Un d e r s t a n d i n g ©

Emotional
Understanding
STUDIES IN PSYCHOANALYTIC
EPISTEMOLOGY
Donna M. Orange

With a unique blend of clinical compassion

and philosophical reflection, Donna M. Orange
illuminates the nature and process of psychoan-
alytic understanding within the intimate and
healing human context of treatment. Moving
away from objectivist empiricism and its polar
opposite, constructivist relativism, her work
details a paradigm shift to a perspectival realism
that does justice to the concerns of both.

According to Orange, the key to psychoanalytic

work is emotional understanding. Such under-
standing is established between patient and
analyst as they attempt to make sense together
of the patient's suffering. When dialogue
involves the analyst's empathic participation in
the emotional predicament in which the patient
has formed a world of experience, this is emo-
tional understanding. Achieved within a secure
emotional tie, this understanding can give a
person a developmental second chance to form
an organization of experience that includes a
sense of integrated self. Often, the basic sense
of reality, undermined by lost trauma or depri-
vation, can establish or reestablish itself.

Disputing the traditional psychoanalytic empha-

sis on verbalization, this volume highlights the
emotional nature of psychoanalytic under-
standing and argues that such understanding

(continued on back flap)

EMOTIONAL UNDERSTANDING
Emotional Understanding
STUDIES IN
PSYCHOANALYTIC
EPISTEMOLOGY

Donna M. Orange

THE GUILFORD PRESS

New York London
© 1995 The Guilford Press
A Division of Guilford Publications, Inc.
72 Spring Street, New York, NY 10012

All rights reserved

No part of this book may be reproduced, stored in a retrieval

system, or transmitted, in any form or by any means, electronic,
mechanical, photocopying, microfilming, recording, or
otherwise, without written permission from the Publisher.

Printed in the United States of America

This book is printed on acid-free paper.
Last digit is printnumber: 9 8 Gd Gy 2 B Il

Library of Congress Cataloging-in-Publication Data

Orange, Donna M.
Emotional understanding : studies in psychoanalytic
epistemology / Donna M. Orange.
“poyem:
Includes bibliographical references and index.
ISBN 1-57230-010-8
1. Psychoanalysis and philosophy. 2. Comprehension
(Theory of knowledge) 3. Comprehension. I. Title.
BEI /5-4,P45073" 1995
150.19’5—de20 95-34661
CIP

Excerpt from “The Longing” is used by permission of Doubleday, a division of

Bantam Doubleday Dell Publishing Group, Inc. ©1962 by Beatrice Roethke,
Administratrix of the Estate of Theodore Roethke, from The Collected Poems of
Theodore Roethke by Theodore Roethke.
Earlier versions of some chapters appeared in the following publications: Chap-
ter 4, in New Therapeutic Visions: Progress in Self Psychology (Vol. 8), and Chapter
12, in Freud’s Case Studies: Self Psychological Perspectives, both published by The
Analytic Press; Chapter 5, in The Widening Scope of Self Psychology, published by
The Analytic Press, and in The Intersubjective Perspective, published by Jason
Aronson. All are adapted by permission.
For all psychoanalytic fallibilists,
especially Bernie
S
ae
L
2.
_
:
—
=
~
 Acknowledgments

ieee people have helped me write this book, whether or not

they will agree with what I have said. Each of them has transformed
“constructive criticism” from an oxymoron into a process of
understanding, of making sense together.
For helpful readings of parts or all of the manuscript in
different phases of its development, I thank Margaret Andrews,
Mary Anker, George Atwood, Howard Bacal, Andrine Baker,
Kathleen Fischer, James Fosshage, Natalie Gannon, Jill Gentile,
Judith Glassgold, Jacqueline Gotthold, Patricia Horn, Peter
Lessem, Frances Madden, Anna Ornstein, Henry Pinsker, Robert
Stolorow, and Peter Thomson. Each has been a thoughtful reader
and a great support in ways too individual to explain. Some—Jackie
Gotthold, Peter Lessem, and especially George Atwood—have read
several versions and have generally suffered through this process
with me. Kitty Moore, my editor at Guilford, suggested that I write
a book, nursed the project along, and rescued me from some of
my tendency toward pedantry. Claudia Kohner has gone far
beyond the normal copy editor’s duties in helping me to make this
book readable. I give what the Dutch call “heartfelt thanks” to all
of you. Nevertheless, the opinions, omissions, and outright mis-
takes in this book remain mine.
[also need to thank and acknowledge all those whose thoughts
or expressions I have unwittingly borrowed without citation. I will
borrow again, this time consciously, from the words of Winnicott
(1965):

Vil
vill / Acknowledgements

I wish to acknowledge my debt to my psycho-analytic colleagues. I

have grown up as a member of the group, and after so many years
of interrelating it is now impossible for me to know what I have
learned and what I have contributed. The writings of any one of us
must be to some extent plagiaristic. Nevertheless I think we do not
copy: we work and observe and think and discover, even if it can be
shown that what we discover has been discovered before. (p. 11)

In this statement, Winnicott rejected the concern with priority and

articulated the notion of the community of scholars. My group
within the community of scholars is the Institute for the Psycho-
analytic Study of Subjectivity, which explicitly intends to be such a
collaborative community, devoted to the development of psycho-
analytic theory and practice. I thank everyone connected with the
institute for being part of the community in which I could “grow
up” and start to feel able to contribute. I am also grateful to those
patients who gave me permission to write about them and about
our process of making sense together. Finally I thank my super-
visees, my students, and especially all my patients for teaching me
understanding.
 Contents

GHAPTER 1
Introduction: Making Sense Together I

CHAPTER 2
Understanding Understanding IZ

CHAPTER 3
Theory-Choice and Fallibilism 5}

CHAPTER 4
Toward an Epistemology of Perspectival Realism Be)

CHAPTER 5
Cotransference: The Analyst’s Perspective 63

CHAPTER 6
Experience: Given and Made 2)

CHAPTER?
Affect and Emotional Life 89

CHAPTER 8
Emotional Memory 105
x / Contents

CHAPTER 9
Emotional Availability IV5)

CHAPTER 10
Misunderstanding: 141
A Collaborative-Pragmatist View

CHAPTER 11
How Does Psychoanalytic Understanding Heal? 159

CHAPTERT2

Illustration: Understanding Schreber 180

References 207

Index 219
G lab AP Ua

Introduction:
Making Sense Together

The person with understanding does not

know and judge as one who stands apart and
unaffected; but rather, as one united by a
specific bond with the other, he thinks with
the other and undergoes the situation with
him.
—Hans-Georc GADAMER, Truth and Method

Tis book is a series of studies in psychoanalytic epistemology.

Epistemology, the inquiry into the nature and limits of human
knowledge, has been undergoing a transformation toward increased
humility because we recognize that our knowledge of anything is
perspectival and thus necessarily incomplete. Similarly, this work of
psychoanalytic epistemology replaces the questions “What can we
know?” and “How can we be certain that we know?” with the queries
“What is psychoanalytic understanding?” and “How does such un-
derstanding heal emotional wounds?” This shift reflects many recent
changes in psychoanalytic thinking: from drive to the organization
of experience as primary motivator, from scientific objectivism to
hermeneutic perspectivism, from seeing psychoanalysis as hard
science to finding it among the humanities or human sciences, and,
above all, from the values of independence and isolation to those of
interdependence and community.
2 / EMOTIONAL UNDERSTANDING

The central thesis of this book is that psychoanalytic under-

standing emerges from mutual participation—primarily emotional
participation—in the intersubjective field formed by the two sub-
jectivities of patient and therapist. The process of struggling for
and reaching good-enough understanding can heal emotional
wounds and alter a person’s organized experiencing.

PSYCHOANALYSIS AND PHILOSOPHY

Studies in psychoanalytic epistemology are necessarily interdisci-

plinary. I bring to this undertaking my years of studying and
teaching philosophy, and those spent studying psychology and in
psychoanalytic training and practice. This book, therefore, is a
kind of discussion between the philosophical and clinical parts of
me, an open conversation that the reader is invited to join. We will
examine some aspect of psychoanalytic understanding in each
chapter, entertaining hypotheses about the nature, function, and
limits of such understanding. Many questions will remain open,
standing as invitations to further study.
This book consists of studies, from various perspectives, of
aspects of psychoanalytic understanding. It forms a sort of tapestry
in which the threads reveal a picture of psychoanalysis as patient
and analyst making sense together, reaching an emotional under-
standing. I begin with the most general nature of understanding
and examine the conditions for the possibility of understanding,
psychoanalytic or otherwise. In the middle chapters I advocate
what I call “perspectival realism,” a revised view of countertrans-
ference, and a conception of experience as both given and made.
These ideas are crucial components of any adequate psychoana-
lytic epistemology. In the later chapters I adopt a more clinical
perspective on understanding, and I suggest that the only sort of
understanding that can heal emotional wounds and integrate
human experiencing is emotional understanding. Throughout I
rely on both philosophical and clinical thinking to explain the ideas
under discussion.
Historically, however, the relationship between psychoanalysis
and philosophy has not been one of mutual respect. Freud stated
that “the delusions of paranoiacs have an unpalatable external
 Introduction / 3

similarity and internal kinship to the systems of our philosophers”

(1919, p. 161), and he claimed that “We have nothing to expect
from philosophy except that it will once again haughtily point out
to us the intellectual inferiority of the object of our study” (1915-
1916, pp. 97-98). The philosopher Grunbaum (1984) denounces
psychoanalytic pretensions to scientific status and suggests that
psychoanalysis generally is intellectually incoherent. Part of the
unfriendliness between philosophy and psychoanalysis may come
from occupational distance. Philosophy lives in the university and
psychoanalysis in free-standing institutes and consulting rooms.
Nevertheless, both disciplines belong to the humanities (Kohut,
1985), and both have formed me. So readers of this book will find
an interdisciplinary inquiry or “conversation” that writers in either
field might not undertake. Plato defined thinking as a conversation
“that the mind carries on with itself about any subject it is consid-
ering” (Theatetus, 189e), and I describe analysis as conversation, as
making sense together. In addition, I believe that a dialogue
between philosophy and psychoanalysis can reach some useful
descriptions of the nature of psychoanalytic understanding.
In this conversation I argue for holding some basic attitudes.
The first attitude places a value on theory-choice and theory-
improvement. This concern reflects the philosopher’s commitment
to the examined life, to acknowledging the fundamental conceptual
presuppositions or assumptions embedded in our clinical theories
and in our work. A second value or attitude concerns the impor-
tance of fallibilism, the commitment to hold theory lightly, to live
with uncertainty and ambiguity, and to be always prepared to revise
our views. This attitude keeps us constantly ready to learn some-
thing, from our patients and from each other.
In addition to these methodological attitudes, I argue for an
epistemology that I call “perspectival realism.” “Objectivism”—the
assumption that the known is independent of the knower—and
“relativism”—Hegel’s night in which all cows are black (nothing is
distinguishable)—are equally poor alternatives. Nevertheless, psy-
choanalysis—in theory and in practice—can move “beyond objec-
tivism and relativism” (Bernstein, 1983) in the direction of a
perspectival or dialogical realism. Such a moderate realism ac-
knowledges the constructivist critique with its insistence on the
contribution of the subject or subjects to the making of meaning,
4 / EMOTIONAL UNDERSTANDING

but it rejects the turn toward relativism. In accord with fallibilism,

it recognizes that each person’s perspective is inevitably partial and
that a more adequate view of anything requires dialogue. In such
conversation we attempt to reach, practically speaking, a good-
enough understanding of whatever is under discussion. In psycho-
analysis, where the subject matter is a person’s emotional life,
understanding that heals requires a mutually experienced emo-
tional connection between patient and analyst.
This view of psychoanalytic understanding raises additional
questions. We must ask what conditions and attitudes support
good-enough emotional understanding. One requirement is the
emotional availability of a particular analyst for a healing connec-
tion with the particular person who comes for therapy or analysis.
This implies the willingness and ability of the therapist to provide
for that person a developmental second chance at a rich and
integrated emotional life. A second condition is that analyst and
patient embrace an enriched conception of memory that includes
tacit and somatic forms as well as verbal expressions. To acknow-
ledge such knowing-beyond-words requires a radical questioning
of empiricist assumptions and of commonly accepted theories of
truth and knowledge.

EPISTEMOLOGY AND INTERSUBJECTIVITY

An adequate psychoanalytic epistemology must eschew individu-

alism and the myth of the isolated mind (Stolorow & Atwood,
1992), and it must move toward both subjective and intersubjective
conceptions of understanding. In ordinary discourse we distin-
guish subjective understanding from knowing-about. Knowing-
about is external and observational. Understanding is knowledge
by participation, in the Platonic sense, knowledge from within. For
example, there is an enormous difference between knowing-about
the Hopi Indian culture and understanding life as a Hopi would,
or between knowing-about the French language and under-
standing French. An ill friend recently told me, “You know, but
you don’t understand, because you have always been healthy.” For
Kohut (1959), the only kind of knowing that could count as
psychoanalytic was knowledge from within, understanding gained
 Introduction / 5

by introspection and empathy (or vicarious introspection). While

we can know something about human beings through social
psychology or neuropsychology, according to Kohut, under-
standing can only be achieved through empathy.
Intersubjectivity theory (Stolorow, Brandchaft, & Atwood,
1987) refines this view by clarifying the notion of “within.” Psycho-
analytic understanding is knowledge gained from inside the inter-
subjective field formed by the intersection of two differently
organized subjectivities. In dialogue, both participants attempt to
expand their original subjective perspectives to take in, compre-
hend, and understand more of the other’s experience. We do this,
as Kohut and other self psychologists have shown, by placing
ourselves, as consistently as we can, in the other’s shoes, both
cognitively and emotionally. We understand by attempting to
participate in the emotional experience, in the being, of the other.
In this book’s exploration of psychoanalytic epistemology,
“understanding” will primarily mean an intersubjective process of
emotional comprehension, of reaching or developing an under-
standing with another. When a bright and appealing young scholar
consults me during a bout of profound depression after a series of
puzzling academic failures, we struggle together to find the source
of the trouble. I call this process understanding. The older psycho-
analytic notion of interpretation fails to capture the intersubjective
nature of this ordinary clinical process, and it underestimates the
influence of the observer’s capacities and assumptions on the
extent and kind of understanding reached. An analyst must be
Gadamer’s “person with understanding,” able and willing to enter
the patient’s suffering and share the painful history, able and
willing to “undergo the situation” with the other. I will call this
combination of capacity and willingness “emotional availability.”
Only when it is present can patient and analyst make sense of what
seems senseless—my bright and usually successful young scholar’s
deep depression and suicidal feelings, for example.
The term “understanding” thus refers to both person and
process, to both self and relation. The individual comprehends, or
takes in, the relation, while the relationship includes, and partly
forms, the experiencing and experienced self. Forcing a choice
between self and relatedness maintains a false dualism that under-
mines both psychoanalytic treatment and theory. In emotional
6 / EMOTIONAL UNDERSTANDING

development, the requirement to choose between ties to caretakers

and development of an articulated self can be pathogenic (Brand-
chaft, 1994). Similarly, the choice in theory between “Tl” and “we”
may result in forms of blindness. Intersubjectivity theory gives
equal weight to the “I” and to the “we,” treats them as inextricably
linked, and thereby offers the best opportunity thus far to compre-
hend psychoanalytic understanding.

MAKING SENSE TOGETHER

Conceptualizing psychoanalysis as “making sense together,” both

raises and presumes partial answers to fundamental questions
addressed in this book. What goes into making sense? Fact?
Theory? And what are these? Of what do we make sense? Reality?
Fantasy? Or what? I will argue that psychoanalysis is primarily a
collaborative effort to comprehend a person’s emotional experi-
ence. Such comprehension means entering into and dwelling
inside the experience of the patient, including the experience of
the analytic relationship, by both partners. Together patient and
analyst struggle to make sense of the patient’s experience of being
the person she or he is, particularly but not exclusively in the
analytic relationship.
Making sense is an affair of memory, emotion, and anticipation,
of past, present, and future. Paradoxically, it sometimes includes the
recognition that some events make no sense in any perspective
available to humans. Making sense stretches the bounds of tradi-
tional bivalued logic and forces us to think about experience in more
holistic, but less neat, categories. It teaches respect for the “un-
thought known” (Bollas, 1987), but it makes us endlessly curious
about it. Psychoanalysis can generate such curiosity if it can foster
comfort with uncertainty and unfinished business. In Rilke’s (1934)
words, one ought to “be patient toward all that is unsolved in your
heart, and to try to love the questions themselves like locked rooms
and like books that are written in a very foreign tongue” (p. 35).
“Making sense” is a way of connecting to the uncharted and myste-
rious parts of ourselves and of one another.
The urge to make sense is distinctively human. We find some
capacity to organize in all living beings, perhaps even in inanimate
 Introduction / 7

nature. Higher forms of life show increasing capacity for feeling,

and more flexibility and complexity in their ways of organizing
experience. Healthy humans have a developing and lifelong pro-
pensity to reflect, to organize experience variously, and especially
to wonder or converse about meanings.
Psychoanalysis is a special conversation about meaning; it is
an attempt of analyst and patient to make sense together of the
patient’s emotional life. In Gadamer’s (1991) phrase, we undergo
the situation together (p. 288), especially in the transference and
countertransference (or cotransference, see Chapter 5). In Hoff-
man’s (1993) words, “I see our intimate involvement with, and
commitment to, our patients as requiring that we be partners with
them in their struggles with often agonizing existential choices and
predicaments” (p. 19). We make sense of a person’s life by feeling
it together and reflecting on it together in the intersubjective field
of treatment.

INTER SOUBIEC TIVITY SEL PSYCHOLOGY

AND PSYCHOANALYTIC UNDERSTANDING

My philosophical perspective on psychoanalytic issues has caused

me to lean toward the intersubjective view of psychoanalysis
because it views understanding as the means to and the goal of
successful psychoanalysis. Intersubjectivity, in this book, refers
broadly to the psychoanalytic theory articulated in the work of
Atwood and Stolorow (1984), and developed both in Stolorow,
Brandchaft, and Atwood (1987) and in Stolorow and Atwood
(1992). For these authors, any two or more subjectivities may make
up an intersubjective field. In childhood or in analysis the interplay
of child and parent or of patient and analyst produces its own
psychological configurations, and these form a system. Psycho-
analysis goes beyond individual subjectivity and seeks to under-
stand the workings of this system and its effect on an individual’s
way of organizing experience.
Intersubjectivity theory describes the emergence and modifi-
cation of subjectivity, and it defines these processes as irreducibly
relational. This book is a development of intersubjectivity theory,
modifying that theory to emphasize the emotional dimension of
8 / EMOTIONAL UNDERSTANDING

human understanding. My idiom—a woman’s voice, perhaps—pro-

vides a more explicit emphasis on emotional life, emotional con-
nection, emotional memory, and emotional understanding.
I want to distinguish my use of the terms “intersubjective” and
“intersubjectivity” from two related ideas. First, by “intersubjec-
tive” I mean a relatedness that can contain any two people to the
extent that they have become subjects, without regard to develop-
mental level. My use of the term differs from that of Daniel Stern
(1985), who, in his description of infant development, defines
intersubjectivity as the attainment of the ability to recognize
another’s subjectivity as connected to one’s own. In contrast, this
recognition by a patient may be a comparatively late achievement
in the intersubjective field of an analysis, especially for patients
such as those described by Guntrip (1969) and Kohut (1971), yet
the intersubjective field exists from the onset of the analysis.
Second, although both intersubjectivity theory and interper-
sonalism are relational theories, they differ. Interpersonal theory
often concerns itself with who is doing what to whom, focusing on
concepts such as gambits, control, agency, and responsibility.
Because the analyst maintains an external perspective, doing
interpersonalist work can interfere with the ability to undergo the
situation with the patient (Gadamer, 1991). Although intersubjec-
tivity theory may at times focus on the experience of control and
agency, it resembles more closely those currents in relational
thinking that emphasize development within a caregiving situation
(Winnicott, 1958; Bollas, 1987; Ghent, 1992) and the exchange of
differently organized and positioned perspectives (Aron, 1992).
On one side, an intersubjective point of view transcends the
Freudian view of human beings as self-contained bundles of better
or more poorly harnessed sexual and aggressive instincts that are
directed at “objects.” Intersubjectivity theory sees humans as
organizers of experience, as subjects. Therefore, it views psycho-
analytic treatment as the dialogic attempt of two people to under-
stand one person’s organization of emotional experience by “mak-
ing sense together” of their shared experience.
On the other hand, my version ofintersubjectivity theory lives
comfortably with self psychology, another relational theory and
my original psychoanalytic home. By speaking of selfobject expe-
rience or selfobject relatedness, self psychology explains how a
 Introduction / 9

patient can use the special intersubjective field of treatment to

form or heal self-experience. In treatment, we offer patients a
developmental “second chance” at a secure emotional attachment.
Within such a bond they can experience the primary selfobject
relatedness needed to develop a strong and valued sense of self.
The psychoanalytic understanding I examine here provides
and works through this emotional “new beginning” (A. Ornstein,
1991) for the patient. Interpretive work, seen as a collaborative
project of making sense together of a patient’s emotional life, both
supports and creates the healing selfobject experience. Under-
standing, in this view, is a relational form of healing. Self psychol-
ogy describes the intersubjective field of treatment as a form of
relatedness in which an analyst or therapist can be unequivocally
on the patient’s side (Tolpin, 1991), entering and remaining with
the patient’s self and relational experience. We do this, of course,
through our cotransference (Orange, 1994)—including our per-
sonal history and the “sense of things” we have inferred from
it—and from our training and theories.
In addition, the attention self psychology gives to the effects
of relational deprivation and of trauma concretely shapes my
clinical thinking. No other psychoanalytic theory, I believe, focuses
so directly on the emotional suffering and confusion of patients.
No matter what level of abstraction or generality my theorizing
may reach, self psychology keeps me emotionally close to patients.
However, intersubjectivity theory, as I conceive it, functions at
a different level of discourse from that of self psychology. It
describes the triadic system or field in any psychoanalytic treat-
ment, classical or relational. The emotional organizing principles
that each participant has distilled from relational experience form
the two subjectivities. The interplay of these two subjectivities
forms the third element of the intersubjective triad. While inter-
subjectivity theory has clinical implications that require the analyst
to be sensitive to the triad, this does not mean that the relationship
is a reified entity separate from the two subjectivities. Instead the
concept ofa “triad” highlights the capacity of the field itself to have
both history and emotional qualities.”
I find intersubjectivity a productive metatheory. As a cognitive

“Ogden (1994) has presented a similar idea.

10 / EMOTIONAL UNDERSTANDING

framework, it helps me to comprehend some differences among

the metapsychologies and clinical approaches of various psycho-
analytic theories. (Chapter 3, “Theory-Choice and Fallibilism,” will
show how this works.) My organizing principles, however, which
lead me to see developing emotional life as a central value, make
me, in practice, a self psychologist. I hope this book contributes to
the growth and development of both self psychology and intersub-
jectivity theory, neither of which I can do without.
I also hope that this book becomes a participant in the larger
psychoanalytic conversation. A major contribution by Greenberg
and Mitchell (1983), developed by Mitchell (1988, 1993), has both
identified and participated in a widespread shift toward relational
theories of human nature, psychopathology, and cure. This change
has revolutioned the conception of psychoanalytic understanding,
and its influence continues to develop in several schools of
thought.
Interpersonalists (e.g., Hoffman 1983, 1991, 1992a, 1992b;
Donnel Stern, 1992) are developing relational theories under the
aegis of social constructivism. This view offers a relativist or
contextualist epistemology as an alternative to the empiricism and
positivism inherent in classical psychoanalysis and ego psychology.
Meanwhile, the British independent school—which originally in-
cluded Fairbairn, Guntrip, Winnicott, Balint, and Bowlby—contin-
ues to grow in the work of Bollas (1987, 1989). Bollas’s contribu-
tions on memory and personal idiom place him, along with the
self psychologists, among those thinkers Ghent (1992) calls the
developmental-relational theorists. Self psychology, given context
by the intersubjectivity theory of Stolorow et al. (1987), has
adopted a phenomenological view of the nature of psychoanalytic
understanding (Kohut, 1959; P. Ornstein & A. Ornstein, 1985). I
am indebted to all of these thinkers—and to those (Brandchaft,
1986; Bacal & Newman, 1990) who have identified the relation-
ships among some of these theories—in my attempt to understand
psychoanalytic understanding.
To repeat, my studies in psychoanalytic epistemology aim to
present a view of psychoanalysis as emotional understanding that
is philosophically defensible and clinically creative. First, I will
argue that my psychoanalytic epistemology involves replacing both
objectivism and relativism with a perspectival realism. Second, I
 Introduction / 11

believe that in our theoretical and clinical studies we need to

replace dogmatism and the search for certainty with a thorough-
going fallibilism, the attitude of holding our own opinions lightly.
In psychoanalysis this attitude has probably been best exemplified
historically by Sandor Ferenczi, who was always ready to say he had
been wrong, and currently by Bernard Brandchaft. Third, I believe
we need to balance and integrate any cognitive cast in psychoanaly-
sis with a clear commitment to the attempt at healing the emotional
life of human beings. Finally, I believe psychoanalysis needs to
continue its recent efforts to replace all forms of “one-body” or
“isolated mind” (Stolorow & Atwood, 1992) psychology with fully
relational and intersubjective accounts of human nature and mo-
tivation. In this spirit I describe psychoanalysis as emotional
understanding gained by “making sense together.” Only together
with our patients, and with each other, can we make sense in our
clinical work and in our search for better theory.
Psychoanalysis is therapy by understanding. It seeks to pro-
mote comprehension and to heal by participation in the emotional
life of human beings. Psychoanalytic understanding is making
sense together.
Gai
gg wl Eee,

Understanding
Understanding

My real love is new understanding.

—HEInz Kouut

Sometimes to understand the present, one

needs to study the past.
—Chinese fortune cookie, quoted in
RICHARD BERNSTEIN, The New Constellation

M ost people enter analysis, or psychoanalytic forms of therapy,

baffled by themselves. Their feelings, reactions, behavior, inhibi-
tions, and difficulties in relating make no sense to them. Even
worse, early caretakers have often convinced these patients that
they are beyond understanding. Our efforts to “make sense to-
gether,” to engage these patients in a process of understanding
themselves and their relationships, often amazes them. “You always
think there are reasons for what I do or feel,” a young woman said
to me with considerable surprise.
If psychoanalytic understanding is as central to the healing
process as I believe it is, it deserves our serious inquiry into its
nature. On the assumption that ideas develop historically, this
*
I had entitled this chapter long before I saw On Understanding Understanding (1994) by the
late Vincent G. Potter. Potter directed my 1979 dissertation on Charles Sanders Peirce, and
he must have influenced my thinking more than I had realized.

Zz
 Understanding Understanding / 13

chapter provides an intellectual genealogy for the idea of under-

standing, and it maps the path through Kohut’s conceptualization
of empathy into psychoanalytic understanding as a way of knowing
together and being together.
Psychoanalysis was born at a particular moment in intellectual
and cultural history. This moment contained a tension between
faith in causality and the search for meaning. Freud’s work in-
cluded both a “Project for a Scientific Psychology” (1895), which
was an attempt to establish physiological causes for all mental
phenomena, and a lifelong effort to explore the meanings of
puzzling human experience. This tension persists to this day in
psychoanalysis as a division between those who regard psycho-
analysis as a science—usually organized around the conception of
instinctual drives—and those who see it as an interpretive, or
hermeneutic, and relational enterprise. Mitchell’s (Greenberg &
Mitchell, 1983; Mitchell, 1988, 1993) work delineates a broad and
deep shift toward the latter point of view.
I believe that the intersubjective conception (Stolorow et al.,
1987) of psychoanalytic understanding not only makes a place for
but also does justice to both points of view. The intersubjective
approach shares the generality of scientific inquiry and the par-
ticularity of empathic concentration on one individual’s organized
and organizing subjective world. Although, like other relational
theories, an intersubjective perspective gives clear primacy to
subjective meaning over objective “reality,” it appreciates both the
particularity of organized emotional experience and the generality
of humanness, thus providing a balanced context for our episte-
mological inquiry into the nature of understanding.

THE HISTORY OF UNDERSTANDING

The modern notion of understanding came into philosophy with

Kant’s (1781) Critique ofPure Reason, which questioned the grounds
for claiming to know any external reality. To save knowledge—es-
pecially scientific knowledge—from his own critique, Kant distin-
guished pure reason (Vernunft) from understanding (Verstand).
Understanding, based on what Kant called “the categories” (struc-
tures or organizers of experience), yields no absolutes, no things-
14. / EMOTIONAL UNDERSTANDING

in-themselves beyond the reach of human experience, and no

extraexperiential deity. Although Kant found it reasonable to
believe in real moral differences and in a deity—the pragmatists
were his legitimate heirs—he confined understanding to experiential
phenomena. Understanding seeks to unify and organize more
direct experience, and it gives us categories for doing so. In Kant’s
view, what we already understand determines what we can come
to understand. We owe to him our contemporary awareness of the
ways our theories and preconceptions shape and limit our percep-
tion.
Hegel criticized the Kantian notion of understanding as being
too limited by its fixed categories and its devotion to abstraction.
Only by dialectical thinking, Hegel thought, could we overcome
the inadequacies of the categories of understanding and thereby
proceed by reason or speculative philosophy to know the whole.
He believed that finite understanding derives meaning only from
the infinite, or absolute totality. Reacting against such views,
Nietzsche rejected both finite understanding and Hegel’s totality
in favor of antirationality, paradox, and eternal recurrence.
It was left to Dilthey (1989) and the hermeneutic philosophers
to rehabilitate understanding. Eschewing metaphysics and com-
prehensive world views, they attempted the more modest task of
examining the process of understanding. Dilthey distinguished the
Naturwissenschaften (natural sciences) from the Geisteswissenschaf-
ten (cultural sciences), among which he included law, economics,
literature, art, philosophy, and psychology. These disciplines re-
quire understanding from within, understanding through flexible
categories drawn from the personal lived experience (Erlebnis) of
interaction in a social milieu. Understanding means the use of such
categories to penetrate beyond the obvious into the life of a person,
the inner spirit of historical epochs, and the meanings and pur-
poses expressed by law, economics, or historical events. Since such
understanding depends on self-knowledge in historical context, it
can never be complete. Instead, this kind of knowing is a constant
approximation of what we seek to know.
For Dilthey, understanding is nota purely cognitive enterprise.
We can explain nature, identify causes of observed effects, but we
seek to understand human beings. Understanding consists of reex-
periencing or sharing the experience of the world as another
 Understanding Understanding / 15

experiences it. Dilthey’s view of understanding resembles Kohut’s

(1959) definition of empathy as vicarious introspection.
Heidegger moved beyond Dilthey by situating the knower
squarely in the known. Heidegger’s Dasein, or being-in-the-world,
offered a compelling alternative to the detached objectivism and
positivism of modern science, and it included the observer within
what is to be observed. Like Kant’s categories, Heidegger’s “fore-
conceptions” spotlighted the observer’s contribution to all under-
standing.
It was only another short step to Gadamer’s (1991) “dialogic”
conception of understanding. According to this view, interpreta-
tion no longer defines the field of hermeneutics; instead the
deeper, broader, and more fundamental process of understanding
does. Interpretation can be, as Winnicott (1965, p. 189) explained,
a means to test the limits of our understanding and to find our way
together beyond these limits. Nevertheless, one person gives an-
other an interpretation. Understanding, on the contrary, emerges
from the work/play of two or more people together. Under-
standing is a relational way of being and knowing.
Gadamer’s view of understanding has several important fea-
tures. Play may be the most important element of his view of
understanding. While Gadamer often speaks of the effort of
understanding and of hermeneutic work, he clearly asks that we
approach it in a playful spirit, with an openness to letting the other
say something new to us. A kind of dialogical volleyball, between
tradition and future, between self and other, between question and
supposition, creates a field in which something new can emerge
from the interplay of subjectivities. (Thus Gadamer escapes from
the Kantian prison in which we can understand only what we
already understand.) In psychoanalysis I think such play is not
restricted to dream analysis but, if the emotional atmosphere is
safe enough, can even be part of the analysis of ruptures and
misunderstandings. “I wonder what is going on with us? We aren’t
usually like this.”
Simultaneously, Gadamer believes (1979) that all under-
standing is ultimately self-understanding. We can understand an-
other only through the perspective of our personal organized
subjectivity. For hermeneutic understanding there is no blank
screen, no neutrality, no anonymity. In Gadamer’s view, we under-
16 / EMOTIONAL UNDERSTANDING

stand by standing under or within, not outside. In other words, to

understand we try to enter not the isolated mind (Stolorow &
Atwood, 1992) of the other but the whole emotional predicament
in which the other has formed a point of view or has organized
experience. This must be something like what Kohut meant when
he spoke of understanding in depth, which referred not so much
to a topographical search, or mental spelunking, but to the under-
standing of “complex mental states” (1978c, pp. 579-580). The
self-understanding required for any comprehension involves this
entry, through our own perspective, into the perspective of the
other. Understanding, according to Gadamer, “is not an act of
subjectivity, but proceeds from the commonality that binds us to
a tradition” (p. 293). Like Sullivan (1953), who reminded us that
“we are all more simply human than otherwise” (p. 32), Gadamer
denies that we can understand from a distance. Similarly, when a
patient asks, “Does any of this make sense to you?” I can say yes
only if Ican feel some kinship with the patient’s struggles.
Nevertheless, the other is other. The interplay, for Gadamer,
between the commonality/familiarity and the strangeness of the
historically situated other is the space of understanding. “The true
locus of hermeneutics is this in-between” (1991, p. 295). Asa result,
no method, technique, or procedure will yield understanding. We
must have the courage to stand under or within the other, to play
with the other, to allow understanding to emerge between us.
Ricoeur (1979), too, recognizes the “nonmethodic,” or emer-
gent, character of understanding:

Strictly speaking, only explanation is methodic. Understanding is

rather the nonmethodic moment which, in the sciences of interpre-
tation, comes together with the methodic moment of explanation.
Understanding precedes, accompanies, closes, and thus envelops
explanation. In return explanation develops understanding analyti-
cally. (p. 165)

Perhaps it is because explanation can be methodic that analysts

have given so much attention to the correctness of interpretations
and to their proper sequencing, surface to depth, for example.
Method provides a sense of security and a safe emotional distance,
both from the patient and from our own emotional responses. The
 Understanding Understanding / 17

price we may pay for these protections is the sacrifice of under-

standing for explanation. In contrast, empathy, a necessary but not
sufficient condition for understanding, is nonmethodical and
fallible. Unlike Gadamer, who replaces empathy with under-
standing, I believe that empathic participation in the emotional
life of the other makes the interplay of psychoanalytic under-
standing possible. To study psychoanalytic epistemology, there-
fore, we must examine the nature and function of empathy.

EMPATHY AND UNDERSTANDING

Although the term “empathy” is common currency in conversa-

tion among mental health professionals, its meaning is woefully
unclear. Comparatively new as an English word, it is a translation
of the German Einfuhlung, which literally means “a feeling into.”
Many thinkers have attempted to define empathy. Weigert (1962),
for example, cites Max Scheler’s “empathy as a form of emotional
contagion based on a process of identification.” Hobson (1985)
notes that “empathy” was first used in esthetics to denote the
appreciation ofa work of art. The word’s meaning then broadened
to include expressed “appreciation of what another person is
experiencing at this moment” (p. 10). Hobson comments further
that we often think of empathy as a one-way process, but that
instead it means a step toward mutuality or conversation. This
suggestion is close to the view of Harry Stack Sullivan, as reported
by Fromm-Reichmann (1950), that “empathy” refers to a nonverbal
“communion between people” (p. 30). Sullivan—and later Winni-
cott (1965)—believed that empathy originated in the preverbal
infant-caretaker relationship.
Here, however, let us look at the assumptions underlying these
definitions and examine empathy as a kind of knowledge. Eager
to free empathy from associations with sentimentality and sympa-
thy, Kohut (1959; 1971) claimed that empathy was the primary—
perhaps the only—epistemological method proper to psychoanaly-
sis. Therapists, he thought, know by empathy—“a major instrument
of psychoanalytic observation” (1971, p. 37)—the experience and
history of others. Empathy, for Kohut (1977), is “vicarious intro-
spection,” the capacity to place oneself, both cognitively and
18 / EMOTIONAL UNDERSTANDING

emotionally, in another’s shoes, to see or hear from another’s

perspective. Empathy, Kohut (1971) held, “is a mode of cognition
which is specifically attuned to the perception of complex psychol-
ogical configurations” (p. 300). Kohut emphasized that empathy
is not equivalent to sympathy, viewing empathy, instead, as a tool
for data collection. Yet, he cautioned against relying solely on
empathy:

The scientific psychologist, in general, and the psychoanalyst in

particular, not only must have free access to empathic understanding;
they must also be able to relinquish the empathic attitude. If they
cannot be empathic, they cannot observe and collect the data which
they need: if they cannot step beyond empathy, they cannot set up
hypotheses and theories, and thus, ultimately cannot achieve expla-
nations. (1971, p. 303)

In his last paper, however, Kohut (1981) qualified the distinction

between empathy and explanation. He came to view explanation
as a higher form of empathy, analogous to the mother’s shift from
physical contact to facially expressed pride in her child’s achieve-
ment: “from a lower form of empathy to a higher form of empathy”
(p. 532). Although Kohut’s “empathy” stopped short of the mutu-
ality found in an intersubjective conception of understanding, it
did involve a relational mode of knowing emotional reality.
What is this mode of cognition that Kohut called empathy?
To offer an answer that retains Kohut’s idea and still does justice
to the other understandings of empathy described above, we
must reach back into the history of philosophy. Scientific empiri-
cism, with its sharp distinction between objective scientifically
verifiable fact and subjective experience, will give us no help.
This tradition sets up certainty as a criterion of knowledge. It
prescribes tests of verifiability like those common in the “hard”
sciences (Carnap, 1936; Hempel, 1951). This view excludes from
the realm of knowledge such unquantifiable matters as a person’s
own history and the experience of another’s subjectivity (the
notorious problem of other minds). Kohut (1984) criticized this
conception of scientific objectivity, pointing out that even small-
particle physics both posits an irreducible interaction of observer
and observed and illustrates the uncertainty principle (cf.
 Understanding Understanding / 19

Sucharov, 1994). A fortiori in psychoanalysis, we must consider

the influence of the observing subject.
Until Hume’s (1739) A Treatise of Human Nature, philosophers
regarded some matters not accessible to empirical testing as
knowable. For these pre-Humean thinkers, such “unscientific”
matters were more knowable though less fully known than the
more easily verifiable facts (Aquinas, 1265-1273). Examination of
these earlier epistemological-ethical ideas—despite the divergence
on many matters among thinkers considered here—may help us
ground a psychoanalytic conception of empathy.
Let us begin with Plato, who believed that the least tangible
things were the most real and most knowable. For Plato, and for
such later Platonists as Plotinus, Augustine, and even Aquinas,
knowing is a kind ofloving participation in the being of the known.
Plato portrayed knowledge as generated by Eros:

The nature of the true lover of knowledge [is] to strive emulously for
the true being and... he would linger over the many particulars that
are opined to be real, but would hold on his way, and the edge of his
passion would not be blunted nor would his desire fail till he came
into touch with the nature of each thing in itself by that part of his
soul to which it belongs to lay hold on that kind of reality—the part
akin to it, namely—and through that approaching it, and consorting
with reality really, he would beget intelligence and truth, attain to
knowledge, and truly live and grow, and so find surcease from his
travail of soul. (Republic, VI, 490a-b)

Although Plato’s view of knowledge may appear unidirectional—

the known affects the knower but not the reverse—he did provide
clues to the reciprocal nature of empathy. Empathy is a kind of
knowledge by contact, contact that depends on kinship and a
passion for understanding. For Plato this way of knowing provides
access to the fully real. The knowledge emerges from a quasi-erotic
contact between the knower and the known, a kind of mutual
participation in each other’s being. Plato conceived the whole
Socratic dialogue as a conversation from which knowledge may
arise. For him, even thinking, which he defined as: “a discourse
that the mind carries on with itself about any subject it is consid-
ering” (Theatetus, 189e), is implied conversation. We might view
20 / EMOTIONAL UNDERSTANDING

such internal conversation as a precursor to the dialogue that

produces empathic understanding.
Aristotle also provided some clues leading to a philosophical
conception of empathy. Consistent with his strongly held convic-
tion that we are by nature social and political beings, he provided
an account of friendship as a key, if not the key, to making a good
human being. In loving a friend, Aristotle (Nichomachean Ethics)
thought, “men love what is good for themselves; for the good man
in becoming a friend becomes a good to his friend” (p. 1064).
Kohut’s (1984) portrayal of the healthy adult as one who is
surrounded by empathic selfobjects resonates with Aristotle’s em-
phasis on friendship. Aristotle characterized friends as grieving
and rejoicing with one another. In addition, discussion and
thought are among the fruits of friendship. And, like Plato,
Aristotle regarded conversation as the best way to seek knowledge.
Later, Spinoza (1677) offered an account of knowing that
illuminates the concept of empathy. For Spinoza, there were three
degrees of knowledge: (1) confused ideas or opinions, or the
images of particulars (we might call this common sense); (2)
adequate ideas, general and symbolic (our scientific theories); and
(3) scientia intuitiva, or knowledge of God (or Nature), which leads
to an adequate knowledge of the essence of things. This third kind
of knowledge is “the intellectual love of God,” that is, it is knowl-
edge based on relatedness and on participation in the reality
known. Since the knower is part of the reality known (i.e., God/Na-
ture), the knower cannot be outside the reality known, as in
scientific empiricism. Likewise, it follows that human beings can
know one another only because they are both parts of, or at least
participants in, a larger common reality, however we may conceive
that larger whole.
In the 20th century, Martin Buber (1937) similarly distin-
guished between the I-It relation of empiricist observation and
manipulation and the I-Thou, or personal, relation. Only in the
I-Thou relation is genuine knowledge of another human being
possible. As for Spinoza, true knowledge depends on being inside
the reality known, or ina relationship encompassing self and other.
We perceive, classify, and subdue things, such as trees. Nevertheless,
if the tree becomes a Thou, it becomes a subject to me, an other.
Similarly we can treat or describe or classify a human being as an
 Understanding Understanding / 21

object; only when he or she becomes Thou can there be relation,

and true knowledge. In relation to the Thou, I become I.
Empathy is the knowledge that emerges from personal rela-
tion and that creates the other as a subject. It is every bit as real
and important as—but distinctly different from—the knowledge
gained by measuring and counting. “The relation to the Thou is
direct. No system of ideas, no foreknowledge, and no fancy
intervene between I and Thou” (Buber, 1937, p. 11). Though
Spinoza captured the complexity of relatedness more successfully,
Buber forces us to recognize that subjectivity becomes real only
when two subjectivities meet in a personal relation. Only in such
a relation can we empathically know—not just know about—one
another. Patients have occasionally remarked that although they
know little about me, they feel that they know me very well. Buber
would not find such a comment surprising.
American pragmatist Charles Sanders Peirce’s view that all
reality is continuous (a philosophy he called “synechism”) provides
another framework for comprehending empathy philosophically.
Although he did not discuss in detail the implications of his
philosophy of continuity for understanding communication be-
tween people, Peirce (1931-1935) did comment that if correct, it
would make sense of “the very extraordinary insight which some
persons are able to gain into others from indications so slight that
it is difficult to ascertain what they are” (vol. 6, par. 161).
Each of the philosophers discussed above views reality as
continuous and knowledge as participation in the common reality.
Empathy, I believe, is emotional knowledge gained by participa-
tion in a shared reality. It is knowledge arising from attunement,
to borrow a notion from current infant research. Empathic parents
or therapists are those who are attuned to the emotional reality
shared in the intersubjective situation (Agosta, 1984). Empathic
response comes from attunement to this shared reality, and must
take form at a frequency or in a mode (auditory or visual, for
example) that the receiver can comprehend. An empathic environ-
ment, to which Kohut so often referred, is one in which each
person can feel like a Thou, a respected and admired partner in a
conversation. Nonresponse or misattuned responses are tempo-
rary lapses in empathic understanding.
For Kohut (1981), the most surprising, and almost embarrass-
22 / EMOTIONAL UNDERSTANDING

ing, admission he found himself forced to make about empathy

was that it can sometimes heal all by itself. He believed that the
fear of death itself could be understood as the fear of the loss of a
connection to the empathic, responsive human environment. In
support of this view, he cited the case of the astronauts who
wanted, if they had to die in space, to at least have their remains
return to earth, to the human world. Why should empathy, Kohut
wondered, even apart from interpretation, have such fundamental
and therapeutic importance for human beings?
To answer this question, we must, with Kohut, view a human
being as a social animal whose existence as a self depends on
participation in the human world. When people feel completely
cut off from empathic response and admiration, they experience
disintegration anxiety. Feeling understood and responded to helps
a person feel connected to others and thereby safe enough to
develop and realize personal aims and ideals.
Empathy in psychoanalysis, nevertheless, or “sustained em-
pathic inquiry” (Stolorow et al., 1987), is no simple matter. It
requires substantial attunement to the patient’s subjective world,
often necessitating a level of consistency captured by the word
“sustained.” For example, it took me a good deal of time, inquiry,
and close observation to understand what my 20-year-old patient
meant by telling me he should get a parrot instead of paying to talk
with me. Initially, of course, it felt like a simple put-down: Nothing
you say is more helpful or intelligent than a tape-recorder or a
parrot would be. Gradually we discovered that understanding-
sounding words had been used in a disrespectful and intrusive way
in his family. Words had described elaborate plans that were never
realized, and he had been left with a strong sense of needing a kind
of holding that mere words, however understanding, could never
provide. As some of these meanings became clearer to us, he
became able to ask for a kind of mutual involvement in planning
concrete changes in his life, especially in his patterns of self-de-
structive behavior. Only later did he gradually become more
interested in analyzing the meanings.
Empathic understanding includes response. Such response
*

To think otherwise is to lose the pragmatic conception of meaning and return to the
isolated mind fallacy (Stolorow & Atwood, 1992). Patients rightly accuse us of not
understanding if we do not respond.
 Understanding Understanding / 23

may involve words, gestures, practical interventions like adjusting

the heat and light for the patient’s comfort, or even silence. If a
parent knows that a child is being mistreated and does not protect
the child, that parent does not understand in any practical sense.
Thus empathy, including empathic response, is a necessary con-
dition for understanding. In psychoanalytic epistemology, empa-
thy defines the way of knowing—vicarious introspection—and the
nature of the known—complex psychological configurations—
that we seek to understand in depth. Understanding, as we will
see, is a relational and intersubjective conception of psychoana-
lytic purpose.

PSYCHOANALYTIC UNDERSTANDING

Psychoanalytic understanding is both relational and intersubjec-

tive. As a relational reality, the only important concern for psycho-
analytic understanding is the human subjective world, or organi-
zation of experience. This organized selfhood emerges, continues,
and changes only in specific relational contexts. Similarly, it is only
when relatedness is present that even partial understanding of the
subjective experience of another is possible.
By calling psychoanalytic understanding intersubjective, I
mean to draw attention to several of its essential features. First,
unlike isolated mind epistemologies, it requires a context of secure
attachment, which, in turn, forms the basis of primary selfobject
relatedness (Lessem & Orange, 1993). Similarly, the intersubjectiv-
ity theory of Stolorow et al. (1987) sees primary emotional bonds
as life-giving.” Although some understanding can occur outside
important emotional bonds, the capacity for empathic under-
standing originally takes form, and later develops, in such bonds.
The psychoanalytic understanding that heals and promotes emo-
tional growth requires such ties.
Second, intersubjectivity theory best describes the interplay
and the shared suffering of psychoanalytic understanding. While
this theory recognizes with Sullivan (1953) that “we are all more

They also stress the potentially pathogenic nature of these bonds when their price is the
* . . .

loss or nonformation of organized self-experience.

24 / EMOTIONAL UNDERSTANDING

simply human than otherwise” (p. 32), it also insists that we are
“differently organized, interacting subjective worlds” (Stolorow et
al., 1987, p. ix). The challenge of understanding arises from the
need to recognize, acknowledge, respect, and, at least temporarily,
transcend these differences. The dialogue of difference can in-
volve struggle and suffering; in the words of Gadamer, we “un-
dergo the situation” with the other.
Third, intersubjectivity theory, like contemporary semiotics,
recognizes understanding as triadic. The triadic nature of under-
standing means more than your subjectivity, my subjectivity, and
our relatedness. It means that yours and mine assume their par-
ticular shape in our relatedness. Semiotics (the study of significa-
tion) recognizes that all contact between subjectivities requires a
mediating sign, a third term. From Peirce (1931-1935) to Umberto
Eco (1992), semiotic philosophers have sought to generalize the
communicative process of understanding. While they may not use
the words relational or intersubjective, they eschew the isolated mind
(Stolorow & Atwood, 1992) and claim that understanding is triadic.
In addition, psychoanalytic intersubjectivity theory as articu-
lated by Stolorow, Brandchaft, and Atwood is a field theory of
understanding. Field is a metaphor borrowed from physics. It
attempts to address the complexity of causality and influence.
Gadamer’s metaphor of interplay makes a similar attempt, and it
highlights the elements of emergent novelty and surprise. Both
metaphors—of field and interplay—transcend the debates about
one- or two-person psychologies in favor of a triad of two subjec-
tivities and the emerging understanding that contains and informs
them. An intersubjectively oriented supervisor, then, will attempt
to evoke descriptions of all elements of the triad: the therapist's
subjectivity, the patient's subjectivity, and the emerging and chang-
ing sense of the “we.”

DEVELOPMENTAL UNDERSTANDING

Psychoanalysis understands developmentally. Every psychoana-

lytic tradition has emphasized development, and each one has
formulated explicit and implicit theories about how development
works to form personality. Freud’s drive theory and his develop-
 Understanding Understanding / 25

mental theories are interrelated. Developmental history is the story

of the drives, and interpreting the drives requires a developmental
context in which wish, fantasy, and compromise take shape in an
individual life. For Ferenczi and his theoretical descendants in
Britain and America, knowing the relational history is decisive for
understanding how a person becomes a particular self-in-relation.
The “complex mental states” Kohut sought to know by vicarious
introspection are those of a becoming and historical person.
Sullivan, founder of the interpersonalist tradition, wrote detailed
and eloquent accounts of the relational development of patholo-
gies. Thus psychoanalysis has always contained a marked “devel-
opmental tilt” (Mitchell, 1988). This is so much the case that no
one wonders why psychoanalysts, rather than behavioral or cog-
nitive therapists, have been fascinated with recent infant research.
Understanding a person psychoanalytically has always included
understanding how a particular person developed and who this
person is becoming.
So why discuss the developmental nature of psychoanalytic
understanding? First, prominent relational theorists have chal-
lenged the central focus on development in psychoanalysis, and
they have spotlighted instead the here-and-now transference-coun-
tertransference interaction. Second, the developmental concep-
tion itself needs to be clarified and extended. Third, recent find-
ings in developmental psychology have raised important questions
for psychoanalysis, both as a theory and asa set of practices. Finally,
I believe that development is the original what that psychoanalysis
understands and that psychoanalyses (including psychoanalytic
therapies) are themselves a developmental second chance.
Several important contributors to the current shift toward a
relational psychoanalytic paradigm have challenged the centrality
of development in psychoanalytic thought and practice. Prominent
among these is Mitchell (1988) whose term “developmental tilt” has
become a catchword for those who believe in working primarily or
exclusively (Gill, 1982) in the here-and-now, “in the transference.”
For Mitchell (1988), developmental tilt “collapses relational needs
in general into the kinds of interactions which characterize the
relationship between the small child and the mother” (p. 152) and
“lends a regressive cast to the psychoanalytic enterprise” (p. 152).
Similarly, Greenberg (1992) argues that our adult patients are
26 / EMOTIONAL UNDERSTANDING

not children and that we are working with adult minds. In his
words, “both our clinical and theoretical goals are best served when
we keep in mind that the psychoanalytic situation is an encounter
between two grown-up people, negotiating a relationship that will
facilitate the ability of one of them to overcome some serious
difficulties in living” (p. 285).
Criticism of the focus on development in psychoanalysis has
come from those who study countertransference and the influ-
ence of the analyst’s subjectivity on the psychoanalytic situation.
Beginning with Racker (1968), extending through Gill (1982)
and Hoffman (1983), and into the work of Ogden (1986, 1989),
theorists have seen the analytic situation less as repetition,
memory, or reenactment, and more as a relational construction
by two people in the present. My response to this argument is
that transference and countertransference are themselves devel-
opmental and relational ideas. People come into treatment be-
cause they can no longer afford to recycle their history; it creates
too much pollution in their current lives. Yet unwittingly they
repeat their patterns with us—who are full of our own memories
and organizing principles—hoping that in a context of under-
standing they can reprocess what they experience as garbage into
something productive. Yes, they are adults, but they feel trapped
in the patterns of childhood, and they want to escape these
through a new experience with us. This is why I call psychoanaly-
sis a developmental second chance.
A related current of thought is the narrative view of psycho-
analysis. It might seem that viewing psychoanalysis as narrative
construction would support a developmental view. On close in-
spection, however, we see that narrative constructivists view the
narratives as arising in the here-and-now of the analytic situation,
bearing little identifiable connection to the history of either
member of the “analytic couple.” Instead, the patient’s life story is
viewed as a product of current conversation. For Spence (1982),
unwitting interpretation by the analyst inevitably and perniciously
forms the narrative. Similarly, Schafer (1983) believes analysts are
always “constructing models of the analysand” (p. 39). Within this
view, what the analyst knows empathically is not so much the
patient as the model constructed in the analysis. The developmen-
tal histories of patient and analyst are peripheral issues.
 Understanding Understanding / 27

There are two conceptual issues embedded in the opposition

to developmental thinking in psychoanalysis. First, those who ally
themselves with this position may fear the emergence of reductive
and constricting theories of human nature. For Gerson (1993), any
theory of human nature—Daniel Stern’s (1985) view of infants’
natural capacities and tendencies toward representation of rela-
tional experience, for example—is dangerous for psychoanalysis.
The danger lies, apparently, not only in the neglect of the infant’s
family context but also in old or new forms of psychoanalytic
realism that may outlast the currently popular skepticism and
relativism. She fears that someone may claim that some features
of human nature are given, even universal. Gerson’s views, how-
ever, are problematic. We must decide these issues on their merits.
Not every form of realism is pernicious (Orange, 1992a, 1992b),
and some forms of extreme skepticism undermine the healing
purpose of psychoanalytic treatment because they discount all
paradigms, some of which may have clinical usefulness. Worse,
they discount and invalidate patients’ experience of their own lives
and of their psychoanalytic treatment. We cannot discard every
theory of human nature just by calling ita theory of human nature.
Developmental theories probably belong in psychoanalysis exactly
to the extent that they further understanding, and they deserve
exclusion or rethinking to the extent that they restrict or hamper
it. Each theory deserves consideration on its own merits.
The other conceptual issue concerns the extent to which
eliminating developmental thinking leads to an unintendedly static
view of the analytic interaction. Relatedness becomes a snapshot
in which two people communicate in a veritable historical vacuum.
A view of transference-countertransference relatedness that ex-
cludes a developmental perspective misses the texture and process
included in an intersubjective approach, in which the two partici-
pants bring both a formative history and “developmental strivings”
(Fosshage, 1992b). Also, by insisting that knowledge consists of
what is observable, the interpersonalists, with their here-and-now
focus, inadvertently return to the very positivism that relational
theorists generally abhor. Granted, narrative constructivism is not
classical positivism, which ignored the influence of the observer
* . . .
Realism is the philosophical belief that some things are, at least partially, independent of
our knowledge or opinions about them. Extreme relativists dispute this claim.
28 / EMOTIONAL UNDERSTANDING

on the observed and on the observing process. It does, however,

share the positivist penchant for isolating whatever is observed
from its historical context.
Developmental understanding can enrich and inform rela-
tional theories of psychoanalysis. In particular, transference and
countertransference—or cotransference (Orange, 1994)—can be
developmental experiences for both participants in psychoanaly-
sis. They are developmental in at least three senses of the word.
First, in transference and countertransference we relive, or emo-
tionally remember, our past relational experience in the present,
as the current relationship triggers or evokes either particular
memories or more generalized organizations of emotional expe-
rience. Second, the relational experience in analysis—no matter
what the analyst’s opinion about wishes and needs (Shabad, 1993)—
is an attempt in the present to repair or restore defective, lost, or
traumatic relational experiences (Emde, 1988b). Third, analysis,
far from concerning primarily the here-and-now, involves develop-
ment toward a future. Fosshage (1992b) emphasizes developmental
strivings, and Emde (1988b) stresses the influence of the analyst’s
positive emotions on forward-moving development. Both express
the conviction—as held by philosopher Henri Bergson (1910)—that
past, present, and future include each other. The future is the least
considered dimension of historical and developmental thinking.
The realization of the missing dimension of the future leads
directly to the need to clarify the conception of development and
its place in psychoanalysis.
It is impossible to address the nature of development without
considering ideas about truth and reality (explored further in
Chapter 10). To develop is to change from something real into
something not entirely different. (Patients often find this implicit
attitude toward change comforting and encouraging.) The poten-
tial for becoming signifies that something had to exist originally.
Not that human development, like Aristotle’s acorn becoming an
oak, is simple and linear. Still, potentials limit outcomes, so we must
find out, to the best of our ability, what these real potentials are.
Further, as Ferenczi, Balint, Winnicott, Bowlby, Kohut, and other
developmentally oriented psychoanalysts have taught us, the rela-
tional conditions into which a baby is born limit, catalyze, or even
shape potentials.
 Understanding Understanding / 29

We can learn littke about human potentials or about what

relational conditions support their flourishing if we believe we can
know nothing, that all truth is construction or fiction (Geha, 1993).
We need a pragmatic, fallibilistic conception of good-enough
truth. Only then can we converse with other human sciences and
allow their thinking to enrich ours and affect our clinical work.
Developmental psychologists tell us, for example, that securely
attached toddlers become curious and well-related school-age chil-
dren. As moderate realists, we can then profitably wonder about
how these findings bear on our experience in psychoanalytic
relationships. If we acknowledge that there is some real difference
between more and less adequate human functioning (a moderate
claim of a moderate realism), we can search for ever-more-adequate
knowledge about what supports and impedes its development. If,
conversely, we deny such real differences, we reduce developmen-
tal thinking to cultural construction.
A developmental view of psychoanalytic understanding, thus,
relies on a moderate realist epistemology, and it works toward
ever-more-adequate conceptions of human nature to guide our
work and our theorizing. In addition, it implies that there is some
substance to the ideas of permanence, change, and continuity
through change. These notions may seem abstract, but they are
crucial to theories of development and of psychoanalytic cure.
Hope for change, at least in feeling states, motivates seekers of
treatment. Since change implies temporality, we inevitably face the
question of the nature of emotional development, and whether it
differs from cognitive forms of change.
Piagetian cognitive development proceeds by assimilation
and accommodation. Assimilation strengthens schemata already
in place, while accommodation to new experience or to new
cognitive capacities modifies them. It might seem that emotional
development works in the same way. Assimilation surely occurs,
for better or worse. Difficulties with accommodating new expe-
rience, that is, with changing the schemata—or emotional convic-
tions—have produced the ubiquitous ideas of resistance (an idea
borrowed from physics) and repetition in psychoanalysis. Old
organizations of experience stay in place in the face of massive
counterevidence. Why? Perhaps psychoanalytic change is not like
Piagetian accommodation after all. Psychoanalytic protest
30 / EMOTIONAL UNDERSTANDING

against Alexander’s program of corrective emotional experience

suggests that we have always had doubts about the possibility of
transforming what is old.
Perhaps the “new beginning” idea (Balint, 1968; A. Ornstein,
1991) has some merit as an alternative to Piagetian accommoda-
tion. Maybe significant change can only occur by making a new
start in the emotional life. Stolorow (1994) has begun to think, and
I do similarly, that old organizing principles, and old ways of
responding and relating, are never eradicated. They remain in
place and come alive in stressful situations that replicate old
relational and emotional experience. For many of our patients,
new relational experience is almost completely new, and it does
not fit anywhere in the old organization of experience. Thus
psychoanalysis offers a second chance at healthy emotional devel-
opment in a life that has convinced a person that nothing new is
possible. This is the most profound meaning of calling psychoana-
lytic treatment a developmental kind of understanding.
Let us now consider some important features of developmen-
tal understanding. Kohut highlighted the developmental function
of mirroring for the creation and maintenance of stable and
positive selfhood. His metaphor of the mirror, of the gleam in the
parent’s eye, however apt and evocative, needs enriching and
complexifying. Mirroring involves recognition of something of
oneselfin the other—Kohut’s “chip off the old block” (1977, p. 13).
This recognition, in turn, requires an intersubjective conception
of mirroring. It implies both particularity and mutuality. I recog-
nize you, and you see that it is you that I recognize. When
recognition becomes fully mutual, we recognize each other. Then
senses of self, other, and “we” begin to form (Emde, 1988a). When
we recognize in one another a common emotional response to
something, we enter the developmental stage that Daniel Stern
(1985) calls intersubjectivity.
Developmental understanding also establishes or consolidates
the sense of one’s importance to another. A patient told me that a
characterization I voiced about her life meant that I had “consid-
ered” her as she had never felt considered. She explained that to
say what I had said to her I had to have given serious thought to
who she was. She felt that both her parents had been far too
self-absorbed to “consider” her. I think much of the therapeutic
 Understanding Understanding / 31

effect of analytic interpretation may lie, not so much in the insights

provided or even jointly found, but instead in the patient’s experi-
encing for the first time being important enough to a parent-sub-
stitute to be thoughtfully considered. Conversely, of course, the
sense of not being adequately considered by the therapist can lead
to rupture or impasse.
Perhaps the most important requirement for emotional devel-
opment in psychoanalysis is the analyst’s emotional availability.
Such availability is necessary for participatory knowing, for shared
understanding. Whether one considers oneself a Piagetian de-
velopmentalist or believes in new beginnings, the analyst’s ability
and willingness to stay with the patient emotionally provide pow-
erful support for cognitive and emotional growth. Unfortunately,
patients often experience interpretation—including developmen-
tal interpretation—as our emotional retreat from them. The devel-
opmental character of understanding requires that we stay close
to the patient’s emotional life and reattune as needed. (We will
return to the topic of emotional availability in Chapter 9.)
Psychoanalysis is a developmental undertaking in several re-
spects. As a science, it studies human capacities when acute or
chronic trauma or deprivation has disrupted healthy growth, and
when adaptation to trauma or deprivation continues to disrupt or
restrict love, play, and work. As a therapy, psychoanalysis is an
opportunity to understand and be understood through a shared
emotional experience, to sit shiveh together for the child whose
early experience cannot be repaired, and to create, through “mak-
ing sense together,” a second chance at developing a good human
life. The central and fundamental purpose of psychoanalysis as a
therapy, and what distinguishes it from any short-term therapy, is
this developmental purpose, this orientation toward the future
through the past. A psychoanalysis makes the future possible
through a shared experience of one person’s past in the present
of both people.
Psychoanalytic understanding, then, is the collaborative effort
to understand the origins and meanings of a person’s emotional
life. In the intersubjective field formed by transference and coun-
tertransference, patient and analyst come to know by participation
in each other’s emotional life. This kind of understanding, both
process and product, heals because emotional ills require emo-
32 / EMOTIONAL UNDERSTANDING

tional remedies. For many of us humans, the greatest pain and

despair come from feeling that our lives and suffering make no
sense. Experiencing them as absurd is what makes them unbear-
able. Making sense together with a trusted guide, especially making
sense of one’s experience with that guide, can provide something
of a “new beginning” in the emotional life.
CarieAe Daleks a3

Theory-Choice
and Fallibilism

A well-schooled man is one who searches for

that degree of precision in each kind of study
which the nature of the subject at hand admits.
—ARISTOTLE, Nicomachean Ethics

lie process of understanding has its own requirements. (A

philosopher would speak of the “conditions for the possibility of
something.” A college catalog would say “prerequisites.” )To make
sense together and to understand emotionally, we need specific
intellectual equipment and attitudes. The history of philosophy
can provide some clues to what is needed for understanding in
general and for that special in-depth emotional understanding that
is psychoanalytic.
Philosophers, like psychoanalysts, usually want to go deeper,
to examine the assumptions or preconceptions underlying any
question. One form of this inquiry is to seek the conditions—
necessary or sufficient—for the existence or truth of whatever one
is considering. The search for the sufficient conditions for the
existence or truth of anything is possible only in either a closed
logical system or for the mind of a deity. Since psychoanalysis is
neither a closed system nor a deity, we can speak only of necessary
conditions for psychoanalytic understanding. These conditions
include both intellectual necessities, like theory and an attitude of

5}
34. / EMOTIONAL UNDERSTANDING

fallibilism, and practical necessities, like emotional availability and

consistency. Undoubtedly others exist. Here let us consider theory
and fallibilism; practical necessities will be addressed in later
chapters.

THEORY-CHOICE AND RATIONALITY

Psychoanalytic understanding includes both theory and practice.

Both theory and practice are forms of understanding. My view of
psychoanalytic understanding as primarily clinical, as a collabora-
tive search for a shared web of meanings, does not diminish the
need for theory. To guide responsive understanding, psychoanaly-
sis needs conceptual frameworks, complex sets of organizing
principles to guide our more reflexive and automatic responses.
Theories usually run quietly in the background, ordering the chaos
of perception and of the data derived from sustained empathic
inquiry. But, if theories are to aid and not impede our work, they
often need attention and improvement, sometimes requiring seri-
ous rethinking. However, if we choose theories from moment to
moment and hour to hour, we risk the integrity and reasonable
consistency of our understanding. We thus confront the serious
problem of theory-choice.
Analysts today view the theory-practice connection in several
ways. Some argue that different theories work better in the hands
of individual practitioners. Others, such as Pine (1990), believe
that different theories work better with specific sorts of patients.
According to this view, a good analyst, like an accomplished
violinist who can play Bach, Mozart, or Brahms as the program
requires, has a flexible repertoire of practical interventions based
on theories of drive, ego, object, and self. Yet others assert that
over time there has been some convergence and some consensus;
some “common ground” has emerged (Wallerstein, 1992). Freudi-
ans protest that they are no longer so distant and silent as relational
analysts portray them. Alternatively, Mitchell (1988, 1993) argues
that many schools of psychoanalytic theory and practice have
made a fundamental shift to a relational model, with its interest in
mutuality and presence.
Sull, many issues remain hotly debated and most analysts
 Theory-Choice andFallibilism / 35

maintain an identification with the school of thought in which they

were trained. Two issues of the journal Psychoanalytic Inquiry
(Pulver, Escoll, & Fischer, 1987;J.Miller & Post, 1990) studied the
shaping of practice by theory, and they exposed profound continu-
ing differences in the ways psychoanalysts allying themselves with
different theories speak with patients in daily clinical work. In each
issue a prominent analyst provided clinical material, including
transcripts of taped sessions. Analysts from various schools of
thought were invited to comment. The differences in the ways
analysts thought they would respond struck this reader as signifi-
cant, which suggests that our choice of theory may seriously affect
the ways in which we work with patients.
On what grounds do we choose our theories? Granted,
people develop and hold theories that express their subjective
organizations of experience (Atwood & Stolorow, 1993). This
observation points us toward a study of the personal and inter-
subjective dialogic processes involved in the making of theory.
Here, however, I consider a different question. What are reason-
able grounds for preferring one theory to another? Although we
may no longer find the scientific rationality that shaped the
Freudian enterprise useful (Mitchell, 1993), many of us revise our
theories during our professional lives on what we think are
reasonable grounds. Freud himself, for example, was in part a
pragmatist who revised his theories as he stumbled on new
clinical evidence. He was less concerned with consistency in
theory—he explicitly denied any interest in philosophy—than with
finding some explanation for the phenomena he observed.
Likewise Kohut saw new clinical findings as reasonable grounds
for theory-revision. This sense of “reasonable grounds” expresses
an often unarticulated commitment to a particular conception
of reasonableness. I will therefore briefly outline some history
of reasonable grounds and reasonableness so we can see how
they bear on theory-choice in psychoanalysis.
The history of philosophy demonstrates that the question of
reasonableness arises in various ways, each of which focuses on a
particular form of the problem: What is reason? What is it to think
rationally? When does a person think or act reasonably? How does
reason differ from what is not reason, that is, from the irrational
and the nonrational? These formulations of the question, scarcely
36 / EMOTIONAL UNDERSTANDING

the only versions, are not strictly equivalent. Yet each is a part of
our question about reasonable grounds for theory-choice and
theory-improvement. Restricting the consideration to one form of
the question would impoverish the inquiry. So, at the risk of
probably unavoidable ambiguities, let us approach each philoso-
phy in the foliowing discussion through its own way of posing the
question, keeping in mind our question of reasonable grounds for
theory-choice.

PHILOSOPHY AND REASONABLENESS

In the world of myth prior to the advent of philosophy, each event

required a single explanation, usually the arbitrary will of an
anthropomorphic deity. The pre-Socratic philosophers of the
fourth and fifth centuries B.c.E. (Kirk & Raven, 1984) sought, for
the first time, a consistent account of reasons “behind” events,
reasons underlying the patterns they found in nature. Thus, a
change in their experience took place: They no longer perceived
each event as a single, or unique, phenomenon, butas part of some
generality. Parmenides and Heraclitus, commonly seen as antago-
nists, both sought this “generality” in whatever continues through
change. Parmenides distinguished the way of truth from the way
of seeming or appearance. He thought reasonableness consisted
in recognizing that truth is more than appearance. He made a
major step toward a conception of reason that somehow penetrates
beyond the appearance of what we see with our eyes. For Par-
menides, attention to what changes without recognition of persist-
ent structure, or logos, was not reasonable.
Although Heraclitus emphasized change over permanence, he
too drew attention to a logos ruling the world. To hold, as Heraclitus
did, that everything changes, is not to say that all change is random.
Thus Heraclitus attempted, even more than Parmenides perhaps,
to account for permanence of patterns in the experienced world.
Further, both Parmenides and Heraclitus wanted, each in his own
way, to view the world as a whole. Insisting on generality, they thus
developed the first complex description of reasonableness in the
Western tradition. In Parmenides and Heraclitus we already find
intimations of criteria for theory-choice: Reason concerns more
 Theory-Choice andFallibilism / 37

than fleeting appearances and is related to what is general and

what endures.
By the time of the atomists, Epicureans, and Stoics, the search
for generality had turned toward the ethical. The ancients had
begun to search for patterns of life that would lead to human
satisfaction. Their first problem was to identify the nature of such
satisfaction. To Democritus, for example, the highest good was a
mind without fear. The next step was to discover how to order
human conduct to promote such aims. Rationality now meant
adapting means to ends, fitting patterns of action to theories of
the good. These thinkers pointed toward pragmatic criteria for the
rationality of theory-choice.
By far the most important advance came, of course, with
Socrates, Plato, and Aristotle. Socrates, as Plato portrayed him,
embodied reasonableness. Socrates had no answers, no theories,
only an insatiable thirst for understanding, for making sense. Yet
for Plato himself, to think or act was to proceed according to
general reason, to participate in a Form, and to know that one is
doing so. Although he accorded a prominent place to myth in his
dialogues, Plato did not retreat from his project of rationality.
Instead he recognized that reason includes much of what the
search for it can lead to denying—such elements as intuition, myth,
and a search for beauty and truth. We can know the Form of the
Good only by a flash of insight (Letter VII, 341c). Still, he did
contrast reason with opinion, which he understood as receiving
one’s views primarily from the crowd. Although Plato affirmed
the necessary relation of rationality to an objective universal
beyond the knower, he recognized that rationality can be only the
rationality appropriated by a knower. He would have recognized
the common clinical finding that emotional reorganization, a
“new beginning,” is necessary to make insight curative. Only
reasonableness that one can emotionally own makes a difference.
With Aristotle came the first system of formal logic and the first
formal attention to reason itself. Aristotle was confident both that
the cosmos—including human life—is intelligible and that human
beings can understand it. Further, he identified the contemplative
* C .

For Plato (Republic, VII), only the Forms, or Ideas, were fully real. What most of us consider
real are mere shadows or reflections. which have only a shared, or derivative, reality and
cannot truly be known.
38 / EMOTIONAL UNDERSTANDING

or theoretical life of reason itself as the highest human good. ‘To

Aristotle we also owe the distinction between practical and theoreti-
cal reason. For him, practical-productive knowing has its source in
the knower and in the knower’s purposes. Theorza, on the contrary,
is thinking for which the source, principle, or origin is in the object
known, not in the scientist. Ethics and politics represent the practi-
cal; physics is an example of theoretical science. (It is probably safe
to assume that Aristotle would have seen psychology and psycho-
analysis as parts of practical reason, since they concern the good
human life.) However, even for Aristotle who saw them as distinct,
the practical and the theoretical are closely interwoven. In Aristotle’s
Nicomachean Ethics, the application of theory became the ultimate
motivation for all the practical sciences. For both Plato and Aristotle,
rationality is a quality more of wise people than of theories. The best
theory is the one that a wise person would choose.
In modern philosophy, Kant (1929) offered a “critique of pure
reason,” arguing that such reason is insufficient to inform us about
anything. For Kant, to be reasonable is to decide carefully the limits
of the knowable and to conduct inquiries inside those limits, in
constant acknowledgment of those limits. Reason is a cautious affair
of seeking in human life the meaning and direction of human life.
For Kant, theory exists for the sake of practice. Theoretical entities—
God, freedom, and the immortality of the soul—are conditions for
the possibility of the practical moral life. Even physics, he thought,
involves elements of such practical values and interests. Kant treated
philosophy as a project of limiting idle speculation, and he pointed
out the practical interest inherent in all reason. He also directed us
to pragmatic consequence as a criterion for theory-choice. His
ethical “categorical imperative”—act as if the principle of your action
should become a law of nature—affirmed the centrality of gener-
alizability as a rule for theory-choice. An excessively particular
theory, or one we would not want applied to ourselves, is excluded
by the Kantian view of rationality or reasonableness.
For Hegel, on the contrary, reason meant seeing any event as
part of a larger whole, especially seeing it historically. To reason is
not to subject reason itself to a Kantian critique, but instead to
place ideas and events in context, especially in temporal context.
Hegel (1807) called the organizer of experience a “subject”: “Rea-
son appeals to the self-consciousness of any and every subject ” (p.
 Theory-Choice andFallibilism / 39

275). True objectivity, for Hegel, meant recognition of the rule of

rational subjectivity, “self-conscious reason” (Lauer, 1976, p. 11).
Theory, for a Hegelian, requires reference to subjectivity, to the
dialectic, and always to history.”
American philosopher Charles Sanders Peirce (d. 1914) gave
the question of rationality, or in his words “reasonableness,” a
pragmatic form. His conception of rational purpose, or concrete
reasonableness, overcame the dichotomy between theoretical and
practical reason, and it provided guidance for theory-choice. Habit,
he believed, is generality in purposeful action or thought. Reason is
the power to form or change habit by reflection on experience.
Reasoning itself is thinking according to habit, to be subjected to the
same critical review as other habits. Peirce recognized that theory-
choice has personal and subjective elements. Still, any such choice
implies a claim of reasonableness transcending idiosyncrasy. Kant’s
view of morality had required generality—take as your moral maxim
what you want applied to every case. Similarly, the “categorical
imperative,” or fundamental moral duty, for Peirce is to think so that
the maxim, or logical organizing principle, of one’s reasoning can
extend consistently to all thinking.
Peirce’s concrete reasonableness (cf. Orange, 1984), however,
is partly an ideal; it does not already exist fully as an absolute
measure of theories. Since our yardstick is only emerging, we thus
must always be cautious, Peirce thought, about calling the enter-
prises of others irrational. As far as they are products of human
purpose, the things that others do are rational in part. They are
efforts to order means to ends, and to promote the emergence of
truth. To aim for the swmmum bonum (the ultimate good), or
concrete reasonableness, requires Peirce’s community of inquirers,
whose categorical imperative is to promote reasonableness. The
growth of reasonableness, for Peirce, is the most satisfactory ideal
aim of all practice. We might add that contributing to the develop-
ment of reasonable psychoanalytic theory is one reasonable aim
of psychoanalytic practice.

"The Hegelian roots of intersubjectivity theory may be minimized for fear of the tyranny
of teleology, the assumption that process has some kind of inherent, predetermined
outcome. There is no Absolute Spirit in intersubjective theory. We could argue, however,
that Hegel’s teleology differs from Aristotle’s simple acorn becoming an oak. Just as in
evolution, development need not mean the outcome is predetermined.
40 / EMOTIONAL UNDERSTANDING

In our century Alfred North Whitehead (1938) both clarified

and undermined the distinction between speculative and practical
reason. In his view, the speculative reason of Plato seeks complete
understanding, whereas practical reason, the rationality of Ulysses,
seeks immediate methods of action. Speculative reason and prac-
tical reason are, however, only forms of reason; each, for White-
head, is incomplete and dangerous without the other. “Some of the
major disasters of mankind have been produced by the narrowness
of men with a good methodology. Ulysses has no use for Plato, and
the bones of his companions are strewn on many a reef and many
an isle” (p. 12). (Warnings against “wild analysis” contain this
caution about practice without theory.) A Whiteheadian would
insist that theory-choice is crucial, but that it involves a continuing
interchange between the speculative and the practical.
Yet holding theory in any reasonable way requires thought,
evaluation, and choice. Philosopher Robert Nozick (1993), in The
Nature of Rationality, suggests two rules for theory-choice, or ra-
tional belief: “not believing any statement less credible than some
incompatible alternative—the intellectual component—but then
believing a statement only if the expected utility (or decision-value)
of doing so is greater than that of not believing it—the practical
component” (p. xiv). Since Nozick shares the pragmatists’ concep-
tion of belief as that on which one is prepared to act, his criteria
depend on what he means by “credible” and “utility.” He under-
stands credibility as consisting of cognitive qualities like coherence
and plausibility. Utility includes emotional qualities. Rationality,
therefore, means the making of both cognitive and emotional
sense. Any proposal for belief that falls short of both deserves
skepticism.

REASONABLE CRITERIA FOR

THEORY-CHOICE IN PSYCHOANALYSIS

What makes it more reasonable to hold one theory than another?

Using the ideas of the philosophers discussed above, and referring
to the discussion of understanding in Chapter 2, I think we can
establish several important criteria: inclusiveness or universalizabil-
ity, practical bearings, and coherence.
 Theory-Choice and Fallibilism / 41

Plato, Hegel, and Peirce would all unite to reject scientific

positivism and reductionism in favor of inclusiveness. Similarly,
some criticisms of drive theory in psychoanalysis treat inclusive-
ness as a criterion. According to this argument, human motiva-
tion and experience include attachment, artistic creativity, inter-
ests in self-development, scientific curiosity, spirituality, and,
especially, the organization of experience. A theory that reduces
away major realms of human experience should be rejected in
favor of a more inclusive theory. Lichtenberg’s (1989) work on
motivational systems grounded in developmental psychology, is
a serious attempt at greater inclusiveness in psychoanalytic the-
ory. Kohut and others have made a similar argument about
analyzability. If psychoanalysis claims to contain universal truth
and wisdom about human beings, but then finds most of those
who seek it too ill for psychoanalytic treatment, something must
be wrong with the theory. Those who embrace object relations
and self psychological approaches to treatment have claimed that
their theories apply more universally.
Consideration of inclusiveness leads us directly to the question
of practical bearings, a second criterion for theory-choice in psycho-
analysis. When good-enough theory is used, it makes a practical
difference. Granted, each school of thought claims its theory, well
applied, yields better results in more cases than other theories do.
My point is that effects are reasonable grounds for theory-choice. In
psychoanalysis particularly, we have a constant personal and profes-
sional interest in continuing to develop theories that work well. We
thus aim to prevent the rigidification of theory. Stolorow (1988) has
formulated a set of questions that captures the intellectual and
practical issues involved in theory-choice:

(1) Does a psychoanalytic framework permit greater inclusiveness

and generality than previous ones: Does it encompass domains of
experience mapped separately by earlier, competing theories, so that
an enlarged and more unified perspective becomes possible? (2) Is
the framework self-reflexive and self-corrective? Does the theory
include itself in the empirical domain to be explained? (3) Most
important, does the framework significantly enhance our capacity to
gain empathic access to subjective worlds in all their richness and
diversity? (pp. 336-337)
42 / EMOTIONAL UNDERSTANDING

I suspect much variation in theory occurs because each theory

positions the analyst differently vis-a-vis the patient in the intersub-
jective field. With different theories in mind, analysts attend to
different elements in the psychoanalytic field, and in turn their
different responses create different events to observe. These dif-
ferences become evident as we listen to discussions of psychoana-
lytic neutrality and intimacy. The classical analyst is the out-of sight
observer who takes no position in the disputes among id, ego, and
superego (A. Freud, 1936). The object relations analyst, “without
memory and without desire” (Bion, 1967), maintains a similar
neutrality among the patient’s internal objects. An interpersonalist
sits emotionally across from the patient, like a friendly opponent
and teacher in chess or tennis. The self psychologist, unabashedly
partial to the patient, sits on the patient’s side, helping the patient
sort out the inner chaos from within the patient’s perspective and
develop a strong self.”
These positional differences suggest that psychoanalytic theo-
ries involve ways of being with people. Analysts attempt to arrange
the intersubjective field according to their theories and organizing
principles for the presumed benefit of the patient and for their
own emotional comfort. Theoretical progress may depend on the
emergence of a consensus about the relative efficacy of these ways
of being relational. Yet analysts will always vary in comfort with
various forms of intimacy, and consensus may prove elusive. What
works best for one analyst may not be reasonable—in the sense of
practical reason—for another.
The third consideration for theory-choice is coherence: Every-
one—even the most committed empiricist—wants a coherent the-
ory. Those who consider themselves correspondence theorists—for
whom truth is a match between thing and idea, original and
copy—sull shudder at charges of intellectual incoherence. If our
opinions seem inconsistent, most of us feel an almost moral
obligation to find ways to harmonize them. Thus eclectic attempts
to hold several theories whose underlying assumptions are incom-
patible are generally unsatisfying. It may also be because of this
discomfort that some theories favor reductionistic explanations.

Fosshage (1992a) suggests that we shift back and forth between two of these positions or
attitudes: outside (the interpersonalist’s position) and within (the self psychologist’s
attitude) the patient’s perspective.
 Theory-Choice and Fallibilism / 43

They do reduce incoherence. However, for those who squirm in

the confines of reductionism, the challenge lies in framing more
inclusive theories or paradigms (Kuhn, 1962). These must account
for the diversity of phenomena so that all the theoretical assump-
tions and available data fit together. I believe a reasonable psycho-
analysis can settle for no less demanding an ideal of rationality.
Seeing theories as Peircean (1931-1935) “habits of belief”
may help to demonstrate the importance of theory-choice. Habits
can be good, bad, and better. They can change when human
purposes change. They can be more or less reasonable, not only
by formal logical criteria but also insofar as they meet the
demands of generality and conduce toward short-term and ulti-
mate human goals. In psychoanalysis, of course, these goals
include healing through psychoanalytic understanding. If the
primary goal of psychoanalysis is the reorganization of a person’s
experiential world, a reasonable theory will lead us toward this end.
Unfortunately, progress toward such an end is difficult to meas-
ure. This complication leads us to consider some forms of uncer-
tainty involved in psychoanalysis.

UNDERSTANDING AND NOT KNOWING,

OR PSYCHOANALYTIC FALLIBILISM

A second necessity for any reasonable psychoanalytic epistemology

is fallibilism, an attitude recognizing that what we “know” or
understand is inevitably partial and often mistaken. The word
“fallibilism”’ emerged in the philosophy of science as a reaction
against the Roman Catholic declaration of papal infallibility. Ac-
cording to this doctrine, the pope cannot be wrong when he speaks
ex cathedra (from the papal chair) on matters of faith or morals.
Philosophers like Peirce contrasted the attitude of science—“con-
trite fallibilism”—with what they saw as the complete dogmatism
and irrationalism of organized religion.
However, the desire to know that we know 1s not restricted to
religion. A student recently asked me how to know when we have
reached truth or understanding in clinical work. My answer in-
cluded reference to pragmatic criteria: to effects on the patient's
life and good-enough understanding within the psychoanalytic
44. / EMOTIONAL UNDERSTANDING

process. I also mentioned the Socratic view that wisdom often

consists in recognizing that we do not know.
My student’s question, however, contains an assumption
derived from the epistemological inquiries of modern philoso-
phy, namely, that we need to be certain that we know (Bernstein,
1983, calls this “Cartesian anxiety”). Many philosophers of this
century have emphatically abandoned the search for certainty as
the index of truth. Both American and continental thinkers have
appealed to logic, the philosophy of science, evolutionary biol-
ogy, human psychological experience, and Heisenberg’s uncer-
tainty principle to support their contention that reality evolves
and that the knower inevitably affects the known. Theories
themselves undergo both gradual transformation—as they are
explored in the community of inquirers (Peirce, 1931-1935)—and
replacement (Kuhn, 1962). Yet psychoanalytic writings and cur-
ricula often express, if only indirectly, the view that a received
body of truth about human psychological functioning—metapsy-
chology—and about the process of change in this functioning—
clinical theory—already exists. In this view, we may need only to
refine theory and to apply it more skillfully; nevertheless, the core
of truth is already available.

The Critique of Positivism within Philosophy

American philosophers—in this respect returning to the ancient
Socratic ideal—have refocused our attention on the process of
inquiry. Peirce (1877) described in “The Fixation of Belief” meth-
ods people use to remove “the irritation of doubt” to settle their
beliefs. Having dismissed the methods of tenacity and authority,
he described the method of science. Peirce, like Kuhn a century
later, was thinking of the physical sciences, the Copernican and
Darwinian revolutions. For Peirce, science is a public and self-cor-
recting method by which a surprising fact evokes a hypothesis for
testing. If it survives, we hold it as theory only until the next
surprising fact comes along. Belief, then, is the absence of actual,
practical doubt. In psychoanalysis, such surprising facts leading to
theory-revision have included Freud’s discovery of transference
and Ferenczi’s recognition of the prevalence of child abuse. Today
the discovery of extensive cognitive-relational capacities and inter-
 Theory-Choice and Fallibilism / 45

acuional processes in infancy may be surprising facts leading to new

beliefs.
Peirce often cautioned, however, that we must hold beliefs
lightly so we can notice surprising facts and keep the process of
inquiry self-corrective. As an antidote to dogmatism, he suggested
that there should be a large sign at the front of every classroom
that reads: “Do not block the path of inquiry.” The ultimate
outcome of inquiry, the truth, according to Peirce, would be the
opinion reached “in the long run” by the community ofinquirers.
(More recently, Kohut, 1973, urged that psychoanalysts think and
function in the community of scholars.)
Peirce’s friend William James (1907) spoke of the “cash value”
of ideas and truth as what “works.” By his provocative expressions
he meant to draw attention to his “radical empiricism” (p. 6). He
thought that all matters for philosophical reflection and inquiry
are questions drawn from experience and are ultimately resolvable
by an appeal to experience. Truth, for James (1909), consisted of
a continual structured process of exchange and of checking be-
tween ideas and experience: “Truth happens to an idea... . It
becomes true, 1s made true by events” (p. 3). Not that an idea is untrue
until experience confirms it; the idea is just pragmatically and
experientially empty.
More recently, American historians and philosophers of sci-
ence—Kuhn and Popper, for example—have drawn attention to the
process character of truth and of the search for truth in the
scientific community. Kuhn (1962) describes the replacement of
important theories, or of overarching paradigms, by more inclusive
theories, as well as the immense resistance new ideas generally
meet. He attributes this resistance to the intrinsic character of
normal science with its organizational structure and processes—
journals, curricula, tenure, and conferences. These, he thinks, can
impede the dissemination, nurturance, and adoption of new ideas.
Popper (1959), in another vein, saw the holding of assumptions
not in principle or practice falsifiable as a major impediment to
growth and change in scientific theory.

ai recenuly heard a story, perhaps apocryphal, that British psychoanalyst Susan Isaacs
returned home distressed from a psychoanalytic meeting at which her thoughts had been
treated harshly. Her allergist husband is said to have commented, “There is no more
powerful allergen than a new idea.”
46 / EMOTIONAL UNDERSTANDING

Popper (1959), in another vein, saw the holding of assumptions

not in principle or practice falsifiable as a major impediment to
growth and change in scientific theory.
Similarly, continental thinkers like Husserl (1931) have advo-
cated a return from dogma to experience. Husserl advocated the
method of transcendental phenomenology, the bracketing or
holding in abeyance (epoché) of all preconceptions to achieve pure
experience and to know the essence of ideas. Today most psychol-
ogists and philosophers agree that all experience—even percep-
tion—is structured, that observation is theory-laden, and that
Husserlian presuppositionless knowing is impossible. Still,
Husserl’s exhortation has further encouraged both the “holding
lightly” of theories and a close attention to experience.
Philosophical hermeneutics has added force to the rejection
of the search for certainty, particularly in the human sciences.
Hermeneutics calls into question the assumption that questions of
meaning ever have just one correct answer (Palmer, 1969). Herme-
neutics, at least agnostic on the question of ultimate truth, at-
tempts to explore the multifaceted interpretations of biblical texts,
of literary works, and, increasingly, of human experiences. It not
only questions the search for a single correct interpretation but it
also replaces the objectivist approach to the text or to the experi-
encing human being. Instead we have phenomenological inquiry
aware of itself as affecting and being affected by the text or the
feeling person. Quantum physics had found that the fundamental
characteristics of the physical world were affected by attempts to
measure them. Similarly, hermeneutics rejects the objectivist as-
sumptions underlying much “scientific” thinking. Instead it has
embraced a focus on subjectivity and intersubjectivity, thereby
requiring us to replace the search for certainty with an acceptance
of the fallibility of knowledge.

The Critique of Positivism within Psychoanalysis

Freud envisioned psychoanalysis as a science in the spirit of
19th-century positivism, modeled on biological neuroscience (Sul-
loway, 1979). The empirical methods of psychoanalysis, he
*

Ellenberger (1970) notes that the young Freud spent a year translating into German works
of English empiricist John Stuart Mill into German.
 Theory-Choice and Fallibilism / 47

origin and holding power to the Freudian hope that the pure
data—the patient’s associations—could be examined in an uncon-
taminated form on a “blank screen” so that correct interpretations
and reliable theories would result.
Since the middle of this century many psychoanalysts have
challenged this view of the psychoanalyst as anonymous and
detached researcher delivering correct interpretations. Like Fer-
enczi, who cared more for therapeutic efficacy than for Freud’s
ideal of scientific purity, some analysts have suggested more en-
gagement with the patient. Citing the vast differences in patients’
presenting difficulties, Alexander and French (1946) urged a much
greater than customary flexibility in practice. They proposed that
psychoanalysis be defined less by its technical rules and by the
development of a transference neurosis. Instead, they thought that
psychoanalysis is defined by its basis in psychodynamic principles
and by its goals. While Alexander has been largely associated with
the notion of “corrective emotional experience,” his primary
concern was for attention to the individual patient’s needs and for
the abandonment of rigidity. Precisely because people are individu-
als, Alexander believed, psychoanalysis must be an inherently
uncertain and tentative enterprise. Alexander’s “flexibility” paid
close attention to the patient’s idiosyncratic ways of making sense
of experience. Alexander’s approach presages the “optimal re-
sponsiveness” Bacal (1985) suggests as a replacement for absti-
nence and frustration. Flexibility and responsiveness based on
empathic understanding are incompatible with a rigid investment
in correctness or certainty.
George Klein (1976) suggested that the superstructure of
metapsychology had obstructed our capacity to learn from clinical
data. He attempted a “theorectomy” on Freud’s work. He wanted
to sift out the clinically rich suggestions from what he saw as the
needless Procrustean bed of experience-distant theories of motiva-
tion and personality that have become known as psychoanalytic
theory. Partly inspired by Klein’s work, I here note the continued
attachment of analysts to such Procrustean beds, both in theory
and in practice, and I will suggest a possible explanation for such
continued attachment.
Like Klein, Atwood and Stolorow (1984) have made a radical
departure—similar to Kant’s “subjective turn” in the history of
48 / EMOTIONAL UNDERSTANDING

philosophy. They avoid rigid a priori notions of personality and

motivation. Their “psychoanalytic phenomenology” explicitly es-
chews rigid adherence to drive theory or to tripartite psychic
structures. Instead they advocate a focus on the subjective organi-
zation of the patient’s experience of self and other. They urge the
formulation of descriptions of pathology, motivation, and the
therapeutic process in experience-near terms. To explain how the
analyst hears, they replace the expectations drawn from metapsy-
chology with the personal organizing activity of analyst and pa-
tient.
With their psychoanalytic intersubjectivity theory, Stolorow,
Brandchaft, and Atwood (1987) carry this approach a step further.
They focus on the intersubjective character of the mutual search
for understanding—not for certainty or absolutes—in psychoanaly-
sis. Like quantum physicists who found that the knower affects the
known even in physics, they insist that the organization of the
patient’s subjective experience is intelligible only as it has taken
form in an intersubjective context. This view depends on—although
the authors do not make this explicit—a process philosophy of
knowledge and reality similar to that articulated by Alfred North
Whitehead (1929), who held that every “actual entity” continually
creates itself in relation with other actual entities by selectively
including and excluding facets of these other entities. To state the
obvious, no one comes into being alone. Such a relational ontology of
organic process requires recognition of the continuous participa-
tion by both subjects in a psychoanalysis. Both take part in making
sense of and in the transformation of subjective worlds.

The Search for Certainty in Contemporary Psychoanalysis

Today we see increasing willingness to hold theories lightly in many
quarters (cf. Cooper, 1993). Still, many psychoanalysts remain
engaged in a search for certain and reliable answers to questions
of theory and technique. This is particularly evident when psycho-
analysts attempt to define psychoanalysis. Some discussants seem
particularly interested in distinguishing psychoanalysis from psy-
chotherapy. Psychoanalysis, they often claim, includes a belief in
unconscious mental processes and a focus in treatment on resis-
tance and transference. Others claim that it is not such theoretical
 Theory-Choice
and Fallibilism / 49

notions that distinguish psychoanalysis from psychotherapy, but

rather it is the use of the couch or the frequency of sessions. Others
claim that the use of the empathic-introspective method of under-
standing the subjective world of the patient is the crucial identify-
ing characteristic of psychoanalytic work. William James might
have asked us what is the “cash value,” or practical bearing, of this
discussion.
Discussions of analyzability also seem to reflect a need for
certainty. Psychologists attempting to gain admission to a prestig-
ious medical psychoanalytic institute have met suggestions that
perhaps they were not “analyzable” and thus not qualified for
psychoanalytic training. In addition, some institutes accept the
work of candidates only if their patients meet criteria for analyz-
ability. Such distinctions seem primarily to serve the maintenance
of power and control, to rationalize treatment failures, and to
preserve the self-respect of those who make them. More flexible
thinking has led to the search for theories and methods that would
regard more people as analyzable. Many are also considering the
possibility that analyzability resides in the analytic couple, not in
the individual.
Another example of the search for single right answers is the
quest for the “correct” interpretation. Interpretations may seem
correct because they emerge from the assumptions of a familiar
psychoanalytic theory. Like some scientific theories, they may be
simple, parsimonious, and “elegant.” On more pragmatic grounds,
they may yield more associations by the patient. Surely some
interpretations—usually those that come more from antecedently
held theories by the analyst than from close attention to the
patient—can be harmful. What remains puzzling is the importance
placed on a kind of objective correctness instead of on a mutual
engagement in coming to understand or in a healing process. This
phenomenon suggests that analysts may at times be more invested
in seeking a kind of cognitive truth—which provides us a feeling of
being grounded somewhere—than in understanding emotional
chaos with its messy fringes.
Practical questions, often raised by candidates in psychoana-
lytic institutes and answered by senior analysts, and sometimes
even discussed in psychoanalytic conferences and journals, carry
an urgency that bespeaks a need for Cartesian “clear and distinct
50 / EMOTIONAL UNDERSTANDING

ideas.” Ought I ever to reveal my experience to the patient? Must

every patient use the couch? Is any action besides verbal inter-
change acceptable in a psychoanalysis? Such earnest questions
suggest an assumption that learning psychoanalysis requires find-
ing generally applicable answers to such procedural questions.
The urgency of the questions may also reflect the felt threat
to our self-cohesion that some patients evoke. Kohut (1984) gave
an example of the rigidity that results from the analyst’s need to
follow rules of technique:

I know of one analysis, for example, which, after making steady

progress with a severely traumatized patient for two years, came to
grief because the analyst insisted on changing the position of her
chair in order to prevent her patient from continuing to glance at
her face at certain crucial moments. The analyst tried to justify this
move to the analysand by telling him that the rules of analysis
prohibited this kind of gratification—that gratifying him by making
her emotionally involved face available to him would be an obstacle
to “remembering” and “working through.” She thereby repeated the
chronically cold attitude of the patient’s schizoid mother who had
imposed bizarre rules of behavior on the child from the time he was
born and had been unable to respond to him with natural warmth
and concern. The analysand felt unable to tolerate this change and
ended treatment. (p. 220)

This example illustrates an adherence to rigid procedural rules,

rationalized as necessary for the patient’s cure, but applied without
reference to the patient’s experience. Apparently such rigidity
supported the analyst's positive evaluation of herself as a profes-
sional. Kohut’s story also demonstrates the disastrous results of
such rigidity and provides a clue to the possible causes of many
treatment failures. Of course, transferential responses will emerge
in response to other analytic attitudes or patterns—for example,
unusual flexibility may be experienced as retraumatization by a
patient whose parents were grossly inconsistent, perhaps alcoholic.
Here, however, our concern is with the harmful effects of rules
intended to support the analyst’s search for certainty.
Historically, the institutionalism reflected in such concerns for
correctness in theory and technique may have originated in Freud’s
 Theory-Choice
and Fallibilism / 51

separation from official medicine and the resulting need to give

psychoanalysts a physician-like status. Freud’s concern to protect
the reputation of his psychoanalytic movement was another source
of analytic reliance on rules (Ricci & Broucek, 1994). Ellenberger
(1970) notes that “With Freud begins the era of the newer dynamic
schools, with their official doctrine, their rigid organization, their
specialized journals, their closed membership, and the prolonged
initiation imposed upon their members” (p. 418).
Why does the search for certainty and correctness in theory
and in practice persist among psychoanalysts? I believe that this
search concretely expresses analysts’ needs for selfobject experi-
ences (Bacal & Thomson, 1993) to maintain a stable psychological
organization in the face of the chaos and pain we meet continually
in our work. Without correct theories, correct interpretations, and
correct techniques to rely on in our many moments of doubt, we
might lose hold of our selves. We might feel afraid or fragmented.
Old pain and confusion might rise to haunt our work. I think that
much of the rigidity and the search for correctness detailed above
is an attempt to protect us from these frightening threats to our
organized sense of stable self-experience.

The Fallibilist Alternative

With other sorts of support for the practitioner—peer groups,
supervision, satisfying personal ties, and absorbing outside inter-
ests—the questions and concerns might change, and uncertainty
might become less anxiety-provoding. We might ask what kinds of
interventions, interpretations, and responses promote mutual un-
derstanding of the patient’s organization of experience? How are
emotional ties between patients and therapists established, main-
tained, and restored? Whatis the relationship between these bonds
and the process of change? How can we learn from our failures or
mistakes? In other words, holding our theories lightly—both gen-
eral and clinical theories—will not only require that we seek support
for our personal stability elsewhere. It may also enable us, both
individually and collectively, to continue theory development in
creative directions that we might never see if we continue the search
for certainty to maintain the stability of our organization of expe-
52. / EMOTIONAL UNDERSTANDING

rience. Theories that recognize the fallible nature of all under-

standing might also reduce some of our shame over not knowing.
In other words, our shame and anxiety can give way to a liberating
Peircean “contrite fallibilism.”
To summarize, in this chapter I have argued for two intellectual
conditions for the possibility of good-enough analytic work, which
are also two necessary elements of any adequate psychoanalytic
epistemology. First, we need theory, carefully chosen according to
some ideal of reasonableness. The refusal of theory-choice is the
refusal to think through and organize our analytic experience on
both sides of the room or the couch. This refusal is a choice of
relativism, a return to Hegel’s “night in which all cows are black.”
Second, we must hold our theories lightly, in a fallibilistic spirit,
ready to be surprised and prepared to admit our theoretical and
clinical mistakes. Analytic training should prepare candidates to
think, not just to absorb the theories of others, and to revise their
thinking as needed.
In later chapters I will consider some practical and emotional
conditions for the possibility of good-enough psychoanalytic un-
derstanding.
(lipase)
BOR 4

Toward an Epistemology
of Perspectival Realism

“
I am so confused,” patients tell me almost daily. They refer to
emotional bewilderment and disorientation, the sources and im-
plications of which we seek to understand. Making sense together
often helps to clear the muddy waters. In the same collaborative
spirit, we psychoanalytic colleagues can approach conceptual con-
fusions that interfere with our professional communication and
our theorizing.
The process of understanding, psychoanalytic and otherwise,
often envolves embracing ambiguity but attempting to clear up
confusion. Ambiguity and confusion differ. Ambiguity occurs
when a term has more than one common meaning, and a speaker
or writer either chooses not to, or fails to, specify the intended
meaning. Sometimes, as recognized by the psychoanalytic princi-
ples of multiple function and overdetermination, removing ambi-
guity results in oversimplification. Often we must simply live with
ambiguity. Conceptual confusion, on the other hand, most often
results when speakers or writers do not know the common deno-
tation or connotation of a term, or how to distinguish it from
related words. Sometimes both ambiguity and confusion appear
today in contemporary discussions by psychoanalysts of the philo-
sophical questions crucial to our profession’s self-understanding.
While the ambiguities may be harmless, the confusions can place

28}
54 / EMOTIONAL UNDERSTANDING

us in a clinical fog, unable to help our patients find a good-enough

sense of reality because we do not know how to find one for
ourselves. To clear up the confusion, we need careful distinctions.
Philosophers have long made distinctions their stock in trade.
In that tradition, I attempt here a modest and limited task: to draw
three distinctions and to point out their importance for psychoana-
lytic theory. Specifically, I distinguish between subjectivity and
subjectivism, between subjectivism and relativism, and between
objectivism and realism. These distinctions will allow me to articu-
late the epistemology that I believe is fitting to describe psychoana-
lytic understanding as an intersubjective process. I call this view
“perspectival realism.”

SUBJECTIVITY VERSUS SUBJ/ECTIVISM

In current usage, the term “subjectivity” roughly replaces Freud’s

concept of “psychic reality.” However, the equivalence is not pre-
cise because “psychic reality” implies the existence or significance
of “external reality” while “subjectivity,” most commonly referring
to the personal organization of experience, leaves open the ques-
tion of external or objective reality. Atwood and Stolorow (1984)
borrow the term subjectivity from Husserl’s transcendental phe-
nomenology. They enrich it with the views expressed in Kohut’s
seminal paper, “Introspection, Empathy, and Psychoanalysis”
(1959), in which he claimed unequivocally that the domain of
psychoanalysis is limited to whatever is accessible through intro-
spection and empathy. Subjectivity includes both process, the
activity of organizing experience, and product, the organization
of experience, which is understood as a relatively enduring con-
figuration. This enduring Gestalt shapes and limits a person’s
future experience and activity.
Subjectivity differs from subjectivism. Epistemological subjec-
tivism holds the Cartesian view that truth and knowledge are
accessible only via individual subjectivity. Ethical subjectivism means
that the goodness or evil of actions depends on the subject’s view of
them, that moral values are radically individual. Epistemological
subjectivism, as, for example, embraced by Husserl but not by all
those inspired by his transcendental phenomenology, ends in radical
 Toward Perspectival Realism / 55

solipsism. In solipsism the knowable is merely the content of one’s

own mind. For Atwood and Stolorow (1984), “The practice of
transcendental phenomenology presents a spectacle of thought
detached from social life, circling inwardly upon itself and mistaking
a reified symbol of its own solitude for the discovery of its absolute
foundation” (p. 13). Husserl’s phenomenology insists on the univer-
sality of the reduction, or “epoché”—taking nothing for granted. It
recognizes as valid only what originates in subjectivity. In the words
of historian of phenomenology Herbert Spiegelberg (1960):

While it is true that Husserl is the founder and remains the central
figure of the [phenomenological] movement he is also its most
radical representative and that not only in the sense that he tried to
go to the roots, but that he kept digging deeper and deeper, often
undermining his own earlier results; he was always the most extreme
member of his movement, and hence became increasingly the lone-
liest of them all. (p. xvii)

In Lauer’s (1978) words, the phenomenological project ends with

only “Edmund Husserl himself in splendid isolation” (p. 165).
Nevertheless, just as phenomenology extends beyond
Husserl’s own view, the emphasis on the study of subjectivity
inspired by Husserl is not coextensive with Husserl’s subjectiv-
ism/solipsism. As Lauer (1978) notes, “there can be no question
that, historically speaking, phenomenology has in recent times
performed the important philosophical function of directing at-
tention more seriously to experience as the only legitimate starting
point of philosophizing” (p. 167). Similarly, we might say that
phenomenology has pointed psychoanalysis toward its only legiti-
mate starting point, the subject's experience. Any phenomenologi-
cal view of the method and theory of psychoanalysis (Kohut, 1959;
Atwood & Stolorow, 1984) requires that we put aside preconcep-
tions—diagnostic, metapsychological, and otherwise—to work as
completely as possible within the subjective experience of the
patient. Only by placing our theoretical and other preconceptions
aside can we gain insight into the essential structures of the
patient’s subjectivity. The qualifier “as possible” recognizes the
limits on this phenomenological project that are imposed by our
own historically constituted subjectivity, our organization of expe-
56 / EMOTIONAL UNDERSTANDING

rience. Although Husserl, who did not concern himself with

understanding others’ experience, took little interest in these
limits, we cannot avoid them. Sometimes we recognize them under
the rubric of “countertransference,” or what an intersubjectivity
theorist might name cotransference (see Chapter 5 for distinction
between countertransference and cotransference). In addition, we
now know that we must recognize our inevitable influence on the
patient’s subjective experience.
For Husserl (1931), however, the search for the essential struc-
tures of subjectivity has to precede any consideration of the phenom-
ena of intersubjectivity, and this belief prevented his philosophy from
ever getting to an exploration of intersubjectivity’s properties and
implications. The radically ahistorical character of Husserl’s phe-
nomenology prevented the consideration of the effects of past
relational experience on a person’s subjectivity. Similarly, the com-
plete suspension of preconceptions eliminated relational patterns
from the search for present structures of subjectivity. Psychoanalytic
phenomenology—in order to be psychoanalytic—must take our past
and present experience of others into account. It must thus be less
philosophically radical than Husserl was. We can leave to philoso-
phers the task of deciding whether a phenomenology embedded in
history and relatedness is still phenomenology. My point is that
defining the domain of psychoanalysis as the domain of the subjec-
tive organization of experience need not commit us to the radical
subjectivism or solipsism of Husserl. Instead we give our subjectivity
essence and structure by assimilating and organizing past and
present experience, especially relational experience. I know myself
as a tenacious or disciplined person, for example, by making sense
of the responses of others to my work habits. Such experiential
knowledge contains both what is given—my weed-pulling, house-
painting, or writing—and my subjective organization of the given
within intersubjective fields.

SUBJECTIVISM VERSUS RELATIVISM

Subjectivism is not coextensive with relativism and may not even

be compatible with it. Relativism, an approach that views knowl-
edge as radically dependent on theory, social context, circum-
 Toward Perspectival Realism / 57

stance, or utility, denies the existence of any universal truth or

moral framework. Truth, for the relativist, varies with socially
constructed theoretical frameworks and is not, as for the subjec-
tivist, a product of the individual’s subjectivity. Goldberg (1988),
for example, views relativism as a denial of objectivism: “Relativism
is a viewpoint that considers the world as a variable thing that need
have no inherent composition save as we choose to categorize it”
(p. 44). A relativist can evaluate truth or morality only from within
a socially agreed-upon system. For a moral relativist, situational
criteria external to the moral agent decide the morality of particu-
lar actions. A subjectivist, on the contrary, understands morality
as a function of the individual’s preferences or values. Both
subjectivists and relativists deny the existence of universal truths
or moral values. However, where they locate the truths and moral
criteria they do recognize differs widely: The subjectivist places
them in the individual, the relativist in the theoretical framework
or social context. American philosopher Richard Bernstein (1983)
carefully distinguishes subjectivism from relativism. In his view, an
absolute subjectivist like Husserl was no relativist. His transcenden-
tal phenomenology was “intended to be the definitive answer to
all forms of relativism, skepticism, and historicism” (p. 11). Con-
versely, a relativist may not be a subjectivist. In Bernstein’s words:

His or her [the relativist’s] essential claim is that there can be no

higher appeal than to a given conceptual scheme, language game,
set of social practices, or historical epoch. There is a nonreducible
plurality of such schemes, paradigms, and practices; there is no
substantive overarching framework in which radically different and
alternative schemes are commensurable—no universal standard
that somehow stands outside of and above these competing alter-
natives. But the relativist does not necessarily claim that there is
anything subjective about these schemes, paradigms, and prac-
tices. (pp. 11-12)

We might reasonably ask Bernstein whether a relativist could ever

be a subjectivist. Relativism here appears not as Husserlian subjec-
tivism but as a Protagorean epistemology and as a moral position
rejecting universals. Protagoras’s “man is the measure” does not
mean that individual subjectivity is the ultimate reality or the moral
58 / EMOTIONAL UNDERSTANDING

court of last appeal. Protagorean relativism means, as Bernstein

says, that “there can be no higher appeal than to a given conceptual
scheme, language game, set of social practices, or historical ep-
och.” It is perhaps this meaning that Fosshage (1994) intends when
he contrasts relativism with scientific positivism, suggesting that
relativism makes better sense of the psychoanalytic situation and
especially of the forms of relatedness we call transference and
countertransference. Still, relativism continues to be vulnerable to
the traditional charge of incoherence: To compare relativism and
positivism, one must take a nonrelativistic epistemological position
that can in turn be evaluated from another external position, and
so on to infinite regress. One must take a nonrelativistic position
to choose relativism. Indeed, one must be a nonrelativist even to
choose among theories. Psychoanalysis, therefore, needs alterna-
tives to relativism, as well as positivism, scientific empiricism, and
naive realism. It is precisely this need that my third distinction will
address.

OBJECTIVISM VERSUS REALISM

Distinguishing subjectivism from relativism prepares us to con-

sider so-called objective reality and its bearing on the psycho-
analytic concentration on experience. An exclusive focus on the
experiential world of the patient may appear to neglect what
interpersonalists call “problems in living.” Empathic introspec-
tion, Or sustained empathic inquiry, may seem to restrict, even
to eliminate, the analyst’s access to data available through
normal perceptual processes. As European thinkers like Gada-
mer and Habermas might ask, What good is a world of mean-
ings detached from praxis, the action that proceeds from prac-
tical wisdom?
To avoid the conceptual problems inherent in subjectivism
and in self-contradictory relativism, and to avoid the neglect of
practical realities, we need to distinguish between objectivism
and realism (cf. Potter, 1994). The exact definitions and history
of various objectivisms need not concern us here. What they
have in common—in contrast to all forms of subjectivism and
relativism—is the claim that there are fundamental and univer-
 Toward Perspectival Realism / 59

sal criteria for judging truth and falsehood, right and wrong. A
common form of objectivism, also known as empiricism, holds
that the ultimate court of appeal is something called “objective
reality,” or “the facts.” In midcentury philosophy of science
(Hempel, 1951; Popper, 1959), this empiricism demanded that
any theory, to qualify as scientific, had to meet the test of
falsifiability. That is, the proponents of the theory had to
specify what experimental results would lead to the rejection or
falsification of the theory. The human sciences (Geisteswissen-
schaften), including psychoanalysis, could thus be easily ex-
cluded from the true sciences, along with religion, metaphysics,
and astrology. Only a theory open to falsification by experimen-
tal evidence could be called scientific or had any “cognitive
significance” (Hempel, 1951; Suppe, 1977). In this spirit, psy-
choanalytic objectivists have viewed transference as distortion
that can be seen by the observer/analyst to be distortion when
compared with the facts, and they regard the capacity for access
to the facts, or good reality-testing, as a major criterion of
psychological health.
Postempiricist philosophy of science, as represented by Kuhn,
Feyerabend, Hesse, and others, has almost universally rejected the
form of empiricist epistemology that demands falsifiability. British
philosopher Mary Hesse (1980) usefully attacks the underlying
assumption that radical differences exist between the natural
sciences and the human sciences. She details five contrasts thought
by objectivists to divide the natural and the human sciences. The
first and fifth of these supposed contrasts are most salient for the
point of view | am advocating:

1. In natural science experience is taken to be objective, test-

able, and independent of theoretical explanation. In human science
data are not detachable from theory, for what count as data are
determined in the light of some theoretical interpretation, and the
facts themselves have to be reconstructed in the light of interpreta-
TOMI eee
5. Meanings in natural science are separate from facts. Mean-
ings in human science are what constitute facts, for data consist of
documents, inscriptions, intentional behaviour, social rules, human
artifacts, and the like, and these are inseparable from their meanings
for agents. (pp. 170-171)
60 / EMOTIONAL UNDERSTANDING

Suppose these differences between the natural and human sci-

ences truly existed. Then transference would resemble mere hu-
man science, a distortion or even a delusion when compared with
the objectively verifiable facts provided by the natural sciences,
evidence provided by medical tests, say. Yet every characteristic of
the human sciences listed above is now assigned to the natural
sciences as well. Thus current philosophy of science challenges
such venerable psychoanalytic conceptions as transference-as-
distortion and reality-testing. Hesse goes on to summarize the
conclusions of postempiricist philosophies of science that under-
mine the contrasts:

1. In natural science data [are] not detachable from theory, for

what count as data are determined in the light of some theoretical
interpretation, and the facts themselves have to be reconstructed in
the light of interpretation. ...
5. Meanings in natural science are determined by theory; they
are understood by theoretical coherence rather than by correspon-
dence with facts. (pp. 171-172)

Rejecting these contrasts does not mean there are no differences

between the natural and the human sciences. Nevertheless, their
differences do not consist in an honorific scientific status accorded
to so-called objective facts. The empiricism so soundly rejected in
recent philosophy of science remains, however, popular in psycho-
analysis (Hanly, 1992). Our theory and practice have remained
relatively insulated from, and, until the recent past, unaffected by
university-based ferment in the philosophy of science. Since
Freud’s time, psychoanalysis has a long tradition of calling itselfa
science and of wishing to be a natural science in that honorific and
empiricist sense. Perhaps, in addition, working wholly in the realm
of meanings leads psychoanalysts to yearn for the certainty and
apparent security of facts and universals. Anyway, postempiricist
understandings of the nature of science make considerable room
for forms of psychoanalysis that avoid an allegiance to objective
reality, especially those that embrace intersubjectivity and other
relational theories.
The rejection of objectivism does not imply the falsehood of
every form of philosophical realism. Realism is the view that some
 Toward Perspectival Realism / 61

matters do not depend on our opinions about them. A realist

believes there is something, or at least something emerging, to be
more fully known, discovered, or articulated. In the words of Peirce
(1868), “The real . . . is that which, sooner or later, information and
reasoning would finally result in, and is which is therefore inde-
pendent of the vagaries of me and you” (p. 168). Peirce thereby
provided a thoroughgoing process conception of reality.’
Scientific empiricism, which we should be careful not to
equate with science, is a popular modern version of objectivist
commonsense realism, with its associated assumption that ob-
server and observed are independent of each other. Its Popperian
form requires that proponents of any theory specify those factual
conditions that would lead them to consider the theory inade-
quate—the falsifiability criterion. Even in the natural sciences,
such empiricist realism has been out of date since the emergence
of quantum physics, with its insistence on the impact of the
observer on whatever is to be observed. Correspondence theories
of truth, according to which truth consists in a match between
things and the ideas that are thought to be copies of them, now
seem naive.
Other forms of realism, especially those that see truth as
gradually emergent in a community of inquirers (Peirce, 1931-
1935), or in a dialogic community, show more promise. One
version of this communitarian or intersubjective (Bernstein, 1992)
realism might be a perspectivalism that would conceive of reality
as socially understood or as a socially articulated process. Each
participant in the inquiry has a perspective that gives access to a
part or an aspect of reality. An infinite—or at least an indefinite—
number of such perspectives is possible. (Hoffman, 1983, applies
a similar perspectivalism to transference and countertransference. )
Since none of us can entirely escape the confines of our personal
perspective, our view of truth is necessarily partial, but conversa-
tion can increase our access to the whole.
Such an intersubjective-perspectivalist realism—what I am call-
ing perspectival realism—is not equivalent to the cultural and
epistemological relativism mentioned earlier. Instead, cultures and
* . . . . . .
Ironically the original philosophical meaning of realism (i.e., that universals exist apart
from human knowledge of them) originated with Plato, who eschewed every form of
commonsense realism.
62 / EMOTIONAL UNDERSTANDING

theories themselves are perspectives on emergent truth. Nor does

such realism describe the historical narrative negotiated in treat-
ment (Spence, 1982; Schafer, 1983). Though such negotiation
provides a small-scale approximation of the larger process, it can
only provide another perspective on “the truth.” Instead, perspec-
tival realism recognizes that the only truth or reality to which
psychoanalysis provides access is the subjective organization of
experience understood in an intersubjective context (Stolorow et
al., 1987). Simultaneously, such a subjective organization of expe-
rience is one perspective on a larger reality. We never fully attain
or know this reality, but we continually approach, apprehend,
articulate, and participate in it. In other words, unlike Husserl’s
phenomenology, an intersubjective theory can admit the impor-
tance of social life and of the continuing effect of practical life in
the world. Kohut’s self psychology views subjectivity as the entire
domain of psychoanalysis and sees so-called external events as
bearing meaning only as the patient experiences and organizes
them. While this view does exclude common-sense realisms, cor-
respondence theories of truth, and scientific empiricisms, it does
not exclude the possibility of dialogic, communitarian, or perspec-
tival realism. In such a moderate realism, the real is an emergent,
self-correcting process only partly accessible via personal subjectiv-
ity but increasingly understandable in communitarian dialogue.
eens
al beR 5

Cotransference:
The Analyst's Perspective

Every word is a prejudice.

—FRIEDRICH NIETZSCHE,
The Wanderer and His Shadow

I grew up as the eldest of 10 children. Everything was scarce, both

economically and emotionally. Thus I was raised to be a provider,
not a recipient, of care and to value myself primarily for the sheer
number of tasks I could do to keep the family going. My earliest
memories involve folding diapers and feeling that I was held respon-
sible for allowing any harm to, or misbehavior by, my younger
siblings. This history-and much more that I will not detail here-con-
cretely shapes my experience as a clinician. Along with my intellec-
tual and clinical training, this history filters, informs, and organizes
both my perception and my responsiveness to patients, whether they
be oldest, youngest, middle, or only children.
Psychoanalytic understanding, grounded in intersubjectivity
theory, thus, must take into account the analyst’s subjective world,
including theory, personality, emotional history, and prereflective
organizing principles. “Cotransference” primarily names the ana-
lyst’s contribution to the intersubjective field in psychoanalytic
treatment. More broadly, the term refers to the concurrent and
mutual organizing activity of analyst and patient. It does not
include the traditional reference to distortion or to the correspond-

63
64 / EMOTIONAL UNDERSTANDING

ing idea of an objective reality to which one party has access and
the other does not. As a perspectivalist term, it does include the
original conception of transfer, or carry-over, from the relational
history in which any personal perspective has been formed.

COUNTERTRANSFERENCE IN THE DEVELOPMENT

OP SELES! GHOLOGM

I begin by examining the concept of countertransference in the

development of self psychology. My colleagues from relational
perspectives other than self psychology say that self psychology pays
too little attention to countertransference. Their helpful critique
provoked me into reconsidering the concept of countertransfer-
ence, and that has led me to develop a concept more consistent
with both self psychology and intersubjectivity theory.
Kohut (1971) began his revolutionary The Analysts of the Self:
“The subject matter of this monograph is the study of certain
transference or transferencelike phenomena in the psychoanalysis
of narcissistic personalities, and of the analyst’s reactions to them,
including his countertransferences” (p. 1). By countertransference,
Kohut meant remnants of the analyst’s own narcissistic distur-
bances that interfered with the development of and the analysis of
the selfobject transferences. He cited, for example, “the tendency
of some analysts (at times due to a mobilization of their counter-
transference) to respond with erroneous or premature or other-
wise faulty interpretations when they are idealized by their pa-
tients” (p. 138). If such countertransferences are stable, according
to Kohut, they often consist of “quasi-theoretical convictions or of
specific character defenses or (as is frequently the case) of both”
(p. 263). In the final chapters of The Analysis of the Self, Kohut
devoted considerable attention to countertransferential responses
of analysts to the various narcissistic transferences.
Kohut (1984) returned to the topic of countertransference
briefly in his posthumous How Does Analysis Cure? where he contin-
ued to regard it as harmful by definition. “If we want to see clearly,”
Kohut wrote, “we must keep the lenses of our magnifying glasses
clean; we must, in particular, recognize our countertransferences
 Cotransference / 65

and thus minimize the influence of factors that distort our percep-
tion of the analysand’s communications and of his personality” (p.
37). He went on to deny the applicability of the influence-of-the-
observer-on-the-observed principle in psychoanalysis. Kohut attrib-
uted difficulties in analytic understanding to the analyst’s “short-
comings as an observing instrument” (p. 38).
Since Kohut saw countertransference as problematic, it may
be difficult for self psychologists to view it as an essential part of
the theory and process of psychoanalytic cure. In addition, Kohut
(1971) thought a good psychoanalytic theory, like a good analytic
treatment, should be unrelated to the analyst’s personality (pp.
222n-223n). Analysis should be a nonidiosyncratic science that
can be taught to noncharismatic practitioners. The practitioners
are not, however, to be traditionally neutral. Sustained listening to
understand and explain, he thought, is not a neutral activity. I think
that Kohut was torn between a desire to emphasize the human
determinants in psychoanalysis and his classical training, which,
even in his last years, made him want to sift out the personal
elements. This ambivalence may have prevented him from concep-
tualizing countertransference as later self psychologists have.
Wolf (1988), for example, adopts Gill’s (1982) usage and sees
countertransference more inclusively as the analyst’s experience of
the relationship (Wolf, 1988, p. 137). He distinguishes among
countertransferences, identifying (1) the analyst’s pleasure in effec-
tiveness; (2) the “countertransferences proper,” which are “based
on the analyst’s residual archaic selfobject needs” (p. 144); and (3)
reactive countertransferences, the tendencies, identified by Kohut,
to unmask defensively the idealizing, mirroring, and merger trans-
ferences. Since Wolf was one of Kohut’s closest collaborators, his
move toward an inclusive conceptualization of countertransfer-
ence is important.
Intersubjectivity theory goes even further toward broadening
the meaning of countertransference. For Atwood and Stolorow
(1984), the psychoanalytic process emerges from the intersection
and interplay of two differently organized subjectivities. In their
words, “Patient and analyst together form an indissoluble psychol-
ogical system” (p. 64). Their vision of psychoanalysis is reminiscent
of Gadamer’s (1976) account of playful exchange:
66 / EMOTIONAL UNDERSTANDING

When one enters into dialogue with another person and then is
carried along further by the dialogue, it is no longer the will of the
individual person, holding itself back or exposing itself, that is
determinative. Rather, the law of the subject matter [dze Sache] is at
issue in the dialogue and elicits statement and counterstatement and
in the end plays them into each other. (p. 66)

Within such a dialogue, Stolorow et al. (1987) understand coun-

tertransference as “a manifestation of the analyst’s psychological
structures and organizing activity” (Stolorow & Lachmann, 1987,
p. 42). They hold that “transference and countertransference
together form an intersubjective system of reciprocal mutual influ-
ence’ (p. 42).
Some self psychologists, especially those influenced by inter-
subjectivity theory, have thus departed significantly from Kohut’s
negative view of countertransference, moving toward a more
inclusive definition of the word. Self psychology now, even more
clearly than before, recognizes the influence of the analyst/ob-
server (whose experience of the analytic relation is countertrans-
ference in the inclusive sense) on the observed. Increasingly we
find discussions of the analyst’s organizing activity, history, and
personality in self psychological case reports. We write less often
as if the analytic patient were the only one organizing or reorgan-
izing experience (Goldberg, 1988; Thomson, 1991).
However, self psychologists at times can be so involved in and
devoted to getting and staying close to the patient’s experience that
we may forget that we are there too. Thus, our cherished effort to
understand our patients from their vantage point may prevent us
from recognizing and remembering our contribution to shaping
the patient’s experience (the influence of the observer on the
observed). It may also interfere with our seeing that we can
understand another’s experience only through our own equally
subjective experience. In the words of Lomas (1987):

By the very nature of things people cannot attain perfect openness

to each other. Our perceptions are based on past experience. Noth-
ing is entirely new to us, otherwise we would completely fail to
appreciate it. However much we strive towards an unencumbered,
receptive state of mind, we bring to each exchange the sum total of
our history, an interpretation that is unique to us, the most coherent,
 Cotransference / 67

manageable and least anguished Gestalt that we have been able to

attain. (pp. 39-40)

The apparently spreading opposition to viewing transference as

distortion is consistent with the acknowledgment that two subjec-
tivities are always at work. Consistency requires that this opposi-
tion should expand to eliminate the distortion idea from counter-
transference.
In addition, I think that the concept of countertransference
makes little sense to clinicians who do not subscribe to theories
of innate aggression. Self psychologists generally view anger and
hostility as understandable responses to deprivation, abuse, and
the frustration of crucial emotional needs for appreciation,
affirmation, validation, and consistent support. “Counter” sug-
gests, among other things, reacting against, or opposing. This is
not comfortable language for psychoanalysts who embrace a
relational approach, especially self psychologists, because we
usually view ourselves as allied with the patient. At the very least,
the traditional use of the term “countertransference” suggests
the possibility of standing apart from the patient’s experience,
as if countertransference were a bounded thing a clinician could
use. On the contrary, I think understanding is incompatible with
standing apart. I believe that the term “cotransference” better
conveys our participation with the patient in the intersubjective
field or play space of the psychoanalytic conversation. This
inclusive term removes the connotation that the analytic relation
is automatically or in most respects adversarial. Instead it affirms
Loewald’s (1986) view that

it is ill-advised, indeed impossible, to treat transference and counter-

transference as separate issues. They are the two faces of the same
dynamic, rooted in the inextricable intertwinings with others in
which individual life originates and remains throughout the life of
the individual in numberless elaborations, derivatives, and transfor-
mations. (p. 276)

“Cotransference” treats the organizing activity of patient and

analyst as “two faces of the same dynamic.” Neither activity needs
a label with pejorative connotations.
68 / EMOTIONAL UNDERSTANDING

“Cotransference,” like the related terms “intersubjectivity”

and “mutual influence,” does not mean that no differences exist
between the participation of analysts and that of patients in
analysis. To acknowledge, as the cotransference notion does, that
psychoanalysis fully involves two subjectivities does not eliminate
the important differences between them. The analyst or therapist
is always there primarily for the sake of the other. Aron (1992)
helpfully articulates this apparent paradox by distinguishing be-
tween mutuality and symmetry. Mutuality means, as Eleanor
Roosevelt liked to say, that “understanding is a two-way street,” that
the subjective worlds of both patient and analyst are fully impli-
cated in the process. Symmetry connotes equality, or at least a
balance, in the contributions and roles of both partners. Psycho-
analysis, in Aron’s view and in mine, is a mutual and asymmetrical
relationship.

COTRANSFERENCE, EMPATHY,
AND HERMENEUTIC INQUIRY

Empathy has occupied a pivotal place in the theory of self psychology

because Kohut (1959) insisted that the psychoanalytic realm was by
definition coextensive with whatever introspection and empathy (or
vicarious introspection) could reveal. Empathy, however, is the
knowing activity of a subject who has her or his own psychological
organization. Therefore, self psychology especially requires an in-
clusive notion of countertransference (or cotransference) as a nec-
essary, though not sufficient, condition for the possibility of empa-
thy. By empathy Kohut meant the focused attempt to enter another’s
subjective reality. Stolorow et al. (1987) call this process “decenter-
ing,” by which they mean that the therapist may need to expand or
modify her own organizing principles in order to understand the
patient's subjectivity. A dialogic or perspectival realism requires such
vicarious introspection for the communication and sharing of per-
spectives. Such empathic dialogue may produce both an under-
standing of already existing perspectives and the creation of new
ones. To achieve empathic understanding, I widen my perspective
(I do not abandon it) by asking myself how the other person’s point
 Cotransference / 69

of view, feelings, convictions, and responses could make sense, could

be reasonable. Because of the need to widen one’s perspective to
accomodate that of another, empathy is an inherently intersubjective
*
process.
Philosophical hermeneutics can elucidate the inevitability of
cotransference. Hermeneutics, as we have seen, was originally a
set of rules or methods for interpreting biblical texts. More recently
Schleiermacher and Dilthey identified hermeneutic inquiry as an
attempt to read the meaning of a text by reference to the author’s
intentions (mens auctoris). How to gain access to the author’s
intentions was a practical problem. With the growth of historical
consciousness in the past century, hermeneutics has come to
include history—we might say development—as vital to under-
standing anything. Modern hermeneutics has come to view a text
or a painting or a dream as a “Sache selbst,” a thing itself (not just a
product of the author’s intentions), partly understandable from
the perspective of an interpreter. The interpreter participates in a
conversation with the text. From this exchange new meanings are
always emerging. We can know nothing of the text without know-
ing the interpreter, including the interpreter’s theories, personal
history, and organizing principles. There is no single, completely
existing truth about the text, person, or dream. Instead, for a
hermeneutic thinker, an indefinite number of possible interpreters
and perspectives exists. Communication among interpreters with
various perspectives may make possible more inclusive and coher-
ent—and in this sense truer—views, perspectives, understandings,
and theories.
Gadamer is now the most prominent proponent of hermeneu-
tic perspectivalism. To adopt this view would require a more
inclusive psychoanalytic notion of countertransference, or cotrans-
ference. Gadamer claims, first, that prejudice is inevitable. By
prejudice he means the inescapable being-somewhere vis-a-vis
whatever we seek to know or understand. He thus intends to strip
“prejudice” of its negative connotations—as difficult a task as

“Both within and outside self psychology, there are those who insist that self psychology is
a “one-body,” not a relational, theory. I believe self psychology’s relentless reliance on
empathic understanding, an inherently two (or more)-person process, places it clearly
among the relational theories in psychoanalysis.
70 / EMOTIONAL UNDERSTANDING

making “countertransference” a neutral or positively valenced

term. Here is Gadamer’s (1976) attempt:

It is not so much our judgment [about truth or value] as our

prejudices, that constitute our being. This is a provocative formu-
lation, for I am using it to restore to its rightful place a positive
concept of prejudice that was driven out oflinguistic usage by the
French and the English Enlightenment. It can be shown that the
concept of prejudice did not originally have the meaning we have
attached to it. Prejudices are not necessarily unjustified and erro-
neous, so that they inevitably distort the truth. In fact, the historic-
ity of our own existence entails that prejudices, in the literal sense
of the word, constitute the initial directedness of our whole ability
to experience. Prejudices are biases of our openness to the world.
They are simply conditions whereby we experience something—
whereby what we encounter says something to us. This formulation
certainly does not mean that we are enclosed within a wall of
prejudices and only let through the narrow portals those things
that can produce a pass saying, “Nothing new will be said here.”
Instead we welcome just that guest who promises something new
to our curiosity. (p. 9)

Similarly, American philosopher Peirce (1931-1935) cautioned:

We cannot begin with complete doubt [in the style of Descartes]. We

must begin with all the prejudices which we actually have when we
enter upon the study of philosophy. The prejudices are not to be
dispelled by a maxim, for they are things which does not occur to us
can be questioned. (vol. 5, par. 156)

Another way to speak of the necessity of prejudice (or of

cotransference) is to consider both the interpretation and the
interpreter, and in particular, the historicity of the interpreter. For
Gadamer, interpretation is not an attempt to read an author’s
mind, as Schleiermacher and Dilthey believed. Instead the dialogic
process, the interplay of interpreter and text or patient, creates
something new: the understanding. Interpreter and text are
equally important, and the historicity, including the prejudices
(organizing principles), of the interpreter takes on an organizing
role. For Gadamer, attributing subjectivity to the text and objec-
 Cotransference / 71

tivity to the interpreter dangerously denies the interpreter’s con-

tribution to the making of meaning.”
However, I am not advocating that we should simply accept
our prejudices or organizing principles; instead we must continu-
ally test them. We test them, not by empiricist criteria to check for
distortion, but in conversation. Continental philosophers often use
the notion of horizon to mean the field of vision, or whatever
perspective is available from where one stands. We test our preju-
dices by attempting to see whether they fit with broadening
horizons. Similarly, we may revise our organizing principles (as in
Piagetian accommodation) or we may develop new organizing
principles (as in a new beginning) to take new experience into
account. Colloquially, we sometimes speak of education or travel
as “broadening our horizons,” enlarging our perspective on the
world. Rightly or wrongly, people commonly make the assumption
that a broader perspective is likely to be truer and that narrowness
is somehow wrongheaded. “Deeper is better” is the psychoanalytic
version of that assumption. (To the objection that delusional
people claim to see broadly and deeply into meanings, a response
might be that we are speaking here of the elaboration of complex-
ity, whereas delusions usually oversimplify.) In the hermeneutical
view, we attain a broader or deeper experience of anything first
by knowing and acknowledging who we are—our historicity and
our prejudices. Only then can we enter the playful exchange that
broadens and deepens our understanding.
In psychoanalytic language, we must know and acknowledge
our cotransference, our point of view or perspective, if we are to
become capable of empathy (or vicarious introspection). In order
to do authentic psychoanalytic work, or to speak authentically of
our work, we must acknowledge the lenses through which we are
reading the text or the patient.
Such a hermeneutical awareness does not address questions

iOwen Renik (1993), commenting on the work of Schwaber (1992) has recently expressed
this well:

Instead of saying that it is difficult for an analyst to maintain a position in which his or
her analytic activity objectively focuses on a patient’s inner reality, | would say that it is
impossible for an analyst to be in that position even for an instant, since we are constantly
acting in the analytic situation on the basis of personal motivations of which we cannot
be aware until after the fact, our technique, listening included, is inescapably subjective.
(p. 560)
72 / EMOTIONAL UNDERSTANDING

about the advisability or inadvisability of so-called countertrans-

ference disclosures. Answers to these questions fall within the
domain of optimal responsiveness (Bacal, 1985). Normally I decide
such matters on pragmatic grounds. Often I must decide quickly,
as when a patient asks, “What are you thinking?” or “How do you
feel about that?” Sometimes, I honestly have to say that I do not
know or cannot quite put it into words yet. The patient thus learns
that Itoo struggle to understand. William James (1902) sometimes
formulated the central pragmatic maxim as: “By their fruits shall
ye know them” (p. 20). In this view, if a type of intervention or
response to a particular patient usually yields understanding and
self-consolidation, then it deserves serious consideration, and vice
versa.
Under discussion here, instead, is the nature of understanding
itself. At issue is the thesis that cotransference (or countertransfer-
ence in the inclusive sense) zs a necessary though not sufficient
condition for the possibility of empathy. Cotransference includes both
historicity and the prejudices/horizons of philosophical herme-
neutics, which are roughly equivalent to personal history and
organizing principles. To understand psychoanalytically, and to
understand psychoanalytic understanding, we must acknowledge
our personal historicity and examine our prejudices. To work
psychoanalytically, we must have access to our historicity. In my
case, for example, I need to know how my family position influ-
ences my response to only or younger children, whom I may envy,
feel excessively responsible for, or see as irresponsible and spoiled.
We must also prepare ourselves to criticize our horizons— espe-
cially our theories of human nature embedded in our psychoana-
lytic theories—and to revise those prejudices that limit our capacity
to understand another’s experience.
Finally, to reexamine the question of the place of countertrans-
ference in any psychoanalytic theory, let us turn to the old question
of the hermeneutical circle. Many have tried to articulate the
paradox that understanding is inevitably circular, that we look to
the part to see the whole and to the whole to comprehend the part.
Palmer (1969) summarizes the view of early Romantic philologist
Friedrich Ast (d. 1841): “Because Geist is the source of all develop-
ment and all becoming, the imprint ofthe spirit of the whole (Geist
des Ganzen) is found in the individual part; the part is understood
 Cotransference / 73

from the whole and the whole from the inner harmony ofits parts”
(p. 77). Similarly, for Schleiermacher, the whole of the text and the
parts of the text explain one another (Palmer, 1969). Dilthey (1989)
provides the example of a sentence that can only be understood
by grasping the inevitable interaction of the whole and the parts.
This view of understanding has implications for the debate
between those who favor here-and-now focus and those who em-
phasize history and development in clinical work. Neglect of either,
in Dilthey’s view, would hamper understanding. For our purposes
here, however, Dilthey (1989) illuminates the necessity of the
dialectic of whole and part, past and present, for understanding.
Among Gadamer’s (1991) important contributions is that he
added the future as a factor in the dialectic. His work demonstrates
that the hermeneutic circle is no longer vicious once the historicity
and horizons of the interpreter take their rightful place.
Gadamer sees clearly that risking and testing prejudices in
“dialogical encounter” is the path to understanding through the
hermeneutical circle. The nature of understanding is that alone we
can come to understand only what we already understand. To risk
testing our organizing principles in dialogue with a text or a person
makes possible a new meaning. Such new meaning may be a newly
complexified organizing principle or a future form of emotional
experience that could emerge only through the conversation. This
account of the process of psychoanalytic understanding in the
language of intersubjectivity theory (Stolorow et al., 1987) is
completely incompatible with objectivist and empiricist theories
of truth or with an exclusive psychoanalytic focus on the subjectiv-
ity of the patient. Vicarious introspection, or empathy, is implicit
conversation between perspectives.
Gadamer’s view thus avoids the feared subjectivism and solip-
sism of the hermeneutical circle. He believes that the path to
understanding in the hermeneutical circle runs inevitably through
the self-knowledge ofthe interpreter. Iffor Gadamer’s (1979) “text”
we read “patient” and for “understand” we read “empathically
understand,” the implications for psychoanalytic self psychology,
and for any psychoanalytic understanding, become clear:

In reading a text, in wishing to understand it, what we always expect

is that it will znform us of something. A consciousness formed by the
74 / EMOTIONAL UNDERSTANDING

authentic hermeneutical attitude will be receptive to the origins and

entirely foreign features of that which comes to it from outside its
own horizons. Yet this receptivity is not acquired with an objectivist
“neutrality”: it is neither possible, necessary, nor desirable that we
put ourselves within brackets. The hermeneutical attitude supposes
only that we self-consciously designate our opinions and prejudices
and qualify them as such, and in so doing strip them of their extreme
character. In keeping to this attitude we grant the text the opportu-
nity to appear as an authentically different being and to manifest its
own truth, over and against our own preconceived notions. (pp.
151-152)

To summarize, I use a perspective derived from philosophical

hermeneutics to explain my claim that countertransference in the
inclusive sense is indispensable to empathy, that it is a necessary
condition for empathy. This conceptualization of countertransfer-
ence should find a prominent place in self psychology or in any
psychoanalytic approach that recognizes empathy as an intersub-
jective way of knowing. I further suggest that countertransference
in this inclusive sense be renamed “cotransference” and that we
reserve the term countertransference for the analyst’s delimited
and reactive emotional memories that interfere with empathic
understanding and optimal responsiveness.
CelivAg ree R 6

Experience:
Given and Made

Lf asked 50 years ago what they seek to understand psychoanalyti-

cally, most analysts would have responded either “transference and
resistance” or “character.” Today we are more likely to say that we
seek to understand the experience of another person or, perhaps,
the shared experience of the “analytic couple” (Nissim-
Momigliano & Robutti, 1992). Nevertheless, we, like our philo-
sophic forebears, may be hard-pressed to say what we mean by
“experience.” In ordinary speech, people talk of learning from
experience or something really being an experience, an event
worth remembering. We call someone an “experienced analyst” or
an “experienced plumber,” and we use “experience” as an active,
transitive verb, as in “I experienced that as an insult.” Self psychol-
ogists claim to stay close to the patient’s experience and to theorize
in “experience-near” language. The term is slippery and difficult,
for reasons that will become evident as we examine its history. Still,
a close look at the term and idea “experience” may illuminate, if
not resolve, some running debates in psychoanalytic theory. A
moderate perspectival realism, or hermeneutic pragmatism, can
help us affirm and recognize both the given (brute, unavoidable)
and the made (organized, construed) aspects of experiencing. Let
us first examine some explicit and implicit conceptions of experi-
ence in analytic theorizing.

75
76 / EMOTIONAL UNDERSTANDING

EXPERIENCE IN PSYCHOANALYTIC THEORY

“Experience” has not traditionally been considered a psychoana-

lytic term. It does not appear either in the index to the Standard
Edition of Freud’s works or in Moore and Fine’s (1990) Psychoana-
lytic Terms and Concepts. Perhaps we take for granted a shared
understanding of this term. Nevertheless, radically varied notions
of experience underlie and buttress psychoanalytic theories and
practices. I will characterize these conceptions as scientific real-
isms, contemporary idealisms, and mixed conceptions. Later I will
return to the philosophical history of the idea of experience.
Scientific realism is the ontological view that what is true and
real is actually out there. Accompanying this view is the epistemo-
logical claim that we, or at least some of us, can tell what is true
and what is false. Such realism is usually tied to a correspondence
theory of truth (cf. Protter, 1985; Potter, 1994). Correspondence
theory holds that truth consists ina match between already existing
facts and our ideas about or words for them. Freud betrayed his
scientific realism—including an allegiance to correspondence the-
ory—in his frequent references to “external reality.” External reality
makes demands on us, disillusions us, deprives us of loved ones,
and so on. Nevertheless, it is always something out there, outside
the subject, outside psychic reality, irreducibly given. When the
word “experience” does appear in the Standard Edition of Freud’s
works, it is usually a translation of Erlebnis, or experience in the
sense of occurrence or event. This usage of the word experience
suggests externality largely independent of the subject. The em-
piricist epistemological project of the scientific realist becomes to
decide how, to what extent, and with what degree of certainty, the
mind can know the independent reality of the given. The observer
has little or no effect on the observed.
American ego psychology emphasized adaptation and reality-
testing. It accepted or adopted a correspondence theory of truth
(Hanly, 1992) with the associated idea of experience as the more
or less accurate registering of what actually happened. The notion
ofpatients distorting and of analysis as correcting these distortions
reflects this point of view. Ego psychologists view adaptation to
reality as an important component of mental health.
 Experience / 77

On the other end of the spectrum we find contemporary

voices who vociferously oppose scientific realism and the corre-
spondence theory of truth. These contemporary idealists oppose
scientific realism, asserting that we create experience, either in the
mind, or in analytic conversation, or in both. Depending on the
degree of radicalism, these views are a return to the idealism of
the 18th-century philosopher Berkeley, for whom the subject was
the only source of knowledge. As ontologies, these idealisms imply
that the real is the mental; as epistemologies, they claim that we
know only our own mental or conversational products, whatever
we make or create. These views include a coherence theory of truth,
according to which truth inheres in a whole system of beliefs. A
theory is true if it hangs together, both logically and aesthetically.
Prominent proponents of psychoanalytic idealism include
constructivist Hoffman (1983, 1991, 1992a), narrativists Spence
(1982) and Schafer (1983), and fictionalist Geha (1993). Hoffman
(1991) considers his view a relativist one, and by constructivism he
means not only a challenge to the “naive patient” fallacy and the
blank screen but a more general epistemological position. He now
calls his position “critical constructivism” (Hoffman, 1992b, 1993).
“Experience,” he explains, “taken as a whole, is partially consti-
tuted by what we make of it, retrospectively, in the context of
interpretation, and prospectively, in the context of experience-
shaping actions” (1993, p. 18, emphasis added). This nuanced
constructivism, though intended as a radical critique of traditional
views, scarcely belongs with the more extreme views.
Another moderate idealism is that of Schafer (1983). While
he thinks the analytic process consists largely of creating narra-
tives, he argues that subjectivity itself sets limits on our narratives:
“The introspection narrative tells us that far from constructing or
creating our lives, we witness them. It thus sets drastic limits on
discourse about human activity and responsibility” (p. 225).
Spence’s (1982) narrative truth is a more extreme position. In his
view, we know nothing in the analytic situation except the narra-
tive constructed by patient and analyst.
Most radical of the current critics of psychoanalytic naive
realism, Geha (1993) calls his view “fictionalism.” I will let him
speak for himself:
78 / EMOTIONAL UNDERSTANDING

Psychoanalysis molds the worlds that it interprets. It creates them; it

does not find, uncover, or discover them. An analysis in its entirety
constitutes a work of narrative fiction composed around all the many
familiar texts that surface during the analytic process, from dreams
to slips of the tongue. Consequently, psychoanalysis emerges as
essentially an enterprise of construction, not reconstruction, or at
least not reconstruction of something other than the mind’s inven-
tions. (pp. 214-215)

A story corresponds to no exteriorities. It is self-referential. It

reflects nothing other than, if you will, the cross-reflections of its
own integral elements. Every element of a story is determined—as
Gestalt psychology once stressed—by the integration that emerges
as the recognized story. That is, elements are located, affected,
allowed to affect, and conferred with meaning only within the
terms of the story. Every bit of the story is imagined. The book is
about itself. (p. 225)

That this view finds an audience in such a highly and widely

respected journal as Psychoanalytic Dialogues attests to the depth of
discomfort analysts have come to feel with scientific realism.
“Reality” (the analyst’s view) and “distortion” (the patient’s view)
must still be alive and kicking as acceptable psychoanalytic con-
cepts, either in some external world or in our fictional account of
the current psychoanalytic scene, to evoke such drastic theoretical
measures. The solipsism inherent in extreme subjectivisms and
relativisms becomes, as exemplified in Geha’s account, an inescap-
able folie a deux, a shared fiction from which there is no escape,
perhaps not even into another fiction.
However, many analytic theorists—including the more moder-
ate psychoanalytic idealists Hoffman and Schafer—are using mixed
conceptions of experience. While in his seminal paper, “Introspec-
tion, Empathy, and Psychoanalysis,” Kohut (1959) emphasized the
centrality of introspection and empathy as means of accessing
psychological phenomena, he also acknowledged that such em-
pathic and introspective observation can use the findings of the
sciences:

It may, of course, sometimes be useful for the psychologist to take

his clues from biological findings or principles in order to orient his
expectations about what he might observe. The final test, however,
 Experience / 79

is psychological observation itself; and it is erroneous to extrapolate

the interpretation of a specific mental state from biological princi-
ples, especially if they contradict our psychological findings. (p. 223)

Guntrip (1969) later took exactly this position. Thus both Kohut
and Guntrip intended to affirm the centrality of the psychol-
ogical—whatever is knowable by introspection and empathy—with-
out denying that experience is always the experience of something.
They recognized that the nonpsychological sciences with their
more external perspectives may provide information to guide us
as we search into the meaning of complex mental states.
Stolorow and Atwood (1992) also use a mixed conception of
experience as both given and made. Ambiguities persist, however.
They, for example, use “experience” primarily as a noun. They
refer to “structures of experience” and to the “organization of
experience,” a central idea in their theory of psychoanalytic inter-
subjectivity. What do they mean by experience? First, it is the what
that we structure or organize. This sounds like experience as bare,
unprocessed givenness, a logical necessity for an empiricist but a
psychological impossibility. At the same time, these authors, phe-
nomenologists rather than empiricists, emphatically endorse Ko-
hut’s view that introspection and empathy provide the only access
to true psychoanalytic data. We can, therefore, infer that they mean
subjectively organized experience, not mere representation of
external reality. In addition, their intersubjective theory, like self
psychology generally, insists on the constitutive role of the emo-
tional environment on the formation of experience. Some might
see this as a contradiction in their theory. A more sympathetic
reading sees intersubjectivity theory precisely as an attempt to
account for both the external, or contextual, and the internal, or
subjective, elements in the creation of personal experience. Their
view Calls for, if not provides, a conception of experience as always
partly organized, as more complex than a simple “blooming,
buzzing confusion” (James, 1892, p. 29).
Stolorow and Atwood (1992) also reexamine the notion of
unconsciousness, thus raising further questions for psychoanalysis
about experience. They outline three kinds of unconsciousness.
Their “prereflective unconsciousness” refers to structures of expe-
rience—or organizing principles—which are not themselves experi-
80 / EMOTIONAL UNDERSTANDING

ence but are instead highly general inferences and expectancies

distilled from experience. These structures are unconscious inso-
far as they work outside awareness, like our basic biological systems
when intact and healthy. Within this meaning of unconsciousness,
“experience” means the past and present content, available to
memory or not, that organizing principles organize. Stolorow and
Atwood’s second type of unconsciousness, “dynamic unconscious-
ness,” like Freud’s dynamic unconscious, contains memories of
events and bits of self-knowledge and relational knowledge that
were once consciously known. This material then became uncon-
scious because it created conflict for the knower. In the view of
Stolorow and Atwood, this knowledge was “sequestered” because
it jeopardized needed ties to caretakers or threatened the psychol-
ogical intactness of the potential knower. Here, too, the idea of
experience does not require consciousness. Instead, dynamic un-
consciousness requires the disavowal, dissociation, or perhaps
repression of events or bits of relational knowledge that have
already become experience. Prereflective unconsciousness thus
creates dynamic unconsciousness. Not that prereflective uncon-
sciousness is a causal agent; instead “maintaining certain preref lec-
tive structures or organizations of experience may require the
repression or denial of particular contents” (Atwood, personal
communication, 1994). Finally, “unvalidated unconsciousness”
contains events, emotions, or elements of self experience that did
not find receptive acknowledgment and response from caretakers.
In my terms, these unvalidated elements have not fully become
experience and now are unavailable for conscious experiencing.
(A. Miller, 1990, has written similarly about the need for a witness
to trauma. See Chapter 9.) Fully conscious experience is articulable
memory both for events and for the emotions that organize them
into experience.
Another attempt to conceptualize experience comes from
the psychoanalysts involved with infant research. Daniel Stern
(1985), for example, describes the development of organized
relational experience. The caretaker’s influence combines with
the infant’s inborn and developing capacities for subjective rela-
tional experience. The infant’s process of forming RIGs (repre-
sentations of interactions generalized) most clearly and fully
qualifies for designation as experience. Beebe and Lachmann
 Experience / 81

(1988), similarly, have contributed a sophisticated model of mu-

tual influence. They imply that experience arises from a combi-
nation of outer and inner elements, or what I call the given and
the made. This view, and attention to infant studies and early
childhood generally, are opposed by proponents of both the
empiricist and idealist poles of the continuum. Those who em-
brace the empiricist (scientific realist) notion of independent or
objective fact waiting to be registered are critical of Daniel Stern’s
work because it focuses on experience as process, as something
that develops. Those who lean toward the idealist, or social
constructivist, end of the spectrum are critical of infant studies
because they rely on assumptions about universality, reality,
human nature, or innate capacities, assumptions that sit uncom-
fortably with the idea that most or all of what we know is singly
orjointly a construction, narrative, or fiction.
Ogden’s (1989) The Primitive Edge of Experience illustrates the
need to make our ideas of experience clear and consistent. I find
his uses of the term “experience,” while often evocative, confusing
when taken together. He speaks, for example, of a “schizophrenic
fragmentation wherein there is very little of a self capable of
creating, shaping, and organizing the internal and external stimuli
that ordinarily constitute experience” (p. 196). Here he uses a
conception of experience as stimulus, much as scientific empiri-
cists, unequivocal realists, and classical behaviorists do. On the
other hand, he speaks throughout of complex experiences like that
of ambivalence. He attempts to expand the Kleinian “positions”
by speaking of depressive, paranoid-schizoid, and autistic-con-
tiguous forms of organized experience. He eloquently formulates
the analytic task:

As analysts, we attempt to assist the analysand in his efforts at freeing

himself from forms of organized experience (his conscious and
unconscious “knowledge of himself”) that entrap him and prevent
him from tolerating the experience of not knowing long enough to
create understandings in a different way. The value of developing
new ways of knowing lies not simply in the greater self-understanding
one might achieve, but as importantly in the possibility that a wider
range of thoughts, feelings, and sensations might be brought into
being. (p. 1)
82 / EMOTIONAL UNDERSTANDING

Combined with a notion of emotional safety that makes the

not-knowing tolerable, Ogden’s view of the analytic task would
be close to mine. He here uses a complex notion of experience
as organized and as reorganizing, but he does not do justice to
his own rich understanding of experience by defining it as
stimuli.
This brief survey illustrates my contention that contemporary
psychoanalysis includes objectivist, idealist, and mixed concep-
tions of experience. Let us now look to the history of philosophy
for some clarifications of these conceptions.

EXPERIENGE IN THE HISTORY OF PHILOSOPHY

Although Aristotle distinguished theoretical from practical knowl-

edge (experience), experience as a concept did not enter philo-
sophical argument until the late Middle Ages with Roger Bacon (d.
1292), who viewed experience as an antidote to authority (Co-
pleston, 1950). Likewise, the philosopher William of Ockham (d.
1349)—best known for “Ockham’s razor,” or the principle of
parsimony—argued that we would never know some realities, like
the existence of freedom, by authority or reason alone, but only
because experience forced us to recognize them. Thus, without
using the 20th-century term, Ockham introduced the notion of
“the given,” or of the “givenness,” of knowing.
Later the Renaissance philosopher and scientist Francis Bacon
(d. 1626) distinguished between mere experience and true experience
(Copleston, 1950). Mere experience is like common sense and
involves grasping at whatever sense we can make out of what comes
our way. True experience, on the contrary, is scientific and
planned. It involves turning on the light of theory and making
specific tests. Francis Bacon, thus, recognized that the uses of
“experience” in ordinary language and daily life often refer to mere
givenness, whereas a fuller conception involves the organizing
contribution of the knower.
With Descartes, Francis Bacon’s conception of two types of
experience—“mere” and “true”—fell away. Descartes preached the
systematic doubt of all experiential knowledge and the reliance on
 Experience / 83

reason alone, recognizable by its “clear and distinct ideas,” as the

only reliable criterion. While he acknowledged that the existence
of natural phenomena like magnetism could not be inferred from
rational systems alone, he insisted that we know such factual
matters only when we understand them by reason. We should
always hold as suspect “that deceiver,” experience.
In reaction, the British empiricists Locke and Hume claimed
that all knowledge came through the senses. For them, only what
Francis Bacon called “mere experience” deserved our trust.
Hume’s famous critique of causality—we know only coincidence
(what today we call correlation), not cause—relies on this notion of
bare, unorganized, reason-free, atomistic experience. Experience
became reducible to the perception of the effects of external reality
on the immaterial mind.
Ironically, the reduction of experience to sense data evoked
an apparently opposing position, Berkeley’s idealistic “to be is to
be perceived.” Sense data are unintelligible; only ideas (today’s
constructions, narratives, and fictions) are knowable. In this view,
experience is the product of intelligence, of creative thought, of
the experiencer.
Despite major regressions to Cartesian rationalism, to empiri-
cism, and to empiricist-based idealisms, since the time of Kant,
experience has been conceptualized as both given and made. For
Kant (1781), the data of sensation and perception become knowl-
edge only as apprehended through the categories, or structures, of
the understanding. The mind knows nothing scientific by itself. It
is a structured potential for knowing and valuing, or Kant would
say, for experience. Like the infant perceptual capacities for relat-
edness, the categories await the data of perception to form experi-
ence, or scientific knowledge. The categories organize the data of
perception into experience.
Fascinated with the notion of experience, the American prag-
matists may be Kant’s truest heirs. Peirce’s (1931-1935) work, for
example, illustrates the need to give full attention to both the given
and the made in experience. On the one hand, he spoke of “brute
experience” (vol. 4, par. 172), of “surprise,” (vol. 5, par. 51), and of
experience as shock (vol. 2, par. 139). This part of experience is
change that the subject cannot deny; experience “is the enforced
84. / EMOTIONAL UNDERSTANDING

element in the history of our lives” (vol. 5, par. 581). “We experi-
ence vicissitudes, especially” (vol. 1, par. 336). Such experience is
both source and test of our knowledge.
However, scientific experience was for Peirce, as for Francis
Bacon and Kant, much more than “mere” observation:

Modern students of science have been successful because they have

spent their lives not in their libraries and museums but in their
laboratories and in the field; and while in the laboratories and in the
field they have been not gazing on nature with a vacant eye, that is,
in passive perception unassisted by thought, but have been observ-
ing—that is, perceiving by the aid of analysis—and testing suggestions
of theories. (vol. 1, par. 34)

Peirce appreciated both the brute quality of experience and its

structured elements. He brought these together in his theory of
abduction, according to which science advances when surprising
facts impinge on our theories. Then we must be ready to revise
our theories, imagine new possibilities, and return to the field and
laboratory with new eyes.
For William James experience served as a continual challenge
to entrenched theories. Experience, for James, was the materia
prima, or underlying reality, of everything; things and thoughts,
matter and mind, reason and feeling, were just forms of experience
(1905). He called this position—which placed him toward the
empiricist, or scientific realist, end of the spectrum—radical em-
piricism. He argued, as had his friend Peirce, that emotion and
intuition are part of human life and thus part of human reason-
ableness. Emotion—or, as psychologists say today, affect—was often
for James that part of experience that could or should not be
denied. Still, emotion and experience are neither objective (given)
nor subjective (made) in themselves. In his words, “subjectivity and
objectivity are affairs not of what an experience is aboriginally
made of, but of its classification. Classifications depend on our
temporary purposes” (p. 74). So, for example, I may treat my
suffering as objective: “I have a pain in my foot,” or as subjective:
“I feel miserable,” depending on whether my purpose is to gain
doctoring or sympathy. The experience itself, for James, is neither
given nor made, itjust is. This doctrine of pure experience led to
 Experience / 85

comparisons between James and European phenomenologist

Husserl. For emotions, James continued,

the relatively “pure” condition lasts. In practical life no urgent need

has yet arisen for deciding whether to treat them as rigorously mental
or as rigorously physical facts. So they remain equivocal; and, as the
world goes, their equivocality is one of their conveniences. (p. 76)

James saw experience as the complete substratum, as the bloom-

ing, buzzing confusion to be organized by human purposes.
Philosophical hermeneutics has developed a different ap-
proach to the problem of experience. In Gadamer’s version, it
eschews the questions and disputes of traditional epistemology
and criticizes its attempt to derive experience from subjectivity. In
other words, Gadamer rejects the whole Cartesian enterprise of
deriving reality from mind and the empiricist philosophies based
on the same dualistic and individualistic assumptions. (The tradi-
tional epistemological project in psychoanalysis has recently re-
ceived a cogent critique from Stolorow and Atwood, 1992, under
the rubric of “the myth of the isolated mind.”) Any attempt to
demarcate the proportions of the given and the made in experi-
ence is, for those who thinks hermeneutically, wrongheaded and
destined to fail.
Instead, Gadamer replaces Dilthey’s empathy—the effort to
enter another’s experience, to contact another’s unities of mean-
ing—with his own view of understanding emergent from conversa-
tion. In Gadamer’s (1991) words:

We say that we “conduct” a conversation, but the more genuine a

conversation is, the less its conduct lies within the will of either
partner. Thus a genuine conversation is never the one that we wanted
to conduct. Rather, it is generally more correct to say that we fall into
conversation, or even that we become involved in it. The way one
word follows another, with the conversation taking its own twists and
reaching its own conclusion, may well be conducted in some way, but
the partners conversing are far less the leaders of it than the led. No
one knows in advance what will “come out” of a conversation.
Understanding or its failure is like an event that happens to us. Thus
we can say that something was a good conversation or that it was ill
fated. All this shows that a conversation has a spirit of its own, and
86 / EMOTIONAL UNDERSTANDING

that the language in which it is conducted bears its own truth within
it—i.e. that it allows something to emerge which henceforth exists.
(p. 383)

We might ask Gadamer whether he means that understanding

can do without a conception of subjective experience. Perhaps
the prejudices he considers so valuable in the effort to under-
stand are a kind of organized subjective experiencing. Neverthe-
less, he raises for psychoanalysis the possibility that under-
standing is more than empathy, that our focus on experience
avoids our historical and intersubjective “embeddedness” (Stolo-
row & Atwood, 1992). Gadamer prods us to develop a more
thoroughly relational conception of experiencing, or to drop the
idea of experiencing.
Since, however, experience as a word and a concept is every-
where in psychoanalysis, keeping Gadamer’s criticism in mind, I
will suggest some ways to think about it. These ideas are not
original, but they need to be made explicit and brought into focus.
Bringing them together, however, should make it clearer why
neither scientific objectivism nor simple social constructivism is
an adequate psychoanalytic epistemology.

EXPERIENCE AS INTERPRETATION

I suggest the following ways to think about experiencing:

1. All experience is both given and made. I do not mean that

we can just conceive it either way, like the particles and waves of
quantum physics, or the ducks and rabbits of Gestalt theory. Both
the given and the made are necessary to constitute experience
from any perspective. We cannot usually know the exact contribu-
tion of each element, nor can we usually distinguish them neatly
from one another. Sometimes the given consists of what has
previously been organized; it is, in other words, the relatively given.
This mixed conception of experience requires our ability to toler-
ate ambiguity, the lack of which is illustrated by the controversy
over false and recovered memory.
2. Givenness refers to brute, at least partly unprocessed,
 Experience / 87

undeniable events or occurrences. Colloquially we say, “Well, that

is a given,” that is, the matter is relatively self-evident. Givenness
involves the sense that something smacks one in the face like a
40-mile-an-hour wind. Yet the given may include an emotional
response or reaction. Givenness may come to include our past
organized experiences. The given is a necessary epistemological,
logical, and psychological condition for the possibility of experi-
encing.
3. Making refers to subjective and relational organizing activ-
ity, as in the expression, “What do you make of it?” Like Kant’s
categories of the understanding, but more intersubjectively con-
figured than these, our organizing activity is a second necessary
condition for the possibility of any experience. We organize what-
ever is given in the present emotionally and cognitively from past
relational experience. To experience is to organize the given. Experi-
encing is a developing process, not a finished product. Fantasy and
dreaming, narrative and construction, are special kinds of organ-
izing activity.
4. Events become experience by emotional processing in an
explicit or implicit intersubjective and historical context.
5. To reexperience a feeling or event is to take the past
event-transformed-into-experience as the given and to reorganize
it, or remake it, according to old or new emotional organizing
principles, or modes of emotional inference. We reach, either in
inner dialogue or in conversation with another, a new under-
standing.
6. In psychoanalysis, transference and countertransference
(or cotransference) include both the given and the made. Part of
the given, for each participant, is the otherness of the other, the
brute actuality of a not-me. (Of course, as George Atwood [per-
sonal communication, 1994] has pointed out to me, the experience
of otherness itself contains elements of the given and the made.)
What is “made” is my interpretation or understanding of the other,
and of our relation, from my particular vantage point, which
includes my emotional history and my theories.
7. The boundary between the given and the made shifts with
the intersubjective context. I do not mean that the given and made
are poles of experience, but rather that taken together, they
comprise experience. A “sense of reality” means that we possess,
88 / EMOTIONAL UNDERSTANDING

at least temporarily, the conviction that the greater portion of our

experience lies on the given side (Ferenczi, 1909).
8. As far as bare and unorganized events are either over-
whelming or find no responsive emotional context, they may fail
to become experience. They remain dissociated, unconscious, and
unavailable for integration into a whole experienced life.
9. The distinction between the given and made does not,
however, correspond to the continuum between unconsciousness
and consciousness. Granted, events and emotions that we find
overwhelming or difficult to make sense of—relatively disorganized
events—are less likely to come to awareness, but as Freud taught us,
they have their ways of surfacing. The given and the made com-
prise all experience, conscious or unconscious.

To summarize, experience results from the endless and con-

stant interaction, or dialogue, between the given and the made. It
emerges within and between the subjectivities involved in any
intersubjective field. Individually and together we make sense of
(or experience) what is partly brute, unorganized, surprising, or
confusing.
Finally, a question that encapsulates this entire problem. Sup-
pose we were to agree to use the word experience only as a verb? We
could no longer, for example, refer to structures of experience, nor
simply to self-experience. We would instead refer each time both
to the interpreter’s organizing activity and to whatever the inter-
preter interprets. All experience would become interpretation or
organizing activity. I do not believe such a shift in usage will ever
catch on, nor can I make this shift consistently myself. Still, the
question highlights my central thesis—a thesis widely shared today
by all psychoanalysts who acknowledge the influence of the ob-
server on the observed: Whenever we experience, we do some-
thing—making sense or organizing—to something—the given, the
partly unorganized, even the chaotic. Psychoanalytic under-
standing consists of a collaborative effort to make sense of this
experiencing.
Cle DAM ROY

Affect and Emotional Life

TES experience, given and made, that is of interest to a psycho-

analytic epistemologist is emotional experience. Human emo-
tional life is what psychoanalysts seek to understand and to heal.
If our bodies hurt, we see a physician, at least initially. If our
thinking needs improvement, we go to school or read books. If our
cars will not run, we take them to a mechanic. If our emotional life
feels beyond our power to understand or manage, we may see a
psychotherapist. Ordinarily, people take emotional pain as real,
and as a reason to seek help. “I don’t know why I feel so bad.” Yet
within psychoanalytic thought emotions have long been seen as
less than fully real, as mere epiphenomena, as derivative from
those essential motivators, the instinctual drives. Emotions, or
affects, were either signals of sexual or aggressive conflicts, or the
effects of continuing and unsuccessful unconscious attempts to
resolve these conflicts. Since emotion signified trouble, a psycho-
analytic cure meant reducing or eliminating emotion. Making the
unconscious conscious, full of cognitive insight, should render
emotional signals from the unconscious almost unnecessary.
In contrast with this longstanding cognitive emphasis within
psychoanalysis, much recent psychoanalytic writing regards affects
as psychoanalytic bedrock. Krystal (1988), for example, points to
the inability to read and integrate one’s own feelings as the core
of most psychopathology. Even more recently, Spezzano (1993) has
claimed that psychoanalysis, both in Freud and in the work of

89
90 / EMOTIONAL UNDERSTANDING

object relations theorists, has always included a theory of affects.

In Spezzano’s view, psychoanalysis is a theory of affects. Krystal,
Spezzano, and other writers provide an important antidote to the
cognitive cast of both traditional and some recent psychoanalytic
theory. I will consider these contributions in more detail and then
suggest some emphases that I believe are crucial to an adequate
psychoanalytic theory of emotional life. Last, to illustrate my view
of psychoanalytic understanding as making sense together, I will
apply my perspectives to an emotion common in human life, envy.
First, however, a word about terminology. “Affect,” sometimes
“affects” in the plural, is a word psychoanalysts use for primary or
fundamental emotions, usually described from an observer’s point
of view. When emotion belongs to the speaker, that is, when it is
subjectively experienced, we call it a feeling. We say “I feel,” or “I
have a feeling,” not “I have such-and-such an affect.” Although
Krystal (1988) considers “affect” and “emotion” synonymous, the
words have different connotations. I prefer to use “emotion” for
feelings—to emphasize their character as complex processes rather
than as simple entities. Emotions are among Kohut’s “complex
mental states”—knowable or known only by introspection and
empathy. “Affect,” on the contrary, lends itself to the atomistic
assumptions that I will challenge below. The technical term “af-
fect” adds no meaning to the idea “emotion” and distances us one
step further from the feeling or unable-to-feel person. However,
when discussing the work of others, I will adopt their language.
When advancing my own views, I will use the words “feeling” or
“emotion” for subjective emotional experiencing. I will use the
words “emotion” or “emotional life” for what we can know only by
introspection or empathy, that is, by psychoanalytic methods of
observation. “Emotional life” will also refer to the totality or
complexity of subjectively experienced feeling, but described as if
from outside. In this usage, someone might say, “I don’t under-
stand—or I hate—my emotional life.”

RECENT PSYCHOANALYTIC WORK ON AFFECT

The important work of Henry Krystal, gathered in Integration and

SelfHealing: Affect, Trauma, and Alexithymia (1988), provides one
entry into recent psychoanalytic thinking on affect. Krystal’s con-
 Affect and Emotional
Life / 91

tribution includes his view of affect as originally undifferentiated

somatic response that, under ordinary conditions, develops by
differentiation, articulation, and desomatizing. With adequate
parenting, a child learns, during toddlerhood but especially in
latency, to bear emotional distress and to know that it will pass.
Krystal names the ability to bear the intensity of emotional pain
without excessive escapes into anesthetics such as drugs, alcohol,
food, or emotional deadness “affect tolerance.” He considers
bearing affect states and knowing that the future need not resem-
ble the overwhelming past the basic gauge of mental health.
The most common obstacle to acquiring the ability to tolerate
affect, in Krystal’s view, is massive psychic trauma in infancy or
adulthood. Working with hundreds of Holocaust survivors taught
him—as working with Vietnam War veterans, rape victims, and
survivors of severe child abuse was later to teach others—to recognize
the freezing, numbing, and blocking, the death-in-life that partly
define trauma in adults and in verbal children (Terr, 1990). Courtois
(1988), van der Kolk (1984, 1987), Horowitz (1986), and Herman
(1992) have described the intrusive symptoms of posttraumatic
stress: nightmares, sudden rages, exaggerated startle responses, and
flashbacks. Preverbal trauma, on the other hand, as far as we as
adults can ever imagine it, is the experience of overwhelming
emotion, prolonged into timeless terror, suffered without escape and
without help. Krystal believes that the adult residues of such early
trauma appear either as emotional frozenness or as panicky re-
sponses to any emotion. Emotions are then experienced as the
return of the dreaded, timeless, and overwhelming terror of infancy.
Krystal, like Spitz and Bowlby before him, sees early loss as the
paradigm example of massive infantile trauma. Infants brought to
institutions after the war deaths of their mothers struggled in terror,
then lapsed into helpless numbness, the precursor of alexithymia.
By “alexithymia,” Krystal (1988) means “patients’ impaired
ability to utilize emotions as signals to themselves” (p. 243). The
emotional life of alexithymic patients is usually somatic, unverbal-
ized, undifferentiated, and vague. Such people do not recognize
emotion as emotion, in themselves or in others. Instead they may
become physically ill, or just numb. Therapy, for these patients,
involves recognizing, differentiating, and desomatizing affect.
Krystal sees affect itself-even painful emotional states—as con-
structive and useful.
92 / EMOTIONAL UNDERSTANDING

Given the theoretical and clinical fruitfulness of Krystal’s work,

my differences may seem minor, but they have extensive theoretical
and practical implications. First, extensive infant research, as sum-
marized by Tronick (1989), has found facial responses in newborns
that correspond to anger, fear, joy, curiosity, and so on. If emotional
responsiveness is originally so varied, then the question becomes,
what has happened to that emotional life in people who become
alexithymic? Perhaps we must see trauma as shutting down what
already exists, rather than as interfering with developmental paths
of affect differentiation and desomatization.
The second area in which I differ from Krystal concerns his
view of emotion as an internal matter. While he acknowledges both
environmental influences on the developed ability to bear affect
and the effect of externally perpetrated trauma on emotional life,
he considers affect regulation primarily an individual task and
mental health a matter of the individual’s ability to master this
task. Similarly he considers trauma, particularly in infancy, an
overwhelming private experience of timeless terror. A shift within
Krystal’s theory to a relational perspective on human nature,
development, health, and pathology would place his work in the
center of current psychoanalytic thinking.
In this vein, Stolorow et al. (1987) hold that the intersubjective
field shapes and maintains affect. Drawing on Krystal’s work, they
highlight the extent to which the degree of affect tolerance, for
example, depends on the ways the person’s parents responded to
their child’s emotions. More broadly, emotional life takes shape as
a person’s automatic response to a history of parental response to
his or her emotional expressions. In adulthood in general, and in
treatment in particular, emotional life, shaped by the person’s
relational history, similarly develops and heals in mutual inter-
change.
Stolorow and Atwood (1992) see trauma itself in intersubjec-
tive terms. They hold that the shocking and painful affect becomes
unbearable and overwhelming because the child finds no under-
standing and comforting response: “Pain is not pathology. It is the
absence of adequate attunement and responsiveness to the child’s
painful emotional reactions that renders them unendurable and
thus a source of traumatic states and psychopathology” (v. 54). For
example, a patient who at age 8 had lost a favorite uncle to an
 Affect
and Emotional Life / 93

airplane crash needed his parents to attend to his feelings and

worries, not only to their own grief. Analysis provided this patient
with the opportunity, an emotional “second chance,” to find the
attuned responsiveness to his emotional states that could make
these states less terrifying and more bearable.
From a relational point of view, Spezzano (1993) has at-
tempted to remedy what he sees as the psychoanalytic neglect of
affect since Freud and to integrate a theory of affect into psycho-
analysis. His account makes it clear that Freud developed and used
a theory of affect.
Similarly, Spezzano shows that the object relations theorists in
Britain (especially Fairbairn and Winnicott) and in North America
(Loewald, 1980) included a theory of affects in their thinking and
that it enriched Freud’s theory of affects. At the same time,
Spezzano believes that by placing structural theories in the center
of their thought, Freud and these theorists obscured and margi-
nalized their psychoanalytic theories of affect. Spezzano’s own
contribution, as he sees it, is to correct this misunderstanding by
making explicit his claim that psychoanalysis zs a theory of affects.
From this point of view he claims that human psychology consists
of “shifting dialectical arrangements of affective states” (p. 214)
and that the “full development of affect is what psychoanalysis
seeks” (p. 215). In Spezzano’s view of psychoanalytic cure:

Within the analytic holding environment, the analysand gets a

second chance to achieve competence in using affects as information
about his unconscious psychic activity, especially his processing of
contacts with others. Repeated experiences of competent affect
regulation within the transference give the patient the material with
which to construct a self-representation that sustains a sense of
perceived affective competence. The conviction that one can com-
petently regulate one’s affective life is a state of well-being. (p. 216)

Although he does not mention the work of the intersubjectivity

theorists, Spezzano explains that he sees affect as intersubjectively
regulated and maintained. He also explains that his theory of affect
is not purely cognitive or even representational. Additionally, he
captures one form of what I will call “emotional memory” (see
Chapter 8):
94 / EMOTIONAL UNDERSTANDING

They [referring to Dreyfus & Wakefield, 1988] portray the process

here as more ofa representational one than I want to do. Iam trying
to get at a different situation from the one in which a representation
of the father or mother becomes the prevailing object representation
and so casts an emotional tone on the child’s whole psychological
life. . . A metaphorical way to grasp this notion is imagine that the
heat of south Florida could get inside a child who grew up in such a
climate and he would always feel oppressively hot. If a child’s pain,
loneliness, anxiety, or grief is allowed to persist too often and too
long, then that affect or blend of affects comes to be the way that
child feels all the time. (p. 225)

Despite my admiration for Spezzano’s carefully nuanced work,

I think it involves, as does the work of Tomkins (1963) and Krystal
(1988), an atomistic treatment of single primary affective states,
such as excitement, as underlying prime matter (the given). These
views suggest the existence of original or fundamental affects,
which, like the elements of the periodic table, may combine, but
that we can study in isolation. Emotions, in such a view, are like the
empiricist’s bits of sense data, lacking the complexity and relational
meaning that they should have if, as Spezzano holds, they are
intersubjectively regulated and maintained. Relational and inter-
subjective experience comes later developmentally in these views,
and organizes what is given.
These affect theorists (Tomkins, Krystal, and Spezzano), in
their yearning for theoretical elegance and simplicity, may also
fall into the trap of reductionism. Classical drive theorists insisted
that “it all came down to” sexuality and aggression; Greenberg
(1991) replaces those drives with effectancy and safety. Similarly,
the affect theorists (e.g., Krystal and Spezzano) hope to find a
simple principle of explanation for human emotional life. Like
Freud, they sometimes imply that the goal of human life is to seek
pleasant affect states and avoid unpleasant states. Yet Aristotle
explained long ago that pleasure and pain are byproducts of
human activity, not ends in themselves. Pleasure and pain are
qualities of experience, not things in themselves. The oversimpli-
fication involved in reducing emotions to states or things belongs
to what Whitehead (1925) called “the fallacy of misplaced con-
creteness.” Ironically, the reverse side of this fallacy is too much
abstraction. The affect theorists also fall into this trap. An
 Affect and Emotional
Life / 95

abstraction called “affect” becomes a general principle of expla-

nation. Such abstraction breaks up emotional complexity, creat-
ing the myth of the isolated affect, isolated from context and
emotional complexity.
Infant studies (e.g., Daniel Stern, 1985; Tronick, 1989) allow
us to see human nature in less reductionistic ways. Possessing
extensive relational and organizational capacities, infants are born
with differentiated and complex emotional lives. Iwonder whether
babies may not already have several months of prenatal emotional-
relational experience that they continue to reorganize in the face
of so much that is new. We might imagine that even before birth,
a baby has absorbed from the mother a capacity or incapacity to
contain anxiety, for example, or a sense that comforting and
calming are or are not possible. From the beginning, the intersub-
jective situation is the home of emotional life. This field both
organizes and gives meaning to emotion.
Perhaps Spezzano thinks that in order for affect (like instinc-
tual drive) to be taken seriously in psychoanalysis, it must precede
relatedness developmentally. Unfortunately, although his general
perspective is clearly relational, adopting the view that affect
precedes relatedness may place Spezzano among those who
believe that the sources of motivation are found primarily or
exclusively in the patient. Yet a fully relational view of psycho-
analysis, one that sees even emotion as constituted in relatedness,
does not discount affect. Instead it sees people as continually
attempting to make sense of the complex emotional life that they
always live in implicit and explicit relatedness to others. My
thinking stresses the inherently complex and relational nature of
emotional life. With this complexity recognized, I agree with
Spezzano that emotional life is psychoanalytic bedrock—the what
that we seek to understand.

EMOTIONAL LIFE AS COMPLEX AND RELATIONAL

As an antidote to the views discussed above, I wish to emphasize

two essential features of emotion: its complexity and its depend-
ence on historical and present contexts of relatedness. First, let us
consider the complexity of emotional life.
96 / EMOTIONAL UNDERSTANDING

Emotional life, an irreducibly complex process, requires an

epistemology that resists the urge to oversimplify. Relational his-
tory makes understanding emotional life an intricate task. We
continually organize and reorganize in layers of meaning. Psycho-
analysis has long recognized this complexity by referring to multi-
ple function (Waelder, 1936) and overdetermination (Freud,
1910). According to the principle of multiple function, any psychic
phenomenon—a dream or a symptom, for example—may serve
many psychological purposes at once. Overdetermination, simi-
larly, means that any psychic event has many causes. More recently,
Kohut (1977) called psychoanalysis the depth psychological study
of “complex mental states” (p. 244). He meant to insist that
psychological life, understood in depth, is never simple or reduc-
ible to mental atoms.
When we attempt to extract an “affect” from the continuity
and complexity of any emotional life, and use that affect to explain
something, we make two mistakes. First, we abstract and extract
what is inextricable. Second, we may violate the integrity of the
person’s experience. Although some of this violence is unavoid-
able, patients often point it out to us. When we attempt to help a
patient articulate a feeling, we often hear: “But that’s not all,” or
“It’s more than that,” or “It keeps changing.”
One effect of the psychoanalytic tendency to speak of single
emotions has been the focus on ambivalence and its acceptance as
a model of mental health. In this view we are always torn between
love and hatred, conceived as two basic and simple affects. We must
learn to feel both toward the same person at the same time. On
the contrary, I see emotional life as originally complex. It makes
more sense to wonder how it disintegrated, how it became over-
simplified. How did the responses in a given family bring a child
to feel that loving a parent was incompatible with anger, or
disappointment, or interest in something else besides the parent?
How did the child develop the conviction that feeling itself was
dangerous to significant ties?
However, isolation or dissociation of some emotions from the
whole of emotional life is only one form of difficulty. Many
emotions, like shame and dread, are themselves internally layered.
Shame involves self-hatred in the face of the explicit or implicit
other's perceived or expected disapproval. It is complex, often
 Affect and Emotional
Life / 97

multiply layered, and usually continuous with moments of more

intense pain. People sometimes say, “I’m ashamed that I’m
ashamed about this.” Likewise the feeling of dread involves both
emotional memory and an expectation of further pain or terror,
and it usually includes a sense of depressive helplessness.
A second essential feature of emotional life is its relational
character. Emotions are responses to relational events or needs,
and emotional expression is an attempt to connect, or to regulate
connection, with another. The social smile in infants is a social
smile. Smiling and crying are methods of “object seeking” (Fair-
bairn, 1952). Any thoroughly relational theory of human nature
or psychoanalysis must treat emotional life in that context. Emo-
tional experience begins, continues, and heals in specific intersub-
jective contexts. When emotional experience is presented as inde-
pendent of context—psychiatry speaks of “inappropriate affect,”
for example—this may mislead us into thinking of emotion as mere
internal signal. Instead, from the perspective of intersubjectivity
theory, we see the emotional expression of the moment as formed
by relational history and as evoked or triggered by the intersubjec-
tive field of the present. Its reference to the future often consists
in the expectation that the relational experience of the future will
resemble that of the past, but it includes an anxious hope that
someone will respond differently.
Not only complex and relational, emotional life is emotional.
This apparent tautology is important only because both psychiatric
and psychoanalytic languages have attempted to describe and work
with emotion as if it were a cognition or an instinctual derivative.
In either case, it is viewed as residing in the individual. On the
contrary, I see emotion as a primarily noncognitive and nonverbal
relational response. It can be linked to cognitions or schemata, but
it has its own reality. Even the language ofintersubjectivity theory
has been ambiguous on this issue. The talk of “organizing princi-
ples” (Stolorow et al., 1987), representation (Beebe & Lachmann,
1988), and schemata (Fosshage, 1994), has a cognitive cast that
may deny to emotion a reality of itsown and a prominent place in
psychoanalytic discourse. Consequently, I speak of “emotional
organizing principles” and “emotional modes of inference.” Pre-

*Fosshage (1994) strives for balance by speaking of affective-cognitive schemata.

98 / EMOTIONAL UNDERSTANDING

cisely because these are emotional, they usually operate in such an

automatic manner that identifying them is difficult.
The tendency in psychoanalysis toward cognitive formulations
becomes even more prominent when we describe our clinical work
as making the unconscious conscious, as illuminating unconscious
organizing principles, or as clarifying representations or schemata.
I think the failure of psychoanalysis to grant emotion a life of its
own may account for the persistence of the widely accepted idea
that we do not know how psychoanalysis heals. None of the official
explanations provides an answer to why it works when it works,
and why it does not when it does not. The problem is, as Ferenczi
knew well, that psychoanalysis is emotional medicine for emo-
tional ills. Ideas, insights, interpretations, and other cognitive
approaches may support emotional healing, but they do not
provide it. Recognizing this painful truth, Italian psychoanalysts
like DiChiara (in Nissim-Momigliano & Robutti, 1992) suggest that
only if the analyst can find room inside herself or himself for thes
patient is there any hope. Similar ideas come from such Ferenczi
descendants as Balint, Kohut, and the Ornsteins (cf. Orange, 1995)
and from the independent British tradition (i.e., Suttie, Fairbairn,
Guntrip, Bowlby, and Winnicott).
Perhaps our leaning toward cognitive expressions comes in
part from the painful emotional experience for the analyst that
successful analytic treatment requires. We cannot, as Gadamer
(1991) reminds us, stand back if we are to understand. We must
enter and participate in the emotional life we and our patients
create together in the intersubjective field. This draining work
requires a depth and intensity of involvement not captured by
cartoons of analysts sitting behind patients and taking notes. So
we look for words and ritual to drain off some of the emotional
intensity and to dilute our connection to our patients. Neverthe-
less, our patients pay the price for our distancing and for our
reluctance or inability to be emotionally available. Such availability
means a readiness for a complex and emotional relationship.
If emotional life truly is complex, relational, and “emotional,”
then certain clinical consequences follow. One is that our patient’s
“Yes, but . . .” may not be defensive but instead may be a plea for
a fuller understanding of “complex mental states” (Kohut, 1959).
If we believe that emotion really differs from cognition, then we
 Affect and Emotional
Life / 99

will distinguish emotion and cognition in talking with patients and

support a respect for the contribution of each to a whole human
life. We will show regard for a “sense of things”—ours or the
patient’s—whether or not this sense is verbalizable. In a Winnicot-
tian spirit, we will make more room in many psychoanalytic
treatments for art, music, and poetry as means of creating a shared
emotional life. We will also have less need to reduce these “forms
of feeling” (Hobson, 1985) to any form of cognition or insight.
I will now provide an example of understanding an emotion
as a complex, relational-historical, and truly “emotional” matter.
The instance of envy as embedded in shame highlights the contrast
between reductionism and the psychoanalyst’s attempt to discover
complex psychological configurations.

ENVY AND SHAME

According to the 1971 edition of the Oxford English Dictionary, in

the 14th and 15th centuries “envy” meant “malignant or hostile
feeling” and “active evil, harm, mischief.” In recent centuries, it
has come to have the more specific meaning “the feeling of
mortification and ill-will occasioned by the contemplation of
superior advantages possessed by another.” While Freud used the
more current meaning, especially in his writings on the psychology
of women (Freud, 1925), the strain in psychoanalysis represented
by Melanie Klein and Otto Kernberg harkens back to the earlier
meanings. In this view, human constitutional aggression and
innate destructiveness are manifest in efforts to destroy the “good
object” just because it is good. Here I wish briefly to review the
positions of Klein and Kernberg and to suggest an alternative way
to understand envy within the psychoanalytic theory of intersub-
jectivity.
Melanie Klein (1975) defined envy as hatred directed toward
the good object. She believed that children, out of innate aggres-
siveness, resent their mother’s possession of good things, like milk,
for example, because the mother has control over the supply and
because they therefore must depend on her for it. Infants want to
spoil and destroy this goodness because they cannot have it all for
themselves. The Kleinian view places the origin of envy squarely
100 / EMOTIONAL UNDERSTANDING

within the individual, and it sees that person as progressively

isolated by the envy. Both bad and good objects get destroyed,
persecutory anxiety increases, and hope is lost as the good possi-
bilities are eliminated.
In a similar vein, Kernberg (1986) describes the envy his “bor-
derline” patients display toward their analysts as resulting from the
fact that these patients, like Klein’s infants, fear dependency. ‘To
protect themselves against their fears of being in a receptive and
dependent position, these patients devalue and attack their analysts.
In Kernberg’s words, “The greatest fear of these patients is to be
dependent on anybody else, because to depend means to hate, envy,
and expose themselves to the danger of being exploited, mistreated,
and frustrated” (p. 220). Kernberg attributes such inability to receive
to the reactivation of “oral rage and envy.” Often, he observes, this
incapability prevents learning inside and outside the analysis. Pa-
tients feel that their envy will destroy the analyst and that they
therefore cannot face it or move beyond it.
While the Klein-Kernberg view sees envy as always expressing
innate aggressiveness and natural hostility, self psychologists often
conceptualize envy as the manifestation of a patient’s self-experi-
ence as deficient, inadequate, or shameful. Kohut (1971) made
explicit the connection between shame and envy:

The intense reactions of such [shame-filled] people to their setbacks

and failures, too, are—with rare exceptions—not due to the activity
of the superego. After suffering defeats in the pursuit of their
ambitious and exhibitionistic aims, such individuals experience at
first searing shame and then often, comparing themselves with a
successful rival, intense envy. This state of shame and envy may
ultimately be followed by self-destructive impulses. These too, are
understood not as attacks of the superego on the ego but as attempts
of the suffering ego to do away with the self in order to wipe out the
offending, disappointing reality of failure. (p. 181)

Envy, then, expresses longstanding feelings of shame and inade-

quacy, generated—in an immediate instance—by an experience of
failure.
Alice Miller (1986) describes envy as a manifestation of per-
vasive underlying feelings of inadequacy:
 Affect and Emotional
Life / 101

A patient once said she had the feeling that she had always been
walking on stilts. Is somebody who always has to walk on stilts not
bound to be constantly envious of those who can walk on their own
legs, even if they seem to him to be smaller and more “ordinary”
than he is himself? And is he not bound to carry dammed-up rage
within himself, against those who have made him afraid to walk
without stilts? In this way, envy of other things can appear, the result
of the defense mechanism of displacement. Basically he is envious
of healthy people because they do not have to make a constant effort
to earn admiration, and because they do not have to do something
in order to impress, one way or the other, but are free to be “average.”
(p. 330)

In contrast to the constitutional aggression theories, Miller sees

envy as reactive, as a product of an emotional climate that has
deprived a child of healthy pride and self-esteem.
A view grounded in intersubjectivity theory would take the
approaches of Kohut and of Miller one step further and see the
envy as arising in response to specific and regular patterns of
experience in the emotional environment. Envy might arise origi-
nally from the experience of failure—itself an intersubjectively
generated experience—to which the caretaker responded with con-
demnation or scorn, compounding the damage. For example, the
parent may have pointed out the child’s failures to others and/or
may have compared the child to a sibling, relative, or neighbor who
learned faster or was better coordinated. The child, in response to
feeling unworthy and devalued in the eyes of those whose opinions
naturally mattered most, forms a pattern of shame-based envy.
Every subsequent occasion when someone else possesses some-
thing good becomes another indication of the child’s failure and
worthlessness. Often this envy becomes coupled with a fundamen-
tal conviction of being doomed to failure. Then, of course, many
failures result, and the invidious comparisons continue.
This type of shame may begin as early as the first year oflife.
Daniel Stern (1985) views the infant as forming a rudimentary
self in the first year, including what he calls the “subjective self”
(p. 124ff.). This self is based on affect attunements and involves
the infant’s recognition of the other’s recognition of the infant’s
emotional experience. I imagine that continual or traumatic
misattunements impair the development ofa sense of effectancy.
102. / EMOTIONAL UNDERSTANDING

I further suspect that these misattunements form the early foun-

dation for the child’s later sense of worthlessness, with its accom-
panying envious conviction that others always have (are worth)
more.
If we attend closely to the relational contexts in which envy
occurs, we may find ourselves questioning the innate aggression
theory of envy. A patient in his early 30s, for example, who
originally sought treatment for panic attacks, became extremely
anxious in social situations in which he had to converse with young
couples who already owned homes. His envy of homeowners—
especially of those whose parents had provided them with the
down payment—was a manifestation of his shame and embarrass-
ment over his original “home.” His abusive father had abandoned
him as a toddler to the care of his alcoholic mother and schizo-
phrenic grandmother, both of whose screams were often audible
to neighbors. The shame also reflected his expectation that others
would see him as a loser. This patient spent his first 3 years in
treatment attempting to convince me that he—the patient—was a
truly terrible person and that something was terribly wrong with
him. My inability or refusal to adopt the view of him that he
assumed I must have provided a new context in which to organize
his experience of himself in the presence of others.
Another patient, an incest-and-torture survivor, continually
envies the “normality” of her peers. She envies their happiness,
their families, their apparent ease. This envy often arises, however,
in a specific intersubjective context: She has confided parts of her
story and some of her hopeless feelings to a friend or family
member, who responds by telling her to let the past go and get on
with her life. First she finds herself withdrawing from the would-be
advisor, but then she wonders why she cannot follow all this good
advice and envies those who seem able to do so. She then enters
a period of intense self-loathing; envy is transformed into shame.
In treatment, she expects me to experience a similar impatience
with her, and she is constantly on the alert for the tiniest signal
that I may find her impossible or disgusting.
In a third example, an actress becomes depressed when her
peers get roles for which she has auditioned or when they become
“household names.” She envies their success, their money, their
friends, their self-confidence. When she is working as an actress,
 Affect and Emotional
Life / 103

she experiences little envy and is pleased for others who succeed.
Her sense of success, however, never outlasts the current perform-
ing engagement. In her family, her performing was never welcome,
and, after 15 years and some successes in “the business,” her father
still asks when she is going to grow up and get a job. Her mother
assumes that the patient will create a disaster out of anything she
attempts. The envy arises as an expression of shame over her
family’s and her own expectations of failure. “What’s wrong with
me?” the patient sobs, assuming I too will believe this is the right
question. Her past accomplishments usually seem completely
unreal to her.
In treatment, envy of the therapist/analyst may be an expres-
sion of this shame. The analyst’s education, office, fees, vacations,
and even manner of dress may evoke envy linked to the patient’s
sense of being a hopeless failure. Recently a young man said he
envied me my sense of security. Patients often believe their thera-
pists have more knowledge or possessions, better family relation-
ships, and better mental health than they do. While these beliefs
often manifest patients’ generalized convictions, they also result
from our professional demeanor or reserved behavior. The shame-
based envy often arises in specific situations of misunderstanding
or misattunement. Sometimes I miss the despair in a patient’s
account of failed attempts to form friendships and intimate rela-
tionships. Then the patient may conclude that such matters are
easy for me, that I have all these things in abundance, and that I
could not possibly understand such a shameful and hopeless case.
Close attention to the intersubjective contexts in which envy of the
therapist occurs may yield evidence to challenge the innate-aggres-
sion theory of envy. The disruptions may evoke generalized emo-
tional organizing principles based in early experiences of self-with-
other.
To summarize, I think that it is reasonable to understand envy
in most instances as a relational expression of shame, that is, of a
severe devaluing of the self. Sometimes it may involve deficits in
the sense of self as continuous, times when there is a lapse in a
person’s ability to retain a sense of the reality of past successes.
Envy usually arises when a person compares him- or herself with
others to the detriment of the self. It is often specifically triggered
by misattunements experienced as meaning that something is
104. / EMOTIONAL UNDERSTANDING

wrong with the person. When we as therapists respond to envy in

a patient, not as though it were evidence of hatred and aggression,
but rather as an expression of the presence within the patient of
a sense of self-as-deficient (perhaps in the context of an intersub-
jective misattunement) the patient will usually feel understood,
that her or his self-experience has been treated with respect.
Envy thus serves as an example of my contention that emo-
tional life is inherently complex and relational. The emotion itself
is complex, though its intensity can mislead us into seeing it as a
simple entity. In addition it has complex ties to a person’s whole
organization of emotional experience and to the particular rela-
tional situation in which it arises. The healing of an emotional life
full of envy involves not so much affect tolerance (Krystal, 1988),
as it requires that patient and analyst understand together the
complex involvement of the patient’s basic emotional sense of a
deficient relational self. When this sense of self becomes stronger
and more positive, envy recedes or disappears, and with it much
shame.
To sum up, I have argued for replacing an atomistic concep-
tion of affects—a too-easy substitute for instinctual drives as the
explanatory foundation in psychoanalysis—with an attentiveness to
the totality and complexity of aperson’s emotional life. The details
and the history of the particulars are important but only as far as
they conduce toward understanding a person’s organized emo-
tional “sense of things.” We must neither reduce the whole emo-
tional life to the sum ofits parts nor mistake the affective trees for
the emotional forest.
tiie Agel EK Ss

Emotional Memory

I would unlearn the lingo of exasperation. . . .

I would believe my pain, and the eye quiet on
the growing rose.
—THEODORE ROETHKE, “The Longing”

lesychoanalytic understanding requires memory. To make sense

of ourselves we need to remember how we came to feel and act as
we do. An important problem in contemporary epistemology,
however, has been its ahistorical character. The recent psychoana-
lytic emphasis on the here-and-now and on the collaborative
construction of narratives can similarly neglect development and
history. Yet a conception of psychoanalytic understanding based
in intersubjectivity theory—which views all emotional life as con-
figured by past relational experience, requires an enriched appre-
ciation of remembering.
“Emotional memory,” one type of remembering, is any felt
residue of the relational past. A situation, a thing, or an event—a
separation, a sofa, a graduation—produces emotion in us—fear,
anticipation, sorrow—we may not understand. Emotional memory,
which names a cluster of ways of knowing, reexperiencing, and
expecting, largely noncognitive and nonverbal, has long been
known to psychoanalysis. It includes transference, dreams, body
memory, vague and particular dreads, many moods, overreactions,
and the experiences underlying some forms of repetition. Al-
though the content of emotional memory may be verbal experi-
ence, we usually carry such memory in nonverbal forms. Begin-

105
106 / EMOTIONAL UNDERSTANDING

ning with Freud, psychoanalysts have known that nonverbal expe-

rience can carry meaning. The concept of emotional memory
provides a way to think about the connections among the phenom-
ena of preverbal and wordless memory. What the phenomena have
in common is the continuing emotional effects—conscious or
unconscious—of our relational history.
Emotional memory is not necessarily pathological or patho-
genic; it is human. We carry our history within us, only a small part
of which is cognitively processed. Most experiencing is visceral,
emotional, and only partly organized. Relational circumstances—
including, of course, the implicitly relational experience of being
alone—that somehow resemble earlier ones can trigger or evoke
such emotional memory. Close attention to emotional memory,
and to those events that evoke it, can expand and deepen our
psychoanalytic understanding. It is often emotional memory, not
immediately recognizable as memory, that we attempt to make
sense of together in analysis.

SOURCES OF THE CONCEPTION

OF EMOTIONAL MEMORY

The notion of emotional memory has obvious antecedents. Several

recent philosophers, in contrast to the midcentury reduction of
philosophy to linguistic analysis, have insisted that experience
includes more than words can express. French philosopher Henri
Bergson (1910), for example, emphasized the temporal continuity
of experience, as contrasted with the atomist discontinuities so
beloved by empiricists. In his words:

We instinctively tend to solidify our impressions in order to express

them in language. Hence we confuse the feeling itself [of temporal
duration, for example] which is a perpetual state of becoming, with
its permanent external object [the clock], and expressly with the word
which expresses this object [time]. (p. 130)

Similarly, Alfred North Whitehead (1948) pointed out the neces-

sary incompleteness of linguistic cognition: “There is not a sen-
tence which adequately states its own meaning. There is always a
background of presupposition which defies analysis by reason of
 Emotional Memory / 107

its infinitude” (p. 73). Whitehead suggested both humble and

proud views of linguistic expression. Language captures only a
small part of experience, but language invests the present with the
past and renders the past “articulated memory.”
Philosopher Michael Polanyi (1958) wrote extensively about
tacit knowledge, the “more than we can say” that we know. Polanyi
spoke of the personal participation of the knower, including what
Polanyi called the inarticulate or the “ineffable.” Not intending the
mystical connotation of the term “ineffable”, he used it instead to
mean “something that I know and can describe even less precisely
than usual, or even only very vaguely” (p. 88). As examples, he cites
knowing how to ride a bicycle or how to recognize one’s own
raincoat. There is no reason, he claimed, for this kind of knowledge
to be articulable. The problem, he thought, lies in the common
assumption that only what language can articulate counts as
knowledge. He cites Wittgenstein’s (1921) famous aphorism,
“What we cannot speak about [as a verifiable proposition of
natural science] we must pass over in silence” (p. 74). This ex-
presses, in Polanyi’s view, both the Cartesian devotion to clear and
distinct ideas and the modern philosophical allegiance to linguistic
clarity. Such clarity comes at a price: The richness of tacit knowl-
edge, and its personal character, are lost. In psychology and the
other social sciences, Polanyi thought, this becomes an important
loss. Not surprisingly, he criticized Freud for his advocacy of
scientific detachment in psychoanalysis.
Tacit or inarticulate knowledge includes topographical knowl-
edge—the knowing-one’s-way-around of a surgeon or a taxi driver—
and instrumental knowledge—skills such as diagnostics to be
taught and learned by example. Another form of inarticulate
knowledge is “our own capacity to distinguish what we know from
what we may be saying about it” (p. 91). The “what we know” is
existential meaning, an understood but not articulated meaning.
In addition, words themselves have subsidiary inarticulate
meaning that includes memory:

Words convey nothing except by a previously acquired meaning. . . .

When I receive information by reading a letter and when I ponder
* . . . , . .
I think Polanyi misunderstood Wittgenstein here. Wittgenstein’s Tractatus Logico-Philoso-
phicus (1921) emphasizes a distinction between saying and showing. Many important
realities can be shown.
108 / EMOTIONAL UNDERSTANDING

the message of the letter, Iam subsidiarily aware not only of its text,
but also of all the past occasions by which I have come to understand
the words of the text, and the whole range of this subsidiary
awareness is presented focally in terms of the message. (Polanyi, 1958,
p22)

Polanyi did not directly address the question of emotional

knowledge. Still, his notion of “tacit knowledge,” knowledge by
personal participation in the known, is an important conceptual
foundation for what I am calling emotional memory. Not every
instance of tacit knowledge is emotional memory. Nevertheless,
many bits and pieces of procedural knowledge—the topographical
and instrumental skills mentioned above—involve a wordless sense
of the relational context in which they were learned. A child learns
to tie his or her shoes, to tell time, or to ride a bicycle, for example,
in a particular emotional environment, which may be intimate or
distant, supportive or scornful. The accompanying emotional
memories may become articulable, but most frequently they just
continue to form the underlying emotional tone of much adult
experience. Perhaps whenever the adult needs to learn something
new, he immediately feels “like a klutz” or “like a loser.” Another
adult may feel awkward or embarrassed every time someone is
watching while she ties her shoes. In this example, the tacit
knowledge of how to tie one’s shoes also includes the tacit knowl-
edge—the intersubjectively formed organizing principle—that one
is a failure.
Similarly, Gadamer’s philosophical hermeneutics points out
the ways in which words only partly express what is unsaid. In a
conversation, both speakers and listeners bring a web of precon-
cepuion—Gadamer’s “prejudice”—and tradition, thereby creating a
new tradition from their exchange. History and memory thus
become the unarticulated bases of all attempts at understanding.
In Gadamer’s (1991) view, prejudice—preconceived bias—forms
the possibility of our knowing anything, especially something new.
Memory, tacit or articulate, unconscious or conscious, makes new
experience and knowledge possible. Just as we cannot read without
prior knowledge of language, we cannot experience our emotional
life in the present without the web of felt meaning that we carry
from our past.
 Emotional Memory / 109

In “Remembering, Repeating and Working Through,” Freud

(1914) introduced the idea of repetition as remembering to psy-
choanalytic thought. He believed that patients usefully enact what
they cannot remember directly. They repeat the experiences un-
derlying their symptoms, inhibitions, “unserviceable attitudes,”
and “pathological character traits” (p. 151). Thus, without having
to recognize the sources of their difficulties, patients bring their
troubles into the treatment. In Freud’s words, “one cannot over-
come an enemy who is absent or not within range” (p. 152). The
conception of emotional memory, therefore, has its roots deep in
the beginnings of psychoanalysis.
Emotional memory, however, differs from, and includes
more than, repetition. The notion of repetition—usually refer-
ring to repeated patterns of behavior or interaction—describes
people from an external viewpoint. The idea of emotional memory,
on the contrary, highlights the subject’s experience, felt now as if it
were then. In analysis we commonly find that the intersubjective
field both evokes and develops such remembering. Recently I
told a patient that I had visited and liked her hometown. In
response, she began to tell stories of having been tormented
and terrorized by older girls in junior high school. She com-
mented that she had not remembered these experiences for
many years. We could link her terror then to the rage she now
feels at some kinds of mistreatment. Perhaps it was my venturing
even a mild feeling about her hometown that opened up her
access to emotional memory.
Ferenczi, too, alerted us to the physical-emotional ways
that we carry our history. His work with survivors of incest
(Ferenczi, 1933) significantly anticipated what today’s clinicians
(e.g., Horowitz, 1986; Herman, 1992) understand about post-
traumatic stress. He recognized that experiences of confusion
and shame could live on in a person’s experience. For instance,
Ferenczi (1929) found that a hated child could encode this early
relational experience into a lifelong desire to die or a reduced
desire to live. He noted that such emotionally encoded convic-
tions were impervious to talk therapy alone, and he wondered
what else might help.
Ferenczi (1932) thought that adults have two systems of mem-
ory: subjective memory (emotional and bodily) and objective mem-
110 / EMOTIONAL UNDERSTANDING

ory (of external events). Infants, on the contrary, have only subjec-
tive and bodily sensations and responses, and thus only subjective
memory. He believed that this subjective memory continues to
predominate for the first 3 or 4 years of life. Yet at moments of
trauma, people of all ages register experience in this mode. “The
‘memory’ remains fixed in the body and only there can it be
awakened” (pp. 260-261). Ferenczi thought it unreasonable to
expect that people would directly and consciously remember such
early experience or trauma. Instead, they reexperience or subjec-
tively remember it in analysis, and in this way traumatic memory
becomes accessible. Ferenczi’s work identifies the theoretical impli-
cations of (1) taking trauma seriously and (2) describing develop-
mental differences in ways of experiencing and knowing.
Much later, Hans Loewald (1960b) described memory as
inherently relational, “inextricably interwoven with experiences of
separation, loss, object withdrawal, or cessation of satisfying exter-
nal interactions” (p. 160). He distinguished between repre-
sentational and enactive remembering, explicitly including more
than acting out and transference repetitions in enactive remem-
bering. He held that enactive remembering is characteristically
unconscious:

From the point of view of representational memory, which is our

ordinary yardstick, we would say that the patient, instead of having
a past, 2s his past; he does not distinguish himself as rememberer
from the content of his memory. (p. 165)

Loewald noted that increased affect interferes with repre-

sentational memory because the distance required for repre-
sentation is usually absent. He also thought that moods are a form
of nonrepresentational remembering, citing anniversary reactions
as an example.
Similarly, Bollas (1987), of the British Independent School
speaks of “existential memory” and of the “unthought known.” He
considers moods, the search for transformational experience, and
the handling of the self as forms of memory. Moods, he believes,
create a “conservative object.” This object “preserves a self state
that prevailed in the child’s life just at the moment when the child
felt he lost contact with the parents” (p. 113). Bollas thinks that as
 Emotional Memory / 111

adults we seek transformational experience that changes self-expe-

rience by altering our physical and emotional environment in the
same way that caretaking, the “transformational object,” did for us
as infants. Even our treatment and handling of ourselves as adults
is a way of remembering the ways—gentle or harsh, for example—
caretakers managed us as children.
By “existential memory” Bollas means “nonrepresentational
recollection,” memory registered in one’s being. In his words, “a
person’s character is a subjective recollection of the person’s past,
registered through the person’s way of being with himself and
others” (1987, p. 35). More recently, Bollas (1989) has charac-
terized what he calls “ego structure” as memory. He claims that
“infants do internalize the mother’s actual idiom of care, which is
a complex network of ‘rules for being and relating’ ” (p. 195). The
child, he believes, organizes these relational rules and assumptions
into a deep personal structure. He continues:

Isn’t ego structure a form of memory, and its structure a testimony

to the logic of its formation rather like a building recollects an
architect’s intent? If so, this type of memory is operational and
structural and not representational and recollective. (p. 195)

My thinking about emotional memory, though not tied to object

relations theories, is heavily indebted to the writings of Bollas. His
implicit rejection of mind-body dualism provides a basis for
beginning to examine the memorial character of all human expe-
rience. His expression “somatic knowledge” (1987, p. 282) conveys
an appreciation for the way experience encodes itself in our whole
being as memory. He thus expresses anew the relational theorists’
conviction that relational experience becomes self experience. In
general Bollas expresses recognition and respect for “that part of
the psyche that lives in the wordless world” (1987, p. 3).
Likewise, Joyce McDougall’s (1989) thinking points toward
that presymbolic and largely nonrepresentational knowledge that
Iam calling emotional memory. She studies the memorial quality
of psychosomatic illness, the ways we carry our past in our bodies.
Emotion, she claims, “ts essentially psychosomatic” (p. 95). She has
dropped the term “alexithymia” (Krystal, 1988) because of its
exclusive concentration on the missing ability to verbalize emo-
112. / EMOTIONAL UNDERSTANDING

tion, and she examines instead the positive content of body

memory. Here is an eloquent example of her thinking:

The extreme fragility, observable in the course of analysis, of the

narcissistic economy of many addicted, disaffected, and somatizing
analysands, linked to the incapacity to contain and to elaborate
verbally numerous affective experiences, provides hypothetical
answers regarding possible etiological factors. At the level of recall,
there is frequently reference to a family discourse that promulgated
an ideal of inaffectivity, as well as a condemnation of imaginative
experience. Beyond these elements of conscious recall I have
sometimes been able to reconstruct with my patients the existence
of a paradoxical mother-child relationship in which the mother was
felt to be out of touch with her child’s emotional needs. Perhaps in
response to her unconscious fear of her own affective life, she (in
the analysand’s memory) controlled to the utmost her child’s
thoughts, feelings, and spontaneous gestures. While we may never
know just what transpired in the intimate bodily and psychological
exchanges between mother and infant to render emotional expe-
rience unacceptable or lifeless, we are able to observe what happens
when experiences charged with affect arise in the psychoanalytic
relationship. Pulverized affect will sometimes come to light as part
of the discovery of a lost continent in the inner psychic world. (pp.
103-104)

McDougall’s work illustrates the clinical inquiry and inference

needed to use emotional memory in the psychoanalytic situation.
She is more inclined than Iam to view body memory as patho-
logical and as resulting from a failure of verbalization. In addi-
tion, although she speaks the language of drive and discharge,
her ideas fit more comfortably in a relational framework. Her
work illuminates the effects of intersubjective experience on
bodily memory.
Kohutian self psychology has, since its beginnings, attended
to knowledge, memory, and experience that extend beyond the
realm of language. Kohut (1978b) said that long before he articu-
lated his self psychology, he was “fascinated by the problem of
understanding contentless traumatic states” (p. 932). This interest,
he said, stimulated his attempts to articulate psychological under-
standings of music. In his work on music, Kohut distinguished the
 Emotional Memory / 113

content of a parental communication, accessible to verbalization

and secondary processing, from its form or the tone. This tone may
be “piercing or cutting, heatedly angry, or coldly killing by morti-
fying distance” (1957, p. 241). Later, Kohut’s central conception
of selfobject experience conveyed his continued attention to the
wordless connections between humans and their emotional caretakers. For
example, Kohut’s identification and articulation of the constitutive
developmental function of idealizing—which by its very nature is a
wordless and remembered yearning—could only have come from
attunement to nonverbal connections and communications.
Finally, the theory of intersubjectivity developed by Stolorow
et al. (1987) provides a theoretical framework for emotional
memory. Understanding all psychic phenomena as resulting from
the interplay of differently organized subjectivities, memory can
only be seen as relational. In addition, with Daphne Stolorow (D.
Stolorow & R. Stolorow, 1987), these authors suggest that affect
forms the core of selfhood, a view that challenges the centrality
of representational knowing. The “organizing principles” for
which these authors search in their “sustained empathic inquiry”
must then be more emotional than strictly cognitive. More re-
cently, Stolorow and Atwood (1992) have reexamined and en-
riched the psychoanalytic idea of unconsciousness, expanding it
to include a conceptual place for parts of one’s history that because
they were never validated, never became conscious experience.
Their theory thus acknowledges the many ways in which early
intersubjective experience becomes encoded.

THE CONCEPTION OF EMOTIONAL MEMORY

Emotional memory includes any form or part of experience that

largely bypasses cognitive processes and carries significant resi-
dues from the intersubjective worlds of the past. Emotional
memory has an unmediated quality that makes it feel compelling.
Examples include transference, dreams, and attractions to peo-
ple who resemble our parents. In addition, the study of posttrau-
matic stress has drawn attention to nightmares, flashbacks, exag-
gerated startle responses, and rages. Recent awareness of the
sequelae of child abuse has also highlighted sexual phobias,
114. / EMOTIONAL UNDERSTANDING

impaired body sense, and extreme self-hatred as forms of emo-

tional memory.
Unlike unconsciousness, which is defined by what remains
outside awareness, emotional memory concerns what and how a
person does know. It needs no theory of repression, but requires
instead an understanding of the many ways people of any age
register and encode their experience (Schachtel, 1959; G. Klein,
1966). The idea of emotional memory does not, however, replace
that of unconsciousness; for example, we can have greater or lesser
cognitive awareness about a given form of body memory. What a
conception of emotional memory can do is explain why making
the unconscious conscious has such limited therapeutic efficacy.
The emotional memory remains embedded in the person’s organ-
izing principles, retaining much of its power until sufficient new
relational experience is in place. This new experience in turn
becomes emotional memory, which like all emotional memory is
only partly articulable.
Developmental psychologists have attempted to describe the
emergence of memory. Distinguishing between recognition and
recall, these researchers have found that infants can recognize their
mother’s face in the earliest days and months of life. Babies and
toddlers later develop more sophisticated memory capacities
(Piaget, 1968). Despite the awareness by Piaget and his followers
of sensorimotor memory, they primarily studied the development
of cognitive memory, both recall (for Piaget, evocation) and
recognition. Sensorimotor memory, which is so strongly related to
what I am calling emotional memory, became for the Piagetians
primarily a precursor of the fully representational memory of
symbolically organized schemata (cf. Jones, 1995).
More recently, in the large literature on infant cognitive and
relational capacities, Daniel Stern (1985) has provided a less
cognitive cast to the study of early memory with his RIGs (repre-
sentations of interactions generalized). Stern (1988) distinguishes
between specific and prototypic memories, seeing the latter as
representations that endure:

Since the representation is an abstracted accumulation—undergoing

constant updating—of historical events, it will be a very conservative
force upon interpreting any currently lived-event (the interpersonal
 Emotional Memory / 115

reality). In other words, past experience will have enormous weight

in the construction of present subjective experience. People will
repeat the same behaviors, selective inattentions, interpretation, etc.
This is, in fact, the single stickiest problem in therapy. (p. 51)

This conservative function of memory resembles the view of

memory presented by Piaget and Inhelder (1973), who believed
that memory in the wider sense (our total and organized store of
knowledge) has a significant influence on the particular memories
we retrieve (memory in the strict sense). In the words of Flavell
(1977), “what the head knows has an enormous effect on what the
head learns and remembers” (p. 189). We may carry these proto-
typic memories all the time, as Daniel Stern believes, or they may
arise only in response to triggers or stimuli. According to Stern,
these representations, or prototypic memories—in contrast to the
verbalizable content-laden specific memories (Piaget’s memory in
the strict sense)—carry “the full weight of past history” (p. 51).
Perhaps emotional memory consists in part of these RIGs (repre-
sentations ofinteractions generalized), but often in a less cognitive,
less organized, and more directly sensorimotor way than Stern’s
account suggests. Stern (1983) has acknowledged, however, that
affect memory is “only roughly translatable into a language code”
(p. 17). I think Stern’s view is consistent with the depth of convic-
tion with which adults hold emotional and relational organizing
principles. Stern’s work also explains why the experience behind
these principles can be difficult, if not impossible, to articulate.
Emde (1983), another infant researcher, writes of a “pre-
representational” affective core of the self. It “guarantees our
continuity of experience across development in spite of the many
ways we change” (p. 165). Emde finds several sources of evidence
for an affective core of the self. A common-sense argument is our
belief that we know another to the extent that we contact the
other’s emotional life. In addition, he mentions research showing
that similar dimensions of quality (pleasure/unpleasure) and
quantity (intensity) characterize emotional life in infants, chil-
dren, and adults. He further points out that cross-cultural studies
and infant research have found similar manifestations of emo-
tional life. Emde concludes that because affects are similar
throughout life and across cultures and research modalities, they
116 / EMOTIONAL UNDERSTANDING

represent a core experience. He also notes the evocative effect

of the mother’s emotional availability. He takes the tendency of
infants toward “social referencing”—the infant or toddler checks
the mother for emotional responses in situations of uncertainty—
as evidence for a predominant affective core of the self. If Emde
is correct, emotional memory would consist largely of prerepre-
sentational encoding of relational experience. Neither Emde nor
I believes, however, that such sensorimotor and affective encod-
ing stops with the acquisition of language. Instead, I think, such
tacit memory continues to be the core of our knowing, not the precursor
of representational, or symbolic, cognition. I thus prefer Polanyi’s
“inarticulate knowledge” or my “emotional memory” to Emde’s
prerepresentational self, but I value Emde’s emphasis on such
knowledge as the core of selfhood.
In summary, the study of emotional memory, both in theory
and in clinical practice, teaches a new respect for knowing that
precedes, underlies, and extends beyond the verbal realm. It
teaches us to presume that all experience has meaning and history,
even—or especially—when it cannot be adequately articulated. For
clinicians, this means we must often be content with partial under-
standings. We bring to our work and to our patients’ search for
self-knowledge the attitudes of understanding parents, who know
that their child’s experience somehow makes sense but that good-
enough understanding is often the best possible. This fallibilistic
attitude works well if the tie to the analyst is strong and if a safe
place has been created for the patient’s emotional life in the
analysis. In turn, the analyst’s emotional receptivity to and respect
for both verbal and nonverbal aspects of the patient’s experience
can strengthen the therapeutic bond.

CLINICAL EXAMPLES OF EMOTIONAL MEMORY

Terry came to treatment in her early 20s having heard her psychol-
ogy professor speak of the successful treatment of incest survivors.
She was born in South America, where she lived until she was 7
years old. Her mother’s family practiced revengeful sorcery exten-
sively. At the age of 4, Terry was left in their care when both of her
parents moved to the United States to find work. When she and
 Emotional Memory / 117

her older sister joined their parents 3 years later, their violent and
alcoholic father frequently beat her mother and sister, and he
raped Terry. Terry could say this much about her history when she
began treatment. A few months later she dropped out of school,
feeling that everyone could see that she was actually an animal and
not human. Occasionally, when she could not reach me, she would
write what she was feeling. Here is an example:

My poor little cells are screaming for freedom again. My whole body
is Shaky. I woke up with a physical and emotional pain in my gut. I
feel that same terrible, devastating feeling of loss. As though the most
vital part of me is dead; so why get up? To tell you the truth I’m pissed
at myself for having gotten up, because it means I’m going to live
through today. And for what?! There are tears in my eyes and pain
in my soul. I do feel as though something very precious had died or
as lost. I don’t feel real or whole. The only real thing I feel is this
overwhelming sadness and pain... . I look so fucking normal on the
outside. Meanwhile in the inside there’s a volcano, because what I
see is darkness, dirtiness, ugliness. I see a type of torture chamber, with
preces of myself on several different torturing gadgets; stretching,
turning, pulling. With ugly, threatening faces sneering at my frag-
ments and laughing at their futile attempts to escape. .. . I look out
from a small crack on the dungeon’s wall and see people singing,
playing, laughing. And I yearn so much to be one of them.

Terry sometimes found notes in her handwriting from classes

she could not recall having attended. She reported that friends
and family told her she was like different people. Sometimes she
was adult and competent, sometimes curled up in a fetal position
in a corner, sometimes flirtatious, sometimes sobbing for days at
a time, sometimes enraged and violent, though usually only
toward herself. Often she has desperately wanted to take a large
knife, cut open her middle, and get something terrible and
disgusting out.
Terry has read Sybil and knows that she resembles people
diagnosed as having multiple personalities. Over her 5 years in
treatment, what has helped most, however, has been encouraging
her to construe her diverse feelings and states as emotional mem-
ory. This process has not made everything verbalizable, but it has
had several other effects. She has gained access to more of her
118 / EMOTIONAL UNDERSTANDING

horrifying history. She has come to understand that there are

reasons for her feelings and responses that she formerly had
characterized as crazy. As a result, she is now less inclined to blame
herself, and she is less suicidal. Any sense of being loved, however,
is dangerous for her. Terry had loved, and felt loved by, her abusive
father. When she and her boyfriend decided to get married, she
“freaked out” and expected him to hurt her. Once she understood
this as remembering, she calmed down remarkably.
Because Terry had suffered severe trauma at the hands of both
women and men, a complicated transference emerged. She expe-
riences me as both benevolent and as highly dangerous. Perhaps
the emotional bond appears to promise safety, thereby evoking the
memory of other caretakers from whom she might have expected
protection. On the other hand, her parents had left her in the care
of women who mistreated her severely. Her memories of these
horrors surface in her terror of me, a physical-emotional terror
that a part of her recognizes as unrelated to the actual me. She
recoils in fright if Imake any unexpected movement. Each year in
the spring she disappears from treatment for a month or two. Only
recently have we come to understand that spring reminds her of
the weather in her South American country, which triggers feelings
that I may hurt her and that I will be unable to protect or help her.
On the other hand, she feels I am the only person who has always
treated her respectfully, who has believed in her worth when she
could not.
Terry exemplifies the wordless “unthought known” (Bollas,
1987) of emotional reaction and expectancy. My work with Terry
has involved our coming to understand together that some expe-
riences are horrors beyond words.
Some briefer illustrations may further clarify my under-
standing of emotional memory. A patient who feels immobilized
and cannot understand why he is unable to get himself to do
anything to improve his life, especially in terms of relationships,
came to see this state as memory. His psychotically depressed
mother had stayed and raged at his alcoholic and gambling-ad-
dicted father. This patient’s paralysis preserved both the inability
of his mother to change her situation and his attachment to his
more affectionate father who loved to sit and watch baseball on
television.
 Emotional Memory / 119

Another patient, learning to play bridge, found herself feeling

depressed, hopeless, and tearful. Every rational thought went out
of her head when her teacher, an older man, criticized her play of
the hand or her bidding. She came to recognize that this man’s
sarcastic and condescending tone closely resembles her father’s.
She recalled that card-playing in her family had often occasioned
these feelings in a similar relational context. Understanding such
“overreaction” as emotional memory, she could go ahead and
learn to play bridge from someone else. She did not have to
understand her feelings as meaning she was now incapable of
learning anything or doing anything right.
Another patient, a late adolescent whose principal symptoms
are both vague and particular fears and dreads, originally thought
she was simply “crazy.” Her treatment has often consisted of
exploring these fears and dreads as emotional memory. Some of
these feelings have antecedents that she can remember cognitively
but about which she had never told anyone. We understand her
silence as due in part to shame over having been repeatedly
molested as a child. In addition, she had never seen a connection
between what happened then and what she is feeling now. Her
emotional memories encode in particular the relational experi-
ence of having no one to rely on and of being taken repeatedly to
the home of the abuser even after she had told a parent about the
molestation. She has found that treatment helps because “now I
know there are reasons for my feelings even when I can’t say them.”
Also someone knows and cares about what she is feeling, even if
no one can change the facts of her history.

IMPLICATIONS

A clinical focus on emotional memory has several advantages. First

among these is a positive regard for the patient’s experience.
Traditionally psychoanalysis has emphasized the negative: the
unconscious, the out-of-control, the acting out, the resistance. Now
we can attend to what the patient does know and begin to explore
the many forms of this knowledge. A frequent side-effect of this
respect is a gradual reduction in the patient’s shame about feelings
and needs. One man said that the most helpful intervention in his
120 / EMOTIONAL UNDERSTANDING

treatment was my response that it was all right to feel disappointed

and that we could learn something from that. Even the shame itself
can express a memory. Another patient was so shame-ridden that
she would stand up and face the corner of the room when she had
to cry. We understand this as remembering her sense of how she
had felt as a child when her parents had responded dismissively to
her feelings.
Understanding emotional memory also helps explain why
symptoms rarely disappear completely and can return under stress.
Our history resides in our whole being. Insight—even emotional under-
standing—may mitigate the effects of history, slowly making them
manageable and tolerable, but the emotional history remains.
What can be healing is the relational experience of safe attachment
and of a mutually pursued search for understanding. Such experi-
ence creates new emotional memories, new tradition (Daniel
Stern, 1991), and new possibilities. Still, no analysis completely
removes the effects of rape or child abuse, or keeps the war veteran
from terror at the sound of firecrackers. We need not feel that
psychoanalysis fails because insight does not remove emotional
memory. We cannot expect that it should.
The study of emotional memory may also enhance our under-
standing of transitional phenomena (Winnicott, 1958). We can see
them as expressions of nonrepresentational relational memory.
Winnicott thought that the ability to use transitional phenomena
showed some history of attachment and was therefore a positive
prognostic sign. Similarly, we might see the capacity for transi-
tional experience as one kind of emotional memory and regard
its emergence as a sign of progress in treatment. Respect for
nonrepresentational modes of knowing and remembering can
attune us to such signs of growth.
Attending to emotional memory has other implications for
psychoanalytic understanding. Informally we might say that our
attention needs to shift, at least in part, from the words to the tune.
Many theorists acknowledge that nonverbal elements enter the
treatment process and require analysis. Often, however, this is
expressed as a concession, betraying again the psychoanalytic bias
in favor of verbalization. I believe, on the contrary, that while words
can be rich resources for the expression and empathic under-
standing of emotional experience, and can help patients respect
 Emotional Memory / 121

and appreciate their emotional lives, affective memory can be only

partly articulated. I also think that the psychoanalytic emphasis on
verbalization reflects a Cartesian mind-body dualism. It perpetu-
ates a devotion to the “myth of the isolated mind” (Stolorow &
Atwood, 1992) or to Ryle’s “ghost in the machine” (1949), concep-
tualizations that need to be rejected. This renunciation will lead
us to avoid characterizing nonverbal expressions of history and
development in pejorative terms like “enactment” or “acting out.”
We can then begin to value and explore the nonverbal expressions
and responses of both patient and analyst.
An advantage of emotional memory as a theoretical-clinical
conception is its inclusiveness. It regards as resources for psycho-
analytic understanding such indicators as tone of voice, startle
responses, and facial expression. Many clinical puzzles, about both
patient and analyst responses, yield to recognition of the emotional
memory involved. According to Peter Lessem (personal commu-
nication, 1993), the idea of emotional memory can frequently be
a clue in couples therapy to the sources of conflicts and misunder-
standings. It can open the way to empathic understanding within
the couple and in the therapist. The entry of dissimilar sets of
emotional memories into the intersubjective field of the marriage,
and into the treatment, is what all concerned need to understand.
Emotional memory, in other words, is a significant component,
only partly organized and only partly articulable, of the organiza-
tion of experience.
A correlative concept to emotional memory is “emotional
amnesia,” a common clinical phenomenon. This occurs in people
who have clear, even detailed, recall for past events but no feelings
about them. I sometimes work with rape or incest survivors who
retain clear memories of what happened, but they cannot feel
anything about it. In two instances, these patients have been
intensely suicidal. The restoration of emotional memory in such
instances becomes the central work of treatment.
Finally, analysts, no matter how well analyzed, are full of
emotional memory. Our relational experience, too, has been
encoded as the “unthought known” (Bollas, 1987), and it surfaces
with every patient in one way or another. This is the “cotransfer-
ence,” that mixture of organizing principles and personal history
that always shapes the analyst’s experience of the analytic relation-
122 / EMOTIONAL UNDERSTANDING

ship with a given patient (see Chapter 5). Our ability to attune to
our own emotional experience, verbalizable or not, must be a key
instrument that we use as we attempt to promote in our patients
awareness of and respect for the fullness of their emotional lives.
Not only do we model such awareness and respect, we also use our
emotional memory as a guide to optimal responsiveness. Thus
clinical guidelines ought to be less precise and more general than
they have traditionally been so that clinician’s emotional knowl-
edge can have room in which to work. Clinical supervision ought
to support this use of affective memory and tacit knowledge to
guide responsiveness in the treatment situation.
Not everyone agrees. Interpersonalist and social constructivist
Donnel Stern (1989) writes of countertransference as our “unfor-
mulated experience” of patients. Like Sullivan (1940), he believes
we must escape from the “grip” of the interpersonal field—the
impasse created by the nonverbal experience of both people—by
verbalization. Stern quotes Tauber and Green (1959) on respecting
the grip of the field, noting that these authors believe that without
the analyst’s capacity to be so gripped, the patient “[would] have
no respectable card of admission to the relationship” (p. 146,
quoted in Donnel Stern, 1989, p. 21). Nevertheless, the grip must
and can only be broken, according to Tauber and Green, by
reflective verbalization.
Although Donnel Stern’s “unformulated experience” may
seem to resemble my concern for the tacit elements of experience,
we have, I think, two differences. One concerns his belief that “it
is only as experience can be verbally represented that it becomes
valuable or informative” (p. 9). Without verbal articulation, we
have only unformulated experience:

Before being articulated the experiences are relatively undifferenti-

ated, and thus in the sense that they cannot be known—cannot be
reflected upon—they do not exist. Words do not clothe experience.
They construct it. (1989, p. 1)

Donnel Stern assumes, unlike Polanyi, that knowledge requires

differentiation and articulation. My conception of emotional
memory, in contrast, intends to convey a positive regard for tacit
knowledge as possessing its own truth and as sometimes dimin-
 Emotional Memory / 123

ished by our efforts to express it in words. (Nonliterary art forms

such as dance express such an appreciation for the integrity of tacit
knowing and a respect for what we sense.) Darlene Bregman
Ehrenberg (1992) articulates the importance of tacit knowing and
the limits of verbalization:

It is well known that words can serve as barriers or bridges to

communication, or as both simultaneously. Words can be used to
conceal or reveal; they can be used in an attempt to evoke feelings
or to elicit certain kinds of behavioral responses; they can be
weapons, camouflage, cries for help, a means to test another, gifts,
or even a way to put ideas and images into the mind of another. They
can be used to seduce, amuse, amaze, charm, insult, penetrate,
invade, betray, hurt, shock, deceive, distract, manipulate. . . . Since
words can be a medium for acting out by patient or analyst, and since
what goes on affectively, often nonverbally, can have profound
impact, both positive and negative, the importance of becoming
more aware of the impact of what goes on beyond words, even in the
context of verbal communication, cannot be overestimated. (p. 14)

Second, some interpersonalists, and Donnel Stern in particu-

lar, seem to minimize the role of memory in shaping human
experience and in the formation and maintenance of a sense of
self. They speak as if analysis consists of horizontal slices of the
here-and-now, in which only interpersonal influence in the present
is examined. My view, like that of the developmental-relational
theorists (e.g., Ghent, 1992), presupposes a longitudinal, develop-
mental inquiry and sees the present as importantly formed by
memory.
Even so, Donnel Stern calls attention to the centrality of the
analyst’s tacit experience of the patient. He suggests that gaining
some access to this knowledge may break up therapeutic impasses.
Such emphasis on the analyst’s use of self-experience to under-
stand relational experience, and vice versa, is one part of the
pragmatic usefulness of the conception of emotional memory.
This chapter has investigated notions that we already use.
Terms like the unconscious, sensorimotor knowledge, alexithymia,
the prerepresentational self, and even affect have their place in
historical and contemporary psychoanalytic discourse. Still, none
of these quite captures the sense of visceral knowledge that I am
124. / EMOTIONAL UNDERSTANDING

calling “emotional memory.” There may thus be a theoretical

justification for coining a new term. My motivation, however, is
more practical: The term “emotional memory” speaks to many
patients with no translation and little explanation beyond saying
that our history lives within us. I find that many patients use the
term “emotional memory” as an access point to rich associative
material.
The advantages also accrue to the analyst. If our theories use
terms that need little translating, we can stay closer to the patient.
In addition, using the term emotional memory encourages a
salutary, intellectual humility. Technical terms can deceive us, and
our patients, into thinking we know more than we do. If we have
to say what we mean in everyday words, we are more likely to
encounter the limits of our understanding, as well as the limits of
the verbal realm. Perhaps as psychoanalytic fallibilists we will admit
more often that we do not know very much. This more modest
attitude can produce a “let’s figure it out together” replacement
for the psychoanalytic emphases on verbal interpretation as some-
thing an analyst gives to a patient and on the analyst’s authority or
expertise.
Finally, experience-near language is usually indefinite. Phi-
losophers since Aristotle have cautioned us against seeking more
precision than the subject at hand warrants. Emotional truth,
powerful as it is, may often be uncertain as to content. As psycho-
analysis gradually relinquishes its claim to be a natural science and
takes its proper place among the realms of human wisdom, the
uncertain and the imprecise will find the respect they deserve.
Cte NAR RO

Emotional Availability

The quality of understanding is personally

endured.
—Dina VaLiino Maccio, “Surviving,
Existing, Living: Reflections on
the Analyst’s Anxiety”

JEefore the emergence of the recent relational emphasis in

psychoanalysis, analysts often attributed analytic success or failure
to the “analyzability” of the patient. Now we place more weight on
the abilities of agiven analyst to work with a particular patient. We
look at our emotional history and organizing principles, including
our theories, and call these countertransference or cotransference
(see Chapter 4), noting that they are often evoked by analytic work
generally and by work with a particular analysand. In this chapter,
however, I wish to consider a more general ability or disposition
of analysts that I call “emotional availability.” I view emotional
availability as an underlying and often overlooked element in the
success or failure of therapeutic relationships. It is an indispensable
condition for the possibility of psychoanalytic understanding, and
it thus deserves consideration as part of a psychoanalytic episte-
mology. Emotional availability is an active and responsive prepar-
edness for empathic understanding.
Attachment researchers Emde and Sorce (1983) claim that the
emotional availability of caretakers provides emotional security for
infants and promotes their exploration in situations of uncertainty.
By “emotional availability” they mean (1) the mother’s communi-

125
126 / EMOTIONAL UNDERSTANDING

cating her awareness of the child’s emotional states and (2) her
readiness “to respond empathically and to offer her own emotional
expressions as information when the infant is uncertain and looks
to her” (p. 26). These researchers found that infants whose mothers
were emotionally available showed more pleasure in play, a higher
level of play, more exploration and curiosity, and more active—
though less clingy—interest in their mothers than did those infants
whose mothers were reading a newspaper. Emde and Sorce believe,
thus, “that maternal emotional availability plays a crucial role in
infant development since it helps to create an atmosphere that
fosters enjoyment, curiosity, and enhanced opportunities for learn-
ing” (p. 28).
This view, reinforced by studies of infants with depressed
caretakers (Cohn & Tronick, 1983; Tronick, 1989), has obvious
implications for a developmental view of health and psychopathol-
ogy. My concern here, however, is with a psychoanalytic parallel
rather than with the developmental consequences of the argument
made by Emde and Sorce. | think that the analyst’s emotional
availability provides an atmosphere of emotional safety that en-
courages exploration and curiosity in the patient in the same way
that the caretaker’s emotional availability does for the infant. In
addition, I propose that emotional availability has the same com-
ponents in both infancy and analysis and that it operates by the
same primary communicative means, vocalization and visual ref-
erencing.
The first component of emotional availability is the care-
taker’s communication “through her behavior that she is aware
of the infant’s emotional expressions and is monitoring ongoing
activity” (Emde & Sorce, 1983, p. 26). Similarly, Kohut (1971)
pointed out the self-sustaining effects of parental mirroring of
the child’s emotional states. In analysis, we convey emotional
availability to patients in various ways. We vocalize in verbal and
semiverbal ways, fine-tuning our responses to convey our aware-
ness of patients’ emotional states by our choice of words and
tone. We sit in ways that respond to patients’ emotional commu-
nication, and we adjust the heating or lighting for their comfort.
Once a patient decided to enter treatment with me because, she
said, “You make faces.” Whether or not I was saying anything,
she could tell I was staying with her. For another person the
“noises” I made performed a similar function, just as a listener
 Emotional Availability / 127

on the telephone communicates attentiveness by making

semiverbal sounds. Probably a person’s inborn preference for
visual or auditory processing combines with her or his emotional
history to determine the channels of receptivity to emotional
communications. Like sensitive parents, we must be ready to
adjust our mode of expressing emotional availability to suit the
receptive capacities of a particular patient.
This component of emotional availability, a readiness to at-
tune and respond, is nonspecific. First, it can take many forms. We
convey this readiness for attunement in many nonverbal ways, and
thus it can be missed in written transcripts of treatment. A super-
visor or consultant who looks for this intersubjectively determined
capability for responsiveness may register its presence or absence
in the supervisee’s liking or disliking the patient. Its absence can
also be detected in frequent distancing responses, often justified
by reference to theories that support analytic neutrality and ano-
nymity. Frequent reference to diagnostic categories is another
indicator of emotional distancing. Embracing the concept of
emotional availability erases neutrality and anonymity as rules for
analytic conduct. Analysts who are emotionally available adjust
how much they reveal of themselves to their patients to the needs
of the individual patient, in the same way that parents attune their
level of accessibility to the child.
This first component of emotional availability is nonspecific
in another way. It is a general disposition, readiness, or responsive-
ness (Bacal, 1985), not a type of interpretation, intervention, or
response. Lichtenberg, Lachmann, and Fosshage (1993) commu-
nicate this point by emphasizing the need to examine a sequence
of analytic exchanges to gain a sense of the responsiveness of the
analyst to the shifting and developing states and experiences of the
patient. Emotional availability is captured beautifully in a photo-
graph of Winnicott and a child patient (Grosskurth, 1987, p. 372).
There he looks affectionately absorbed in and fascinated by the
child, exemplifying his notion of “primary maternal preoccupa-
tion.” In addition, his writings about infancy and about psycho-
analysis, as well as Margaret Little’s (1990) account of her analysis
with him, convey Winnicott’s awareness of the particular impor-
tance of his emotional availability in some treatments, especially
those involving significant regression. Little’s account further
describes the interference of concurrent events in the analyst’s life
128 / EMOTIONAL UNDERSTANDING

on his or her emotional availability and of the significant effects

on treatment of even temporary unavailability of the analyst.
The Winnicottian “holding environment” is another way to
speak of emotional availability. Its essential component—an at-
tuned, nonintrusive presence—creates the emotional safety neces-
sary for the development of a child’s or patient’s “true self” or
“idiom” (Bollas, 1989). This nonspecific presence, or facilitating
environment, makes possible the child’s or patient’s personal,
idiosyncratic, and articulated selfhood.
Generality is another way to speak of the nonspecific character
of emotional availability in both early caretakers and analysts.
Many parents can respond only to those feelings and emotional
expressions of their children that affirm themselves. Similarly, we
analysts may have restrictions on our emotional responsiveness,
overall or with some patients. One man, for example, remarked
that his previous therapist was “all there” when he brought good
news. When he was sad, disappointed, angry, or perplexed, she
was “gone.” Certain patients, moreover, come to us for just that
generality of emotional availability that they miss in themselves.
An actress once came into treatment with me because, she said,
she could not “get into” some emotions and was thus restricted in
the parts she could play well. Needing to find me emotionally
available in just those areas where she was not, she was especially
alert to my emotional limitations. Thus we analysts need to be
aware of the limits of our potential for empathic responsiveness
and work continuously to expand these abilities. Freud (1912)
pointed toward this full availability of the analyst in his expression
“evenly suspended attention” (p. 111). Unfortunately, he down-
played the emotional aspect both in this statement on technique
and in his metaphor of the analyst as surgeon (1912, p. 115).
Let us now return to the definition of emotional availability
provided by Emde and Sorce (1983): “She [the mother] is available
to respond empathically and to offer her own emotional expres-
sions as information when the infant is uncertain and looks to her”
(p. 26). This readiness to offer our emotional expressions—verbal,
semiverbal, or nonverbal—is a crucial component of the conversa-
tion that creates psychoanalytic understanding. We offer our
emotional expressions, not as a substitute for those of the patient,
but as pump-priming, or facilitating, responses, our participation
 Emotional Availability / 129

in the analytic squiggle game (Winnicott, 1965). Often our at-

tempts will be inaccurate, but in the atmosphere of emotional
safety provided by this very responsiveness, many patients can use
what we offer as a kind of catalyst for their own emotional
expression. We show by such attempts that we are trying to
understand, that we can imagine the patient to be having some
emotional response, and that various—and perhaps less-than-ele-
gant—expressions of emotion are more than acceptable to us.
These attempts are trial balloons, similar to those interpretations
by which we test the limits of our understanding (Winnicott, 1989),
and they convey to the patient that guessing is just fine. Together
we are attempting to find and create an understanding.
Concrete clinical expression of this emotional readiness to
offer a response depends both on the therapist’s style and on the
intersubjective situation. With certain patients, I lean forward in
my chair, and the conversation intensifies. Others are frightened
by my leaning forward, and they lose track of what they were
saying. With some patients, I start sessions by asking how they are
feeling. This has the advantage of establishing an emotional com-
munication from the beginning of the session. Often I respond
quite spontaneously to stories I am told with “Oh, no!” or “Ouch!”
With someone who finds it difficult to feel except by somatizing,
I sometimes tell the patient what I or others have felt in similar
situations. If I perceive that my trial balloon is not resonating with
the patient, I will then ask again what the patient is feeling. My
emotional responses and attempts to prime the pump often evoke
emotion in patients, even in people generally distant from their
emotional lives.
Reluctance to engage in such use of our own emotional life to
get closer to patients and to support their expression and explora-
tion may come from several sources. Many therapists endured the
deprivation of a silent and invisible analyst who believed that this
analytic posture would promote intrapsychic structuralization.
Like parents who raise children as they were raised themselves, we
often treat our patients as our analysts treated us. Another possi-
bility is that some of us, like Freud, may dislike having others look
at us for many hours a day. We may use the traditional analytic
setup and procedures to protect ourselves from the effort of
emotional engagement, which is so similar to the hard work of
130 / EMOTIONAL UNDERSTANDING

good-enough parenting. Too, we may be uncomfortable being

wrong as much as we will inevitably be if we offer our emotional
responses to patients, fearing that we may compromise our profes-
sional stature.
Another reasonable concern is our fear that our emotional
availability will be experienced by the patients as intrusive, a fear
that is especially likely if our own parents or analysts substituted
their realities or agendas for ours. We must continuously monitor
patients’ experience of us, including their sense of our emotional
response to them (Hoffman, 1983; Aron, 1991, 1992). This infor-
mation provides a guide for when and how to offer our emotional
responses. As with children, we see whether they feel free to come
and go (as in secure attachment) or whether they become more
than temporarily clingy or oppositional (as in insecure attach-
ments). Emotional availability does not mean making or not
making any particular response. Instead, it means a continuous
readiness to explore thoughtfully the emotional experience, inter-
subjectively configured in the transference and cotransference, of
whatever we do or do not do with the patient.
One young man had been seriously disorganized by the de-
mands of his parents to adapt to their suddenly changing agendas.
For the first 4 years of treatment he experienced almost anything I
said or did as an attempt to crush him by imposing my thoughts,
feelings, and needs on him. He used to complain that analysis and
psychotherapy were set up, scheduled, and arranged for the conven-
ience and needs of therapists and not of patients. After 4 years of
treatment, he announced, “I think you are actually on my side.” He
had gradually come to see—by my having acknowledged and con-
firmed his view that my needs largely did structure the analytic
situation—that I in fact accepted his sense of the tyranny of my
interventions and of the whole arrangement. Feeling that his point
of view had been accepted, he came to believe that I would seek and
follow his agenda, which in time translated into a sense that I was
with him, that I was emotionally available to support his growth into
a person in his own right. In the words of Mitchell (1988):

Unless the analyst affectively enters the patient’s relational matrix or,
rather, discovers himself within it—unless the analyst is in some sense
charmed by the patient's entreaties, shaped by the patient’s projec-
 Emotional Availability / 131

tions, antagonized and frustrated by the patient’s defenses—the

treatment is never fully engaged, and a certain depth within the
analytic experience is lost. (p. 293)

Similarly Renik (1993) advocates revisions in our theory of tech-

nique “that will make it unnecessary for us to ask ourselves, in vain,
not to be passionately and irrationally involved in our everyday
clinical work” (p. 570).
In another instance of offering emotional expressions, I ex-
pressed a sense of differentness. A 40-year-old man who had
devoted himself to improving the world through political action
found himself isolated and depressed. He knew he had always felt
this way, and he saw little hope for change in his experience. He
came to each session saying he could not see what therapy was
doing for him, or could do. He believed that only political and
social changes were important; the minutiae of his feelings and
history were uninteresting and mattered little. For months I tried
to find ways to enter his experience and respond with empathic
understanding. Finally I said that I had a different feeling, that, to
me, the nuances, details, and “minutiae” of his emotional life and
history weve interesting and important, and that I guessed we really
had a big difference of opinion. He left the session with a puzzled
look. In his next session, however, he told me stories of his
childhood, speculated about their influence on his life, and ap-
peared genuinely interested in my comments. Although one could
worry about compliance, this patient tends more to opposition.
The change lasted, with some fits and starts. Perhaps, offering my
interest—in Emde and Sorce’s (1983) words, my emotional expres-
sions—grounded him and gave him the emotional security needed
for reflective exploration of his own experience.
A third fear related to offering patients our own emotional
expressions is that it will make them dependent on us and will
interfere with the articulated development of their own experi-
ence. Careful monitoring of the impact of our emotional availabil-
ity on our patients can prevent this. Toddlers cling less and explore
more when the caretaker is emotionally available but not intrusive.
Many of our patients, however, come to us with seriously disturbed
attachment histories. The most ordinary emotional availability or
responsiveness, as Winnicott (1965) and Balint (1968) noted in
132. / EMOTIONAL UNDERSTANDING

their studies of regression to dependency, may evoke the response

of a starving person when offered ordinary food. Or our patients
may display the signs of the anxious, clingy attachment that a child
would after a natural or human disaster. At this point, we therapists
stand at an important intersection. We may panic in the face of the
regression, ask ourselves what we are doing wrong, and then
withdraw from the patient—perhaps by using a “borderline” diag-
nosis—confirming her or his worst fears. On the other hand, we
can understand the clinging as a temporary traumatic response,
remain emotionally available, and wait it out, trusting that emo-
tional security will return or establish itself for the first time. We
must know, even if the patient cannot, that dependency, within a
secure attachment, is a necessary step on the road to the interde-
pendence characteristic of mental health.
Finally, we may avoid emotional availability because it makes us
feel vulnerable, not only to the patient but also to our own inevitably
unfinished business. To understand from within emotional attach-
ment means, as Ferenczi and others have found, that we revisit our
own pain. I think that a principal reason for a training analysis is to
know the sources of our own suffering deeply enough so that we can
connect with the suffering of others. Knowing our cotransference—
our personal history and our emotional organizing principles—can
make greater emotional availability possible.
Two notes of caution are in order. The first is that emotional
availability does not mean providing patients with whatever they
want. The toddlers studied by Emde and Sorce were not allowed
dangerous toys, and the mothers had to remain in their chairs.
Parents must prevent children from doing dangerous things and
from harming others. Similarly, we can set limits based on the
needs of our patients or of our own. Like parents who need some
rest or a moment to go to the bathroom, our emotional availability
can have limits. Winnicott, for example, allowed himself to have a
genuine vacation even if he had to hospitalize a patient to make
this possible (Little, 1990). We must respond as fully as we can
when we are with our patients and, like good parents, help them
manage when we cannot be with them. Emotional availability, for
analysts or for parents, does not mean having no limits or bounda-
ries. It does, however, challenge us to understand where and why
we set these limits.
 Emotional Availability / 133

Second, emotional availability is always limited by the particu-

larity of analyst and patient. Our cotransference includes our
emotional history and the general inferences (organizing princi-
ples) we have drawn about ourselves and others from this history.
These principles lead us to adopt theories of human nature, some
of which may be psychoanalytic theories. These theories also form
part of our cotransference, and they limit or expand our emotional
availability to patients generally. This is particularly evident with
patients whose emotional organization interacts with ours, making
us more or less or differently responsive.
Many impasses in treatment develop because the organizing
principles of patient and analyst are too different for them to find
or maintain a common ground of understanding. Other treatment
problems develop, as the intersubjectivity theorists have repeatedly
shown (Stolorow et al., 1987), because analyst and patient are too
similar in their emotional organization. This situation, or “inter-
subjective conjunction,” can make it difficult to recognize what is
going wrong, or why the treatment seems not to be progressing. A
40-year-old woman, for example, came for treatment because of
intense anxiety and growing depression, with an alarming wish to
be dead that she related to her failing marriage. She had, out of
deference to her parents’ wishes, married a wealthy man and had
become a very competent servant, managing the home and pro-
viding excellent care for their two daughters, now adolescents. She
reminded me of Stevens, the butler in Remazns of the Day. With no
sense of a life, or preferences, or opinions, or purposes of her own,
her only function was to make sure things ran smoothly for the
nuclear and extended families. In the culture of both her and her
husband’s families, this was the only role for a woman, even an
extremely intelligent one.
For many years, by her original account, the system had run
smoothly. Her family of origin had been “wonderful” and her
marriage “okay.” Only now, when she had developed a friendship
with another married woman, had she begun to feel so anxious
and depressed. The company of this friend made her feel impor-
tant in her own right, and comfortable and safe in ways she could
never remember having felt before. Within this context, she began
to realize what she had been missing. In addition, the contrast
between her marriage and that of her friend brought despair over
134. / EMOTIONAL UNDERSTANDING

her own future life prospects and anxiety at the almost inconceiv-
able thought of her own freedom. She preferred not to discuss the
loneliness of her own marriage, nor the anger she sometimes
momentarily felt when her husband berated her or failed to
volunteer any help at times when she was obviously overburdened.
What she wanted from me was help with feeling better, putting
options out of her mind, and putting up with the conditions of her
life.
My original sense was that I was very different from her. She
seemed to feel entirely trapped while I had, after all, left a destruc-
tive marriage. If she could just come to understand what I had
come to understand and feel, she could be just fine. I, of course,
knew what would be best for her. The intersubjective field formed
by my agenda and sense of things—undoubtedly indirectly commu-
nicated—with her very strong tendency to comply with others’
expectations of her only heightened her anxiety. Torn among
complying with her parents’ expectations, her husband’s demands,
and now my agenda, she felt bound to lose someone. For all sorts
of “practical” reasons, she became unable to keep regular appoint-
ments. The needs of others always intervened.
Realizing that the treatment was failing, I had to enlarge my
perspective. In order to do this, I needed to become aware of my
own emotional organizing principles and needs, to see how similar
these were to hers and to recognize my own impact on the
treatment. What helped me was noticing this patient’s ways of
taking care of me in sessions—telling me she was fine, asking about
my well-being, watching the clock—and remembering how I had
been like that with my own analyst. This patient and I were very
alike in our compulsive caretaking and in our assumption that our
only value as persons lay in our capacity and skill as caretakers. So
I was taking care of her, trying to fix her life—in proper analytic
interpretive style, of course—and she was taking care of me, trying
to establish her value in my eyes and to maintain her fragile sense
of worth in her own eyes.
When we reflected together on our caretaking patterns,
changes began. The need to be helpful and caretaking loosened
its grip on me, and her freedom in relation to me very gradually
increased. Our tie no longer depended on her divining and
complying with my hopes for her. We began to talk more about
 Emotional Availability / 135

the complexity of compliance, caretaking, and the loss of selfhood

required to maintain ties in her family of origin and in her current
family. I began to be more able to feel my way into her emotional
predicament. Simultaneously she began to report more sustained
frustration with her marriage and her family role, along with some
efforts to tell her husband and children that she expected respect-
ful treatment. She also began to ask them for occasional help, and
she was surprised that they protested less than she had expected.
She is working at perceiving and following her own feelings and
interests, and she is just beginning to sense that these will lead her
wherever she needs to go. As a result, she feels less trapped. She
does feel a new kind of sadness—less despairing, but full of mourn-
ing for the person she never had a chance to become.
This story illustrates the need to be aware of the inevitable
cotransferential limits on our emotional availability to patients.
Such discoveries led Ferenczi to his experiments in mutual analysis.
At the very least we need self-reflection and consultation to
maintain and develop our emotional availability.
In conclusion, emotional availability provides needed balance
in the mutual but asymmetrical (Aron, 1992) analytic relationship.
Long ago Aristotle (Nicomachean Ethics) noted that friendship
requires some sort of equality between the friends. In analysis or
in analytic psychotherapies, the educated emotional availability
that the analyst can offer balances the money and vulnerability
that patients must provide. This is an asymmetry patients often
find so shameful that they call it “paid friendship.” We must
acknowledge some truth in their complaint, but also ask if our
distancing makes the asymmetry more painful than necessary.
Some writers (e.g., Hoffman, 1993) speak of the analyst’s authority
or expertise. I suggest that if the analyst is an expert, this expertise
consists primarily in a capacity, probably both innate and learned,
for reflective emotional availability.

BERTER TALE SHAN NEVER;

THE EMOTIONALLY AVAILABLE WITNESS

Emotional availability, an idea borrowed from attachment theory

(Emde & Sorce, 1983), fits easily into my view of self psychology.
136 / EMOTIONAL UNDERSTANDING

Serving selfobject functions, or providing opportunities for selfob-

ject experience, requires emotional availability. Here let us exam-
ine a form of selfobject experience particularly important in the
treatment of trauma survivors, the special emotional ability or
readiness of the analyst or therapist to be a witness.
Self psychology has, from its inception, identified the mirror-
ing of a child’s natural grandiosity or expansiveness as an essential
ingredient of healthy development. It has named this mirroring
“selfobject” responsiveness to indicate that a child, or anyone, can
use mirroring to build and maintain a continuous, cohesive, and
positively valued sense of self. Here I wish to draw attention to
another selfobject experience—closely related to mirroring—par-
ticularly involved in psychoanalytic healing. For now let us agree
to call this the “selfobject experience of witness.” Witnessing, a
special form of participation in the intersubjective field, makes the
other’s experience real and valid and important to that other.
In The Untouched Key: Tracing Childhood Trauma in Creativity
and Destructiveness, Alice Miller (1990) claims that the crucial
difference in the outcome of severe child abuse depends on the
presence of someone in the child’s life who witnesses, and thus
gives the child the opportunity and ability to experience, the
child’s pain. Without such a witness, Miller believes, the child
cannot experience the abuse as abuse. Instead it is torture that must
be endured. The child often feels she or he deserves treatment that
an observer would see as cruel and outrageous. In the presence of
some, even minimally, validating witness, the child can experience
the abuse as mistreatment and, thereby, find ways to express it,
perhaps in art. In Miller’s words:

Men of various professions frequently ask me why they didn’t

become a Hitler but have lived their lives as more or less peaceful
physicians, lawyers, or professors, even though they, like Hitler, were
beaten every day when they were children. They use this question to
argue against my thesis that brutal, unfeeling, and thoroughly de-
structive treatment of children produces monsters—not by chance
but of necessity. Then I always inquire about the details of the
person’s childhood, and on closer examination it turns out in every
case that a particular witness helped the child experience his feelings
to some degree. In Adolf Hitler’s childhood, such a stabilizing
witness was totally lacking. I have often compared the structure of
 Emotional Availability / 137

Hitler’s family to a totalitarian regime in which there is no possibility

of recourse against the police state. (pp. 50-51)

In treatment, we can often find that there was a witness in the

patient’s history, however occasional and fleeting. Indeed, the
existence of such a witness may be a necessary precondition for
the possibility of seeking treatment, that is, for at least minimal
hope that a human being or a human connection can help. We
find, nevertheless, that many patients with severe self disturbances
are able to find in treatment, apparently for the first time, just such
a witness. Miller, in fact, applies her theory to the treatment of
children:

If mistreated children are not to become criminals or mentally ill, it

is essential that at least once in their life they come in contact with a
person who knows without any doubt that the environment, not the
helpless, battered child, is at fault... . Here lies the great opportunity
for relatives, social workers, therapists, teachers, doctors, psychia-
trists, officials and nurses to support the child and to believe her or him.
(pp. 168-169)

Similarly, the analyst or therapist who wants to understand what

happened to the child whose adult self comes for treatment
becomes the witness who makes it possible for the adult to experi-
ence the full horror of his or her history, and thus to begin to heal.
What we often call denial, disavowal, or unconsciousness may
often be experience never truly experienced (cf. Stolorow & At-
wood, 1992). It may be the given (the brute event) of which we can
make (construe, organize) nothing. When patients tell us that no
one but the analyst understands, they often mean that they are
only beginning to know their history. Such clinical phenomena
point to the thoroughly intersubjective character of self-knowledge.
The following examples illustrate the therapeutic function of
witnessing: Consider Terry, the patient of mine described in
Chapter 8, “Emotional Memory.”” Her father’s family has a com-
plex history of incest (family members are often related both as
child and sibling, for example) and violence—her father had mur-

The description ofTerry’s history to follow is different from the one in Chapter 8 because
* . “ .

it includes information recalled later in the analysis.

138 / EMOTIONAL UNDERSTANDING

dered someone, and for many years he beat and raped his wife,
daughters, and son. Her mother’s family is also violent and contin-
ues to practice revengeful sorcery.
Her mother’s continuing denial, her inability to be a witness,
exacerbates Terry’s struggle to reclaim her history, and thus her-
self. This patient, in her mid-20s, exhibits the severe discontinuities
of self-experience typical of multiple personalities. (Many cases of
discontinuity in self- experience—psychiatry calls these dissociative
phenomena—may result from the absence, at crucial moments in
a person’s history, of the validating witness.) The flashbacks Terry
suffers in treatment allow me to serve as a witness, and this, in turn,
enables Terry to establish the continuity of her experience. My
emotional availability has been necessary to produce enough of a
sense of safety and of self-cohesion to make it possible for Terry to
recognize her terrors as memory.
Another patient, Cheryl, is the child of parents who are
disturbed in various impulsive and narcissistic ways. On the
surface, Cheryl appears to have every advantage—she is strikingly
good-looking, highly intelligent, and affluent. Initially Cheryl
could not understand why she was so anxious and depressed.
After our extensive work at making sense together of her subjec-
tive experience, she began to empathize with her emotional life
and find it valid. In her words, “I see that there are reasons for
my feelings.” Once she found that she could use me as a witness
to her painful history, thereby becoming able to possess and
articulate her experience, she began to find witnesses and soul-
mates in literature. She would bring examples into the treatment.
“Have you ever read The Man Without a Country?” she asked. “I
feel just like the person who belongs nowhere and to nobody.”
She then found similar selfobject experiences in the human world
outside treatment.
For such patients defense and resistance protect a vulnerable
self from retraumatization. Remembering is experienced as dan-
gerous partly because it includes the memory of being alone with
whatever the trouble was, without the support and validation of
witness. Not until the tie to the analyst is strong can vivid kinds of
remembering be risked, for without a secure connection the
patient's fear that the memories will be overwhelming and lead to
psychosis or self-destruction prevents their emergence. The tie to
 Emotional Availability / 139

the analyst makes it possible for the patient to discover and to

survive realizing—making real—the full horror of what happened
to her or him as a vulnerable child. Part of the horror was being
alone.
Clinical experience leads me to speculate that for those pa-
tients who had someone to be a witness, and the more reliable that
witness remained for them, the sooner such a memory-permitting
tie to the analyst becomes possible. In contrast to Terry, Sara, the
daughter of an alcoholic father and a psychotically depressed
mother, had a first-grade teacher whose home she and a sibling
visited every day after school for their remaining school years. This
patient had no memory of having discussed being berated, beaten,
locked in basements, and, much less, molested, with this teacher.
She was unsure whether the teacher was aware of her home
situation. Still, “she never sent us home, and never asked why we
came over so much.” In treatment, this patient did exhibit severe
“dread to repeat” what had happened to her, the phenomenon
described by A. Ornstein (1991). This dread was most evident in
a hyperalertness to, and curiosity about, my thoughts and reac-
tions. Such caution and attunement had been an indispensable
protection from violence in her childhood. Still, her readiness to
use me as a witness, demonstrated by the early and steady avail-
ability of traumatic memories, is most likely due in part to the
selfobject function of witnessing provided by Sara’s teacher. When
prolonged misunderstandings occur between us, however, Sara
begins to feel that she remembers little or nothing of her child-
hood. When her sense of my availability as a witness is restored,
she resumes the process of coming to know her own history.
The notion of an emotionally available witness offers an
intersubjective account of the analyst’s contribution to the process
of remembering. It allows us to describe a selfobject process in
which previously unavailable history becomes experience that
contributes to self-consolidation. History becomes self-experience,
becomes “my history,” in the presence of the other who says, in
one way or another, “That is horrible. That should never happen
to a child.”
This witnessing is indeed a subset of mirroring if mirroring
means appreciative response to what is valuable in the child.
Implicitly it says to the person, “I see you as precious and worthy
140 / EMOTIONAL UNDERSTANDING

of respectful treatment. You had no way to know the horror of what

happened to you because you were treated as worthless or bad.”
Witnessing is also part of the validation that makes possible the
child’s trust in her or his own experience and sense of the real.
This thoroughly intersubjective conception assumes the need for
the other as a condition for the very possibility of experience.
According to Stolorow and Atwood (1992), “the child’s conscious
experience becomes progressively articulated through the validat-
ing responsiveness of the early surround” (p. 31). Both the appre-
ciative responsiveness of mirroring and the confirming responsive-
ness of validation are involved in witnessing. The specificity of
witnessing is the recognition of the horror, of the mistreatment,
of the pain that otherwise cannot become fully conscious experi-
ence. The pain is brutally given, relatively unorganized experience.
It needs the responsive emotionality of the intersubjective field or
potential space (Winnicott, 1971) to allow it to become real and
meaningful experience. The patient, in other words, can experi-
ence raw pain but needs the responsive other to construe it, to
understand its enormity and meaning. Analyst and patient make
sense of it together.
To recapitulate, witnessing means the presence of a responsive
person who makes it possible for the child, or a patient who was
the child, to recognize the horror of whatever happened to him or
her and to feel the appropriate pain. Witnessing allows the child
to experience and the patient to remember. It thus undoes disso-
ciation and allows a person to establish the continuity of a self-pos-
sessed life. It undoes shame and restores the positive valuation of
the self. It establishes and maintains self-experience, and it clearly
deserves designation as a “selfobject” function. In cases of post-
traumatic stress, witnessing is one form the emotional availability
of the analyst must take.
Emotional availability is an essential practical condition for
making sense together and for the possibility of a developmental
second chance in psychoanalysis. With good theory held lightly,
and emotional availability offered generously, a clinician has the
fundamentals for psychoanalytic understanding.
GuligagitieltRoael: 0

Misunderstanding:
A Collaborative-
Pragmatist View

I am the master of this college, and what I

know not, is not knowledge.
—Attributed to WILLIAM WHEWELL,
of Oxford

Pragmatism unstiffens all our theories.

—WILLIAM JAMES, Pragmatism

M isunderstanding is not the logical opposite to understanding.

Instead, misunderstanding is inherent in the process of under-
standing, and it is often the normal condition of psychoanalytic
work. Infant research has shown that attunement requires contin-
ual mutual readjustment between mother and infant (Daniel Stern,
1985; Beebe & Lachmann, 1994). Self psychology has highlighted
the constructive potential of empathic disjunctions or ruptures.
Misunderstanding and lack of understanding in the clinical situ-
ation can lead to deeper and fuller understanding, including more
intimate mutual attachment. In Kohut’s (1994) words, “The long
not-being-able-to-understand is often the necessary precondition
for a deeper understanding” (p. 264). Such a view, however,
requires a rethinking of ordinary either-or views of truth and

14]
142 / EMOTIONAL UNDERSTANDING

reality, and it implies a pragmatist’s commitment to a thoroughgo-

ing philosophical fallibilism. Unnecessary misunderstanding can
result from theoretical inflexibility and dogma. The collaborative
pragmatist, on the contrary, works with the patient to make sense
of emotional experience.

TRUTH AND REALITY IN PSYCHOANALYSIS

Psychoanalytic understanding clearly has something to do with

truth and reality. The nature of truth and reality, however, is not
so clear. One approach is to shrug our shoulders and concede that
philosophers have been struggling to find adequate conceptions
of truth and reality for millennia now.Surely we psychoanalysts
ought not to expect to find an easy resolution to this quandary.
But we cannot ignore the issue of the nature of truth and reality
because it has practical bearings on psychoanalytic theory (accord-
ing to James, 1907, there is nothing so practical as a good theory)
and on our clinical work.
Let us address theory first. If we view understanding as
intentional (in the phenomenological sense, that is, as under-
standing of something), then we immediately confront the twin
issues Of epistemology and ontology. Epistemology focuses on
the question of the adequacy (or truth) of our understanding;
ontology addresses the status (real or imaginary?) of whatever we
seek to understand—a thing, a text, a person, an idea, or logical
statement. Psychoanalytic epistemology raises these same ques-
tions. We ask both how well we understand (epistemology), and
also what level of reality we are meeting (“I'd like to wring her
neck” vs. “I plan to shoot her tonight”). If we fail to reflect on
these philosophical issues, we doom ourselves to the psychoana-
lytic unexamined life. Those who eschew metaphysics, goes the
old philosophical saw, will be controlled by unconscious meta-
physics. I do not attempt a Kleinian (G. Klein, 1976) “theorec-
tomy” or, what is similar, a Husserlian cleansing of presupposi-
tions. Instead, I suggest that we psychoanalytic theoreticians
make our unconscious philosophical presuppositions—about
knowing, reality, and human nature and motivation, for exam-
ple—as conscious as we can. Only then can these intellectual
 Misunderstanding / 143

organizing principles leave the closed Cartesian study for the

open smoke-free rooms of dialogue.
On the practical and clinical side, unexamined conceptions of
truth and reality can wreak havoc. They contribute to many serious
instances of misunderstanding. Most therapists are likely to have
worked with patients who have lost trust in themselves or in the
possibility of therapeutic help because, in the name of truth or
reality, previous therapists have undermined or invalidated the
patients’ sense of things. Clinical use of conceptions like transfer-
ence as distortion, can mean to the patient that the analyst
possesses truth or reality, and that the patient does not. Of course,
therapists hope that patients do not lose faith in themselves as a
result of having been in therapy. Such misunderstandings—often
the result of our theoretical and practical choice of position—are
unproductive and should occur infrequently in a psychoanalysis
conducted in a collaborative (making sense together) and fallibilist
spirit.
I propose, therefore, to review some major conceptions of
truth and reality in modern philosophy and in the history of
psychoanalysis. I will then articulate some conceptions of truth and
reality most consistent with an intersubjective view of psychoana-
lytic understanding.
The venerable philosophical question of the nature of truth
has become a major issue in psychoanalysis today, probably to the
advantage of both disciplines. Philosophy may clarify its old ques-
tions by seeing them worked out in a newer venue. Psychoanalysis
stands to gain a clearer understanding of its own premises, espe-
cially of its devotion to reflective awareness.

Correspondence Theories of Truth

Most psychoanalysts discuss the nature of truth as if two, and only
two, options existed. The first is the common sense theory, also
known as the correspondence theory of truth. In philosophy the
precursors of this approach are Locke and Hume, and its ordinary
guise is the ontology of naive realism. According to correspon-
dence theories, ideas in the mind are more or less accurate copies
of things, facts, realities, or states of affairs that exist; the existence
of these is not dependent on whether humans have any knowledge
144. / EMOTIONAL UNDERSTANDING

or awareness of them (Potter, 1994). Truth exists when ideas match,

or correspond to, external realities, when language accurately
pictures the world (Wittgenstein, 1921). The conceptual problems
with this point of view appear when we consider how to test the
match tetween ideas and those external realities. In a sense we
need to introduce another mind (an outside authority), to judge,
and the accuracy of this judge in turn requires checking, and so
on to infinite regress. The ideas we are trying to match to external
reality we arrive at by necessarily subjective means (“To me, my
father was a giant”). The requirement by correspondence theories
that subjectively derived ideas be “objectively” verified ends up
reducing subjectivity’s usefulness to that of a more or less compe-
tent copy machine. This reduction eliminates the only matter of
interest to psychoanalysis or accessible to psychoanalytic inquiry—
the experience of the subject.
Nevertheless, correspondence theories were much in vogue
when psychoanalysis was born in the late 19th and early 20th
centuries. Logical positivism—the intellectual offspring of the
successes of modern science—produced the verification criterion
for evaluating scientific theories. According to logical positivists,
a theory is only as good as the quantifiable experimental evidence
that supports or verifies it. In a weaker form, positivism views
theoretical statements as bearing meaning or cognitive signifi-
cance only to the extent that their proponents can specify what
experimental evidence would count as falsifying the theory. Either
way, for the logical positivist truth is the match between theory
and experimental evidence.
In psychoanalysis, correspondence theorists are most identifi-
able by their devotion to the idea of transference as distortion, the
mismatch between a patient's sense of things and the analyst’s
“reality.” Correspondence theorists also tend to object strenuously
to the narrative-truth views of Spence and Schafer. Charles Hanly
(1992), a psychoanalyst who calls his view “scientific realism,”
recently endorsed a correspondence theory. Likewise, interperson-
alist Zucker (1993), in “Reality: Can It Be Only Yours or Mine?”
asserts:

Positivists consider it easier to falsify a theory than to verify it. One good counterexample,
in this view, disproves a theory.
 Misunderstanding / 145

The problem of establishing well-grounded knowledge in our field

is exceedingly difficult, but this is no warrant for surrendering to
the lures of subjectivity. Our field has hardly addressed itself to
developing methodologies equal to the difficulty and complexity
of our material. It has done little, if anything, on such problems as
what constitutes data, what is the potential of different kinds of
data for activating experience, it commonly mistakes abstractions
for raw data, it has not worked on, let alone developed rules of
evidence in relation to data and, in my opinion, has not required
and trained for a high standard of reasoning and logic in its
thinking. (p. 485)

Zucker apparently believes that psychoanalytic data can be evalu-

ated on other than subjective grounds. Although psychoanalysis
surely involves some quantifiable aspects appropriate for empirical
research, I believe with Kohut (1959) that only the study of data
obtained by introspection and empathy is truly psychoanalytic. To
know anything thoroughly is to surrender to its lure, and to know
anyone psychoanalytically we must surrender to the lure of subjec-
tivity. Zucker’s experience-distant logic, the logic of empiricism
and positivism, tests theoretical ideas against “the facts”—which
positivism believes to be independent of observer bias—and checks
to see whether theory and fact match up. On the contrary, clinical
and theoretical reasoning in psychoanalysis, like the scientific logic
of discovery, must remain close to experience. In the logic of
discovery, the important work is the collaborative framing of
plausible hypotheses or surmises (making sense together) to ac-
count for surprises or anomalies. We do need this kind oflogic in
psychoanalysis. It will allow us to take subjective experience seri-
ously, and still do justice to the common sense embedded in
correspondence theories.

Coherence Theories of Truth

While correspondence theories define truth as factual accuracy,
coherence theories—the second approach to the nature of truth—de-
fine truth as what “rings true,” a reference to subjectivity. Coherence
theories, emphasizing the unavoidable contribution of the human
mind to all knowing, highlight the limits of knowledge. Proponents
of coherence theories claim, modestly and accurately in their opin-
146 / EMOTIONAL UNDERSTANDING

ion, that truth exists to the extent to which ideas hang together, or
cohere. To decide truth and falsehood, they consider logical criteria
such as consistency, elegance (i.e., parsimony), and the absence of
internal contradiction. Coherence theorists count Kant and Hegel
among their philosophical ancestors. In this century, the hermeneu-
tics of Gadamer and the postempiricist philosophies of science of
Kuhn and Feyerabend are well-known representatives of the coher-
ence theory of truth. Prominent psychoanalytic advocates of this
point of view include Spence (1982), Schafer (1983), Hoffman
(1991), and, in self psychology, Goldberg (1988).
The correspondence and coherence theories of truth are
more or less practical methods for evaluating the worth of ideas.
Yet we can also see that they bear on our modes of relating.
Empiricist theories fit most naturally with critical and competitive
modes of relating. Coherence theories usually assume that we find
truth through collaboration and thus bear a closer resemblance to
the pragmatist ideas to be considered next.

The Pragmatist Shift to Meaning

In ordinary life, the kind we live when we are less aware of being
philosophers or psychoanalysts, we use both theories. I use an
almost automatic correspondence theory to check whether my
idea that I turned off the stove matches the dials and lights on the
stove itself. Analogously, if Isit on a jury in a trial where physical
evidence is scarce, I use a coherence theory of truth to evaluate
the stories I hear. Both approaches to evaluating ideas function in
our everyday thinking. Further, each method has yielded a theory
of truth that its adherents claim is the ultimate truth about truth.
Nevertheless, neither theory alone is a good-enough theory to
account for daily experience. We need to seek a more adequate or
comprehensive theory of truth.
Fortunately, we have a third opinion, which has sources in
American philosophy and deeper roots in Aristotle and Kant. This
view is the pragmatist shift from truth to meaning. William James
(1907) described this shift with his usual charm:

I am happy to say that it is the English-speaking philosophers who

first introduced the custom of interpreting the meaning of concep-
 Misunderstanding / 147

tions by asking what difference they make for life. Mr. Peirce has only
expressed in the form ofan explicit maxim what their sense for reality
led them all instinctively to do. The great English way ofinvestigating
a conception is to ask yourself right off, “What is it known as?” In
what facts does it result? What is its cash-value, in terms of particular
experience? And what special difference would come into the world
according as it were true or false? (p. 268)

Peirce (1877) provided the more precise maxim to which James

referred:

Consider what effects, that might concezvably have practical bearings,

we conceive the object of our conception to have. Then, our conception
of these effects is the whole of our conception of the object. (vol. 5, p.
258)

Thus practical bearings and intellectual conceptions were, for

Peirce, inextricably linked, perhaps differing only as foreground
and background do in Gestalt studies. Both James and Peirce made
the shift in theory, so natural in practice for psychoanalysts, to a
pragmatic, or meaning-based, view of the nature of truth. Both
were asking not for truth itself but for the difference it makes in
the conduct of life to think one way or another. Peirce (1877)
elaborated:

The whole function of thought is to produce habits of action; and

... whatever there is connected with a thought, but irrelevant to its
purpose, is an accretion to it, but no part of it. If there be a unity
among our sensations which has no reference to how we shall act on
a given occasion, as when we listen to a piece of music, why we do
not call that thinking. To develop its meaning, we have, therefore,
simply to determine what habits it produces, for what a thing means
is simply what habits it involves. Now, the identity of a habit depends
on how it might lead us to act, not merely under such circumstances
as are likely to arise, but under such as might possibly occur, no
matter how improbable they may be. What the habit is depends on
when and how it causes us to act... . Thus, we come down to what is
tangible and conceivably practical, as the root of every real distinc-
tion of thought, no matter how subtle it may be; and there is no
distinction of meaning so fine as to consist in anything but a possible
difference of practice. (vol. 5, pp. 256-257)
148 / EMOTIONAL UNDERSTANDING

MEANING AND PSYCHOANALYTIC UNDERSTANDING

A shift to a focus on meaning has many logical corollaries, equiva-

lent for a pragmatist to practical consequences. The remainder of
this chapter will address those practical consequences for under-
standing and misunderstanding in psychoanalysis.
The first of the corollaries is that both popular theories of
truth—the correspondence and coherence theories—are inade-
quate. To assess the truth of our ideas, we need the reference to
the external world, the point of reference central to the correspon-
dence theories. We also require the reference to conceptual unity,
which is basic to the coherence theories. Nevertheless, the two
approaches do not add up to the whole truth; taken separately or
together, they reduce truth to a sort of solution to a puzzle. They
remove truth from the realm of human experience and of tempo-
ral and historical process. Only a shift to a pragmatic, or meaning-
based, conception of truth can overcome these problems.
In psychoanalysis, similarly, we can see that each traditional
theory of truth is a partial truth. A psychoanalyst announces to her
patients a planned week of vacation. One patient says the analyst
is selfish and thinks only of herself. If the analyst really understood,
and took seriously, the patient's suffering, she would not leave. A
second patient envies the analyst, seeing her as rich, privileged,
and free to pursue her pleasures. Another believes the analyst must
be ill or on the verge of burnout. A fourth says, well, everybody
takes vacations—have a good time. The next is convinced that
either patient or analyst will die or come to harm during the
vacation. Neither a correspondence view (“No, you're wrong”),
nor a coherence response (“Well, does that fit with what else you
know about me?” or “I guess this fits with what we know about
you!”) will help here.
Such a common clinical situation illustrates the need for a
pragmatic, or meaning-oriented theory of truth. The correctness or
falsehood of patient beliefs about the vacation is trivial compared
with the immense importance of their meaning, or practical bearing,
for the patient. These meanings are distinct exactly insofar as they
affect the patient’s habits of action and interpretation, the analyst’s
response to the patient's interpretations, and thus the intersubjective
 Misunderstanding / 149

field of the analysis. The shift to meaning does not imply that we
gain access to “the whole truth,” but rather improves the likelihood
that we are considering some kind of truth that matters.
The second corollary ofa pragmatic theory is that our psycho-
analytic theories differ in meaning only to the extent that they lead
us to different habitual responses to patients. Believers in the
principle of distortion—most Freudian and Kleinian analysts—will
pursue some line of interpretation designed to convince the
patient that instinctual wishes and fantasies determine and distort
his or her responses. Self psychologists may say that each patient
response expresses the real state of the selfobject experience, and
the therapist will respond with that specific understanding. A
collaborative pragmatist may, depending on the situation, simply
accept the patient’s view. Then she or he will work collaboratively
with the patient to figure out the meanings of the vacation, of the
way it was announced, of the patient’s response, and of its effect
on the joint psychoanalytic experience.
Our theories of truth also bear on the question of theory-
choice (see Chapter 3). We choose theories (engage in theory-
choice) neither for their correspondence properties, which we can
never adequately check, nor simply for their elegant wholeness.
Instead, in a fallibilist and pragmatist spirit, we embrace them for
the help they provide in elucidating meanings in practical ways
and for shaping our responses to situations we have not yet
envisioned. We can now see more clearly that a psychoanalytic
theory is more than a conceptual scheme. It is a way of being with
people, a way of life.
A third corollary of the shift to a focus on meaning is fallibi-
lism, the systematic and persistent recognition that one can always
be mistaken. Fallibilism acknowledges the inevitable limits on any
individual’s, or any finite number of individuals’, ability to know.
It replaces the search for certainty and distortion-correction with
a dialogic search for reasonableness or meaning in a community
of inquirers. In the psychoanalytic situation, fallibilism means the
assumption that understanding is always partial, incomplete, and
capable of improvement. Fallibilism is an intrinsic facet of a
pragmatic approach to the search for truth and meaning, and of
the perspectival realism (see Chapter 4) that matches it in ontology.
150 / EMOTIONAL UNDERSTANDING

In the psychoanalytic situation, the analyst’s fallibilism can

produce, or at least make possible, greater patient self-reflective-
ness. The analysis becomes a safe place to come to know and
remember who one is and what makes one tick. Theoretical
fallibilism can engender a collaborative “let’s figure this out to-
gether” atmosphere, one in which it feels safer to wonder, to do
thought experiments and feeling experiments in the transference
with a trusted guide and companion. Some sorts of defensiveness
and resistance may never appear in such an analysis (Brandchaft,
1983), and other forms of self-protectiveness may become super-
fluous over time. Hoffman (1987) describes some of the advan-
tages of adopting an attitude of theoretical fallibilism in his article
“The Value of Uncertainty in Psychoanalytic Practice.”
To read, however, recent discussions of what analysts’ author-
ity and expertise should be is to wonder whether we truly see
ourselves as collaborators and participants on the side of the
patient’s emerging selfhood in a struggle for meaning and truth.
Perhaps instead we still seek some correspondence- or coherence-
based certainty. Tansey (1992), for example, has compared con-
ceptions of analytic expertise in what Mitchell (1988) calls the
drive-conflict, developmental arrest, and relational-conflict
models. Tansey prefers the relational-conflict model, which “calls
upon the analyst to be expert at generating collaborative inquiry
with the patient into repetitive patterns of interaction as they
unfold within the treatment relationship in one form or another”
(p. 314). In addition to questioning the original classification (I
believe that one can be a developmentalist without allegiance to
a simplistic developmental arrest model), as a fallibilist I have
additional questions. Why is it so important to assert our exper-
tise, even if its nature is as benign as the sort Tansey attributes
to the relational-conflict theorist? If his aim is the reduction of
the extreme relational asymmetry he finds in the other models,
then why concentrate on expertise at all? What are we afraid of
losing?
Similarly, Hoffman’s (1993) treatment of “the intimate author-
ity of the psychoanalyst’s presence” presents a collaborative picture
of the analytic relationship. Still, if authority and power are so
important, isn’t the patient an authority and an expert on her or
his own life? Why are our authority and expertise so important to
 Misunderstanding / 151

us? Usually when people feel adequately confident—even if that

confidence includes appropriate uncertainty about what they are
doing—they feel no need to emphasize their authority, power, and
expertise. When analysts can live with uncertainty, they provide a
space for the process of understanding and avoid the rigidity that
contributes to unnecessary misunderstandings.

CLINIGAL THEORY AS'A*SOURCE

OF MISUNDERSTANDING

The search for certainty, however, is not the only source of misun-
derstanding in psychoanalysis. Analysts’ attachment to metapsy-
chologies and their associated clinical theories can contribute to
many an impasse. Momentarily bypassing other sources of analysts’
cotransference, this section will provide an example of the influ-
ence of our clinical theories on misunderstanding in analytic work.
We can no longer regard the patient as the sole source of trouble;
misunderstanding is a thoroughly intersubjective phenomenon
(Brandchaft, 1985). Patients bring to the field of the psychoana-
lytic encounter their emotional history, their dreads and longings,
and their patterned ways of responding and of organizing emo-
tional experience. We analysts and therapists bring all these same
influences, plus general and clinical theories. The illustration to
follow is one of many possible examples. Other influences would
include clinical theories based on mechanistic metapsychologies,
ethnocentrism, sexist assumptions, homophobia, and the equation
of schizophrenic autistic states with normal infancy.
The misunderstanding I will focus on results, I believe, from
an overreliance on the traditional psychoanalytic conception of
object constancy. I will briefly present some recent history of the
concept of object constancy and then elaborate my concern about
both its theoretical underpinnings and its application in clinical
situations.
As the term is generally used, “object constancy” denotes the
developmental achievement of the ability to retain an image or
representation of the caretaker in her or his absence. Debate about
when this can be accomplished usually turns on the question of
when infants possess or develop particular cognitive capacities and
152. / EMOTIONAL UNDERSTANDING

on how such capacities may be related to the achievement of object

constancy. Those, for example, who regard Piagetian object per-
manence as a prerequisite for object constancy will place its
achievement later than do those who do not. Whenever object
constancy is achieved, what is ordinarily thought to be at stake is
libidinal object constancy, the ability to regard the object as reliably
existent whether it is felt as gratifying (present) or frustrating
(absent). This capacity is supposed to overcome, or preclude the
need for, such early defenses as splitting and denial. In the view of
Mahler, Pine, and Bergman (1975), object constancy makes possi-
ble a healthy resolution of the separation-individuation process.
Proponents of this view see the absence of object constancy
in adult life and in treatment as primarily attributable to an excess
of constitutional aggression. Such a lack, they believe, paradoxi-
cally results in excessive expression of instinctual drives, as well as
in early and sometimes unstable defensive systems, leading in
treatment to chaotic transference reactions. This theory blames
the failure to achieve libidinal object constancy for “borderline”
behavior and personality organization.
There are theoretical problems in this formulation. It relies on
a biological and drive-based, not an experience-based, conception
of human motivation. In addition, it depends on an intrapsychic,
or one-person, idea of development. It deemphasizes the relational
context or intersubjective field, so we find little reference to
parental consistency as a developmental influence on the child’s
ability to experience the parent as a constant object. Similarly, this
view overlooks the question of the therapist’s consistency of
responsiveness in what appears to be a patient’s lack of object
constancy. What we need is a thoroughly intersubjective under-
standing of how children develop the ability to retain a sense of
connection to their caretakers and, analogously, of how this proc-
ess unfolds in an analysis.
Above all, I suspect that the emphasis on the lack of libidinal
object constancy often misses the importance of the reverse phe-
nomenon, the importance to the child or patient of the sense of
being held in memory by the caretaker or therapist, of existing
with constancy for the other. Perhaps the capacity to feel remem-
bered by another, or to feel continuously significant for the other,
is a usually taken-for-granted prerequisite for being able to benefit
 Misunderstanding / 153

from the particular selfobject process sometimes called a “holding

environment” (Winnicott, 1965). This capacity, which may be a
basic condition for the possibility of many selfobject experiences,
allows a person to feel continuously and stably existing for another,
or perhaps even significant to the other. Such a capacity is not a
quality of an isolated mind (Stolorow & Atwood, 1992); its devel-
opment requires the presence of a stable and attentive other. Its
absence usually suggests serious disruptions in early attachment
experiences. The therapist’s ability to hold the patient in memory
and to express this holding—another form of emotional availabil-
ity—together with the patient’s gradually attained capacity to expe-
rience, and to rely on, being held in memory, may then make
possible other developmental processes.
In treatment, some patients seem to have enormous difficulty
feeling remembered by their therapist or analyst. Once we bring
this difficulty to the foreground of our awareness, we can notice a
range of clinical phenomena. The most extreme examples, and
those that have alerted me to this difficulty, involve patients who
feel nonexistent and become panicky when they cannot feel exis-
tent in the mind of the other. Such patients, often labeled border-
line, may require emotionally available therapists or analysts will-
ing to extend themselves beyond the traditional confines of
analytic therapy (cf. Bacal, 1985, on optimal responsiveness). A
colleague has told me of a patient who asked to have her therapist
telephone her at a specified time each day. After several months,
this became unnecessary, as the patient became more able to feel
her continued existence both in the mind of her therapist and
gradually in her own experience. Another gave her therapist books
to take with him on vacation to make sure that he would remember
her when he was gone. A third patient gave me a refrigerator
magnet that was also a Christmas decoration. Asked about the
magnet in February, I said I was putting it away with my holiday
things, and the patient became very dejected. It turned out that
the purpose of the magnet from the patient’s point of view was to
remind me of the patient, thereby keeping her in existence.
Severely abused and tortured in childhood, this woman suffered
severe discontinuities in her self-experience. She needed to use my
memory of her from day to day in order to feel that she continued
to exist as a member of the human species. A milder and more
154. / EMOTIONAL UNDERSTANDING

common example of a patient’s belief that he or she does not exist

for the therapist includes the patient’s surprise that the analyst
remembers details emotionally significant to the patient. Such
memory opposes the patient’s sense that out of sight is out of mind
and out of existence.
Another patient, when in extreme anxiety states, often called
friends and acquaintances just to see if they remembered him and
could tell him his name. Once they did, he was temporarily
reassured of his continuing existence. For several years he never
called his analyst when in these states, on the assumption, which
emerged later, that he would not be remembered, recognized, or
known. Meanwhile, he remained in an unsatisfying relationship
with a girlfriend, and the treatment seemed stalemated. Gradually
he came to feel safe enough to call his analyst for the type of
reassurance he had sought from friends. Together the patient and
therapist came to understand that prior to calling the therapist he
had felt that he did not exist for her. Now, with a sense of his
existence for the therapist, he could exist apart from the girlfriend
and live alone comfortably.
These examples illustrate difficulties people may have in
feeling the self as continuing in existence without the presence or
reassurance of another person. The problem, surely grounded in
early experiences of physical or emotional abandonment, is an
intersubjectively generated lack of the ability to use a particular
kind of selfobject experience, perhaps a selfobject experience as
fundamental as Kohut’s mirroring and idealizing. Providing this
selfobject experience might be described as holding in memory,
and the patient’s use of it as feeling existent for the other. In
extreme forms, deficits in this capacity may cause a person to feel
lost, as if she or he is disappearing, or even completely nonexistent,
when there is no immediate perception of her or his existence or
significance for another person. In the intersubjective context of
treatment, such patients may feel extremely needy, demanding, or
baffling to their therapists. We may respond by falling back on our
familiar defenses—distancing by diagnosis, for example.
There are various ways in which we can work with the impasses
that then occur, depending on both the patient’s and our own
particular patterns of experiencing, or organizing principles.
Other variables include the history of the particular bond estab-
 Misunderstanding / 155

lished in treatment and the therapist’s degree of comfort with a

range of interventions and responses. Sometimes the consistent
presence and responsiveness of the therapist who has become
aware of the nature of the difficulty is enough. The treatment of
the man who called people to hear them say his name was helped
in this way. Often all or most of the process must go on silently,
though articulation sometimes helps. If I try to articulate the
difficulty but nothing changes, I know I must be content to work
in the nonverbal realm.
Sometimes, telephone calls or keeping Christmas magnets up
all year may be necessary. Such interventions probably deserve the
name of transitional phenomena, though perhaps in the opposite
sense of that originally intended by Winnicott (1958). A more
traditional intervention based on Winnicott’s idea of transitional
phenomena would be for the analyst to lend patient a small item
from her office to keep while the analyst is on vacation. The reverse
is illustrated by the patient who gave her analyst books to take with
him on vacation. During his first vacation, she had slashed her-
self—not as a suicide attempt but as an effort to feel her own reality.
Once she found a way to assure herself that he would remember
her, she had no more major difficulties with his vacations.
A particularly evocative response by a therapist aware of a
patient’s severe difficulty with feeling held in memory and existent
for the other is the following: The patient, who had extreme
difficulty with both object constancy in the more traditional sense
and with feeling continuously existent for herself and for the other,
deteriorated each year as her analyst’s long vacation approached.
One year the analyst, who always wore a set of three bracelets, lent
the patient one to wear while she was gone. Not only did the patient
have something that belonged to the therapist to use as a transi-
tional object, but the patient also knew that her therapist would
frequently be aware of the missing third bracelet and would thus
remember the patient—hold her in existence—during the vacation.
Parenthetically, we may note that the meaning of gifts or loans, to
or from analysts, may often lie in the transitional realm and may
sometimes, like other transitional phenomena, be spoiled by too
much analysis. In other situations, discussion may allow both
participants in the analytic field to understand the meaning of the
gift and in that way further the analysis.
156 / EMOTIONAL UNDERSTANDING

Interventions in which an analyst takes some action to help the

patient feel held in memory may seem unnecessary to analysts who
believe that verbal interpretation makes up the entire realm of
psychoanalytic work. We can respond to this objection in two ways.
First, the trend in psychoanalysis for many years has been to
expand the range of patients with whom we can work and to
understand human beings as motivated primarily by relational
concerns. Increasingly we are working with people whose difficul-
ties seem to originate in preverbal interactions or lack of interac-
tions with early caretakers. Often we find that purely verbal
responses to these difficulties leave the patient feeling lost, misun-
derstood, or despairing. Relying solely on verbal responses may
result in the impasses and treatment failures we experience from
time to time.”
A second, and more important, response to those who hold
that the psychoanalytic endeavor is purely verbal is my belief that
our difficulties in noticing deficits in feeling held in memory, and
our discomfort with interventions that could establish or restore
this experience, may be based on the mistaken notion that the
healthy person is self-sufficient. I believe, on the contrary, that
human beings are interdependent by nature. The sense of self as
cohesive, continuous, and positively valued develops and continues
in an intersubjective context. I often find it necessary to remind
myself and my patients that needing others is nothing to be
ashamed of. In his posthumously published How Does Analysis Cure?
Kohut (1984) eloquently challenged the separation-individuation
conception of maturity:

Self psychology holds that self-selfobject relationships form the es-

sence of psychological life from birth to death, that a move from
dependency (symbiosis) to independence (autonomy) in the psychol-
ogical sphere is no more possible, let alone desirable, than a corre-
sponding move from a life dependent on oxygen to a life inde-
pendent of it in the biological sphere. The developments that

Of course no response or intervention will be helpful unless the therapist is comfortable

working in that way—although it may be on the outer edge of her or his comfort zone. The
response must also come from some understanding of the nature the patient's particular
suffering, whether or not the patient can articulate this. In addition, no single intervention
can be recommended; what is necessary, instead, is to recognize the patient's efforts to
create a reliable bond.
 Misunderstanding / 157

characterize normal psychological life must, in our view, be seen in

the changing nature of the relationship between the self and its
selfobjects, but not in the self’s relinquishment of selfobjects. (p. 47)

If we accept Kohut’s view of our lifelong need for others and

begin to recognize the centrality of the need to feel existent for the
other, we can understand some clinical and everyday phenomena.
One therapist, for example, had two surgeries several years apart.
He found overall that after the first operation, when he called
patients from the hospital as soon as he could, his patients reported
much less distress than after the second operation, when he did
not call his patients as quickly. Even generally high-functioning
patients felt disoriented and lost as the days went by and they heard
nothing. They knew that no news was good news. The therapist’s
death would have been reported to them. The experience was not
exactly of the loss of the therapist. Instead patients lost the sense
that they continued to exist in the therapist’s memory, their
familiar sense of the relationship within which they were coming
to possess a sense of their own existence.
Similar phenomena can be found in everyday life. Anyone who
has moved a long distance will have had the experience of being
able to maintain some friendships but not others over time and
distance. I once had a friend—a close friend, I thought—in Seattle
who told me that when I moved to New York, it would be the end
of our friendship. She would feel that I no longer really existed and
that she would no longer exist for me. No measures I took to
convince her otherwise were successful in overcoming these con-
victions. We might speculate that to maintain a friendship over
time and distance, both friends need to have achieved both object
constancy and the sense of being held in memory by the other.
To return to the clinical situation, Iam suggesting that many
misunderstandings and impasses result both from patient difficul-
ties feeling held in memory, and therefore in existence, and from
analysts’ reluctance, or inability, to be emotionally available
enough to struggle with the patient toward an understanding of
this problem. The sense of existence comes from the reliable
experience of existence for the other, of being known, remem-
bered, and understood. Some stalemates can be overcome if we
recognize, welcome, and support the efforts of patients to create
158 / EMOTIONAL UNDERSTANDING

transitional means of reassuring themselves of their continuing

existence and importance for us until this ability is firmly estab-
lished. The pragmatist shift to an epistemology of meaning, and
to an ontology of perspectival realism, gives us great flexibility in
understanding these clinical phenomena. Our clinical theories
must support and articulate such relational understanding.
Misunderstanding often seems to be the normal state of the
psychoanalytic triad—the two subjectivities and the intersubjective
field that includes them. If some fundamental emotional safety
exists, however, analyst and patient together can attain under-
standing by continually working through, in a fallibilistic spirit, the
small and large misunderstandings.
ene releeek lol

How Does Psychoanalytic

Understanding Heal?

To cure rarely, to relieve suffering often, and

to comfort always.
—Old medical injunction

As I neared the completion of this book, a patient announced

to me one day, “I don’t think I care about being understood. I don’t
expect people to understand me. I want to feel loved and cared for
whether I am understood or not.” He thought that just such a
feeling of being loved and cared for was what was working in his
treatment. This patient thus forces me to articulate the implica-
tions of my pragmatic and intersubjective view of understanding
for a theory of therapeutic action or efficacy. An honest pragma-
tist must, of course, acknowledge in a fallibilistic spirit that our
clinical theories are never more than working hypotheses. We must
also, like the ancient physicians, admit that genuine cure is a
comparatively rare occurrence.
Nevertheless, the “cash value” (James, 1907) of any psychoana-
lytic theory lies in its account of cure. I have placed the idea of
understanding in the center of the epistemology and clinical
theory of psychoanalysis. Now I must explain the implications of
this position for the question of therapeutic action, a question that
*
Dr. Peter Lessem and I collaborated in writing early versions of some sections of this
chapter.

159.
160 / EMOTIONAL UNDERSTANDING

has a long and thoughtful history. This history reflects a gradual

shift from the interpretation-and-insight view toward an explicit
emphasis on the healing power of relational and emotional under-
standing.

THE EFFICACY OF PSYCHOANALYSIS

Since Breuer and Freud’s (1895) Studies on Hysteria, it has been

clear that psychoanalytic treatment in the hands of a skilled
practitioner can be helpful. On the other hand, why this should be
so and how the process works have never been clear for very long
to very many people. As both participants in and observers of the
psychoanalytic process, we often find ourselves at a loss to articu-
late the reasons for successes and failures. The question of thera-
peutic efficacy has, however, obvious practical significance. If we
know what helps, we will do it, unless the cost proves too great to
us as therapists. More than any other, perhaps, this question
bridges the gap between psychoanalytic theory and practice, and
it relies on the hermeneutic pragmatism that characterizes my
account of psychoanalytic understanding. The question of thera-
peutic efficacy, precisely because it is so difficult to resolve, spans
the history of psychoanalysis.
Breuer and Freud (1895) originally thought that people re-
cover from “hysterias” by recalling early traumas and by the
cathartic reexperience of the emotional states associated with
these early traumas, that is, by abreaction. Once Freud adopted his
topographical view of the mind, he asserted that analysis cures by
making the unconscious conscious. Wishful conflicts, once ac-
knowledged, lose their power, and symptoms disappear. With the
coming of Freud’s structural theory, this process meant that ego
control replaces id wishes and that mature organization supplants
infantile chaos. With little change, this drive-based understanding
of psychoanalytic cure persists today in Freudian ego psychology
and Kleinian analysis.
Starting in the 1930s, however, dissenting voices emerged. In
Budapest, Ferenczi, who stressed the emotional quality of the
unique psychoanalytic bond (Bacal & Newman, 1990), wondered
whether the relationship itself might not be the curative factor. In
 How Does Psychoanalytic Understanding Heal? / 161

addition, he emphasized the therapeutic potential of regression

and emotional reliving in the transference. Viewing the traditional
reserved analytic attitude as inappropriate to heal the “trauma-
tized child” in the patient, he thought analysts needed to be more
responsive. They ought to make the analytic relationship a place
of safety in which the patient could relive the original trauma in a
context that is different from the original one, thereby making it
possible for the patient to experience a new beginning.
Ferenczi underscored the analyst’s contribution to the thera-
peutic bond. He stressed (1) the ways in which what the analyst
provides to the patient differs from what the patient has experi-
enced in the past, (2) the analyst’s love for the patient, and (3) the
importance of reducing impediments in the analyst to under-
standing and connecting emotionally with the patient. The first
two of these concerns figured prominently in Ferenczi’s remark-
ably up-to-date discussions on the treatment of trauma. For exam-
ple, Ferenczi (1988) contrasted his view with Freud’s:

An abreaction of quantities of the trauma is not enough. The

situation must be different from the actually traumatic one in order
to make possible a different, favorable outcome. (p. 108)

If the present process is to have a different outcome from the original

trauma, then the victim of traumatogenic shock must be offered
something in reality, at least as much caring attention, or a genuine
intention to provide it, as a traumatized child must have. (p. 28)

No analysis can succeed if we do not succeed in really loving the

patient. Every patient has the right to be regarded and cared for as
an ill-treated, unhappy child. (p. 130)

Without discounting the power of transference, Ferenczi un-

derscored the actual personality of the analyst in the therapeutic
situation. Believing that the analyst’s personality strongly influ-
ences the course of treatment, he criticized the overvaluation of
theoretical insight. Personal qualities of the analyst, as well as
feelings of liking, interest in, or indifference toward patients, come
through and evoke unconscious responses from the patient (p.
191). Ferenczi was a solitary voice stressing the profoundly rela-
tional nature of the psychoanalytic process, including the need for
162. / EMOTIONAL UNDERSTANDING

attention to countertransference. This attention, he believed, fa-

cilitates the analyst’s understanding of and emotional availability
to the patient. Toward these ends, Ferenczi experimented with the
radical innovation of mutual analysis. He hoped that by allowing
patients to hear and explore his responses and transferences to
them he would reduce the interference of his countertransference
and what he called his “obtuseness.”
In Britain, Strachey (1934), in his remarkable paper “The
Nature of the Therapeutic Action of Psycho-Analysis,” described
the curative role of the therapeutic relationship. Within the safety
of the analytic bond, the patient could more easily make use of
interpretations. Strachey described the elements that contribute
to the patient’s ability to integrate interpretations. These include
the patient’s will to recover and capacity to assimilate reasonable
arguments, as well as the relationship with the therapist. Strachey
believed that the patient’s positive attachment to the analyst in the
transference makes therapeutic change possible through modifi-
cation of the superego. The patient assimilates the analyst into his
or her tripartite psychic structure as an auxiliary superego. This
auxiliary superego, a good object, differs from the bad objects of
the patient’s past. Effective, or “mutative,” interpretations help the
patient become aware of the contrast between the archaic fantasy
object and the real analytic object. The resulting introjection of
this less aggressive, more benign object into the patient’s superego
modifies superego aggression, thereby creating interference with
the habitual neurotic process. For Strachey, psychic change results
from the internalization of the analyst as a good object via mutative
interpretation.
Also in Britain, several analysts with a radically social concep-
tion of human nature challenged drive theory. They suggested that
the basic human striving is for connection with others, often, in
deference to Freud, called “objects.”” This major transformation
of theory—perhaps even a paradigm shift—to a relational model is
still in progress. Greenberg and Mitchell (1983), as well as Bacal
*

Freud's conception of the object probably came from philosopher Franz Brentano, from
whom he took five courses. Brentano held that intentionality, or reference to an object,
defines psychic life. Thus, to think is to think something, to desire is to want something,
and so on.
 How Does Psychoanalytic Understanding Heal? / 163

and Newman (1990), have extensively explored this change in

theoretical focus.
Tan Suttie (1935), for example, who I suspect has been ne-
glected because he was so straightforwardly radical, understood
human beings as motivated primarily by the need and desire for
companionship and love. He saw hatred as frustration in the search
for love. Differentiating sexuality from tenderness, he accused the
Freudians of reductionistic pansexualism. Suttie complained, in
addition, of what he called the taboo on tenderness, or antiemo-
tionalism, in scientific psychology, in society, and _particularly
among psychoanalysts. He thought that society underappreciates
and undercompensates the work of mothers and nurses, and he
attributed this phenomenon to a general aversion to tenderness.
Noting that society views as unmanly tenderness for people or
animals, he thought that men had often substituted sexuality for
the love and tenderness that were taboo for them. In Suttie’s view,
Freud, by building the taboo on tenderness into his theory, reduced
tenderness, love, and companionship to derivatives of sexuality.
Suttie believed that psychoanalysis provides an opportunity to
restore lost or damaged capacities to find companionship and love.
He liked to quote Ferenczi’s saying, “It is the physician’s love that
heals the patient,” and he felt that this position has enormous
practical bearing:

If we do not like a patient we are hopelessly handicapped in treating

him. No amount of technical skill, theoretical knowledge or consci-
entiousness will atone for the absence of a sympathetic under-
standing and the capacity to “put oneself in the patient’s place.” (p.
74)

Suttie believed that all mental illness, no matter what its biological
concomitants or how isolative it appears, is a disturbance in social
relatedness. He therefore provided a developmental, and in today’s
terminology, thoroughly intersubjective, account of the develop-
ment of symptoms:

Mind is so intimately and constantly dependent upon interplay with

other minds that any disturbance of its interpsychic [Suttie’s word]
164 / EMOTIONAL UNDERSTANDING

relationships further alters the affected mind in a “vicious circle.” The

loss of touch with others produces a vast number of secondary
symptoms, reparative, compensatory, defensive, defiant, etc., and
produces in the observer’s mind the illusion that the patient's trouble
is of relatively recent, definite and sudden onset, whereas in reality
much of the disturbance and distress is due to emotions evoked by
the impairment of companionship (of love and of interest) in the
distant past. Further, every lapse from sociability on the part of the
patient produces an antipathetic response from his social environment,
which in turn has its repercussions upon himself. Thus a vicious circle
of protest and counter-protest and misunderstanding is set up. In
consequence the patient is alienated not so much of his own accord
as by a sort of emotional ostracism on the part of others. He did not
intend to become isolated, even unconsciously. He was forced into
its (ps 182)

This intersubjective account of psychopathology has important

implications for understanding the therapeutic action of psycho-
analysis. For Suttie the task of psychotherapy is “to induce the
patient to lay aside her age-old defenses against the infantile dread
of isolation, and to find an adequate substitute in adult love and
interest-companionship” (p. 203). In another place, he claimed that
psychotherapy involves “the overcoming of the barriers to loving and
feeling oneself loved, and not the removal of fear-imposed inhibitions
to the expression of innate, anti-social, egoistic, and sensual de-
sires” (pp. 53-54).
Like Suttie, Fairbairn challenged the fundamental conceptual
structure of Freudian psychoanalysis when he claimed that human
beings are object-seeking from birth. He sought to replace the
Freudian emphasis on impulse and drive with a focus on how
people maintain crucial ties in the face of neglect or frustration of
vital relational needs. According to Fairbairn, a person copes with
the frustration that results from unsatisfactory early object rela-
tionships by splitting psychic experience. The unification of the
split ego, or split psyche, became for Fairbairn the aim of psycho-
analytic therapy. He regarded the split ego as an internal “closed
system” that evolved as a reaction to the effects of unsatisfactory
early object relationships. Thus, Fairbairn (1952) believed that “the
chief aim of psycho-analytical treatment is to promote a maximum
synthesis of the structure into which the original ego has been split”
 How Does Psychoanalytic Understanding Heal? / 165

(p. 380). To do so, the patient needs help to release bad objects
from repression and to dissolve “libidinal” ties to them in order to
become free to form healthier object relationships. As Bacal (1990)
paraphrases Fairbairn, “Interpretation alone is insufficient; the
patient’s maintaining his inner world as a closed system has been
partially determined by his sense of hopelessness in obtaining any
satisfaction from objects in external reality upon whom he might allow
himself to become dependent” (p. 357).
To feel safe enough to risk releasing internalized bad objects
from repression (i.e., to experience them as bad), and to experi-
ence them in the transference, the patient must experience the
analyst as a good object (Bacal & Newman, 1990, p. 152). In
Fairbairn’s words, “It is the actual relationship between the patient
and the analyst [that] constitutes the decisive factor in psychoana-
lytical, no less than in any other form of psychotherapeutic care”
(p. 385). More precisely, “the relationship between the patient and
the analyst is not just the relationship involved in the transference,
but the total relationship existing between the patient and the
analyst as persons” (p. 379). This tie with “a reliable and beneficent
parental figure” (p. 377) was the relationship denied to the patient
in childhood.
The most influential contributor to the paradigm shift to a
relational model is Winnicott (1958, 1965). Focusing on the simi-
larities between the mother-infant relationship and the analytic
situation, he saw analysts as providing a holding environment
similar to that furnished by good-enough mothering. A regressive
experience in such an analysis, he thought, frees the patient from
the persistent dominance of a compliant false-self organization,
thereby making possible the emergence of a spontaneous, true self.
Winnicott’s work on play and on transitional experience opened
our eyes to the wide range of human experience, especially includ-
ing the creative regions, that has relational meaning. He thus
helped us to see nonverbal and playful activities of bonding both
in childhood and adulthood. His highlighting of “primary mater-
nal preoccupation” in infancy, with its considerable demands on
the mother, parallels his emphasis on the management of the limits
of analysts’ emotional availability. He said, more than half seri-
ously, that his patients had to “queue up” for their regressions
(Little, 1990). Similarly, Gotthold (1992) notes both the necessity
166 / EMOTIONAL UNDERSTANDING

and difficulties of analytic wholeheartedness with patients like

those about whom Winnicott wrote.
Bowlby, who has been ignored in British psychoanalysis both
because of his ethological analogies and because his thought was
radical, articulated the bonding hypothesis even more clearly than
Winnicott did. In his last book, Bowlby (1988) summarized his life’s
work under two headings: (1) the importance for psychoanalysis
of considering how the actual conditions of a child’s emotional
environment affect the person’s development and (2) the develop-
mental primacy of experiences of attachment, separation, and loss,
or, as he sometimes said, the making and breaking of emotional
bonds.
Although Bowlby rejected drive theory and the Kleinian
language of Winnicott, he saw the clinical work of Winnicott as
most closely allied with his own thinking. However, while Bowlby
saw the task of therapy as clearly focused on issues of relatedness,
he viewed the process itself as insight-oriented. Bowlby acknow-
ledged his similarity to Kohut on this issue. What is remarkable is
how clearly Bowlby (1988) articulated the basic condition for the
possibility of any healing through insight:

The first [task] is to provide the patient with a secure base from which
he can explore the various unhappy and painful aspects of his life,
past and present, many of which he finds it difficult or perhaps
impossible to think about and reconsider without a trusted compan-
ion to provide support, encouragement, sympathy, and, on occasion,
guidance. (p. 138)

Other aspects of psychoanalysis emphasized by Bowlby were ex-

ploration, comparison of divergent experiences and perspectives,
and understanding. But the creation of emotional security was
Bowlby’s lifelong interest. He compared the secure-base-providing
role of the therapist with “that of amother who provides her child
with a secure base from which to explore the world” (p. 140). The
therapist provides a zone of safety in which the patient can explore
the effects of his or her personal history—of trauma, neglect, or
other trouble—on self-experience in the past and present.
Michael Balint, an analysand of Ferenczi, imported Ferenczi’s
ideas into the group of British psychoanalysts who embraced the
 How Does Psychoanalytic Understanding Heal? / 167

social conception of human beings. Balint made important addi-

tions to Ferenczi’s thinking about the importance of the patient-
analyst relationship. Balint viewed psychoanalysis as a two-person
or two-body psychology, not the one-person psychology of tradi-
tional analytic therapy. Like his mentor Ferenczi, therefore, he
encouraged careful attention to the analyst’s contribution to the
therapeutic situation. Moreover, in Balint’s words, “The events
during an analysis are not determined by the patient’s associations
and transference, or by the analyst’s interpretation, but by an
interaction between the two” (Balint, 1953, as quoted in Bacal &
Newman, 1990, p. 127). The course of an analysis, Balint main-
tained, is not a simple product of the analysand’s early experience.
It also results from the current relations among the patient, the
analyst, and the ethos of the analytic situation.
Balint’s relational theory of the genesis of psychopathology,
especially his conception of “the basic fault,” engendered his view
of therapeutic action. His “basic fault” referred to a major discrep-
ancy, or gap, betweena patient’s needs in infancy and the capacity
of the people in the child’s early environment to respond to these
needs. By regressing in the transference to the level of the basic
fault, the patient attempts to form the needed reparative relation-
ship with the analyst. Once regressed to this level, the patient can
discover that rigidly maintained, self-protective conditions for re-
lating and loving are no longer necessary. In the phase Balint
(1968) called “the new beginning” (pp. 131-132), a person can
relinquish these rigid conditions.
Meanwhile, the American Hans Loewald (1960a), working in
ego psychology with its objectivist assumptions but influenced by
the pioneering British psychoanalysts, wrote an extraordinary
paper, “On the Therapeutic Action of Psychoanalysis.” Loewald
argued that the relational features of the analyst’s interpretive
activity are central to the therapeutic action of psychoanalysis. In
his words, the “resumption of ego development is contingent on
the relationship with the new object, the analyst” (p. 221). “The
newness consists in the patient’s rediscovery of the early paths of
the development of object relations leading to a new way ofrelating
to objects and of being oneself” (p. 229). This new relational

* : fi ag =
This idea resembles my intersubjective conception of the psychoanalytic triad (Chapter 2).
168 / EMOTIONAL UNDERSTANDING

experience for the patient comes about largely through the ana-
lyst’s interpretation of the patient’s transference distortion. “The
chiselling away of transference distortions” (p. 225) permits the
process of identification that Loewald, like Strachey, saw as central
to the new object tie. Growth occurs, Loewald believed, by the
internalization of relational exchanges between the self and the
other. The analyst provides regulating and organizing functions
for the patient by interpretation in a way analogous to the mother’s
care for the child. For Loewald, the patient internalizes the inter-
action process in which the analyst’s interpretations supply an
“integrative experience” for the patient. This process mediates
between the patient’s idiosyncratic, childish beliefs and the ana-
lyst’s more highly differentiated organization.
To summarize, we could say that each of these authors—Fer-
enczi, Strachey, Suttie, Fairbairn, Winnicott, Bowlby, Balint, and
Loewald—conceived of psychoanalysis as a return to the road not
taken by the patient because it was not available to her or him as a
child. These theoreticians believed that the lack of crucial attach-
ment bonds, or primary emotional ties, prevents the emergence of
a robust self. In analysis the patient returns to the conditions of
infancy, not in a regressive sense but as an emotional opportunity
for a much needed attachment that makes possible progressive
development in adulthood.
Because of Strachey and Loewald, the question of how analysis
works has been prominent in recent psychoanalytic thought. We
turn now to how this issue has been approached within self
psychology, both by Kohut and by some of those who have contin-
ued to develop self psychological theory. In the spirit of inquiry
and growth of theory proposed by Kohut (1977, p. 312), I have
slightly modified Kohut’s (1984) question “How does analysis
cure?” to ask: How does psychoanalytic understanding heal?
Kohut’s (1977) explicit answer was that optimal frustration
promotes transmuting internalization. By “frustration” he seems
to have meant the disruptions and misunderstanding that inevita-
bly occur, even in a treatment characterized by the empathic
inquiry and empathically informed interpretations by the analyst.
If adequately analyzed, these disruptions of the self-selfobject
milieu enable the patient to internalize the analyst’s selfobject
 How Does Psychoanalytic Understanding Heal? / 169

functions—mirroring and soothing, for example. The patient thus

builds up newly cohesive, stable, and positively valued psychic
structure, or selfhood.
Kohut reaffirmed this view of cure in his 1984 book, empha-
sizing that frustration is inherent in the analytic process, which can
provide only understanding and explanation, not gratification of
the needs being understood. In his words, “It is the accretion of
psychic structure via an optimal frustration of the analysand’s
needs or wishes that is provided for the analysand in the form of
correct interpretations that constitutes the essence of the cure” (p.
108). Yet in this same work, Kohut also hinted that while self
psychologically oriented analysis makes no major technical depar-
tures from classical analysis, something besides interpretation may
be involved in psychoanalytic cure. In his account of the disruptions
that lead to transmuting internalization of psychic structure, Kohut
emphasized the mending or repair of the self-selfobject tie, or
empathic bond, between analyst and patient (Jaenicke, 1987).
Although, to my knowledge, Kohut never said that the process of
mending a broken tie in the present makes possible a partial
healing of the self broken in the past—his explicit emphasis was
more on structure-building than on healing—his work suggests that
self psychologically informed psychoanalysis works in this way. In
addition, when this occurs, it may give the patient a feeling of hope
that further healing is possible.
In this vein, Kohut (1981) suggested that, much as he wished
to regard empathic understanding simply as a scientific tool for
gathering data, he had been forced to recognize and admit that
empathy itself might be curative. Thus part of Kohut’s legacy
to psychoanalysis is the recognition that both relatedness and
empathy-informed interpretation are crucial to psychoanalytic
cure. The open questions concern the relative importance of
these two elements and the nature of the relationship between
them.
In fact Kohut placed the formation of self-consolidating emo-
tional connections squarely in the foreground of analytic thought
and practice. The selfobject conception, self psychology’s theoreti-
cal heart, placed the ability of emotional bonds to strengthen
self-experience right in the center of emotional experience, devel-
170 / EMOTIONAL UNDERSTANDING

opment, and cure. In other words, Kohut too thought that analysis
gives patients a second chance at healthy emotional development
based on attachment. Nevertheless, this emphasis surfaced most
clearly in his later works.
As noted above, Kohut (1977) originally claimed that change
occurs through transmuting internalization. In his view the patient
takes in forms of self-experience made newly available by selfobject
experience in treatment, especially while mending nontraumati-
cally disrupted selfobject bonds. Gradually the patient incorpo-
rates forms of self-experience—ideals, ambitions, enthusiasms,
firmness, for example—from his or her therapist’s reasonably
consistent responsiveness, presumably missing in the patient’s
childhood. Kohut accounted for the increased experience of self-
cohesiveness, self-continuity, and positive self-experience by these
“transmuting internalizations.”
While internalization is undoubtedly a spatial metaphor that
is vulnerable to criticism as overly concrete and simple, the trans-
muting part of the inferred process is more abstract and complex.
The patient inevitably and continually transforms the current
selfobject experience with the analyst according to already organ-
ized preconceptions inferred from her or his emotional history—
importantly including the history of experience with the analyst—
and thus gains new psychological organization or structure. In
addition, it is clear that Kohut meant that selfobject experience
changes the patient over time into a stronger person with a firmer
and more positive sense of self. In his last writings Kohut (1977,
1984) placed more emphasis on this kind of change. However, he
was reluctant to do this because he wanted empathy to be under-
stood as a method of investigation, not as a direct route to cure
through being kind. His own accumulated experience, however,
led him to acknowledge that something was curative about the
experience of feeling understood (1981).
An intersubjective account of psychoanalytic understanding
places the process of organizing and reorganizing experience at its
center (Stolorow et al., 1987; Stolorow & Atwood, 1992). Stolorow
(1994) has moved away from a transformational view that sees
organizing principles as replaced or radically modified in treat-
ment. He believes instead that we acquire an expanded repertoire
of principles for organizing experience more flexibly. Relational
 How Does Psychoanalytic Understanding Heal? / 171

predicaments that closely resemble the intersubjective situations in

which we formed our original assumptions can evoke them again.
Yet we know that people do become more flexible, more moderate,
more generous, and more content. How does this happen?

Al TAGHMENT SELFOBJECT EXPERIENCE,

ANDES GERAPEUTIGIEFFICGAGY.

Psychoanalytic understanding is, among other things, a form of

loving, and it can be experienced in that way by the patient. It
differs from empathy, which is value-neutral and can be used to
hurt people. Psychoanalytic understanding, as it characterizes
both practitioner and process, is unequivocally propatient
(Tolpin, 1991). Although patients may not recognize for a long
time that we are on their side, we must know that we are. If we
cannot find or maintain this attitude with a given patient, we
ought to consult our colleagues and, if necessary, refer the
patient. Often we can recognize our inability to stay on the side
ofa patient in the kind of humor-—is it ironic or sarcastic?—we use
in speaking with colleagues about this patient. Another clue
comes in our use of diagnostic labels like “borderline” or “hys-
teric,” which denigrate the patient and short-circuit the interplay
of psychoanalytic understanding. Labeling may have other func-
tions, of course, but none of these, in my view, furthers the
process of understanding.
Being propatient, although only one part of cure or healing,
is, like emotional availability, a necessary condition for its possibil-
ity. It probably forms part of that emotional availability so crucial
to the attachment process that I see as the core of the therapeutic
efficacy of psychoanalytic treatment.
What then is the connection between attachment and emo-
tional healing? Clearly not all psychological change requires a
crucial emotional bond to an analyst or therapist. Drugs, cogni-
tive-behavioral therapies, and strategic or systemic family thera-
pies operate—or claim to—without such bonds. I believe that an
adequate psychoanalytic conception of therapeutic action
through understanding requires that we look again at the selfob-
ject conception.
172. / EMOTIONAL UNDERSTANDING

The cornerstone of self psychological theory is the idea of

selfobject experience. In my view the particular human being who
provides selfobject experience matters profoundly. Thus, we can
clarify the selfobject notion by reference to ideas that have emerged
from research into early attachments. Prominent attachment theo-
rists include Bowlby, Ainsworth, Sroufe, and Main. In contrast to
classical psychoanalytic theory, attachment theory asserts that
needs for safety and security, rather than for reduction of physi-
ological drive tensions, lead to the formation of a bond between
caretaker and infant (Bowlby, 1979).
Self psychologists and attachment researchers share in com-
mon a central belief in the overriding importance of the tendency
of human beings to form strong emotional bonds to individual
others. Both believe that this tendency to form strong bonds with
special others is at the core of human functioning and human
psychology throughout life. As Bacal and. Newman (1990) point
out, both approaches stress the importance for healthy develop-
ment of relationships with phase-appropriately responsive and
supportive figures. Additionally, both theoretical traditions main-
tain that this tendency is present in the infant and continues
throughout adult life ull death. Further, both believe that a princi-
pal feature of competent personality functioning and mental
health is the ability to form emotional ties with people, in both the
careseeking and caretaking roles.
Significant differences, nevertheless, exist between the two
theories. Self psychologists view self-development as originating
in, and maintained by, the experience of support from responsive
and idealizable others. Self psychology calls these experiences
“selfobject” to suggest that we feel people who provide them as
supports to our selfhood, not primarily as subjects of their own
experience. When caretakers disappear or fail, the child can often
use another available adult to supply the needed ideals, validation,
and support.
Attachment theorists, partly to the contrary, see the develop-
ment of a self as contingent on reliable emotional bonds to
particular caretakers. Recent infant research views infants as origi-
nally capable of and disposed to such ties. The stability of these
bonds provides a sense of safety for the child, a secure base
(Bowlby, 1988) from which the child can venture forth to explore
 How Does Psychoanalytic Understanding Heal? / 173

the world. To lose such an irreplaceable caretaker can be pro-

foundly traumatizing, and the loss may never entirely heal.
Attachment theory has been conceptualized by its researchers
in behavioral, dyadic terms. Generally, theorists and scientists in
the attachment tradition—Bowlby, Ainsworth, Sroufe, and many
others—have emphasized the behaviorally observable effects of the
formation and disruption of attachment. They also correlate secu-
rity of attachment with various abilities and behaviors later in
childhood and adolescence. Conceived in measurable and behav-
ioral terms, attachment theory has become a prominent paradigm
in infant research.
Yet attachment theorists sometimes neglect the subjective
experience of attachment, including the personal meanings of
attachment, separation, and loss. According to Greenberg and
Mitchell (1983), Bowlby does not “account for the emotional need
for and meaning of attachment and relationship in the develop-
ment of a distinctly human self” (p. 187).
Self psychology, on the contrary, addresses the experience of
attachment and loss. An example of this is the recent interest
among self psychologists in the importance of the significant other
for the patterning of self-experience. This is evident in Stolorow et
al.’s (1987) intersubjectivity theory, Bacal’s (1990) and Bacal and
Newman’s (1990) work delineating the object relational “bridges”
to self psychology, Beebe and Lachmann’s (1988) emphasis on
mutual influence structures in their work on the development of
representations, Fosshage’s (1992b, 1994) work on the organiza-
tional conception of transference and the self in the relational
matrix, and Lessem’s (1992) work on the relational patterning of
affective experience. Self psychology now addresses many of the
same issues that have occupied attachment researchers.
To account for certain clinical phenomena—especially ofloss,
idiosyncratic personality development, the repetition of painful
relational experience, and the uniqueness of each psychoanalytic
treatment—self psychology needs to include attachment within its
central theoretical ideas. According to the attachment theorists,
however, attachment is always to a particular individual. In the
words of Bacal and Newman (1990), self psychological theory
“does not provide for an acknowledgment of the importance of
object specificity” (p. 231). “In focusing on the experience of
174. / EMOTIONAL UNDERSTANDING

selfobject function, . . . selfpsychology theory has lost sight of the

object that provides that function” (p. 230). If self psychology is to
fulfill its promise, it must find a way to take the particularity of
relational experience into theoretical account. I believe that stable
attachments form a necessary condition for the possibility of “primary
selfobject relatedness” (a term explained below). Such relatedness in turn
is indispensable to the integration of affect that is crucial to cohesive,
continuous, and positively colored self-experience.
Let me add a point of clarification: My focus here is not the
question of the link between self psychology and object relations
theories. For my purpose there is no need to decide whether self
psychology is truly part of object relations theory or whether object
relations theories in some interesting ways anticipated self psychol-
ogy. Others deeply versed in both ways of thinking (Brandchaft,
1986; Bacal & Newman, 1990; P. Ornstein, 1991) have extensively
considered these questions.
Instead we must use the empirical findings of attachment
research to clarify and enrich what self psychology—a psychoana-
lytic theory that relies on introspection and empathy as its methods
of collecting data—has taught us about the relational origins of self-
experience. In “Introspection, Empathy, and Psychoanalysis: An
Examination of the Relationship Between Mode of Observation
and Theory,” Kohut (1959) articulated the difference between
empirical theories and those based primarily on the data gained
by introspection and empathy. In his words:

Some concepts used by psychoanalysis are not abstractions founded

on introspective observation or empathic introspection, but are
derived from data obtained through other methods of observation.
Such concepts must be compared with the theoretical abstractions
based on psychoanalytic observations; they are not, however, identi-
cal with them. (p. 221)

Attachment theories “are derived from data obtained through

other methods of observation.” I do not, therefore, propose a
simple merger of attachment theory with self psychology. These
theories belong to different realms of discourse, to distinct
conceptual schemes. Nevertheless, awareness of the findings of
attachment research will expand the range of our empathy and
 How Does Psychoanalytic Understanding Heal? / 175

will help us refine and clarify some theoretical notions of self

psychology. Genuinely psychoanalytic theories always include
“introspection and empathy as an essential constituent” (Kohut,
1959, p. 209). Still, those who seek to develop psychoanalytic
theories must consider empirical findings and use these to im-
prove our powers of empathic observation. Let us therefore
examine the connections among selfobject experience, attach-
ment, understanding, and psychoanalytic cure.

Primary and Derivative Selfobject Relatedness

In its brief history, self psychology has variously conceived the
selfobject as person, function, dimension of experience, and vital-
izing experience. Here I present my own developing view of the
selfobject experience in secure attachments.
I will begin by distinguishing the selfobject connection from
other forms of experienced relatedness. First, it differs from the
I-Thou, or subject-subject, reciprocal connection, which defines
a special kind of intersubjective field in which two people, either
momentarily or fundamentally, stand in relation, at times perhaps
mutually acknowledged, as subjects of experience. (Selfobject
connection may, however, exist within this intersubjective form.)
While prolonged I-Thou relatedness often sustains mutual selfob-
ject relatedness, only when we describe the other felt as support
for the self are we speaking of selfobject relatedness. Selfobject
relatedness is an asymmetrical relational experience.’ It can, how-
ever, exist for both people in a mutual relation of land Thou. Aron
(1992) says that the psychoanalytic relationship is at once mutual
and asymmetrical. Similarly, we can view selfobject relatedness
(asymmetrical by definition) as existing within an intersubjective
field in which both people fully participate.
Second, selfobject relatedness differs from personal relatedness
in the legal or philosophical sense (Macmurray, 1957). In these views,
the person or self is an agent in relation to other agents. Likewise,
selfobject relatedness is not interpersonal in the interactive sense
understood by most Sullivanian psychoanalysts. Instead, selfobject
relatedness is a thoroughly subjective relational experience.
Lynn Preston (personal communication) believes that selfobject experience is intrinsically
bidirectional, that both people must give and receive if selfobject experience is to occur.
176 / EMOTIONAL UNDERSTANDING

Third, selfobject relatedness is not I-It, instrumental, or subject-

object relatedness (in the philosophical, not the psychoanalytic,
sense of an object), although things, including ideas and forms of
culture, may sometimes serve secondary, or derivative, selfobject
functions (a concept to be explained later in this chapter). The I-It
relation is one of user to object or item. When we experience another
as support for the stability of our self-experience, we do not automat-
ically reduce the other to the status of a thing. The common
reference to the “use” of another as selfobject may mislead us into
thinking that the special personality of the other is irrelevant. We
may drift into the assumption that the providers of selfobject expe-
rience are as interchangeable as similar objects of use.We cannot
drive into any emotional gas station and order regular unleaded
selfobject experience, as if anyone would do as well as anyone else.
Kohut did not see people as replaceable items. He taught us, on the
contrary, not to differentiate between archaic and mature selfobject
needs as if the distinction were between I-It and I-Thou relatedness,
between relatedness that is primarily self-gratifying and that which
springs from a true desire to connect with others. Throughout life,
mature people have many kinds of connections to other human
beings and considerable flexibility in their relational capacities.
Selfobject relatedness is a special kind of relatedness that
creates and maintains positive and stable self-experience. We may
feel the other as a selfobject and simultaneously experience her or
him as subject or as object. Selfobject experience can coexist with,
and inhere in, various forms of relational experience. A person,
for example, who normally treats me as an adversary may give me
some grudging admiration that, at least temporarily, strengthens
my self-respect. Essential to selfobject relatedness is its experiential
character, its nature as subjective and as strengthening to a stable
and positive sense of self. Self psychology uses the psychoanalytic
access through introspection and empathy to discover selfobject
relatedness. If introspection and empathy yield the only truly
psychoanalytic knowledge, and if we can know selfobject related-
ness only so, then selfobject relatedness is a fully psychoanalytic
conception. (This inference displays the tight connection between
Kohut’s epistemological and methodological views [1959] and the
central theoretical conceptions of self psychology.)
Expressions like “a form of relatedness,” “a process of feeling
 How Does Psychoanalytic Understanding Heal? / 177

connection,” and “experienced relatedness” are almost inter-

changeable. Two assumptions underlie this terminology. It implies,
first, that experience, whether self-experience or relational experi-
ence, is process. It is neither finished history nor encapsulated
moment. It always involves interplay or conversation, among past,
present, and future. Second, intentionally assuming that relatedness
is process, | prefer the word “relatedness” to the more static-sound-
ing “relation” or “relationship.” This choice avoids making the
selfobject conception overly concrete. Instead, it retains experi-
ence-near and process-suggestive terms.
The intersubjectivity theory of Stolorow et al. (1987) provides
a theoretical framework for the specificity of the other and for the
particularity of selfobject relatedness. These authors insist repeat-
edly that an intersubjective field consists of the intersection and
interplay of two differently organized subjectivities. If, in such a
field, one subject finds the other a support for stable and positive
self-experience, it is that subject’s experience of the particular other
as providing support that I designate “primary selfobject related-
ness.” This definition does not refer to infancy or maturity. It
requires only an important bond in which one or both subjects
experience the other as support for valued, cohesive selfhood.
Granted, not every intersubjective field is an attachment, or in
Bowlby’s (1979) words, an “affectional bond.” Still, selfobject
relatedness is the person’s experience, at any age, of a significant
human other or attachment figure as support for the estab-
lishment, development, and maintenance of continuous, cohesive,
and positive self-experience.” I name this experience “primary
selfobject relatedness,” and I believe that it inheres only in impor-
tant emotional ties.
Undoubtedly, other self-vitalizing experiences can be impor-
tant in childhood and adulthood. Many people feel, for example,
that some form of physical activity strengthens their sense of self.
Others gain a similar sense of self-vitalization from music or other
experiences of human culture or natural beauty. Let us call these

hae question of negative experience of a significant other arises here, either as “bad
selfobject” (an oxymoron, I think) or, as George Atwood (personal communication, 1994)
puts it, “people we may rely on negatively to support our sense of self, i.e., as counterex-
amples of who we are, where we solidify our sense of self through sharpening our contrast
with particular others.” I do not claim that selfobject experience is the only psychologically
important experience we have of significant others, just that it is the only type that heals.
178 / EMOTIONAL UNDERSTANDING

secondary forms of self-vitalization “derivative selfobject experi-

ence” (no reference to instinctual derivatives intended). This
broader category of selfobject experiences is implicitly relational.
The usefulness of these secondary selfobject experiences derives
from primary selfobject relatedness in attachment bonds. Deprived
of primary selfobject relatedness, people usually find that selfob-
ject experience of these nonhuman forms only fleetingly sustains
a sense of self. Self psychologists have observed that the ability to
use this larger class of experience improves, expands, and becomes
more flexible once the basic need for primary selfobject related-
ness has found appropriate response in significant emotional
bonds.
Selfobject experience, therefore, is a large class of both pri-
mary and derivative self-strengthening phenomena, within which
selfobject relatedness is the primary and indispensable form. The
derivative forms, implicitly and derivatively relational, resemble
Winnicott’s (1958) transitional experience. They have their impor-
tance as developmental achievements in their own right or as
transitory substitutes, at any age, for the special human relatedness
called selfobject relatedness.
Both self psychology and attachment theories point toward
new ideas of development and maturity. Kohut used the expression
“archaic” to describe forms of early relatedness that he thought
persisted in narcissistically disordered personalities. He assumed,
however, an undifferentiated matrix in which the infant experi-
ences the caretaker only as part of the self. Recent research
(Lichtenberg, 1983; Daniel Stern, 1985) has, however, convinced
most self psychologists that infants can recognize their caretakers
from the earliest days of life and that they are born with sophisti-
cated relational capacities. Attachment theories, in addition, see
emotional bonds as a lifelong need in primates, including humans.
Few of us now share the assumptions about infancy on which
Kohut’s characterization of early selfobject relatedness as “archaic”
rested. We need, therefore, to ask ourselves what we could mean,
if anything, by speaking of mature selfobject relatedness.
This whole distinction, I believe, needs to be laid to rest.
Selfobject relatedness is neither mature nor immature. Almost
everyone is born with the capacity for such relatedness, but not
nearly everyone is born into an emotional environment that makes
 How Does Psychoanalytic Understanding Heal? / 179

this experience readily available in stable, secure attachments.

Without such a human environment, we go about, as if starved for
relational oxygen, seeking substitutes in anxious attachments, sub-
stances, or compulsive activity. Even these activities, however, are
signs that a person has not given up. Relational maturation con-
sists, not in relinquishing or diminishing the need for human
attachments that can provide selfobject relatedness, not in realizing
some ideal of independence from others, but in regaining and
developing the original disposition to find well-being in the human
world.
Immaturity, to repeat, is not attachment to significant others,
nor is maturity a take-it-or-leave-it attitude toward selfobject relat-
edness. One of Kohut’s most important contributions was a rejec-
tion of shame over our human need for relatedness. His conception
of selfobject relatedness as self-constitutive affirmed the lifelong
legitimacy of this need. If we water down the selfobject conception
and make it overinclusive, we may then idealize a lesser need for
human relatedness and intimacy. We then lose Kohut’s fundamen-
tal insight into human nature, neglect the findings of attachment
theories, and return to a version of maturity morality.
Primary selfobject relatedness is the person’s experience, at
any age, of a connection with a significant human other or attach-
ment figure as support for the establishment, development, and
maintenance of continuous, cohesive, positive self-experience.
Such relatedness is crucial for learning to recognize, differentiate,
and express a range of emotional experience. Primary selfobject
relatedness, facilitated by optimal responsiveness (Bacal, 1985),
provides a context in which we can comfortably come to include
our own emotional life in an organized self. Then we no longer
need to reject major portions of our self-experience, or to live a
divided, disorganized, severely restricted life. Secure attachment
makes primary selfobject relatedness possible. This emotional
climate provides for the integration of affective experience into an
organized and positively colored sense of self.
I believe psychoanalytic understanding creates in adulthood
the opportunity for a second chance at such primary selfobject
relatedness. There is no greater bonding agent than a prolonged
attempt to make sense together of someone’s emotional life.
GAS IPI ROME

Illustration:
Understanding Schreber

[God’s] actions have been practiced against

me for years with the utmost cruelty and
disregard as only a beast deals with its prey.
—DaANIEL PAUL SCHREBER,
Memoirs of My Nervous Illness

Such a father as this was by no means unsuitable

for transfiguration into a God in the affectionate
memory of [the] son from whom he had been so
early separated by death.
—SIGMUND Freub, “Psycho-Analytic Notes
on an Autobiographical Account of a Case
of Paranoia (Dementia Paranoides)”

ete Schreber, the German judge whose memoir Freud

analyzed, illustrates many aspects of my view of understanding.
The contrast between the reading of Schreber’s memoir by Freud
and those done from a self psychology-intersubjectivity theory
point of view dramatically supports my contention that theory-
choice matters, that it has practical clinical import. Simultaneously,
it serves as an example ofthe need for fallibilism, or holding theory
lightly, so we can notice and take account of new information or
perspectives. In addition, my rethinking of Schreber demonstrates
that we need not choose between self psychology and intersubjec-

180
 Illustration: Understanding Schreber / 181

tivity theory, that concentrating on a patient’s self-experience

requires close attention to the intersubjective contexts of its past
and present origins. The attempt to understand a person from
writings alone has obvious and severe limits. Still, I believe this
effort can illustrate my view that understanding comes from
participation, from entry into the whole emotional predicament
within which a person has organized and continues to organize
experience, and from making sense together. I therefore complete
my exploration of the nature of psychoanalytic understanding with
a reexamination of the case Schreber made for himself.
Today we know Schreber because Freud wrote about him.
Unlike Freud’s own patients about whom he wrote, Schreber was
never seen by Freud. This places Freud and a modern reader at the
same starting point, except that we now have both Freud’s (1911)
“Psycho-Analytic Notes on an Autobiographical Account of aCase
of Paranoia (Dementia Paranoides)” and considerable biographi-
cal research on Schreber, his family, and his psychiatrist Flechsig.
No one has access to the vast array of nonverbal data on which the
empathic-introspective method relies so heavily in clinical psycho-
analysis (Schwaber, 1983). What we do have in common with Freud
is a substantial autobiographical account ofa psychosis, Schreber’s
Denkwiirdgikeiten eines Nervenkranken, or Memoirs of My Nervous
Illness (1903). The purpose of this chapter is not to add to the
biographical research on Schreber, nor even to second-guess
Freud. My intent is to provide a rereading of the Memoirs from the
perspective of psychoanalytic self psychology, that is, from within
the tradition originally articulated by Heinz Kohut (1971, 1977,
1984) and developed from the intersubjective perspective I share
with Stolorow et al. (1987).
The first section of this chapter will provide a brief summary
of Schreber’s Memoirs and some biographical data; the second
section will comment on Freud’s account; and the third section will
summarize some psychoanalytic contributions to the literature on
Schreber since Freud. The chapter will focus on Schreber’s self-ex-
perience from a relational-self-experience perspective. Almost
every part of Schreber’s self-experience consisted of his inference
from, and organization of, his experience of being treated in
particular ways by others. Recent research by psychoanalysts and
historians supports more than a small developmental “kernel of
182. / EMOTIONAL UNDERSTANDING

truth” in Schreber’s beliefs. In addition, Schreber clearly presented

his delusions as his understanding of his treatment in the various
asylums. “Here is what is happening to me,” he seemed to say.
Schreber wrote the Memoirs as an effort to organize and commu-
nicate his own experience so he could be found legally competent
to manage his own affairs and to live outside the asylum. His book
is the work of a judge writing to a judge, that is, by writing the book
Schreber placed himself in an intersubjective field in which he
could expect to find acknowledgment and respect. The final
section of this chapter will examine this self-restorative process, the
selfobject character of the book itself, and in particular the poten-
tial selfobject functions of the judge and court.

SCHREBER AND HIS MEMOIRS

Born in 1842, Daniel Paul Schreber, hereafter “Schreber,” was

the second son and third of five children born to Daniel Gottlob
Moritz Schreber (from now on “Moritz Schreber”) and Pauline
Haase. Dr. Moritz Schreber, author of books on medical gymnas-
tics and on childrearing practices, died when Schreber was 19
years old. Not much was known about Schreber’s mother until
Israels’s (1989) biography of Schreber. It now appears that she
was a major figure for Schreber until her death when he was in
his 60s. Schreber became ajurist and rose quickly through the
court system to become a prominent judge in Leipzig. He mar-
ried in 1878, a year after his older brother, at age 38, committed
suicide by gunshot. In 1885, Schreber became a candidate for the
Reichstag (the imperial Diet, or legislature) from Chemnitz, where
he held the post of Landgerichtsdirektor, the rank below president
of the district court (Israels, 1989, p. 156). His first period of
nervous disorder, as he termed it, or of hypochondria, as his
psychiatrist Paul Emil Flechsig called it, occurred almost imme-
diately after he lost this election. In the words of the clinic’s
psychiatric reports, “He imagines that he has lost thirty to forty
pounds in weight. Has in fact gained two kilogrammes. Com-
plains that he is being purposely deceived about his weight”
(quoted in Baumeyer, 1956, pp. 61-62). By Schreber’s (1903) own
 Illustration: Understanding Schreber / 183

account, the first period passed “without any occurrences bor-

dering on the supernatural” (p. 35). After 6 months in Flechsig’s
clinic in Leipzig, he returned to his wife and his work for 8 years.
In 1893, he was appointed Senatspraesident in the Oberlandsgericht
(superior court) in Dresden, and within weeks of taking up this
position he was back in Flechsig’s clinic for another 6 months.
He was then transferred, after a 2-week stay in the Lindenhof
clinic in Coswig, to the Sonnenstein public asylum at Pirna, near
Dresden, for the following 8 years. The Memoirs chronicle this
second period ofillness. Schreber was released from Sonnenstein
in 1902, but in 1907 after his mother’s death, he became ex-
tremely agitated and was admitted to a clinic in Dosen, where he
died in 1911.
Schreber began the Memozrs first, “to acquaint my wife with my
personal experiences and religious ideas” so she would, after his
release from Sonnenstein, be prepared to understand his “various
oddities of behavior” (p. In). The project gradually gained, in his
mind, a larger and larger intended audience. The expected readers
expanded to include the courts that could find him competent to
manage his own affairs and live outside the asylum, his former
psychiatrist Flechsig, and finally an educated public who might find
the work of scientific and religious value. Schreber’s “personal
experiences and religious ideas” became inextricably linked in his
account because the religious ideas became his settled way of
understanding and organizing his personal experiences. Neverthe-
less, for clarity, I will present his more-or-less straightforward
narrative of his illness and treatment first.
After some general ideas about religious metaphysics and soul
murder, Schreber began to tell his story:

I will first consider some events concerning other members of my family,

which may possibly be related to the presumed soul murder; these
are all more or less mysterious, and can hardly be explained in the
light of usual human experience (the further content of this chapter
is omitted as unfit for publication). (p .61)

(The sections about Schreber’s family had been censored before

publication.) We are left to surmise what the rest of this chapter
184. / EMOTIONAL UNDERSTANDING

contained. Schreber’s subsequent references to his family and to

Flechsig usually spoke less directly about early ancestors of his
relatives or of Flechsig.
Schreber then turned to the history of his illness. Within this
account, he noted that just after his appointment as Senatspraesident
he awoke one morning thinking “that it must really be rather
pleasant to be a woman succumbing to intercourse” (p. 63). He also
reported a sense of feeling burdened by his new position, in
particular the need to earn the respect of the much older judges
over whom he had to preside. He began to have difficulties
sleeping, and he consulted Flechsig, who initially raised his hopes
of a cure by prescribing sleeping drugs. When these did not work
and Schreber looked for means of committing suicide, Flechsig
advised Schreber to admit himself to Flechsig’s asylum. The same
pattern of the failure of sleeping drugs followed by suicide attempts
recurred. Flechsig finally tried chloral hydrate as a sleeping aid.
This treatment was successful, but Schreber’s wife stopped visiting,
and Flechsig, according to Schreber, could no longer look him
straight in the eye when Schreber asked if he would recover. From
then on, Schreber lived in a world of voices, divine miracles, and
“fleeting-improvised” people, and he spent his days “bellowing” at
God.
According to Schreber’s account, he understood that the
Order of the World had been disturbed and that he had to
cooperate with God in resisting his own unmanning. He found,
however, that his resistance was accompanied by divine interven-
tions like the compression-of-the-chest-miracle, the writing-down-
system, the appearance and disappearance of his stomach, the
opening and closing of his eyes by miracles, the head-compressing
machine, the coccyx miracle, which prevented him from staying in
one place or position, the breaking of his piano strings, the system
of unfinished sentences, and the constant torment of the voices.
Gradually Schreber became convinced that the way to make
these tortures stop was to cooperate in his own transformation
into a woman. He had to accept a completely passive role in his
own life, thereby placating God, who, Schreber came to believe,
was actually hostile to him. By accepting the sexual identity
designated for him, he could redeem the world by giving birth to
a new race.
 Illustration: Understanding Schreber / 185

FREUD S ACCOUNT.

Freud (1911) welcomed Schreber’s Memoirs as a wonderful piece

of evidence to support his own theory linking paranoia and
homosexuality. As his title, “Psycho-Analytic Notes on an Autobio-
graphical Account of a Case of Paranoia (Dementia Paranoides),”
indicates, Freud saw Schreber as “a case of paranoia.” Schreber was
a clear confirmatory example of what Freud termed the “remark-
able fact that the familiar principal forms of paranoia can all be
represented as contradictions of the single proposition: ‘I (a man)
love him (a man)’” (p. 63). This theory-bound reading of the
Memorrs, with Freud’s propensity to exonerate fathers once he had
minimized or disavowed the seduction theory (Bloch, 1989), un-
doubtedly shaped his understanding of Schreber. Nevertheless,
Freud’s essay contributed significantly to the understanding of the
psychoses.
First and most important, Freud made the shift from symptom
to meaning. Rejecting the psychiatric custom of inferring a diag-
nostic category from lists of symptoms, or of detailing delusions
and concluding that the patient is insane, Freud insisted that
symptoms and delusions have meaning. They refer, in other words,
to something in the patient’s experience or to the way the patient
organizes experience. While Freud may have made gratuitous
assumptions about the content and meaning of Schreber’s experi-
ence—assumptions that probably limited his access to other mean-
ings—still, he did consistently regard the psychoanalytic task as
understanding the content and structure of the patient’s subjective
world.
More particularly, Freud saw Schreber’s sense of being emas-
culated (his soul murder and self-loss) as central to his experience
both of his threatened self and of the threatening others. Freud
read “the end of the world” as referring to the destruction of
Schreber’s subjective world. Freud understood that the require-
ment that Schreber should redeem the world was a secondary,
reactive, or even perhaps restorative aspect of his delusions. In
addition, Freud (1911) saw Schreber’s fear of sexual abuse as
central to his experience and as probably involved in the “soul-mur-
der” (p. 44). Freud was, however, unable to guess at any special
reasons for Schreber’s conviction that he was likely to be so abused.
186 / EMOTIONAL UNDERSTANDING

Further, Freud clearly saw the parallels and identifications drawn

by Schreber among God, Flechsig, and the sun—all three referred
to Schreber’s father—and Freud recognized Schreber’s resulting
mixture of hatred, love, and puzzlement toward them.
In fact, Freud was particularly well attuned to an important
part of the subjective meaning of Schreber’s belief that he must be
transformed into a woman. Schreber was required to become a
woman so he could feel like a woman—a person, in the eyes of both
Freud and Schreber, who derives pleasure from being done to,
from adopting a passive attitude, from submission. In addition,
Freud and Schreber both saw female as equivalent to emasculated.
Since Freud understood Schreber’s God as his father, he thus
recognized that Schreber felt compelled to take up a compliant
passivity so extreme as to involve a change in physical sex charac-
teristics. Because by this time Freud was locating pathology solely
in the patient, he could not go further and ask what kind of
childrearing might have produced the experience of such an
extreme requirement of passivity or self-loss. Nor could Freud ask
why the loss of selfhood—for Freud and Schreber, of masculinity—
had to be accepted so completely that Schreber could no longer
experience this loss as soul murder but had to feel it as redemptive.
Freud (1911) understood, however, just as I will argue in this
chapter, that “the delusional formation, which we take to be the
pathological product, is in reality an attempt at recovery, a process
of reconstruction” (p. 71). Freud recognized, as did Schreber’s
physicians, that Schreber was more “sane” in his general behavior
as his delusions became more fully articulated and organized.
Finally, Freud saw the Memoirs as Schreber’s attempt to rehabilite
himself by trying to resolve his disputes with God/father. Freud
(1911) commented on Dr. G. Weber’s (director and chief psychia-
trist of the Sonnenstein asylum) view that the Memoirs were “un-
blushing”: “Surely we can hardly expect that a case history which
sets Out to give a picture of deranged humanity and its struggles to
rehabilitate itself should exhibit ‘discretion’ and ‘aesthetic’ charm”
(D.Sc):
Among the limitations of Freud’s essay, already alluded to, is
his method: the use of Schreber as a case to illustrate and support
a theory, thus preventing Schreber from being seen as a person
with a history of relationships reflected in the self-states described
 Illustration: Understanding Schreber / 187

in the Memoirs. Freud’s commitment to a one-person view of

human nature and of psychopathology made it difficult, or perhaps
impossible, for him to present Schreber’s childhood or adult
environments, including his treatment relationships, as structuring
his inner world. Niederland (1984) would later view his researches
into the work of Moritz Schreber as support for Freud’s dynamic
formulation. Still, Freud did not himself think it important to use
in his account available information about either Schreber’s family
or about Flechsig’s treatment philosophy. Nor did Freud, as far as
we know, try to meet Schreber, who was still alive when Freud was
writing about him. Perhaps this omission on Freud’s part can be
attributed to a concern that such researches would undermine or
complicate his use of Schreber as a case to illustrate a one-person,
instinct-based theory of paranoia.
We do have evidence that Freud thought about the effect of
Schreber’s early environment on him. Freud wrote to Ferenczi on
October 6, 1910: “What would you think if old Dr. Schreber had
worked ‘miracles’ as a physician? But was otherwise a tyrant in his
household who ‘shouted’ [bellowed?] at his son and understood
him as little as the ‘lower God’ understood our paranoiac” (Freud
& Ferenczi, 1993, p. 222). We do not know why Freud chose to
exclude these relational considerations from his published work
on Schreber, but we can guess he found them inconsistent with his
one-person view of psychopathology. If so, this omission illustrates
my contention about the practical consequences of theory-choice
and the importance of holding theory lightly.
Another limitation of Freud’s essay on Schreber is that despite
Freud’s remarkable shift from symptom to meaning, he sometimes
confused symbol and meaning, collapsing meaning into simple
reference. He took symbols like unmanning as referring to castra-
tion, when Schreber made it clear that the much more serious and
more real threat was soul murder or soul stealing. Stolorow et al.
(1987) term sucha collapse of meaning into symbol “concretization.”
Another example of confusing symbol and meaning in Freud’s
account—probably owing to his desire to support his own theory—is
the assumption that Schreber transformed his father into God
because “such a father as this was by no means unsuitable for
transfiguration into a God in the affectionate memory of the son
from whom he had been so early separated by death” (p. 51). Here
188 / EMOTIONAL UNDERSTANDING

Freud saw the reference, or denotation, of the symbol but missed

the emotional meaning. Schreber’s God, a tyrant who regulates
every part of life, was a tormentor. Freud recognized the distinction
Schreber drew between Flechsig himself and “the Flechsig soul,”
between the objective and the subjective realities, and Freud knew
each had a separate reference. Nevertheless, he bypassed the ques-
tion of what experiential meaning Schreber’s complaints against the
Flechsig soul might carry. Freud apparently assumed that these were
transference distortions of the behavior of an unequivocally benevo-
lent physician. In addition, Freud saw Schreber’s “megalomania” as
compensatory for the insult of being turned into a woman. However,
Freud missed—and here we cannot blame him for not seeing with
Kohut’s eyes—that the compensation in narcissistic grandiosity was
for the complete self-loss that becoming a woman signified, a self-loss
that had been required of him as a child.
A third limitation of Freud’s interpretation, identifying the
psychosis with an “outburst of homosexual libido,” results from
Freud’s reliance on drive-theory assumptions about human moti-
vation. Self psychologists instead attribute motivational primacy to
self-consolidation—the need to organize emotional experience—
and to relational concerns. Freud’s Schreber, on the contrary, is a
self-enclosed system of instinctual energy transformations. A re-
lated, though nonidentical, assumption—about homosexuality as
one form of libido—led Freud to suggest that Schreber’s psychosis
manifested unconscious homosexuality, despite all evidence to the
contrary. Schreber never behaved as a homosexual, nor is there
any evidence that he thought of himself in that way. Freud, never-
theless, identified “feminine” and “homosexual” and took “it must
be rather pleasant to be a woman succumbing to intercourse”
Schreber, 1903, p. 63) as all the evidence he needed. For Freud,
passivity or receptivity equals femininity, and femininity is equiva-
lent, in a male, to homosexuality. Feeling attracted to same-sex
partners is not required. As Lothane (1989) points out, Schreber
gave no sign of sexual attraction to men. To Freud, this had to be
unimportant: Homosexuality was an intrapsychic condition, not a
relational matter.
Because of the limitations of his instinct theory, Freud also
apparently missed the possibility that Schreber actually was perse-
cuted and thus was not entirely delusional. (Freud, 1911, did, of
 Illustration: Understanding Schreber / 189

course, insert his famous enigmatic caveat, “It remains for the
future to decide whether there is more delusion in my theory than
I should like to admit, or whether there is more truth in Schreber’s
delusion than other people are as yet prepared to believe” [p. 79],
but he did not explore the implications of this statement.) Among
those who have explored the possibilities, Lothane (1989) draws a
convincing picture of the ways Schreber may have been mistreated
by Flechsig. He construes Freud’s reticence not only as political but
as resulting from Freud’s steadfast disinterest in the relational
context of Schreber’s difficulties.
Altogether, Freud’s account directs us to the meanings in
Schreber’s psychosis, and then it systematically obscures these
meanings. It has thus become the task of later psychoanalytic
commentators and researchers to attempt to get closer to Schre-
ber’s own experience. Self psychology is especially well suited for
this task because of its commitments to experience-near theorizing
and to understanding the patient from the patient’s point of view.

PonenOANA
aii GACCOUNIS oINCEFREUD

Beginning with his 1951 paper “Three Notes on the Schreber

Case” and continuing through the second edition of The Schreber
Case (1984), Niederland provided the readers of Freud and Schre-
ber with what he regarded as the “kernel of truth” in Schreber’s
complaints. His researches led him to believe that the “miracles”
Schreber felt perpetrated on him were thinly veiled references to
his father’s childrearing methods. Niederland searched the books
of Moritz Schreber and found pictures and descriptions of various
pieces of apparatus—intended to correct improper posture or
prevent its emergence—that seemed to resemble the “compression-
of-the-chest-miracle,” the “head-being-tied-together-machine,” and
others. He quoted extensive passages from Moritz Schreber’s works
that suggest an effort to control every part of a child’s physical and
mental life. In this way the child would develop so much self-control
that he or she would not even feel externally coerced. No further
discipline, according to Moritz Schreber, should be necessary after
the fifth or sixth year of life. Niederland suggested that, like other
19th-century parents, Schreber’s father’s concern was to prevent
190 / EMOTIONAL UNDERSTANDING

children from masturbating. Niederland assembled a horrifying

picture of the probable world of Schreber’s childhood. This por-
trait not only makes his later fragmentation under stress under-
standable, and much detail of his report interpretable, but it also
leaves the reader wondering how Schreber managed to function
as long as he did. Niederland’s book makes the older brother's
suicide completely unsurprising.
What is surprising (to a reader unconcerned with protecting
Freud and his theories) is that Niederland, having marshaled so
much evidence of Schreber’s persecutory childhood environ-
ment, nevertheless repeatedly and explicitly agreed with Freud’s
view of the case. Niederland concurred that Schreber was a “case
of paranoia” to be explained in terms of intrapsychic conflict
between love and hatred for the father, that is, rejection of his
unconscious homosexual desire for the father and, later, for Flech-
sig. Niederland believed that his researches reinforced Freud’s
interpretation by showing that Schreber had reason to hate, and
to love, his father and that the content of Schreber’s Memoirs made
even more sense than Freud had thought.
Niederland did not see that he had seriously undermined
Freud’s attempt to exonerate the father and place the cause of the
paranoia solely in the patient. If the parallels Niederland drew are
correct, early environment shaped Schreber’s subjective world
beyond any extent Freud was prepared to consider after he re-
placed the seduction theory. Niederland’s relentless pursuit of
historical meanings in Schreber’s Memoirs makes his reluctance to
draw the obvious conclusions from his own work puzzling.
Schatzman (1973) has no such hesitation. He, like Shengold
(1989), straightforwardly accuses Moritz Schreber, with the full
cooperation of his wife, of the soul murder, by prolonged physical
and emotional abuse, of his sons. He agrees with Freud that the
God of the Memoirs is Schreber’s father, a deity who, Schreber only
gradually comes to realize, intends to destroy his mind. Schatzman
details, again by extensive reference to Moritz Schreber’s books,
the systematic ways the child, from infancy, is robbed of self-deter-
mination precisely under the rubric of self-determination. The
child is programmed to want and not want precisely what the
parents determine that the child should want and not want. This,
to Schreber’s father, is self-determination. (Schatzman provides a
 Illustration: Understanding Schreber / 191

telling partial list of the titles of Moritz Schreber’s books: The

Cold-Water Healing Method, The Systematically Planned Sharpening of
the Senses, and The Harmful Body Positions and Habits of Children,
Including a Statement of Counteracting Measures. )
More recently, Lothane (1989, 1990), in the interpersonalist
tradition, makes a strong case for regarding Schreber’s psychosis
as precipitated by his treatment by Flechsig and the other psychia-
trists and by his wife’s efforts to have him declared incompetent to
manage his own affairs. Less convincing is Lothane’s (1989) at-
tempt “to vindicate both Schrebers, father and son” (p. 206).
Lothane regards his own method as historical (fact not fancy) in
contrast to what he sees as the hermeneutic or theory-bound
method of Freud. He notes that the Memoirs seem to contain
Schreber’s account of what actually happened to him (“On the Ist
of October 1893 I took up office as Senatspraesident to the Superior
Court in Dresden”) and his interpretation—cleverly disguised as
delusional to avoid accusations of libel by Flechsig—of events
(“Divine rays above all have the power ofinfluencing the nerves”).
Lothane apparently believes in a “just the facts” story about Schre-
ber, as if any story could be told without interpretation or perspec-
tive (see Chapter 4). He thus dismisses the works of Niederland
and Schatzman as “unproven inferences and constructions” (p.
209) and Freud’s views as hermeneutics.
In Lothane’s (1989, 1990) own interpretation of Schreber’s
story Schreber’s psychosis was nondelusional; it was an extremely
anxious response to his here-and-now situation, especially to his
treatment by Flechsig. Agreeing with Schreber, Lothane believes
that Flechsig committed soul murder on Schreber by assisting
Schreber’s wife in having him declared incompetent. According to
Lothane, Flechsig thus “unmanned” Schreber by hypnotizing him,
thereby robbing him of his reason, and by sending him to Sonnen-
stein, a public asylum for untreatable cases. Only then, according
to Lothane, did Schreber’s behavior become “insane.” Schreber’s
diagnosis was, in this view, an iatrogenic psychosis. It is interesting,
Lothane thinks, that Schreber never accused Weber, chief psychia-
trist at Sonnenstein, of soul murder, even though Weber, according
to Lothane, seriously mistreated Schreber by opposing his release
when Schreber’s behavior, by Weber’s own account, had for a long
time been reasonable, civil, and courteous.
192. / EMOTIONAL UNDERSTANDING

Lothane’s information about Flechsig, and his use of it to

corroborate Schreber’s statements in the “factual” parts of the
Memoirs, is striking enough to make me wonder if more respectful
treatment might not have prevented Schreber’s full deterioration
into a desperate, suicidal, bellowing madman who believed no
one around him was real. Apparently Flechsig, a psychiatrist of
his historical time, was interested only in biological treatments.
What Lothane does not consider are the ways in which Schreber’s
early experience in his family preconditioned him to the experi-
ence of the stresses of his adult life—“overwork,” Schreber called
it—as well as to his mistreatment by Flechsig, Weber, and possibly
his wife. Lothane is well aware of the intersubjective process in
Schreber’s treatment, but he misses the way a child may experi-
ence the relational world of the family and later find the adult
world similar to that of childhood. In what follows, I will attempt
to take the intersubjectively generated traumas of Schreber’s
childhood and his adulthood equally seriously. Schreber illus-
trates the clinical truism that abused children frequently become
abused adults. What made Schreber extraordinary, besides
Freud’s interest in him, were his capacity and determination to
tell his story and thus to heal himself by freeing himself from
unjustified confinement.”
Kohut (1978a) wrote only briefly about Schreber. In Kohut’s
view, Freud’s central insights in his writing on Schreber, were that
““the step back . . . to narcissism’ is characteristic of the psychoses,
and that “The delusional formation . . . [is not the central pathology
but]... an attempt at recovery, a process of reconstruction ...’” (Kohut,
1978a, p. 306, quoting Freud, 1911, pp. 71-72). In his comments
on Niederland’s work on Moritz Schreber, Kohut remarked that
the historical data could throw light on the essence of Schreber’s
psychosis: “the narcissistic fixation and regression” (p. 307). Kohut
(1978a) believed that

the secret of Schreber’s psychosis is bound up with his father’s

personality—adding the important fact . . . that the mother was
subordinated to, submerged by, and interwoven with the father’s

Without appropriate treatment, or other Opportunities for substantial and primary

selfobject experience, of course, his attempt at self-restoration was only partly and
temporarily successful.
 Illustration: Understanding Schreber / 193

overwhelming personality and strivings, thus permitting the son no

refuge from the impact of the father’s pathology. (p. 307)

Kohut went on to explain that the father’s pathology consisted

of a special kind of psychotic character, in which reality-testing is
generally present, but which, as in Hitler, is organized around a
central idée fixe:

The absolute conviction father Schreber had toward his ideas, the
unquestioning fanaticism with which he pursued them, betrays, I
believe, their profoundly narcissistic character, and I would assume
that a fear of hypochondriacal tensions lies behind the rather overt
fight against masturbation. His fanatical activities, too, although
lived out on the body of the son, belong to a hidden narcissistic
delusional system. The son, in other words, is felt as part of the
father’s narcissistic system, and not as separate. (p. 307)

Thus Kohut shifted the emphasis in understanding Schreber to the

relational world of his childhood and to its bearing on his adult
self-experience.

SCHREBER’S RELATIONAL EXPERIENCE

Schreber’s self-experience, the primary concern of a self psychol-

ogically oriented analysis, can only be understood as the product
of his experience of the intersubjective contexts, the emotional
environments, in which he organized his sense of himself. While
we have no direct access to the relational worlds of Schreber’s
childhood or adulthood, his Memoirs (1903) provide an eloquent
account of his experience of and his interpretation of his psychiat-
ric treatment. Without claiming to know the “facts” about either
Schreber’s childhood or about his treatment, we can consider the
“organizing principles” (Stolorow et al., 1987) that he inferred
from his relational experiences. This section will focus on the
relational contexts in Schreber’s life and Schreber’s experience of
them. The next section will attempt to describe Schreber’s self-ex-
perience, its basis in his relational experiences, and its vicissitudes
during the period covered by the Memoirs.
194. / EMOTIONAL UNDERSTANDING

Schreber (1903) viewed his psychiatrist Flechsig and at least

some of his caretakers as persecutors. He experienced them as
attempting to murder his soul, to rob him of his reason, and to
“unman” him for the sake of their own needs. He felt that they
needed to get away from him because he was convinced that his
needs, the “attraction of my nerves” (p. 128), were too much for
the people around him. He thought that they gave him sleeping
medicines so they could get away from him—not an implausible
guess. They were, in other words, responding to their own needs,
not to his.

Always the main idea was to “forsake” me, that is to say, abandon me;
at the times I am now discussing [just before he was sent away from
Flechsig’s asylum in 1894] it was thought that this could be achieved
by unmanning me and allowing my body to be prostituted like that
of a female harlot, sometimes also by killing me and later by
destroying my reason (making me demented). (p. 99)

The beginning of this experience of persecution was a sense

of being misunderstood. Early in November 1893, Schreber came
to Flechsig complaining of sleeplessness and was given a combina-
tion of drugs that not only did not help him sleep but made him
so anxious that he started to attempt suicide. By Schreber’s ac-
count, the psychiatrists tried alternately to treat him with weaker
sleeping drugs and with chloral hydrate, seeing his entire difficulty
as a biologically based sleep disturbance. Each time the drugs
failed, he tried to commit suicide. He felt that no attempt was made
to understand him as an anxious living person:

It is my opinion that Professor Flechsig must have had some idea of

this tendency, innate in the Order of the World, whereby in certain
conditions the unmanning of a human being is provided for. ... A
fundamental misunderstanding obtained, however, which has since run
like a red thread through my entire life. It is based upon the fact that
within the Order of the World, God did not really understand the living
human being and had no need to understand him, because, according
to the Order of the World, He dealt only with corpses. (p. 75)

God... saw human beings only from without; as a rule his omnipres-
ence and omniscience did not extend within living man. (pp. 59-60)
 Illustration: Understanding Schreber / 195

Schreber’s indictment suggests that massive failures in empathic

understanding, with a complete inattention to his subjective world,
precipitated his turn from overwork and anxiety toward psychosis.
God, Flechsig, and Moritz Schreber were devoted to an Order of
the World, a scientific empiricism, in which the subjective world
of the living human being could have no place. They could only
comprehend beings with no feelings. Clearly Schreber meant in
the quoted statements that he had never felt understood as a living
human being with needs and feelings of his own, but had been
seen, throughout his life, “only from without.” He felt used and
misunderstood by those who should have been his caretakers and
protectors.
Once those others had misunderstood him, and classified him
as a hopeless case, Schreber felt that they could and did abandon
him. Once his wife, who had been visiting him daily, taking him
out, and attempting to raise his spirits (p. 68), took a four-day
vacation. He then had the night of “a quite unusual number of
pollutions” (p. 68), which Freud took as an outburst of homosexual
libido and Schreber understood as decisive in his deterioration.
After that time he saw his wife rarely, experienced her as unreal,
and began to talk instead with supernatural powers. He felt aban-
doned by everyone. No mention exists in any of his hospital records
of any attempt by his wife, his mother, or his siblings to get him
released from the hospital. The significance of the night of emis-
sions, or “pollutions,” may be that the combined abandonments
meant complete loss of control: Moritz Schreber had believed that
nocturnal emissions, and, of course, all masturbation, could and
must be prevented.
Abandonment was also integral, not simply sequential, to the
experience of misunderstanding. Misunderstanding of another
can result from abandoning the subjective world, that is, the
experience, of the patient or child. For Schreber, Flechsig’s misun-
derstanding of him was experienced as so great an abandonment
that he sometimes felt invisible: “something in the nature of a
wizard had suddenly appeared in the person of Professor Flechsig
... I myself, after all a person known in wider circles, had suddenly
disappeared” (p. 97). At other times he felt that he must have
leprosy, the disease of abandoned outcasts, or the plague. Later he
felt required to think continuously, for fear God would misunder-
196 / EMOTIONAL UNDERSTANDING

stand and regard “my mental powers as extinct” (p. 166). A partial
function of the bellowing, paradoxically, was to interfere with
God’s abandonment of or withdrawal from him. It was both an
indicator of madness and a cry for help. “It remains a riddle to me
that the cries of help are apparently not heard by other human
beings: the sound which reaches my own ear—hundreds of times
every day—is so definite that it cannot be a hallucination” (p. 166).
He was, however, deeply ashamed of his own needs. “The genuine
‘cries of help’ are always instantly followed by the phrase which has
been learnt by rote: ‘If only the cursed cries of help would stop’ ”
(p. 166). We may speculate that in Schreber’s family there had been
no way for a child to cry for help. Both as a child and as a patient
he felt abandoned, unsupported, and unvalidated (in his terms,
misunderstood) in his extreme distress.
Schreber’s sense of the total unreliability of others may be
closely related to the experience of others as abandoning him. In
the years before writing his account, Schreber felt that people do
not even persist in being. They are fluchtig hingemacht (fleetingly
made up), or, in Macalpine and Hunter’s translation (Schreber,
1903), “cursorily improvised.” People were not real; they were
made-up contraptions. We can only speculate on the origins of this
prominent feature of Schreber’s experience of the human world.
Perhaps Moritz Schreber’s children never knew whether they
would find him playful and affectionate or punitive and repressive.
The father’s books suggest that both attitudes are central to
childrearing. Or perhaps Schreber’s experience of his psychiatric
treatment was that it included considerable improvisation and little
consistency. Schreber may have experienced the massive unreliabil-
ity in the environment as its unreality. Another possibility is that
Schreber’s upbringing deprived him ofany sense of his own reality
as a center of experience and initiative, which led him to say that
others were unreal. If he is unreal so must others be. He may have
felt himself to be a made-up contraption like the people in the
illustrations in his father’s books on medical gymnastics (cf. Nied-
erland, 1984, pp. 81, 95). In any case, it is likely that Schreber’s
sense of the unreliability and unreality of human beings—particu-
larly of those who should have been consistently helpful like his
parents and physicians—contributed to his sense of abandonment,
and the sense of abandonment, in turn, reinforced his sense that
 Illustration: Understanding Schreber / 197

people were unreal and unreliable. Increasingly he understood

both involvement with others and abandonment as intended to
contribute to the destruction of his reason.
From misunderstanding and abandonment, soul murder con-
tinued to its central business of “unmanning.” Lothane (1989)
points out that, in German, “the word Entmannung has two basic
meanings: the concrete one of gelding or castration, and the
metaphorical one of loss ofvirile power, vigor, and pride” (p. 237).
I agree with Lothane’s view that Schreber consistently used the
word in the second sense; I would add only that he felt the “loss”
as a robbery and a betrayal. Consider the following:

A plot was laid against me (perhaps March or April 1894), the

purpose of which was to hand me over to another human being after
my nervous illness had been recognized as, or assumed to be,
incurable, in such a way that my soul was handed to him, but my
body—transformed into a female body and, misconstruing the above-
described fundamental tendency of the Order of the World—was
then left to that human being for sexual misuse and simply “for-
saken,” in other words left to rot. (Schreber, 1903, p. 75)

Schreber’s understanding of the intersubjective explanation

for the efforts by others to murder his soul was that they saw him
as a threat, as dangerous. He often spoke of the “miracles”
directed against him as attempts to reduce his power to attract
the nerves of God. He suspected that God—whom I take to stand
for Moritz Schreber and, at times, Flechsig—had a manifest need
to dominate, a need that covered a profound vulnerability. “God
Himself must have been or be in a precarious position, if the
conduct of a single human being could endanger Him in any way
and if even He Himself, if only in lower instances, could be
enticed into a kind of conspiracy against human beings who are
fundamentally innocent” (p. 59). Parenthetically, this sense of
being a threat to his older colleagues in his new position as
Senatspraesident may have been one precipitant for his second
period of illness. In Flechsig’s clinic, he was likely to have
questioned his treatment and thus seemed a threat to the estab-
lished psychiatric hierarchy; as a child he may have known from
experience that his father could not tolerate explicit or implicit
198 / EMOTIONAL UNDERSTANDING

questioning of his authority. Whatever the origins of this sense

of others as threatened by his “nerves” (read as: feelings, needs,
ideas), Schreber’s conviction that others experienced him as
dangerous runs throughout the Memoirs.
Another part of the soul murder was Schreber’s sense of being
used a guinea pig, a subject in endless experiments. Moritz Schre-
ber supported his childrearing theories by claiming he had tested
them on his own children. Flechsig probably tested his biological
theories of psychiatry on the patients in his clinic. Schreber as
patient thought he was surrounded by “tested souls.” Experiments,
of course, must be replicated: “God cannot learn by experience”
(prlo5):
To be an experimental subject is, of course, not to be a person
in one’s own right, but to exist only to validate others’ theories and
to support the narcissistic needs of the experimenter. Schreber’s
primary complaint was that people attempted to destroy his reason
and change his awareness of his own identity (p. 99), a common
effect of childrearing by narcissistic parents (A. Miller, 1981).
The principal vehicle for the destruction of Schreber’s soul or
self, was, in his experience and expectation, sexual abuse. In his
last months in Flechsig’s clinic, “the most disgusting was the idea
that my body, after the intended transformation into a female
being, was to suffer some sexual abuse, particularly as there had
even been talk for some time of my being thrown to the asylum
attendants for this purpose” (p. 101). Now, whatever our estimate
of the likelihood of sexual abuse of patients in Flechsig’s clinic,
Schreber’s own sense of vulnerability and of being used was clearly
tied to the experience of sexual abuse. He may have identified this
vulnerability and the accompanying shame as equivalent to becom-
ing female. If Schreber had been sexually abused as a child—possi-
ble in a family where children were experimental subjects—he
would understandably experience any threat of sexual abuse as
“unmanning,” as depriving him of all autonomy, and as central to
the stealing of his soul.
The sense of being used as an experimental subject may also
have contributed to Schreber’s messianic convictions. He believed
God was creating a new race of humans out of his nerves, “new
human beings out of Schreber’s spirit” (p. 110). Moritz Schreber
had had grandiose hopes for the improvement of the species by
 Illustration: Understanding Schreber / 199

his childrearing methods, and he may have told his children of

these dreams. For Schreber, as a mental patient, exposure to the
experiment-over-treatment preference at Flechsig’s clinic may have
evoked a central organizing principle: transformation into a pas-
sive and vulnerable (i.e., female) person gives your life meaning—
you contribute to the salvation of the world. Unmanning, he
thought, might be “with the purpose of creating new human
beings” (p. 117). Actively taking charge as Senatspraesident would
have been too much opposed to this meaning, and it probably
contributed to the evocation of his fantasy about how lovely being
a woman passively succumbing to intercourse might be.

SCHREBER’S SELF-EXPERIENCE

Schreber’s self-experience was organized by his relational experi-

ence both as a child and as an adult. His experience of persecution
led him to see himself as dangerous to others and to explain the
persecution and the miracles as attempts to control him because
he was dangerous. His experience of what he called soul murder
led him to experience himself as empty, both vulnerable and
invulnerable (p. 212), helpless and unfree, unprotected (p. 117n),
and female. Experience as an experimental subject led him to think
of himself as important only if he could be used for some larger
purpose like the salvation of the world. All these dimensions ofhis
self-experience clearly emerged from his relational experiences as
described above.
In addition, Schreber’s self-experience was fragmented. He
spoke of the partitioning of souls and of nerves strung out across
the heavens, and he commented that he was inclined “to believe
that the natural unity of the human soul used to be respected” (p.
109). His lack of cohesion displayed itself in his difficulty knowing
who does the writing in the writing-down-system. He did not know
how it came about that he was housed separately from the other
patients; only later did he discover that it had been a response to
his bellowing. The fragmentation was thus felt both as spatial and
as temporal. Possibly because his relational experience had been
traumatically inconsistent, and, perhaps, with Flechsig, desperately
disappointing, he had considerable difficulty feeling himself as
200 / EMOTIONAL UNDERSTANDING

continuous in time. He reminds me of some highly intelligent and

creative patients who protect themselves from overwhelming
trauma through dissociation, with the resultant loss of continuity
of experience of self and others. The confusion involved in such
fragmentations may be integral to the soul murder process. Since
the usurpation of the child’s subjectivity is the essence of soul
murder, Schreber had no basis for knowing anything. Schreber’s
selfexperience during his confinements also took on an intensely
negative coloration. Not only did he feel small, vulnerable (female),
and without protection from the rays (p. 117n) but he also saw
himself as stupid. Cognitively, he always knew that he had been a
prominent judge, but this knowledge did nothing to hold at bay
the voices that tormented him. When fellow patients would insult
him, “the stupid twaddle of the voices ‘has been recorded,’ “Why
don’t you say it (aloud)?’, ‘Because I am stupid,’ or even “Because
I am afraid,’ etc., tells me that it is still God’s purpose that I relate
these insulting forms of speech to myself” (pp. 199-200). He felt
ashamed and humiliated by his condition and by his confinement.
The voices often called him “ ‘wretch’—an expression quite com-
mon in the basic language to denote a human being destined to
be destroyed by God and to feel God’s power and wrath” (p. 124).
A particularly evocative expression of Schreber’s negative self-
valuation was his conviction during his first period of “nervous
illness” that he had lost weight. To have weight, as philosopher Robert
Nozick (1989) points out, is to be real and substantial, to have to be
taken into account. In Nozick’s words:

The weight of something is its internal substantiality and strength. It

may help to think of its opposite. What is meant when a person is
called a “lightweight”? It might be impact and importance that are
being talked about here, but usually, I think, what are meant are those
qualities that importance is (or should be) based upon. People are
commenting on how substantial the person is, how considered his
thoughts, how dependable his judgment, how that person holds under
buffeting or deeper examination. A weighty person is not blown by
winds of fashion or scrutiny. The Romans called it gravitas. (p. 178)

This description probably fit Schreber the jurist well, and it points
to the magnitude of the loss he felt.
 Illustration: Understanding Schreber / 201

The notion of weight is closely related to that of importance,

which might be conceived as a more relational matter, that is, as
having-weight-for-someone. In fact, Schreber’s specific concern
was about validation: “I believe I could have been more rapidly
cured of certain hypochondriacal ideas with which I was preoccu-
pied at the time, particularly concern over loss of weight, if I had
been allowed to operate the scales which served to weigh patients
a few times myself” (p. 62). For self psychologists, the self-experi-
ence of having weight, making a difference, would grow from the
relational experience of having importance in the eyes of early
caretakers and of having felt mirroring responses to one’s own
emerging selfhood. While we know that Moritz Schreber’s chil-
dren were important to him, from his writings we may infer that
this importance resided in their value as experimental subjects and
as exemplars of his childrearing methods. As mentioned above, he
intended to eradicate every trace of the child’s own will. The wishes
and desires of children carried no weight with him, and his son,
despite his impressive accomplishments, internalized a profound
sense of himself as a lightweight. Schreber, as noted above, expe-
rienced himself and others as merely fleeting and improvised. As
an asylum patient, the weightless Schreber was given to fits of
bellowing, as if to impress his existence and presence—his weight—
on his world and on God. For years, to experience himselfas having
any weight, he had to see others as fleeting-improvised Lilliputians.
This view of the weight-loss experience may also lend intelligibility
to Schreber’s conviction that he was becoming a woman, a person
of lesser weight and unimportant in 19th-century German society.
He usually described his transformation into a woman as a process
of shrinking. In his experience he replaced his quantitative loss (of
weight) with a qualitative loss (of manhood).
Before we leave Schreber’s self-experience as related in the
Memoirs, we may note the absence of any obvious sadness in
Schreber’s words themselves. Schreber portrayed himself as feeling
angry, humiliated, frustrated, abandoned, and destroyed, but
never as sad. Perhaps sadness was the emotion that was thoroughly
eradicated in his childhood by a constant demand to be cheerful.
In addition, he may have had to ban this emotion from his
repertoire in order not to suicide like his brother. In any case, his
losses were considerable: home, wife, position and respect, auton-
202 / EMOTIONAL UNDERSTANDING

omy, and peace of mind. Yet instead of feeling these losses, he said
that he lost weight and masculinity.

SCHREBER’S EFFORTS AT SELF-RESTORATION

From the beginning of his illness, Schreber displayed a remarkable

determination to restore, repair, and reclaim his stolen self. Not
content with just surviving, he struggled to reestablish himself as
a person of weight in his own eyes, in the eyes of God, and in the
eyes of the human community. I will discuss his efforts in three
categories: (1) his activities, (2) his paradoxical-passive efforts, and
(3) the paranoia itself, seen as a self-reparative response to extreme
narcissistic injury (soul murder).
Under the heading of activities, we may consider Schreber’s
piano-playing, chess-playing, learning of poetry, and, of course, his
writing of the Memozrs. The first three activities were intended to
convey to God, seen now as persecutor, that Schreber’s soul had
not been entirely destroyed. They also functioned to ward off the
voices and miracles that otherwise tormented him.
The writing of the Memoirs was, however, the most direct of
Schreber’s efforts to restore himself to the status of a person in the
human community. If Alice Miller (1990) is correct, abused chil-
dren without a validating witness can neither experience their own
pain, nor can they experience themselves as abused. Schreber was
partly healed by his own process of attempting, by writing, to find
such witnesses. He proclaimed both that he suffered and that
crimes had been perpetrated on him. The probable reason that
portions of his book were censored was that he had indicted his
abusers by name, thereby claiming his own status as a human being.
The Memozrs not only expressed his distress and outrage at the way
he had been treated and at his own mental state, but it also signified
his finding sufficient self-respect to challenge his tutelage. He
overcame his feelings of weakness, helplessness, and shame enough
to confront those who kept him in a less-than-human status. That
he found the courage to engage in such an action of self-reclama-
tion makes it probable that with adequate human support, he
might have recovered faster, more thoroughly, and more perma-
nently.
 Illustration: Understanding Schreber / 203

We can explain the restorative effect of writing the Memoirs by

reference to the self psychological notion of selfobject experience.
Even if primary selfobject relatedness is missing, anything can
function as a selfobject to the extent that it contributes to the
cohesiveness, continuity, and positive valence of a person’s self-ex-
perience. For Schreber, the writing of his book apparently pro-
vided such derivative selfobject experience. By telling his story,
even metaphorically, he attempted to make a coherent, continuous,
and cohesive whole out of what felt absurd, confusing, and frag-
menting. Both the story he told, and the action of telling it,
transformed him from a bellowing madman into a learned, cul-
tured, and genteel person who ate dinner and discussed various
topics at the table of the director of the asylum. The story,
submitted to the courts and to the director, also demanded recog-
nition of the transformation. So not only did the act of writing
serve as a selfobject experience for Schreber, but the book was
clearly intended to evoke additional, even primary, selfobject expe-
riences from his wife, the medical establishment, and the larger
community.
Shifting now to Schreber’s paradoxical-passive efforts at self-
restoration, he also attempted from the time of his commitment
to Sonnenstein to repair himself by surrendering to the require-
ments he felt had been placed on him. Literary critic E. Barry
Chabot (1982) has pointed out a significant continuity among
Schreber’s desire to sleep, his catatonia, and his acceptance of the
female “soul voluptuousness” (Schreber, p. 209). Each meant to
him the possibility of release from torture by giving in to externally
imposed requirements for the sake of a larger purpose. Initially,
Schreber said that a person who could not sleep would surely have
to suicide. Later he found that even with nocturnal sleep he was
tormented by voices that demanded his complete immobility and
by “miracles” that made every position he took, day or night,
uncomfortable. (Schreber’s father had invented devices and exer-
cises to control children whether waking or sleeping.) Then for
many months, the Memoirs inform us, Schreber sat for hours a day
without moving. Finally he understood that God—not just “little
Flechsig”—was tormenting him and demanding both his mental
and physical passivity. Then he realized as well that he must actively
cultivate the mental-physical state of female soul voluptuousness,
204. / EMOTIONAL UNDERSTANDING

the ultimate acquiescence. All three—sleep, catatonia, and soul

voluptuousness—were perhaps attempts to rescue the self from
torment. The last, however, became even temporarily healing when
Schreber could understand its larger salvific meaning. Unfortu-
nately he somehow, in the very acceptance of his passive role, both
actively cooperated in his own destruction and rescued a vestige of
himself, a kind of compromise sanity. We, of course, can see that
this solution could not be stable for Schreber because it was based
on compliance, on nonbeing, rather than on being a self. It was
acceptance of the soul murder.
Finally Schreber’s very paranoia may have been a prolonged
effort at self-reparation. What he called soul murder was a lifelong
narcissistic injury, an insult to the self, a cumulative trauma. His
system of beliefs—delusions, many would call them—transformed
his sense of vulnerability and stupidity into a grandiose belief that
only he had access to ultimate religious truth. His helplessness
became a power to attract the nerves of God. Confusion became
a privileged access to meaning. His sense of profound insignifi-
cance became a mission to redeem the world precisely by adopting
the role of insignificance assigned to women. A self psychological
reading of Schreber must enthusiastically support Freud’s (1911)
view that “the delusional formation, which we take to be the
pathological product, is in reality an attempt at recovery, a process
of reconstruction” (p. 71).
Recognizing that Schreber did not simply write a summary of
his delusions is important; he wrote his story with a beginning, a
middle, and an ending. The beginning is lost to us because censors
cut the sections referring to his family. The middle describes the
miracles and other torments, along with Schreber’s attempts to
survive by resistance to the soul murder. His ending recounts the
change, development, or transformation of his experience. By his
account, once he accepted the fate dealt to him, he no longer found
himself alone among cursorily improvised contraptions. He found
other people real and himself significant. His book expresses
Schreber’s understanding of the process of what we can see as the
temporary and partial restoration ofhis stolen self.
To summarize, Schreber’s complaints fundamentally concern
feeling profoundly misunderstood. His Memoirs was a plea for
respectful understanding, an attempt to allow others to enter and
 Illustration: Understanding Schreber / 205

share his emotional experience and to make sense of it with him.

Faced instead with people who regarded him as a clinical case, he
made his own case by writing for a court by which he hoped to be
understood and restored to his status as a human being. Where he
found the resources to imagine himself into such an intersubjective
field we do not know, but his writing shows the power of the need
for experienced understanding if a person is to be well.
The “Schreber case” also illustrates the influence of theory on
our attempts to understand. If we refuse to do the hard work
involved in conscious theory-choice, we leave ourselves to the
control of unconscious, and thus unexamined, premises. In the
story of Schreber, we can see the destructive power of uncritically
held scientific empiricism (Schreber’s father and Flechsig) and
dogmatic instinct theory (Freud and Niederland). Further, even if
we do consider and choose theory, we must hold it lightly. My own
view of psychoanalytic understanding must remain provisional and
open to surprise. Only so can Ijoin the other in the healing process
of making sense together.
 a -
7
J ee

7 | a8 -

<-—~"
ne
ee fo heoan
os 1 awe 0100 1d (pAeegeagie, oo ae Pea

oe ee al a
=" F
0 emis Pe) moe pa eS oo es bain
sew ends, aatiee beang . 12
;
ati Ss a Vien ee OS teGetr
= a Ge
“we
ots 6 amano 14 Rhee Gia ant -
ae ) Ge OSes DAV eae? Wit | be

iin ni) Decieaf — ¢ (eves

4 | Ae A eg ox * * Ming es? 10
eo : vse ah 4 NEI GCSG
Serpette iy we PWV eee |
. Me at
: inn *euar4s 1.2 - * 60 ae
i itis Sees aeim oS) )eGa
PTT, a) a Bo 2 lie =) @ aj) Oe
goodee =a) :aieee ts) ae w— i) 6aals

.
* >
ae ~
-_ is

16e

>

= . a

- a tc
~~ « Th ws @
D (0° ateleiae!
(nan Sie a
- > “s) =e6 f Ge
%:.18 - See

ee ar. oa
 References

Agosta, L. (1984). Empathy and intersubjectivity. In J. Lichtenberg, M. Bornstein,

& D. Silver (Eds.), Empathy I (pp. 43-61). Hillsdale, NJ: The Analytic Press.
Alexander, F., & French, T. (1946). Psychoanalytic Therapy: Principles and Applica-
tion. New York: Ronald Press.
Aquinas, T. (1265-1273). The Summa Theologica, Selections (English Dominican
Fathers, Trans.). Londen: Everyman.
Aristotle (1941). Nicomachean ethics. In The Basic Works of Aristotle (R. McKeon,
Ed.). New York: Random House.
Aron, L. (1991). The patient’s experience of the analyst’s subjectivity. Psychoana-
lytic Dialogues, 1, 29-51.
Aron, L. (1992). Interpretation as expression of the analyst’s subjectivity. Psycho-
analytic Dialogues, 2, 475-508.
Atwood, G., & Stolorow, R. (1984). Structures of Subjectivity: Explorations in
Psychoanalytic Phenomenology. Hillsdale, NJ: The Analytic Press.
Atwood, G., & Stolorow, R. (1993). Faces in a Cloud: Intersulyectivity in Personality
Theory (2nd ed.). Northvale, NJ: Jason Aronson.
Bacal, H. (1985). Optimal responsiveness and the therapeutic process. In A.
Goldberg (Ed.), Progress in Self Psychology (Vol. 1, pp. 202-226). New York:
Guilford Press.
Bacal, H. (1990). The elements of a corrective selfobject experience. Psychoana-
lytic Inquiry, 10, 347-372.
Bacal, H., & Newman, K. (1990). Theories of Object Relations: Bridges to Self
Psychology. New York: Columbia University Press.
Bacal, H., & Thomson, P. (1993, October). The psychoanalyst’s needs and the effect
of their frustration on the treatment: A new view of countertransference. Paper
presented at the Sixteenth Annual Conference on the Psychology of the
Self, Toronto.

207
208 / References

Balint, M. (1968). The Basic Fault: Therapeutic Aspects of Regression. Evanston, ee

Northwestern University Press, 1992.
Baumeyer, F. (1956). The Schreber case. International Journal of Psycho-Analysis,
37, 61-74.
Beebe, B., & Lachmann, F. (1988). Mother-infant mutual influence and precur-
sors of psychic structure. In A. Goldberg (Ed.), Frontiers in Self Psychology
(pp. 3-25). Hillsdale, NJ: The Analytic Press.
Beebe, B., & Lachmann, F. (1994). Representation and internalization in infancy:
Three principles of salience. Psychoanalytic Psychology, 11, 127-165.
Bergson, H. (1910). Time and Free Will (F. Pogson, Trans.). New York: Harper
Torchbooks, 1960.
Bernstein, R. (1983). Beyond Objectivism and Relativism. Philadelphia: University
of Pennsylvania Press.
Bernstein, R. (1992). The New Constellation: The Ethical-Political Horizons of
Modernity/Postmodernity. Cambridge, MA: MIT Press.
Bion, W. (1967). Second Thoughts. New York: Jason Aronson.
Bloch, D. (1989). Freud’s retraction of his seduction theory and the Schreber
case. Psychoanalytic Review, 76, 185-201.
Bollas, C. (1987). The Shadow of the Object: Psychoanalysis of the Unthought Known.
London: Free Association Books.
Bollas, C. (1989). Forces of Destiny: Psychoanalysis and Human Idiom. London: Free
Association Books.
Bowlby, J. (1979). The Making and Breaking of Affectional Bonds. London: Tavis-
tock/Routledge.
Bowlby, J. (1988). A Secure Base: Parent-Child Attachment and Healthy Human
Development. New York: Basic Books.
Brandchaft, B. (1983). The negativism of the negative therapeutic reaction and
the psychology of the self. In A. Goldberg (Ed.), The Future of Psychoanalysis
(pp. 327-359). New York: International Universities Press.
Brandchaft, B. (1985). Resistance and defense: An intersubjective view. In A.
Goldberg (Ed.), Progress in Self Psychology (Vol. 1, pp. 88-96). New York:
Guilford Press.
Brandchaft, B. (1986). British object relations and self psychology. In A. Gold-
berg (Ed.), Progress in Seif Psychology (Vol. 2, pp. 245-272). New York:
Guilford Press.
Brandchaft, B. (1994, March). Structures of pathological accommodation and change
im analysis. Paper presented at the meeting of the Association for Psycho-
analytic Self Psychology, New York.
Breuer,
J., & Freud, S. (1895). Studies on hysteria. Standard Edition 2. London:
Hogarth Press, 1955.
Buber, M. (1937). J and Thou. Edinburgh, Scotland: T. & T. Clark.
Carnap, R. (1936). Testability and meaning. Philosophy of Science, 3, 419-471.
Chabot, E. (1982). Freud on Schreber. Amherst: University of Massachusetts Press.
Cohn, J., & Tronick, E. (1983). Three-month-old infants’ reactions to simulated
maternal depression. Child Development, 54, 185-193.
 References / 209

Cooper, S. (1993). Interpretive fallibility and the psychoanalytic dialogue. Journal

of the American Psychoanalytic Association, 41, 95-126.
Copleston, F. (1950). A History of Philosophy: Medieval Philosophy: Albert the Great
to Duns Scotus. Westminster, MD: Newman Press.
Courtois, C. (1988). Healing the Incest Wound: Adult Survivors in Therapy. New
York: Norton.
Dilthey, W. (1989). Introduction to the Human Sciences (M. Neville,J.Barnouw, F.
Schreiner, & R. Makkreel, Trans.). Princeton: Princeton University Press.
Eco, U. (1992). Interpretation and Overinterpretation. Cambridge, England: Cam-
bridge University Press.
Ehrenberg, D. (1992). The Intimate Edge: Extending the Reach of Psychoanalytic
Interaction. New York: Norton.
Ellenberger, H. (1970). The Discovery of the Unconscious. London: Penguin.
Emde, R. (1983). The prerepresentational self and its affective core. Psychoana-
lytic Study of the Child, 38, 165-192.
Emde, R. (1988a). Development terminable and interminable: I. Innate and
motivational factors from infancy. International Journal of Psycho-Analysis,
69, 23-42.
Emde, R. (1988b). Development terminable and interminable: II. Psychoanalytic
theory and therapeutic considerations. [nternational Journal ofPsycho-Analy-
sis, 69, 283-296.
Emde, R., & Sorce,J.(1983). The rewards of infancy: Emotional availability and
maternal referencing. In J. Call, E. Galenson, & R. Tyson (Eds.), Frontiers of
Infant Psychiatry (pp. 17-30). New York: Basic Books.
Fairbairn, W. (1952). Psychoanalytic Studies of the Personality. London: Tavis-
tock/Routledge and Kegan Paul.
Ferenczi, S. (1909). Stages in the development of a child’s sense of reality. In Férst
Contributions to Psycho-Analysis (E. Jones, Trans.; pp. 102-107). London:
Hogarth Press, 1952.
Ferenczi, S. (1929). The unwelcome child and his death instinct. In Final
Contributions to the Problems and Methods of Psycho-Analysis (M. Balint, Ed.;
pp. 102-107). New York: Brunner/Mazel, 1955.
Ferenczi, S. (1932). Notes and fragments. In Final Contributions to the Problems
and Methods of Psycho-Analysis (M. Balint, Ed.; pp. 216-278), New York:
Brunner/ Mazel, 1955.
Ferenczi, S. (1933). The confusion of tongues between adults and the child. In
Final Contributions to the Problems and Methods of Psycho-Analysis (M. Balint,
Ed.; pp. 156-167). New York: Brunner/Mazel, 1955.
Ferenczi, S. (1988). The Clinical Diaries of Sandor Ferenczi. Cambridge, MA:
Harvard University Press.
Flavell, J. (1977). Cognitive Development. Englewood Cliffs, NJ: Prentice Hall.
Fosshage, J. (1992a, April). Countertransference as the analyst's experience of the
analysand: The influence of listening perspectives. Paper presented at the
meeting of the Division of Psychoanalysis of the American Psychological
Association, Philadelphia.
Fosshage, J. (1992b). Self psychology: The self and its vicissitudes within a
210 / References

relational matrix. In N. Skolnick & S. Warshaw (Eds.), Relational Perspectives

in Psychoanalysis (pp. 21-42). Hillsdale, NJ: The Analytic Press.
Fosshage, J. (1994). Towards reconceptualizing transference: Theoretical and
clinical considerations. International Journal of Psycho-Analysis, 75, 265-280.
Freud, A. (1936). The Ego and the Mechanisms of Defense. New York: International
Universities Press, 1966.
Freud, S. (1895). Project for a scientific psychology. Standard Edition 1 (pp.
283-397). London: Hogarth Press, 1950.
Freud, S. (1910). Five lectures on psycho-analysis. Standard Edition, 11 (pp. 9-55).
London: Hogarth Press, 1957.
Freud, S. (1911). Psycho-analytic notes on an autobiographical account of a case
of paranoia (dementia paranoides). Standard Edition 12 (pp. 3-82). London:
Hogarth Press, 1958.
Freud, S. (1912). Recommendations to physicians practising psycho-analysis.
Standard Edition 12 (pp. 109-120). London: Hogarth Press, 1958.
Freud, S. (1914). Remembering, repeating and working through. Standard Edition
12 (pp. 145-156). London: Hogarth Press, 1958.
Freud, S. (1919). Preface to Reik’s Ritual: Psycho-Analytic Studies. Standard Edition
17 (pp. 259-263). London: Hogarth Press, 1955.
Freud, S. (1925). Some psychical consequences of the anatomical distinction
between the sexes. Standard Edition 19 (pp. 243-258). London: Hogarth
Press, 1961.
Freud, S., & Ferenczi, S. (1993). The Correspondence of Sigmund Freud and Sandor
Ferenczi: Vol. 1. 1908-1914 (E. Brabant, E. Falzeder, & P. Gampieri-Deutsch,
Eds., P. Hoffer, Trans.). Cambridge, MA: Harvard University Press.
Fromm-Reichmann, F. (1950). Principles of Intensive Psychotherapy. Chicago: Uni-
versity of Chicago Press.
Gadamer, H. (1976). Philosophical Hermeneutics (D. Linge, Trans.). Berkeley:
University of California Press.
Gadamer, H. (1979). The problem of historical consciousness. In P. Rabinow &
W. Sullivan (Eds.), Interpretive Social Science: A Reader. Berkeley: University
of California Press.
Gadamer, H. (1991). Truth and Method (2nd ed.,J.Weinsheimer & D. Marshall,
Trans.). New York: Crossroads.
Geha, R. (1993). Transferred fictions. Psychoanalytic Dialogues, 3, 209-244.
Gerson, M. (1993). Sullivan’s self-in-development: Family context and patterning.
Contemporary Psychoanalysis, 29, 197-218.
Ghent, E. (1992). Paradox and process. Psychoanalytic Dialogues, 2, 135-159.
Gill, M. (1982). Analysis of Transference (Vol. 1). New York: International Univer-
sities Press.
Goldberg, A. (1988). A Fresh Look at Psychoanalysis: The View from Self Psychology.
Hillsdale, NJ: The Analytic Press.
Gotthold, J. (1992, October). Curative fantasy: Its function in the treatment process.
Paper presented at the Fifteenth Annual Conference on the Psychology of
the Self, Los Angeles.
 References / 211

Greenberg,J. (1991). Oedipus and Beyond. Cambridge, MA: Harvard University

Press.
Greenberg, J. (1992). Developmental perspectives in psychoanalytic practice:
Panel discussion. Contemporary Psychoanalysis, 28, 251-299.
Greenberg, J., & Mitchell, S. (1983). Object Relations in Psychoanalytic Theory.
Cambridge, MA: Harvard University Press.
Grosskurth, P. (1987). Melanie Klein: Her World and Her Work. Cambridge, MA:
Harvard University Press.
Grunbaum, A. (1984). The Foundations of Psychoanalysis: A Philosophical Critique.
Berkeley: University of California Press.
Guntrip, H. (1969). Schizoid Phenomena, Object Relations and the Self. New York:
International Universities Press.
Hanly, C. (1992). The Problem of Truth in Applied Psychoanalysis. New York:
Guilford Press.
Hegel, G. (1807). Phenomenology of Spirit (A. Miller, Trans.). Oxford, England:
Oxford University Press, 1977.
Hempel, C. (1951). The concept of cognitive significance: A reconsideration.
Proceedings of the American Academy for the Advancement of Science, 80, 61-77.
Herman,J. L. (1992). Trauma and Recovery. New York: Basic Books.
Hesse, M. (1980). Revolutions and Reconstructions in the Philosophy of Science.
Brighton, England: Harvester Press.
Hobson, R. F. (1985). Forms of Feeling: The Heart of Psychotherapy. London:
Tavistock.
Hoffman, I. (1983). The patient as interpreter of the analyst’s experience.
Contemporary Psychoanalysis, 19, 389-422.
Hoffman, I. (1987). The value of uncertainty in psychoanalytic practice. Contem-
porary Psychoanalysis, 23, 205-215.
Hoffman, I. (1991). Discussion: Toward a social-constructivist view of the psy-
choanalytic situation. Psychoanalytic Dialogues, 1, 74-105.
Hoffman, I. (1992a). Reply to Orange. Psychoanalytic Dialogues, 2, 567-570.
Hoffman, I. (1992b). Some practical implications ofa social-constructivist view
of the psychoanalytic situation. Psychoanalytic Dialogues, 2, 287-304.
Hoffman, I. (1993). The intimate authority of the psychoanalyst’s presence.
Psychologist Psychoanalyst, 13, 15-23.
Horowitz, M. (1986). Stress Response Syndromes (2nd ed.). Northvale, NJ: Jason
Aronson.
Hume, D. (1739). A Treatise ofHuman Nature. Oxford, England: Oxford Univer-
sity Press, 1896.
Husserl, E. (1931). Ideas: An Introduction to Pure Phenomenology. New York:
Macmillan.
Israels, H. (1989). Schreber: Father and Son. Madison, CT: International Universi-
ties Press.
Jaenicke, C. (1987). Kohut’s concept of cure. Psychoanalytic Review, 74, 537-548.
James, W. (1892). Textbook of Psychology: Briefer Course. New York: Holt.
James, W. (1902). The Varieties of Religious Experience. London: Longmans Green.
James, W. (1905). The place of affectional facts in a world of pure experience.
212 / References

In Essays in Radical Empiricism (R. Perry, Ed.; pp. 72-80). New York: Dutton,
1971.
James, W. (1907). Pragmatism. Cambridge, MA: Harvard University Press, 1975.
James, W. (1909). The Meaning of Truth. Cambridge, MA: Harvard University
Press, 1975.
Jones, J. (1995). Affects as Process: An Inquiry into the Centrality of Affect in
Psychological Life. Hillsdale, NJ: The Analytic Press.
Kant, I. (1781). Critique of Pure Reason (N. Kemp Smith, Trans.). New York:
Macmillan, 1929.
Kernberg, O. (1986). Factors in the psychoanalytic treatment of narcissistic
personalities. In A. Morrison (Ed.), Essential Papers on Narcissism (pp.
213-244). New York: New York University Press.
Kirk, G., & Raven, S. (1984). The Presocratic Philosophers: A Critical History with a
Selection of Texts (2nd ed.). Cambridge, England: Cambridge University
Press.
Klein, G. (1966). Perception, Motives and Personality. New York: Knopf.
Klein, G. (1976). Psychoanalytic Theory. New York: International Universities
Press.
Klein, M. (1975). Envy and Gratitude, 1946-1963. New York: Delacorte Press.
Kohut, H. (1957). Observations on the psychological functions of music. In The
Search for the Self (Vol. 1, P. Ornstein, Ed.; pp. 233-253). Madison, CT:
International Universities Press, 1978.
Kohut, H. (1959). Introspection, empathy, and psychoanalysis: An examination
of the relationship between mode of observation and theory. In The Search
Jor the Self (Vol. 1, P. Ornstein, Ed.; pp. 205-232). Madison, CT: International
Universities Press, 1978.
Kohut, H. (1971). The Analysis of the Self. New York: International Universities
Press.
Kohut, H. (1973). The psychoanalyst in the community of scholars. In The Search
for the Self (Vol. 2, P. Ornstein, Ed.; pp. 685-724). Madison, CT: International
Universities Press, 1978.
Kohut, H. (1977). The Restoration of the Self. Madison, CT: International Univer-
sities Press.
Kohut, H. (1978a). Discussion of “Further data and documents in the Schreber
case” by William G. Niederland. In The Search for the Self (Vol. 1, P. Ornstein,
Ed.; pp. 305-308). Madison, CT: International Universities Press.
Kohut, H. (1978b). Conclusion: The search for the analyst’s self. In The Search for
the Self (Vol. 2, P. Ornstein, Ed.; pp. 931-938). Madison, CT: International
Universities Press.
Kohut, H. (1978c). Letter to a colleague. In The Search for the Self (Vol. 4, P.
Ornstein, Ed.; pp. 577-591). Madison, CT: International Universities Press,
OSE
Kohut, H. (1981). On empathy. In The Search for the Self (Vol. 4, P. Ornstein, Ed.;
pp. 525-535). Madison, CT: International Universities Press, 1991.
Kohut, H. (1984). How Does Analysis Cure? Chicago: University of Chicago Press.
 References / 213

Kohut, H. (1985). Self Psychology and the Humanities: Reflections on a New Psycho-
analytic Approach (C. Strozier, Ed.). New York: Norton.
Kohut, H. (1994). The Curve of Life: Correspondence of Heinz Kohut, 1923-1981 (G.
Cocks, Ed.). Chicago: University of Chicago Press.
Krystal, H. (1988). Integration and Self-Healing: Affect, Trawma, Alexithymia.
Hillsdale, NJ: The Analytic Press.
Kuhn, T. (1962). The Structure of Scientific Revolutions (2nd ed.). Chicago: Univer-
sity of Chicago Press, 1970.
Lauer, Q. (1976). A Reading of Hegel’s Phenomenology of Spirit. New York:
Fordham University Press.
Lauer, Q. (1978). The Triumph of Subjectivity: An Introduction to Transcendental
Phenomenology. New York: Fordham University Press.
Lessem, P. (1992, October). The relational patterning of affective experience. Paper
presented at the Fifteenth Annual Conference on the Psychology of the
Self, Los Angeles.
Lessem, P., & Orange, D. (1993, October). Self psychology and attachment: The
importance of the particular other. Paper presented at the Sixteenth Annual
Conference on the Psychology of the Self, Toronto.
Lichtenberg, J. (1983). Psychoanalysis and Infant Research. Hillsdale, NJ: The
Analytic Press.
Lichtenberg, J. (1989). Psychoanalysis and Motivation. Hillsdale, NJ: The Analytic
Press.
Lichtenberg,J.,Lachmann, F., & Fosshage,J.(1993). Selfand Motivational Systems:
Toward a Theory of Psychoanalytic Technique. Hillside, NJ: The Analytic Press.
Little, M. (1990). Psychotic Anxieties and Containment: A Personal Record of an
Analysis with Winnicott. Northvale, NJ: Jason Aronson.
Loewald, H. (1960a). On the therapeutic action of psychoanalysis. International
Journal of Psycho-Analysis, 41, 16-33.
Loewald, H. (1960b). Perspectives on memory. In Papers on Psychoanalysis. New
Haven, CT: Yale University Press, 1980.
Loewald, H. (1980). Papers on Psychoanalysis. New Haven, CT: Yale University
Press.
Loewald, H. (1986). Transference-countertransference. Journal of the American
Psychoanalytic Association, 34, 275-287.
Lomas, P. (1987). The Limits of Interpretation. Northvale, NJ: Jason Aronson.
Lothane, Z. (1989). Schreber, Freud, Flechsig and Weber revisited: An inquiry
into methods of interpretation. Psychoanalytic Review, 76, 203-262.
Lothane, Z. (1990). [Panel on Schreber at the American Academy of Psychoanaly-
sis.] On tape.
Maccio, D. (1992). Surviving, existing, living: Reflections on the analyst’s anxiety.
In L. Nissim-Momigliano & A. Robutti (Eds.), Shared Experience (pp. 89-
120). London: Karnac Books.
Macmurray,J.(1957). The Selfas Agent. Atlantic Highlands, NJ: Humanities Press
International, 1991.
Magid, B. (Ed.). (1993). Freud’s Case Studies: Self Psychological Perspectives.
Hillsdale, NJ: The Analytic Press.
214 / References

Mahler, M., Pine, F., & Bergman, A. (1975). The Psychological Birth of the Human
Infant. New York: Basic Books.
McDougall, J. (1989). Theaters of the Body: A Psychoanalytic Approach to Psychoso-
matic Illness. New York: Norton.
Miller, A. (1981). Prisoners of Childhood (R. Ward, Trans.). New York: Basic Books.
Miller, A. (1986). Depression and grandiosity as related forms of narcissistic
disturbances. In A. Morrison (Ed.), Essential Papers on Narcissism (pp.
323-347). New York: New York University Press.
Miller, A. (1990). The Untouched Key: Tracing Childhood Trauma in Creativity and
Destructiveness (H. Hannum & H. Hannum, Trans.). New York: Doubleday
Anchor Books.
Miller, J., & Post, S. (Eds.). (1990). How theory shapes technique: Perspectives
on a self psychological clinical presentation. Psychoanalytic Inquiry, 10,
(459-624).
Mitchell, S. (1988). Relational Concepts in Psychoanalysis: An Integration. Cam-
bridge, MA: Harvard University Press.
Mitchell, S. (1993). Hope and Dread in Psychoanalysis. New York: Basic Books.
Moore, B., & Fine, R. (1990). Psychoanalytic Terms and Concepts. New Haven, CT:
Yale University Press.
Niederland, W. (1951). Three notes on the Schreber case. Psychoanalytic Quar-
terly, 28, 151-169.
Niederland, W. (1984). The Schreber Case (2nd ed.). Hillsdale, NJ: The Analytic
Press.
Nissim-Momigliano, L., & Robutti, A. (Eds.). (1992). Shared Experience. London:
Karnac Books.
Nozick, R. (1989). The Examined Life. New York: Simon and Schuster.
Nozick, R. (1993). The Nature ofRationality. Princeton: Princeton University Press.
Ogden, T. (1986). The Matrix of the Mind. Northvale, NJ: Jason Aronson.
Ogden, T. (1989). The Primitive Edge of Experience. Northvale, NJ: Jason Aronson.
Ogden, T. (1994). The Subjects ofAnalysis. Northvale, NJ: Jason Aronson.
Orange, D. (1984). Peirce’s Conception of God. Bloomington: Indiana University
Press.
Orange, D. (1992a). Commentary on Irwin Hoffman’s “Discussion: Toward a
social constructivist view of the psychoanalytic situation.” Psychoanalytic
Dialogues, 2, 561-566.
Orange, D. (1992b). Subjectivism, relativism, and realism in psychoanalysis. In
A. Goldberg (Ed.), New Therapeutic Visions: Progress in Self Psychology (pp.
189-197). Hillsdale, NJ: The Analytic Press.
Orange, D. (1993). The restoration of Schreber’s stolen self. In B. Magid (Ed.),
Freud's Case Studies: Self Psychological Perspectives. Hillsdale, NJ: The Analytic
Press.
Orange, D. (1994). Countertransference, empathy, and the hermeneutical circle.
In R. Stolorow, G. Atwood, & B. Brandchaft (Eds.), The Intersubjective
Perspective (pp. 177-186). Northvale, NJ: Jason Aronson.
Orange, D. (1995, April). Relationship theories and self psychology: The Ferenczi
 References / 215

connection. Paper presented at the meeting of the Division of Psychoanalysis

of the American Psychological Association, Santa Monica, CA.
Ornstein, A. (1991). The dread to repeat: Comments on the working through
process in psychoanalysis. Journal of the American Psychoanalytic Association,
39, 377-398.
Ornstein, P. (1991). Why self psychology is not an object relations theory: Clinical
and theoretical considerations. In A. Goldberg (Ed.), The Evolution of Self
Psychology: Progress in Self Psychology (pp. 17-29). Hillsdale, NJ: The Analytic
Press.
Ornstein, P., & Ornstein, A. (1985). Clinical understanding and explaining: The
empathic vantage point. In A. Goldberg (Ed.), Progress in Self Psychology (Vol.
1, pp. 43-61). New York: Guilford Press.
Palmer, R. (1969). Hermeneutics: Interpretation Theory in Schleiermacher, Dilthey,
Heidegger, and Gadamer. Evanston, IL: Northwestern University Press.
Peirce, C. (1868). Some consequences of four incapacities. In Collected Papers of
Charles Sanders Peirce (Vol. 5, C. Hartshorne & P. Weiss, Eds.; pp. 156-189).
Cambridge, MA: Harvard University Press, 1931-1935.
Peirce, C. (1877). The fixation of belief. In Collected Papers of Charles Sanders Peirce
(Vol. 5, C. Hartshorne & P. Weiss, Eds.; pp. 223-247). Cambridge, MA:
Harvard University Press, 1931-1935.
Peirce, C. (1931-1935). Collected Papers of Charles Sanders Peirce (C. Hartshorne &
P. Weiss, Eds.). Cambridge, MA: Harvard University Press.
Piaget, J. (1968). On the Development of Memory and Identity. Barre, MA: Clark
University Press and Barre Publishers.
Piaget,J.,& Inhelder, B. (1973). Memory and Intelligence. New York: Basic Books.
Pine, F. (1990). Drive, Ego, Object, and Self: New York: Basic Books.
Plato (1961). Collected Dialogues. Princeton, NJ: Princeton University Press.
Polanyi, M. (1958). Personal Knowledge: Towards a Post-Critical Philosophy. Chicago:
University of Chicago Press.
Popper, K. (1959). The Logic of Scientific Discovery. New York: Harper & Row.
Potter, V. (1994). On Understanding Understanding. New York: Fordham University
Press.
Protter, B. (1985). Toward an emergent psychoanalytic epistemology. Contempo-
rary Psychoanalysis, 21, 208-227.
Pulver, S. (Ed.). (1987). Models of the mind: Perspectives on a clinical study.
Psychoanalytic Inquiry, 7, 141-299.
Racker, H. (1968). Transference and Countertransference. New York: International
Universities Press.
Renik, O. (1993). Analytic interaction: Conceptualizing technique in light of the
analyst’s irreducible subjectivity. Psychoanalytic Quarterly, 62, 553-571.
Ricci, W., & Broucek, F. (1994, October). Neutrality, abstinence and anonymity
revisited. Paper presented at the Seventeenth Annual Conference of the
Psychology of the Self, Chicago.
Ricoeur, P. (1979). The model of the text: Meaningful action considered as a text.
In P. Rabinow & W. Sullivan (Eds.), Interpretive Social Science: A Reader (pp.
73-101). Berkeley: University of California Press.
216 / References

Rilke, R. (1934). Letters to a Young Poet. New York: Norton.

Ryle, G. (1949). The Concept of Mind. London: Hutchinson.
Schachtel, E. (1959). Metamorphosis. New York: Basic Books.
Schafer, R. (1983). The Analytic Attitude. New York: Basic Books.
Schatzman, M. (1973). Soul Murder: Persecution in the Family. New York: Random
House.
Schreber, D. (1903). Memoirs of My Nervous Illness (1. Macalpine & R. Hunter, Eds.
& Trans.). Cambridge, MA: Harvard University Press, 1955.
Schwaber, E. (1983). Construction, reconstruction, and the mode of clinical
attunement. In A. Goldberg (Ed.), The Future of Psychoanalysis (pp. 273-291).
New York: International Universities Press.
Schwaber, E. (1992). Countertransference: The analyst’s retreat from the pa-
tient’s vantage point. International Journal of Psycho-Analysis, 73, 349-362.
Shabad, P. (1993). Resentment, indignation, entitlement: The transformation of
unconscious wish into need. Psychoanalytic Dialogues, 3, 481-494.
Shengold, L. (1989). Soul Murder: The Effects of Childhood Abuse and Deprivation.
New Haven, CT: Yale University Press.
Spence, D. (1982). Narrative Truth and Historical Truth. New York: Norton.
Spezzano, C. (1993). Affect in Psychoanalysis: A Clinical Synthesis. Hillsdale, NJ:
The Analytic Press.
Spiegelberg, H. (1960). The Phenomenological Movement (Vols. 1-2). The Hague,
The Netherlands: Martinus Nijhoff.
Spinoza, B. (1677). Ethics. New York: Hafner, 1949.
Stern, Daniel (1983). Implications of infancy research for psychoanalytic theory
and practice. Psychiatric Update, 2, 7-21.
Stern, Daniel (1985). The Interpersonal World of the Infant. New York: Basic Books.
Stern, Daniel (1988). The dialectic between the “interpersonal” and the “intrap-
sychic”: With particular emphasis on the role of memory and repre-
sentation. Psychoanalytic Inquiry, 8, 505-512.
Stern, Donnel. (1989). The analyst’s unformulated experience of the patient.
Contemporary Psychoanalysis, 25, 1-33.
Stern, Donnel. (1991). A philosophy for the embedded analyst: Gadamer’s
hermeneutics and the social paradigm of psychoanalysis. Contemporary
Psychoanalysis, 27, 51-58.
Stern, Donnel. (1992). Commentary on constructivism in clinical psychoanalysis.
Psychoanalytic Dialogues, 2, 331-363.
Stolorow, D., & Stolorow, R. (1987). Affects and selfobjects. In R. Stolorow, B.
Brandchaft, & G. Atwood, Psychoanalytic Treatment: An Intersubjective Ap-
proach (pp. 66-87). Hillsdale, NJ: The Analytic Press.
Stolorow, R. (1988). Intersubjectivity, psychoanalytic knowing, and reality. Con-
temporary Psychoanalysis, 24, 331-338.
Stolorow, R. (1994). The nature and therapeutic action of psychoanalytic inter-
pretation. In R. Stolorow, G. Atwood, & B. Brandchaft (Eds.), The Intersub-
jective Perspective (pp. 43-55). Northvale, NJ: Jason Aronson.
Stolorow, R., & Atwood, G. (1992). Contexts ofBeing: The Intersubjective Foundations
of Psychological Life. Hillsdale, NJ: The Analytic Press.
 References / 217

Stolorow, R., Brandchaft, B., & Atwood, G. (1987). Psychoanalytic Treatment: An

Intersubjective Approach. Hillsdale, NJ: The Analytic Press.
Stolorow, R., & Lachmann, F. (1987). Transference—The organization of experi-
ence. In R. Stolorow, B. Brandchaft, & G. Atwood, Psychoanalytic Treatment:
An Intersubjective Approach (pp. 28-46). Hillsdale, NJ: The Analytic Press.
Strachey, J. (1934). The nature of the therapeutic action of psychoanalysis.
International Journal of Psycho-Analysis, 15, 127-159.
Sucharoy, M., (1994). Psychoanalysis, self psychology, and intersubjectivity. In R.
Stolorow, G. Atwood, & B. Brandchaft (Eds.), The Intersubjective Perspective
(pp. 187-202). Northvale, NJ: Jason Aronson.
Sullivan, H. (1940). Conceptions of Modern Psychiatry. New York: Norton.
Sullivan, H. (1953). The Interpersonal Theory of Psychiatry. New York: Norton.
Sulloway, F. (1979). Freud, Biologist of the Mind: Beyond the Psychoanalytic Legend.
New York: Basic Books.
Suppe, F. (1977). The Structure of Scientific Theories (2nd ed.). Urbana: University
of Illinois Press.
Suttie, I. (1935). The Origins of Love and Hate. London: Routledge and Kegan
Paul, 1988.
Tansey, M. (1992). Psychoanalytic expertise. Psychoanalytic Dialogues, 2, 305-316.
Tauber, E., & Green, M. (1959). Prelogical Experience. New York: Basic Books.
Terr, L. (1990). Too Scared to Cry. New York: HarperCollins.
Thomson, P. (1991). Countertransference in an intersubjective perspective: An
experiment. In A. Goldberg (Ed.), The Evolution of Self Psychology (pp.
75-92). Hillsdale, NJ: The Analytic Press.
Tolpin, M. (1991). Conversations. In J. Masterson, M. Tolpin, & P. Sifneos (Eds.),
Comparing Psychoanalytic Psychotherapies. New York: Brunner/ Mazel.
Tomkins, S. (1963). Affect, Imagery, Consciousness, II: The Negative Affects. New York:
Springer.
Tronick, E. (1989). Emotions and emotional communication in infants. American
Psychologist, 44, 112-119.
van der Kolk, B. (1984). Post-Traumatic Stress Disorder: Psychological and Biological
Sequelae. Washington, DC: American Psychiatric Press.
van der Kolk, B. (1987). Psychological Trauma. Washington, DC: American
Psychiatric Press.
Waelder, R. (1936). The principle of multiple function. Psychoanalytic Quarterly,
D, 45-62.
Wallerstein, R. (Ed.). (1992). The Common Ground of Psychoanalysis. Northvale,
NJ: Jason Aronson.
Weigert, E. (1962). Sympathy, empathy, and freedom in therapy. In L. Salzman
& J. Masserman (Eds.), Modern Concepts of Psychoanalysis. New York: Citadel
Press.
Whitehead, A. N. (1925). Sctence and the Modern World. New York: Macmillan.
Whitehead, A. N. (1929). Process and Reality. New York: Macmillan.
Whitehead, A. N. (1938). Modes of Thought. New York: Free Press, 1966.
Whitehead, A. N. (1948). Essays in Science and Philosophy. New York: Philosophical
Library.
218 / References

Winnicott, D. (1958). Through Paediatrics to Psycho-Analysis. New York: Basic

Books.
Winnicott, D. (1965). The Maturational Processes and the Facilitating Environment:
Studies in the Theory of Emotional Development. New York: International
Universities Press.
Winnicott, D. (1971). Playing and Reality. London: Routledge.
Winnicott, D. (1986). Holding and Interpretation. New York: Grove.
Winnicott, D. (1989). Psychoanalytic Explorations. Cambridge, MA: Harvard Uni-
versity Press.
Wittgenstein, L. (1953). Philosophical Investigations (3rd ed., G. Anscombe,
Trans.). New York: Macmillan.
Wittgenstein, L. (1921). Tractatus Logico-Philosophicus (D. Pears & D. McGuinness,
Trans.). Atlantic Highlands, NJ: Humanities Press, 1961.
Wolf, E. (1988). Treating the Self: Elements of Clinical Self Psychology. New York:
Guilford Press.
Zucker, H. (1993). Reality: Can it be only yours or mine? Contemporary Psycho-
analysis, 29, 479-486.
 Index

Abandonment, 195 Attunement, 21, 141

Abreaction, 160, 161 Atwood, G., 4, 7, 11, 16, 22, 24, 35,
Accomodation, 29-30, 71 47-48, 54, 55, 65, 79-80, 85,
Activities, of self-restoration, 202- 86, 87, 92-93, 113, 121, 137,
203 140, 153, 170, 177
Affect, 90. See also Emotion and Augustine, 19
emotional life, 89-104 Availability. See Emotional availability
recent psychoanalytic work on,

Affectional bond, 177, 178 B

Affective memory. See Emotional
memory Bacal OMA > len e753.
Affect tolerance, 91, 92, 104 1GOMI6 2. 65 el67el2 7 3—
Aggression, 67 174, 179
Ainsworth, M., 172, 173 Bacon, F., 82, 83, 84
Alexander, F., 47 Bacon, R., 82
Alexithymia, 91-92, 111-112, 123 Balint, M., 10, 28, 30, 98, 131-132,
Ambiguity, 53-54, 86 166-167, 168
Ambivalence, 96 Basic fault, 167
Analyst, perspective of. See Cotrans- Beebe, B., 80-81, 97, 141, 173
ference Bergman, A., 152
Analyzability, 49, 125 Bergson, H., 28, 106
Aquinas, T., 19 Berkeley, G., 77, 83
Archaic relatedness, 178 Bernstein, R., 3, 12, 44, 57, 58, 61
Aristotle, 20, 28, 33, 37-38, 39, 82, Bion, W., 42
94, 124, 135 Body memory, 112
Aron, L., 8, 68, 130, 135, 175 Bollas, G., 8, 10, 110=111, 118, 121,
Asset, F., 72 128
Assimilation, 29 Boundaries, of therapists, 132
Attachment, 126-128, 177, 178, 179 Bowlby, J., 10, 28, 91, 98, 166, 168,
selfobject experience, and thera- WP, Wa, ala
peutic efficacy, 171-179 Brandchaft, B:, 5, 6,7, 10) 11, 24.
Attitudes, methodological, 3 48, 150, 151, 154, 174

AND
220 / Index

Brentano, F., 162 D

Breuer, J., 160
Buber, M., 20-21
Darwin, C., 44
Decentering, 68
Democritus, 37
C Denial, 137, 138. See also Uncon-
sciousness
Certainty, in psychoanalysis, 48-51 Dependency, of patients, 131-132
Chabot, E. B., 203 Derivative selfobject relatedness,
Character, 75 175-179, 203
Circle, hermeneutical, 72-73 Descartes, R., 44, 49-50, 54, 70, 82-
Clinical examples, of emotional 83, 85, 107, 121, 143
memory, 116-119 Developmental arrest, 150
Clinical theory, as source of misun- Developmental-relationalism, 10
derstanding, 151-158 Developmental tilt, 25
Closed system, 164-165 Developmental understanding, 24-
Coherence theories, 42-43, 77, 32
145-146, 148, 149 DiChiara, G., 98
Collaborative-pragmatist view, of Dilthey, W., 14-15, 69, 70, 73, 85
misunderstanding, 141-158 Dissociation, 138, 140, 200
Common sense, 82, 143. See also Dread, 96, 97
Correspondence theories to repeat, 139
Community, 61, 62 Dynamic unconsciousness, 80
Complexity, of emotional life, 95-
97, 98-99, 104
Complex mental states, 96, 98 E
Conception, of effects, 147
Concretization, 187 Eco, U., 24
Confusion, 53 Effects, 41-42, 43-44, 147
Constructivism, critical, 77 Efficacy of psychoanalysis, 160-171
Contemporary idealisms, 77, 81 therapeutic, attachment, selfob-
Content, versus form, 113 ject experience and, 171-
Copernicus, N., 44 179
Correspondence theories, 42, 76, Ego psychology, 76, 160, 167
77, 143-145, 146, 148, 149 Ego structure, 111
Cotransference, 7, 9, 28, 56, 63-74, Ehrenberg, D., 123
87, 121-122) 125, 130) 132, Ellenberger, H., 51
ISS Sell Emde, R., 28, 30, 115, 116, 125-
Countertransference, 2, 7, 25, 26, WAG, NAS, Wel, Wee. es
Yay ssheeieealeyvaterday atswin lr, Emotion, 84-85, 90. See also Affect
WS, GH Emotional amnesia, 121
in development of self psychol- Emotional availability, 4, 5, 31,
ogy, 64-68 125-140, 153, 157, 162, 165,
empathy, and hermeneutic in- Wy7all
quiry, 68-74 Emotional life
Critical constructivism, 77 affect and, 89-104
Critique of positivism as complex and relational, 95-99
within philosophy, 44-46 Emotionally available witness, 135-
within psychoanalysis, 46-48 140, 202
 Index / 221

Emotional memory, 8, 93-94, 105 Fears, of therapists, 129-132

124 Feelings, 90. See also Emotion
clinical examples of, 116-119 Ferenczi, S., 11, 25, 28, 44, 47,
conception of, 106-116 88, 98, 109-110, 132, 135,
implications of clinical focus on, 160-162, 163, 166-167, 168,
199-124 187
Emotional understanding, 2, 4, 8, Feyerabend, P., 59, 146
10. See also Subjective under- Fictionalism, 77-78
standing Field theory, 24, 67, 122
Empathy, 5, 15, 78-79, 85, 86, 90, Flashbacks, 138
125, 145, 169, 170, 171, 174, Flavell,J., 115
175, 176, 181. See also Emo- Flechsig, P. E., 181, 182, 183, 184,
tional availability 186, 187, 188, 189, 191, 192,
countertransference and, and her- 194, 195, 197, 198, 199, 203,
meneutic inquiry, 68-74 205
and understanding, 17-23 Form, content versus, 113
Empiricism, 59, 60, 61, 62, 73, 81, Fosshage, 528, 29,58,19 7,012,
83, 145, 146, 174, 175. See also NAS
Scientific realism French, T., 47
radical, 84 Freud, A., 42
Enactive remembering, 110 Freud, S., 2-3, 8, 13, 24-25, 34, 35,
Envy, and shame, 99-104 44, 46-47, 51, 54, 60, 76, 80,
Epicureans, 37 88, 89-90, 93, 94, 96, 99, 106,
Epistemology, 142 107, 108-109, 128, 129, 149,
and intersubjectivity, 4-6 160, 161, 162, 163, 164, 180,
of perspectival realism, 53-62 181, 185-189, 190, 191, 192,
Existential meaning, 107 195, 204, 205
Existential memory, 110, 111 Future, development toward, 28
Experience, 2, 14-15, 29-30, 46
given and made, 75-88
in history of philosophy, 82-86 G
as interpretation, 86-88
as process, 177 Gadamer, H., 1, 5, 7, 8, 15-16, 17,
in psychoanalytic theory, 76-82 24, 58, 65-66, 69-71, 73-74,
relational, of Schreber, 193-199 85-86, 98, 108, 146
selfobject. See Selfobject experi- Geha, R., 29, 77-78
ence Generality, 128
self, of Schreber, 199-202 Gerson, M., 27
unformulated, 122 Gestalt, 54, 67, 78, 86, 147
Ghost in the machine, 121
Gifts, 155
FE Gill, M., 26, 65
Goldberg, A., 57, 66, 146
Failure, 101, 103 Gotthold, J., 165-166
Fairbairn, W., 10, 93, 97, 98, 164- Greenberg, J., 10, 13, 25-26, 94,
165, 168 162, 173
Fallibilism, 3, 4, 10, 11, 29, 34, 43- Green, M., 122
52, 116, 124, 142, 143, 149- Grip, of interpersonal field, 122
150, 158, 159, 180. See also The- Grunbaum, A., 3
ory-choice Guntrip, H., 8, 10, 79, 98
222 / Index

H Intersubjectivity, 13, 23-24

epistemology and, 4-6
self psychology, and psychoana-
Habermas,
J., 58 lytic understanding, 7-11
Habit, 39, 43, 147, 149 Introspection, 5, 78-79, 90, 145,
Hanly, C., 76, 144 174, 175, 176, 181
Healing, through psychoanalytic un-
derstanding, 159-179
Hegel, G., 3, 14, 38-49, 41, 52, J
146
Heidegger, 15 James, W., 45, 49, 72, 79, 84-85,
Heisenberg, W., 44 141, 142, 146-147, 159
Hempel, C., 59
Heraclitus, 36
Hermeneutic inquiry, 46, 75, 85 K
countertransference, empathy
and, 68-74 Kant, I., 13-14, 15, 38, 47-48, 83,
Hesse, M., 59-60 84, 87, 146
History Kernberg, O., 99, 100
of philosophy, experience in, 82- Klein, G., 47, 114, 142
86 Klein, M., 81, 99-100, 149, 160, 166
of understanding, 13-17 Knowing-about, subjective under-
Hobson, R. F., 17, 59 standing versus, 4-6. See also
Hotimans i lOsZos Ole iceno Not knowing
130, 135, 146, 150 Kohut, H., 3, 4-5, 8, 10, 12, 13, 15,
Holding environment, 93, 128, 153, 16, 17=18, 20, 21-22, 25, 28,
165 30, 35, 41, 45, 50, 54, 55, 62,
Homosexuality, Freud and, 185, 64-65, 66, 68, 78, 90, 96, 98,
188, 190, 195 100, 112-113, 126, 141, 145,
Human nature, 27 154, 156-157, 166, 168-170,
Hume, D., 19, 83, 143 174, 175, 176, 178, 179, 181,
Husserl, E., 46, 54-55, 56, 57, 62, 188, 192-193
85, 142 Krystal, H., 89, 90-92, 94, 104, 111
Hysterias, 160 Kuhn, T., 43, 44, 45, 59, 146

Idealisms, contemporary, 77, 81 Lachmann, F., 66, 80-81, 97, 127,

Illustration, 180-205 141, 173
Inclusiveness, 41 Lauer 0739755
Inhelder, B., 115 Lessem, P:, 23, 1121, 159) 173
Instrumental knowledge, 107, 108 Lichtenberg, J., 41, 127, 178
Internalizations, transmuting, 170 Linguistic analysis, 106-107
Interpersonalism, 8, 10, 27, 42 Little, M., 127-128, 132, 165
Interplay, 24 Locke, J., 83, 143
Interpretation, 15, 16, 31, 49, 69, Loewald, H., 67, 93, 110, 167-168
70-71, 162 Logical positivism. See Positivism
experience as, 86-88 Lomas, P., 66-67
Intersubjective conjunction, 133-135 Lothane, Z., 188, 189, 191-192, 197
 Index / 223

M Objectivism, 3, 10, 57, 73

versus realism, 58-62
Object relations, 42, 90, 93, 111,
Maccio, D., 125
164-165, 167-168, 173, 174
McDougall,J., 111-112
Ockham, William of, 82
Mahler, M., 152
Ogden, T., 9, 26, 81-82
Main, M., 172
Ontology, 142
Making sense together, 1-11 Optimal responsiveness, 47, 72,
Meaning
153, 179
confusion of symbol with, 187- Organization, 6-7
188 Ornstein, A., 9, 10, 30, 98, 139
existential, 107
Ornstein, P., 10, 98, 174
pragmatist shift to, 146-147 Overdetermination, 96
and psychoanalytic under-
standing, 148-151
Memory, 4, 6 P
emotional, 8, 93-94, 105-124
Mere experience, 82, 83 Palmer, R., 46, 72, 73
Mill,J.S., 47
Paradoxical-passive efforts, at self-
Miller, A., 100-101, 136-137, 198,
restoration, 203-204
202 Paranoia, and self-restoration, 204
Mirroring, 30, 126, 136, 139-140,
Parmenides, 36
154, 168 Peer groups, 51
Misunderstanding, 141-158, 194-
Peirce, C., 12, 21, 24, 39, 41, 43, 44-
197, 204-205 45, 52, 61, 70, 83-84, 146-147
Mitchell, S., 10, 13, 25, 34, 35, 130- Perspectival realism, 2, 3-4, 10, 75,
LSPS ORG 220173 149, 158
Multiple function, 96
epistemology of, 53-62
Mutative interpretations, 162 Phenomenology, 54-56, 57, 62
Mutuality, 68 Philosophy
critique of positivism within, 44-
N experience in history of, 82-86
psychoanalysis and, 2-4, 142-
Narrative, 26, 27-28, 77, 144 143, 146
Newman, K., 10, 160, 163, 165, and reasonableness, 36-40
167, 172, 173-174 Piaget, J.,29-30, 31, 71, 114, 115,
Niederland, W., 187, 189-190, 191, 152
192, 196, 205 Pine, F., 34, 152
Nietzsche, F., 14, 63 Plato, 3, 4, 19-20, 37, 38, 40, 41, 61
Not knowing, understanding and, Play, 15, 24, 65-66, 67, 71, 126, 165
43-52 Plotinus, 19
Nozick, R., 40, 200 Polanyi, M., 107-108, 116, 122
Popper, K., 45, 61
Positivism, 27-28, 58, 144, 145
O critique of, 44-48
Posttraumatic stress, 91, 109, 113,
Object, 162, 176 120, 140
Object constancy, 151-155, 157 Potter, V., 12, 58, 59, 76, 143
Objective memory, 109 Pragmatic criteria, 41-42, 43-44, 75
224 / Index

Pragmatism, 83 Reality, in psychoanalysis, 29, 142-

Pragmatist shift to meaning, 146- 147
147 Reasonable criteria, for theory-
Pragmatist view of misunderstand- choice, 40-43
ing, 141-158 Reasonableness, philosophy and,
Prejudice, 69-71, 72, 73, 108 36-40
Preref lective unconsciousness, 79-80 Relatedness and developmental un-
Primary selfobject relatedness, 175- derstanding, 27-29
179, 203 of emotional life, 95, 96, 97-99,
Process 102, 103-104
experience as, 54, 177 as process, 177
relatedness as, 177 selfobject, primary and deriva-
Product, 54 tive, 175-179, 203
Protagoras, 57-58 understanding as, 15, 23, 24
Prototypic memories, 114-115 Relational experience, of Schreber,
Psychoanalysis 193-199
certainty in, 48-51 Relativism, 3, 4, 10, 29, 52
critique of positivism within, 46- subjectivism versus, 56-58
48 Renik, O., 71, 131
efficacy of, 160-171 Repetition, 29, 109
and philosophy, 2-4 dread of, 139
theory-choice in. See Theory- Representational remembering,
choice 110
truth and reality in, 142-147 Resistance, 29, 75
Psychoanalytic accounts, of Schre- Response, 22-23
ber, since Freud, 189-193 Ricoeur, P., 16
Psychoanalytic fallibilism. See Fallibi- RIGs (representations of interac-
lism tions generalized), 80, 114, 115
Psychoanalytic theory, 142 Rilke, R., 6
experience in, 76-82 Roethke, T., 105
Psychoanalytic understanding, 23- Ruptures. See Misunderstanding
24,171 Ryle, G7 121
healing through, 159-179
intersubjectivity and self psychol-
ogy and, 7,9, 10, 11 S
meaning and, 148-151
Psychoanalytic work, on affect, 90-95 Sadness, 201-202
Psychosomatic illness, 111-112 Schafer, R., 26, 62, 77, 78, 144, 146
Schatzman, M., 190-191
Schleiermacher, F., 69, 70, 72-73
R Schreber, D. P., 180-205
efforts of, at self-restoration, 202-
Radical empiricism, 84 205
Rationality, theory-choice and, 34- Freud’s account of, 185-189
36 and his memoirs, 182-184
Realism, 27, 29 psychoanalytic accounts of, since
objectivism versus, 58-62 Freud, 189-193
perspectival, 2, 3-4, 53-62, 75, relational experience of, 193-199
149, 158 self-experience of, 199-202
scientific, 76, 77, 78, 81, 84, 144 Schwaber, E., 71, 181
 Index / 225

Scientific realism, 76, 77, 78, 81, Stern, Donnel, 10, 122
84, 144. See also Empiricism Stoics, 37
Self-experience, of Schreber, 199- Stolorow, D., 113
202 Stolorow, R., 4, 5, 7, 10, 11, 13, 16,
Selfobject, 136, 139, 140, 156-157, 22, 23, 24, 30, 35, 41, 47-48,
168, 169, 182, 203 54, 55, 62, 65, 66, 68, 73, 79-
Selfobject experience, 136, 138, 80, 85, 86, 92-93, 97, 113, 121,
139, 140, 149, 153-155, 170, 133, 137, 140, 153, 154, 170,
192, 203 173; 177, 181, 187; 193
attachment and, and therapeutic Strachey, J., 162, 168
efficacy, 171-179 Stress, 192
Selfobject relatedness, primary and posttraumatic, 91, 109, 113, 120,
derivative, 175-179, 203 140
Self psychology, 5, 42, 62, 68, 69, Subjective memory, 109-110
74, 75, 79, 100, 112, 135-136, Subjective self, 101
141, 146, 149, 156-157, 168- Subjective understanding. See also
WOM 2 lis lol Omics Emotional understanding
180, 181, 188, 189, 193, 201, versus knowing-about, 4-6
203, 204 Subjectivism
countertransference in develop- subjectivity versus, 54-56
ment of, 64-68 versus relativism, 56-58
intersubjectivity and psychoana- Sullivan, H., 16, 17, 23-24, 25, 122,
lytic understanding and, 7, 175
8-9, 10 Supervision, 51, 127
Self-restoration, efforts of Schreber Suttie, I., 98, 163-164, 168
at, 202-205 Symbol, confusion of, with mean-
Semiotics, 24 ing, 187-188
Sensorimotor memory/knowledge, Symmetry, 68
114, 115, 116, 123 Synechism, 21
Separation-individuation, 152
Sexual abuse, 198
Shame, 96-97, 119-120, 179 al
envy and, 99-104
Shengold, L., 190 Tacit knowledge, 107-108, 116,
Socrates, 19, 36, 37, 44 122-123
Solipsism, 55, 56, 73 Tansey, M., 150
Somatic knowledge, 111 Tauber, E., 122
Sorce,|, 125-126, 123, 131, 132, 135 Teleology, 39
Soul murder, 197-198, 199, 200, Telephone’calls, 153, 154, 155
202, 204 Tenderness, aversion to, 163
Soul voluptuousness, 203, 204 Theory
Spence,D., 26,62,77, 144-146 clinical, as source of
Spezzano, C., 89-90, 93-94, 95 misunderstanding, 143, 151-
Spiegelberg, H., 55 158
Spinoza, B., 20, 21 psychoanalytic. See Psychoanalytic
Spitz; R91 theor
Splitting, 164 Theory-choice, 3, 33-43, 52, 205.
Sroufe, A., 172, 173 See also Fallibilism
Stern, Daniel, 8, 27, 30, 80, 81, 95, and rationality, 34-36
101, 114-115, 120, 141, 178 reasonable criteria for, 40-43
226 / Index

Therapeutic efficacy, attachment, psychoanalytic. See Psychoanalytic

selfobject experience and, 171- understanding of Schreber,
179 180-205
Therapists, fears of, 129-132 subjective. See Subjective under-
Thomson, P., 51, 66 standing
Tomkins, S., 94 of understanding, 12-32
Tone, 113, 119 Unformulated experience, 122
Topographical knowledge, 107, Unthought known, 118, 121
108, 160 Unvalidated unconsciousness, 80
Transference, 7, 25, 26, 27, 28, 31,
44, 50, 58, 59, 60, 61, 64, 66,
67, 75, 87, 93, 118, 130, 150, Vv
152, 161, 162, 165
as distortion, 143, 144 Vacations, 132, 148, 149, 153, 155
Transitional phenomena, 120, 155,
157-158, 165, 178
Transmuting internalizations, 170 WwW
Trauma, 91-92, 109, 110, 112, 118,
132, 136-140, 160, 161, 192. Waelder, R., 96
See also Posttraumatic stress Weber, G., 186, 191, 192
True experience, 82 Weight, 200-202
Truth, in psychoanalysis, 142-147. Whewell, W., 141
See also Coherence theories; Whitehead, A. N., 40, 48, 94, 106-
Correspondence theories 107
Winnicott, D., 8, 10, 15, 17, 28, 93,
98, 99, 120, 127-128, 129, 131-
U 132, 140, 153, 155, 165-166,
168, 178
Ulysses, 40 Witness, emotionally available, 135-
Unconsciousness, 79-80, 88, 113, 140, 202
114, 123, 137, 160 Wittgenstein, L., 107, 144, 174
Understanding Wolf, E., 65
developmental, 24-32
emotional. See Emotional under-
standing empathy and, 17-23 Z
history of, 13-17
and not knowing, 43-52 Zucker, H., 144-145
requires that the analyst find a place inside
herself or himself for this particular patient.
Because much of emotional understanding is
tacit understanding, it requires attention to the
kinds of memories that precede and extend
beyond words.

In her work, Donna M. Orange not only mends

the historical rift between philosophy and
psychoanalysis but weaves a tapestry that
incorporates both. In so doing, she provides a
clear explication of the philosophical underpin-
nings of emotional understanding and the
epistemology of the therapeutic enterprise.

Laying the groundwork for a fuller, more

encompassing view of psychoanalytic practice,
Emotional Understanding is enlightening
reading for all mental health professionals inter-
ested in psychodynamic theory and treatment.

About the Author

Donna M. Orange, Ph.D., Psy.D.,
holds two doctorates: one in
Philosophy from Fordham
University and the other in
Clinical Psychology from
Yeshiva University. A faculty
member of the Institute for the
Psychoanalytic Study of Subjectivity and a
supervisor at the Graduate School of Applied and
Professional Psychology at Rutgers University,
she maintains a private practice in New Jersey.

Cover photograph by Donna M. Orange

Cover design by James Ty Cumbie
 Critical Acclaim for
Emotional Understanding
“In a remarkable and novel way, this book brings together contemporary psychoanalytic
theories and clinically relevant aspects of philosophy to answer the question, ‘What is
emotional understanding and how is it being communicated?’...
The book will richly
reward the experienced as well as the novice in the practice of psychoanalysis and
psychoanalytic psychotherapy.” —Anna Ornstein, M.D.

"In this brilliant and beautiful book, philosophern—psychoanalyst Donna M. Orange

grounds the clinical psychoanalytic enterprise in the solid epistemological foundation it
has long and sorely needed....Emotional Understanding provides a philosophically
sound view of the psychoanalytic process that will serve as an invaluable guide for all
clinicians who seek to heal emotional wounds and help establish new ways of emotional
experiencing.” —Robert D. Storolow, Ph.D.

“Donna M. Orange has written an eloquent and inspiring volume, teaching us to have
more respect and regard for our patients than for our theories....Mental health profes-
sionals will be greatly enriched by reading this book." —Morton Shane, M.D.

"With deceptive simplicity, Donna M. Orange explores here the basic premises that
underlie psychotherapeutic effectiveness. Her collaborative model of the treatment
process illuminates such bedrock issues as emotional memory, understanding and mis-
understanding, and healing. In a voice consistent with her theoretical convictions, she
moves fluidly from sharing her subjective emotional experiences to making intellect-
ually incisive inferences about their meaning. By exemplifying the rare combination of
philosophical sophistication and personal humility, Orange has encouraged all of us in
the field to ‘hold lightly’ our pet explanatory constructs.” _—Nancy McWilliams, Ph.D.

ISBN 1-57230-010-8

wlford Press

72 Spring Street
|
| |
New York, NY 10012 9"781572 300101