Worlds of Experience: Interweaving Philosophical and Clinical Dimensions in Psychoanalysis (Book Review)

Author:  Stolorow, Robert D., George E. Atwood, and Donna M. Orange
Publisher: New York: Basic Books, 2002
Reviewed By: Louis Rochschild, Spring 2004, pp. 35-37

Schachtel (1959/2001) noted that young children desire an orderly, structured world. He illustrated this by way of the experience of a young child becoming upset when an adult reader skips a page in a children’s story. Schachtel explained that the child wishes to be able to master the order of things with the precision of accurate prediction. Outside of psychoanalysis, Susan Gelman (2003) has similarly shown that the desire for order and continuity leads to the development of essentialist thinking in young children. Schachtel and Gelman would agree that finding order appears to be a necessary component of development. For his part, Schachtel added that once stability is assured, that a playful creativity could be utilized in the engagement of structure. That is, that one might find pleasure in diversity or a shift in the order of things.

However, it appears common enough that the desire for order and continuity remains strong and that, like the young child, adults often cry out upon experiencing a rupture in continuity. In a tone that may be considered playful, Mary Gergen upon noticing this tendency has suggested: “Perhaps we need a new entry into the DSM-IV–DAS–Descarte’s Anxiety Syndrome. The symptoms include existential angst, fear of chaos, and melancholia for the loss of foundational principles.” (Gergen, 1997, p. 608). I may use my own predictive power to infer that most would agree that the idea of adding another category to the DSM had best be playful. Yet, that is not to detract from the fact that it is with this syndrome and the epistemology that leads to it that the book under review is concerned.

The Cartesian knot within psychoanalysis is the central focus of the current book. The authors state in the preface that their aim is to deconstruct Cartesian assumptions, as they exist in psychoanalytic thinking, and to move beyond these assumptions into what the authors call “intersubjective contextualism.” Much of this work is not new to readers of Psychoanalytic Psychology as considerable portions of five of the eight chapters were published there between 1999 and 2002. Yet, a reworking of these papers into a whole allows the work to stand in its own right in a fashion that is accessible and affords the reader a chance of increased understanding of this position.

In addition to the book consisting of a reworking of several papers, it is notable that several authors have constructed it. One might say that several individual “worlds” contributed to its coming into existence. Here the world(s) of Robert Stolorow’s and George Atwood’s decades long relationship and continued dialogue with Donna Orange is presented in a highly readable package. As one might expect from a book that takes on both philosophical and clinical dimensions of psychoanalysis, the offering is divided into two sections, theoretical and clinical. A fourth author, Julia Schwartz co-wrote one of the clinical chapters entitled “Worlds of trauma.”

With such a chorus of voices, it comes as no surprise to this reviewer that community is taken up as a subject of discussion throughout the book. The theoretical community presented here is one that is based in a theory that calls for a moving beyond a subject/object dichotomy by way of fallibilism (a la Charles Peirce) and hermeneutics. Here the authors note in a spirit that could appear part of a post-modern zeitgeist, that a community in which difference is encountered in dialogue is necessary for scholarship. Such a comment calls into question what sort of encounter affords difference (of any sort) the possibility of community and what such a community might be. To answer this, the authors further state that from a position they label “perspectival realism” (Donna Orange is noted as the creator of the term.), “…we can hear our patients and colleagues as having access to realities that are hidden from us by our own perspective.” (p. 114).

To illustrate this further, the authors offer a full account of the well known parable of the blind men who each touching one part of an elephant, attempt to convince the other blind men what constitutes the entity labeled elephant based on their limited positions. The reader is invited to re-experience this classic tale in which one blind man describes a snake like object as the essence of an elephant due to his sampling of the trunk while another finds an elephant to be like a tree due to experiencing the knee, that each disagrees with the other, and that each is wrong. The authors add that this parable illustrates the epistemological attitude of perspectival realism.

This is a striking point as the comment concerning perspectival realism that is quoted above is to my mind a different definition than the one offered by the parable. In both cases, perception is understood to be constrained by one’s point of view. However, the quote contains an ability to hear realities that are hidden from one’s perspective, a quality the blind men do not possess. It appears that lacking this component leads the blind men to neglect perspectival realism in favor of each isolated mind arguing that their point is correct. Such a difference is the central thesis of the book under review. That a parable that offers isolated minds defending their objectivist points of view is utilized as an epistemological illustration of perspectival realism is of some concern.

Elsewhere (Rothschild & Haslam, 2003), I have argued that always situated, human desire (or pragmatic need) adds valence to construct a point of view, and that desire itself may occlude the legitimacy of other points of view. However, as a temporal shift in desire or motivation can reveal, multiple points of view can be correct at different historical points. That the parable finds a narrative center in the blind men being wrong may usher in an attitude that is unfortunate in its relation to the authors’ stated purpose. Such a conception is worth tracking as a notable part of the authors’ post-Cartesian psychoanalytic theory construction is the critique of others’ views, namely, Kohut and members of the body of thought known as relational psychoanalysis. The authors state that their critique of Kohut is not to devalue and exclude, but to open a dialogue. The same might be said of the authors’ critique of relational theorists on the grounds that relational theorists (i.e., Aron and Benjamin) want to have their Cartesian cake and eat a post-Cartesian theory too. While acknowledging the intrigue of such critique, I felt at times, that the tone of the text posited the notion that the other was wrong and not that the other had access to different realities. As Foucault (1983/2001) noted, this is a danger of critique. My central concern is not with critiquing another as being wrong, but the apparent dwelling in a contradictory space, one that simultaneously affirms and denounces the other.

The authors begin their Cartesian critique by problematizing the concept of an isolated mind. Common to the community of those who take on the scientism that posits a stable, objective world, the authors note that they have often been accused of being relativists. To answer such a critique, the authors turn to the work of Richard Bernstein (1983). Bernstein has noted the confusion that arises when the illusions of a definite world are suspended. Clinicians know of this uncertainty in vivo, as it is not an easy task to dispense with maladaptive defenses in the face of something different and ambiguous. Yet, Bernstein’s critique is concerned with the level of scientism, not individual functioning. Simply put, those who subscribe to a philosophy that posits a definite world tend to become anxious when that point of view does not hold. Stolorow et. al., contend that this difficulty is cultural. That is, the belief in an isolated mind surrounded by a stable, external world is a defensive function found at a cultural level. Such a view has been shared by others (e.g., Varela, Thompson, and Rosch, 1991) who have also made note of Bernstein’s work to demonstrate that eastern philosophy has addressed the subject/object dichotomy for centuries. Further, Varela et. al., note that relativity or reactive nihilism (cf., Deleuze, 1962/1983) is directly linked in eastern philosophy to a belief in a fixed world by a critical reflection on the mind’s tendency to cling to anything that appears stable and the continuous frustration found in such an act of grasping. Although such a perspective is not explicitly linked herein to such schools of thought (i.e., eastern or Buddhist philosophy and post-structuralist French philosophy), the theoretical and clinical illustrations offered in the volume under review may be considered to fit such a profile.

Although the text is divided into two sections, the clinical section of the book truly begins with the case material found in the introduction. Here the reader is presented with an uncommon view into the origins of Cartesian philosophy. Rather than the usual origin point of the western philosophical tradition itself, one finds psychological origins in an examination of letters between Descartes and Princess Elizabeth of Bohemia: Descartes himself contended with the alienating effects of depression and trauma. Here Descartes chooses self-reliance over the percept of embeddedness. The authors note this choice as Descartes’ attempt at mastering body (including affect) with rationality and differentiate such a move from the primacy of affect found in spaces such as the intersubjective Kohutian focus on attunement.

The danger of the illusion of the isolated mind and the difficulty of finding an intersubjective contextualist path is most effectively illuminated in a stirring fashion by a recounting of trauma experienced by Stolorow during a conference eighteen months following the cancer-related death of his wife. The manner in which such a telling captures alienation and aloneness or as the authors’ note, “a profound singularity” (p. 125) makes Stolorow’s account a must read for anyone working clinically. In addition to exploring the therapeutic engagement of affect in order to recontextualize the isolated mind of a traumatized individual, the authors additionally tackle the alienating experiences of the psychotic. Further, their treatment of mania could well be required reading for anyone who seeks to find a foothold with phenomenology in an atmosphere in which such conditions are increasingly sought to be understood solely through a medicalized lens.

In short, this slim volume is packed with philosophical theory and clinical vignettes that make for engaged reading. It is ambitious in this regard. The number of philosophers that are utilized in the process of situating their theory range from Wittgenstein to Gadamer, and a full portrayal is beyond the scope of this review. Further, several clinical vignettes are provided in addition to those noted in this review. The book should appeal to a wide variety of readers both familiar with nuances of philosophical theory and those just beginning to consider the importance of the relationship between philosophical and psychoanalytic theories.


Bernstein, R. (1983). Beyond objectivism and relativism. Philadelphia: University of Pennsylvania Press.
Deleuze, G. (1962/1983). Nietzsche and Philosophy. (H. Tomlinson, trans.). New York: Columbia University Press.
Foucault, M. (1983/2001). Fearless Speech. J. Pearson (Ed.). Los Angeles, CA: Semiotext(e).
Gelman, S. (2003). The Essential Child: Origins of Essentialism in Everyday Thought. New York: Oxford University Press.
Gergen, Mary (1997). Skipping stone: Circles in the pond. In M. Gergen & S. N. Davis (Eds.) Toward a new psychology of gender: A reader. (pp. 605-611). New York: Routledge.
Rothschild, L. & Haslam, N. (2003). Thirsty for H2O? Multiple essences and psychological essentialism. New Ideas in Psychology, 21, 31-41.
Schachtel, E. G. (1959/2001). Metamorphosis: On the conflict of human development and the psychology of creativity. Hillsdale, NJ: The Analytic Press.
Varela, F.J., Thompson, E., and Rosch, E. (1991). The embodied mind: cognitive science and human experience. Cambridge, MA: MIT Press.

Reviewer Note

Louis Rothschild, a member of the local chapter, Rhode Island Association for Psychoanalytic Psychologies, is in independent practice in Providence, RI.


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