Sunday, January 29, 2012

Robert Stolorow - Dynamic, Dyadic, Intersubjective Systems: An Evolving Paradigm for Psychoanalysis

As an adjunct to my "academic" training as a counselor, I have been participating in a psychoanalytic study group (5 semesters, 10 weeks each). We have completed three semesters so far, and I can honestly say that everything I thought I knew about psychoanalytic therapy was partial at best, and most often just completely wrong.

Coming into this, I knew that attachment theory had reframed a lot of thinking for people like Daniel Siegel and Allan Schore, both of whom were trained in the psychoanalytic tradition (which seems true of many psychiatrists), and both of whom have shifted their studies to affective neurobiology.

While those people worked with the more objective realm of attachment and neuroscience, many other people had been influenced by the profound shift initiated by Heinz Kohut's Self Psychology model, which redirected psychoanalytic thinking from Freudian drive theory to Kohut's self theory.

Foundational to Kohut's model was the idea that infants have various attachment needs that are experienced as "selfobject needs." This is a crucial idea to modern psychoanalytic thinking, so here is a defintion from Wikipedia:
Selfobjects are external objects that function as part of the "self machinery" - 'i.e., objects which are not experienced as separate and independent from the self.'[13] They are persons, objects or activities that "complete" the self, and which are necessary for normal functioning. 'Kohut describes early interactions between the infant and his caretakers as involving the infant's "self" and the infant's "selfobjects"'.[6]

Observing the patient's selfobject connections is a fundamental part of self-psychology. For instance, a person's particular habits, choice of education and work, taste in life partners, may fill a selfobject-function for that particular individual.

Selfobjects are addressed throughout Kohut's theory, and include everything from the transference phenomenon in therapy, relatives, and items (for instance Linus van Pelt's security blanket): they 'thus cover the phenomena which were described by Winnicott[14] as transitional objects. Among 'the great variety of selfobject relations that support the cohesion, vigor, and harmony of the adult self...[are] cultural selfobjects (the writers, artists, and political leaders of the group - the nation, for example - to which a person feels he belongs).'[15]

If psychopathology is explained as an "incomplete" or "defect" self, then the self-objects might be described as a self-prescribed "cure".

As described by Kohut, the selfobject-function (i.e. what the selfobject does for the self) is taken for granted and seems to take place in a "blindzone." The function thus usually does not become "visible" until the relation with the selfobject is somehow broken.

When a relationship is established with a new selfobject, the relationship connection can "lock in place" quite powerfully, and the pull of the connection may affect both self and selfobject. Powerful transference, for instance, is an example of this phenomenon.
Kohut initially identified three major selfobject needs that, when not met developmentally, become forms of transference in therapy - mirroring (having our feelings validated through an other reflecting them back to us), twinship (the sense that you are like me and that I am not alone), and idealization (the need to see a caregiver or other as ideal and to model our own sense of self on that person). Modern Self Psychologists have added several other needs, but these three remain the core.

One other idea is also crucial - Kohut saw the therapeutic relationship as based entirely on the therapist's ability to experience empathy for the client - if we cannot get inside their experience, we cannot understand where their development has been derailed and what is needed to get it moving again. For Kohut, empathy was as much an exploratory tool as it was an experience. Again, from Wikipedia:
Kohut maintained that parents' failures to empathize with their children and the responses of their children to these failures were 'at the root of almost all psychopathology.' [9] For Kohut, the loss of the other and the other's selfobject function (see below) leaves the individual apathetic, lethargic, empty of the feeling of life, without vitality, in short, depressed. [10]

For the infant to move from grandiose to cohesive self and beyond, meant a slow process of disillusionment with phantasies of omnipotence, mediated by the parents: 'This process of gradual and titrated disenchantment requires that the infant's caretakers be empathetically attuned to the infant's needs'.[6]

Correspondingly, to deal in therapy with earlier failures in the disenchantment process, Kohut 'highlights empathy as the tool par excellence, which allows the creation of a relationship between patient and analyst that can offer some hope of mitigating early self pathology.'[11]

Kohut describes human empathy as a therapeutic skill. When a patient acts in a certain way, "put yourself in his/her shoes" - and find out how it feels for the patient to act in this manner.

Using the skill of empathy, the therapist is able to reach conclusions sooner (with less dialogue and interpretation), and there is also a stronger bond between patient and therapist, making the patient feel more fundamentally understood. For Kohut, the implicit bond of empathy itself has a curative effect; but he also warned that 'the psychoanalyst...must also be able to relinquish the empathic attitude' to maintain intellectual integrity, and that 'empathy, especially when it is surrounded by an attitude of wanting to cure directly...may rest on the therapist's unresolved omnipotence fantasies.'[12]

The conceptual introduction of empathy was not intended to be a "discovery." Empathic moments in psychology existed long before Kohut. Instead, Kohut posited that empathy in psychology should be acknowledged as a powerful therapeutic tool, extending beyond "hunches" and vague "assumptions," and enabling empathy to be described, taught, and used more actively.
Kohut was not the first to identify the importance of empathy in therapy, but he was the most important in shifting psychoanalysis from the Freudian objective stance to the emerging intersubjective stance.

In the late 1970s and early 1980s, as Kohut was finally becoming better known in the psychoanalytic world, Robert Stolorow, Donna Orange, George Atwood, Lewis Aron, Bernard Brandchaft, Daniel Stern (mostly in the developmental realm of infants), and Stephen A Mitchell, among many others, were developing an intersubjective model of therapy that owes a debt to Kohut's empathic model, but also to the emerging postmodern models of relational experience.

The paper I am sharing here (only the beginning, as it is too long) is by Stolorow, from 1997, but it offers a good introduction to the ideas of dynamic intersubjective systems theory as it is applied to psychoanalytic work.

Citation:
Robert Stolorow, R. (1997). Dynamic, Dyadic, Intersubjective Systems: An Evolving Paradigm for Psychoanalysis. PSYCHOANALYTIC PSYCHOLOGY, 14(3), 337-346.

An Evolving Paradigm for Psychoanalysis
Robert D. Stolorow, PhD
Institute of Contemporary Psychoanalysis, Los Angeles

Abstract:
Dynamic systems theory is a source of powerful new metaphors for psychoanalysis. Phenomena such as conflict, transference, resistance, and the unconscious itself are grasped from this perspective as dynamically emergent properties of self-organizing, nonlinear, dyadic, intersubjective systems. The conception of development as evolving and dissolving attractor states of intersubjective systems richly illuminates the processes of pattern formation and change in psychoanalysis. Effective interpretations are seen as perturbations of the therapeutic system that permit new organizing principles to come into being.
A new scientific paradigm has been evolving from the investigation of phenomena that have variously been called dynamic, nonlinear, self-organizing, or chaotic systems. With origins in physics, chemistry, and mathematics, this new perspective has been applied to the study of complex biological systems (von Bertalanffy, 1968; Waddington, 1977) and is being employed in the search for common principles underlying the behavior of such diverse phenomena as chemical reactions, clouds, forests, and developing embryos and children. Dynamic systems theory (Thelen & Smith, 1994) is centrally concerned with conceptualizing the process of developmental change—that is, the generation of "emergent order and complexity: how structure and patterns arise from the cooperation of many individual parts" (p. xiii). In accounting for the "messy, fluid, context-sensitive" (p. xvi) nature of the developmental process, this framework is exceptionally well suited to serve as a source of guiding metaphors for psychoanalysis.

In this article I present an overview of some basic tenets of dynamic systems theory, drawing heavily from the work of developmentalists Thelen and Smith (1994). Interspersed throughout the discussion are examples of how systems theory has already infiltrated my thinking about fundamental psychoanalytic issues. I conclude by applying the principles of dynamic systems to a conceptualization of the process of change and resistance to change in psychoanalysis.

Within a general systems philosophy (Laszlo, 1972; Sucharov, 1994), any living system is part of a hierarchy. Each system contains subsystems, or elements, that constitute the whole. Two or more systems interacting cooperatively form a suprasystem. Conceptualizations of psychological development that focus on the child's mental activity as the system under study (e.g., Thelen & Smith, 1994) highlight the exquisitely context-dependent nature of the child's self-regulatory processes as these influence and are influenced by exchanges with caregivers. Other formulations (e.g., Sander, 1985) enter the living hierarchy at the more encompassing level of the child-caregiver suprasystem and emphasize the ongoing processes of reciprocal mutual regulation within the dyad. Self-regulation and mutual regulation always occur simultaneously and are inextricably interrelated (Beebe & Lachmann, 1994). One or another will predominate as a function of the level of the living hierarchy targeted by the investigator. Because psychoanalytic investigation is concerned with comprehending the process of change within the patient—analyst relationship, the level of the hierarchy most relevant to psychoanalysis is the dyadic system. Furthermore, because the focus of psychoanalytic investigation is always psychic, or subjective, reality—the particular dyadic systems formed by the reciprocal interplay between worlds of experience (i.e., intersubjective systems) constitute the unique domain of inquiry of psychoanalysis. Therefore, I have chosen the phrase dynamic, dyadic, intersubjective systems to capture the nature of a new, evolving paradigm for psychoanalysis.

To summarize, I am concerned here with systems concepts existing at three levels of abstraction and generality. The most general and inclusive is the overarching concept of dynamic systems, and the application of principles of dynamic systems to psychoanalysis is the central aim of this article. A specific category of dynamic systems comprises systems formed by the interaction between two human beings (dyadic systems). More specific still are those formed by the interplay between two subjective worlds (intersubjective systems), the unique domain of psychoanalytic inquiry. The concept of a dynamic, dyadic, intersubjective system mends the long-standing false dichotomy in psychoanalysis between intrapsychic and interpersonal theorizing because it brings to focus both the individual's world of inner experience and the embeddedness of this world with other such worlds in a continual flow of reciprocal mutual influence (Stolorow & Atwood, 1992, p. 18). From a dynamic systems perspective, the very distinction between one- and two-person psychologies is obsolete because the individual and his or her intrapsychic world are included as a subsystem within the more encompassing intersubjective suprasystem. For this reason, I have sometimes quipped that perhaps my theoretical viewpoint is a "no-person psychology," concerned as it is with how worlds of inner experience and intersubjective fields mutually constitute one another.

A cardinal feature of the dynamic systems approach to development is that it categorically rejects teleological conceptions of preordained end-states toward which developmental trajectories are presumed to aim. Accordingly,
development does not "know" where it is going from the start.... There is no end-state other than the end of life itself.... Development is the outcome of the self-organizing processes of continuously active living systems [italics added]. (Thelen & Smith, 1994, p. 44)
Also rejected is the idea, prominent in much psychoanalytic developmental theory,
that development unfolds according to some predetermined schema or epigenetic
master plan:
Although behavior and development appear structured, there are no structures. Although behavior and development appeal' rule-driven, there are no rules. There is complexity. There is a multiple, parallel, and continuously dynamic interplay of perception and action, and a system that, by its thermodynamic nature, seeks certain stable solutions. These solutions emerge from relations, not from design. When the elements of such complex systems cooperate, they give rise to behavior with a unitary character, and thus (:o the illusion of structure. But the order is always executory, rather than rule-driven, allowing for the enormous sensitivity and flexibility of behavior to organize and regroup around task and context. ... [Such organization is] emergent and not designed [italics added], (Thelen & Smith, 1994, p. xix)
Rejection of teleological thinking and of the notion of preestablished developmental programs has been a hallmark of what has come to be known as the intersubjective perspective in psychoanalysis (Stolorow, Atwood, & Brandchaft, 1994). Psychoanalytic inteirsubjectivity theory is a field theory or systems theory that seeks to comprehend psychological phenomena not as products of isolated intrapsychic mechanisms and fixed intrapsychic structures, but as forming at the interface of reciprocally interacting worlds of experience (Stolorow & Atwood, 1992). From this perspective, intrapsychic determinism gives way to an unremitting contextualism for which "a dynamic [systems] account provides a biological rationale" (Thelen & Smith, 1994, p. xxi). With regard to psychological development, my collaborators and I, along with Sander (1985) and Beebe and Lachmann (1988), proposed that the organization of the child's experience must be seen as a property of the child-caregiver system of mutual regulation and, further, that it is the recurring patterns of intersubjective transaction within the developmental system that result in the establishment of invariant principles and themes that unconsciously organize the child's subsequent experiences. The forging of such principles and themes within the child-caregiver system is an example of dynamically emergent form, of "pattern formation without a program" (Thelen & Smith, 1994, p. 71). In this view of psychological development, we, like Stern (1985), eschew traditional psychoanalytic assumptions about universally occurring developmental phases dominated by innately preprogrammed imagery and crises. Contrary to Kohut's (1984) idea that a self possesses an inherent design awaiting a responsive milieu that will enable it to unfold, it is our view that the trajectory of self-experience is shaped at every point in development by the intersubjective matrix in which it crystallizes (Stolorow & Atwood, 1992). In harmony with the dynamic tenet that "all mental activity is emergent, situated, [and] historical" (Thelen & Smith, 1994, p. xxiii), we hold that any psychological constellation can be grasped only in terms of its unique intersubjective history, the relational systems in which it originated and is continuing to be maintained.
Read the whole essay.
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