Australian Chapter of The International Association for Relational Psychoanalysis and Psychotherapy

What is Relational Psychoanalysis?

Relational psychoanalysis is more of a perspective than a theory per se.

Some authors have preferred to think of it as series of questions, perhaps the overriding one being Steve Mitchell persistently asking, "what do we have to presume to be true for any particular formulation to be true?"

And Phil Ringstrom PhD describes the Relational School as a “community of those who have nothing in common....it should be thought of as the 'middle school' of American Psychoanalysis".

It is a term that has evolved in recent years to describe an approach to clinical work that attracts many practitioners from many different parts of the world.

IARPP Australia Relational Psychoanalysis Psychotherapy Psychotherapist circles

What is Relational Psychoanalysis?

Relational psychoanalysis is more of a perspective than a theory per se.

Some authors have preferred to think of it as series of questions, perhaps the overriding one being Steve Mitchell persistently asking, "what do we have to presume to be true for any particular formulation to be true?"

And Phil Ringstrom PhD describes the Relational School as a “community of those who have nothing in common....it should be thought of as the 'middle school' of American Psychoanalysis".

It is a term that has evolved in recent years to describe an approach to clinical work that attracts many practitioners from many different parts of the world.

The term "relational" applies, most broadly, on three levels:

  • Fundamental to this outlook is an appreciation that, all ideas, including psychoanalytic conceptions and accumulated wisdom, are historical, linguistic, political, and contextual.

  • An appreciation that individual experiences and intrapsychic structures derive largely from and are transformations of relationships with significant others.

  • The discovery that therapeutic change operates, at the same time, both intrapsychically and interpersonally and is most usefully explored in terms of the evolving relationship between patient and therapist.

Although not a hard and fast set of concepts and practices, one core feature is the notion that psychic structure–at the very least, those aspects of psychic structure that are accessible to psychotherapeutic intervention–derive from the individual’s relations with other people. This, of course, is intended as an alternative to the classical view that innately organized drives and their developmental vicissitudes are, at root, the basis of psychic structure. (For an extensive discussion of relational psychoanalysis, click on Relations: Introduction to the First IARPP Conference in the IARPP Newsletter, Volume 1, Number 1.)

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How to understand the Relational Psychoanalysis

Charles Spezzano helps us here with a series of questions and answers that he accumulated over the years when asked by students and colleagues what relational psychoanalysis is about.

BIG 'R' little 'r' relational

Relational psychoanalysis has been described both in terms of “r”elational and “R”elational psychoanalysis. The little 'r' relational refers to everyone who ascribes to many of the basic tenants of the relational movement in psychoanalysis.

Big 'R' relational refers to a collective of ideas that some of the originating authors of Relational Psychoanalysis were developing in relationship to one another.

Simply put, this Q&A will be descriptive of both “r” and “R” psychoanalysis without attempts to differentiate between the two which is beyond the purpose or intent of this piece.

Relational Psychoanalysis - a collective of ideas

Relational psychoanalysts from a host of traditional analytic backgrounds, including, Interpersonal (Sullivanian), Freudian, Kleinian, Winnicottian/Bionian, Jungian, Lacanian, Kohutian, all share, a “meta-theoretical” position that ascribes to the mutual influence and regulatory processes that are descriptive of a “two-person” psychological model.

On this “meta-theoretical” level, the concept of “relationality” is synonymous with “contextuality” (Fosshage, 2003; Ringstrom 2010b). Meanwhile, even those Relationalists who retain a conviction in concepts such as “drive theory” are adamant that any exploration of “drives” must be considered in relationship to the context that gives rise to the articulation of or diminishment of said “drives.”

An important philosophical perspective of the Relationalists is that any analysis is potentially fraught with dialectical positions, that is, the struggle with “opposites.” These include quandaries from what is “inner vs. outer” to “one-person vs two person psychology”, to “intrapsychic vs. interpersonal”, to “reality vs. fantasy” and so forth.

A both/and perspective

The Relational perspective is about coming to terms not with “either-or” perspectives or a “one must choose” one, but through to how we grapple with opposites. In other words, how do we cultivate a “both/and” perspective. For example, how is it possible for idealization to be seen as involving both a developmental and defensive function? Or, how can aggression be both a reaction to contextual circumstance as well as instinctual? Of course multiple self-state theory is instrumental to helping the Relationalists understand these seeming contradictions. That is, that one self-state for example can be employing idealization for developmental purposes and another for defensive ones. Or, while circumstances may give rise to an aggressive reaction, aggression is also an “instinctual ‘force’” in its own right.

In short, in embracing chaos, and complexity, and non-linear dynamic systems theory, the Relationalists argue not that “we must choose,” rather that we must grapple with the intrinsic complexity arising both within and between the analysand’s and analyst’s subjective experiences and subjective frames of reference. These, therefore, must be taken up in relation to both party’s participation, while also adhering to concepts particular to each one’s deeply personal sense of subjectivity, such as agency, responsibility, will, and of course, one’s unconscious. Often this leads to grappling with what is at stake for whom in any particular episode of analytic engagement. That is, who has “what” at stake in any particular clinical conundrum? Mostly , though not always, what is at stake weighs more heavily upon the patient than the therapist, hence psychoanalytic treatment tending to be an asymmetrical process, despite its being intrinsically relational.

Understanding enactments

One of the best, early formulations of enactment is “recurrent patterns of conduct (that) serve to actualize the nuclear configurations of self and object that constitute a person’s character. Such patterns of conduct may include inducing others to act in predetermined ways, so that a thematic isomorphism is created between the ordering of the subject and interpersonal fields.” (Atwood and Stolorow, 1984, p. 91; 2014, p.71) (Parenthetically, this definition phenomenologically illustrates a very post-modern view of what contemporary relational analysts view as “projective identification”).

What is compelling about this definition of enactment is that it shifts the language of “projection” (as in transportation of a part of the patient “into” the analyst) into the language of communications (and therefore both affect and information theory) as to how over time one can induce experiential states in another. This formula is basic to modes of human influence - think of seduction, sales, upbeat services in high-end restaurants and hotels, evangelical movements, as well as countless coercive forms of influence which purposively induce states of shame, guilt, negative self-image, and of course experiences of positive states of being. These processes are all part and parcel of the common dynamics of family life, in which the “politics” of choice and autonomous decision making are adjudicated or thwarted. Nevertheless, what is problematic about this definition - from a relational perspective - is its linearity, i.e. it’s “cause/effect” inference.

From the Relational perspective, this formula of projection/induction is understood to pertain to both analyst and analysand. As just one example of many Relational authors, Hoffman (1994) specifies how the analyst’s theory can become its own version of “projective identification” that is the projection of the analyst’s ‘theory of mind’ with which the analysand comes to identify. Consider for a moment the adage, Why do Freudian analysands have “Freudian dreams” and Jungian analysands, “Jungian” ones?

So what is critical from the relational perspective is recognizing the analyst’s contribution to the enactments – at least, as much, as the patient’s. Indeed, one could argue that it is IN the analyst’s recognition of his or her involvement in the enactment that a portal emerges enabling the pairing’s resolution through “mutual recognition”. (For a deeper consideration of the bi-literal influences in “enactments” see discussion of “Mutual Inductive Identification” below.)

But more to the point, enactments involve the enacting of that which is inaccessible to analytic reflection and is therefore “outside” of empathic/introspective attunement or interpretation. Enactments typically involve “implicit”, “unformulated”, “pre-reflective” phenomena occurring for both analyst and analysand. They typically “stage” something in a manner such that it hopefully can come to be understood. Another way to think of enactments is that they involve a quasi-“dramatic form” - a “scene” if you will - that then presents the analytic couple with something to take up and to take apart and to be compelled to make sense of lest they devolve into impasse. Each is forced to take up their contributions to the enactment, which moves them beyond their “mutual negation” of each other into the possibility of “mutual recognition” (see below for further elaboration of these concepts). And, because of the mutual involvement of enactments, the analyst learns more about him or herself as well. As Slavin and Kriegman (1998) write, “the analyst too, must change.”

Now it is commonly said that if the analyst simply remains attuned to the “repetitive dimension” of the transference, enactments need not occur. Unfortunately, this is a bit like driving to San Francisco by looking only in the rear view mirror. Enactments produce the unpredictable, the emergent and most importantly that which is NOT accessible to the dialogue to be attuned to. That’s because we are talking about the implicit domains of communication (for both analyst and analysand) and typically not the explicit.

In short, enactments are simply part of the fabric of psychoanalytic engagement and discourse (Renik). In my experience, every “worked-through” enactment is worth hundreds of moments of “accurate” empathic attunement, though the latter is critical to making the intersubjective-relational field trustworthy enough such that the enactments can be worked through in profoundly salutary ways.

But the point is, enactments are critical because they take up the problems of authenticity in analysis, especially when all the “goodness” of empathic attunement” or all the correctness of “interpretations” leaves barren the question of the mutually of impact. And it is in impact, that we realize agency. It is in that impact that we come to recognize the “third force” within psychoanalytic evolution which is the addition of collaboration and negotiation to the hallowed halls of interpretation and empathic attunement.

This is the radical “sea-change” in psychoanalysis that the Relational perspective offers, quite uniquely actually.

UNDERSTANDING 'THE THIRD' according to Jessica Benjamin?

I prefer to first take up this question with Ogden’s formulation of the “psychoanalytic third” which is captured in what is perhaps the best introduction of any psychoanalytic text (both Steve Mitchell and I shared this quote as a personal favorite) which is as follows:

“You, the reader, must allow me to occupy you, your thoughts, your mind, since I have no voice with which to speak other than yours. If you are to read this book, you must allow yourself to think my thoughts while I allow myself to become your thoughts and in that moment neither of us will be able to lay claim to the thought as our own exclusive creation... a third subject is created in the experience of reading that is not reducible to either writer or reader.” (Ogden, 1994)

What Ogden is showing us is that all texts are engaged and transformed by the reader such that the text no longer belongs exclusively to either the author or the reader. What emerges is something much more complex. It is the influence that each one’s “mind” is having upon the other’s and what emerges in this complex engagement is something that is “beyond” what either might contrive of as his or her own. This engagement leads to the development of a “third” element of mutual communication and understanding, though this often emerges first unconsciously, hence the Relationalists idea of the “relational unconscious.”

Though Ogden’s example pertains to text, it extends to the analytic coupling in so far as it recognizes that, that with which the dyad is grappling belongs to neither, at least in any exclusive sense. I take this up in much greater detail in my examination of the place of “Improvisation” in psychoanalytic treatment, AND its place in relation it’s opposite, “mutual inductive identification.” (see below)

Benjamin also formulates a multitude of configurations of “thirdness” (the –“third-the-one”, “one-in-the-third”, the “moral third” and so forth –these are topics I take up in my new book A Relational Psychoanalytic Approach to Couples Psychotherapy). In a more general sense, Benjamin’s sense of the “third” involves the ineffable phenomenon of two subjectivities co-authoring a position from which to recognize each other. This involves to subject-to-subject relating (as opposed to subject-to-object) but emerges from the more profound and ineluctable position that in intersubjective engagement - especially in its most raw (non-reflective) form - there is a heightened potentiality that the two will misrecognize one another. And, when there are high stakes relating to their disagreement, the “fat-hits-the-fire.” This latter phenomena might be thought of as “negative thirdness” (or what I have called ”noxious thirdness” Ringstrom, (2001) in which the dyad spirals in “reversible complementarity” (Benjamin, 2004) that is, the “swapping” of positions of “dominance and submission” or the “doer” and the “done-to.” What is “dominant”, by the way, is whose mode of mentalization (symbol and meaning making prevails).

The question, is this a “mental space” that is open to taking up and negotiating difference (including taking up struggling with the “nonnegotiable”) or does it devolve into versus each partner fighting for their psychic reality in what feels like a “life and death” struggle for the sanctity of their own mind. (Think of George and Martha in “Who’s Afraid of Virginia Woolfe?”) This is why the “dominance and submission” of modes of mentalization are pervasive at times of intersubjective crisis (such as dire episodes of “mutual negation”) and this applies sometimes to analyst and analysand as well. I incorporate these ideas in my book on couples treatment in terms of “the (couple’s) relationship having a mind of its own.”

At the cutting edge

A few final notes are that Ogden assumes the traditionalist position of the analyst “subjugating” his or her reality to that of the patient. This accords the analytic tradition of abstinence, neutrality and anonymity, i.e. the “three analytic pillars” (“ideals”) of treatment in “preparation for interpretation.” From some contemporary psychoanalytic perspectives, it involves the analyst’s subjugation of his or her alterity to the role of “affect attunement.”

The radical edge of Relational Psychoanalysis appears to value a bit more investment in “mixing it up.” Hence, I believe that the cutting edge of Relational treatment is found in Improvisation as does Daniel Stern (2007), who writes:

“An improvisational view is a logical next step in the field. In the last decades we have seen the application of chaos and complexity theory, along with dynamic systems theory open up our clinical eyes to various features of the therapeutic situation, such as: the emphasis on process; the approximate equality of the contribution of patient and therapist, i.e. the notion of co-creativity; the unpredictability of what happens in a session from moment to moment, including the expectance of emergent properties; a focus on the present moment of interaction ; and the need for spontaneity and authenticity in such a process.” (p. 101)

In this latter manner, the analyst does not so much subjugate her or his experience as utilize it to “play-off-of-and-with” the material emergent in the treatment. This cultivates episodes of “mutual recognition” and “thirdness” though it also readily “courts” the phenomena of “enactments” or what I prefer to call “mutual inductive identification.”

As a final note, Benjamin seems to not so readily buy into Ogden’s view of “subjugation” as this is too close an approximation of the analyst ascribing to a position of “submission.” However, in the face of impasses, resultant of unresolved enactments, Benjamin, ala Ghent (1990) would posit the idea of “surrender”. A simple understanding of “submission” vs. “surrender” is that the former involves the individual’s “submission” TO the will of another, whereas the latter involves the individual’s “surrender” OF a more egoistic, prideful position. What a difference a preposition makes!?!

Mutual recognition and negotiation.

Unfortunately, there is a woefully common misreading and therefore misrepresentation of the concept of “mutual recognition.” This misreading assumes that the idea of “mutual recognition” involves the required recognition of the analyst’s narcissistic needs and involvement in the treatment. This is simply balderdash.

“Mutual recognition” at least from Benjamin’s and most Relationalists’ perspective is meaningless, absent, its dialectical opposite, “mutual negation.” The Relational position is that as we are all both discoverers and creators of our subjective sense of reality, we frequently can end up at odds with one another. This especially appears in forms of omnipotent fantasy to which we are all subject, in which the question is, “who is in control of and responsible” for the “reality” in which we are both participating. In omnipotence, we are prone to believe our own convictions and to the extent that these “emotional convictions” (Orange, 1995) misrecognize the subjectivity of the other we “negate” him or her. Nevertheless, to the extent that we need to believe in our convictions, these differing perspectives of others may end up feeling threatening.

The Relational perspective adheres to the position that both the analyst and analysand can, during various episodes of the treatment, feel threatened, and therefore revert to the familiar – including omnipotent fantasy and emotional conviction. And, when we revert to what is familiar to us, we tend to misrecognize the subjectivity of the other. Indeed, we implicitly often unconsciously begin to “induce” the other to become “familiar” and in so doing, we decontextualize the mutuality of our experience in a manner that begins to “objectify” one another, that is turn one another into “objects.” (This defines “mutual inductive identification” – please see a more complex definition below).

Where this becomes crucially relevant in psychoanalytic treatment is taking up how both transference and countertransference positions are prone to “objectify” the other that is, “constructing” the analyst or analysand in some role. The role in which one is cast, unfortunately, creates an “as if” reality - sometimes a “not me” experience (Stern, 2011) – within each that further cultivates “self-fulfulling prophecies” in so far as the longer we treat the other in an “as if” manner, the sooner we begin to shape each other into enacting that version of reality. This is why Bromberg (1998) wrote that “projective identification is a precursor state for enactments.”

It is this latter “as if” construction that must be “destroyed” to discover the actual subjectivity of the other. These ideas relate to Winnicott’s notion of “disillusionment” as in the child must attempt to “destroy” his or her “as if” fantasy of the (m)other to find her as a real, independent subject separate from his fantasy of her. In treatment, this pertains especially to working-through transference. The analysand must, much like the toddler does, challenge the “(m)other/analyst” in a manner that threatens to “destroy’ her, to then realize that what is left after the “destruction” is an intact person (subject) who is not destroyed but who remains curious and engaged. All of these are later taken up in terms of what Pizer (1998) refers to as “negotiation” which involves the “negotiation” of separate perspectives, without devolving either into “twinship” and merger, or the opposite, perniciously, irreconcilable differences between parties.

Improvisation.

What is Mutual inductive identification and where does it fit in relationship to Improvisation?

Much like “mutual recognition” makes little sense without its dialectic, “mutual negation”, “Mutual Inductive Identification” means very little, absent, its dialectical opposite, “Improvisation.” Therefore I will discuss Improvisation first.

Improvisation takes up the challenge that Winnicott (1971) presented psychoanalysts with. He wrote:

“If the therapist cannot play, then he is not suitable to work. If the patient cannot play, then something needs to be done to enable the patient to become able to play after which psychotherapy may begin.”

Play can be interactive but it also can be seen as a state of mind. I am frequently asking myself at points of analytic session, “Have we lost our ability to play with ideas and feelings and more importantly, have I lost my ability?” When so, I sense we are on our way to “mutual inductive identification,” but first more on Improvisation.

The playful spirit of Improvisation is an additive process, meaning each participant’s contributions are building upon one another’s. One of participants says something suggestive of his version of reality, i.e. what their relationship is and what is happening between them. Then the other picks up on it in some form of “yes/and”, which is implicitly conveying, “I recognize what you are saying and here’s another spontaneous thought and feeling of my own about it.” To and fro, the participants begin to play-off-of-and-with one another in a manner that avails them of what Bollas refers to as the bi-directional “free associational” process. This departs from the linearity of the patient producing data from which the analyst lays in wait to make the most salient interpretation or to engage in an optimally empathically attuned response.

In the “to-and-fro-ness” of improvisation, analyst and analysand, “court surprise” (Stern, 1997) and begin to cultivate episodes of a “relational unconscious” as well as “thirdness.” If ever there is a mode of complexity theory in practice, improvisation is it!

In contrast to improvisation, the constraint of play in psychoanalysis involves a different process, one which I have described as a process of “mutual inductive identification.” Mutual inductive identification corresponds largely with the relational construct of enactments, as well as bi-directional modes of projective identification.

The comparison of improvisation with “mutual inductive identification,” takes up the rich and largely unsettled question in relational psychoanalysis of the relationship of “enactments, projective identification, and interaction” (Aron, 1996, 2003). At the root of these ideas is the question: when, where and how the analytic dyad can or cannot play with thoughts, feelings and interactions that arise both within and between them.

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