of progress. All of these phenomenological presentations and others as well are discussed in the cases presented in this book.

Empathic exploration from the patient’s point of view is crucial. In less severe states, the patient may report his experience in great detail yet has no access to the unconscious processes that might illuminate his suffering. At other times, however, the patient feels trapped in a claustrophobic panic inside an accelerating process gone completely out of his control or in the throes of unbearable pain and a feeling of the impending collapse of his very being. In such states of extreme endangerment, more commonly expe-rienced when he is alone, a patient may behave as if he were immersed in a nightmarish dream while lacking the mentation to conceptualize the “as if.” He has no access to a reality that might enable him to wake himself up, locate what is happening in his mind, and put a stop to it.

Psychoanalysts from the beginning have encountered this kind of phe-nomenology lurking behind various diagnostic categories. Many analytic theorists dispatched the various manifestations of this condition to the therapeutic wasteland of unanalyzability by diagnostic fiat. Almost as frequently, it came to be considered an intractable source of resistance to the analytic process itself. In my practice, however, I came to realize that




the mental activity that had been marginalized in this way was an intimate part of human experience (Fairbairn, 1929, p. 78) and that the position to which it had been assigned by traditional psychoanalytic theories (as an isolated phenomenon happening solely within the patient) was a function of the way it was being viewed within the theories themselves, theories that had helped render the experience inaccessible. An impoverishment of our curiosity and understanding had been objectified, even as experience was increasingly revealing, in the years from 1960 to 1980, a proliferation in the literature of delineations of analyzable and unanalyzable patients, punctuated by reports of negative therapeutic reactions, incomplete analy-ses, and analytic failures (Brandchaft, 1983). The golden age of psycho-analysis was coming to an end. It was to be succeeded by a crisis that has still to run its course.

Worlds BEyond BEliEf

The present group of studies reflects my attempt to break out of the circu-lar impasse as I experienced it toward the end of my training (1956) at the Los Angeles Psychoanalytic Institute. Becoming dissatisfied with attempts to understand and treat patients from within the perspective of classical analysis that placed oedipal conflict, and pre-oedipal retreats from it, at the center of development and psychopathology, I found myself struggling nonetheless to fit my observations and understanding into the theoretical frameworks I had learned. Yet, it seemed to me that the problems of my patients were so relentless, both because my understanding was inadequate and because the problems originated very much earlier and at a deeper level than the classical paradigm postulated. I felt that I might make bet-ter progress if I could somehow find modes of understanding that would make a better fit with the actual experiences of the particular patients I was observing, rather than the reverse.

At the time no such alternative perspective was available in the training institutes of the American Psychoanalytic Association, and I was led by my reading to the contributions of the British school of object relations, regarded here at that early time with considerable contempt and hostility. Indeed, as I recall, it fell to me to deliver the first paper on Mrs. Klein’s object relations theories to an Institute of the American Psychoanalytic Association in Los Angeles in 1959 (see Kirsner, 2000, pp. 167–168). In search of greater understanding, I traveled to London and secured inter-views with several of the most prominent contributors to the object rela-tions school of thought, including Winnicott, Segal, Rosenfeld, Heiman, Khan, and also Wilfred Bion, with whom I developed a friendship of many years lasting up until his death. I came away impressed with their enthusiasm for the use of psychoanalytic method even in the most severely




disturbed individuals and particularly with the conceptual clarity of models that placed the living relationship between self and object at the center of normal development and pathological character formation from its onset.

I was especially drawn to the Kleinian school, largely because of Herbert Rosenfeld’s understanding of the negative therapeutic reaction and his detailed descriptions of his attempts to treat psychotic patients psychoana-lytically, as I was myself struggling with a similar attempt at the time. My previous efforts to treat seriously disturbed individuals psychoanalytically had already left me with a lasting clinical impression of the interfacing of seemingly disparate psychological systems, incommensurable and immeasurable, organizing the mental life of the patient and thus also the treatment, a situation that seemed to be absolutely refractory to analytic understanding at that time.

Stimulated by an enthusiastic response to my inquiries in Great Britain, I arranged after a time to spend a sabbatical in which I could engage in a serious effort at observing and integrating the new findings. Fortunately, three patients agreed to continue their analysis with me for six months in London in 1967 when the choice was offered them. These patients included a composer, a writer, and a woman who had herself been looking forward to an opportunity to pursue graduate studies in London through contact with the British Museum. All felt that their own separate interests could be advanced by making the move, and all were and remained enthusiastic about it. For my part, I was afforded the unique opportunity of learning about a new discipline in close supervision with leading authorities, together with the chance to observe supervisory sessions conducted by other outstanding contributors to the literature and to attend classes at the British Institute, to which I was given generous access. I also took advantage of the sabbatical to engage in a personal analysis with a leading Kleinian analyst, as did my wife, Elaine. The interlude was invaluable—it opened me to a mental world of new possibilities that I had not previously imagined. Buzz Aldrin, after he returned from walking on the moon, spoke of worlds that lie “beyond belief.” Truly, I felt I had found such a world.

Importantly, I developed a close personal and professional relationship with Herbert Rosenfeld. I was impressed with the particular skills he had perfected in his attempts to get closer to the actual experience of his psy-chotic patients. I noted his close attention to minute details of his patients’ communications and how carefully he extended this stance to include non-verbal facial and postural cues in his attempt to stay with his patients’ immediate experience. Much later, I came to appreciate how sensitively Rosenfeld recognized his psychotic patients’ almost impenetrable sense of aloneness and their exquisite vulnerability to narcissistic trauma, which vulnerability generated an imprisoning protective shield. I noted with admiration how earnestly he grappled with the problem of maintaining




contact with the patients’ experience, paying special attention to shifts that would ordinarily have been bypassed, and attempting to engage the patients consistently in bringing the experience into verbal discourse. Later, my contact with Evelyn Schwaber and her work on “listening” (1983) extended my understanding of the listening process and provided further indications that listening, with its affirmation of the simple, con-tinuing presence of another, frequently provided the basic and at times the only sustaining link to the analyst and to the therapeutic bond. Still later, Heinz Kohut’s (1977) commitment to an “empathic immersion in the psychological field” and in particular to a “long-term immersion in the transference” (p. xxii) struck another echoing chord. Together these disparate experiences resulted in my conviction that careful and sustained attention to minute shifts in affect states was an absolute requirement to gaining access to the prereflective and prerepresentational dissociative fragments of traumatized relational experience. Only if these remnants, which one patient memorably described as “the feeling in my bones,” could be brought into the domain of dialogic discourse could the surrounding splitting, dissociation, and estrangement be overcome and the basic qual-ity of self-in-the-world transformed through the mediating quality of the analytic experience.

The friendly association with Rosenfeld continued for some time. He was a tall, attractive man with a prominent forehead; his speech was impec-cably British with a slight Germanic accent. He was both thoughtful and extremely generous with his time and could spend hours discussing a topic of mutual interest. He was also an avid collector of fine art, and we spent many hours together visiting museums. If he was your friend, you could be certain of his intense loyalty.

Rosenfeld visited us at our home in Los Angeles several times, and we enjoyed skiing together at Lake Tahoe. In turn, Elaine and I were invited to visits with Herbert and his wife, Lottie, at their vacation home in Angmering-on-Sea in England. Time was regularly set aside for long walks, and with the sea as the background, the setting was ideal for uninterrupted and intensely stimulating conversation. Rosenfeld, a gifted analysand of Melanie Klein, was a prodigious writer, talented speaker, and sought-after teacher. He was widely considered, along with Hanna Segal, to be heir apparent to the lead-ership of the Kleinian school, and it was a privilege to have such access to an authoritative spokesperson for the new discipline. Our talks were scholarly and friendly, but as I became more familiar in succeeding years in my own practice with the concepts to which I had been introduced, our ideas began to diverge. Now, close attention to minute details, the very quality I had so much admired in Rosenfeld’s work, was rendering me unable to remain unaware of unintended and discordant effects of much of the interpretive understanding derived from the teachings of Melanie Klein. In this painful process of self-reflection, my patients were indispensable allies (Brandchaft




& Stolorow, 1984), helping to establish within me the experiential basis for the description of the patient–analyst interaction as belonging irreducibly to a system of reciprocal mutual influence.

A point of no return was reached as I became convinced that critical transference disjunctions that I was observing were not simply erroneous disparities from the side of an individual analyst unable to deal with the complex transference–countertransference problems inevitably encoun-tered when one persisted in an attempt to penetrate primitive psychological defenses but the result of a faulty understanding of the living interaction of the moment, skewed by theory-embedded inferences and unintentionally damaging to the residual sense of self in patients who had become haplessly frozen in the very narcissistic reactions that were being confronted. For his part, Rosenfeld consistently held to the position, as did a whole generation of analysts trained in Great Britain, that these reactions in the patient were in the main endogenously rooted in early developmental formations. He saw them not only as originating from within but also as defending against normal dependence, thus constituting an obstacle to the development of an appreciation for and a love of objects (and in the analysis for the analyst), which he held to be a primary goal of the therapeutic process. These inborn dispositions, he maintained, were activated inevitably in a well-conducted analysis in the form of negative transference organizations. The reactions needed to be analyzed to the depths of their intrapsychic roots as Mrs. Klein had advocated in her defining constructs, that is, as indications of the patient’s destructive instinctuality, especially envy, organized as a narcis-sistic defensive system.

In his signal explications of disjunctions in the therapeutic field, mean-while, Rosenfeld favored yet another basic contribution of Melanie Klein, the theory of projective identification. The theory had the effect of appearing to repair the disrupted analytic mismatch by offering a new fitting together. However, I gradually became aware that it did so by a covert demand that the patient repudiate or disavow the validity of portions of his own percep-tual reality in the service of an unquestioning adherence to the correctness of the analyst’s presumption of an isolated, endogenously arising source, an interpretive stance that had the effect of restoring the analyst’s position as ultimate authority over the patient’s subjective reality. The therapeutic alli-ance being co-created thereby was ultimately based upon what the analyst believed his impact really to be and what the patient should and should not feel in response, as the analyst continued to be informed by his training and by his own analysis, fidelity to which, he had been taught insistently and through a variety of channels, was the marker of emotional maturity achieved by the triumph of gratitude over infantile envy.

For me, observations of this interpretive strategy and the underlying per-spective accompanying it in action came to provide convincing evidence that a pathologic system was now being co-created by the analyst’s contribution.




In my view, such interpretive strategies also provide a reservoir for the transgenerational perpetuation in psychoanalysis of systems of pathologi-cal accommodation, insufficiently recognized as such. As I continued to focus on this critical phenomenon, I came to recognize that the telltale sig-nal of a triggering of an in vivo traumatic experience in the patient could be verbal or silent, attitudinal or postural, and that it most frequently escaped the attention of both patient and analyst, as it was transacted at the pre-reflective level of unconscious experience. That is why I have subsequently emphasized that the stance of sustained empathic-introspective investiga-tion is essential (Brandchaft, 1983; Brandchaft & Stolorow, 1990).

In reflecting on my own experiences, I was forced to come to terms with an awareness of how the use of the theory of projective identification had protected me from the disorganizing impact on my own mental state of being wrong or seriously inexact. I have since characterized this theory as providing a cordon sanitaire for the analyst’s contribution to the co-creation in the present of the patient’s current pathological state. It has led me sub-sequently to seriously question my own belief systems whenever they might be objectified and then reasserted as a putatively objective means of under-standing the patient, whether as in the theory of projective identification or as in some of the newer theorems of today’s psychoanalysis. I came to recognize that any theoretical system is a product of a particular subjectiv-ity that at best has access to only a portion of the intersubjective world. In essence, I saw clearly that any theoretical concept that locates the source of the difficulty in the patient, while bestowing upon the analyst a presumptive knowledge of what that difficulty really is, brings with it a deadening of the therapeutic process and threatens the genuine basis for the therapeutic bond—the articulation and expansion of the patient’s understanding of his subjective world. The experiences I have just described became a founda-tion for an attitude that Orange (1995) later characterized in the gener-ous dedication with which she introduced her own recent groundbreaking work: “For all psychoanalytic fallibilists, especially Bernie.”

Meanwhile, I should note that, my efforts notwithstanding, the theory of projective identification continues to occupy a central role in a diverse array of therapeutic approaches, including those described by such distinguished analysts as Bion and Ogden, albeit in a revised context. However, contem-porary thinkers still retain the imagery of two relatively encapsulated vesi-cles, “container” and “contained,” and of the transport of mental contents from one to the other. The concept of experience subjectively organized only and always within a system of reciprocal mutual influence has come for me to answer better the questions addressed by the theory of projective identification.

Although Rosenfeld and I drifted apart, changes took place in his think-ing that were reflected in his last work, Impasse and Interpretation (1987), in which passages seem to me to be literal extensions of discussions we




carried on, especially in his final chapter where Rosenfeld wrote that he wished to “emphasize some of the crucial aspects of my approach and some of the ways I have changed my opinions” (p. 205). I like to think I had an impact on these changes. Beyond this, evidence of his continuing regard was evidenced in a very friendly phone call I received from him toward the end of his career.

More certain is the impact of our association upon me. In the end I was left to deal on my own with a profound sense of loss of a friend and mentor who had earned my respect and love. I was also left with the recognition that I was entertaining a challenge to a hallowed underlying explanatory edifice that had provided me for a time with a sense of cohesion and mean-ingfulness in my work, with deep inner roots in the relationships of my own antiquity. And I had acquired a far greater sensitivity to the crushing conse-quences, manifest in psychological and actual alienation, that accompany the recognition that my attachment had been based on faulty premises that I could no longer embrace. The experience has proved especially valuable in enabling me to distinguish between an attachment that is voluntary, authentic, and facilitating and a different kind of attachment that contin-ues to exert its influence only so that one may avert the consequences of unbearable loss. I have come to recognize in my life and in my practice what a great deal of work is often necessary before one can become able to recognize and appreciate this essential difference in the quality of experi-ence and resist the pull to ignore it.

KohuT

The overall doctrine of psychoanalysis, in which intrapsychic and instinc-tual determination continued to occupy a central position, was irrevoca-bly falling apart in my mind and with it a substantial portion of what had seemed to me to be me, both with shattering effect. Looking for some more suitable framework within which the experience I was accumulating might make sense, I became interested in the work of Heinz Kohut, at first through my reading of his groundbreaking contribution on the subject of narcissism (1971). Kohut’s approach to the phenomenology of narcissism, which had come widely to be regarded as among the most severe resistances to growth of the personality and to the goal of object love, provided a path-way to move beyond Rosenfeld’s (1965) distinctively different portrait of narcissism considered in its destructive aspects. Extending the recognition of the role of objects in development and pathology that had marked the contributions of the British object relations theorists through his seminal construct of the selfobject, Kohut arrived at an understanding of self expe-rience as inextricably embedded in one’s selfobject relations throughout the life span rather than in one’s biological heritage. This change constituted




a revolutionary departure. I can still remember the feeling of enlivenment as I became aware of how different the same processes could look and feel when the viewer’s perspective had changed. In this early work, Kohut had stripped the concept of narcissism of its accretion of moral assumptions and brought it into the arena of phenomenological consideration (see also 1959, 1966). His revised approach to what he subsequently called “disorders of the self” then led to his introduction of the new paradigm of self psychol-ogy (1977).

I first heard Kohut speak at a conference in Boston, then at a second meeting in Chicago. My impression of him was informed by a sense of awe: I had never before witnessed the ability to weave a narrative of complex details together with such a depth of understanding. Kohut then attended a conference at UCLA, at which I delivered a paper critically reappraising the concept of the negative therapeutic reaction (Brandchaft, 1983). He was extremely gracious in his response and invited Elaine and me to visit Elizabeth and him at their home in Chicago.

In person, he proved equally impressive. A small man, he was genial, warm, engaging, and yet quite intense; he was also a deeply cultured man acquainted with music, the arts, and history—traits I associated with his Viennese background. At the conclusion of a most pleasant evening, which included a connoisseur’s choice of wine, Kohut asked me to join his Study Circle. An incident that evening still stands out for me; it occurred when I asked Kohut at what point he came to recognize the inadequacy of the clas-sical psychoanalytic paradigm he had achieved such recognition in teach-ing. He thought for a while and then said, I thought with a sad note, “I always knew it. I just couldn’t face it directly.”

The discussions that took place over the next several years in the Study Circle, argued by a group of highly gifted individuals at sometimes over-heated weekend meetings, marked the laying down of the theoretical struc-ture of a new psychology of self experience. These discussions resulted on my part in contributions to multiple Self Psychology Conferences—presentations from several of these form the bases for chapters in this book—as I attempted to clarify important controversies that developed within the ranks of the leaders in the development of the new orientation of self psychology. Vexing and still pertinent questions were raised about which principles of psychoanalytic thought had enduring value and which need to be abandoned or changed in the reconstructed foundation of psy-choanalysis. Moreover, behind the turbulence on intellectual matters, one could recognize the continuing attempt on my part and by the others, each in his own way, to grapple with the age-old problems entailed in systems of pathological accommodation, of tradition versus change, of transformation versus loss and chaos.

A number of Kohut’s contributions have had a continuing effect on my own work, that is to say, on me. The principle of co-determination in




particular has become indispensible to me since Kohut first asserted that the influence of the analyst is not confined to the impact of the counter-transference but constitutes an immanent and ever-present factor in the process being observed. Kohut brought an end to the imprisoning effect inherent in the doctrine of intrapsychic determinism, which isolates the patient from the field in the analyst’s perception. The mythology of the ana-lyst as an independent and authoritative observer of the events unfolding before his eyes had hitherto prevailed in the ranks of classical and Kleinian analysts alike (Brandchaft & Stolorow, 1990) and had decisively shaped their descriptions of the therapeutic alliance. In stressing the immanence of the analyst’s influence, to the contrary, Kohut articulated clearly a factor with which I had been struggling in my discussions with Rosenfeld.

Yet, extending the observational focus from a point within the intrapsy-chic organization of the patient so as to include the unrecognized impact of the analyst, as a person and in terms of his theories, called for radi-cal changes, not only in theory but in essential qualities bearing upon the demanding requirements for empathic resonance and introspective reflec-tion in the therapist engaging in the endeavor. Specificity of understanding and communication, which determine the intimate quality of the bond, had now become critical in the interaction.

The matter of specificity, which was to have far-reaching significance and will be discussed in later chapters, became especially clear to me as the concepts of defense and resistance were reconsidered from the vantage point of the primacy of the protection of self experience. Kohut (1977) had recognized that the concepts based on the classical model of resistance as primarily informed by feelings of hostility or rivalry with the analyst were outmoded. Instead, he found resistance and defense most commonly to be expressions of desperate attempts on the part of the patient to pro-tect an enfeebled and endangered self organization from the disorganizing impact of unempathic intrusions from the side of the analyst. However, in his early departures he failed to distinguish clearly between two different types of defensive organizations. On the one hand, the acutely vulnerable individual might fall back upon highly developed structures that enabled him to protect himself by distancing and by sequestering authentic expres-sions whenever the threat of a repetition of childhood trauma was posed by his environment. This is the “dread to repeat” identified by Anna Ornstein (1974). This familiar defense involves, in the main, protecting the integrity of self experience by attenuating the person’s tie to the object.

But a very different process was involved, I argued (Brandchaft, 1994), when whole sectors of self experience were largely abandoned to main-tain vitally needed object ties even while a kernel of one’s selfhood might be sequestered, wrestling with experiences of annihilating loss. I believed the differentiation was crucial because it involved grasping that the basic personality structures were being commandeered, even in the present, to




the dominating influence of a pathological system of accommodation. Kohut originally conceptualized the essential pathology of the self as hav-ing its roots in missing structure, that is, structure the child had failed to acquire developmentally because of faulty or missing selfobject responsive-ness. The concept of missing structure, of structure that the child had not acquired, was an oxymoron that simply rendered pathological structure, and especially structures of pathological accommodation, within which lay embedded the imprisoning organizing principles the child had acquired, unavailable to the investigative process. Kohut seemed to have borrowed his conceptualization from ego psychology’s postulation of ego defects and carried it over inappropriately because of the continuing influence of his past on his present thinking.

As I became more familiar with the new constructs, I became aware of other conflating influences that were widely dispersed into Kohut’s theoreti-cal edifice. Thus, for example, vis-à-vis the analytic treatment of borderline and psychotic states, I attempted to move past Kohut’s worries about irre-versible self-fragmentation and find a strategy for treatment based on closer scrutiny of the intersubjective field. In connection with the difference in our views on borderline patients, which I reviewed in a joint publication with Stolorow (Brandchaft of Stolorow, 1984), Kohut, in a personal communi-cation, subsequently commented that he had “long held views compatible with those developed here.” He wrote, “Insofar as the therapist is able to build an empathic bridge to the patient, the patient has in a way ceased to be a borderline case … and has become a case of (severe) narcissistic per-sonality disorder” (cited in Stolorow et al., 1987, p. 118).

Similarly, I came to feel that the newly conceptualized narcissistic or selfobject transferences were being treated as spontaneous products with-out regard to the contextual influence exerted by the new theories being advanced. In addition, transference manifestations were frequently being dealt with by a theory-dictated division into selfobject and “failing” self-object transferences. This left no room for the singular importance of non-selfobject experiences, that is, experiences that do not contribute to the strengthening of the patient’s self organization, such as I believed lay at the heart of the clinical experience of developmental pathology that had become familiar to me in my own work. In addition, I came to feel that too rigid a focus on the selfobject dimensions of “grandiose self” configura-tions in mirror transferences and “idealized object” configurations in ide-alizing transferences (Kohut, 1971) could obscure pathological formations and enactments hidden behind these. Such a focus can therefore contribute importantly to the persistence of dissociative mechanisms. I have encoun-tered this conflating process frequently, and evidence for it appears in sev-eral chapters of this book. It is, in large part, my growing recognition of the extent to which the empathic stance can slip from understanding to ritual that has convinced me that only an emphasis on subtle microshifts




in affect state provides the clues to events otherwise concealed. Each of these efforts at reconsideration of Kohut’s findings, I am now aware, were follow-up portions of an underlying attempt to throw open the window of an emancipatory understanding to new areas where I felt I was encounter-ing restrictions to it.

An EmAncipATory pErspEcTivE

Psychoanalysis, as Kohut noted, was in urgent need of a methodology that, by continually expanding the data of observation and limiting the role of inference, could extend the range of psychoanalytic understanding and treatment to areas from which it had been formerly excluded (Kohut, 1966, 1971). Only by responding to this need, said Kohut, could life be breathed into the dying discipline in which he had led an entire professional life. In my work I have similarly come to embrace this investigatory principle and, with my colleagues, have endeavored to extend it beyond limits encoun-tered by Kohut, for example, in his conceptualization of borderline and psychotic conditions, as well as, importantly, in his descriptions of analyz-able transferences and his theories of cure through “optimal frustration” and “transmuting internalizations.”

Kohut’s essential contributions on co-determination were easily assimi-lated and expanded into the framework of intersubjectivity that Atwood and Stolorow had independently begun to develop. As I described earlier, I joined this work enthusiastically at an early stage, and the resulting col-laboration, and the lasting friendships, constitutes an irreplaceable part of my life. The individual path I have followed could not have been possible without this help and unwavering encouragement.

In terms of the present volume, the early chapters of this book will pres-ent the clinical material, arrived at through attempts at sustained empathic inquiry, which cried out for an altered understanding within the frame-work of self psychology. The later chapters of this book trace the develop-ment of the concept of pathological accommodation in concert with a more decisive shift to an emphasis on intersubjectivity. Study of the findings of leading observers of child development (Sander, Beebe and Lachmann, Lichtenberg, Crittenden, Daniel Stern) further strengthened my belief that the origins of the pathological systems are to be found in the very earliest intersubjective interactions in which lived experience comes to be structured and a mode of organizing experience is maintained. Yet, there remained the terribly vexing question of what an analyst could or could not contribute to a transformation of the pathological configurations. As my conviction grew as to their primitive origins and adhesive character-istics, I came to believe that further progress in this direction might be afforded by a systematic study of the relatively neglected area of preverbal




and even prerepresentational fragments of unconscious experience—“the feeling in my bones” experience—where the origins of the systems of pathological accommodation might be interred (see Stolorow, Atwood, & Brandchaft, 1992).

The requirements for such investigation are as exacting as they are neces-sary: The analyst must continually monitor the limits he is encountering in his attempts to attune himself empathically to his patient’s dysphoric reac-tions so that he can recognize where his previous efforts have come under the shaping influence of his own unconscious system of invariant orga-nizing principles and theoretical preconceptions. Liberating himself from these automatic modes of organizing experience enables the analyst to go “beyond belief” so as to be in a position to recognize and validate the core of an alternate subjective reality, that of the patient that has inadvertently come under attack. Repeated consistently, this process provides the basis for a necessary disenmeshment and decentering and is responsive to Bion’s (1977) calls for the abandonment of “memory and desire” and the achieve-ment of “negative capability” as a prerequisite for the establishment of a therapeutic milieu.

The characterization “emancipatory” for my approach was first suggested by Stolorow, for which I am in his debt. The term depicts a continuing bond to Freud’s ideals as described by him, as he recapitulated his own history of discovery: “There was nothing left for me but to remember the wise say-ing that there are more things in heaven and earth than are dreamed of. Anyone who would succeed in eliminating his preexisting convictions even more thoroughly could no doubt discover even more things” (Freud, 1918, p. 12). What I see as pivotal in an emancipatory approach is the analyst’s capacity to liberate his own vision of what is true or best for his patient, let go of such preconceptions, and start anew.

The patient frequently enters analysis with his capacity for self-reflection having been stunted by virtue of an unresponsive and insecure developmen-tal setting. Therefore it is clear that the analysis must consistently facili-tate and help the patient to expand his ability to pay attention to his own experience, and especially to his perceptions of the analyst’s contribution, gradually including that “immanent to the patient’s experience” (Kohut), which requires gaining access to preconscious, procedural, and prereflec-tive domains, so that it can be brought into conscious expression. Only the patient is in a position of ultimate authority as to the perceptual basis of his subjectivity. In the end only he is in a position to be able to deter-mine what is “him” and what is an approximation. Thus only his growing self- reflective knowledge can provide assurance that an incipient revival of pathological accommodation in the treatment can be detected and cor-rected and that one of authentic self experience can be reinstituted and sustained. Such a therapeutic regimen depends absolutely on the commit-ment of the analyst to provide a safe, responsive, and understanding milieu




in which the process can unfold and engage deeper levels of the patient’s experience, in which the patient can come to feel recognized as a “whole” person.

Every analyst, like his patient, comes to the analytic engagement with his own set of preformed invariant organizing principles, which will be “immanent” in his experience of his patient. These constructs will have been shaped by the analyst’s own development and life course and espe-cially by the influence of his own analytic training. Importantly, they may take the form of theoretical commitments and will be sustained by the social and professional milieu in which the analyst lives. Disjunctive experi-ences in his experience with his patient are uniquely valuable in this context as they afford the analyst the opportunity to become more aware of the assumptions underlying his understanding and, in the dialogic interaction, to bring about the necessary corrections. Consequently the liberating pro-cess either works as a continually bidirectional dynamic or falls short. The age-old “either–or” dilemma of psychoanalysis of whose view shall prevail, the patient’s or the analyst’s, yields to the recognition that both patient and analyst are involved in a reciprocity of experience and that the questions to be investigated devolve around what ways that reciprocity emerges.

The critical reflective reexamination of invariant organizing precepts that have been unconsciously shaping the analyst’s experience is thus an indis-pensable component of an emancipatory approach. None presents greater difficulty. Just as the analyst would help free the patient to think for him-self, so must the analyst use the experience to free and to expand his own ability to think for himself. As is the case with the patient, so also must the analyst recognize, if he is to liberate himself, where he is coming under a compulsive need to rely on doctrine, authority, or the mind-numbing pull of facile familiarity. No easy matter this, in as much as his “training” and analysis are likely to have established limits not only on what the analyst knows but also on what he believes he needs to know.

Especially does the reflective capacity to think “beyond” become critical when there is disjunction between the interacting subjectivities of analyst and patient. Each step of the way the analyst must take into account the intensity of his patient’s fears of displeasing, offending, or alienating the ana-lyst, fears that constantly threaten to bring the exploratory process to a halt by shunting it quickly into the more familiar groove of pathological accom-modation. The analyst must become aware of subtle, all but undetectable indications of how the patient’s responses, verbal or nonverbal, to interpre-tations, which the analyst feels were simply attempts at accurate descrip-tions of the patient’s experience, indicate that they were heard as containing unspoken commands with “you should” or “you shouldn’t” inextricably affixed. Such fears and underlying assumptions, invariably encountered, are the unspoken residue of a host of experiences of the reactions of sig-nificant people, from the patient’s caregivers onward, to information they




didn’t want to hear. The analytic process must provide the opportunity for bringing to light the elements of the analyst’s contribution that link the present with the past and, by deciphering their threatening meaning, open the interaction to a new dialogic influence. The quality of the analyst’s lis-tening stance and the passion behind his absolute commitment to help his patient to continue to express exactly how he feels, together with his ability to recognize and acknowledge his ownership of his own contribution, help to preserve and repair the endangered bond. As the analysis proceeds in an atmosphere of greater safety and curiosity that facilitates exploratory inter-est, it comes to focus on the invariant unconscious meanings of the experi-ence that have become engaged and the antecedents that have significantly shaped the patient’s life and have imparted those specific meanings.

The system is one of reciprocal mutual influence always. The ana-lyst’s ability to emancipate himself from his doctrinal commitments, from the dictates of Antiquity, is an indispensable concomitant to the patient’s freeing himself from an acceptance that depends on his having to accept the understanding of the analyst as having greater objectivity and thus being superior to his own—as the “therapeutic alliance,” in all its variations, has always essentially maintained (Greenson, 1967). Sooner or later, all theoretical constructions become limiting because they respond only to what is already known. Sooner or later, progress depends not on the answers that have been given but on the questions now being asked. Keeping the ability to question alive, both in the field and in the consulting room, is axiomatic in an emancipatory perspective as I intend the term.



toward an emancipatory psychoanalysis: …...2 toward an emancipatory psychoanalysis 9 3...

Documents