The Relational Psychoanalytic Orientation

Fourth Year Adult Psychoanalytic Training (APT)
2022-23, 2nd Trimester — Fridays, 1:45-3:15pm


Introduction

As part of the SPSI curriculum for the classes you’ve taken thus far, you’ve been exposed in some depth to traditional one-person psychoanalytic theories, including the original versions of drive psychology, ego psychology, self psychology and American and British object relations theories. Though these psychoanalytic schools of thought vary considerably, one thing they have in common is that they place great, if not exclusive, emphasis on the presumed internal workings and vicissitudes within the individual mind. All of these theories moved psychoanalysis in important directions: ego psychology developed an increased appreciation of the individual’s defense mechanisms, as well as beginning to include the role of the environment in shaping and influencing psychic development; self psychology promoted a greater understanding of the vicissitudes of a person’s sense of self-worth, as reflected in such features as the presence of a grandiose self, narcissistic injury, and developmental empathic failure; and object relations theory aimed to elaborate the inner object world, including the interaction among internalized representations.

While some of these schools of psychoanalytic thought implicitly moved psychoanalytic theory toward a two-person psychology (especially theories influenced by the work WRD Fairbairn, DWW Winnicott, Hans Loewald, and selected others), contemporary relational theories have taken the most decisive and radical turn toward a two-person model.

A major shift credited to the relational psychoanalytic orientation is that it moved psychoanalytic theory away from the near exclusive study of the individual mind or psyche, toward the interaction between two “real” people, the patient/client and the therapist or analyst. The term “relational psychoanalysis” was originally coined in the 1980s by Stephen Mitchell, Jay Greenberg and their colleagues at the Post-Doctoral Program at New York University. In this seminar, we’ll cover an array of authors that are closely representative of the relational tradition. Relational authors argue that personality emerges out of the matrix of early formative relationships with parents and other significant figures. One important difference between relational theory and traditional psychoanalytic thought is in its theory of motivation, which assigns equal if not more importance to the quality of relatedness between an individual and his/her interpersonal surround, rather than focusing on the vicissitudes of inborn instinctual drives.

Relational psychoanalysis is associated with such concepts  as social constructivism (e.g., Irwin Hoffman, Donnel Stern); enactment (e.g., Owen Renik, Lewis Aron, Anthony Bass); and countertransference (e.g., Epstein & Feiner, Karen Maroda ). What all these authors have in common is that they tend to view transference and countertransference as co-creations carved out of the psychoanalytic dyad of patient/client and analytic therapist. Contrast this to traditional theories that view transference as residing within the patient, which is then projected or displaced onto the analyst. Also, while the earlier traditional analytic theorists tended to view countertransference and enactment primarily as “errors” on the part of the analyst, occurrences that would negatively affect the treatment process, relational authors view them—and indeed, the analyst’s subjectivity in generally—as inevitable, unavoidable, potentially not a hindrance, but potentially an aid to the analytic process when properly worked with. Relational analysts are more likely than traditional analysts to view countertransference as the product of the analyst’s own ongoing subjectivity in interaction with the patient’s psyche. As such, it is a highly informative source of information about the patient and the analytic process per se. Those associated with the relational orientation tend to approach the work with a spirit of greater egalitarianism between patient and analyst. The relational style of interpretation aims to be experience-near, eschewing traditional interpretations that can at times be intellectualized, stilted, and/or authoritarian-sounding (e.g., see Stephen Mitchell’s critiques). When treating patients/clients, relational psychoanalysts recommend a mixture of judicious and disciplined restraint and a degree of spontaneity on the analyst’s part. Relationally-oriented psychoanalysts decry the traditional sole focus on interpretation, cognitive insight, and free association; they believe that the analytic relationship itself has a large impact on the analytic process and outcome, and that interpreting its development is an additional “royal road” to the unconscious, along with dreams, one’s fantasy life, and the like.

The relational perspective and its interpersonalist precursors were the first major psychoanalytic approaches to be greatly influenced by feminism and postmodernism. In addition, queer theory and postcolonial critique have influenced the evolution of relational thinking. Consequently, one of the defining features of relational psychoanalysis is an appreciation of the role of culture and subcultural differences in shaping mental life, one’s sense of self, and interpersonal relationships. Variables such as gender, race, ethnicity, class, and sexuality are understood to be necessary considerations in theory building and in the conceptualization of an individual patient and the treatment process itself. Some authors make such consideration explicit, while for others it is implicit given the emphasis on the “matrix” in relational theory.

A word of context about the design of this course in its 2022-2023 iteration.  It can take three or more years of continual coursework in a “contemporary” institute—almost all of it devoted to the relational literature and its contributors-- to fully understand, appreciate, and be able to apply this orientation’s thinking to one’s clinical understanding and practice.  Here at SPSI we have only one dedicated course, of only 11 sessions, in which to accomplish a sturdy and substantive overview of all this material. So we have to be realistic about the constraints involved.

In part because of this, a few of the assigned readings will be summary condensations (often, though, from the seminal thinkers themselves) of the main viewpoints associated with the topic. These readings may not feel quite as gripping as you’d wish—for one thing, they may not dive into a particular clinical illustration--but they’re important for covering certain key bases about the orientation. I am glad to offer additional, more targeted readings to help deepen your engagement with any particular theorist or idea, according to your personal level of interest—just let me know if you’d like further suggestions.  By the way, I replaced some—though not all—of the readings I’d heard you’d already covered in earlier classes with others equally compelling.

All that said, much of what you’ll be reading about may already feel familiar to you, as if, “Well, of COURSE this is what psychoanalysis is!” The reason you might have this reaction is that by now, much of this perspective has been absorbed--to a greater or lesser extent, and more or less accurately or successfully--into the analytic mainstream.   Relationalists fought a long, hard fight to get these concepts out there and accepted, and to the degree that it sounds like second nature, it’s because this effort was successful.  But you’ll understand this position much more thoroughly if you become conversant with the underlying arguments and perspectives put forth in these seminal readings.

If it seems indicated, I may offer some study questions for you in advance of the class sessions, to help guide your thinking as you engage with the assigned papers throughout the trimester. If the readings end up feeling especially dense for a given week, I’ll try to let you know in advance (or use your own discretion) as to what to concentrate on for that particular class session. Papers listed under “Further Suggestion(s)” are of special interest and to be potentially read on your own.

I look forward to having a meaningful and engaged experience together as we explore these vibrant theoretical perspectives and their clinical implications.

By developing the skills outlined in the Learning Objectives, clinical associates’ clinical flexibility and case conceptualization skills will be expanded, thereby enhancing both patient/client retention and treatment efficacy.

Learning Objectives

By the end of this course, clinical associates will be able to:

  1. Discuss the difference between one and two-person psychologies, and to articulate general guiding principles of the relational orientation and its range of theories, and explain how these have evolved from earlier traditional psychoanalytic theories.
  2. Compare and contrast the relational orientation with two of their precursors, the middle school of British object relations and the interpersonalist perspective. The learner will be able to consider conceptual and methodological aspects.
  3. Describe relational perspectives on enactment, countertransference, and therapeutic authority, among other central concepts. Through case examples, the learner will be able to apply the principle that psychic experiences are co-creations or constructions between patient and analyst.
  4. Demonstrate a greater appreciation for how factors such as race, gender, sexuality identity, and ethnicity impact psychological life and the clinical process.

December 2, 2022 — Introduction to the Relational Orientation: Its History and Conceptual Framework

[32 pages]

Aron, L. and Lechich, M., (2017) “Relational Psychoanalysis” in Textbook of Psychoanalysis (eds. Gabbard, Litowitz, Williams), pp211-224 

Aron, L. (2001) “Relational Theory and its Boundaries” in A Meeting of Minds, pp31-64.

(Read 47-64 in “A Meeting of Minds”. The rest is optional or for your reference.)

Further Suggestions

Aron, L. (2001) "The Relational Orientation: An Introduction" in A Meeting of Minds, pp1-30.

December 9, 2022 — Interpersonalist Theory and its Influence

[41 pages]

Mitchell & Black (1995) “Harry Stack Sullivan and Interpersonal Psychoanalysis” in Freud and Beyond: A History of Modern Psychoanalytic Thought, pp60-84.

Levenson, E.A. (1988). The Pursuit of the Particular—On the Psychoanalytic Inquiry. Contemp. Psychoanal., 24:1-16.

January 6, 2023 — The Usage of the Analyst’s Subjectivity within the Analytic Relationship

[51 pages]

Aron, L. (1991). The Patient’s Experience of the Analyst’s Subjectivity. Psychoanal. Dial., 1(1):29-51.

Karen, R. (2012). Beckoning: The analyst’s growth as a therapeutic agent. Contemporary Psychoanalysis, 48(3):301-328.

January 13, 2023 — The Range of Potential Interactions and Intentions on the Analyst’s Part

[55 pages]

Mitchell, S. (1997), Ch5: “Varieties of Interaction” in Influence & Autonomy in Psychoanalysis, pp143-168.

Mitchell, S. (1997), Ch6, The Analyst’s Intentions in Influence & Autonomy in Psychoanalysis, pp169-203

(You can read only up to the top of page 197.)

Further Suggestions

Mitchell, S.A. (1998). The Analyst's Knowledge and Authority. Psychoanal Q., 67(1):1-31.

January 20, 2023 — Ritual and Spontaneity

[45 pages]

Hoffman, I.Z. (2001) Ch9: “Ritual and Spontaneity in the Psychoanalytic Process” in Ritual and Spontaneity in the Psychoanalytic Process, pp219-244.

Maroda, K. (2012) Self-disclosure and advice in Psychodynamic Techniques: Working with Emotion in the Therapeutic Relationship, pp107-135.

(Read up to p. 125)

January 27, 2023 — Unformulated Experience & Dissociation

[51 pages]

Stern, D.B. (1983). Unformulated Experience —From Familiar Chaos to Creative Disorder. Contemp. Psychoanal., 19:71-99.

Bromberg, P.M. (1993). Shadow and Substance: A Relational Perspective on Clinical Process. Psychoanal. Psychol., 10(2):147-168.

February 10, 2023 — Enactments and Therapeutic Action

[46 pages]

Bromberg, P.M. (2006) Potholes on the royal road: Or is it an abyss? in Awakening the Dreamer, pp85-107.

Stern, D. (2010). Ch4, The Eye Sees Itself: Dissociation, Enactment, and the Achievement of Conflict in Partners in Thought: Working with Unformulated Experience, Dissociation, and Enactment, pp71-105.

(End at page 93.)

Further Suggestions

Bass, A. (2003). “E” Enactments in Psychoanalysis: Another Medium, Another Message. Psychoanal. Dial., 13(5):657-675.

February 17, 2023 — Intersubjectivity (Schwartz; BCPG)

[59 pages]

Schwartz, H.P. (2012). Intersubjectivity and Dialecticism. Int. J. Psycho-Anal., 93(2):401-425.

Boston Change Process Group (2018) Moving through and being moved by embodiment in the psychoanalytic relationship, Contemp. Psychoanal. 54(2), 299-321.

Spezzano, C. (2012) Ch2 “Intersubjectivity” in Textbook of Psychoanalysis (2nd Edition) (Gabbard, Litowitz, and Williams, Eds.) American Psychiatric Publishing, pp105-115

February 24, 2023 — The Analytic Third

[46 pages]

Benjamin, J. (2018). Ch1, “Beyond Doer and Done To: An Intersubjective View of Thirdness,” in Beyond Doer and Done to: Recognition Theory, Intersubjectivity and the Third, pp21-49.

Ogden, T.H. (1994). The Analytic Third: Working with Intersubjective Clinical Facts. Int. J. Psycho-Anal., 75:3-19.

March 3, 2023 — Gender, Sexuality, Race

[33 pages]

Dimen, M. & Goldner, V. (2011). Ch10, “Gender and Sexuality” in Textbook of Psychoanalysis (2nd Edition), pp133-152.

Leary, K. (2012). Race as an Adaptive Challenge: Working with Diversity in the Clinical Consulting Room. Psychoanalytic Psychology, 29(3), 279-291.

Further Suggestions

Suchet, M. (2007). Unraveling Whiteness. Psychoanal. Dial., 17(6):867-886.

March 10, 2023 — Clinical Approaches to Character Pathology (with special attention to borderline functioning, micro-trauma, and hysterical relatedness)

[51 pages]

Davies, J.M. (2004). Whose Bad Objects Are We Anyway? Repetition and Our Elusive Love Affair with Evil. Psychoanal. Dial., 14(6):711-732.

Crastnopol, M. (2018) Getting better: Impediments and aids to psychic change. Contemporary Psychoanalysis, 54:511-539.

(The second half can be skimmed)

Further Suggestions

Mitchell, S.A. (1986). The Wings of Icarus: Illusion and the Problem of Narcissism. Contemporary Psychoanalysis, 22:107-132.

Davies, J.M. Frawley, M.G. (1992). Dissociative Processes and Transference-Countertransference Paradigms in the Psychoanalytically Oriented Treatment of Adult Survivors of Childhood Sexual Abuse. Psychoanal. Dial., 2(1):5-36.

McWilliams, N. (2010) Paranoia and political leadership. Psychoanalytic Review 97(2), 239-261.

Lionells, M. (1986) A reevaluation of hysterical relatedness. Contemporary Psychoanalysis, 22:570-597.