Relational Psychoanalysis. Volume 2: Innovation and Expansion (Book Review)

Author:  Aron, Lewis and Harris, Adrienne
Publisher: The Analytic Press
Reviewed By: Susan DeMattos, PhD, Vol. XXVII, 1 (Winter 2007), pp. 46-51

The first volume of Relational Psychoanalysis occupies a special place in my heart and mind. Published in 1999, I remember the excitement of early continuing education seminars on articles from the book; and I remember being jealous of those fortunate enough to be in an online seminar with the editors, Stephen Mitchell and Lewis Aron. When the online seminar was offered the next year, it was interrupted by the sudden, too soon death of Stephen Mitchell. I keep the New York Times notice of his death in the front of that volume as a reminder of all he has done and some of what we have lost.

That first volume gave me a way to think about Lacan and Bion through an article by Michael Eigen; expanded my sense of the unconscious in articles by Donnel Stern and Robert Stolorow and George Atwood; alerted me to the complexities of a two person psychology and attending to the subjectivities of both analyst and patient in articles by Hoffman, Chodorow, Greenberg, Aron, Bromberg, Stuart Pizer, and Renik; and introduced me to the importance of intersubjectivity in papers by Benjamin and Ogden. Mitchell, Spezzano, Harris, and Davies and Frawley hinted at the power that comes from looking from a different perspective. But certainly the most personally transformative article introduced me not only to the thinking of its author, Emmanuel Ghent, but through him the work of Winnicott’s colleague, Marion Milner. As the editors were preparing this second volume of Relational Psychoanalysis, Emmanuel Ghent also died. The editors are aware of the huge challenge they face of charting the growth of relational psychoanalysis in the context of great promise and great loss.

In this review I hope to trace what Mitchell and Aron hoped to accomplish in the first volume, and to describe the view of relational psychoanalysis that emerged, the responses to the vision of that volume, the purposes of the second volume, and how well the articles in the second volume meet the editors’ purposes.

Mitchell and Aron had outlined both a retrospective and a prospective purpose for that first volume. They chose articles that would suggest where the relational trend came from and some key ideas of the relational trend. Prospectively they wanted to shed light on two hotly debated issues: the debate around drive theory and the role of constructivism in relational psychoanalysis. They concluded that relational concepts provide alternative understandings of the same phenomena that drive/defense theory try to understand; they favored “a form of constructivism that grants some weight to the materiality of the body and its attributes” (p. xvi) while at the same time acknowledging that these attributes are social constructions.

Mitchell and Aron noted that relational psychoanalysis shares certain ideas with Freud.

A psychoanalysis that does not draw on basic features of Freud’s thought and practice would be virtually unrecognizable as psychoanalysis—thinking about mind in terms of unconscious processes; exploring the dialectic between present and past; grounding states of mind in bodily experiences; a careful, patient listening to the analysand’s associations; a play in the dialectic between fantasy and reality; the focus on feelings about the analyst (transference) and psychical obstacles to uncomfortable thoughts and feelings (resistance). (p. ix.)

In a workshop on the therapeutic action in relational psychoanalysis, my colleague Billy Brennan and I (Brennan & DeMattos, 2003) noted that relational thinkers posit a different model of the mind, that rather than seeing the mind as a set of predetermined structures emerging from inside an individual organism, Mitchell (1998) drew on a social theory of mind that redefined mind as “transactional patterns and internal structures derived from an interactive, interpersonal field” (p. 17). Once you accept a theory of mind that involves two people, then technique is naturally going to be examined in terms of the impact and participation of the analyst in the relationship. As Crastnopol (2001) has pointed out, this means that the relational analyst needs to be grounded in his or her own subjectivity and engage in interventions “out of the underlying conviction that this approach will progressively allow patient and analyst together to experience and fully recognize aspects of the patient’s self that were heretofore unknown or unaccepted” (p. 388).

The relational view has been critiqued by several contemporary analysts. Of the critiques I wish to discuss, only Silverman’s (2000) was written before Mitchell’s death. In 2000, Silverman did an interrogation of the relational turn and expressed concern that Mitchell’s appeal to contemporary philosophers to support his view of mind and his defining validity as a function of utility were problematic. Mitchell responded:

There is no place in any of my writings in which I argue against the idea that the patient has a mind with preexisting properties before ever encountering the analyst or that there are no continuities among the versions of ourselves that emerge with different people. This would, of course, be preposterous. But I think a problem with preconstructivist thinking is the assumption that there is a static organization to mind that manifests itself whole cloth across experiences. A very good description of the way I think about mind as preexisting but not preorganized is to be found in Ogden [Reverie and Interpretation, 1997, p.190]:

The internal object relationship … is not a fixed entity; it is a fluid set of thoughts, feelings, and sensations that is continually in movement and is always susceptible to being shaped and restructured as it is newly experienced in the context of each new unconscious intersubjective relationship. In every instance it will be a different facet of the complex movement of feeling constituting an internal object relationship that will be most alive in the new unconscious intersubjective context. It is this that makes each unconscious analytic interaction unique both for analyst and analysand. (p. 155)

In responding to Silverman’s concerns about validity, Mitchell writes that psychoanalytic knowledge is generated in the intersubjective mix between analyst and patient and that “the only way analyst can know anything about the mind of the patient is in interaction with his or her own mind” (ibid, p. 157). These versions of the patient’s mind are unique to the particular analytic encounter and so can not meet traditional definitions of validity.

Busch (2001) is particularly critical of the social theory of mind espoused by Mitchell and other relational writers. For Busch, the primary goal of analysis is to free the individual patient’s mind, replacing the inevitability of action with the possibility of reflection. He objects to the relational analyst’s stance of not knowing and exploring the relational matrix rather than the patient’s individual mind. Greenberg (2001) has written of his concern about relational analysts’ “risk-taking, engaging patients in a highly personal way that breaks the traditional analytic frame” (p. 359). He worries about relational psychoanalysis becoming a movement with all the excesses that movements bring, outlining four relational principles and then expresses this concern:

Consider the four principles as I have outlined them. The personal influence of each analyst, the uniqueness of each analytic dyad, the inevitable uncertainty about what is happening at any moment in the treatment, and the consequent unpredictability of the effects of any intervention all suggest that there is no one way of working that can be privileged across the board over any other. Each analyst and each analysand must find the mode of engagement that best serves the analytic goals the participants have defined. There is no way, the relational critique reminds us, to assert a priori the benefit of any technical intervention. . . And yet, the clinical examples through which relational authors illustrate their perspective seem always to point us in a particular direction. (pp. 363-364)

Eagle, Wolitzky, and Wakefield (2001) also raise concerns about the relational view of the mind and the relational analyst’s stance of not knowing.

Our main thesis is that new view theorists, in attempting to justify their critique of classical theory, have taken philosophical positions that are untenable, create at least as many difficulties as they are intended to resolve, and undermine assumptions essential to psychoanalysis. We also maintain that these positions are unnecessary to sustain the legitimate criticisms of psychoanalysis advanced by new view theorists. We show that even they are uncomfortable with a philosophical position that precludes any attempt to uncover truths about mental contents. This discomfort is reflected both in the disjunction between their conceptual stance and the clinical material they present, and in their tortured redefinitions of truth and objectivity. We conclude that a fruitful philosophical position for psychoanalysis is a “humble realism” in which one recognizes the uncertainty of psychoanalytic inference but nonetheless is governed by the ideal that interpretation and understanding attempt to “tally with what is real in [the patient].” (p. 461)

Most recently, Mills (2005) has offered an appreciation and a critique of relational psychoanalysis. Mills examines three main philosophical tenets of relational psychoanalysis: the primacy of relatedness, intersubjective ontology, and psychoanalytic hermeneutics. In terms of the primacy of relatedness, Mills states, “relational theory is merely stating the obvious” (p. 158), and that what is really unique to relational psychoanalysis is the abnegation of the drives. Mills is also concerned that relational psychoanalysis privileges intersubjective systems in a way that diminishes “the individually constituted and constitutive mind” (p. 162). Thirdly, Mills notes that the relational theorists have “embraced a constructivist epistemology and method of interpretation” (p. 162) but do not clearly define their theoretical system that guides analytic method.

I read these critiques before I read the second volume of Relational Psychoanalysis. So I came to this second volume with some curiosity about whether the editors and contributors would address these critiques of the nature of mind, the nature of therapeutic action, the authority of the analyst, and the elaboration of the theoretical system that guides analytic method.

What immediately becomes clear when looking at the table of contents is that the editors do intend to address therapeutic action, and the nature of mind, and the social and cultural dimensions of relationality. In the Introduction, Aron and Harris make it clear that they are aware of the dangers of relational psychoanalysis becoming a school or of being vague and eclectic. Following the sensibilities of the first volume, Aron and Harris continue to refer to a tradition rather than a school:

In the spirit of pluralism, we begin with a guiding premise that there can be multiple pathways in the development of theories and that individuals in distinct and different communities work and interact and influence each other in ways that can only add to the health of our discipline and our practice. (p. xiv).

While Mills states that what makes relational theory unique is the abnegation of the drives, Aron and Harris return to Mitchell’s 1988 book on relational concepts to find the relational approach being much more inclusive, housing theorists who maintain an allegiance to the drive model, theorists who use drive model language but redefine key terms, and theorists who broke from drive theory. As Aron and Mitchell wrote in the first volume, drive theorists and relational theorists are exploring the same phenomena but using different language. This gave me a sudden pang of missing Emmanuel Ghent (2002) who dealt with these issues so movingly in his last published paper, “Wish, Need, Drive.”

Unlike Mills, Aron and Harris are not defining relational concepts as a theory but as a structure or schema or plan of action or strategy “that holds together various concepts, thus allowing a theorist to integrate his or her own theory within it” (p. xvi). Aron and Harris describe how Mitchell established such a structure with three dimensions (a self pole, an object pole, and an interactional pole). This is the beginning of elaborating how to think intersubjectively that is extended in the papers by Beebe and Lachmann and Karlen Lyons-Ruth.

The first part of this second volume on therapeutic action serves as a thoughtful response to Greenberg’s concern that relational authors “seem always to point us in a particular direction.” Demonstrating their commitment to the spirit of pluralism, the editors present a series of papers on therapeutic action that both share a recognition of the interactive nature of the analytic field and demonstrate a variety of points.

If in the first volume Hoffman, Chodorow, Greenberg, Aron, Bromberg, Pizer, and Renik had alerted me to the complexities of attending to the subjectivities of both analyst and patient, in this second volume Ehrenberg, Slochower, Cooper and Levitt, Slavin and Kreigman, Maroda, and Jacobs explore the choices analysts have in this interactive, intersubjective field. Ehrenberg, drawing on her interpersonal training and extending it by relating to the work of Winnicott (“the continuity–contiguity moment”) and Guntrip (“the moment of real meeting”), sees analyst and patient as “observing–participants” (p. 7) engaged in a mutual and authentic collaboration. In this article, Ehrenberg stresses the value of sharing her unprocessed, immediate reactions to her patients. However, in the afterward she notes, “disclosure is only one of the many possible responses we can offer at any given moment. How to determine the kind of response is the critical issue” (p. 19). Ehrenberg also keeps the memory and thought of Mitchell alive by continuing to dialogue with him and clarifying what she means by the intimate edge: “an interactive creation that exists only intersubjectively. It is always unique to the moment”(p. 20).

Offering a counterpoint to Ehrenberg’s article, Slochower explores when the analyst’s subjectivity should be kept in the background. Also drawing on Winnicott, but this time using Winnicott’s idea of the analytic holding environment, Slochower explores analytic situations in which mutuality is not clinically possible until there is some holding that allows the patient to develop his or her subjectivity without being overwhelmed by the analyst’s “otherness.” Slochower writes:

When the reality of my separate subjectivity consistently disrupts inner process and cannot be worked with or worked through, I turn to the holding process. I use holding in a metaphoric sense to allude to the coconstructed creation, by patient and analyst, of an illusion of analytic reliability and attunement. (p. 34)

As Ehrenberg stresses the importance of the therapist’s disclosure, and Slochower explores when the therapist needs to stay in the background, Cooper and Levitt explore another dimension of the analyst–patient interaction: “the patient’s experience of the analyst as old and new.” Cooper and Levitt note that their paper was inspired by Greenberg’s paper on neutrality (published in the first volume of Relational Psychoanalysis). While Greenberg had equated new objects with good objects and old objects with bad objects, Cooper and Levitt see three possible readings of Fairbairn and end by encouraging analysts to cultivate new ways of describing old and new.

Slavin and Kreigman offer another context to understand the work of Ehrenberg, Slochower, and Cooper and Leavitt, who each in a different way address the action of the analyst, to explore why the analyst needs to change, how in order for the patient to change the analyst must change. Using Winnicott and concepts from evolutionary psychology, Slavin and Kreigman develop a theory of conflict, negotiation, and mutual influence. Some of the themes that had been present in Benjamin’s and Pizer’s articles in the first volume are revisited by Slavin and Kreigman through the lens of evolutionary psychology:

We develop here a perspective in which the centrality of the conflict between the patient’s and analyst’s needs and identities leads to continuing efforts to break down each other’s identity: to reveal and examine each other’s biases (identities, loyalties, agendas) and the inevitable conflicts between them. Patient and analyst continuously experience each other doing this. (p. 82)

Maroda focuses on one of the ways analysts need to change: by showing some emotion. Maroda highlights the importance of affective communication citing the recent research of neurobiologists and emotion researchers. The title of Maroda’s article, “Show Some Emotion,” is in some sense a tease: she tells us that we cannot help but show our emotions.

But over the years, as I have become more comfortable with not attempting to hide my own emotional experience and allow it to naturally register on my face, my patients have less need for me to verbalize what I am feeling. They often can see and feel what I am feeling and can silently receive the feedback they need. So, as I have become more comfortable with my own feelings, my patients need less overt disclosure. (p. 143)

Maroda’s argument is echoed by the research of Heller and Haynal who found that a psychiatrist’s facial expression while interviewing patients who had made a suicide attempt was a much better predictor of subsequent suicide attempts than the psychiatrist’s conscious assessment.

Maroda’s article points to the importance of knowing one’s feelings so that the analyst does not mislead her or his patient. Jacobs also makes this point in his contribution. He writes that neutrality does not include misleading or double-binding patients by refusing to acknowledge their accurate perceptions of the analyst.

The second part of volume two is devoted to relational perspectives on development. The contributors to this section, Beebe and Lachmann, Fonagy and Target, Coates, and Lyons-Ruth, use current infant–caregiver observation research and attachment research to demonstrate how minds are developed in interaction. Fonagy and Target’s concept of reflective functioning seems very close to Busch’s idea of helping his patients develop minds that reflect rather than act. No philosophers are quoted in these papers, but there is solid support for a social theory of mind.

The articles in the third part of the volume bring society into the clinic by discussing the urban poor (Altman), perversion (Dimen), race (Leary), and homosexuality (Corbett). Again, there are echoes of earlier work by Harris and Mitchell (2002a, 2002b). But this is also an indication where a relational strategy/tradition can take us.

In closing, I was very grateful for the careful editing of these papers that made for enjoyable reading. I was also glad that the editors continued the tradition of the first volume of providing introductions to each paper that put them in context and afterwords that allowed the authors to reflect on the development of their ideas.

References

Aron, L. (1999). The patient’s experience of the analyst’s subjectivity. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 245-268). Hillsdale, NJ: The Analytic Press.
Benjamin, J. (1999). Recognition and destruction: An outline of subjectivity. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 183-210). Hillsdale, NJ: The Analytic Press.
Brennan, B.W. & DeMattos, S.E. (2003, November). Relational conversations/relational transformations: An examination of therapeutic action in relational psychoanalysis. Paper presented at the International Federation for Psychoanalytic Education, Pasadena, CA.
Bromberg, P.M. (1999). Shadow and substance: A relational perspective on clinical process. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 381-406). Hillsdale, NJ: The Analytic Press.
Busch, F. (2001). Are we losing our mind? Journal of the American Psychoanalytic Association, 49, 739-751.
Chodorow, N.J. (1999). Toward a relational individualism: The meditation of self through psychoanalysis. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 111-130). Hillsdale, NJ: The Analytic Press.
Crastnopol, M. (2001). Commentary to Greenberg’s “The analyst’s participation,” Journal of the American Psychoanalytic Association, 49, 386-398.
Davies, J.M. & Frawley, M.G. (1999). Dissocialize processes and transference-countertransference paradigms in the psychoanalytically oriented treatment of adult survivors of childhood sexual abuse. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 271-304). Hillsdale, NJ: The Analytic Press.
Eagle, M.N., Wolitzky, D.L., & Wakefield, J.C. (2001). The analyst’s knowledge and authority. Journal of the American Psychoanalytic Association, 49, 457-488.
Eigen, M. (1999). The area of faith in Winnicott, Lacan and Bion. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 3-37). Hillsdale, NJ: The Analytic Press.
Ghent, E. (1999). Masochism, submission, surrender: Masochism as a perversion of surrender. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 213-242) Hillsdale, NJ: The Analytic Press.
Ghent, E. (2002). Wish, need, drive: Motive in the light of dynamic systems theory and Edelman’s selectionist theory. Psychoanalytic Dialogues, 12, 763-808
Greenberg, J.R. (1999). Theoretical models and the analyst’s neutrality. In Relational psychoanalysis: The emergence of a traditioned. S.A. Mitchell L. Aron. Hillsdale, NJ: The Analytic Press, pp. 133-152.
Greenberg, J. (2001). The analyst’s participation: A new look. Journal of the American Psychoanalytic Association, 49: 359-381.
Harris, A. (1999). Gender as contradiction. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 307-335). Hillsdale, NJ: The Analytic Press.
Heller, M. and Haynal, V. (1997). A doctor’s face: mirror of his patient’s suicidal projects. In J. Guimon (Ed.) The body in psychotherapy (pp. 46-51). Basil, Switzerland: Karger.
Hoffman, I.Z. (1999). The patient as interpreter of the analyst’s experience. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 41-75). Hillsdale, NJ: The Analytic Press.
Mills, J. (2005). A critique of relational psychoanalysis. Psychoanalytic Psychology, 22, 155-188.
Mitchell, S.A. (1988). Relational concepts in psychoanalysis. Cambridge, MA: Harvard University Press. Mitchell, S.A. (1999). The wings of Icarus: Illusion and the problem of narcissism. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 155-179). Hillsdale, NJ: The Analytic Press.
Mitchell, S.A. & Aron, L. (Eds.), (1999). Relational psychoanalysis: The emergence of a tradition Hillsdale, NJ: The Analytic Press.
Mitchell, S.A. (2000). Response to Silverman 2000. Psychoanalytic Psychology, 17, 153-159.
Mitchell, S.A. (2002a). Psychodynamics, homosexuality, and the question of pathology. Studies in Gender and Sexuality, 3, 3-21.
Mitchell, S. A. (2002b). The psychoanalytic treatment of homosexuality: Some technical considerations. Studies in Gender and Sexuality, 3:23-59.
Ogden, T.H. (1999). The analytic third: Working with intersubjective clinical facts. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 461-492). Hillsdale, NJ: The Analytic Press.
Pizer, S.A. (1999). The negotiation of paradox in the analytic process. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 338-364). Hillsdale, NJ: The Analytic Press.
Renik, O. (1999). Analytic interaction: Conceptualizing technique in light of the analyst’s irreducible subjectivity. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 408-424). Hillsdale, NJ: The Analytic Press.
Silverman, D.K. (2000). An interrogation of the relational turn: A discussion with Stephen Mitchell. Psychoanalytic Psychology, 17, 146-152
Spezzano, C. (1999). A relational model of inquiry and truth: The place of psychoanalysis in human conversation. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 427-458). Hillsdale, NJ: The Analytic Press.
Stern, D.B. (1999). Unformulated experience: From familiar chaos to creative disorder. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 79-107). Hillsdale, NJ: The Analytic Press.
Stolorow, R.D, & Atwood, G.E.(1999). Three realms of the unconscious. In S.A. Mitchell and L. Aron (Eds.) Relational psychoanalysis: The emergence of a tradition (pp. 367-378). Hillsdale, NJ: The Analytic Press.

Susan deMattos

Copyright

© APA Div. 39 (Psychoanalysis). All rights reserved. Readers therefore must apply the same principles of fair use to the works in this electronic archive that they would to a published, printed archive. These works may be read online, downloaded for personal or educational use, or the URL of a document (from this server) included in another electronic document. No other distribution or mirroring of the texts is allowed. The texts themselves may not be published commercially (in print or electronic form), edited, or otherwise altered without the permission of the Division of Psychoanalysis. All other interest and rights in the works, including but not limited to the right to grant or deny permission for further reproduction of the works, the right to use material from the works in subsequent works, and the right to redistribute the works by electronic means, are retained by the Division of Psychoanalysis. Direct inquiries to the chair of the Publications Committee.