Relational psychotherapy : a primer 9781315810911, 1315810913

Table of contents :
Content: 1. Relational therapy and its contexts --
2. Beginning with the basics : structure, ethics, and empathy --
3. Assessment : what's wrong when your client feels bad? --
4. Between past and present, memory and now --
5. The terribly hard part of relational psychotherapy --
6. The wonderfully good part of relational psychotherapy --
7. Ending and going on.

Citation preview

o

ILe l a t i o n a l Psychotherapy

Pa tricia A. D eY ou ng

RELATIONAL PSYCHOTHERAPY A Primer

Patricia A. DeYoung

I l Routledge | % Taylor & Francis Croup LONDON A ND NEW YORK

F irst p u b lish e d 2003 by R o u tled g e P u b lish e d 2013 by R o u tled g e 2 P ark S q u are, M ilto n P ark , A b in g d o n . O x o n 0 X 1 4 4R N 711 T h ird A v e n u e, N e w Y ork, N Y , 10017, U S A

Routledge is an imprint o f the Taylor & Francis Group, an in forma business © 2003 by P a tric ia A . D eY oung

L ib rary o f C o n g re ss C ard N u m b e r 2002152051 C o v e r desig n by K im b erly G lyder. E x cep t as p e rm itte d u n d e r U .S . C o p y rig h t Law , no part o f th is book m ay be re p rin ted , re p ro d u c e d , tran sm itte d , o r u tilize d in any form by any e le ctro n ic, m cc h an ic al, o r o th e r m ea n s, no w k n o w n o r h e re a fte r in v en te d , including p h o to co p y in g , m ic ro film in g , and re co rd in g , or in a n y in fo rm a tio n sto ra g e or re triev a l sy ste m , w ith o u t w ritten p e rm issio n from the p u b lish ers. T r a d e m a r k N o tic e : P ro d u ct or c o rp o ra te n a m e s m ay be trad e m a rk s or re g iste re d tra d e m a rk s, a n d arc u se d only for id e n tific a tio n a n d e x p la n atio n w ith o u t in ten t to infringe.

L ib ra ry of C ongress Cataloging-in-Puhlication Data

D eY o u n g . P atricia A ., 1953 R e la tio n a l p sy c h o th e ra p y : p rim e r / P a tric ia A . D eY o u n g ., 1953— p. cm . In c lu d e s b ib lio g ra p h ic a l re fe re n ce s a n d index. 1. In terp e rso n a l p sy ch o th erap y . 2. In terp e rso n a l re la tio n s. 3. P sy c h o th e ra p ist and p a tie n t. I. T itle. R C 4 8 9 .I5 5 D 495

2003

6 1 6 .8 9 r14— dc21

IS B N 13: 9 7 8 -0 -4 1 5 -9 4 4 3 2 -8 (hbk) ISB N 13: 9 7 8 -0 -4 1 5 -9 4 4 3 3 -5 (pbk)

2002152051

CONTENTS

A cknow ledgm ents

v

In troduction

vii

1

R elational T herapy and Its C ontexts

2

B eginning w ith the Basics: Structure, Ethics, and Em pathy

45

3

Assessm ent: W h a t’s W rong W h e n Your C lien t Feels Bad?

69

4

Between Past and Present, M em ory and Now

103

5

T h e Terribly Hard Part of Relational Psychotherapy

133

6

T he W onderfully G ood Part o f R elational Psychotherapy

163

7

E nding and G oing O n

197

References

213

Index

216

iii

1

To Mary B. Greey

ACKNOWLEDGMENTS

T his book w ouldn’t have seen the light o f day w ith o u t the editors at Brunner-R outledge. B ernadette C apelle was th e first to take an interest, G eorge Zim m ar guided me toward a form at th a t w ould work, and S han­ no n Vargo and C indy Long suggested useful substantive and stylistic revisions. I’m grateful th a t th e Brunner-R outledge team saw the value in w hat I had to say and helped me fashion an appropriate vehicle for it. G raduates and students o f the T oronto Institute o f Relational Psy­ chotherapy will recognize the book at once because the gist o f it is w hat they have heard from me over the years. I owe th em thanks for all the ways they taught me how to translate relational theory into language they could u n d e rstan d and use. I am also grateful to my colleagues, past and present, at TIRP: Louise G am ble, Rozanne G rim ard, Mary Greey, Carl Moore, Jim O lthuis, Rita Fridella, and C ath erin e C om uzzi. Each o f them has brought a unique, valuable perspective to the relational synthesis we have worked on together. I have, o f course, been a stu d e n t o f therapy myself. My u n d e rstan d ­ ing o f self psychology has b een deepened in supervision and study groups w ith How ard Bacal, Ellen Lewinberg, and A lan Kindler. A self psycho­ logical psychoanalysis w ith Sam Izenberg has taught me from the inside o u t w hat it’s like to benefit from a relationship th a t’s dedicated to the patient, thoughtful reworking o f o n e ’s own organizing principles. Peer supervision groups have been a n o th e r rich resource for learning how to p u t relational theory into practice. T h an k s to the m em bers o f my c u rren t and longstanding group—Pat A rcher, Midge Breslin, Judy Lester, Susan M arcus, Sonia Singer, and Lisa W alter—n o t only for w hat I’ve learned from them , b u t also for their gratifying enthusiasm about my book project.

vi

A c k n o w le d g m e n t s

T h a n k s , to o , to m em b e rs o f a n o th e r s tu d y /s u p e rv is io n g ro u p —D ian e J o h n s o n , A lisa H o rn u n g , H a rrie t T arshis, a n d Jan T u rn e r—for th e ir supportiv e, h e lp fu l re sp o n se to a n early v e rsio n o f th e text. My clien ts have ta u g h t m e as m u ch a b o u t re la tio n a l th era p y as any­ on e, for o n e by o n e th ey teach m e how to be w ith th e m . I am gratefu l for all th a t we have discovered to g eth er, fo r sh a red jo u rn ey s a n d projects co m p le te d well, a n d fo r p e rm issio n to use so m e v ignettes o f th a t w ork. A ll o f th e lo n g er case h isto ries given are co m p o sites o f m any stories I ’ve h e a rd over th e years—except for Lucy’s story. S h e graciously gave m e per­ m ission to use h e r story as I h a d w ritte n it, a n d I’m th a n k fu l for th a t a n d for w h a t we acco m p lish ed together. I owe special th a n k s to th o se colleagues a n d frie n d s w h o read early versions o f th e m a n u s c rip t w ith a critical eye a n d a w illingness to chal­ lenge my ideas a n d agendas: p sy c h o th e ra p ist read ers M idge B reslin, Pat A rch er, S o n ia Singer, S u san M arcus, M ary G reey, Betty Kaser, a n d C a th y Schw artz, a n d w riterly readers A d rie l W eaver a n d A d ria n a n d J o h a n n a Peetoom . I owe special th a n k s o f a n o th e r k in d to M ary G reey, w h o has b e en n o t o nly a T IR P colleague a n d a careful re ad e r o f early versions o f th e text, b u t also a loving p a rtn e r w h o has w elcom ed th e p resence o f th is b o o k in o u r daily lives. H e r u n sh a k a b le c o n fid e n c e in m e h e lp e d m e keep th e fa ith in d iffic u lt tim es, a n d h e r g o o d -n a tu re d s u p p o rt m ade it all so m u c h easier th a n it m ig h t have been. Pat D eY oung T o ro n to S ep tem b er, 2002

INTRODUCTION

In a sm all, q u ie t, sim ply fu rn is h e d ro o m , tw o p eo p le sit facing o n e an ­ o th e r. O n e o f th e m talks as th e o th e r listens. T h e o n e w h o is ta lk in g looks te n se a n d anxious as she tries to exp lain th e tro u b le to th e o n e w h o is listen in g . W h e n tears sp rin g to h e r eyes, sh e d ab s a t th e m w ith a c ru m p le d tissue. T h e listen e r p u ts a box o f tissues w ith in th e sp e ak e r’s reach a n d c o n tin u e s to listen w ith o u t in te rru p tin g her. T h ese tw o p eo p le w ill be h ere to g e th e r for exactly 5 0 m in u tes. B oth o f th e m h o p e th a t by th e e n d o f th a t tim e, th e listen er will have b een able to offer m e an in g fu l h elp to th e o n e in distress. T h ey will m e et again n ex t w eek at th e sam e tim e for a n o th e r 50 m in u tes, because th e tro u b le is co m p licated a n d th e h elp isn’t a q uick fix. You are th e o n e w h o sits a n d listens. You are th e p sy ch o th erap ist. O n e h o u r a t a tim e, o n e p erso n a t a tim e, you listen to th e tro u b le p eo p le have living th e ir lives. You h e a r a b o u t w h a t goes w rong, a n d you h ea r a b o u t how anxio us, fru stra ted , a n d depressed they feel. T h e y confess to you th e self-destructive p a tte rn s th e y ’ve fallen in to as th e y ’ve trie d to d o th e b est they can. T h e y ’re stuck. T h e y ’re at th e e n d o f th e ir ro p e. T h e y ’re in p ain . You listen to th e m o n e by o n e, a n d every h o u r you th in k h ard : W h a t m e an in g fu l h elp can I offer th is person? Every tim e you answ er th a t q u e stio n , every tim e you offer a co m ­ m e n t, a suggestion, o r a n in te rv e n tio n , you d o so w ith co n scio u s o r su b ­ lim in al reference to a th e o ry o f how p sy chotherap y w orks. T h e th e o ry to w h ich you refer w ill give you som e k in d o f co n c ep tu al filter for u n d e r­ sta n d in g w h a t’s w ro n g in th e p ic tu re, a n d it w ill give you a m a tch in g set o f ideas a b o u t w h a t needs to change if th is p e rso n is to feel b etter. T h e th e o ry will also gu id e you, th e th e ra p ist, to m ake c e rta in moves to facili­ ta te th o se necessary changes.

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Som e general theories o f psychotherapy—psychodynamic, feminist, solution-focused, o r cognitive-behavioral therapies, for example—view many kinds o f psychological problem s thro u g h th e sam e lens o f assessment a nd treatm ent. O th e r m ore specific theories o f psychotherapy have been developed in response to specific problem s, such as phobias o r eating disorders. M ost experienced therapists work from a general theory o f psychotherapy, and th e n they integrate this general theory w ith various specific theories th a t they have found useful w ith different kinds o f cli­ e n t problem s. In o th er words, m ost therapists identify as a certain kind o f therapist (psychodynam ic or feminist, for example), and they are also eclectic in the best sense o f the word: they choose approaches carefully from diverse sources—because they w ant the best outcom es for th eir cli­ ents. T his book puts forward a general theory o f psychotherapy, a theory 1 call relational psychotherapy. It’s n o t entirely new, for its roots are in psy­ chodynam ic and hum anist therapies th a t have been aro u n d for m any years. It also owes a lot to fem inist theories about a fundam entally rela­ tional self. B ut at th e same tim e, relational psychotherapy, understood in its own term s, is a new ph en o m en o n . O ver the last 15 years, a relational perspective has opened up new vistas for psychoanalytic theory. A nd o f course analysts aren’t the only therapists w ho read psychoanalytic theory. T h rough books, journals, and conferences, by way o f therapist training institutes a nd inform al supervision and reading groups, relational theory has becom e a pow erful force o n th e psychotherapy scene in N o rth Am erica. T here arc very good reasons for the strength of this new m ovem ent: First, relational theory is a powerful and useful general theory o f psycho­ therapy; second, a relational approach provides a strong fou n d atio n for responsible, coherent eclecticism; and third, relational psychotherapy is a reasonable and flexible alternative to goal-oriented, authority-driven m odels o f psychotherapy. R elational psychotherapy is a m odel driven by the client’s experi­ ence and the client’s needs. It pays close a tte n tio n to how those needs are u nderstood and addressed w ithin the therapy relationship. T he relational therapist tunes in very carefully to all o f the client’s experience, and espe­ cially to the client’s ongoing, m om ent-to-m om ent, and cum ulative expe­ rience of the therapy. Since relational psychotherapy is so client-centered and experience-near, I have w ritten this p rim er o f relational psychotherapy in a way th a t tracks very closely a client’s experience o f relational psycho­ therapy. Since a relational therapist is always personally engaged in the

In tr o d u c tio n

IX

process o f therapy, I will speak to you, the (would-be) relational therapist, w ith as m uch im m ediacy and personal presence as a w ritten text allows.

THE BOOK: AN OVERVIEW T he chapters o f this book are laid o u t in a sequence th a t m irrors a client’s deepening involvem ent in th e therapy process. C h a p te r 1 responds to a question a client m ight ask before beginning therapy w ith you: W h a t’s u niq u e ab o u t relational therapy? or, W h a t does it offer th a t o th er thera­ pies d o n ’t? T he chapter is a useful resource w hen clients com e from o th er kinds o f therapies o r are “shopping” and asking you questions, hoping to u n d erstan d where relational therapy fits in the spectrum o f treatm ent possibilities. Even if clients d o n ’t ask about your theoretical orientation—and m ost d o n ’t—they pick up o n your confidence in your ow n way o f working. C onfidence comes from experience, b u t it also comes from knowing where you stand and w hat you th in k . W hile this entire book is in ten d ed to help you develop your th inking ab o u t relational therapy, C h a p te r 1 will give you a sense o f where a relational therapist stands in relation to o th er therapists. In the chapter, after I sketch the prim ary them es o f relational therapy, I com pare and contrast various contem porary theories o f psy­ chotherapy from this vantage point, this relational p o in t o f view. T his poin t o f view, w hich the book will develop, is n o t the property o f one school o f therapy. R elational theory is spoken in m any voices. W h a t I present is a working synthesis o f several relational theories, a relational eclecticism. In the last part o f C h ap ter 1, therefore, I review the several sources th a t co ntribute to the case I make for a dynam ic, creative rela­ tional therapy. C h ap ter 2 begins w ith the assum ption th at the client has decided to give you a try. I pursue the question: A t the beginning o f every course of therapy, w hat do you, the therapist, need to know and com m unicate about the structure, boundaries, and ethics o f relational therapy? T he next question is: W h a t can clients expect will happen w hen they show up for sessions, and w hat can they hope for as therapy progresses? To these two basic questions ab o u t how the therapy will be done, I propose the basic answer o f empathy. As a relational therapist, you will not predict any particular course o r outcom e o f therapy, b u t you will dem onstrate your com m itm ent to u nderstanding the client o n her ow n term s. You will stay as close as possible to w hat she says about her own experience, and you

X

In tr o d u c tio n

will do w hatever you can to e n ter in to th e feeling o f th a t experience an d to com m unicate your em pathy to her in ways th a t let h er know you get it. Em pathy is such an apparently sim ple m ed iu m an d m e th o d th a t clients are often n onplussed in its presence, at least at first. O ften they w an t m ore d irect in terv en tio n in w h at they perceive is going w rong for th em . T hey w onder, H ow can ju st “being u n d e rsto o d ” ever help? B ut your active, inquiring, supportive em pathy only seems to be a sim ple pro­ cess. A nd your clients soon begin to feel its effects. In th is second chap­ ter, I explore in d e p th w hat em pathy is, how it works in relational therapy, a n d how it provides a broad, sturdy base for m ore specific k in d s o f inter­ ventions. C h a p te r 3 addresses th e qu estio n o f assessm ent. As your client tells you th e story o f his trouble, how will you p in dow n th e essence o f w h at’s w rong for him? T his is a critical question, o f course, because providing accurate help depends o n m aking an accurate assessm ent o f w h at’s w rong. H ere I begin to spell o u t o n e o f th e basic tenets o f relational psycho­ therapy: w h at’s w rong is n e ith e r entirely inside th e client, in his psycho­ logical m akeup or dysfunctional patterns, n o r entirely outside in th e world, in forces th a t im pinge o n him . Instead, according to a relational m odel o f psychotherapy, th e problem exists in tho se spaces o r activities w here o utside influences an d inside responses interact to create th e shape an d feel o f a “self.” I explain how p attern s o f in teractio n betw een self an d o thers becom e principles th a t organize a personal psychology, an d I show how these p attern s very quickly becom e w oven in to in teractio n s betw een th erap ist an d client. N oticing these p attern s as they em erge betw een you an d your client is fu n d am e n tal to a relational assessm ent o f w h at’s w rong for him . It’s n o t easy, even as a relational therapist, to h o ld in m in d this d efin itio n o f w h at’s w rong, o r o f “pathology”—th a t it is a fu n ctio n o f the ongoing in teraction o f inside an d outside. B ut clients are even m ore likely to slip into th e assu m p tio n th a t w h at’s w rong has to be so m eth in g defec­ tive inside them selves, unless it is th e direct result o f abuse o r persecu­ tio n —in o th e r w ords, th a t they m ust be eith er sick o r victim s. C h a p te r 3 o pens u p th e possibility o f a th ird way to th in k ab o u t w'hat’s w rong, o ne th a t slowly b u t surely can begin to m ake sense to your client. In C h a p te r 4 I take up an im p o rta n t issue th a t can’t be avoided once organizing principles are o n th e table, th e issue o f th e relatio n sh ip betw een past an d present, especially a trau m atic past an d th e w'ork o f healing in th e present. T hose principles th a t organize a clien t’s sense o f self-in-relation cam e in to being over tim e a n d in certain relational con­

In tr o d u c tio n

XI

texts. Most often, clients who work the longest and most intensely in therapy are those who are struggling to recover from the im print of rela­ tional traum a that they suffered early in their lives. For many of them, painful early relationships included significant neglect and physical or sexual abuse. They may not know th at this is w hat’s hurting them . More likely they do make some connection between past and present because ideas about traum atic childhood abuse, repressed memories, and recov­ ered memories have become commonplace in popular culture. W hat remains very unclear, though, in media stories of abuse and recovery and in clients’ understanding of their own histories, is how the past remains alive in the present. N or is it clear how certain kinds of experiences in the present can reduce the power of the past to under­ mine the client’s current well-being. Confused clients wonder, “Do I have to recover repressed memories in order to feel better?” “Are certain kinds o f memories especially im portant to remember?” “Do I have to feel all th at pain all over again?” “How does remembering the past help me feel better now?” I address these questions by presenting a relational definition of traum a, one closely connected to the idea of psychological organizing principles. I m aintain that specific traum atic events, however damaging, are far less powerful than the ongoing traum atic relationships in which those events are usually em bedded. Reliving w ith a therapist the impos­ sible binds of traum atic relationship can be the most powerful way of remembering, and this kind of remembering often makes “video” memory o f specific events unnecessary. W hile em otional release or catharsis may be part of the work, it isn’t w hat heals; what matters most is the consis­ tent, caring presence of som eone who hears and understands the client’s pain. Finally, C hapter 4 shows how reliving the past as a here-and-now relational struggle can lead to im portant changes in the principles that organize a client’s everyday self-with-other experience. Reliving the past as a here-and-now relational struggle is w hat tradi­ tional psychodynamic therapy calls transference, and more specifically, negative transference. C hapter 5 is about so-called negative transference. I call it “the terribly hard part of relational therapy”—because th at’s what it is, both for you and your clients. As clients share themselves with you more deeply, they hope that you will understand them ever more deeply and completely. But at the same time, their painful relational history leads them to expect that you will fail them , judge them, and abandon them. A nd inevitably, in small ways at least, you do fail them . Then, suddenly and often subtly, a client’s com m on, self-defining experience of

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b eing d isc o u n te d a n d d e m e an e d is h a p p en in g w ith you. Your lapses o f a tte n tio n m ay co m m u n icate th a t you d o n ’t care at all. Your inevitable sm all m istakes are deeply w ounding. T hese m o m e n ts o f m isu n d ersta n d ­ ing ru p tu re th e relatio n sh ip , a n d repairing th e ru p tu res takes careful em p ath ic w ork to u n d e rsta n d how things w ent w rong betw een you and th e client. Som e clients can go th ro u g h repeated ru p tu res a n d repairs w ith o u t needing to see a larger p icture o f w h a t’s h ap p en in g . B ut m any are fright­ e n ed a n d a sh a m e d o f b e in g so easily a n d p ro fo u n d ly h u r t by th e ir th era p ist’s lapses. If you can explain w h a t’s h a p p e n in g in a way th a t vali­ dates th e ir acute need to be u n d e rsto o d a n d th a t m akes th e ir p ainful in te rp erso n al feelings an issue o f th e therapy re lationship, you can su p ­ p o rt a n d steady th em th ro u g h these d ifficult tim es. A t th e sam e tim e, in your role as th erap ist, you n eed som e su p p o rt a n d steadying too. Feeling deeply m istrusted m akes even th e m ost c o m m itted relational th era p ist w a n t to pull back from a relatio n sh ip . W ithdraw ing, however, even w ith­ draw ing to explain, is a critical m istake, for it leaves your client feeling a b a n d o n e d a n d p u n ish e d for having painful feelings. E xplaining helps, b u t staying presen t a n d e m p ath ic helps m ost. Flow can you m anage to stay involved, a n d w ith such a mess? Flow can I m anage to w rite a c h ap ter th a t stays w ith this m essiness—these com ­ plex, p ainful realities o f this aspect o f relational therapy? As fate o r luck w ould have it, w h e n I cam e to w rite C h a p te r 5, I h a d ju st fallen in to tro u b le w ith my ow n relational analyst, so I w rote from a clien t’s perspec­ tive a b o u t th e terribly h ard p a rt o f relational therapy. I kept this acco u n t in th e c h ap ter because I could th in k o f n o b e tte r way to c o n n ec t th e chapter firm ly to a c lie n t’s experience o f negative transference. T his, I th o u g h t, will keep o u r discussion o f transference from w ithdraw ing into th e safety o f theory. As a relational th erap ist, you sim ply m ust u n d e rsta n d how frighten­ ing, w ounding, enraging, a n d d ish e arten in g therapy can be for clients w hen th e th erap y relatio n sh ip feels a fam iliar kind o f bad to th em . You m ust u n d e rsta n d this, for if you d o n ’t, th e th erap y will fall apart. You have to be able to feel how d ifficult it is for clients ju st to keep com ing and talking a b o u t all this d istu rb an ce and p a in w ith th e very perso n w ho’s m aking th em feel so bad. To be able to do th at, they have to be absolutely sure th a t this is w hat you w ant—to u n d e rsta n d their feelings in this m ess—and th a t you are d e te rm in e d to listen to th e m w ith o u t getting defensive a n d blam ing th em .

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But w hat if, in the face o f m istrust and bitterness, your own h u rt and disap p o in tm en t show? W h a t if you do get defensive and lose your em pathic perspective? It’s inevitable th a t this will happen to you som e­ tim es. W h a t’s im p o rta n t is w hat you do after this happens, because if you d o n ’t catch yourself (with help in supervision), there is a real danger th a t the relationship will spiral downward into an angry, despairing stand­ off. In C h ap ter 5 I discuss how to regain your balance in this difficult work, about how to catch those downw ard spirals before they get o u t o f hand. As o th er relational theorists do, I m aintain th a t even tough im­ passes do n o t have to rem ain im possible in relational therapy. O n the contrary, working thro ugh a relational impasse is often the m ost power­ ful, effective work you can do. In the closing exam ple o f C h ap ter 5, my client and 1 are struggling to repair a ru p tu re betw een us. Here, too, it’s clear th a t we’ve stum bled into this trouble together because o f w hat we each bring to the situation, because o f th e ways in w hich we are each doing th e best we can. N either o f us is at fault for o ur feelings. O nce again I emphasize the hum anness and vulnerability o f b o th partners in the therapy relationship as they try to work o u t troubles betw een them w ith openness, courage, and good faith. In C h ap ter 6 , 1 move from w hat’s very hard about relational therapy to w hat’s very good ab o u t it. T h e chapter is about the everyday health and well-being th a t relational therapy envisions for its clients, and about how the therapy process begins to make this well-being possible—through subtle b u t p rofound changes in how clients can experience themselves w ith others. I briefly introduce m odels o f developm ent th a t give us lan­ guage for these changes: changes in w hat K ohut calls selfobject experi­ ences, S tern calls RIGs, Bowlby calls w orking m odels o f attachm ent, Lichtenberg calls m otivational systems, and the Stone C e n te r w riters call capacities for connection. I d o n ’t m ake a special case for any o ne o f these explanatory systems. O ver against nonrelational models o f h u m an devel­ opm ent, they seem quite sim ilar and m utually com plem entary. T hey all envision psychological health and well-being as products o f healthy rela­ tionships from infancy onw ard. W ith in any one o f these systems, depen­ dency can be redefined as your clients’ ways o f connecting w ith you, particular kinds o f co nnection th a t help th em grow stronger and m ore connected to others and to themselves. C h a p te r 7 describes how relational therapy ends. B ut first I address how the changes th at begin in the relationship betw een you and your

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client becom e a solid, reliable p art o f the client’s ongoing experience o f self w ith others. Relational therapy doesn’t m ake clients invulnerable to fu rth er pain, b u t it does give th em a firm grasp o f w here th eir vulner­ abilities are, and o f how to protect them selves as necessary, express th em ­ selves w ith tru s tw o r th y o th e rs , a n d w o rk th ro u g h in ju rie s a n d m isunderstandings to resolutions o f m utual benefit. As therapy winds down, clients w on’t be happy all the tim e, b u t on the o th er hand, they w on’t always be expecting the w orst and believing th a t they b ring it on themselves. T h eir deepened capacity for being understood and for u n ­ derstanding others will su p p o rt m ore interpersonal ease and security, and that, in tu rn , will bolster th eir confidence and su p p o rt th eir ideals and am bitions. W h en all o f this is true, clients arc ready to let th e therapy relationship becom e m em ory—an experience th at lives w ithin th em as possibilities for new kinds o f being and being-with. In term inating therapy, as you and your client review the journey together, you will notice how profoundly th e relationship betw een you has changed. M utual respect and tru st will have grown and deepened betw een you. So it happens th a t ending relational therapy becom es som e­ thing m ore th a n ending a treatm ent process. T he end o f relational therapy m eans th a t there m ust be a good-bye spoken betw een persons w ho have com e to m ean som ething to one another. Your client will need tim e and space to feel this good-bye deeply, to grieve the loss o f the relationship, and to sense how it will c ontinue as m em ory. T h e two o f you can end, however, w ith the confidence th at the changes begun in therapy will con­ tin u e to ripple outw ard in liberating a nd transform ing ways. T h u s a good ending can becom e a good beginning for a new' phase in your client’s life. A nd there in brief, from beginnings to endings, is the story this book tells ab o u t how' relational psychotherapy works. Before I expand on th a t story, however, I have two m ore introductory things to say. T h e first is ab o u t identifying th e clients w'ho need and get the m ost o u t o f rela­ tional therapy. T he second is about identifying the therapists w ho are best suited to this kind o f work.

W H O N E E D S R E L A T IO N A L T H E R A P Y ? I’ve said th a t relational psychotherapy is a general theory o f therapy th at works well across a wide range o f client problem s. A ccording to relational theory, this is true because very m any so-called psychological difficulties arc rooted in relationship, b o th problem atic cu rren t relationships and

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old relationships th a t still have pow erful effects o n a clien t’s everyday well-being. Psychotherapists o f m any persuasions have discovered, how ­ ever, t h a t psy ch o lo g ical p ro b le m s can be tre a te d as if th e y are an in d iv id u al’s in te rn al problem s or, to p u t it a n o th e r way, an indiv id u al’s problem s w ith dysfunctional p a tte rn s o f feeling, th o u g h t, a n d behavior. From a relational perspective, this k in d o f tre a tm e n t addresses only th e sym ptom s o f problem s th a t are rooted in relatio n sh ip —a n d yet it is often q u ite effective. H ow can this be? For m any clients th e experience o f sh arin g th e ir troubles a n d find­ ing a wise a n d h elpful guide is itself a pow erful relational re o rie n ta tio n : they’re n o t sick o r crazy in c o m parison to everyone else in th e w orld, th e ir tro u b le m akes sense to a n o th e r person, a n d this perso n w ants and offers to help. In o th e r words, th e trea tm e n t, th o u g h n o t relational by d e fin itio n , is itself a positive relational experience a n d changes som e­ th in g a b o u t w h a t clients can expect from th e ir relational w orld. F u rth e r­ m ore, w h e n clients change som e p a tte rn s o f th o u g h t a n d behavior th a t leave th e m disem pow ered a n d depressed, they change—even if inadvert­ ently—som e p a tte rn s o f interacting w ith others. From a relational per­ spective, these m ore positive a n d efficacious in teractio n s have as m uch (or m ore) to do w ith th e c lie n t’s im provem ent th a n th e so-called in te rn al o r in dividual changes th e clien t has m ade. A relational perspective also explains why clients such as these d o n ’t n eed a specifically relational ap­ proach. It sees th e m as relatively healthy: even as they com e for help, these clients are living w ith in a sense o f self-w ith-other th a t is relatively flexible a n d o p e n to change. T h a t is why they can receive new kinds o f in te rp erso n al help and try new kinds o f in te rp erso n al interactions. T hey d o n ’t n eed a specifically relational therapy in o rd e r to m ake relational change possible. O th e r clients a ren ’t so fo rtu n ate. T hey live w ith in a m u ch m ore d angerous self-w ith-other w orld, th o u g h very o ften they d o n ’t know th a t this is th e case. T hey know' a b o u t th e ir sym ptom s, th e ir specific fears, anxious behaviors, a n d addictions. T hey usually know a b o u t co n stan t, insidious bad feelings a b o u t them selves, feelings o f incom petence, social anxiety, depression, a n d sham e. T hey may have tried self-help books, selfim provem ent program s, a n d o ften a course o r two o f therapy, b u t n o th ­ ing m u ch has changed for th em over th e long term . T hey suspect th a t maybe n o th in g can change for th em . A n d yet th e ir u n h a p p in e ss draws th e m back to therapy, for it seem s clear to th e m th a t th e re ’s som e k in d o f psychological pro b lem going on. Maybe, th e n , th ere could be som e kind o f help after all.

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W h en you hear a story like this, w ith or w ith o u t a history o f unsuccessful previous therapy, you are probably listening to a client w ho could m ake good use o f intensive, specifically relational therapy. W h a t’s gone w rong before, you m ight guess, is th at her self-help and self-im provem ent efforts have d o n e n o th in g to change w hat she can expect from th e world. T he self-with-other world she lives w ithin keeps o n telling her th a t she’s defective, she’s n o t trying hard enough, or she’s b o u n d to fail, and this self-with-other given, though mostly unconscious, is far from flexible and open. In fact, this client’s relational expectations and relational self-protections are quite rigid and closed to outside influence. T his m eans, for example, th a t w hether she knows it o r not, she can’t help b u t see you as one m ore person w ho will judge her, feel disgust about her feelings and needs, and ask things o f her she can’t produce. Your kindness and good intentions may barely register in the face o f her convictions. Unless you a nd she can find ways to address these relational problem s betw een you, therapy will becom e for her just one m ore ro u n d o f self-protection, com ­ pliance, and secret sham e. O n the o th er hand, if you can address these problem s and so make way for new kinds o f interactions betw een you, therapy can becom e a m atrix for powerful and long-lasting change. Som etim es these clients w ho have already worked hard to change themselves will ask, “How do you th in k you can help me.7” T h a t’s a diffi­ cult question to deal w ith because although you w ant to give an honest answer, you d o n ’t w ant to say som ething th a t will m ake the situation seem even m ore threatening. C lients w ho are relationally vulnerable pro­ tect them selves as best they can from know ing the extent o f th eir vulner­ abilities. As a relational therapist, you know th at they will com e to trust you only insofar as you respect a nd u n d e rstan d these vulnerabilities. You know th a t this long, slow interaction o f und erstan d in g and tru st will take tim e, lots o f tim e. You also know th a t these clients w ould rather locate th eir trouble inside them selves th a n in th eir relationships w ith others, for they know “for sure” th a t u'hat they can get from the world can’t be changed. T he best they can ever do, therefore, is change th em ­ selves. Furtherm ore, the last th in g they can bear to im agine is trouble betw een them selves and th eir therapist, because experience tells them th a t in any conflict, the m ore powerful person will blam e, sham e, and em otionally annihilate the less powerful person. All th at being said, there are som e sim ple ways to talk w ith a client a bout the essence and advantages o f a specifically relational course o f psychotherapy. O ften I say som ething like this:

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I’m a relational therapist. So while I know th a t you feel bad inside, I also see th a t a lot o f those bad feelings—worry, low self-esteem, fear o f failing—exist at the b oundary o r interface where you m eet the world. They’re relational feelings as well as self-feelings. They sound like: “Am I good enough? Have I m ade a m istake in th eir eyes? D o they like me? Am I in trouble?” W h en you feel th a t th e answers to those questions are negative, th en you feel badly about yourself, in yourself. It seems to me th a t even w hen you’re n o t th inking about it, you live w ith a lot o f negative answers to those relational questions. A nd I th in k th a t’s been true for quite a while, and it has w orn you down. In relational psychotherapy, we spend a lot o f tim e o n those rela­ tional feelings. They tu rn up in three m ain ways. First, there are your daily relationships w ith your family, friends, and co-workers. W e’ll look at w hat happens in those interactions th at leaves you feeling badly a bout yourself. You m ight begin to notice patterns there th a t make you th in k o f earlier relationships in your life. T h a t would be the sec­ o nd way relational feelings would tu rn up in therapy. W h en those early relationships com e to your m ind, we will talk about how they told you w ho you are, w hat you’re w orth, and w hat you can get from life. T hose early relationships can leave you w ith a powerful script a bout w hat you can expect even now. T he th ird kind o f relationship we’ll keep in m ind is the one betw een you and me, how you and I are w orking together. It will be especially im p o rta n t to notice if I’m mis­ u n derstanding you o r if it feels to you th a t this therapy is becom ing my agenda, n o t yours.

W hat I don’t say in this answ'er, because my client probably won’t understand w hat I mean, is that this is how relational psychotherapy proposes to “make the unconscious conscious.” It’s w orth saying here, though, because it bears on the question at hand: W ho needs relational psychotherapy? The succinct, technical answer is: Relational psychotherapy is especially good for those people who, in order to lead lives of relative well-being, need to be released from the bonds of punitive, constricting unconscious organizing principles. In this view, a view developed w ithin relational and intersubjectivist theories of psychoanalysis, the unconscious isn’t a place or a thing; it’s a self-perpetuating patterning or organizing of self-in-relationship that remains out of a person’s awareness but shapes all of his self-cxperiencc. This is not the traditional psychoanalytic theory of the unconscious; and yet, in the case I’m making here, relational therapy takes a position th at has traditionally been reserved for psychoanalysis. Just as traditional

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psychoanalysis has b een pro p o sed as a trea tm e n t th a t probes for th e u n ­ conscious conflicts th a t cause tenacious psychological sym ptom s, symp­ to m s th a t can ’t be u n d o n e in any sim pler, q uicker way, so relational psychotherapy proposes relational tre a tm e n t as a way to brin g to light th e u n c o n sc io u s relational p a tte rn s th a t u n d e rlie ten acio u s psychological sym ptom s, sym ptom s th a t d o n ’t give way in shorter-term , m ore goal-ori­ e n te d psychotherapies. In sim ple term s, th e n , th e q u estio n o f w h e th er a p a rticu la r client m ight need a specifically relational app ro ach com es dow n to questions su ch as th e following: H ow longstan d in g is this trouble? H ow tenacious? H ow tho ro u g h ly does it p erm eate th e c lie n t’s experience? H ow deeply does it th rea te n th e c lie n t’s sense o f being a cohcsive, w orthy self? In sh o rt, H ow bad is it? If it’s pretty bad, a relational th era p ist will begin co n tem p latin g a longer term , intensive relational app ro ach to therapy. B ut let’s n o t forget th a t a relational th era p ist envisions m ost psycho­ logical difficulties as sym ptom s o f con flictu al a n d d isco n n ected relatio n ­ ships w ith o thers and w ith oneself. As such a therapist, you take a relational approach in all o f your w ork. So w h e n you begin to th in k th a t intensive relational therapy m ight be especially useful for a particu lar client, you’re th in k in g n o t o f a differen t app ro ach to th is client, b u t o f a tte n d in g even m ore carefully and specifically to th e clien t’s relational history a n d rela­ tio n al struggles a n d o f focusing th e therapy as explicitly as possible o n th e p a tte rn s th a t develop w ith in th e c lie n t-th e ra p ist re lationship. Very o ften, w ith a client in this group, a m ore intensive relational trea tm e n t em erges organically from your general relational app ro ach to th e p ro b ­ lem s th e client brings. T h a t k in d o f develo p m en t serves you b o th well, for th e client has tim e to test your integrity, a n d you have tim e to dis­ cover so m eth in g a b o u t how th e relatio n sh ip sets itself up betw een you. N o t everyone w h o com es to th erap y a n d w ho could p ro fit from an intensive relational approach has th e p atience o r interest to d o th e work. O n th e o th e r h a n d , som etim es th e m ost unlikely candidates settle in for th e long haul, if only o u t o f desp eratio n . I th in k th a t any client w h o can allow h im self to w a n t o r need so m eth in g from you in th e therapy rela­ tio n sh ip can be a c an d id ate for relational therapy. N o m atter how con­ flicted th e w a n t o r how m uted th e need, if th e client has invested som e personal passion to be u n d e rsto o d a n d you can m eet th a t n eed w ith personal, responsive presence, th e therapy relatio n sh ip can begin to form a n d move. Eventually th e client will n eed to be able to reflect som ew hat o n w hat goes o n betw een you, b u t th a t’s a capacity th a t can be developed as th e therapy progresses.

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W HO MAKES A GOOD RELATIONAL THERAPIST? Relational psychotherapy isn’t for every client, and it certainly isn’t for every therapist, either. O ften, therapists w ho are drawn to relational work have com e from families o f origin in w hich relationships were tense, conflictual, and unrew arding, and they’re likely to have carried away from th a t form ative familial experience a certain com bination o f characteris­ tics: (1) a profound longing for relationship th a t is m eaningful and sup­ portive; (2) a sense o f responsibility for supporting fragile, unhappy family m em bers, especially unhappy parents; and (3) personal psychological or­ ganizing principles th at leave them w ith a som ew hat fragm ented, precari­ ous, o r depleted sense o f self In o th er words, therapists drawn to relational work are often first o f all very good candidates for relational therapy themselves. In fact, if they do n o t do th eir ow n therapy first, to bring to awareness the principles th a t organize th eir own experience, therapists w ho com e from such families are likely to repeat th eir histories in their work—feeling at first bo th stim ulated and overw helm ed by responsibility and then fragm ented o r depleted as they lose them selves in their efforts to help. O n the o th e r h an d , therapists w ho have com e to term s w ith their own relational history, however traum atic it m ight have been, d o n ’t have to keep repeating th a t history in th eir personal o r professional lives. They’ve discovered th at it’s possible to develop new ways o f being w ith others in the world, ways th a t leave them feeling m uch m ore whole, alive, and secure in them selves. If they’re draw n to learning a nd practicing rela­ tional therapy, no d o u b t they have experienced the relationship w ith th eir own therapist as the transform ative elem ent o f therapy. They know w hat a difference it makes to be understood deeply and consistently in th eir own term s. They d id n ’t enjoy living through repetitions o f th eir worst fears w ith their therapist, b u t on the o th er hand, they found th at com ing o u t the o th er side into a relationship o f open tru st was profoundly liberating. They know ab o u t slow, quiet m ovem ent from anxiety to con­ ten tm en t, from insecurity to confidence, from low-grade, isolating de­ pression to vital engagem ent w ith o th er people. Like all those w ho have know n life-changing experiences, therapists whose self-experience has been changed by relational therapy w ant to share w hat they’ve learned w ith others in need. I im agine th a t you recognize som ething o f yourself in this picture. (After all, you are reading this book.) But you m ight still ask, “W h at docs it take to practice relational psychotherapy for 20 o r 30 years?” It takes

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the passion for the healing power o f relationship th a t I’ve just described. But like any o th er profession, it also requires specific traits o f m ind and personality. If you enjoy being a relational therapist, you enjoy entering into the stories o f people’s lives. T hose stories aren’t always pleasant, but you find them m eaningful, like powerful dram as or novels. You p onder m eanings and consider connections betw een things carefully. You are able to feel your own feelings deeply, and you’re n o t afraid o f your clients’ strong feelings. You’re good at pattern recognition, and also at putting com plicated ideas into sim ple, evocative language. You can th in k o n your feet and take quick, considered risks, b u t you’re n o t impulsive o r reac­ tive. You u n d erstan d and m anage your own em otions well. You can sit quietly for long periods o f tim e, and you have an abundance o f patience w ith long, slow processes. You arc able to balance your life: for all the tim e you spend listening and caring, you spend plenty o f o th e r tim e be­ ing active, self-expressive, and connected to others in ways th a t excite and n u rtu re you. T hose personal characteristics d o n ’t com e together into a profes­ sional self, a relational therapist self, w ith o u t specific training in rela­ tional psychotherapy, train in g th a t includes b o th book learning and practical learning from closely supervised w ork w ith clients. A nd though you may be exquisitely well-suited for the work and quite well-trained, you w on’t thrive for 20 or 30 years in a relational therapy practice w ith­ o u t a strong com m unity o f peers w ith w hom you can co n tin u e to grow and learn. You may have noticed th at I haven’t m entioned w hether you’re a social worker, an educator, a psychiatric nurse, a family doctor w ho prac­ tices psychotherapy, a pastoral counselor, a psychiatrist, or som eone trained exclusively in psychotherapy. I haven’t distinguished betw een agency or hospital work and work in private practice. T his is because I believe it’s possible for relational therapy to be d o n e by persons in many professions a nd settings. It’s a portable m odel w ith significant efficacy even in those settings th a t restrict the n u m b er o f sessions available to a client. T he m ost am enable, com fortable setting for relational psychotherapy may be the office o f a relational psychoanalyst, b u t th at doesn’t m ean th a t rela­ tional psychoanalysis is the benchm ark for relational therapy. In fact, many relational analysts no longer make a sharp d istinction betw een analy­ sis (on the couch, several tim es a week) and therapy (face to face, once or twice a week), as long as th a t therapy moves toward nondirective explora­ tion o f the p a tie n t’s unconscious patterns o f experience, especially as those patterns emerge in the c lie n t-th era p ist transference.

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As you’ll see, th e relational th eo ry I’m a b o u t to explore w ith you is in fo rm ed a n d in flu en ced by relational psychoanalytic theory. B ut I’m n o t w ritin g to psychoanalysts. As I’ve m en tio n ed , a w ealth o f relational psychoanalytic th eo ry has appeared in th e last decade o r so; relational psychoanalysts have plenty to read. I’m w riting to th e rest o f us, w ho w a n t to learn how to p u t this w ealth o f insight to w ork in a nonanalytic psychotherapy practice. O n e final note: since I identify w ith lay psychotherapists in a nonm edical tra d itio n o f therapy, I have always spoken o f th e people I w ork w ith as clients, n o t patients. B ut I tru st th a t if “p a tie n t” is th e w ord th a t w orks for you, you’ll m ake th e tran sla tio n for yourself.

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RELATIONAL THERAPY AND ITS CONTEXTS

In this chapter, I’ll outline th e m ost fundam ental characteristics o f rela­ tional psychotherapy: it’s ab o u t self-with-other, and it’s about how selfw ith-other experience is a constant, active force in anyone’s life. T h e n I’ll expand o n w hat this m eans by explaining w hat relational therapy is not. It’s n o t a m edical m odel o f psychotherapy, n o t an individualistic m odel, and n o t a rationalistic m odel. W h e n I’ve o u tlined the essence o f rela­ tional psychotherapy in these ways, I will com pare and contrast it w ith oth er cu rre n t m odels o f psychotherapy. Finally I will introduce several relational theories o f psychoanalysis and psychotherapy th a t converge w ithin w hat I’m presenting as relational psychotherapy. This first chapter operates on the prem ise th a t if you w ant to under­ stand w hat relational therapy is, you n o t only need a basic definition of it, you also have to refer to the contexts th a t give the definition its m ean­ ing. In th e sam e way, if you w ant to know where you stand as a relational therapist, it’s im p o rta n t to know n o t only the essence o f your ideas, b u t also where those ideas situate you in relation to o th er therapists. T his chapter aim s to help you recognize w here you will find yourself if you choose to practice relational psychotherapy.

IT ’S A B O U T S E L F -W IT H -O T H E R First o f all, relational therapy is all about self-with-other. T his self-withoth er focus m eans th a t w hatever the stories a client tells in therapy, from the d istan t past or from yesterday, the therapist tries to u n d erstan d them in term s o f w hat was going on betw een the client and others. As a rela­ 1

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tio n al th era p ist, you th in k o f your clien t’s history as a relational history. You know th a t w ith o u t a context o f o th ers w ith in w hich to be b o rn , n o n e o f us has a p erso n al history. You w ork w ith th e relational p rinciple th a t we are all creatures o f social, political, a n d fam ilial contexts—th a t we are always being form ed by o u r in teractio n s w ith o th ers a n d by how we learn to p erform “s e lf’ in th e various contexts o f o u r lives. So w h e n a clien t tells you a story as if th ere were no o th e r people in it—last night he was desperately trying to finish a project w ith o u t falling in to his private pitfalls o f p erfectionism a n d p ro c ra stin atio n —you know how thickly pop u lated th a t scene really is. You know th a t ju st o u t o f his awareness, th e re ’s how h ard it is to please his father, a n d how his m o th e r is o n a n o th e r planet, n o help at all, a n d how his o ld er sister can do w hatever she sets h er m in d to. You keep th e relational story in m in d . It’s as tru e for him today as it was 20 years ago, th o u g h d ifferent actors (a boss, a wife, a colleague) may be playing th e m ain characters. You know th a t public school tau g h t all th e kids o f his gen eratio n th a t grades m attered m ore th a n th e pleasure o f e xploration, a n d th a t as a m iddle-class N o rth A m erican he believes th a t individual accom plishm ent is th e m ark o f a successful life. B ut as far as he knows, w orking h ard to finish his project, this is ju st his in tern al, individual struggle to dodge inevitable failure. As a relational therapist, you swim against this stream o f “isolated self.” You nudge your clien t to explore how d ifficult expecta­ tio n s a n d p ainful interactions, past a n d present, e n g en d er his bad feel­ ings a n d his paralysis. Likewise, w hen he feels good, you n otice w ith him th e signs o f a supportive, enlivening relational env iro n m en t. As a relational th erap ist, you take a self-w ith-other view of th e sto­ ries your clients tell, b u t th a t’s n o t all. You also believe th a t w hatever h ap p en s in a therapy session can be u n d e rsto o d as a self-w ith-other story. A lm ost every in te rac tio n betw een your client a n d yourself puts in to play som e kind o f interactional p attern . A n o th e r o f yo u r clients m ight feel, for exam ple, th a t she has to say a n d d o certain kinds o f things to m ake this “g o o d ” therapy. So she tries h ard to b rin g up im p o rta n t events to talk abo u t, she con cen trates o n feeling h e r feelings authentically, a n d she recounts insights sh e ’s h a d over th e week. You sense how h ard she’s w orking to please you, a n d you d o n ’t deny h e r your positive feedback, b u t at th e sam e tim e you focus o n u n ­ d e rstan d in g exactly w hat sh e ’s th in k in g a n d feeling as she talks w ith you. Bit by bit, she begins to grasp th a t you arc less interested in h e r d oing therapy “rig h t” th a n in u n d e rsta n d in g h e r reality in d e p th . As she experi­

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ences your u n d e rstan d in g , b eing u n d e rsto o d begins to m atter m ore to h er th a n your approval. A particu lar self-w ith-other m eaning she carries a ro u n d —th a t only h er p erfo rm an ce m atters to o th ers—begins to be u n ­ d e rm in e d gently. All o f this is im p o rta n t relational w ork, th o u g h n o t a w ord has b een spoken directly a b o u t it. A fter a w hile, your clien t does say so m eth in g a b o u t this shift, this differen t way o f being w ith you, a n d you m eet h e r w ith w ords th a t recog­ nize a n d fit w hat sh e ’s trying to say. T h is is a relational in te rp reta tio n , particularly helpful because it em erges as a shared discovery. It’s also one o f th o se insights th a t have th e m ost pow er to change things for your client because it involves a n d changes th e relatio n sh ip betw een th e two o f you. It’s likely th a t w hen you a n d your client talk a b o u t this p a tte rn a n d how it’s changing, she will m ake c o n n ec tio n s to presen t relatio n ­ ships in h e r life, w here th is p a tte rn rem ains pow erful, a n d to past rela­ tio n sh ip s in h er life, w here this self-w ith-other p a tte rn first to o k shape for her. In this way, th e two o f you will be able to link a relational story o f her life, past a n d present, w ith th e relational story th a t develops betw een you. L earning h appens as things change betw een you a n d your client, and a lth o u g h it need n o t always be p u t into words, w ords can m ake th e learn in g m ore real. Talking a b o u t history, m aking c o n n ectio n s, talking a b o u t b o th old a n d new experiences in therapy, tracking th e shifts be­ tw een th em , exploring how th e new way w orks—all o f this—helps your client. In all o f this you rem ain careful n o t to be a th era p ist w ho knows, o r w ho sees w h a t’s really going o n . You signal to your clien t th a t you d o n ’t possess th e tr u th ab o u t her; instead, th e two o f you arc figuring things o u t betw een you as you go along. T h is stance may have felt strange to her at first, w hen she cam e in seeking an a u th o rity to guide her. B ut you c o n tin u e to invite a n d encourage her in to c o llaboration. For her, it’s th e very activity o f c o llab o ratio n th a t creates a new self-w ith-other experi­ ence. N ow you are d o in g so m e th in g differen t w ith h er th a n was possible w hen she first cam e in; so m e th in g differen t is h a ppening.

I T ’S A B O U T S E L F -W IT H -O T H E R IN A C T I O N T his em phasis o n d o in g so m eth in g differen t is th e second essential char­ acteristic o f relational therapy. T h is relational therapy, w hich is all ab o u t self-with-other, is also by n a tu re a perform ative therapy. I d o n ’t m ean by

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this th a t th e therapy is a p erform ance. I m ean th a t th e m aterial w ith w hich therapy w orks a n d th e changes th a t therapy sets in m o tio n can all be fo u n d in th e various k inds o f doing—actions, th o u g h ts, w ords, silences, feelings—th a t exist a n d play o u t betw een self an d others. T h u s, from a relational perspective on therapy, p a rticu la r insights (“my family history form ed m e in this way,” “these are my self-defeating p a tte rn s,” a n d so forth) have no pow er to change anything for a client unless they are perform ative insights, o r insights th a t are intim ately con­ nected to interactive, em o tio n al experience. T h e essence o f therapy isn’t in insight o r in te rp re ta tio n —those ideas th a t you a n d your client figure o u t together. It’s in everything th a t you a n d your client do together—how you in te rac t to co n stru ct ideas, how th o se m eanings m ove b o th o f you, a n d how your in teractio n s change over tim e, especially w hen you reflect o n w h a t goes o n betw een you. In this m odel, you c an ’t be an expert observing your client from an objective place o u tsid e o f th e relational story th e two o f you will play o u t together. You have to e n te r right into th e story, know ing full well th a t relational problem s a n d im possibilities are going to tu rn up, a n d in te n d ­ ing to w ork th ro u g h th o se difficulties to m ake a b e tte r relatio n sh ip pos­ sible. You’re th ere to help your client u n d e rsta n d herself; th is is n o t your therapy. B ut still, th e re ’s n o way you can keep yourself safely outsid e o f th e relatio n sh ip and also be a full p a rtic ip a n t in it. It’s also clear th a t in this m odel th e clien t is n o t th e problem . Above all, th e p roblem is n o t ju st inside th e client. You a n d your clien t will discover how th e interactive p erfo rm an ce o f his self-w ith-other know l­ edge sends h im o ff th e rails over a n d over again, w recking his well-being a n d self-esteem. S om etim es you will have your p a rt in sen d in g h im off th e rails, b u t if you b o th pay close a tte n tio n to how it unfolds a n d repeats itself, together you can find a way to p erform your interactio n s differ­ ently. W h atev er keeps going w rong will tu rn in to a story you can tell together, a n d th e n th ere will be a way to brin g a new story in to being. In o th e r w ords, a lth o u g h w orking it o u t may well involve im p o rta n t new u n d e rstan d in g s, things will change w hen th e two o f you can do your rela­ tio n sh ip in a significantly d ifferen t way. T h a t’s a perform ative therapy. T hese, th en , are th e two m ost im p o rta n t characteristics o f relational psychotherapy: its focus o n self-w ith-other experience a n d its em phasis th a t th e d o in g o f such experience is w hat b o th h u rts a n d heals. In those two ways, it’s differen t from m any o th e r kinds o f therapies. It’s possible

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to explain th a t difference in negative term s, too, w hich is w hat I’ll do now, very briefly: (1) relational therapy isn’t a m edical m odel o f therapy; (2) relational therapy doesn’t hold an individualistic view o f the client; and (3) relational therapy doesn’t give rational, linear, cause-and-effect explanations o f how change happens.

N O T A M E D IC A L M O D E L M ost people go to therapy because they are suffering som e kind o f em o­ tional pain, and they hope th a t an expert, a “doctor,” will make the pain go away. W h e n clients com e to you seeking such relief, you take them seriously, b u t you also gently d isappoint th eir expectation o f a cure ad­ m inistered by an expert. As a relational therapist, you offer them a differ­ e n t kind o f experience. You say, “I d o n ’t believe I have the answers for you, b u t I do w ant to u n d e rstan d w hat the trouble is for you, how it feels to you.” You move away from the position o f expert in order to p u t your­ self o n th e client’s side. It’s a calculated risk (will he leave therapy?), b u t it’s a risk you believe in taking. Any client w ho is suffering enough to search o u t a therapist feels isolated in his pain and at a loss to u n d erstan d it. Beneath his despera­ tion for im m ediate relief, there lies a profound, often inarticulate long­ ing to be understood, n o t to feel so all alone. As you w ork to understan d exactly w hat he is saying, his troubled thoughts and feelings, he may be able to let go o f his hope o f being quickly “fixed.” Why? Perhaps because he senses th a t “fixing” isn’t w hat he needs after all. Being u nd ersto o d in d ep th and in detail soothes his feelings o f hopelessness and powerless­ ness. As he “makes sense” to you, he starts to feel stronger. He feels som e hope just because you have listened w ith respect and care. Your risk is beginning to pay off. W h at you hope for over the long term is th a t he will com e to under­ stand th a t w hat causes his distress isn’t a kind o f defect o r illness inside o f him. Instead it has a lot to do w ith feeling all alone and m aking sense to no one, experiences he has suffered over and over in his life. W h at therapy offers isn’t a d octor to cure him b u t a fellow hum an being w ho will un d erstan d his longings, losses, hopes, and fears, som eone w ho will engage w ith him as he struggles to work o u t a happier, healthier way of being w ith others in the world.

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N O T IN D IV ID U A L IS M As a relational therapist, you d o n ’t take on th e job o f “fixer.” You also refuse to see your clients as self-contained, individual objects th a t need fixing. You make th a t refusal every tim e you try to find o u t w hat h a p ­ pened between a client and som ebody else th a t left the client feeling so bad. You make th a t refusal w hen you im m erse yourself in your client’s world o f experience and w hen you acknowledge th a t your own behavior can have a profound effect o n a client’s well-being. T hose kinds o f refus­ als are a p a rt o f refusing to practice an individualistic m odel o f psycho­ therapy. I’ve said th a t relational therapy is all about self-with-other experi­ ence. T h a t’s in sharp contrast to m ore individualistic views o f therapy. R elational therapy debunks the m yth th a t each o f us is responsible for o ur own happiness, th at som ehow we can each find a way to hold o u r self in well-being. It undercuts the belief th a t m ental health is som ething we individually have and enjoy—o r we d o n ’t. It cuts across the assum ption th a t o ur individual histories are bottled up inside each o f us, and th a t it’s just those old feelings th a t make us feel badly here and now. It doesn’t buy th a t if w e’d just work o n ourselves, we could m anage to claim ou r power, increase o u r self-esteem, and improve o u r confidence. It doesn’t prom ise the N o rth A m erican dream o f self-fulfillment, self-authentica­ tion, o r the autonom ous, self-responsible, fully realized individual w ho is evolved and conscious. It doesn’t believe in self-help. As a relational therapist, you suggest to your clients that, on the contrary, they can’t feel good by them selves o r better o n th eir own. You encourage and su p p o rt your clients’ connections w ith others, and you struggle w ith your clients for m ore authentic, complex, and rewarding relationship in the therapy itself. You do this because you believe th a t an individual can feel genuine power, agency, and well-being only in the context o f healthy interpersonal connection.

N O T R A T IO N A L IS M It’s n o t surprising, th en , th a t relational psychotherapy also takes a tu rn away from rationalism . M ost W estern ways o f th o u g h t begin n o t just with the individual, b u t w ith the individual m ind, w ith Descartes’ “I think, therefore I am .” T h e m ind establishes and validates reality, and it does so through logical processes. Psychoanalysis and psychotherapy have lived

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firm ly w ith in th is tra d itio n since th e tim e o f Freud. Freud saw h im self as a m o d e rn scientist; his m edical m odel o f trea tm e n t, w hich seeks to u n ­ d e rstan d a n d change w hat is w rong w ith in th e individual p a tie n t, is a m odel w ell-grounded in a rationalistic, scientistic view o f h u m a n n ature. T his basic schem e is n o t changed by th e fact th a t, in its term s, access to w h a t’s w rong is th ro u g h th e irratio n al—th ro u g h dream s, fantasies, in­ stincts, and em otions. H ere reason is pitted against em otion , feeling against th o u g h t, id against ego. T h erap y facilitates th e tran sla tio n o f “prim ary process,” th e stu ff o f dream s a n d em otions, in to “secondary process,” the stu ff o f th o u g h t and mastery. In everyday language: T herapy is ab o u t getting in to your feelings a n d th e n m aking sense o f them . N ow it m ight seem th a t a n o n ra tio n a list stance w ould require being o n th e side o f e m o tio n , feeling, dream s, a n d prim ary process, a n d against reason a n d m aking sense o f feelings. B ut relational psychotherapy takes a differen t tack, believing th a t this split betw een reason a n d e m o tio n is ju st a n o th e r tricky form o f rationalism . R elational therapy d o e sn ’t work to get clients to be m ore ra tio n al a b o u t th e ir feelings, b u t n e ith e r does it say they sh o u ld get o u t o f th e ir heads a n d in to th e ir feelings. R elational therapy d o e sn ’t buy into th a t split betw een m in d and e m o tio n . Instead, as a relational therapist, you believe th a t in all o f th e activities o f th e ir daily lives your clients are p u ttin g into play and experi­ en cin g d ifferen t in te rco n n e c te d and com plex systems o f self-with-other, w hich include—all at once—actions, beliefs, th o u g h ts, body-feelings, im ­ ages, self-states, em otions, a n d energies. If things are w rong for your cli­ ents, things are w rong in th o se com plicated systems o f th in k in g /fe e lin g / ex p erien c in g /re sp o n d in g , a n d before your clients can sta rt feeling better, w hole systems n eed to sta rt w orking in differen t ways. N o t only does rationalism specialize in e ith e r/o r th in k in g —e ith e r th o u g h t o r feeling, m in d o r e m o tio n , for exam ple—it also specializes in straig h t o r linear cause-and-effect th in k in g . N ow if w h a t I ju st said is true, if w h a t’s w rong for clients is w rong in com plicated systems o f self-witho th e r experience, it w ould be pretty d ifficult to say, “C hange this, a n d it will all be b etter!” In o th e r words, in its d e p artu re from rationalism , rela­ tio n al th erap y also d e p arts from linear sequences o f w orking o n symp­ tom s, p roducing a catharsis o r an insight, a n d th e n having sym ptom relief. As a relational th erap ist you know th a t change h ap p en s in m u ch m ore com plex, systemic, a n d n o n-linear ways. For exam ple, w hen change be­ gins from th e inside o f a clien t’s relatio n sh ip w ith you, th e client will gradually experience m any sm all, in te rco n n e c te d differences in how she relates a n d feels in o th e r contexts.

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T hese d e p artu res—from th e m edical m odel, individualism , a n d ration alism —help m ake relational therapy w h a t it is. N ext, 1 will use these dep artu res to distinguish relational therapy from som e o th e r therapies. O n c e again, to identify m ore clearly w hat relational therapy is, we will com pare it w ith w h a t it is not.

N O T FREUDIAN THERAPY S igm und Freud was th e original d o c to r w ho invented talk therapy as a cure for m ental illness, a n d his in flu e n ce o n w h a t clinicians a n d th e general public u n d e rsta n d a b o u t th e th era p eu tic process rem ains pro­ fo u n d a n d pow erful, even a m ong th o se w h o disagree th o ro u g h ly w ith his p o sitio n .' In th e o p in io n o f classical Freudians, th ere is, o f course, a treat­ m e n t relatio n sh ip betw een th era p ist a n d p a tie n t, b u t th ere is no real relationship outside o f th e form al one o f d o c to r-p a tie n t (som etim es called th e th era p eu tic alliance). Feelings th a t arise in th e p a tie n t tow ard th e th era p ist are th e p a tie n t’s transference u p o n th e th era p ist o f th e p a tie n t’s past feelings tow ard so m eo n e else. T his may evoke som e countertransfer­ ence feelings w ith in th e therapist, w hich th e th era p ist keeps o u t o f th e tre a tm e n t relatio n sh ip in o rd e r to u n d e rsta n d a n d in te rp re t th e p a tie n t’s m aterial correctly. As we have noted , this m aterial o f dream s, feelings, a n d fantasies is seen as a p ro d u c t o f th e irratio n al u n conscious. It in­ cludes th e m aterial o f transference, w hich becom es a very im p o rta n t pro­ jectio n —as visible as if p u t u p o n an em pty screen—o f th e p a tie n t’s illness. T h e goal o f classic psychoanalytic trea tm e n t can be stated in m edi­ cal term s: to cure th e p a tie n t o f th e sym ptom s o f neu ro tic illness. T his can be d o n e by brin g in g th e c o n ten ts o f th e p a tie n t’s u n conscious into conscious awareness. H ow is this accom plished? T h e d o c to r in terp rets to th e p a tie n t th e real m eanings o f his o r h er instinctual, irratio n al m ental processes as they are revealed in dream s a n d in transference feelings a n d fantasies. Sym ptom s are cured as previously u nconscious conflicts are resolved, o r at least as such conflicts becom e issues guided by th e p a tie n t’s ra tio n al th in k in g and decision-m aking processes. Individualism is a given in this m edical scenario; an individual pa­ tie n t is cured th ro u g h a process o f change th a t takes place entirely w ith in th e p a tie n t’s in n e r w orld. A n d th a t process is fu n d am en tally a rational one, b o th in th e sense th a t it brings rationality to th e irrational, a n d in th a t it takes place in fairly linear cause-and-effect sequences. T his F reu d ian perspective is far from obsolete. O u r clients can ab­

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sorb this sam e sense o f how therapy w orks from a fte rn o o n T V talk shows, w here th e story goes as follows: M em ories a n d w hat they d o to you u n ­ consciously brin g o n all kinds o f sym ptom s—depression, agoraphobia, anorexia, insom nia, anxiety, substance abuse, a n d w orkaholism , to nam e a few. To get help for these sym ptom s, you n eed to find a th era p ist w ho will help brin g back your m em ories, especially th e feelings o f th e m e m o ­ ries. W h e n you get th e feelings o u t a n d m ake sense o f th e m em ories— w hen you truly know th e story h id d e n in your unco n scio u s—th e n you can be well. Let m e illustrate this way o f d o in g therapy w ith an exam ple. “Ja n e ” is th e oldest child o f a fath er w hose alcoholism exploded in to v iolent rages a n d a m o th e r w hose alcoholism d rifte d in to d espair a n d neglect o f h e r c hildren. Jane learn ed early to be wary o f h e r father, to cover for h er m o th er, a n d to look after herself a n d h e r younger siblings. T h e com pe­ tence she learned young has served h e r well: she p u t herself th ro u g h university a n d social w ork school, m arried, a n d is now a w orking m om o f sons aged 8 a n d 6. She has com e to th erap y because she o ften feels de­ pressed for n o reason she can identify, sh e ’s afraid o f a grow ing distance from h e r h u sb a n d , she w orries a lot a b o u t being in ad eq u ate as a profes­ sional a n d as a m other, a n d o n th e w hole, she feels “lousy” a b o u t herself. Classic psychodynam ic trea tm e n t focuses o n Jane’s history a n d hopes to u n e a rth th e feelings o f a b a n d o n m e n t, sadness, anger, loneliness, a n d d espair th a t she b u ried in o rd e r to take c o m p eten t care o f herself a n d others. T h e th era p ist asks h e r to talk a b o u t h e r everyday feelings and experiences, slowly helps h e r talk a b o u t h e r past, a n d suggests links be­ tw een past a n d present. T h e th era p ist expects th a t Jane will som etim es see h er as th e attentive m o th e r she never h a d (positive transference), and som etim es as th e unavailable, neglectful m o th e r she once did have (nega­ tive transference). T h e th erap ist slowly brings this transference m aterial in to th e conversation to o —o n e m ore pow erful way for Jane to retrieve th e conflicts a n d em o tio n s h id d e n b e n e a th h e r system o f defenses. As this unconscious m aterial becom es conscious, th e th era p ist helps Jane w ork th ro u g h it, m ake sense o f th e story o f h e r life, feel h e r ow n feelings in it, a n d m o u rn h er losses. In th e en d , Ja n e ’s ego, o r conscious sense o f self, will em erge far stronger and far less b u rd e n ed by old feel­ ings o f anger, helplessness, a n d sham e. T h e th erap ist will have helped Jane find a n d feel th e conflicts w ith in herself, enab lin g h e r to leave a lot o f th o se old feelings b e h in d , “resolved.” T h a t’s th e classic story o f how therapy works, a n d it’s a good story— a far b e tte r story th a n th e o n e in w hich Jane is sim ply prescribed a n tid e ­

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pressants because th ere ’s no visible reason for her depression. How would relational therapy tell a different story? First, in the relational story, the question is not, “W h a t’s w rong w ith Jane?” b u t rather, “W h at’s wrong for Jane?” T h at is to say, the “w rong” she brings to therapy isn’t an illness to be rooted o u t or cured. T he trouble can’t be located only in repressed m em ories and th eir sym ptom atic ef­ fects, because w hat’s w rong is entangled w ith everything Jane knows and feels ab o u t being in the world—especially ab o u t being w ith others in the world. So it’s n o t a sickness, and it’s n o t an inner, individual problem , either. H er system knows from experience w hat’s safe to do, feel, and say; it tells her w ho will listen, and w ith w hat kind o f attitu d e and feeling tow ard her. It also tells her, very clearly, w hat’s dangerous. For good rea­ son, Jane is convinced th a t she needs to protect herself in very particular ways from certain threats th a t com e w ith interacting w ith others in the world. As a relational therapist, you will n o t try to uncover and treat Jane’s internal illness; instead, you will try hard to u n d erstan d w ith her how her relational w orld works. A nd so, in your w ork together, you will focus first o f all on the present, n o t o n the past, and n o t o n particular re­ pressed feelings, b u t o n how Jane makes sense and safety for herself in the world. As a relational therapist, you’ll be saying to Jane, in one way and another: “You’re m aking the best sense you can o f the cards you’ve been dealt; you’re protecting yourself as best you can in a dangerous in­ terpersonal world. T h a t’s n o t illness, b u t a m ark o f survivor health .” You’ll also notice, however, how costly Jane’s ways o f surviving can be. Jane’s extreme com petence covers for a lot o f self-doubt, and her driven pace is a pro d u ct o f anxiety. In therapy, you let her know, “Here you d o n ’t have to produce or perform .” But perform ing hard a nd well is Jane’s way o f connecting w ith others and feeling like she m atters to them . She may be b u rn in g herself o u t and m issing real connection w ith her hus­ band and sons, b u t w ith o u t her perform ance, she’s lost, anxious, de­ pressed, and she feels lousy ab o u t herself. T his relational dilem m a is the core o f w hat is w rong for Jane, and eventually it’s right there in the therapy room w ith you. B ut slowly she lets herself relax and share m ore o f her vulnerability w ith you. You keep offering her a way o f being together th a t’s less wor­ ried about outcom es, less driven, less anxious, and less lonely th a n she’s been before. As Jane gets well in this therapy, you u n d erstan d h er progress n o t as the result o f the catharsis o f repressed em otions, n o r as an increase in her “ego” to m aster those em otions. W h at you u n d e rstan d is th a t Jane

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is no longer so trapped in old patterns o f self-with-other interactions and feelings. Jane knows m ore ab o u t those patterns th a n she used to, b u t m ost im portantly, she can have different self-with-other experiences. C er­ tainly som e o f those patterns and expectations have changed inside of her, b u t w hat m atters to Jane is th a t she feels m ore real, m ore com petent, and m ore w orthw hile in her daily life. She feels these changes because o f the m ore relaxed and open interactions she’s now having w ith her thera­ pist, her husband, her sons, her friends, and her co-workers. T h a t’s w hat’s m aking her feel better! A nd th a t’s n o t how classical psychoanalytic theory w ould explain the process o r the outcom e o f a successful therapy.

N O T J U N G IA N T H E R A P Y B ut o f course th ere ’s a plethora o f o th e r therapies, and m any o f them define them selves by differing from the Freudian tradition. C arl Jung was one o f th e first psychoanalysts to learn from Freud and th en to move in his own u nique direction. Like Freud, Jung was a physician, b u t one w ho bro u g h t the spiritual and transpersonal to the problem o f m ental illness. In Jungian therapy and its derivatives, th ere ’s hope for a cure, b u t through a self-transform ational journey o f the soul, n o t thro u g h the re­ lease o f repressed mem ory. For Jung, as for Freud, dream ing is a royal road to the unconscious. Jung’s unconscious, however, is archetypal as well as personal. Jungian therapy is about resolving complexes th a t cause symptoms, and although those complexes are rooted in a client’s rela­ tional history, they are also related to archetypal problem s we all have to solve, and have b een solving since the first m yths were told. T his journey, th en , leads to a kind o f m edical-spiritual cure; it involves the realization o f Self u n d ersto o d as Soul. Jungians offer a kind o f sp iritual-m edical m odel o f therapy.2 Jane’s Jungian therapist encourages her to w rite dow n her dream s. In m any o f them , large male figures th reaten violence while Jane trem bles and hides. In others, Jane notices w om en lying w ounded in the shadows, b u t she can’t stop—she’s b eh in d schedule, and the faster she hurries, the more things keep falling apart. T he therapist and Jane talk about how these male and female figures aren’t just images o f her parents; they are also shadow images o f Jane herself. Since m asculine energy has been a threat to her, she can’t c o u n t o n the m asculine side o f herself (which Jung calls her anim us) to help her th in k clearly and act w ith grounded confidence in the world. Fler internal image o f “w om an,” learned first

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from h e r m o th er, has becom e h e r ow n wom an-self, lying badly w o u n d e d a n d helpless as she h u rries by. As Jane c o n tin u e s to dream a n d talk, new dream figures a n d lan d ­ scapes appear. M ale figures becom e less threaten in g ; in h er jo u rn als, Jane can im agine negotiating peace w ith th em a n d even getting th em o n her side. T h e w om en in h er dream s take o n m any new shapes—dangerous, angry, alluring, lively, a n d wise. Jane begins to enjoy m eeting these w om en as b o th em issaries o f a pow er beyond h e r a n d also as parts o f herself. In Jun g ian term s, Jane is b eg in n in g to in dividuate, disen tan g lin g herself from th e com plexes o f h e r personal history in o rd e r to discover th e self she was m ea n t to be. T his sketch show s th a t a lth o u g h Jungians offer a d ifferent k in d o f curc th a n F reudians do, it’s still a cure for so m eth in g w ith in th e client. T h a t “w ith in ” is related to a w hole w orld o f archetypes, m yths, a n d sym­ bols, a n d th e clien t’s rela tio n sh ip to th e w orld is m ediated th ro u g h this sense o f sym bolic m eaning. T h e re ’s a w orld o f com plexity w ith in , m irro r­ ing a sym bolically com plex w orld w ith o u t, b u t change h ap p en s w ithin, a n d only secondarily in th e relationships betw een w ith in a n d w ith o u t. In sh o rt, Jun g ian therapy is individualistic; conflicts a n d resolutions take place w ith in th e indiv id u al’s psyche. Ju n g ian therapy also m akes ra th e r ra tionalistic and linear connec­ tio n s betw een sym bols, dream s, a n d images a n d how clients can use th em to u n d e rsta n d a n d live th e ir lives better. T h e w orld o f archetypes and sym bols, so m eth in g o th e r th a n th e w orld o f everyday th o u g h ts and ac­ tions, affects th e everyday w orld in h id d e n b u t direct ways. From a rela­ tio n a l p ersp ec tiv e , w h a t’s m issin g in th is p ic tu re is th e sense th a t underlying b o th w orlds is a w orld o f countless interactive, feclingful ex­ periences o f self-w ith-other th a t have tau g h t o n e a n d c o n tin u e to teach one everything o n e know s a b o u t w h a t it is to be h u m a n in th e w orld. T hese experiences are w h a t give rise to shifting sym bols, dream s, and images. T hese sym bols, w h e th er personal o r arch ety p al, are im p o rta n t ex p ressio n s o f ex p erien c e , b u t from a re la tio n a l perspective, th ey c a n ’t be seen as th e g ro u n d o r p rim a ry d a ta o f e x p erien ce. Ju n g ian w ork can help clients change how they envision them selves and th e n how they feel a b o u t them selves. From a relational perspective it’s clear th a t changes in o n e ’s sym bolic view o f self can affect how one experiences self w ith o ther. I w ould argue, th o u g h , th a t this is a circui­ tous route to self-with-other change, a n d it carries th e risk o f getting stalled w ith in an inner, sym bolic world. R elational therapy encourages clients to com e o u t w here o th e r people arc. H ere, it argues, is w here you can w ork

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directly o n w hat troubles you. Your in n er world is certainly involved, b u t it’s just p art o f th e w hole picture. T he w hole picture can certainly be grasped through symbols, and your experience o f it can be painted, danced, an d dream ed. Expressing yourself in these ways may help you feel m ore w hole and real. B ut o n th e o th er hand, your experience m atters just as m uch w hen you use everyday language for it a nd we see it in the ordinary light o f day.

N O T S H O R T T E R M S O L U T IO N -F O C U S E D T H E R A P Y These days, due to insurance com pany paym ent plans th a t dem and quick results for m oney spent o n therapy, and also due to cutbacks in public health spending, short-term therapies arc strongly proposed as the best alternative to the longer term “analytic” o r “psychodynam ic” o r “insighto rien ted ” therapies. Short-term therapy is delivered in many forms; it may, for exam ple, be called cognitive-behavioral, solution-focused, strate­ gic, o r goal-oriented. Like th e analytic therapies, these therapies depend o n a m edical m odel o f m ental illness and cure. However, they find m ental illness in a different place in the h u m an being. W h a t’s w rong is n o t in the u n c o n ­ scious, in repressed feelings, drives, or archetypes. W h a t’s w rong are de­ structive o r c o u n te rp ro d u c tiv e th o u g h ts, p a tte rn s o f behavior, and interpersonal habits, a po in t o f view n o t so different from relational per­ spectives o n w hat’s wrong. Short-term therapies, however, believe they can diagnose, isolate, and treat the problem abstracted from the client’s whole context o f lifecxpcrience. Furtherm ore, and in even sharper contrast to a relational m ode o f work, short-term therapies are expert-oriented. T he expert, not necessarily a m edical doctor, b u t nevertheless an expert w ho knows and w ho cures, is the one w ho recognizes and isolates those habitual and counterproductive patterns o f th o u g h t and action and w ho devises strat­ egies th a t change them into healthier, m ore productive patterns. In this kind o f therapy, Jane will be helped to identify the negative beliefs she has about herself and the negative w ords she speaks to herself th a t reinforce those beliefs. She will learn to tu rn dow n the volum e on those thoughts, substituting positive messages to herself about her own good qualities and m any fine achievem ents. She will also be helped to see th a t her depression takes hold w hen she w ithdraw s from h e r family in exhaustion. She will learn to notice her exhaustion earlier, ask for som e

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help around the house, allow herself some rest, and find ways just to “hang o u t” w ith her spouse and sons. For Jane, this is all hard work and against her nature, but when she makes herself think and act in these different ways, she does notice changes in how she feels. Here the doctor-patient interaction is one of rational common sense, and treatm ent is based on expectations th at certain thought and behav­ ior changes will lead to certain predictable changes in feeling. In this sense, reason can conquer em otion. A t the same time, and in their favor from a relational perspective, these therapies don’t believe that insight cures; they don’t think that just knowing w hat the problem is and where it might be coming from will instigate change. For these short-term thera­ pies, the point is not to tell your life story, outer or inner, in ways which make expanded and transform ational kinds of sense—making the uncon­ scious conscious as Freudians and Jungians do—but to set goals, change patterns, and do things differently. W hen you start to do things differ­ ently, different experience will follow. Relational therapy agrees with that premise, b u t it knows th at doing and feeling interpersonal relationships differently involves a complicated process of undoing old patterns and learning new ones, a process you can’t do on your own or hurry up with willpower. How individualistic are these therapies? O n the one hand, they move the focus of treatm ent from a client’s inner world of unconscious con­ flict to her conscious thoughts, behaviors, and habits of daily life, most of which take place in social contexts. O n the other hand, these thera­ pies include strong emphases on autonomy, self-assertion, and taking charge of one’s own life. “You have the power to make the changes that will make your life more rewarding”: so goes their keynote address. By contrast, relational therapies insist that the em otional quality of your life depends on the quality of relationships that sustain you in all of the aspects o f your life. Relational therapies point out, too, that a treatm ent picture that includes one expert problem-solver and one person with problems is a very narrow slice of w hat’s possible—or, in fact, of w hat actually happens— between any two persons engaged with one another as client and thera­ pist. All kinds of interpersonal hopes, fears, judgments, and feelings are inevitably woven into any therapeutic treatm ent, for better or for worse. From a relational perspective, it just makes sense to acknowledge this reality and then to try to work with it productively.

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NOT HUMANIST THERAPY T he therapist’s em pathy and uncon d itio n al positive regard for the client and her authentic presence w ith the client are the hallm arks o f hum anist and client-centered therapies. Since th e 1940s, the hu m an ist therapy m ovem ent has c onfronted the psychiatric establishm ent w ith a n onm edi­ cal m odel o f helping people w ho suffer psychological and em otional dis­ tress. Its practitioners speak o f personal growth instead o f cure. C arl Rogers and his colleagues insisted o n the term “client,” n o t “patient,” in order to emphasize th a t therapy isn’t ab o u t illness. W h at clients need, they said, is n o t a cure, b u t a selfless kind o f love w ithin w hich they can grow into th eir full potential as h u m an beings. T his agape love com es to clients in the form o f the therapist’s un co n d itio n al positive regard, empathy, and genuineness.3 In these ways, a h u m an ist therapist is fully “in ” the interactions w ith a client. She does n o t aspire to the position o f objective expert or fixer o f w hat’s wrong. She believes th at the potential for healing lies w ithin the client, as does u n tap p ed potential for self-developm ent and self-actu­ alization. T he therapist’s accepting presence is th e m edium w ithin which the client sheds his fears and begins to realize his h id d en potential. T his way o f being w ith clients is, I believe, a prototype o f relational practice. B ut it falls sh o rt o f full relational awareness w hen the therapist sees herself as only a benign, neutral m edium for growth, som ething like a good mix o f sun and rain for the n u rtu ran c e o f healthy plants. T he h u m an ist therapist provides an interp erso n al context for the client’s growth; she does not, however, becom e personally entangled in th at growth process. It’s for this reason th a t Rogers can give sh o rt shrift to w hat psy­ choanalytic theory calls transference and countertransference. For Rogers, transference is just one m ore constriction a client leaves b eh in d as he blossom s in response to uncon d itio n al positive regard, and this warm regard, by its very nature, is given w ithout any countertransferential strings attached. In sum m ary, then, this friendly, antim edical m odel o f therapy has two strong individualistic aspects: its goal o f in n er self-actualization and its disavowal o f relational entanglem ents between client and therapist. T here are h um anist therapies th at borrow m ore from psychodynamic theory th a n Rogers did, giving credence to interpersonal them es th at they acknowledge as transference and countertransference. But they frame these relational issues in individualistic ways. G estalt therapy, for example,

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encourages clients to refuse to accept projections laid o n th em by others, and to recognize and w ithdraw th eir ow n projections as the products o f th eir own historical baggage. “Your s tu ff’ and “my s tu ff’ m ust becom e com pletely disentangled (an impossibility w ithin relational thought). For transactional analysis, too, the goal o f analyzing interpersonal transac­ tions is to recognize the roles you’re caught in—the games you play unw it­ tingly—so th a t you can escape them ! N ow here does there seem to be any awareness o f the inescapable em beddedness o f any self w ith many o th er selves, an interdependency th a t is as life-giving as it is difficult to manage. H ow do hu m an ist therapies situate them selves vis-à-vis the rational? T hey are less tied to insight th a n any o f the therapies I’ve considered so far. C ure is experiential, especially thro u g h new experiences and expres­ sions o f self. T his is especially visible in gestalt, psychodram a, and trans­ actional analysis (T A /en co u n ter group) versions o f hu m an ist therapies. T hey pay a lot o f a tte n tio n to how we m ake o u r lives and senses o f self from w hat we have learned w ith others, w hich we forever after reenact w ith others. It’s im p o rta n t to u n d erstan d how th a t works, they say, but changes in those scripts take place only w hen we feel and express the pain they cause us, and feel and express a self breaking through and moving beyond those scripted constrictions. C hanges happen w ithin us as ou r blocks are released, o ur feelings are spoken, and o u r alienated parts o f self are reintegrated. Let’s im agine Jane w ith a hu m an ist therapist who is n o t w edded to any particular way o f helping Jane find and express her feelings. Early in therapy, Jane talks about fear—fear o f m aking mistakes, fear o f displeas­ ing her husband, fear o f terrible accidents happening to her children. A fter a while she can acknowledge th a t she feels fear in sessions, too, fear o f being judged and rejected. T he therapist encourages her to fully expe­ rience her fear, to stay w ith it. She w onders w ith Jane if this is an old feeling. A nd o f course it is; suddenly Jane feels a wave o f th e terrible tight anxiety th a t w ould fill her body w hen her father had been d rinking and a fight betw een her parents loom ed. Later, w hen Jane feels safer, she will talk a bout som e o f the things in her life th a t make her annoyed an d frustrated. T he therapist will help her identify these feelings as anger, affirm ing the energy and power o f lucid, constructive anger. As Jane becom es m ore com fortable w ith feeling an­ gry, she begins to rem em ber the rage she felt as a child, helpless to change w hat kept happening. H er therapist says it m ight help to release som e o f th at rage, and Jane finds herself p o u n d in g a pillow and yelling, “I hate you!” A nd th e n her rage crum bles into sobs. B eneath Jane’s rage, her

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therapist explains, there lies a deep well o f sadness th a t Jane has never let herself feel—u ntil now. Now, for a while, Jane will need to cry her sadness—for the h u rt and lonely child she was, for how m uch she needed to be loved, for the way her drivenness has robbed her o f happiness. She can even cry ab o u t wanting her therapist to be the m o th e r she never had, as she desires this desperately and knows it can never be. So m uch o f w hat m ight have been can never be. But through her tears o f grief, Jane also feels herself m ore alive and m ore real th a n she has ever felt before. N othing w ithin her scares her terribly anymore. She knows her b linding fear, her rage, and her w renching sadness. She may be w ounded, b u t she has herself at last. As she looks a round, she begins to see th a t there may be som e goodness in her life after all, and hopes and prom ises for the future. We see here th a t while the therapist is a skilled facilitator o f Jane’s process, the process is understood to happen inside o f Jane. It happens in her feelings, n o t in her m ind. M ost hum anist therapies m ake a m antra o u t o f “I’ve gotta get o u t o f my head.” But as I’ve noted, this m ind/body, thinking/feeling, h e a d /g u t split is one o f the trickier form s o f rational­ ism as it appears in therapy. Rationalism appears in a n o th e r form w hen hum anist therapies lead clients to believe th a t if they get in touch w ith th eir feelings, have a cathartic, authentic experience, release a block, and integrate a p art o f them selves long alienated, th e n they can expect th at th eir em otional lives will change dramatically. In oth er words, hum anist therapies tend to suggest linear cause-and-effect sequences in the doing o f em otional “work.” This, along w ith th eir em phasis on individual pro­ cess, sets up conditions in w hich clients can work o n them selves end­ lessly and blam e them selves for n o t d o in g it right w hen they d o n ’t experience th e rewards they hoped for. By contrast, in a relational m odel, change always happens w ithin relationship w ith a n o th e r person, even while it is experienced as change in in n er m eanings and feelings. T his slight shift o f em phasis m eans th a t in relational therapy the client doesn’t carry the burden o f change. Fur­ therm ore, a lthough having m any em otions and expressing th em in bo th strong and subtle ways may be p art o f a relational therapy, the success of the therapy doesn’t depend o n any particular form o f em otional release. T h ere’s n o th in g a client has to experience o r express in order to be doing therapy “right.” T he work is in whatever happens betw een a client and therapist as they talk, and in whatever thoughts and feelings arise from th a t conversation. T his contrast betw een different concepts o f therapy “w ork” shows

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up well in gro u p therapy. In a h u m a n ist m odel o f group therapy, m em hers o f th e gro u p take tu rn s d oing “pieces o f em o tio n al w ork,” facilitated by a th era p ist w ho is skilled in helping th e m access a n d release feelings a n d th e n identify aspects o f them selves th a t can be integrated in to a fuller, m ore a u th e n tic self. As each m em ber works, th e o th ers are su p ­ portive spectators, o r perhaps even p articip an ts in a psychodram a th a t th e th era p ist designs to help th e w orking m em ber access feelings, m em o­ ries, a n d parts o f self. Each p erso n ’s real o p p o rtu n ity for change and grow th will com e w h e n it is his o r h e r tu rn to work. In a relational group, th e actio n h ap p en s betw een group m em bers, w hile th e th era p ist nudges conversations tow ard m ore h o n e st a n d em ­ path ic exchanges. G ro u p m em bers explore th e ir m u tu a l assum ptions a n d m isu n d erstan d in g s, th e ir in te rp erso n al needs, hopes, a n d fears, a n d th e p a tte rn s o f in te rp erso n al feelings th a t em erge in th e gro u p interactions. G row th happens for th e participants as relationships betw een th em deepen in to netw orks of m u tu a l u n d e rstan d in g s w ith in w hich persons can freely assert them selves a n d also offer to each o th e r genuine, th o u g h tfu l, and caring su p p o rt. H ow does this picture transfer to individual relational therapy? T h in k o f a gro u p o f two, yourself a n d yo u r client. You are b o th th e facilitator o f this sm all group a n d a full p a rtic ip a n t in it. You will facilitate a relation­ ship th a t will give your client m any chances to assert herself freely and to experience g enuine, th o u g h tfu l, a n d caring su p p o rt. You will also partici­ pate in th e collaborative process o f fin d in g o u t how to keep this relatio n ­ ship betw een th e two o f you alive a n d well, d eep en in g a n d growing. You believe th a t jo in in g w ith you in this c o llab o ratio n will tu rn o u t to be m ore useful a n d rew arding for your client th a n if you ju st helped h er to “w ork o n herself.”

N O T NARRATIVE THERAPY W ith its links to th eo ries o f th e social c o n stru ctio n o f th e self, narrative therapy m akes an im p o rta n t acknow ledgm ent o f th e lim its o f individual self-creation a n d self-realization. It suggests th a t in o rd e r to u n d e rsta n d yourself, you m ust locate yourself w ith in th e pow er dynam ics o f your ow n social context, for exam ple, as a w om an o r a m an, as a person-ofcolor o r a w hite p erson, as a g a y /q u e er o r straight p erson, as a perso n w ith working-class, middle-class, o r upper-class roots. W h atev er your lo­ cation, it says, th ere arc pow erful political a n d cultural stories th a t speak

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to you in y o u r p a rtic u la r c o n te x t to tell you w h o you can be in th e w orld, w h a t you can d o , how you can feel a b o u t yourself, a n d w h a t yo u ’re w o rth . W ith in th ese stories, w h ich c o n stru c t y o u r family, to o , th e re is also your fam ily n a rra tiv e o f you. All o f th is is im p o sed o n you as if it w ere your ow n story, sq u e lch in g w h o you really are, w h a t you really n e ed , a n d w h o you really c o u ld b ecom e. N a rrativ e th era p y helps you n o tic e th e story you are en actin g , a n d it backs you u p to try to break o u t o f th e o ld n a rra ­ tive a n d in to new o n e s th a t su it you b e tte r.4 W ith a n a rra tiv e th e ra p ist, Ja n e discovers th a t th e rules sh e lives by a n d th e sta n d a rd s she strives to m eet are set by forces o u tsid e o f herself. T h e c u ltu re o f h e r c h ild h o o d , rein fo rc ed by h e r p a re n ts’ behavior, ta u g h t h e r th a t it was a w o m a n ’s place to suffer in silence, to clean u p m esses, a n d to keep th e fam ily going n o m a tte r w h at. Even as a little girl, she ste p p ed u p to th e task. N ow she realizes th a t sh e ’s living o u t th a t very sam e sto ry b o th a t h o m e a n d at w ork, a n d every th in g a ro u n d h e r c o n ­ spires to keep h e r in it. B u t sh e learn s to resist th e pressures fro m h e r h u sb a n d , h e r c h ild re n , h e r in-laws, a n d h e r boss, w h o all p ro fit fro m h e r h yper-com petence. As she resists, she also begins to develop a n d test o u t a new sto ry for herself, o n e in w h ic h sh e m atters as m u c h as a nyone else, o n e in w h ich sh e gets to speak h e r m in d w h ile jo in in g w ith o th e rs in w o rk in g to w ard m u tu a l goals. F ro m a re la tio n a l perspective, su c h n a rra tiv e th era p y gets very h igh m arks for th e th o ro u g h g o in g re la tio n a lity o f its w orldview . N a rrativ e th erap y also know s th a t it is th e c lie n t’s perform ance o f th e n arrativ es assigned to h im th a t d e te rm in e s th e p a th o f his life, his self-im age, a n d his e m o tio n al well-being. T h erefo re, ra th e r th a n trying for specific changes in his self-image o r e m o tio n s, it tries to set in m o tio n perfo rm ativ e changes o f n a rra tiv e th a t will su b tly alte r how w h o le system s o f his re la tio n a l in­ tera ctio n s w ork. T h is idea a b o u t ch an g e resem bles re la tio n a l ideas a b o u t th e p e rfo rm a tiv e pow er o f th e th e ra p e u tic re la tio n sh ip to ch an g e how a c lie n t p e rfo rm s a n d ex p erien ces m any o th e r re la tio n sh ip s. O n th e o th e r h a n d , a n d in c o n tra st to a re la tio n a l perspective, nar­ rative th era p y can b e q u ite e x p ert-o rie n ted a n d even ra tio n alistic in its d e te rm in a tio n o f w h ic h na rra tiv e s are b a d for clients a n d why. H isto ri­ cally, it has b e e n lin k e d w ith e m a n cip a to ry political th eo ries su ch as M arx­ ism a n d radical fem inism , w hich p ro p o se stro n g a rg u m e n ts against c ertain n arratives a n d in favor o f o th ers. R elationally speaking, th e d a n g er here is th a t th e e x p erts’ ideas a b o u t w h a t n arrativ es h u r t a c lie n t can take over th e c lie n ts’ ow n w ords for w h a t h u rts th e m , c rea tin g a false, c o m p lia n t c o n n e c tio n betw een th em selves a n d th e ir th erap ists.

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A n o th e r danger, from a relational perspective, lies in th e assum p­ tio n o f an a u th e n tic self w ho may he oppressed by false narratives right now, b u t w ho can em erge in to his o r h er ow n g en u in e tru th . T h is “W h o you really are” o r “W h o you’re really m ea n t to beco m e” can be a fairly individualistic self-actualization co n stru ct, after all. It seem s to d e p en d o n th e a ssum ption th a t w ith in each perso n th ere is an essentially con­ text-free b eing w ho exists u n d e rn e a th layers o f oppressive social co n stru c­ tion. Relationalists protest th a t th ere ’s no state o r m o m e n t of being h u m an a p a rt from context, social c o n stru ctio n , a n d relationship. W h o we can be is always a n eg o tiatio n o f w h a t’s possible w ith in w hat we have b een given, contextually. A lternative, liberating p erso n al narratives becom e possibilities for us only w hen they arc sustained w ith in a context o f alter­ native, liberating relationships. In o th e r words, as a relational th erap ist, you d o n ’t im agine th a t for any client th e re ’s a tru e, h id d e n story o f w h o she is. T h e re ’s th e self-witho th e r story she lives inside o f now, a n d th ere are o th e r stories possible, w hich could be better for her. B etter has to d o w ith w h e th er new selfw ith-other experiences give h e r m ore freedom a n d su p p o rt th a n she had before, w h e th er they allow h er m ore self-expression, m ore joy a n d pride, a n d a firm er sense o f herself, h e r goals, a n d h e r principles. As a rela­ tional therapist, you will w ork w ith your clients’ self-w ith-other n a rra ­ tives, b u t you w o n ’t be trying to help th e m find alternative o r “tru e ” selves—as if th e lives they have b een living have b een false. Instead you will help th em find m ore com fortable, constructive, rew arding, and re­ sponsive ways to live as th e selves they have always been, a n d w ith in con­ texts th a t sustain th em .

N O T RADICAL FEMINIST THERAPY A fine a rticu la tio n o f radical fem inist therapy can be fo u n d in Laura Brow n’s book Subversive Dialogues.5 H er version o f radical fem inist therapy has q uite a lo t in c o m m o n w ith narrative therapy. Brow n, too, u n d e r­ stan ds th a t a clien t’s well-being is far m ore d e p e n d e n t o n w hat com es from h e r social su rro u n d in g s th a n sh e ’s likely to th in k ; th a t any clien t’s sense o f self is tho ro u g h ly contextual a n d c o n stru cted w ith in netw orks o f social power. T h e depression, anxiety, low self-esteem, phobias, addic­ tions, a n d o th e r sym ptom s th a t clients brin g to therapy are all rooted, Brow n says, in m any kinds o f d isem pow erm ent a n d su b jectio n —to w hich som e m em bers o f society arc m ore subject th a n others. However, all m em ­

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bers suffer from living in hierarchical o r patriarchal social stru ctu res th a t invest in a n d m ain tain subjection. D o m in an ce is n o t just a p roblem for th e “losers” b u t for th e “w in n ers,” too, w ho becom e alienated from th e m ­ selves, from th e ir tru e selves, by th e d o m in a tin g scripts they are p erfo rm ­ ing w ith o u t a second th o u g h t. W ith a radical fem inist th erap ist, Jane learns th a t th ere is a very pow erful reason for h e r pervasive sense o f powerlessness: a patriarchal society is engineered to disem pow er w om en a n d c hildren. T h is was in force w hen she was a child, cru sh in g a n d silencing b o th h e r m o th e r and herself, a n d it’s still tru e now. Ja n e ’s early experience, su p p o rte d by u b iq ­ u ito u s cultural stories a b o u t a w om an’s place, has p erm eated Ja n e ’s sense o f herself. A ny story she can tell herself a b o u t h e r life assum es th a t she has far m ore responsibility th a n pow er in life. H er th era p ist helps h er notice those assum ptions and th e n question them . She enters em pathically i n to J a n e ’s e x p e rie n c e to h e lp h e r k n o w h o w d if f e r e n t k in d s o f d isem pow erm ent have m ade h e r feel. She helps Jane n otice w h e n th e expectations o f h e r boss o r h e r h u sb a n d leave h e r n o o p tio n s b u t acqui­ escence. She encourages Jane to claim h er rightful power, b o th rig h t now a n d retrospectively. T h e th era p ist backs Jane in h e r fight against th e o p pression she m eets every day and th e o p pression she has internalized, w hich over th e years has becom e a self-definition. As Jane finds w ords for w h a t has hap­ p e n ed to her, she also finds w ords for w ho she is now —h e r ow n words, w ords th a t resist forces th a t w ould d efine h e r in th e ir term s. T his is th e critical m ove for Ja n e ’s well-being: for h e r to be no longer a paw n o f p atriarch al power, b u t to becom e so m eo n e w ho know ingly a n d passion­ ately resists. To this e n d , in th e service of resisting d o m in a tio n , h e r radi­ cal fem inist th erap y has b een a subversive dialogue. In this b rie f description you may hear th a t th e re ’s a certain story a b o u t a c lie n t’s experience, a story a b o u t oppression a n d th e clien t’s need for liberation a n d em pow erm ent, th a t th e radical fem inist th era p ist will tell th e clien t to explain to h e r why she feels th e way she does. Brown holds her political convictions respectfully in her work w ith clients, b u t she does allow h er beliefs to com e through, and for th at she doesn’t apologize. O n th e o th e r h a n d , Brow n allows m ore th a n som e narrative therapists do for th e com plications o f th e th era p eu tic re lationship, w hich she says c o n tain s m any pow erful sym bolic elem ents, especially elem ents o f power, th a t n eed to be talked a b o u t in therapy. H er w ork is also satu rated w ith im plicit acknow ledgm ents o f th e th era p eu tic pow er o f accurate em pathy, enacted as hearin g a n d speaking in th e c lie n t’s “m o th e r to n g u e.”

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Nevertheless, in Brown’s presentation o f fem inist therapy, change comes about mostly through new understandings rath er th an through new relational experiences. T hose understandings are facilitated by an expert, this tim e an expert o n w hat patriarchy does to us all. A t the same tim e, though, th a t expert is in te n t on em pow ering the client, telling her th a t she is the expert o n her own experience, and th a t her voice is w hat matters. T he therapist is b o th an expert diagnostician o f a fundam entally social disease and also an anti-expert w ho resists the m edicalization o f sym ptoms and the hierarchies o f m edical m odels o f cure. T h a t’s a para­ doxical position to hold. A nd so is the position th a t therapy work m ust be und ertak en w ith individuals, b u t th a t it strives, essentially, to build fem inist com m unity. Brown acknowledges these c onundrum s. But work­ ing w ith them is just p art o f the challenging job o f doing fem inist therapy, she says.

“N O T S ” A R E U S Now it’s tim e to g ather up all the “nots” I’ve p u t forward, all the disclaim ­ ers. I’ve proposed th a t relational therapy departs from a m edical m odel, from individualism and rationalism . I’ve said th a t relational therapy is neither Freudian n o r Jungian therapy. I’ve said th a t it’s n o t solutionfocused, n o t narrative therapy, and th a t although b o th hum anists and radical feminists may practice it, it’s neither hum anist n or radical femi­ nist therapy. Now it’s tim e for m e to gather up all those “nots” and dis­ claim th em —because relational therapy is also a product o f its context, and th at context includes all those them es and schools against which it defines itself. For exam ple, relational therapy may n o t be a m edical m odel, b u t wc can hardly deny th a t it seeks to help, to ease suffering, and to improve a client’s quality o f life. Relational therapy claims n o t to be individualistic, yet m ost o f the w ork is d o n e w ith o n e person at a tim e, w ith concern for th a t individual’s well-being; moreover, the positive changes th a t clients experience in relationship they also experience as positive changes in their personal internal patterns o f expectations a nd responses. T h ough we may call relational therapy nonrational, relational therapists and th eir clients are always trying to m ake som e sense o f w hat’s h appening in therapy. Furtherm ore, droves o f relational theorists keep w riting carefully reasoned articles and books a bout how this n o n ratio n al therapeutic process works. Relational theory makes transform ative changes to Freudian theory,

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b u t it rem ains heavily in d eb te d to th e central F reudian ideas th a t m uch m ore m otivates a perso n ’s behavior th a n th a t perso n is aware of; th a t p rio r experience influences th o se m otivations; a n d th a t in th e process o f repeated intense conversations betw een two persons, th o se m otivations a n d influences may becom e visible, alm ost palpable, in th e transference th a t begins to shape th e conversation. W h e n a relational th era p ist has a Ju n g ian kind o f open n ess to th e pow er o f dream s a n d m eta p h o rs to ex­ press th e n uances o f a clien t’s experience, th e d im e n sio n s o f h er em ­ path ic u n d e rsta n d in g expand. As we n o ted above, relational therapy jo in s w ith shorter-term actiono rien ted therapies in th e ir suspicions th a t intellectual analyses o f a clien t’s unco n scio u s m ight n o t help him m ove tow ard m u ch change in his life. R elational therapy agrees th a t change in a clien t’s sense o f self requires changes in a clien t’s actions a n d experiences. O f course, th e h u m a n ist therapies have created th e very possibility o f no n m ed ical therapy—therapy in w hich clients can expect respect, em pathy, a n d su p p o rt for th e ir ow n developm ental process, a n d therapy in w hich th e th era p ist will be genu­ inely p re se n t in th e th e ra p e u tic re la tio n s h ip . N a rrativ e th e ra p y h ig h ­ lights th e p ow er o f social c o n te x t to c o n s tru c t p e rso n a l n a rra tiv e s, a n d it show s how th e pow er o f th o se narratives lies in th e ir reiterated perform ances, two them es crucial to relational therapy. A n d radical fem i­ nist therapy rem in d s relational therapists th a t social relations o f u n eq u al pow er and en ac tm e n ts o f d o m in a n c e a n d subm ission com e rig h t in to th e therapy ro o m w ith any two persons w ho e n te r it. In all these ways, relational therapy joins w ith o th e r therapies in c o m m o n tasks a n d u n d e r­ standings. B ut if it’s im p o rta n t for m e to acknow ledge th a t relational therapy shares history a n d im p o rta n t co n cern s w ith schools o f th erap y th a t do n o t define them selves as relational, it’s even m ore im p o rta n t for m e to acknow ledge th a t a relational perspective has b een n u rtu re d in several differen t schools o f psychotherapy a n d psychoanalysis. W h a t I am sim ply calling “relational th era p y ” is in d eb te d in differen t ways to each o f them . N ow I will in tro d u ce th o se d ifferen t schools o f th o u g h t th a t provide us w ith a rich diversity o f relational perspectives o n psychotherapy.

S T O N E C E N T E R S E L F -IN -R E L A T IO N T H E R A P Y T h e w om en o f th e S tone C e n te r for D evelopm ental Services a n d S tudies at W ellesley C ollege have developed a k in d o f fem inist therapy th a t sets

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itself w ith in th e context o f fem inist political theory, including analyses o f racism , classism, a n d heterosexism . A t th e sam e tim e, S tone C e n te r theorists believe th a t th e w ork o f th erap y is n o t th e sam e as th e w ork o f political resistance a n d subversion. T h e ir th erap y does n o t d e p en d , th en , on a fem inist expert w ho can explain to her clients how social a n d p oliti­ cal c o n d itio n s c o n strain th e ir lives a n d how they can resist th o se con­ straints. T h e Stone C e n te r’s strongest em phasis is on healing th a t happens th ro u g h th e experience o f c o n n ec tio n . T his em phasis m akes it less ratio­ nalistic, less insight-driven, a n d less linear th a n B row n’s way o f w orking. W h ile L aura Brow n seeks to subvert patriarchy th ro u g h resistance m obilized in therapy, th e S tone C e n te r th eo rists seek to subvert p atriar­ chy th ro u g h w om en’s ways o f being in co n n ec tio n . T hey begin w ith th e prem ise th a t w om en have particularly relational, c o n n ec te d ways o f be­ ing w ith others, a n d th a t th o se ways o f being are h e alth ie r th a n m ascu­ lin e d is c o n n e c te d a n d a u to n o m o u s ways o f b e in g in th e w o rld . D isco n n ectio n is w h a t causes tro u b le betw een a n d w ith in h u m a n beings, including th e w ide range o f troubles th a t com e to be labeled “m ental illness.” In general, patriarchal society fosters au to n o m y a n d d isconnec­ tio n , a n d a m ore p a rticu la r source o f tro u b le is th e k in d o f d isconnec­ tio n h a n d e d dow n from g en eratio n to g e n era tio n in tro u b le d families. So w hen Jane com es in for therapy, h e r self-in-relation th era p ist is especially a ttu n e d to Jan e’s d isc o n n ec tio n s—from significant o th ers in h e r life, from h e r ow n feelings a n d self-experience, a n d also from th e th era p ist as th e two o f th e m talk. T h e th era p ist keeps offering h e r ow n capacity for em pathy u n til Jane begins to b rin g m ore o f h e r self, h e r real th o u g h ts a n d feelings, in to th e conversation. In th e am biance o f em pa­ thy, Jane finds herself m ore able to accept th e fearful, h u rt, a n d angry parts o f herself. H er c onfidence a n d self-esteem grow. H er depression fades as she is able to take from th e relatio n sh ip w ith h er th era p ist stro n ­ ger capacities to engage w ith o th e rs in ways th a t brin g herself a n d o th ers m u tu a l satisfaction. T h e therapy process, however, is n o t as easy as it looks in this b rief sketch. A ccording to S tone C e n te r theory, if a clien t is in o ngoing em o­ tio n al pain, anxiety, o r o th e r sym ptom s o f psychological trouble, th e ro o t o f h e r tro u b le is very likely a p ro fo u n d sense o f d isc o n n ec tio n a n d isola­ tio n from others. B ut th a t d isc o n n ec tio n is usually h id d e n a n d very resis­ ta n t to change. W hy is this th e case? It’s th e case because in h e r culture a n d in h e r family, a client like Jane has learn ed th a t in o rd e r to get along in life a n d n o t get h u rt by th e people closest to her, she m ust squelch h er

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desires for g e n u in e c o n n e c tio n to th e m , c o n n e c tio n in w h ic h she gets to be fully herself. Ja n e w a n ts c o n n e c tio n a n d sh e also n e ed s to p ro te c t h e rse lf from th e d a n g ers o f c o n n e c tio n . So Ja n e lea rn s to p re te n d at c o n n e c tio n , a n d h e r p re te n se gives h e r ju st e n o u g h c o n n e c tio n to get by. S he becom es g o o d a t b e in g th e p e rso n o th e rs w a n t h e r to be, a n d she carries th is a c c o m m o d a tin g m o d e o f social o p e ra tio n o u t fro m h e r fam ily o f o rig in in to th e rest o f h e r life. E ventually, o f co u rse, sh e fin d s h e rse lf p ro fo u n d ly d isc o n n e c te d a n d isolated fro m o th e rs , a n d n o t only th a t, d isc o n n e c te d fro m h e rse lf a n d feeling b a d in m any ways. T h ese sym ptom s are w h a t m otivate h e r to get help. W ith o u t th em , sh e’d hardly know sh e’s in trouble, for th is is life as she know s it. W h e n she com cs for th era p y w ith a S to n e C e n te r o r self-in-relation th e ra p ist, Ja n e is invited, over a n d over again, in to a process o f g e n u in e re c o n n e c tio n w ith o th e rs (in p a rtic u la r h e r th era p ist) a n d w ith herself. H e r th e ra p is t tries to be fully p re se n t to Jane even w h e n Ja n e stays h id ­ d e n , a n d sh e d o e sn ’t give u p try in g to engage her. T h is re c o n n e c tin g is a lo n g slow process because Ja n e hangs o n tightly to th e a cc o m m o d a tin g , p leasing strategies th a t keep h e r safe from d an g ero u s re la tio n sh ip . B u t th e th e ra p is t re m a in s steady, sho w in g u n d e rs ta n d in g a n d e m p a th y w h e n ­ ever Ja n e is able to speak o r to signal th o u g h ts a n d feelings th a t b elo n g ju st to her. E ventually Ja n e begins to feel th e th e ra p is t’s em pathy, a n d th e n m o m e n ts o f e m p a th y for herself. Finally sh e begins to re c o n n e c t w ith feelings, th o u g h ts , a n d experiences she o n c e d e n ie d were ever a p a rt o f her. H aving received e m p a th y a n d u n d e rs ta n d in g fro m a n o th e r a n d given it to herself, she can b eg in to fin d h e r way to m u tu ally e m p a th ic a n d rew arding c o n n e c tio n s w ith o th e rs in h e r life.6 If th is e x p a n d e d sto ry o f self-in-relation th e ra p y s o u n d s very m u ch like th e re la tio n a l p sy ch o th erap y I’m p u ttin g forw ard, t h a t ’s because my d e fin itio n o f re la tio n a l th era p y owes a g re at deal to th e S to n e C e n te r. So why n o t sto p here? C e rta in ly we can leave Ja n e h ere a n d tru st th a t h e r th era p y process will be richly re la tio n a l. B u t I w a n t to u n d e rs ta n d m ore a b o u t th e process th a t th e S to n e C e n te r calls “c o n n e c tio n .” I w a n t to investigate m o re closely, for exam ple, w h a t h a p p e n s w h e n b o th c lie n t a n d th e ra p is t engage in b ehaviors th a t are sim u lta n eo u sly “c o n n e c tin g ” a n d “d isc o n n e c tin g .” I w a n t to u n d e rs ta n d a variety o f in te ra c tio n s a n d states o f b e in g th a t c a n ’t be d e fin e d as sim ply c o n n e c te d o r d isc o n n ec te d . So I lo o k b e y o n d S to n e C e n te r self-in-relation th e o ry for fu r th e r c o m p o ­ n e n ts o f a co m p re h en siv e re la tio n a l psychotherapy. I lo o k to re la tio n a l

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psychoanalytic th eo ry for m ore in fo rm a tio n a n d ideas a b o u t this com pli­ cated process.

RELATIONAL PSYCHOANALYSIS—THE BIG PICTURE R elational psychoanalysis is a com plex p h e n o m e n o n constantly on the move. To try to capture th e m o tio n and fluidity o f its developm ent, I will describe it in term s o f stream s: trib u ta rie s flow ing into m ajor w atercourses th a t th e n carry forw ard diverse cu rren ts a n d sub-stream s. Two m ajor trib u ­ taries flow into th e contem porary river o f relational psychoanalytic theory— object relations theory, especially as developed w ith in th e B ritish inde­ p e n d e n t school (e.g. W in n ic o tt, G u n trip , Fairbairn, and B alint), a n d in­ terp e rso n a l psychoanalysis, an A m erican m ovem ent orig in atin g in the w ork o f H arry Stack Sullivan. B oth in te rp erso n al a n d object relations form s o f psychoanalysis arc still currently practiced; they have fed the m ain stream o f relational theory, b u t they also c o n tin u e along courses o f th e ir ow n. For th e sake o f sim plicity, however, I w on’t deal w ith th e m as relational schools them selves b u t as precursors o f c o n te m p o ra ry psycho­ analytic th eo ry th a t self-identifies as “relatio n al.” In my sim plified sketch o f th e big picture, this c o n tem p o rary psy­ choanalytic relational th eo ry is split in to two d istin c t stream s. O n e calls itself “self psychology” and th e o th e r calls itself “relational psychoanaly­ sis.”7 T h e stream th a t calls itself “relational psychoanalysis” carries along w ith in it m any diverse currents: th e in te rp erso n alist one, o f course, b u t also constructivist, fem inist, a n d object relations form s o f explicitly rela­ tio n al theory. In his overview o f th e relational field, th e relational psy­ choanalyst Lewis A ro n inclu d es even c o n te m p o ra ry in te rsu b je ctiv ist versions o f self psychology in th e stream o f “relational psychoanalysis.”8 In my view, however, th e self psychology stream ru n s q uite independently, a n d it will be som e tim e before th e two stream s agree o n a co m m o n language and a m erger o f perspectives a n d energies.9 Let m e o u tlin e briefly my sense o f th e m ajor differences betw een these two stream s o f con tem p o rary relational psychoanalytic theory. First, they have differen t histories. In terp e rso n a list th eo ry is th e strongest force w ith in th e w ide, eclectic stream th a t calls itself “relational psychoanaly­ sis.” W ith in this stream , in te rp erso n alist th eo ry m eets object relations th eo ry (as well as fem inist a n d constructivist theories) a n d a m a lg am ate s/ tra n s fo rm s it. T h e s e c h an g e s are w ro u g h t d iffe re n tly by d iffe re n t relationalists, b u t in general, in this stream , object relations th eo ry (theory

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a bout the intrapsychic interactions o f various images o f self and other) becom es a com plem ent to active, here-and-now, interpersonalist ways o f engaging in the therapeutic dialogue. T h e theory proves useful as it pro­ vides m etaphors for whatever it is th a t’s going on inside the patien t th a t also makes the therapy interaction go on in certain ways. By contrast, the history o f self psychology shows little interpersonalist influence. It also has a different relationship w ith object relations theory, having taken the theory m ore literally and sought to transform it directly a n d coherently. For exam ple, H einz K ohut, th e fo u n d e r o f th e self psychological m ovem ent, invented th e term “selfobject” in order to focus a tten tio n on a particular kind o f in n er interaction betw een images o f self and others (“objects”). T his “selfobjcct” kind o f in n er interaction is an experience o f self-with-other th a t invisibly sustains a self from infancy onward. He believed his idea tilled an im p o rta n t gap in object relations theory, a gap in understan d in g the treatm en t needs o f patients w ho were m issing the experience o f th a t self-sustaining relationship w ith an o th e r person. K ohut’s ideas took o n a life o f th eir own, however, as early self psy­ chologists kept o n exploring the selfobject relation and how it is created by the analyst’s subjective em pathic im m ersion in th e patien t’s subjective experience. As self psychologists saw m ore clearly how this space o f “em ­ p a th y ” is actually c o n stru c te d by two in te rac tin g subjectivities, th e intersubjective school o f self psychology emerged. It’s at this p o in t th at self psychology began to m ature into the fully and explicitly relational theory th a t I refer to in this text. In short, self psychology slowly found its way toward the question, “W h a t’s happening in the therapeutic relationship?” while form s o f th at question had been o n the interpersonalist agenda from its beginnings. T h at question m arked Sullivan’s break from the classical Freudian tradi­ tion. He and his colleagues w ent on to expand the terrain o f psycho­ analysis outside o f m edicine and psychiatry, especially w ith the founding o f the W illiam A lanson W hite Institute in New York in the 1940s. T he inclusion o f Ph.D .s as faculty and students o f th a t Institute, along w ith the In stitu te’s historical co m m itm ent to freedom o f th o u g h t and its op­ position to the constraints o f the A m erican psychoanalytic establishm ent, created m uch space for philosophical and social understandings o f the psychoanalytic enterprise. Over the years, various interpersonalist ana­ lysts have integrated existentialism , herm eneutics and phenom enology, social and linguistic constructivism , and fem inist and post-structuralist th o u g h t into th eir constructions o f psychoanalytic theory.

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In m any ways th e m ovem ent th a t calls itself relational psychoanaly­ sis is a direct c o n tin u a tio n o f th e energies em b o d ied in th e W h ite Insti­ tute. For exam ple, graduates o f th e In stitu te fill p o sitio n s o n th e editorial b o ard o f Psychoanalytic Dialogues a n d th e faculty o f th e relational stream o f th e p ostdoctoral program in psychoanalysis at New York U niversity. A n d so w hat I am recognizing as “relational psychoanalysis” carries for­ w ard th e in terp erso n alist c o m m itm e n t to philosophical e x p loration and social critique. C o n siste n t w ith this c o m m itm e n t is th e em phasis rela­ tional psychoanalysis places o n th e m u tu a l c o n stru ctio n o f m ean in g in th e analytic rela tio n sh ip —th e d e co n stru c tio n o f a p a tie n t’s destructive, co n strain in g lite-m eanings, a n d th e re co n stru c tio n o f a narrative th a t provides m ore personal satisfaction a n d agency in th e w orld. By contrast, relational self psychology focuses less o n th e transfor­ m atio n o f lived m ean in g in analysis a n d m ore o n th e tran sfo rm a tio n o f self-experience, especially th e experience o f self in relation to others. It can be argued th a t th e re ’s fun d am en tally n o t m uch difference betw een trying to change a p a tie n t’s unco n scio u s organizing p rinciples o f self-ex­ perience a n d trying to change a p a tie n t’s unco n scio u s personal m ean­ ings. Perhaps th e two stream s m ight fin d a p o in t o f m erged p u rp o se a n d language here. However, in c u rre n t practice th ere rem ain significant dif­ ferences betw een a self psychological focus o n (re)developing organizing p rin c ip le s o f self-w ith-other e x p erien c e a n d a re la tio n a list focus o n (re)constructing m ore useful relational m eanings by w hich to live. I th in k th a t these differences com e dow n to differences betw een th e worldviews o f m edicine a n d o f th e h u m an itie s a n d social sciences, o r betw een a relatively “objective” scientific view a n d a m ore self-consciously c o n stru cted ph ilo so p h ical (lately p o stm o d ern ) view o f psychoanalysis. W ith its historical links to th e A m erican m edical psychoanalytic estab­ lish m e n t a n d its source in object relations, self psychology ten d s to couch its u n d e rsta n d in g o f a p a tie n t’s self-experience in som ew hat sc ien tific / m edical term s ra th e r th a n in philosophical term s. O bject relations theory, a m edical m odel o f psychoanalysis, ta u g h t self psychology to locate a p a tie n t’s pathology in dam aged o r stu n ted in te rn al psychological struc­ tures o r functions, a n d to u n d e rsta n d this pathology as a d irect result o f faulty' interactions w ith early caregivers. A lthough self psychology has m ade radical changes to this p icture o f pathology, it c o n tin u e s to see its new a n d developing p icture o f personality developm ent, pathology, a n d treat­ m e n t as “tru e ” in a relatively objective, scientific sense.

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Interpersonalist theory taught “relational psychoanalysis” th a t pa­ thology is located in faulty patterns o f m aking m eaning o u t o f interper­ sonal interactions, and th a t these patterns are best addressed directly a nd in the present, so th a t the patien t can com e to un d erstan d w hat’s going o n and take responsibility to deconstruct the old m eanings and construct new ones. “R elational psychoanalysis” now works in subtle, ind ep th ways w ith regression and transference—w ith powerful, unconscious m anifestations o f early traum a as they becom e lived in the therapy rela­ tionship. O ften analysts o f this school use object relations language about a p a tie n t’s parts o f self, defenses, and projections in order to understan d a nd explain th eir clinical work. But the explanation rem ains a tool, a m eaning-m aking m etaphor. T h ere’s not the atten tio n self psychology pays to infant studies about m utual attu n e m e n t and form s o f dyadic interac­ tion; th ere ’s n o t th e self psychological search for ever m ore reliable tem ­ plates o f optim al developm ent, the better to u n d e rstan d pathological developm ent in infancy and childhood a n d the possibilities for new opti­ mal developm ent in adulthood; and, o f course, th ere ’s n o t th e concom i­ ta n t d a n g er self psychology always faces (danger from a re la tio n a l perspective) o f being pulled back into a m edical m odel o f an expert doc­ to r w ho treats a p a tie n t’s objectively understood pathology. So m uch for the contrasts betw een these two m ajor stream s o f rela­ tional psychoanalytic theory. I’ll go o n soon to expand on each o f them in its own term s. But first let me say th at if you are a new stu d e n t of relational psychoanalysis or psychotherapy you would do well to realize two things. First, you should know th a t your relationalist m entors were m ost likely first trained in interpersonalist a n d /o r object relations theo­ ries, and th a t those theories rem ain an im p o rtan t background to their th inking about th eir work. In th eir own developm ent as clinicians and theorists, your relational m entors w ould have first sought ways to m ore fully “relationalize” those theories in th eir practice. T his is the way rela­ tional theory cam e into being. T he second th in g for you to know, th en , is th a t if you choose to step into a cu rre n t stream o f relational theory, you w on’t really know w hat this stream carries w ith it, especially u n d e r the surface, unless you know where it cam e from . I’m suggesting th a t a seri­ ous, sustained look into object relations theory and interpersonalist theory can only enhance your u nderstanding o f whatever relational psychoana­ lytic position you find yourself draw n to.

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M O R E A B O U T “R E L A T IO N A L P S Y C H O A N A L Y S IS ” Since the days o f H arry Stack Sullivan, the interpersonalist school has m aintained th a t a person’s learned interpersonal pattern s o f interaction are at the ro o t o f his psychological problem s. Inevitably, these patterns will be p u t into play betw een a client and his therapist, and so paying atten tio n to w hat happens in th a t relationship is the best way to find o u t w hat the psychological problem is and how it works. Paying atten tio n also starts the process o f changing the patterns o f interaction betw een these two participants in the therapy, and change th at happens in the therapeutic relationship will have a powerful im pact on the rest o f the client’s relationships and self-experience. C o n tem p o ra ry relational psychoanalysts m ove beyond th e early interpersonalists w hen they say th a t a therapist can n o t stand outside o f the therapy process as a neutral “particip an t-o b serv er” in order to o b ­ serve a client’s patterns w ith com plete objectivity. T hey recognize, instead, th a t client and therapist are b o th involved in the m utual construction o f th eir relationship. Very intentionally, they replace a one-body psycho analysis w ith a two-body o r (as I’ve been saying) a self-with-other m odel. Lewis A ron, for example, writes extensively ab o u t the inescapable m utu­ ality o f th e psychoanalytic process.10 O w en R enik’s m etap h o r for the therapist’s engagem ent in the therapy process is “playing w ith your cards face-up.”11 D arlene E hrenberg challenges relational therapists to push the therapeutic conversation to th at “intim ate edge” w here client and thera­ pist are having strong, if h id d en , reactions to one an o th e r m om ent by m o m en t.12 W hile proposing a radically relational m odel o f m utual interaction between client an d therapist, analysts o f this relational stream m ust also p u t som e words to w hat’s w rong for th eir clients and to w hat happens w hen th eir clients start to change for the better. As I noted above, many o f th em use object relations language to describe w hat they m ight call the intrapsychic aspects o f the client’s experience. In a series o f influential books, Stephen M itchell explores how theories o f intrapsychic reality— b o th classical and object relations theory—can be understood in term s o f a fundam entally relational theory o f psychoanalysis.1’ Jessica B enjam in’s work is an o th e r good exam ple o f creative inclu­ sion o f object relations language w ithin a relational imperative. H er theory refuses to collapse into each o th er the term s o f intrapsychic (inside-self) and intersubjective (self-with-other) reality. From B enjam in’s explicitly fem inist perspective, intersubjectivity is an achievem ent o f m utual recog­

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n itio n betw een two subjects—a fragile, paradoxical relational achievem ent th a t is always at risk o f breaking dow n in to th e u n h e alth y “m atc h ” o f relations o f d o m in a tio n , w here o n e p erso n (often fem ale) serves as object to th e o th e r’s (often m ale) subjectivity. T hese breakdow ns, w ith th e ir fantasies o f objectified o th ers w h o are n o t know n as subjects, a n d w ith all th e ir u n n e g o tia te d injuries, conflicts, a n d frustrations, p roduce m uch o f th e m aterial o f intrapsychic reality, B enjam in says. B enjam in does n o t suggest th a t psychoanalysis o r fem inist social action can p roduce a u to p ia o f intersubjective relations. H u m a n beings m ust assert them selves w ith each oth er; aggression is a psychological real­ ity; conflicts o f needs a n d o f wills are unavoidable. B reakdow ns will keep h a ppening, a n d intrapsychic co n stru ctio n s o f reality will rem ain power­ ful a n d form ative. B enjam in’s p o in t, rather, is th a t we do well to sustain th e ten sio n o f recognizing o n e a n o th e r as subjects, w orking th ro u g h o u r conflicts, know ing th a t breakdow ns o f m u tu a l recognition are inevitable, a n d also always h o ld in g th e possibility o f negotiating repair betw een a n d am ong u s.14 B enjam in’s w ork illustrates th e ro o m th ere is for creative theorizing w ith in th e relational psychoanalytic stream . I take note o f h e r positio n for a n o th e r reason, too: it stan d s as an im p o rta n t critique o f fem inist therapy th eo ry th a t w ould sim ply reverse th e term s o f d o m in a tio n and exclude “m asculine” aggression from a fem inine w orld o f harm ony. T he w ork o f Laura Brow n a n d o f th e S tone C e n te r theorists is som ew hat v u lnerable to such a critique. B en jam in ’s p o sitio n also rem inds relational therapists th a t those in te rp erso n al strategies o r negative expectations o f th e o th e r th a t c o n strict a n d tro u b le th e ir clients’ lives can take o n intrapsychic substance; w hat starts o u t as sim ple deficits o r efforts to repair can becom e com plex feelings, fantasies, a n d sym ptom s th a t perm eate th eir clients’ psychological experience. B enjam in protects space for intrapsychic reality, b u t h e r vision o f intersubjectivity d em an d s th e personal, relational presence required by all relational psychoanalysis. W h e n analysis goes well, analyst a n d pa­ tie n t will sustain as best they can th e ten sio n o f th e ir struggle to create a relatio n sh ip o f m u tu a l self-assertion and re cognition o f th e o ther. In this vision o f relational w ork, it is in th e c lie n t’s best interests th a t th e th era ­ pist be a subject w ho com m unicates a n d negotiates directly w ith th e cli­ ent, m aking space for th e clien t’s reciprocal subjectivity, n o t an object w h o provides for th e c lie n t’s needs. From this fem inist p o in t o f view, as from m ore interp erso n alist, social c o n stru c tio n ist, ex istentialist, dialectical, a n d po st-stru ctu ralist

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p o in ts o f view, relational psychoanalysis agrees th a t th e problem s clients bring to therapy have their roots in clients’ problem atic or traum atic rela­ tio n sh ip s w ith others, past a n d present. Insight ab o u t th o se relationships does n o t in itself make change h ap p en . C h a n g e h appens th ro u g h experi­ ence, all o f these versions o f relational psychoanalysis m aintain, and it hap­ pens m ost forcefully th ro u g h experiences o f re lationships th a t em body a n d en act d ifferen t m eanings th a n relationships once did for th e client. S te p h en M itchell, th e best k n ow n c o n tem p o rary spokesperson for relational psychoanalysis, argues th a t th e relational analyst’s expertise lies solely in h e r ability to engage th e client in th e active creation o f new lifem eanings, m eanings th a t offer h im a w ider range for personal engage­ m en t, au thenticity, a n d free d o m .15 A n d so th e relational analyst tries to find th e best m ix o f safety and challenge in how she relates to each client, in o rd e r to keep each clien t actively involved in th e therapy. A relational analyst d o e sn ’t expect th a t any particu lar n o tio n a b o u t developm ental process will be tru e for a particu lar client. B ut she offers differen t ideas as tools w ith w hich a client may c o n stru ct his ow n m eaningful narratives a b o u t his experiences. S he w o n ’t serve up any particular m eanings as tr u th for th e client, because for h e r w h a t m atters is th e a u th e n tic process o f m aking m eaning, and m aking it in re lationship. T his is w h a t gets a client sprung free from old, constricting m eanings. T his is w hat gets change happening. D oing this process together produces th e transform ative power o f therapy. C learly th e process o f relational psychoanalysis is n o t a pro­ cess u n d e rta k e n by an isolated m in d , n o r are its m eanings sim ply the pro d u cts o f linear, ra tio n al th o u g h t. So w ould this k in d o f w ork feel any differen t th a n w orking w ith som eone co m m itte d to a S tone C e n te r self-in-relation model? It’s likely th a t certain differences w ould em erge. First o f all, for relational psycho­ analysis, th e m utuality o f a therapy relatio n sh ip isn’t a m oral issue, as it ten d s to be in S to n e C e n te r th o u g h t. In relational psychoanalysis, m u tu ­ ality isn’t a desired state o f being-together th a t signals successful th era ­ peutic w ork. In its basic form , m u tu al in flu en ce betw een persons is ju st an inescapable fact: in any relationship, it’s im possible for two persons n o t to affect o n e a n o th e r in countless overt a n d su b lim in al ways all th e tim e. For b o th participants, this m u tu al in flu en ce m ight feel q u ite good— o r it m ight feel q u ite h o rrib le. Even in Jessica B enjam in’s m ore n o rm a ­ tive sense o f m utuality, m u tu a l reco g n itio n is a ten u o u s, paradoxical achievem ent, by its n a tu re always vulnerable to forces o f breakdow n, ag­ gression, a n d d estru ctio n , forces th a t never disappear from h u m a n rela­ tio n s o r from th e psychotherapy relationship.

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So th e re la tio n a l analyst w o n ’t c o n c e n tra te o n h e lp in g a c lie n t m ove fro m th e “b a d ” o f d is c o n n e c tio n to th e “g o o d ” o f c o n n e c tio n , fro m isola­ tio n to a steady state o f m utu ality . S h e ’ll assum e th a t som e k in d o f c o n ­ n e c tio n a n d m u tu a lity will h a p p e n , so m e m ix o f useful a n d destructive form s o f relating. S h e ’ll w ait to see w h a t tro u b le so m e k in d s o f m u tu a l in flu e n c e w ill em erge in th e th e ra p y re la tio n sh ip , so th a t sh e can b e tte r u n d e rs ta n d th e m a n d , th ro u g h th e p u sh es a n d pulls o f h e r ow n subjec­ tive eng ag em en t, h e lp to tra n sfo rm th e m in to a th e ra p e u tic re la tio n sh ip th a t m akes m o re space for th e c lie n t’s k n o w in g o f self a n d o f o th ers. A re la tio n a l psychoanalyst w o n ’t assum e th a t less c o n stric ted ways o f b e in g to g e th e r will always feel g o o d . Less c o n stric tio n m eans a w id er range o f possibilities, w h ich m ig h t m e a n new space for d isa p p o in tm e n t, aggression, a n d anger. T h e th e ra p is t w ork in g from a re la tio n a l psycho­ analytic p erspective w o n ’t isolate th e e x p erien ce o f c o n n e c tio n as th e re aso n for a c lie n t’s grow ing e m o tio n a l h e alth . S he will u n d e rs ta n d th a t feeling m o re c o n n e c te d is b u t o n e o f m any new experiences o p e n to a c lie n t as h e sta rts to e x p erien ce self-w ith-other differently. H e m ig h t ju st fin d new ways to s ta n d o n his o w n tw o feet, to speak his ow n tr u th , a n d to p u rsu e his ow n agendas. In sum m ary, a re la tio n a l psychoanalyst c o u n ts o n th e th e ra p y re la tio n s h ip to u n se ttle c lie n ts’ accu sto m e d ways o f being, to stir th in g s u p a n d to get clien ts m oving tow ard new m ean in g s a n d o p tio n s in life. T h is has a significantly d iffe re n t “feel” th a n c o u n tin g o n th e th era p y re la tio n s h ip to pro v id e clien ts w ith a core e x p erien ce o f m ore g e n u in e c o n n e c tio n .

M O R E A B O U T SELF PSY CH O LO G Y W e tu rn no w to self psychology, th e o th e r m ajo r re la tio n a l school o f psychoanalysis. W ith a self psychologist, a c lie n t can always c o u n t o n em p ath y —a c e rta in specific k in d o f re la tio n a l c o n n e c tio n w ith th e th e ra ­ pist. T h era p ists o f th e m ore in te rp e rso n a list re la tio n a l stream believe th a t su ch e m p a th y is a lim ite d , one-way c o n n e c tio n . T oo m u ch e m p a th y can be infantilizing, th e p ra c titio n e r o f “re la tio n a l psychoanalysis” suspects, a n d she believes th a t th e ra p y fo r a d u lts sh o u ld in c lu d e le a rn in g to deal w ith in te rp e rs o n a l p ro b lem s a n d differences, even—o r especially—w h e n th ey o c cu r betw een c lie n t a n d th e ra p ist. A n d so, always k eep in g w ith in th e lim its o f w h a t sh e believes is in th e c lie n t’s best interests, sh e shares h e r th o u g h ts a n d re ac tio n s as they o c cu r d u rin g th e process o f therapy. By c o n tra st, all th e stream s o f th o u g h t w ith in self psychology are w ary o f

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p uttin g m uch o f the therapist’s self into the interaction, at least in its early stages. Why? To answer th a t question, we need to re tu rn briefly to the historical roots o f self psychology. W e’ve noted th a t K ohut invented the idea o f “selfobject” to fill a gap in object relations theory, a gap about how to u n d erstan d and treat patients whose sense o f self is quite fragile and easily depleted or frag­ m ented. He proposed th a t they suffer from deficits o f selfobject experi­ ence—o r experiences o f being able to co u n t o n an o th e r person to take the actions necessary to sustain o n e ’s ow n cohesion, vitality, and self­ esteem. Obviously, these are first o f all parental actions, and such deficits are m ost likely to stem from a p a tie n t’s childhood experiences o f being parented. However, in K ohut’s theory, therapists can step into th a t gap and perform som e o f those essential actions for a while, strengthening the ad u lt p a tie n t’s cohesion, vitality, and self-esteem. O n th e one hand, K ohut’s move is deeply relational. It breaks w ith classical Freudian psychoanalysis and m uch o f object relations theory to say th a t individual autonom y is a bogus therapeutic goal. It says th a t in fact we all d epend o n o thers o u r w hole lives long for o u r psychological a nd em otional well-being. A nd so therapists are n o t infantilizing clients w hen they su p p o rt th eir clients’ legitim ate and im p o rtan t needs to be u nderstood, supported, and affirm ed. In this context it’s easy to see th at m any clients com e to therapy precisely because they have n o t been well enough u nderstood and supported to develop selves th a t are sturdy, co­ hesive, and energetic. A relationship w ith the therapist is w hat creates the m edium in which derailed self-developm ent can begin again.16 O n the o th er hand, however, this classical form ulation o f self psy­ chology is n o t yet a fully relational theory. As analysts from “relational psychoanalysis” and Stone C e n te r theorists p o in t out, this approach is still rather “one-body” (the therapist is involved only as empathy-provider), individualistic (attention is focused o n the client’s self-development), ra­ tionalistic (interpretation in service o f insight is the m ain way o f work­ ing), and linear (self-development follows certain predictable routes w hen the therapist responds in certain prescribed ways). However, a strong cu rre n t w ithin self psychology, m ost visible in the work o f R obert Stolorow, George Atw ood, and D onna O range, has put its energies into exploring the intersubjective context o f the therapeutic relationship. Intersubjective theory and practice seeks to root o u t the m yth th a t it’s an isolated m ind th a t suffers psychological trouble, a myth th a t persists even w hen self psychology says th a t this trouble can be cured through em pathic u n d e rstan d in g .17

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I n te r s u b je c tiv is ts d e s c rib e th e th e r a p e u tic s i t u a t i o n as an “intersubjective field.” T he rules and em otions o f the games played in “th e field” are set up by the interacting subjective worlds o f b o th the therapist and th e client. T he therapist keeps bringing em pathy and a search for understan d in g to the field, b u t th e changes th a t h appen there aren’t simply responses to his em pathy, n o r do they happen just because o f th e client’s new insights o r understanding. M ost im portantly, as thera­ pist and client interact, som ething changes in how the intersubjective dynam ic gets set up and plays o u t between them . T his experienced change in interaction, this “som ething different” in action, is w hat leads to change in the client’s self-experience. H ow ard Bacal’s phrase “optim al responsiveness” brings together the classic se lf p sy ch o lo g ical c o n c e rn fo r a c c u ra te e m p a th y a n d th e intersubjectivists’ awareness th a t therapists keep finding them selves in very different kinds o f intersubjective fields. A therapist seeking to give optim al responses to different clients can’t work according to standard rules for empathy. O n the contrary, as Bacal describes his own work, he tries to respond to each c lie n t in specific ways th a t will create th e best c o n d itio n s for positive change in th is u n iq u e in tersubjective field, th is tw o-person re la tio n s h ip .18 Self psychology has always had a strong developm ental com ponent. K ohut wrote a bout certain trajectories o f childhood self-development th at therapists could su p p o rt w hen the trajectories appeared, belatedly, in therapy. Intersubjective field theory backs itself up w ith studies th a t show how infants and th eir caretakers arc involved in intricate dances of m u­ tual influ en ce.19 Self psychologists are likely to hold in m ind particular developm ental them es in individual experience, noticing in adult clients analogues o f specific patterns o f infant and child behavior. In th eir view, healthy d e v elo p m en t d e p e n d s above all o n c are ta k e rs’ su p p o rtiv e, nonintrusive, em otionally a ttuned responses to a child’s needs. T he Stone C e n te r has a sim ilar m odel o f healthy developm ent, b u t it explains at­ tuned response in term s o f w om en’s ways o f being in em pathic connec­ tion. In contrast to both, “relational psychoanalysis” speaks o f m utual influence in relationships from infancy onw ard, b u t it doesn’t com m it to any developm ental scheme, keeping itself free to work w ith whatever m ight help clients make m eaning o f th eir contem porary experience. H ow does it feel to w ork w ith a self psychologist? I d o u b t it feels m uch different from work w ith a therapist influenced by the Stone C en­ ter, b u t the differences m ight be noticeable. As a self-in-relation therapist does, a self psychological therapist attunes carefully to the details and

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n uances o f th e c lie n t’s experience, w h e th er it be past o r p re sen t experience outsid e o f therapy, o r w h a t’s h a p p en in g in th e th erap y room . He strives for an accurate em p ath ic c o n n ec tio n w ith th e clien t’s th o u g h ts a n d feelings. His em p ath ic im m ersion in th e c lie n t’s experience will help th e client develop a sense o f c o n n ec tio n w ith him a n d also help her c o n n ec t b etter w ith h er ow n self-experience. U nlike a self-in-relation therapist, however, a self psychologist u n ­ d erstan d s these co n n ec tio n s n o t as en d s in them selves b u t ra th e r as ways to help th e clien t redevelop how she can be h e r ow n self in th e w orld, especially in th e w orld o f h e r relationships w ith others. T his self, he be­ lieves, can have m any kinds o f positive self-w ith-other experiences in ad­ d itio n to th e experience o f co n n cc tio n . A n d so, in n o h u rry to achicvc a “c o n n e c te d ” feeling, a self psychologist investigates carefully th e dynam ­ ics a n d m eanings o f in teractio n s w hen a clien t feels afraid o f h im o r h u rt by h im . He helps th e client notice w hen particu lar relational experiences in a n d o u t o f therapy leave h e r feeling fragm ented, shaky, o r d ish e art­ ened, a n d he trusts th a t this u n d e rsta n d in g will help h er regain w hatever c o n n ec tio n —o r strength, eq u ilib riu m , o r energy—she needs. T h e differences betw een self psychological th erap y a n d th e therapy o f “relational psychoanalysis” lie along o th e r lines. R elational psycho­ analysis d o u b ts th a t em pathy u n b ro k e n by experiences o f difference and challenge is th e best facilitator o f grow th a n d developm ent. T h e rela­ tio n al analyst d o e sn ’t th in k o f h erself as a tem porary stand-in for faulty parents, a n d she d o e sn ’t just u n d e rsta n d h e r c lie n t’s self-protections u n ­ til he n o longer needs to use th em . As a m ore proactive p a rticip a n t in h er clien t’s therapy, she will share w hat she th in k s a n d feels in th e therapy, a n d sincc she docs n o t w ork in term s o f a developm en tal m odel th a t always sees th e h u rt child in th e anxious ad u lt, she w orries less th a n a self psychologist m ight a b o u t w h e th er a client is ready to hear w h a t she has to say. By contrast, a self psychologist will stick to his em pathy for all th e differen t ways clients p ro tec t them selves from fu rth e r injury. H e m ight explain his u n d e rsta n d in g th a t they learned th e ir self-protections in d a n ­ gerous circum stances. H e m ight sketch for th e m a c o n tra stin g p icture o f circum stances in w hich ch ild ren get w h a t they need from caregivers so th a t they can tru st people m ore a n d expect m ore from life. H e will w ant to explore w ith clients th e ir th o u g h ts, m em ories, a n d feelings ab o u t w hat they m issed in th e ir form ative years, a n d he will have n o qualm s ab o u t providing for th e m som e o f th e sccurc a tta c h m e n t they crave. Classical self psychologists believe th a t h elping clicnts achicvc in­

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sight a b o u t th e ir unfulfilled needs will help repair self-deficits th a t cli­ ents still experience. A m ore relational self psychologist believes th a t a relationally “o p tim a l” way o f being w ith a client can, all by itself, help fill in som e o f th o se gaps. For exam ple, for clients neglected by distracted, depressed parents, a sp o n ta n eo u s, interested, talkative way o f being m ight be very im p o rta n t. O n th e o th e r h a n d , a client w ith intrusive, d e m a n d ­ ing p arents a n d o ld er siblings m ight find a silent, n o n in tru siv e presence ju st w hat she needs for long stretches o f tim e. T hese tailor-m ade ways o f being-w ith are extensions o f th e self psychologist’s em pathy, v ariations o n w hat th e relational self psychologist H ow ard Bacal w ould call optim al responsiveness. M any self psychologists, w hile they know th a t th e conccpt is slippery (w hat’s “o p tim a l”?), find th a t th e con cep t o f op tim al re­ sponsiveness catches th e sp irit o r feel o f self psychological work.

TOWARD A SYNTHESIS OF RELATIONAL THEORY D espite th e differen t em phases o f th e relational schools we’ve looked at, I still believe th a t self-in-relation theory, “relational psychoanalysis,” a n d self psychology are fun d am en tally m ore alike th a n d ifferen t in w h a t they have to say a b o u t how relational psychotherapy works. In later chapters, I will be draw ing o n all o f these resources as I in tro d u c e th e principles o f relational practice. I will take a m o m e n t here to show how, in spite o f th e ir differences, they each add so m e th in g to e n h an c e a relational pic­ tu re o f therapy. W e will look in o n Jane o n e last tim e. S he’s w ith an eclectic relational th era p ist w h o is using several relational m odels to u n ­ d erstan d th e ir w ork together. S tone C e n te r th eo ry helps th e th era p ist u n d e rsta n d how Jane uses strategies o f care-taking a n d co m petence to stay in a sem blance o f rela­ tio n sh ip w hile keeping herself o u t o f m ore v u lnerable k inds o f connec­ tio n in w hich she m ight get h u rt. H er strategies, however, are w reaking long-term havoc w ith h er em otional well-being. W h e n h e r relational th era­ pist th in k s along S tone C e n te r lines, she know s th a t Jane will be helped th ro u g h re co n n e ctio n —w ith th e therapist, w ith herself, a n d w ith o th ers in h er life. R elational psychoanalysis helps th e th e ra p ist notice how these selfprotective a n d self-destructive strategies are played o u t again a n d again betw een Jane a n d herself. A n d so th e th era p ist keeps trying to establish real c o n n ec tio n w ith Jane, even if th a t som etim es m eans p u ttin g h e r ow n feelings o n th e table o r challenging Jan e’s strategies. B ut, retain in g a self

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psychological sensitivity, th e th era p ist is careful never to stray far from an em p ath ic grasp o f Ja n e ’s experience, a n d especially o f h er experience o f th e therapy. She know s th a t if she is to provide th e su p p o rt th a t will help Jane grow stronger, she c a n n o t u n d e rc u t o r second-guess Ja n e ’s experi­ ence o f reality. D evelopm ental self psychological theories tell th e therapist how Jane’s strategies for self-protection com e from u nconscious principles th a t orga­ nize how she m akes sense o f h e r life experiences, be they large o r sm all, trau m atic o r benign. T h in k in g developm entally, Jan e’s th era p ist sees how h e r disco n n ectin g strategies are b u t o n e p a rt o f Jan e’s com plex a n d deepseated way o f being a self in th e w orld. T his is w hat Jan e’s relational psychotherapy is taking on: h e r deeply in grained p a tte rn s o f being a sclfw ith-othcrs. Intersubjectivity th eo ry increases th e com plexity o f th e scene expo­ nentially w hen it notices th a t n o t only Ja n e ’s organizing p rinciples b u t also her therapist’s organizing principles are creating th e field w ithin which th e therapy will be played out. Each p a rtic ip a n t’s strategies for safe con­ n ectio n a n d safe d isc o n n ec tio n will m atch, miss, excite, a n d u p set the o th e r’s strategies, as each p a rticip a n t w orks tow ard being u n d e rsto o d a n d u n d e rsta n d in g th e o ther. As Jane starts to feel better, S tone C e n te r th eo ry will p o in t o u t to th e th era p ist th e developing good c o n n ec tio n betw een h erself a n d Jane a n d betw een Jane and m any o th ers in h e r life. “R elational psychoanaly­ sis” will p ro m p t h e r to celebrate Ja n e ’s developing ability to create new life-m eanings for herself, full o f new possibilities for in te rp erso n al en ­ gagem ent, au thenticity, a n d freedom . A n d from a self psychological per­ spective, th e th era p ist will u n d e rsta n d Ja n e ’s progress as differen t kinds o f re-developm ent a n d new develo p m en t o f self. Classical self psychology puts th a t self-developm ent in term s o f posi­ tive selfobject transferences h o lding firm for Jane, giving h er security while h er self grows stronger. Bacal roots it in th e m any good experiences o f self-with-other, elicited by a th e ra p ist’s optim al responsiveness th a t Jane needs in o rd e r to thrive. As we shall see in m ore detail in C h a p te r 6, self psychologists believe th a t if Ja n e ’s th era p ist can anticip ate th e differen t a n d som etim es su rp risin g form s good c o n n ec tio n can take betw een the two o f th em , she will be able to w ork m ore com fortably a n d productively w ith these positive pow ers as they are un leash ed . A n d th a t will give Jane even m ore room to get stronger, to shine, a n d to enjoy p articip atin g in life. I’m using this last look at Jane to sketch th e possibility o f a rela­

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39

tio n al psychotherapy th a t draws q u ite freely o n differen t schools o f rela­ tion al theory. T h e relational therapy I’m w riting a b o u t isn’t to be fo u n d in only o n e o f th e relational schools. Each school has its lim its, I believe. For exam ple, striving for im m ersion in th e c lie n t’s experience can fool self psychologists into th in k in g th ey ’re n o t in th e p icture o f w h a t’s hap­ p en in g right th ere in th e room . O n th e o th e r ha n d , th e q uestion, “W h a t’s going o n a ro u n d here?” can be to o th rea te n in g for a client to face, o r else e norm ously com plex as it’s u n tan g led in relational psychoanalysis. Som e­ tim es clients d o n ’t w ant o r need to know m u ch a b o u t this com plexity as long as th e relatio n sh ip is w orking well en o u g h for th em . A t th e sam e tim e, however, user-friendly S tone C e n te r theory, w ith its em phasis on c o n n ec tio n , w ears a bit th in w ith o u t th e technical su p p o rt o f psychoana­ lytic theory, especially w hen th e th era p eu tic c o n n ec tio n is full o f ru p ­ tures a n d c o n u n d ru m s. A n d so I treasure my freedom to be b o u n d by no school b u t to try to w ork o u t a useful synthesis o f these d ifferen t rela­ tio n al theories. A n eclectic o r synthetic th eo ry has its lim its, too, perhaps in h e re n t in n o t p u ttin g any o n e th eo ry in to practice w ith single-m inded passion. A n o th e r o f th e in h e re n t lim its o f any relational app ro ach lies in th e fact th a t so m uch th a t is w rong for o u r clients is w rong because o f th e rela­ tio n s o f d o m in a tio n th a t p erm eate th e ir social w orlds, a n d ours. O u r society does n o t teach us to recognize each o th e r as subjects across o u r differences o r to negotiate o u r separate in te n tio n s a n d desires w ith m u ­ tual respect. M any o f us w ho are draw n to relational psychotherapy w ork are also deeply co n ce rn ed a b o u t this larger pictu re o f relational break­ dow n. Som etim es w orking w ith o n e client at a tim e can seem like trying to em pty an ocean w ith a bucket. B ut we persist. As we have seen, rela­ tio n al therapists o f various persuasions speak o u t a b o u t th e social and political contexts a n d m eanings o f th e ir w ork.20 It’s clear to m e th a t any relational th erap y w o rth th e nam e m ust at least deal honestly w ith th e effects o f differing social powers u p o n th e life experience o f o u r clients a n d u p o n th e c o n stru ctio n o f th e social relation o f psychotherapy as it develops betw een each clien t a n d ourselves. O th e r factors th a t co n stru ct a n d therefore lim it any p ra ctitio n er’s relational th eo ry are th e givens o f his o r h e r personal a n d professional history. As we’ve seen in th e last p a rt o f this chapter, relational th eo ry ab o u t psychoanalysis and psychotherapy is a do m ain o f m any diverse waters a n d m u ch eclecticism even w ith in d e fin e d stream s o f practice. All o f us relationalists have o u r ow n ways o f locating ourselves w ith in th is com ­ plex dom ain. Now th a t I have described th e com plexity o f relational theory,

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the tim e has com e for m e to acknowledge, as clearly as I can, my bias w ith in it.

MY THEORETICAL BIAS I have been influenced by each o f the relational schools, b u t I have been m ost profoundly and thoroughly influenced by self psychology, especially the intersubjectivity and infant d evelopm ent branches o f self psychologi­ cal theory. H ow d id this h appen—w hen I am a w om an com m itted to the challenges and joys o f co nnection (a natural for Stone C en ter theory) and a Ph.D . by way o f a thesis o n the intersection o f post-structuralist educational theory and relational psychoanalysis? It happened, I th in k , because my first training in psychotherapy, in b o th a faculty o f social work and a private therapy training institute, was in object relations theory. I learned to th in k about therapy through those developm ental and quasi-medical categories, and as I pursued my special interest in w orking w ith traum a survivors w ho were classified as “border­ line,” the self psychology th a t was just th e n em erging o u t o f object rela­ tions theory gave me m ore and m ore o f w hat I needed to un d erstan d my work w ith my clients. How m ight I have structured my u n d erstan d in g o f relational therapy if I had started in a different place? O r w ith a different client population? I’ll never know —and we all have to start som ewhere. T h ere’s m ore to th e story, for self psychology has influenced me not only professionally, b u t also personally. O ver the years I have been a cli­ e nt (or patient) in several different kinds o f therapies, short-term and long-term, expressive and analytic, and the therapists w ith w hom I con­ nected m ost usefully were them selves influenced by self psychology. M ost recently I have been in a long-term psychoanalysis w ith a self psycholo­ gist. In th a t relationship I have grown stronger, m ore authentic, and m ore alive in myself and in my connections w ith others, and I have un d er­ stood my grow th in theoretical term s th a t I have com e to share w ith him —term s th a t belong to an intersubjectivist, developm ental self psy­ chology. As generations o f therapists and analysts can testify, th ere ’s n o th ­ ing m ore deeply form ative o f a certain u n d erstan d in g o f therapy than a powerful and positive experience “inside” it. O f course I can find su p p o rt for my bias. In my experience as bo th client and therapist, I’ve becom e convinced th a t em pathy creates a better context for grow th and change th a n explanation or con fro n tatio n does. I’ve found th a t I can hope for “c o n n ec tio n ” w ith very frightened clients,

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41

b u t w h a t I n e e d m o s t to c a r ry us t h r o u g h h a rd tim e s is so m e intersubjectivist u n d e rsta n d in g a b o u t how’ we in h a b it disco n n ected rela­ tio n al spaces together. I believe th a t th e p ro fo u n d changes facilitated by relational therapy can best be u n d e rsto o d as changes in th e experience o f self-with-other. T hese m utative experiences d o n ’t n eed to be co n stru cted o r rem em bered as new m eanings; perhaps they d o n ’t even n eed to be th o u g h t a b o u t consciously. T h a t’s because p ro fo u n d new relational expe­ rience itself engenders change in w h a t’s relationally possible for a person. A n d finally, I believe th a t in fan t studies, th o u g h observer-constructed a n d culture-specific, reveal so m eth in g reliable a b o u t how form ative inter­ personal dyads w ork a n d a b o u t how in te rp erso n al develo p m en t goes off track a n d can be b ro u g h t back o n track in a th era p eu tic dyad. All o f these convictions will d e te rm in e how I go o n to tell th e story o f how relational psychotherapy works. My bias will sh in e th ro u g h clearly. I m ig h t say t h a t for all o f th e s e re a so n s 1 am m o st d ra w n to intersubjectivist, developm entally-m inded, self psychological relational theory. B ut th e tru th , I th in k , is th a t my bias constructs even th e “rea­ so n s” I use to su p p o rt it. My bias has certainly helped c o n stru ct my sketch o f th e Big Picture o f con tem p o rary relational psychoanalytic theory. So it goes w ith bias a n d theorizing. If you are new to relational theory, you need to know th a t bias is inevitable in this com plex field. As you try to find your way in it, it will be im p o rta n t for you to u n d e rsta n d how vari­ ous biases shape various m odes o f relational theory. It will be im p o rta n t th a t you pay a tte n tio n , over tim e, to your ow n biases and to how they d e te rm in e w hat you u n d e rsta n d a n d w hat you w ant to pursue. O n th e w hole, it behooves relational therapists to rem em b er th a t even th e ir th eo ry is a relational activity, a sclf-w ith-othcr p h e n o m e n o n th a t em erges from in te rac tio n a n d is held in being—for a w hile—in com ­ m unities o f shared th o u g h ts a n d experiences. A fter a w hile, th e ir th eo ry will be o n its way to new interactio n s a n d new co n stru ctio n s. K now ing all o f this, relational ists can b o th th ro w them selves in to th e creative tussle o f theo rizin g a n d also rem em ber to h o ld th e ir theo ries lightly.

T H E R E L A T IO N A L V IS IO N : R E P R IS E In spite o f all its biased diversity an d eclectic complexity, relational theory does rest o n som e shared givens, o n w hat we m ight call a c o m m o n rela­ tion al bias, a n d in o rd in ary language it goes so m eth in g like this: All h u ­ m an beings are in d ee d creatures form ed by th e ir social contexts. T h ere ’s

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n o escaping th is reality. B ut som etim es som e o f us have o p p o rtu n ities to reflect on w hat form s us, a n d th ro u g h th a t reflection, to m ake room for changes we hope for. T herapy offers such o p p o rtu n ities. As a relational therapist, you will offer a clien t a p articu lar k in d o f o p p o rtu n ity to grapple w ith th e relational forces th a t have form ed him . You will offer him th e chance to engage in a relatio n sh ip th a t will p u t tho se forces in to play. It’s a real relationship, an d your ow n form ative forces will be in it, too. In this relationship, for his benefit, you will re­ flect together o n his past an d p resent experience in th e w orld and o n w hat th e two o f you experience together. You will h o p e for new m eanings to em erge, a new narrative th a t makes better sense o f his experiences, an d a new way o f being in relationship together. You will ho p e, ultim ately, th a t this will all lead to significant changes in how he can experience h im self in his social contexts—as less depressed an d anxious, as m ore c o n n ected an d alive, m ore secure, m ore able to to lerate risk an d loss, m ore em path ic w ith others, m ore co n fid e n t in his ow n agendas, an d m ore firm ly co m m itted to im p o rta n t values an d ideals. N o n e o f these hopes for change is u n iq u e to relational therapy. W h a t’s u n iq u e ab o u t relational therapy, in all o f its in carn atio n s, is how it proposes to get to tho se changes—th ro u g h a relatio n sh ip lived o u t for real, together, betw een you a n d your client. T h is relatio n sh ip is a m u tu al risk, a jo in t co m m itm en t, an interactive process, a sh ared journey. T h e rest o f this b o o k tells th e story o f th e journey.

ENDNOTES 1. Freud’s writings arc collccted in a multi-volume work: Sigmund Freud, The Standard Edition of the Complete Psychological Works of Sigmund Freud, translated by James Strachey and published between 1953 and 1966 by Hogarth Press, London. 2. See Carl Jung and Marie-Louise von Franz, Eds., Man and His Symbols (New York: Doubleday, 1964). 3. Carl Rogers, Counseling anti Psychotherapy (Boston: H oughton Mifflin, 1942), and On Becoming a Person (Boston: H oughton Mifflin, 1961). 4. Michael W hite and David Epston, Narrative Means to Therapeutic Ends (New York: W.W. Norton & Co., 1990). Also of interest: Sheila McNamee and Kenneth J. Gergen, Eds., Therapy as Social Construction (Newbury Park, CA: Sage Publications, 1992). 5. Laura Brown, Subversive Dialogues: Theory in Feminist Therapy (New York: Basic Books, 1994). 6. Judith V. Jordan, Alexandra G. Kaplan, Jean Baker Miller, Irene P. Stiver, and Janet L. Surrey, Womens Growth in Connection: Writings from the Stone Center (New York: Guilford Press, 1991). 7. In this text I will put “relational psychoanalysis” in quotation marks when I’m not

R e la tio n a l T h e r a p y a n d Its Contexts

8. 9.

10. 11.

12. 13.

14.

15. 16.

17.

18.

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sure th a t the reader will otherw ise understand th a t I’m talking about th e school o f thought th a t’s a counterpart to self psychology. In this text, th e self-designated school o f “relational psychoanalysis” is a subset o f relational psychoanalysis—th at whole relational m ovem ent w ith in psychoanalysis th at includes self psychology. Lewis A ron, A Meeting o f Mimis: M utuality in Psychoanalysis (Hillsdale, NJ: Analytic Press, 1996), 56. T h is sta te o f affairs is reflected in th e c o n feren ce h isto ry o f th e re la tio n a l psychoanalytic m ovem ent. Self psychological relationalists generate and attend a conference o f th eir own every year; 2002 marks th e twenty-fifth year o f the annual International C onference on the Psychology o f th e Self. Sim ultaneously, for many years analysts from m ore diverse and eclectic relational positions, including many in te rp e rs o n a lis ts , have g a th e re d a n d p re se n te d p a p e rs a t m eetin g s o f th e Psychoanalytic Division (Division 39) o f th e A m erican Psychological Association. In 2002 a new conference was initiated by a new association, th e International Association for Relational Psychoanalysis and Psychotherapy. N am ed in h o n o r of the late relational psychoanalyst Stephen M itchell, the conference was designed to engender conversations between the diverse stream s o f relational psychoanalysis, including self psychology, and to include psychotherapists—n o t just psychoanalysts— in those conversations. Perhaps this marks the beginning o f a new era o f com m on causc and inclusivity am ong relational psychoanalysts and psychotherapists, b u t only tim e will tell. A ron, A Meeting of Minds, 2 5 -2 6 . “Playing w ith Your Cards Face-up" was th e title of a sem inar Owen Renik presented in T oronto in 1999. In “T he Perils o f Neutrality," Psychoanalytic Quarterly 65, 4 9 5 517 (1996), R enik argues persuasively for a d iale ctic a l k in d o f le a rn in g in psychoanalysis th a t requires th a t th e analyst own up to his or her intentions to influence th e patient in ways th a t th e analyst believes will be in the patient’s best interests. W h en these feelings and intentions are on th e table, the patient can engage w ith them as the analyst’s personal and fallible opinions, n o t as m oral or scientific authority, and use them to learn m ore ab o u t his o r her own reality. Darlene Bregman Ehrenberg, The Intim ate Edge: Extending the Reach of Psychoanalytic Interaction (New York: W.W. N orton, 1992). Stephen M itchell, Relational Concepts in Psychoanalysis: An integration (Cam bridge, MA: Harvard University Press, 1988); Hope and Dread in Psychoanalysis (New York: Basic Books, 1993); Influence and Autonomy in Psychoanalysis (Hillsdale, NJ: Analytic Press, 1997); Relationality: From A ttachm ent to Intersubjectiuity (Hillsdale, NJ: Analytic Press, 2000). Jessica B enjam in, The Bonds o f Love: Psychoanalysis, Feminism, and the Problem of Domination (New York: Pantheon, 1988), and Like Subjects, Love Objects: Essays on Recognition and Sexual Difference (New Haven and London: Yale University Press, 1995). M itchell, Influence and Autonom y in Psychoanalysis. H einz K ohut, H ow Does Analysis Cure? (Chicago: University of C hicago Press, 1984). E rnest W olf, Treating the Self: Elements o f Clinical Self Psychology (New York: G uilford Press, 1988). R obert D. Stolorow and George E. Atwood, Contexts of Being: The Intersubjective Foundations of Psychological Life (Hillsdale, NJ: Analytic Press, 1992). D onna M. Orange, Emotional Understanding: Studies in Psychoanalytic Epistemology (New York: G uilford Press, 1995). H ow ard Bacal, Ed., O ptim al Responsiveness: H ow Therapists Heal Their Patients (Northvalc, NJ: Jason A ronson, 1998).

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19. D aniel Stern, The Interpersonal World o f the Infant: A Vie«' from Psychoanalysis and D evelopm ental Psychology (New York: Basic Books, 1985). Joseph L ichtenberg, Psychoanalysis and M otivation (Hillsdale, NJ: Analytic Press, 1989). 20. For example, Stone C en ter theory attends no t only to gender b u t also to culture, race, class, and sexual orientation. Jessica Benjam in consistently positions herself at the intersection of feminist and relational psychoanalytic theory. Neil A ltm an, writing as a relational psychoanalyst w ho also uses projective-introjective object relations theory to understan d the intrapsychic and relational power o f social constructs, envisions th e realities o f econom ics, race, and class e n te rin g th e th era p eu tic relationship as concretely as a th ird person, w ith profound effects on both client and therapist and on th eir relationship: Neil A ltm an, The Analyst in the Inner City: Race, Class, and Culture through a Psychoanalytic Lens (Hillsdale, NJ: Analytic Press, 1995). Relational analysts and therapists arc am ong th e contributors to a collection o f essays th a t explore sim ilar questions about connections between m ulticulturalism and social diversity' on th e one hand and psychoanalytic o r psychodynamic theory on the other: RoseMarie Pérez Foster, Michael Moskowitz, and Rafael A rt Javier, Eds., Reaching across Boundaries o f Culture and Class: Widening the Scope o f Psychotherapy (Northvale, NJ: Jason A ronson, 1996).

2 BEGINNING WITH THE BASICS Structure, Ethics, and Empathy

F IR S T S E S S IO N S , F IR S T Q U E S T IO N S In order to look at the basics o f relational psychotherapy, we’ll start from the vantage p o in t o f your first m eeting w ith a particular client. Let’s say th a t a week ago this client left you a ph o n e message. A friend had recom ­ m ended you, she said. You re turned her call, and in your b rief conversa­ tion, she volunteered th a t she’s having trouble w ith different things in her life right now, work and relationships. T hings aren’t going well, and she th in k s she needs som eone to talk to. She told you th a t she hasn’t tried therapy before, and she asked if you could say som ething a bout how you work. You said, “I th in k it will be im p o rtan t for us pay carcful a tte n tio n to w hat’s troubling you, and th e n we’ll go from there. W e’ll stay w ith your sense o f w hat you need from therapy. T h a t’s my approach to therapy—it’s client-centered.” You established a tim e and fee w ith her and m ade sure she knows where your office is. She asked ab o u t parking, and how long a session would last, and you answered her questions. Now, as you m eet her in the w aiting room and introduce yourself, she greets you anxiously. You’re aware o f som e perform ance anxiety your­ self, som ething th a t’s always a round w hen you m eet a new client, b u t you m anage it by concentrating o n p utting her at ease. You invite her into your office, and as she settles into the chair opposite yours, you suggest th a t she tell you w hat the trouble is, w hat’s on her m ind. She outlines the trouble in her life while you listen quietly, m aking b rief com m ents th at show you’re getting it, and asking a few questions for clarification. After

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a long, complex story has emerged and you’re nearing the end o f the session, she asks, “So, do you think you can help me?” You reiterate what you said on the phone, something like, “I think what you need from me, right now, is that I really understand w hat you’re going through.” Her face says she doesn’t quite get it, so you go on. “Just understanding it together can make a big difference. Sometimes the next part—w hat to do differently—comes clear as soon as you’ve had a chance to explore w hat’s actually happening. W e’ve made a good start on that today, I think.” T he idea of a good start satisfies her. Since it’s time to end, you ask her w hether she would like to make another appointm ent, and she says she would like to do that. “See you next week,” you say warmly as you see her to the door. You close the door and sit down for a m om ent, wondering, “How did that go for her? W h at’s she feeling now?” You feel it went pretty well; it seemed th at she was able to take in your understanding. How did that happen? W hat did you do to help make that happen? It’s second nature by now—how you let your feelings show on your face, how you tell a client you’re there with “M m hm m ” and “Yes” from time to time. You check in with her, saying things like, “It sounds like th at was the hardest part,” or “If I’m getting it, you had really mixed feelings about that event.” W ith this client, as with every client, you paid attention to what seemed to put her at ease. Some clients need questions and prompting, especially in a first session. O pen space and time make them too nervous to know what to say. This client seemed to need you to be quiet while she organized her thoughts. You didn’t think th at out while you were with her. You just fit your energy level and rhythms of speech to hers, casing her way. So although you never said a word about the therapy relationship, already you’ve begun to work on it from your side as you interact with the cues she has given you. Near the end of the session, your client remarked, “T h at was easier than I thought it would be! The time just flew!” It seems this is one of those clients who from the beginning can experience you as someone who wants to understand who they are, who tries to put them at ease and draw them out. You’re happy to do your part to make th at experience possible. This is a com fortable and promising way to begin therapy. Now your client is on the street, maybe in a coffee shop, thinking about what happened. Maybe she’s mulling over how com fortable it felt. But questions and worries begin to swirl around, too. Was it too com fort­ able? She wonders, “Exactly what kind of a relationship is this? If it’s not

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clinical, if the therapist isn’t going to diagnose the problem and prescribe a treatm ent, how is it different from a friendship?” She rem em bers w'hat you said about how understanding helps. She d id n ’t know w hat it w ould feel like to be understood, bu t now she w ants m ore o f that; she w ants to count on that. She w onders how m uch she can co u n t o n your un d er­ standing. If she were feeling really rotten tom orrow, could she call you on th e phone? W ould you com e to her rescue? W h a t are th e boundaries of this relationship? Because you know these questions will com e up soon for your cli­ ent, early in the next session you talk about som e o f the practical b o u n d ­ aries o f th e therap y , th in g s you d id n ’t get a ro u n d to in th e first session—policies about how you respond to phone messages, about pay­ m ents and receipts, cancellations, extra sessions, and vacations (hers and yours). If you th in k the two o f you m ight frequent som e o f th e same organizations or areas o f town, you ask how she’d like to handle acciden­ tal meetings. W ould she like you to acknowledge her or not? Paying atten­ tion to the many small ways in w hich therapy is a strange, specialized relationship w ith its own boundaries and protocols helps to settle her anxiety about how to continue in this relationship. She can relax w hen she knows th a t you know how to handle this strangeness. You can handle the strange situation o f a therapy relationship be­ cause you’ve given it a lot o f thought. You w on’t spell it all o u t unless your client asks you to, b u t behind all the ways in w hich you set up the param eters o f how the two o f you will be together, there stands your coherent sense o f the structure and boundaries o f any therapy relation­ ship. Since you arc a relational therapist, it fits together som ething like this: A t the heart o f relational therapy there is th e therapist’s com m it­ m ent to be present, w ith caring an d focus, in the relationship. T h at com ­ m itm ent is particularly about being present while in session in the therapy room . You will be available for emergencies at o th er times, b u t you know very well th a t th e m ost useful therapy work you can do w ith your client happens w ithin the boundaries o f regular sessions at regular tim es. You will express th a t conviction in various ways. If your client makes a phone call w hen in distress, you will be considerate and understanding. You will acknowledge and affirm your client’s need to make a connection for reas­ surance, b u t you will probably also keep the call sh o rt and suggest th at th e two o f you discuss this issue in m uch m ore detail w hen you next meet. A nd w hen you do meet, you will w ant to spend tim e trying to

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u n d e rsta n d w h a t h a p p en e d to so distress your client. W h a t your client begins to realize is th a t th e kind o f being-w ith th a t she c o u n ts o n and longs for is best available to h er in session. B ut as she settles in to th a t rhythm , she also realizes how m uch m ore available you are to h er in ses­ sion th a n she ever im agined could be possible. T h o se feelings th a t scared h e r after th e first session—feelings th a t she needed yo u r care a n d u n d e rsta n d in g far m ore th a n she ever w anted to—may n o t go away. A n d yo u r clien t’s feeling o f n o t w a n tin g to need you may becom e an angry e m o tio n tangled up w ith re sen tm en t th a t you can ’t be available to h e r all th e tim e. W h atev er you sta rt to stan d for in h er daily th o u g h ts, how ever pow erful h e r feelings tow ard you may becom e, as a relational th erap ist you h o ld firm in th e belief th a t those feelings are a rich resource for th e w ork o f therapy. You w ant to h ear ab o u t those feelings. T h a t’s how available you are to h e r in session. T h ere is n o th in g betw een th e two o f you th a t sh e ’s n o t allowed to talk abo u t, and th e m ore she is able to talk abo u t, th e better. T h is k in d o f talking may be frightening for her, b u t it m akes for pow erful learning a n d change. All o f th is is to say th a t th e im p o rta n t b o u n d a rie s in therapy—no social c o n ta ct betw een yourself a n d your client, n o o th e r kinds o f dual relationships, m eeting only at set tim es a n d in a set place, a n d d o in g the im p o rta n t w ork o f therapy in sessions—have a critically im p o rta n t func­ tio n . T h e p o in t o f th e m all is to m ake a safe space for h o n e st talk in th e therapy re lationship. Because this is therapy, a n d only therapy, you and your clien t can explore w h a t’s h a p p en in g betw een th e two o f you. To­ g ether you can note h er responses to how you treat h er—h e r fears, fanta­ sies, wishes, assum ptions, hopes, a n d resentm ents. It’s th e very firm ness o f your m u tu a l c o n tra ct to do therapy, so m e th in g th e two o f you do together at regular tim es, th a t creates th e freedom to be deeply real w ith in th a t tim e. N o o rd in ary rela tio n sh ip could bear th is k in d o f in ten se work­ ing o n w hat h ap p en s betw een two persons, in th e interest o f o n e o f those parties b eing p ro foundly u n d e rsto o d . It’s also very im p o rta n t to note th a t for a relational therapist, b o u n d ­ aries are n o t a b o u t avoiding o r subverting your c lie n t’s d ep en d en cy o n you. In th e first place, dependency, w ith its negative c o n n o ta tio n s, isn’t a useful w ord for w h a t h ap p en s in therapy. Secondly, w h a t is o ften called depen d en cy will be an im p o rta n t p latform for th e changes therapy fos­ ters. As I’ll explain later (in C h a p te r 6), th e relational th era p ist believes th a t th e therapy relatio n sh ip can m eet som e im p o rta n t needs th a t m ight help a client jum p-start som e blocked p erso n al grow th. A n d it will be just as im p o rta n t for th e clien t to talk a b o u t h e r good relational feelings in

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therapy as it is for her to be open ab o u t the things th a t w orry and upset her. If your client expresses misgivings about the b oundaries o f relational therapy, you can tell her straightforw ardly th a t although the relationship involves both o f you, it is there entirely for her benefit and well-being. You m ight say som ething like, “W h a t I get o u t o f this is just to do good work w ith you, to be the best therapist I can be w ith you; the relationship is for you.” You m ight add, “A nd I find this especially im p o rta n t to say to people w ho have been m anipulated a nd used in relationships.” You know th a t if your client has already been abused, tricked, and taken advantage of in relationships w ith powerful people, she will need to hear th at said ou t loud. H er fears o f it happening again w on’t dissolve w ith your reas­ surance, b u t at least she’ll know th at the question, “W h o is this for?” can be spoken, and th a t you know w hat the question m eans to her. In beginning sessions, various aspects o f your professional ethics will emerge as you tell your client ab o u t your und erstan d in g o f your con­ tractual obligations to her—for exam ple, th a t you will re tu rn her tele­ ph o n e calls as soon as possible, th a t you will give her as m uch notice as you can o f any changes in your schedule, th a t whatever she tells you (un­ less it reveals child abuse or the endangerm ent o f life) will be entirely confidential, and th a t although you consult w ith a supervisor a b o u t your work, you will never refer to her by nam e o r reveal any o th e r identifying inform ation. W ith tim e and experience w ith you, your client’s un d er­ standing o f the ethic o f this relationship will deepen. She’ll begin to see how the “co n tract” o f relational therapy, including the ethical obliga­ tions im plicit in it, is entirely consistent w ith how the therapy works. To pu t it simply, you w ant to engage w ith her in ways th at are clear, honest, and always w ith her b enefit a nd well-being in m ind, and you invite her to engage w ith you as honestly as she can, too. T h e better you can do th at together, the better the therapy works. You tell your client th a t if any­ th in g you say o r do feels n o t right or good for her and her well-being, it’s im p o rtan t to say so as soon as possible—because those are exactly the realities in the relationship th a t need to be attended to very carefully, if a relational way o f working is to live up to its potential. As your client tries to u n d erstan d w hat she’s getting herself into w ith this relational therapy, she may well ask you, “How long will this take?” W h at’s an honest and ethical answer to th a t question? M any rela­ tional therapists say simply, “I really d o n ’t know. I th in k we’ll find o u t as we go along.” O th ers m ight elaborate, “Som etim es th ere ’s a very particu­

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lar tro u b le th a t needs an u n d e rsta n d in g ear so th a t you can get your balance back, find your way, a n d get to feeling okay again. T h a t can h a p ­ pen in a few weeks o r m o n th s. O th e r tim es th e re ’s a w hole lo t o u t o f w hack in your life, a n d w h a t you need is a lot m ore tim e to talk a b o u t it, m ore tim e to get to feeling stronger an d m ore okay. It will be your choice— how long we d o this. I im agine you’ll choose o n th e basis o f w h a t you’re getting o u t o f it, how you feel it’s h e lp in g you as we go along.’’ W ith practice, you’ll find answers th a t feel b o th useful a n d h o n e st in various client situations.

W H A T ’S A L L T H I S A B O U T E M PA T H Y ? W e’ve b een no tin g th a t as your client begins relational therapy, she en ­ ters a p a rticu la r k in d o f relatio n sh ip w ith well-defined b o u n d a rie s and ethics. T h e stru c tu re o f this therapy rela tio n sh ip com es from establish­ ing a special, p rotected, repetitive tim e a n d place for talking together. T h e am biance o r “s o u l” o f th is re lationship, however, com es from som e­ th in g else—from your in te n tio n a l a n d th o ro u g h g o in g em pathy. A rela­ tional th era p ist w ith o u t em pathy is like a ten n is player w ith o u t a racquet o r a lifeguard w ho c an 't swim . E m pathy is your relational m ode o f opera­ tio n , your way to keep th in g s m oving. E m pathy is th e prim ary tool o f your w ork a n d th e skill th a t m akes it possible for you to be a therapist. Let’s take a closer look at this em pathy.

Able to Feel W h a t is em pathy? T h e essence a n d m ovem ent o f any h u m a n feeling— fear, anger, respect, sham e, love—are d ifficult to describe. E m pathy is no exception. B ut since it is so crucial in th e u n fo ld in g o f relational therapy, th e re ’s a lot o f talk in th e field a b o u t w hat em pathy is a n d how it works. Perhaps it is b e tte r described as a capacity o r ability th a n as a feeling—in fact, a capacity to feel m any d ifferen t k inds o f feelings. H einz K ohut, th e fa th e r o f self psychology, d efined em pathy as “vi­ carious in tro sp ec tio n ,” o r “th e capacity to th in k a n d feel on eself in to th e in n e r life o f a n o th e r p e rso n .”1 Years earlier, C arl Rogers b u ilt a th e ra p e u ­ tic system o n th e th era p ist’s ability to let h im self go in o rd e r to deeply u n d e rsta n d each particu lar client, w ith “n o in n e r b arriers [to] keep him

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from sensing w h a t it feels like to be th e client at each m o m e n t o f th e re la tio n sh ip .”2 T h e em p a th ic therapist, th e n , is n o t afraid to feel. B ut a ren ’t we all afraid to feel? Isn’t th a t w h a t a lo t o f therapy is ab o u t—h elping people tolerate feelings th a t w ould be to o m u ch to bear alone? H ow can a n em ­ path ic th era p ist be n o t afraid to feel? T h e re ’s a sim ple answ er to th a t q uestion, if n o t so sim ply attain ed : a th era p ist w h o is n o t afraid to en ter th e experience o f th e darkest a n d m ost p ainful m o m en ts o f clients’ lives is a th era p ist w ho has d o n e h e r ow n therapy. She has b een helped by som eone else to face h e r ow n fears a n d feel w h a t she could n o t bear to feel alone. T h is puts a differen t spin o n th e F reu d ian insistence th a t analysts u n d e rg o th e ir ow n analysis. T h e p o in t is n o t th a t you com e to know all th ere is to know a b o u t your ow n in n e r w orkings, b u t th a t you develop th e in n e r courage a n d resilience to be able to feel w hatever needs to be felt—th a t you have, as Rogers p u t it, n o in n e r barriers. In th e h u m a n ist tra d itio n o f psychotherapy, th erap ists are often train ed in groups th a t encourage a u th e n tic en co u n ters a n d expression o f feelings a m o n g m em bers. B ehind th is practice is th e belief th a t intense group experience does even m ore th a n individual therapy can do to help a th era p ist becom e com fortable w ith a w ide range o f feelings w ith in her­ self an d others. B ut however you com e to it, this capacity is crucial for a th erap ist—to be able to be w ith a n d to e n d u re m any kinds o f suffering. O f course, you n eed n o t have experienced all th e varieties o f loss, h u m ili­ atio n , betrayal, a b a n d o n m e n t, unfulfilled longing, loneliness, despair, a n d helplessness th a t o th ers b rin g to you, b u t you do n eed to have truly felt your ow n experience o f any o f th o se k inds o f suffering. If you haven’t faced w h a t h u rts you, you will flin ch away from clients’ stories in o rd e r to pro tect yourself from your ow n history. W h e n you have felt your ow n history, you can also m ake links be­ tw een your experience a n d your clients’ experiences, th e b etter to u n d e r­ stan d th em . Som etim es you will still feel afraid o f a story th a t’s especially h orrific o r hopeless o r strikes very close to hom e. B ut w h e n you have d o n e your ow n w ork in therapy, you will know w hen you feel afraid, and you will know to talk a b o u t your feelings in supportive relationships w ith supervisors a n d experienced peers. Your experience in therapy will have tau g h t you how to get th e help you n eed in o rd e r to acknow ledge, u n d e r­ stand, a n d b ear w hatever feelings com e u p for you as you im m erse your­ self in your clients’ experiences.

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Able to Communicate Feeling R ogers also believed th a t it was essential for th e th e ra p is t to be able to c o m m u n ic a te th e flow o f h e r “feeling-w ith” rhe c lie n t in a n im m ed iate, m o m e n t-to -m o m e n t k in d o f way. T h is c o m m u n ic a tio n was to be a n ex­ p ressio n o f th e th e ra p is t’s g e n u in en ess; th e goal was a k in d o f e m o tio n a l tran sp aren cy . T h is a u th e n tic c o m m u n ic a tio n o f th e th e ra p is t’s e m p a th ic c o n n e c tio n w ith th e client’s experience w ould m ake it possible for th e client to be m ore fully w ith in th e stream o f h e r o w n feelings, in te g ratin g th e m ex p erientially in to w h a t h u m a n ists e n v isio n ed as a fuller, d eep er, a n d m o re a u th e n tic sense o f self. As th e self-authenticating, herc-and-now 1960s gave way to th e 1970s, a c e rta in g ro u p o f psychoanalysts beg an to em phasize e m p a th y too. T h e ir lea d in g th e o rist, H einz K ohut, called th is new stream o f psychoanalytic th in k in g “self psychology,” a n d , as I’ve said, he d e sc rib e d e m p a th y as v icario u s in tro s p e c tio n , o r im m e rsio n in th e p a tie n t’s subjective w orld. Early self psychologists assu m ed th a t th is e m p a th y was a to o l readily available to th era p ists, a n d th ey saw th e c o m m u n ic a tio n o f e m p a th y n o t so m u c h as a gateway to th e p a tie n t’s a u th e n tic ex p erien ce as a gateway to th e p a tie n t’s insight. F o r th e m , v icarious in tro s p e c tio n w ould lead even­ tually to th e p a tie n t’s ability to b e intro sp ectiv e h e rse lf a n d th u s to de­ velop th a t m arriag e o f e m o tio n a l a n d cognitive in sig h t th a t w o u ld free h e r from h e r in te rn a l co n flicts. A self psychological c o m m u n ic a tio n o f em p a th y te n d e d , th e n , to be in th e fo rm o f ideas a b o u t th e p a tie n t’s ex p erien ce th a t w ould lead th e p a tie n t gently tow ard new u n d e rs ta n d ­ ings o f herself. T h e th e ra p is t’s e m p a th y h a d to in clu d e th e ability to tra n s­ late feelings in to ideas th a t d id n ’t get to o far away from th e original feelings. In th e psychoanalytic w orld, it was re v o lu tio n a ry for self psychology to suggest th a t th e th e ra p is t’s e m p a th y was as im p o rta n t as th e p a tie n t’s in sig h t fo r th e re so lu tio n o f psychological p ro b lem s. S elf psychologists n o te d th a t th e ir e m p a th ic u n d e rs ta n d in g fro m a p a tie n t’s p o in t o f view eased th e p a tie n t’s sh a m e a n d th u s b ro a d e n e d space for self-reflection. S u c h e m p a th y also e n co u ra g ed th e p a tie n t to c o u n t o n th e th e ra p is t for th o se p a rtic u la r k in d s o f u n d e rs ta n d in g th a t h a d b e e n m issing for th e p a tie n t in c h ild h o o d . In th e presence o f th ese p a rtic u la r k in d s o f em ­ p a th ic c o n n e c tio n , c e rta in k in d s o f a b o rte d o r s tu n te d self-developm ent co u ld beg in again for th e p a tie n t, filling in deficits in h e r previously shaky self-structure. F o r exam ple, in th e presen ce o f so m e o n e stro n g a n d su p ­ portiv e, th e p a tie n t c o u ld begin to feel safe a n d stro n g herself, a n d in th e presence o f a ffirm a tio n , sh e c o u ld beg in to enjoy h e r ow n co m p eten ce.

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In this self psychological use o f empathy, the therapist’s com m uni­ cations to the patien t are constantly adjusted according to the therapist’s developing sense o f w hich particular kinds o f conn ectio n the p atient needs for optim al growth. Perhaps she needs a kind o f empathy, for ex­ ample, th a t only reflects her experience, for anything added feels in tru ­ sive or controlling. O r maybe, o n the o th er hand, she needs to hear som ething m ore from the therapist, som ething th a t will allow her to feel secure in the presence o f som eone wiser and stronger, or som ething th at will let her know she’s n o t the only one w ho has ever felt this way. Now w hen em pathy is fine-tuned according to the patien t’s needs, w hether they be needs to gain particular insights o r particular kinds of growth, it’s clear th at the therapist is no longer being simply authentic a nd transparent, sharing w hatever comes up in himself in response to the p a tie n t’s flow o f feeling. U nlike th e h um anist therapist, w ho shares his ow n experience, the self psychologist shapes his responses around w hat he u nderstands the p a tie n t’s experience to be. In o th e r words, these early sources o n em pathy, self psychological and hum anist, are proposing two very different kinds o f c om m unication o f empathy. But n e ith e r of th em has th e last w ord, because several decades after Rogers began w rit­ ing and a decade after self psychology came o n to the psychoanalytic scene, infant studies began to com plicate and enrich the picture o f how em pa­ thy is com m unicated betw een infants and th eir caretakers, and, by exten­ sion, betw een any two h u m an beings. As we noted in C hapter 1, although Rogers and oth er hum anists had a profound and prophetic u n d erstan d in g o f the power o f empathy, they still worked from an individualistic worldview. For them , em pathy was a neutral m edium , created by the therapist’s authenticity, w ithin which a client’s authenticity could emerge. They d id n ’t pay m uch atten tio n to how the therapist and client co-created the lim its and freedom s o f their m utual relationship, o r the shape and feel o f th e em pathy possible be­ tween them , and how they thus co-created the very m odes through w hich “se lf’ and “o th er” could be known in this relationship. Likewise, although early self psychologists believed th a t h u m an selves need others like hu­ m an bodies need oxygen, th eir understan d in g o f th e exchange betw een these selves was fairly linear and usually one way—from the provider o f em pathy (th erap ist/p aren t) to the receiver o f em pathy (client/child). A m ore systemic and m utual sense o f the em pathic exchange d id n ’t emerge until the 1980s, w hen therapists began to look at w hat D aniel S tern called “the interpersonal world o f the infant.” Baby studies began to show two things a bo ut empathy: (1) instead o f being a neutral m edium

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offered by one who has the capacity for it to another who needs it, empa­ thy is a system active between participants who are each constantly con­ tributing to how th at system works; and (2) the com m unications that establish and regulate a system of empathy are subtle and ongoing, and they include a wide variety of nonverbal and verbal cues. O ften, instead o f “empathy,” baby-watchers speak of the parent’s attunem ent to the in­ fan t and th e in fa n t’s reciprocal a ttu n e m e n t to th e p aren t. T hese attunem ents, with all of their shadings and near-misses, become patterns o f infant-caregiver m utual regulation—a shape and feel o f relationship th at is formed by and that forms a certain kind of baby and a certain kind of parent. In other words, in this view empathy is not just an under­ standing to be com m unicated between two entirely separate selves; it is itself a complex system of com m unication that, while the com munica­ tion is happening, is shaping the sense of “self’ o f the persons who are com municating, be they infant, child, or adult. This much more complex view of how empathy is elicited, com m u­ nicated, and received leaves contem porary relational therapists with a different set of considerations about how to do their work. Authenticity between two persons becomes a contradictory concept if w hat either per­ son is feeling at any given m om ent cannot escape the influence of the other. But rather than trying to purify empathy of this mutual influence, today’s relationalists pay close attention to the unique ways in which con­ nection takes shape between themselves and each of their clients. This view also makes obsolete the idea of empathy as a one-way movement from the therapist’s vicarious introspection to well-crafted expressions of his understanding, which will help fill in the client’s deficits. As a contem porary relational therapist, you work in a m uch more complicated, bi-directional field. You don’t have to worry, however, that you won’t be objective enough to know what to provide for a client in need. Objectivity is no longer the point. Instead, with a systemic view of empathy, you trust th at in the push and pull of what goes on between you and your client, you will together find ways of connecting th at work for both of you. Exploring, understanding, and improving th at mutual connection is the point. In this systemic and m utual view of empathy, the com municated, shared experience o f em pathic connection between persons becomes far more of a mystery to enter than a tool to master. “Able to com m unicate empathy” means able to persist in th at mysterious dance, making connections happen around, through, and beyond inevi­ table misses and disconnections.

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Able to Know Who Is Who (and W hat Is What) Empathy is a system of mutual cues and responses that regulate each participant’s experience of self and the other in the system. Bur at the same time, each participant is a separate person, with his or her unique subjective reality. Empathy is a mutual activity, and yet the empathy that therapists and the parents of young children put into play does not ex­ pect an equivalent empathy in return. Therapists, like parents, practice intentional, purposeful, and self-reflexive empathy. The therapists and parents concentrate on understanding what the client or child is experi­ encing. Often they do much of the work of suggesting words and mean­ ings for what’s happening. They carry the responsibility of keeping clear whose feelings arc whose. They hold in mind the separate uniqueness of their own and the other’s experience. We might call this constructive empathy, an empathy that knows what it’s doing. This knowing may not be conscious or articulated, but it is present even between adult friends who know that when one is in trouble, the other provides a special kind of listening, listening full of caring and feeling-with, but listening that doesn’t take over the other’s hurt or get lost in it. The Stone Center theorists argue that such mature, intentional em­ pathy is the work that has fallen to women in our culture—and therefore it has not been honored as a gift or a special capacity. In fact, it has been devalued, just as “we-ness” has been set up as the flawed opposite of autonomy. And so, while fully appreciating the interactive mutual nature of empathy, Judith Jordan, one of the Stone Center writers, also high­ lights the strengths and powers embedded in the intentional practice of empathy: (1) a secure, well-differentiated sense of self, including the flex­ ible self-boundaries that make it possible to step into—and out of—the other person’s shoes, feeling both sameness and difference; (2) the ability not only to feel-with but also to give meaning to that feeling with thought; and (3) the ability to use these feeling-thoughts to help the other under­ stand his or her inner world better. Those who have the good fortune to be held within this kind of intentional empathic connection are given a wonderful chance to learn that people can be at the same time both uniquely separate and self­ directed and also joined in their feelings and understandings. In time, the recipients of such empathy will be able to extend this kind of em­ pathic understanding to others. In therapy, a client can also turn this fledgling capacity for empathy toward herself, allowing for the integra­

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tio n o f feelings, m em ories, an d self-representations th a t h ad b een sh u t away by sh am e.3

W HAT DOES THIS EMPATHY DO FOR YOUR CLIENT? T his is all very interesting, you m ight say, b u t how does it play o u t w hen a client sits dow n to talk w ith me? Let’s explore th a t q u estio n for a w hile. First o f all, w hat does it m ean for your client th a t you have b een in therapy yourself, facing your ow n fears an d bearing your ow n m ost p ain fu l feel­ ings? It m eans th a t you know w hat it’s like to be in th e clien t’s chair right now. R em em bering how it was for you, you u n d ersta n d how asham ed she may be to tell her story, or how frightened she may be o f h er em o­ tions. It m eans th a t even th o u g h you never speak o f your ow n experi­ ence, your responses to h er feel g ro u n d ed a n d sure, an d she can begin to co u n t o n you for u n d e rsta n d in g th a t ru n s deeper th a n words. Your co m m itm en t to do in g your ow n em otio n al w ork m eans th a t n o m atter how harrow ing your clien t’s m em ories, how in ten se h er fear o r rage, or how bone-w earying h er depression, you’re th e re for it all. If you sta rt to feel overw helm ed, you take care o f yourself so th a t you w o n ’t a b a n d o n her o r disappear. W h ile th e tw o o f you w ork together, she can be sure th a t you are paying close atte n tio n to how it feels be w ith her, so th a t if you sense som e scare in yourself, som e resistance o r defense against w h at she feels, you will get th e help you need to be able to re tu rn fully to th e relationship. You will be especially careful to know a b o u t th e feelings you have w hen th e feelings she has are all ab o u t you. H er feelings ab o u t you m atter profoundly to h e r therapy, an d if your feelings get in th e way, you w on’t be able to hear how th e therapy is for her. Your ongoing con­ n ectio n w ith your ow n em o tio n al responses an d your ability to deal w ith th e m appropriately m eans th a t th e two o f you will be able to w ork to­ g ether w ith all o f th e very im p o rta n t in fo rm atio n th a t em erges in th e give an d take o f your relationship. W h a t does it m ean for your client, th e n , th a t in a d d itio n to being able to be w ith her in her feelings, you consistently try to co m m u n icate your em pathy? W ell, w ith o u t som e com m unicative effort on your part, she m ight never know th a t you get it! W h a t’s m ore, your ways o f co m m u ­ nicating th ro u g h eye contact, facial expression, body language, and ver­ bal response add up to th e experience o f being w ith a real p erso n —a real p erson w ho is affected by w ho your client is an d w h at she has to say. As she w atches you trying hard to u n d e rsta n d how it is for her, she may be

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able to feel th e care a n d a tte n tio n in y o u r effo rt a n d in y o u r fu rth e r c o n c e rn a b o u t h ow y o u r responses affect her. A ll o f th a t may h elp h e r feel m o re like a real p e rso n herself, w ith a story a n d feelings th a t actually m atter. As a c o n te m p o ra ry rela tio n a l th e ra p ist, you will try to b alan c e y o u r g e n u in e p resence w ith efforts to give y our c lie n t th e k in d o f resp o n se th a t seem s m o st h elp fu l in a given m o m e n t. You k n o w th a t you w ill never strike th e p erfec t b alan c e betw een expressing y o u r a u th e n tic resp o n ses a n d m e etin g y o u r c lie n t’s needs, for th o se tw o in te n tio n s exist in te n ­ sio n . You know , fu rth e rm o re , th a t th is te n sio n is p a rt o f a m u c h m o re com plex p ic tu re in w h ich em p ath y is a d an c e o f se p araten ess a n d c o n n e c ­ tio n all at once, as in fa n t stu d ies d e m o n stra te . W h a t do es it m e a n for y our clie n t th a t you have listen ed to w h at so m e o f th o se baby-w atchers have said a b o u t th e m u tu a lity o f em pathy? It m ean s th a t you a tte n d to how th e tw o o f you keep co -c o n stru ctin g y our ways o f c o n n e c tio n . A t first th is will be ju st p a rt o f y o u r careful listening. Later, as a p p ro p ria te , you m ay share w ith h e r w h a t you n o tic e a b o u t your m u tu a l style o f c o n n e c tio n a n d invite h e r to d o h e r ow n n o ticin g . As th e tw o o f you pay a tte n tio n to th e k in d s o f responses th a t h elp o r h in d e r her, to w h a t scares h e r a n d w h a t m akes h e r feel safe, th e th e ra p y beco m es slowly cleared for freer expressions o f w h o she is a n d w h a t sh e feels. W h a t’s th e overall effect o f th is k in d o f a tte n tio n to th e process o f co n n e c tin g w ith each o ther? A fter a w hile yo u r clien t begins to realize th a t you a re n ’t siftin g th ro u g h h e r feelings in o rd e r to fin d o u t th e real tr u th a b o u t her, s o m e th in g sh e m ig h t never have guessed. O n th e co n ­ trary, she, h e r being, is w h a t is real to you. H e r im m ed ia te ex p erien ce is w h a t m atters. H e r ex p erien ce m a tte rs even m o re th a n th e v ario u s n a rra ­ tives sh e c o n stru c ts to explain h e r experience. F ro m day to day a n d over tim e h e r stories m ay s h ift a n d change in feeling a n d em p h asis. B u t th e b o tto m -lin e “real” for h e r rem a in s th e reality o f th e c o n n e c tio n b etw een th e tw o o f you a n d th e fact th a t you believe her. You k n o w th a t h e r story is w h o sh e ’s co m e to be a n d how sh e ’s co m e to k n o w h erse lf th ro u g h years o f o th e r rela tio n sh ip s. H e r story is as real as sh e is; in fact, sh e an d h e r story are o n e a n d th e sam e b u n d le o f m ean in g s as she tells th e m to you. A n d yet even th e telling p u ts th o se m eanin g s in to f u rth e r m o tio n . T h e m ean in g s m ove betw een th e tw o o f you, a n d y o u r clie n t fin d s h erse lf m oving a n d ch an g in g alo n g w ith th e m . E ventually sh e m ig h t even fin d h erse lf enjoying th e ad v e n tu re o f n o t kn o w in g w h at s h e ’ll say today, w h at will h a p p e n next, o r w h at it will m ean. W e n o te d above th a t a lth o u g h th e th e ra p y re la tio n sh ip is fo rm ed

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through mutual attunem ent, the empathy mobilized in therapy has one purpose: the client’s em otional health and well-being. W h at does it mean for your client that you take responsibility for m aintaining empathy for her w ithout expecting empathy in return? She m ight find th at situation unthinkable, for it’s not how social relationships work. O r perhaps she’s been well-trained in other relationships to look after the other person’s em otional well-being before her own. This training is most potent when it happens to children who must look after emotionally needy parents. If this was the case for her, she may slowly realize how diligently she looks after you w hether you need looking after or not (she has to assume you do). At first it will disorient her whole system to realize th at maybe she doesn’t have to be “good” in therapy, the parentificd child ever careful of a fragile mom or dad. Eventually, though, she may be able to relax, be­ coming secure in the presence o f a com petent, emotionally sturdy adult whose chief concern is her well-being. W hat does it mean for your client th at you can feel her feelings with her and at the same time be clear th at you aren’t her? Let’s put the ques­ tion the other way around. W hat if, as she talked, you would fill up the space between you with your own emotions? W hat if you seemed to be­ lieve that she is just like you, or that you know better than she does what she is feeling and why? This sort of em otional takeover is as disturbing for a client—for anyone!—as em otional abandonm ent. Actually, it’s just the other side of the same coin; to take over another’s em otional space is a very powerful way to fail to be with a person, and thus to abandon her w ithout seeming to. Straightforward desertion can be far easier to cope with, because then at least a person can be clear about what has happened. Clients who come to therapy hoping against hope to be understood, wanting understanding but believing it just can’t happen, have very likely suffered some com bination of em otional neglect and em otional takeover. Whichever side of that coin was up, w hat happened to them was a mas­ sive failure of empathy. Here and now with you, if on the one hand you won’t disappear on them , and on the other hand you won’t take over their em otional space with your feelings, needs, and agendas, they may finally discover a space in which they can find out who they really are through expressing w hat they really think and feel. Infant studies support the claim that anyone’s felt sense o f self (“I know who I am, what I want, how I feel”) comes into being only as there is response to a self’s developing motivations, desires, and feelings. W here there is a dearth of empathy or very inaccurate, intrusive attunem ent to an infant’s or a child’s com m unication of wants and feelings, the child’s

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sense o f self begins to fade an d fragm ent. A therapy o f em pathy offers som eo n e w ho will listen a n d n o t in tru d e , w ho will w ait for a n d celebrate th e re tu rn o f a self’s ow n feelings. A client will fin d h er ow n lost self n o t in th e misty past b u t in her c u rre n t m om ent-to-m o m en t experience, w hen she can finally pay atten tio n to it. T h a t’s exactly w here h er self got lost once, w hen no b o d y paid a tte n tio n o r they paid th e k in d o f a tte n tio n th a t h ad little or n o th in g to d o w ith her. H ow can you show care n o t to take over your clien t’s feelings? You can respond in th e form o f “w ondering.” You can use th e w ord “m aybe” a lot. You can indicate th a t you’re trying to get it; th is is w h at you u n d er­ sta n d so far, b u t you’d like to get it better. C lients will begin to co u n t o n this respectful, open-ended curiosity, an d th e n they will jo in in th e shared process o f “getting it.” In fact, th e process o f creating u n d e rsta n d in g will becom e m ore im p o rta n t to th e m th a n getting a perfect em pathic response right o ff th e b at from you. W hy is this? Because w h at they n eed is n o t perfect em pathy, b u t th e experience o f a relationsh ip in w hich they are free to w ork o u t m utual u n d e rsta n d in g w ith a reliable p artn er. (Infants a n d young ch ild ren d o n ’t need perfect em pathy, either; in fact, overa ttu n e m e n t can be stifling an d intrusive. O n th e o th e r h an d , they do b a d ly n e e d th e e x p e r ie n c e o f o n g o in g r e la tio n s h i p s in w h ic h m isattu n em en ts an d m isunderstandings can be repaired an d th e rela­ tio n sh ip p u t back o n track.)4 You can be sure th a t your clien t will know, if only vaguely, th a t th e re ’s a very good reason for you to be tentative w ith your em pathy. You can’t ever assum e th a t you know exactly how it is for her, because you aren ’t her. N eith er she n o r you can ever get o u t o f your ow n skins, your ow n histories a n d c u rre n t social locations. You can only see h er from w'here you are, a n d she will be reassured to sense th a t you know th a t this is true, a n d th a t therefore you w on’t try to “know it all” o r in som e subtle way tell h er how she feels o r w h a t’s tru e for her. She m ig h t som etim es w ish th a t you h ad a “G o d ’s eye view” o f her a n d all th e answers th a t go along w ith th a t, b u t o n th e w hole an d in th e en d , sh e ’ll be glad th a t y ou’re a fallible real person trying to u n d e rsta n d h er th e best you can. Your u n d e rsta n d in g involves m ore th a n just respectful feeling in to your clien t’s feelings. Your em pathy com es w ith th o u g h t. In your ow n m in d , you co n stru ct an ongoing narrative o f your clien t’s life, past an d present. You th in k a b o u t p attern s in h e r life, h er recu rrin g fears, assum p­ tions, a n d hopes, an d how they play ou t. You th in k a b o u t how sh e is able to express herself and w h at seems to block her. You p o n d e r th e experi­ ences you share in therapy an d w o n d er how they affect h er feelings.

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W hat does it mean to your client that you bring a great deal of thought to your emotional understanding? It might mean that for the first time in her life your client begins to sense th at she does really exist over time as a three-dimensional person who can be known in depth by someone else. As your client experiences your thoughtful connection to her inner world, she learns not what is going on for her—th a t’s hers to discover with your help—bu t how to wonder and think about the workings o f her own inner world. As her capacity to self-reflect expands, her sense of self grows stronger and more resilient. A nd at the same time, it can be a great relief to your client not to have to be thinking all the time, making sense of things, self-reflecting, connecting the dots. It’s a great relief to know that someone else is m ind­ ing the store, to know that she can trust you not to lose track of what’s going on, not to forget the way she’s come or all the things she’s learned about herself. Sometimes, especially if your client always had to keep herself safe by understanding everything, it can be quite w onderful for her to just let herself be, feel, talk, float, and know th at someone she trusts is doing the understanding for a while. You’re on top of it, so right now she doesn’t have to take care of a thing, control for chaos, or make any sense of w hat’s happening. Part of w hat makes those moments of letting go possible is her repeated experience of always being able to come back with you to making meaning and finding understanding w hen she wants to. We took note above of the Stone C enter idea th at through experi­ encing a therapist’s empathy, a client can begin to have empathy for her­ self. This process often begins with a client’s gentler sensitivity to what she’s going through right now. As you listen with care and empathy to her story, she begins to realize that whatever is hurting her, it isn’t trivial, stupid, or a product of her own weakness. T hen she m ight begin to n o tice links between the current trouble and w hat she remembers o f simi­ lar situations and feelings in her years of growing up—when it wasn’t her fault, either. A nother layer of empathy has become available to her: feel­ ings for the child th at she was, a child who made sense of w hat troubled her by deciding that som ething was wrong with her—she was the problem. Now the shame or disgust she has felt about th at child can give way to understanding and then to grief for w hat she lost, and to loving respect for how she did the best she could anyway. W hen there’s more room in your client’s imagination for the reality o f her own struggles, she begins to sec other people differently, too. We might say she has more empathy for them —or more knowing that life is

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n o t a sim ple process o f d o in g things rig h t o r w rong, th a t alm ost every­ body gets b u rd e n e d by family legacies o f sh am e o r guilt, a n d th a t th e secrets o f being okay lie n o t in escaping tro u b le b u t in living th ro u g h tro u b le w ith others, su p p o rte d in m u tu al netw orks o f care a n d u n d e r­ standing. T hese new th o u g h ts a n d feelings will help her fin d a m ore g ro u n d e d , balanced, a n d secure place in h e r ow n p re sen t life. Som etim es th e people she will com e to see differently are som e o f th e people w ho once h u rt h er m ost: a frightening, rageful father to rm e n te d by th e de­ m ons o f his ow n depression, an unavailable m om silenced by h e r ow n self-doubts, a p a rtn e r w hose c h ild h o o d pain got so en tangled w ith hers th a t th ere was n o th in g to do b u t separate. W h a t’s h a p p e n in g to your client? Because she is being u n d e rsto o d , she can know w hat has h a p p en e d to her, w ho she is, a n d w hat she feels. N ow she can move from th e em o tio n al traps o f old relationships in to h er ow n place in th e w orld. As she feels your u n d e rsta n d in g em pathy, she begins to feel in h er bones how a body can be b o th separate, a “self,” a n d c o n n ec te d at th e sam e tim e. She is com ing in to a real sense o f self n o t because sh e ’s gaining h e r in d ep en d en ce, b u t because so m eo n e else has b een th ere w ith her. A n d from th a t alive a n d resilient place o f know ing “T h is is m e!” she is reaching o u t for m ore co n n ec tio n , for relationships in w hich she b o th u n d e rstan d s a n d is u n d e rsto o d , a n d in w hich each p a rticip a n t can com e to feel m ore fully alive, m ore c o n fid e n t o f his o r h er ow n u n iq u e value. So in sum m ary, w hat does em pathy m ean for your client? W h a t docs it d o for her? It’s a way o f being together th a t you will keep o n offering to her. It’s b o th o f you tu n in g in to w hat she feels, th in k s, fears, w ants, a n d hopes for. It’s a system o f u n d e rsta n d in g w ith in w hich you a n d she discover th e m eanings a n d passions o f h e r life. It’s th e way she can recover h er ow n self-experience a n d self-esteem, a n d th e way she can fin d o u t how to live w ith o th ers a n d be b o th co n n ected w ith th em a n d h er ow n separate self, all at th e sam e tim e.

T H E S C O P E O F EM PA TH Y W O R K T h e pow er o f em pathy m akes relational therapy a very versatile way to w ork. For exam ple, a lth o u g h relational therapy d o e sn ’t organize itself a ro u n d th e belief th a t u n d e rsta n d in g w h a t’s w rong will m ake clients feel better, it o ften h appens th a t as your em pathy draws m ore o f th e ir m em o­ ries, beliefs, a n d feelings in to th e light, m any new u n d e rsta n d in g do

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emerge, and often just know ing w hat it’s all about does help th em feel better—less confused, helpless, and “crazy.” Likewise, relational therapy doesn’t try particularly hard to u n e arth clients’ m em ories. It doesn’t in any special way go after th eir feelings, in hopes o f release o r catharsis, no r does it try to pin dow n th eir faulty belief systems and negative th o u g h t patterns in order to change them . Nevertheless, as em pathy creates new safe space for feeling and rem em bering, clients may well rem em ber feel­ ings and events they had forgotten, or they may find them selves rem em ­ bering things in different ways, w ith feelings th a t were never safe to have before. As em pathy allows them to shake off som e sham e, they can ex­ plore w hat they actually believe and th in k , a process th at in itself makes space for new ways o f thinking. A nd th ere’s n o th in g like looking at the therapy relationship itself, through eyes o f empathy, in order for clients to experience the hid d en power o f th eir core belief systems: how they believe others see th em and w hat kinds o f connections they assum e are possible between them selves and anyone else. R elational therapy doesn’t make a special p o in t o f helping a client make specific changes in his life, unless th a t’s the client’s agenda. Your empathy, however, m ight highlight a client’s restless, “stuck” u n h ap p i­ ness and get him moving. Your acceptance o f a client’s self-doubt m ight, paradoxically, give th a t client space to reclaim his confidence. If he is entangled in difficult relationships, you can help him untangle w hat he needs to say to his parents in order finally to “leave hom e,” o r discover his sense o f entitlem ent w ith his boss, o r figure o u t how he wants to negotiate better ways o f give and take w ith friends and lovers. W h en th ere ’s som ebody w ho really u nderstands how tricky and difficult these issues arc for him and w ho stands right beh in d him helping him know w hat he wants, he can find his own way through it all, b it by bit. R elational therapy d oesn’t advertise as bereavem ent counseling, but w hen a client has suffered a loss, as a relational therapist you will stay w ith a client’s pain and sadness, his anger, loneliness, and despair, and the full range o f his m em ories, regrets, and farewells for as long as he needs you to be there. S ooner o r later any client’s experience o f rela­ tional therapy becom es, for a while at least, an experience o f grieving— allowing the pain o f th e past to be real, acknow ledging th a t certain longed-for experiences will never happen, and m o u rn in g lost o p p o rtu n i­ ties, failed hopes, and broken dream s. A n d finally, although relational therapy w ouldn’t characterize itself as a spiritual therapy, th ere’s som ething about creating a quiet spacc in

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w hich to know on eself a n d be k n ow n th a t invites clients to m ed itate o n th e m eanings o f life, in all o f its pain, loss, a n d beauty. Such is th e b re a d th o f a relational m ode o f therapy. But d o n ’t cer­ tain kinds o f psychological tro u b le call for p a rticu la r kinds o f th era p eu tic expertise? Yes. For exam ple, phobias, obsessions, a n d com pulsions often respond well to desensitization a n d relaxation techniques, as d o th e in­ trusive sym ptom s associated w ith recent, su d d e n trau m a. Som e relational therapists will have developed ad d itio n al expertise in these a n d o th e r special m odes o f trea tm e n t. O n th e o th e r h a n d , all relational therapists will suspect th a t th ere is m ore to any story th a n th e sym ptom s a client describes. For exam ple, su d d e n unexpected trau m a will brin g o n in tru ­ sive sym ptom s associated w ith acutc fear a n d anxiety, b u t it will also, in m ore h id d e n ways, shake th e v ictim ’s e n tire sense o f being safe in a pre­ dictable w orld, a n d th is d eeper fear may extend to th e w orld o f his rela­ tio n sh ip s w ith others. Phobias a n d obsessive-com pulsive p a tte rn s are also often sym ptom s o f m ore lo n g stan d in g a n d deeply felt assum ptions th a t th e w orld is n o t safe, a n d a lth o u g h a p e rso n ’s efforts to co n tro l th e d a n ­ ger may focus o n physical events a n d objects, usually th e d anger has a strong in te rp erso n al core. It is n o t safe to be in th e w orld o f people, a n d by som e psychological sleight o f m in d , avoiding o r c o n tro llin g c ertain events o r th o u g h ts will m ake it safer. T his is w here relatio n al therapy can help, gently uncovering th e roots o f in te rp erso n al fear a n d slowly estab­ lishing a relatio n sh ip th a t can be tested a n d expanded tow ard m ore a n d m ore in te rp erso n al safety. A n o th e r way to m ake a scary w orld feel safer is to becom e addicted to a m ind-num bing, feeling-erasing activity o r substance. If a c lie n t’s pre­ senting problem is an addictive a n d disordered relationship to food, d rink, drugs, sex, gam bling, o r o th e r repetitive activities, you may, as a relational therapist, refer h im to a tre a tm e n t cen ter th a t specializes in getting th e problem behavior u n d e r control, o r if you have th e training, you may do th a t w ork w ith him yourself. B ut after th e behavior is u n d e r co n tro l, th e real w ork starts. W h a t is it th a t he h a sn ’t w anted to know a b o u t o r feel? N ow th a t h e ’s n o t n u m b , w h a t’s it like for h im to be in his ow n skin? C a n he talk a b o u t th e em ptiness inside, th e restlessness a n d th e craving? As a relational therapist, you will know th a t th e anxious em ptiness th a t drives his craving is itself only a sym ptom —w hat h e ’s left w ith be­ cause th e re ’s nob o d y a ro u n d w ho sees h im o r takes tim e to know w ho he is, o r at least th a t’s how it was in his form ative years. By now, his discon­ n e ctio n from o th ers is just a given, a n d it’s a long road back, n o t just

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from his addiction but from his conviction that this aloneness is his life. It may take you a long time to get in, to convince him that you’re really there and that he matters. But you’re in it for the long haul. It he’s ever going to get over it, not just the addiction but what drives him to it, this is the kind of long-term help he will need. People w h o have suffered c h ild h o o d physical a n d sexual abuse (w hich always in clu d es e m o tio n a l in tru s io n a n d a b a n d o n m e n t) also n e ed long­ te rm help . T h e ra p ists w h o w ork w ith abuse survivors have a special bod y o f know ledge a b o u t th e sym ptom s survivors suffer—vario u s k in d s o f dis­ sociation, hypervigilance, crip p lin g anxiety, flashbacks, in te n se sh a m e a n d self-hatred, a n d u sin g self-harm to m anage o v erw h elm in g feelings. T h e ra ­ pists o f m any sch o o ls have le a rn e d how to h e lp survivors u n d e rs ta n d a n d m anage th ese sym ptom s in o rd e r to create safer everyday e n v iro n m e n ts for them selves. A t th e ro o t o f all th ese sym ptom s, o f co u rse, is a dev astatin g betrayal o f tru st. T h e very person(s) th e ch ild loo k ed to for love a n d p ro te c tio n also a b u se d h im . A n d yet, to stay alive em o tio n ally a n d physically, th e ch ild h a d to stay c o n n e c te d to th e caregiver(s). If th is is y o u r c lie n t’s story, a t th e d ark , sile n t c e n te r o f all o f his sym ptom s, th a t betrayal lives o n , m ak in g h im sick a t h e a rt. N o o n e c an b e tru ste d . Love is a lie, a trick. If h e d o e s n ’t lo o k o u t for him self, n o b o d y else will. A n d chances are, n o m a tte r h o w well h e w atches o u t a n d is careful, h e ’s g oing to get h u r t again. W h y o n e a rth w o u ld h e tru s t a th e ra p ist, so m e o n e w h o offers care? As a re la tio n a l th e ra p ist, you n o t o nly help m anage a n d q u ie t th e sym ptom s th a t follow tra u m a tic stress, you also step w ith y o u r c lie n t in to th e im possibility o f th e new re la tio n sh ip . You kn o w you c a n n o t h o p e for his tru st; you also k n o w th a t h e need s y o u r help desperately. N o n e o f th is bleak reality is glossed over in re la tio n a l therapy; to accept it a n d to u n ­ d e rsta n d how it p u sh e s a n d pulls th e c lie n t a n d y o u rse lf is w h ere an e m p a th ic process m u st begin. If th e re is ever to be any u n d o in g o f th e k n o t o f betrayal inside y o u r clien t, it will be th ro u g h a long, h a rd process o f le a rn in g to tr u s t you anyway—in spite o f all he know s a b o u t w h a t’s dan g ero u s, a n d in spite o f all th e little ways you will fail h im , scare h im , a n d in th o se ways h u r t h im all over again. T h is b o o k in clu d e s an e n tire c h a p te r (C h a p te r 4) a b o u t th e trials a n d trib u la tio n s o f th is so rt o f in te r­ p e rso n a l jo u rn ey ; for now th e p o in t is, q u ite sim ply, th a t th e deep, persis­ te n t e m p a th y o f re la tio n a l th era p y m ay be th e m o st fittin g th e ra p e u tic resp o n se to th e re la tio n a l d e v asta tio n suffered by su rv iv o rs o f c h ild h o o d abuse.

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Indeed, in alm ost every k in d o f th era p eu tic in te rv en tio n in special situ atio n s, th e th era p ist’s em pathy is a crucial p a rt o f th e trea tm e n t. Fur­ th erm o re, em pathy w ork links up well w ith o th e r m odes o f experience a n d expression in therapy. For exam ple, w hen clients express them selves in sculpture, p ainting, dance, a n d m usic, o r in dream s, stories, a n d psy­ chodram as, they need som eone p re sen t to receive th e ir expression, to feel into it and w o n d e r aloud a b o u t its energies, feelings, and m eanings. Som e relational therapists brin g these o th e r m odalities in to th e ir prac­ tice. T hey seek to b ro a d en a n d d eep en th e em pathy system betw een th em ­ selves a n d certain clients by inviting th o se clients to explore som e o f these o th e r ways o f expressing them selves—nonverbal ways, a n d ways o f talking in story and m etaphor. A n d th e n th ere are all th e possibilities alive in relational w ork w ith m ore th a n o n e p erso n at a tim e. W h a t b e tte r place for th e active, self­ reflexive use o f em pathy th a n in w ork w ith a couple o r w ith several fam ­ ily m em bers? As a relational th era p ist you can extend em pathy freely a n d equally to every person in th e con su ltin g room , know ing th a t they all have th e ir ow n subjective tru th s a b o u t w hat h ap p en s in th e family a n d suspecting th a t every o n e o f th em is feeling m isu n d ersto o d . As th e ir jo in t therapist, you hope, first o f all, th a t your u n d e rsta n d in g will slowly q u iet th e anxiety a n d defensive anger th a t prevent th e m from h e arin g each o ther. Even if they can ’t talk to each o th er, they can see how feelings change as you p u t yourself in th e shoes o f each o f th e m in tu rn . W ith o u t w ords you will be telling th em , over a n d over, “T his is w hat listening looks like. T his is w hat being h eard feels like. W h e n th e re ’s em pathy in this room , everything gets safer, d o e sn ’t it? W o u ld n ’t you like to try it?” In your relational w ork w ith couplcs, long before th e h u rt, angry p a rtn e rs are able to try to extend em pathy to o n e a n o th e r in conversa­ tio n , each begins to h ear sec o n d h an d , w hile th e o th e r talks to you, th e o th e r’s h u rts a n d fears, vulnerabilities th a t had been h id d e n b e h in d walls o f defense a n d blam e. Each also has th e experience o f sharing th o se vul­ nerabilities w ith you, som eone w h o listens w ith o u t ju m p in g in to dis­ agree o r to fix o r change som ething. Slowly—how slowly d ep en d s o n how badly h u rt a n d betrayed each o f th e m feels—you will encourage th em to talk w ith o n e a n o th e r a n d really listen. You may be even m ore specific. You may give th em rules for how they may resp o n d to each o th e r in each step o f th e ir dialogue, at least u n til it becom es easy for each o f th e m n o t only to h ear th e o th e r b u t also to answ er in a way th a t show s em o tio n al u n d e rsta n d in g o f w hat th e o th e r is trying to say. C ouples take ho m e from th is process a lot o f new in fo rm a tio n a b o u t each o ther. B ut n o n e o f

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w hat they learn m atters as m uch to them as th eir new found ability to p u t em pathy to use in their everyday com m unication. Finally, a w ord about relational group therapy. A group set up as relational, set up so th a t group m em bers will learn from th eir exchanges and relationships w ith each other, offers w onderful chances for unleash­ ing the power o f em pathy. O n the one h an d th ere’s the chance for a client to be heard and understood by a peer—n o t a therapist w ho’s been trained to do this “em pathy thing.” Som etim es em pathy can feel m ore trustw orthy w hen it comes th a t way. A n d o n the o th er hand, a client has chances to reciprocate genuinely and find o u t th at his own em pathy is powerful, too. A m utual exchange o f em pathy is always rewarding, and for those w ho grew up w ith tight, cold silence o r w ith disrespectful, care­ less chaos, the giving a n d receiving o f m eaningful em pathy can be exhila­ rating. H ere at last are opp o rtu n ities to p u t into in tentional, reflective practice th a t dance o f being open and boundaried, separate and con­ nected; here a client can find o u t exactly w hat it feels like to m ake his own choices from w ithin a web o f influence, and to be th a t self w ho is a self-in-relation. Probably the therapeutic scope o f em pathy is far broader th a n I have been able to sketch here. O n the o th er hand, as you’ve m ade your way through this section, maybe you’ve begun to w onder if th ere ’s any­ th in g a relational therapist doesn’t take on. Are my claims for the power o f em pathy too sweeping? I hope I have m ade it clear th a t in situations o f special injury and special symptoms, it’s im p o rta n t to have specialized training. Yet all psychological difficulties require careful, caring un d er­ standing o f the client’s experience o f the problem , an d relational thera­ pists arc very well suited to provide such understanding. O ften it turns o u t th a t such u nderstanding is also very effective treatm ent. W hy w ould this be? N ot because em pathy is a magic bullet, but because alm ost any psychological problem can be traced to a self-witho ther problem . A nd m ost self-with-other problem s happen w hen em pathic connection betw een the selves and others in question has broken down. It makes sense, th en , th a t bringing em pathy back into any self-with-other system will begin to ravel up w hat has becom e unraveled through discon­ nection. T h e relational therapist tries to carry this process as far as it will go. T h a t’s why, no m atter w hat problem o r sym ptom s a client brings to therapy, there can be a generic answer to the question, “W h a t’s it like to get into relational psychotherapy?” It’s like stepping into empathy. But som etim es even relational therapy doesn’t work, and clients leave feeling they d id n ’t get the help they needed. W h at m ight have happened?

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W h e n w ould a relational, e m p ath ic app ro ach be likely to fail? W h a t are th e lim its o f th era p eu tic em pathy? W ell, first o f all, since so m uch de­ p en d s o n forging a relationship, th e th erap y can ru n a g ro u n d if you and th e clien t ju st d o n ’t h it it off. W e could call this situ atio n a “personality clash” or, if we could find a way to investigate, we m ight find th a t som e­ th in g a b o u t you stirred up th e c lie n t’s fear o f auth o rity . O r so m eth in g stirred his fear o f becom ing vulnerable. A n d th e n maybe th e clien t’s ag­ gressive m ode o f p rotecting h im self set o ff old w arn in g bells for you. It could be th a t th e negative cycle o f in te rac tio n began w ith you, n o t th e client. B ut in any case, w hat looked like personality clash was ju st plain fear—o n b o th sides. Fear is w hat usually u n d e rm in es th e w ork o f em pathy, fear o f being h u rt again in th e sam e old ways. Som etim es it’s fear o f ju st c ertain inter­ personal dangers, for exam ple, fear o f being belittled by som eone w ith m ore power, fear o f “being b o rin g ,” fear o f being su d d en ly unw elcom e or “in tro u b le ” for n o reason th e client can figure o u t, o r fear o f having assum ptions m ade a b o u t th e m eanings o f his gender, race, class, o r sexual o rie n ta tio n . If a clien t can be helped to express such fears early in the therapy, a n d if you resp o n d by recognizing th e m as valid, th e th era p eu tic relatio n sh ip can be saved. In fact, th e rela tio n sh ip grows stronger w hen its scary aspects are b ro u g h t honestly in to th e o p en . If those fears are strong b u t rem ain u n d e rg ro u n d , th e therapy probably w o n ’t last long. B ut s h o rt o r long, it will have b een an unsatisfying experience for b o th client a n d therapist. S om etim es th e fear th a t a client brings in to therapy is a m ore u n i­ versal d read o f every k in d of in te rp erso n al c o n n ec tio n . Any real c o n n ec­ tio n is a pow erful th reat, for it m akes him unbearably vulnerable to being h u rt. O fte n th is client hardly know s h e ’s scared, because his life is b u ilt a ro u n d ways to live o u t his roles a n d take care o f th e business o f life w ith o u t feeling m u ch at all. He expects you, as his therapist, to tell him why he has his sym ptom s o f depression a n d obsessive tho u g h ts; he w ants to set goals a n d devise strategies for solving his problem s. W h a t h e ’d really like is a b o o k to read a n d a hom ew ork assignm ent. W h a t he really d o esn ’t w a n t is a relatio n sh ip th a t’s alive a n d m oving betw een h im self and th e therapist. (W h at a terrifying thought!) Surely, we m ig h t th in k , in this case relational therapy will be a failure in its ow n term s. O fte n failure does, indeed, tu rn o u t to be th e case here. As th era ­ pist, you m ust respect w hatever th e client needs to do to keep h im self safe. However, you will usually h ang in w ith such a scared a n d rigidly protected clien t for as long as th e clicnt w ants to com c. Why? Because

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you believe th a t u n d e rn ea th all th a t d isconnection and terror, there may still be a spark o f longing to connect. Perhaps th a t spark is exactly why the client keeps com ing. Maybe som ew here the client knows th a t w hat you offer is his best chance at a better life, and maybe if you keep offering em pathy instead o f cure, one day th a t spark o f longing m ight becom e a spark o f relationship betw een the two o f you. T h at w ould be only the beginning o f a long journey o f self-recovery for your client, b u t relational therapy is m ade for those long journeys. In o th er words, even w hen it looks like em pathy isn’t going to work, it m ight just work after all. In fact, paradoxically, this is just the kind o f situation th a t relational psycho­ therapy is best suited to. I’ve been saying th a t em pathy-work can address a broad range of specific problem s clients bring to therapy, b u t relational psychotherapy does have its own central focus. T he kind o f pain it addresses best is exactly th a t kind o f pain th a t’s locked away in a scared and rigid client w ho can’t bear c o nnection because he knows it will hu rt. But at th e same tim e, his self-protection is slowly sm othering th e life o u t o f him . Funda­ mentally, this is a situation o f painful relational dilem m a, o f relationship th a t feels im possible. T his kind o f situation, w hatever its severity, how­ ever it is masked o r expressed by varieties o f symptoms, is the situation th at relational therapy enters over and over, in hopes th at em pathy will begin to make relationship possible again. C h ap ter 3 is all about how situations o f relational d ilem m a get to be th a t way. How do painful interpersonal experiences becom e self-protections th a t end up feeling like jail cells? O r as we therapists o ften hear the question put, “W hy do I keep feeling so bad w hen I try so hard to feel better?”

ENDN OTES 1. Kohut, H o w D oes A n a ly s is Cure?, 82. 2. Rogers, On Becoming a Person, 184-185. 3. Jordan, “Empathy and Self Boundaries,” in Jordan et al., Women’s Growth in Connec­ tion, 67-80. 4. Cf. Beatrice Beebe et al., “Systems Models in Development and Psychoanalysis: The Case of Vocal Rhythm C oordination and A ttachm ent,” I n fa n t M e n ta l H e a lth J o u rn a l, 2 1(1-2), 99-122.

3 ASSESSMENT W h a t’s Wrong W hen Your Client Feels B adÌ

A P A R T IC U L A R K IN D O F B A D F E E L IN G Som e clients com e to us for help w ith situ atio n al troubles in th e ir lives. O th e rs com e suffering from w h a t’s often called em o tio n al d isturbance, psychological dysfunction, o r m en tal illness. B ut such w ords say n o th in g a b o u t th e essence o f th e ir m ore pervasive, persisten t tro u b le. As these clients try to tell us w h a t’s w rong, they search for m ore m eaningful words, w ords they th in k w e’ll u n d e rstan d : “I’m depressed. I feel anxious all th e tim e. I have low self-esteem .” O r else they ju st tell us how they feel—all stru n g o u t, dread in g a n o th e r day, lousy, rotten, utterly w orthless. T hese are th e sorts o f “feeling b a d ” this chapter explores. For such clients, th e ongoing distress they feel is n o t just an em o­ tio n al reaction to a life crisis such as th e d e a th o f a loved one, a business failure, o r th e diagnosis o f c h ro n ic illness. T h e ir tro u b le ru n s deeper th a n th e effects o f stress. T hey usually know th a t it’s a p p ro p ria te to feel sad a n d angry in response to loss, a n d they can recognize a n d m anage th e o rd in ary stress in th e ir lives, th e d em an d s o f family, w ork, a n d m o rt­ gages. T h ey also know th a t so m eth in g else is w rong, a “feeling b a d ” th a t d o e sn ’t go away even w hen life ru n s sm oothly. T h is k in d o f feeling bad has been p a rt o f th e ir lives, p a rt o f th e ir self-experience, for a very long tim e, a n d o ften they th in k it will never be any better. A t tim es o f loss a n d stress, however, th e bad feeling can suddenly get w orse. T h a t’s o ften w hen such clients com e for help. As a relational therapist, you will take such a clien t’s p re sen t crisis seriously. A llied w ith your client, you will feel th e p u n c h th e crisis packs, th e m eanings it holds. 69

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In your presence, she will find som e stre n g th to cope w ith w hat she faces. B ut as th e crisis eases, you w o n ’t be su rp rised to h ear th a t w h a t you and your clien t have dealt w ith is only th e tip o f an iceberg. M uch lies below th e surface, “b ad feelings” th a t have been lurking for a long tim e. Now, perhaps, your clien t will decide th a t it’s tim e to face th o se deep er issues. W h e th e r she cam e in because o f a crisis o r not, w hen your depressed o r anxious client looks for a generic term for how she feels m ost o f th e tim e, “dissatisfied” com es up. N o t w ith a nything in particular—or, per­ haps, w ith m any things in particu lar—b u t th e general feeling is th a t life isn’t w hat she th in k s it co u ld be. For a long tim e she th o u g h t th a t if she got th a t degree o r m ade en o u g h m oney o r m et th e rig h t p erson, she’d be happy. B ut sh e ’s got a carcer now a n d h e r relatio n sh ip is o k a y . . . so w h a t’s missing? Som etim es she th in k s maybe a b etter job, a new city, a lo n g vacation. Maybe having a baby. But th a t th o u g h t scares her. It’s a big responsibility, a n d w h a t if having a baby d o e sn ’t help either? By now she know s th a t she can ’t blam e h e r dissatisfaction, h er low-grade depression, on th e circum stances o f h er life. W o uld it even be fair to brin g a child in to th is scenario? A n o th e r w ord for h er dissatisfaction m ig h t be “d issonance.” H er hopes a ren ’t m atching u p w ith w hat sh e ’s getting o u t o f life, a n d it’s no t th e straightforw ard k in d o f dissonance th a t achievem ents and posses­ sions can resolve. It’s n o t a situ atio n al dissonance; it’s psychological. Re­ latio n al psych o th erap y says th a t w h e n a p e rso n is living in states o f psychological dissonance, m ost likely w h a t’s b e h in d a n d u n d e rn e a th h er discom fort is relational dissonance—longstanding relational dilem m as and im possibilities th a t she has never b een able to resolve. T h ey ’ve becom e so m u ch a p a rt o f h er everyday life th a t she hardly notices th em . B ut she certainly notices th e ir effects. T his is b u t o n e m ore way to say th a t alm ost any psychological pro b ­ lem can be traced to a self-w ith-other problem . T h e problem s a ren ’t com ­ ing ju st from outside, from circum stances, b u t o n th e o th e r h a n d , they a ren ’t com ing ju st from inside, e ith e r.1 W h ere do your c lie n t’s psycho­ logical “b a d feelings” com e from , then? T hey are alm ost always pro d u ced by so m eth in g th a t’s h ap p en in g , in o n e way o r an o th er, betw een your client and o th e r people. S h e’s n o t a closed system , m aking h e r ow n em o­ tio n al w eather. E m o tio n al w eather is an in te rp erso n al, systemic k in d o f w eather, a n d in m any ways h e r personal psychology com es dow n to how she m anages to play h e r parts in th e ecosystem s in w hich she finds her­ self.

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SYSTEMS MAKE A “SELF” A p erso n ’s psychology, o r sense o f self, is pro d u ced by at least th ree differ­ e n t kinds o f systems o p eratin g at th e sam e tim e. First, th e re ’s w h a t’s hap­ p e ning rig h t now or w h a t ju st h a p p en e d betw een th a t person a n d a n o th e r person. Second, each perso n brings a great deal o f self-experience to any in te rac tio n —his p o sitio n o f relative pow er in th e re lationship, his m em o­ ries o f previous m u tu al contact, his desires, fears, a n d hopes, a n d th e m oods a n d feelings th a t color th e m o m e n t o f in teractio n . T hese com ­ plex systems o f p erception, th o u g h t, feeling, a n d belief th a t m ake up a p erso n ’s experience at any given tim e can be called “self-states.” C hanges in em o tio n al to n e o ften signal changes in self-states—from cheerful confidcncc to sham c-laccd anxiety, for exam ple. Let’s p u t these first two systems, th e interactive system a n d th e selfstate system, in to play. Let’s say a clien t o f yours called Ben goes o u t for a beer after w ork w ith a friend, Jim , and Ben decides to talk a b o u t an idea he has for a new little business. Ben has b een th in k in g a b o u t it for a w hile, w orking o u t th e glitches, a n d he th in k s it could fly. He launches in happily a n d Jim listens, b u t w ith o u t show ing m uch feeling, certainly no en th u siasm . A n d suddenly, instead o f feeling excited a b o u t his idea, Ben feels deflated a n d alm ost asham ed o f having b ro u g h t it up. H is self­ state has changed drastically. If he could d o a com prehensive self-state review, h e ’d find th a t n o t only have his feelings changed, b u t h e has also started to th in k his idea m ight be stupid, he has begun to d o u b t his ability to m ake it h a p p en , a n d h e ’s m uch less likely, in this state, to take any actio n to m ove his idea forw ard. O f course, happy excitem ent a n d self-doubting sham e are b o th self­ state possibilities for Ben th a t predate his exchange w ith Jim . Jim ’s re­ sponse d id n ’t create w hat a d eflated state feels like for Ben, o r how quickly Ben can fall in to it. O n th e o th e r h an d , if th ere were a video recording o f th e ir conversation, an observer could p o in t o u t exactly w here Jim failed to m atch B en’s energy and w here Jim m issed th e cues th a t invited his positive response. T h e tape w ould show ju st how systemically p roduced B en’s d eflated feeling state was. Jim ’s self-state w asn’t w h a t Ben expected. A fterw ard he w ished he h a d asked Jim m ore q uestions before he lau n ch ed in to his ow n ideas. Is Jim afraid o f losing his job? O r has he h a d a bad fight w ith his wife? Maybe, Ben th in k s, h e was annoyed w ith m e a b o u t som eth in g I’d forgot­ ten . O r maybe he had a headache. O r m aybe he was th in k in g o f a busi-

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ness idea h e ’d h ad once, b u t it w ent sour. Ben d o esn ’t know how his w ords affected Jim . B ut they did, an d at th e very sam e tim e, Jim ’s re­ sponse was affecting Ben. Two selves, o r “organized w orlds o f subjective experience,” m et in th e pub, an d a n o th e r sm all, systemic w orld was cre­ ated in th e m o m en ts o f th e ir in te ractio n .2 T h a t tw o-person system af­ fected b o th o f th e self-state systems p resent there, if to d ifferen t degrees an d in d ifferent ways. So it goes in h u m a n interactio n .

A SYSTEM THAT MAKES SENSE OF INTERPERSONAL PROCESS B u t th e p lo t thickens. In a d d itio n to th e self-state systems each m an b ro u g h t in to th e interaction, systems o f co n tin u al flux an d change, an d in a d d itio n to th e tw o-person interactive system created d u rin g th e ir con­ versation, th e re was a th ird kin d o f system at w ork to p ro d u ce Ben’s sense o f self in th a t pub. W c m ight call th a t system his in terp erso n al process m em ory. It’s m ade up n o t o f specific m em ories o f in teractio n s betw een Ben an d oth ers, b u t o f generalizations o f how m any sim ilar in teractio n s have gone before an d o f how, therefore, they are likely to go again. If his system d id n ’t stream line discrete event m em ory in to generalized process m em ory, Ben w ould have to w ork his way th ro u g h every action an d inter­ action as if it were his first. D aniel S tern says th a t infants begin stream lining th e ir in terp erso n al learning very early, developing w h at he calls RIG s, an acronym for “Rep­ resentations o f In teractions w hich have been G eneralized.”1 For example, w hen Ben was a baby, like m ost o f us he probably developed a RIG aro u n d th e sequence o f crying, h earing footsteps, a n d being pickcd up an d com ­ forted. N o t only did th a t RIG co n tain action sequences, it was also full o f affect exchanged betw een him an d his carcgivcr, a n d so it also co n ­ ta in ed a to n e o r feeling o f “s e lf’ for him . So alm ost from th e very begin­ ning, even before he h ad a to d d le r’s awareness o f a “m e,” his affectively to n ed self-feelings were b o u n d up in repetitive self-with-other interactions. M aking these RIG s w'asn’t anything he ever had to w ork at; it was ju st th e way his system autom atically m ade sense o f m any bits o f e x p e rie n c e after tho se bits o f experience h ad been repeated in sim ilar sequences m any tim es. As an adult, he d o esn ’t have to be aware o f his RIG s, either. They are still just th e way th e w orld w orks and how he gets along in it. B ut we m ight hypothesize certain R IG s at w ork for Ben in th e p u b this after­

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noon. He was enacting a certain RIG as he entered w ith his excitement, expecting some enthusiasm in return. He had an expectation of a par­ ticular kind of interaction, with all the positive self-feelings th at go with it. But it turned into a different kind of interaction, and a different RIG slipped in, one in which his energy is met with flatness. The deflation th at followed the interchange led to Ben’s self-feeling of shame. Both the expectant and the deflated RIGs were readily available to Ben as active com ponents of his process memory. Each was a response to unfolding imagined and experienced events, and at the same time, each was a con­ struction of events and of certain senses of Ben’s self. I hope that this example makes clear that process memory is a sys­ tem, too, not a elosed book. It’s an activc system, constantly making sense, and to a certain extent creating m uch of the reality a person experiences. Perhaps a better term for process memory is “organizing principles.”4 The work of organizing experience into recognizable patterns is never finished. Organizing principles can be as small as one little RIG and as large as the networks of RIGs that make up a worldview. The word “principles” catches the sense that som ething has been generalized (from memory) th at helps a person manage the task of organizing. Later in this chapter we’ll look at organizing principles more closely. For now it’s im portant just to know that they’re there—th at third system that was interacting with Ben’s selfstate and also with whatever was going on between Ben and Jim. The question of this chapter is, “W hat’s wrong when your client is feeling bad?” So far I’ve said that the “feeling bad” I’m talking about isn’t just an expectable, healthy reaction to crisis or stress. It feels more like chronic dissatisfaction. It’s a kind of psychological dissonance that, I’m arguing, has its origins in relational dissonance. A nd I have sketched out the three kinds of systems that are involved in any relational interactions. Now I can explain that relational dissonance—th at feeling of being jarred by people or disconnected from them —can originate in any of the three systems. W hen, for example, Ben’s self-state is under the influence of financial worries or a nasty cold, it can be difficult for him to enjoy any interactions. W hen there’s som ething off about an interaction, as there was w ith Jim, the interaction itself can disturb both participants, what­ ever the self-states and organizing principles each brought to it. But the kind of relational dissonance that has the most power to produce psycho­ logical dissonancc is the kind that originates w ith organizing principles. Let’s go back to Ben in the pub. W hat happened made him feel bad. But his bad feelings d o n ’t count as the kind of psychological trouble we’re trying to understand unless he can’t shake them off. The relational

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dissonance he experienced d o e sn ’t grow in to psychological dissonance u n til w h a t’s w rong begins to feel like it’s so m e th in g w rong a b o u t him, a n d it do e sn ’t becom e ch ro n ic psychological dissonance u n til th a t w rong­ ness stays w ith him as an un co m fo rtab le, dissatisfied, tro u b led feeling a b o u t him self. As it h ap p en e d , som e o f th a t psychological tro u b le did sta rt to set in for Ben. H e was u n d e rstan d a b ly deflated by Jim ’s flat response, and th e n h e started to feel stu p id a b o u t having b een so excited. R a th e r th a n protest to Jim , “Hey! W h a t’s up? You’re pretty flat today!” o r try to get a d ifferent response from him , Ben w ent qu iet an d began to feel w hat th era ­ pists call “sham e.” It’s a feeling Ben know s all to o well, he tells you in therapy. O n c e it happens, it’s d ifficult to shake off. Let’s explore Ben’s situ atio n further.

“SO M ET H IN G IS W R O N G W IT H ME!” T h e sham e Ben feels did n o t com e sim ply from his de fla te d self-state o r from th e interactio n w ith Jim . A lth o u g h th e in te rac tio n led to sham e, it w asn’t Jim ’s in te n tio n , Ben knows, to m ake him feel stu p id o r asham ed. T h e sham e took h o ld o f Ben as B en’s organizing p rinciples m ade sense o f th e in te rac tio n a n d o f th e changes in his self-state as his excitem ent fell away. H e d id n ’t decide o r th in k it, he ju st knew it: His feelings o f discon­ n ectio n a n d d e fla tio n were so m e th in g w rong w ith him . W h a t was w rong w ith him? T h e first w ord th a t cam e to his m in d was “stu p id ,” a n d it stuck. Ben tells you th a t “stu p id ” is th e w ord th a t usually com es to m in d w hen h e ’s feeling bad in this way, a n d now th a t he th in k s a b o u t it, he know s th a t h e o ften w orries a b o u t d o in g o r saying d u m b things, o r th a t his co-workers o r friends th in k o f him as stupid. Som etim es, w hen h e ’s feeling anxious a n d o u t o f sorts, he has intrusive flashbacks o f stupid m o m en ts from his past. Clearly, Ben has developed a story a b o u t th e psychological dissonance he suffers, a n d th e story says it’s all a b o u t feel­ ing stupid. If only he w o u ld n ’t be stupid, o r feel stupid, he w ould feel better. T h a t’s w h a t Ben assum es, even th o u g h he has never b een able to talk h im self o u t o f th e problem . Ben, however, w on’t be able to talk h im self o u t o f it, because his problem isn’t really a b o u t feeling stupid; it’s a b o u t feeling sham e. T h e p roblem for Ben is th a t w hen so m eth in g is o ff o r jarrin g o r d isconnected betw een h im a n d so m eo n e else, his system organizes th a t in fo rm a tio n to

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mean that there’s som ething wrong with him. The name of this basic feeling is shame, and shame spawns many different kinds of stories, de­ feated stories like “I’m stupid and worthless,” defensive stories like “No­ body understands me,” and counterattack stories like “I do n ’t get mad, I get even.” Some people’s organizing principles tell them they are defec­ tive most of the time—for long periods, and after quite innocuous inter­ actions. They may be able to block out some of this dissonance with strong defenses or counterattacks, but a strong undertone of feeling bad remains a constant for them. I hope that Ben’s story has clarified the idea of psychological disso­ nance. O n the one hand, Ben responds to invitations to connect with others in the world. The tru th is that he needs to connect, in his work­ place and with neighbors and family, if nowhere else. This is how hum an life is lived: one has to interact with others to feel productive and valued in the world. In fact, Ben does the very best he can, wanting to contrib­ ute and to experience life as meaningful and good. Understandably, de­ spite his best efforts, many of his interactions with others are less than perfect. T h at’s life. The real problem for Ben, however, is th at each of those imperfections or “misses” leaves him feeling th at there’s som ething wrong w ith him. It seems he should experience more inner harmony, especially when he tries hard to be responsible and responsive to others. But no, there’s dissonance. How does it happen that some people experience difficulties in in­ terpersonal interactions as problems that can be ignored or solved while other people experience them as their own defectiveness? As I’ve been saying, it’s a m atter of different organizing principles. These principles com e by way o f pow erful, n o n lin e ar learning; they arc autom atic, un thought generalizations that follow upon repetitive interpersonal in­ teractions. So it makes no sense for Ben to blame himself for feeling defective or for failing to change his feelings by thinking better thoughts. Ben needs help to understand his shame feelings as the product of inter­ actions, both present and past. This kind of help will, in itself, ease some of his shame. A nd he needs not to think that now it’s his organizing principles that are “wrong with him ”! As a relational therapist you know that Ben’s organizing principles may be contributing to a great deal of dissonance and discomfort for Ben. But you also know that they lie dorm ant until they arc pulled into action to make sense of specific things that happen to Ben. So you can explain to Ben, “I don’t think the problems you’re struggling with arc just inside you. They’re problems you have living in the world and feeling

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okay d o in g th a t. I th in k th a t in so m e basic ways, th e w o rld d o e sn ’t feel safe to you. W h e n th in g s h a p p e n betw een you a n d o th e r p eo p le, you w o rry w h e th e r th ey are actually o n y o u r side, o r w h e th e r th ey like you very m u ch . I th in k t h a t ’s w h a t’s g ettin g you d o w n . C e rta in th in g s keep h a p p e n in g , th ey lead to th e sam e o ld k in d s o f b a d feelings, a n d th e n you th in k th e re ’s so m e th in g really w ro n g w ith y o u .”

W H E R E IN SID E A N D O U T S ID E M EE T A N D M IN G LE T h is d isc u ssio n has b e e n lea d in g u p to a very im p o rta n t p o in t, im p licit in w h a t I’ve ju st suggested you m ig h t ex p lain to B en. N ow I w a n t to m ake th a t p o in t explicit: It’s n o t th e case th a t psychological p ro b lem s com e fro m e ith e r in sid e o f a p e rso n o r o u tsid e o f a p e rso n . In stead , th ey com e from th e in-betw een spaces w here th e d a ta o f th e o u tsid e w orld a n d th a t p e rso n ’s capacities to m ake sense o f it m ee t a n d m ingle. H ere it’s n o t clear w h a t’s objective a n d w h a t’s subjective, fo r o n e c a n ’t get o u tsid e o f how o n e ’s ow n m in d shapes th e d a ta in o rd e r to kn o w w h a t’s “really” o u t th ere , n o r does o n e ’s m in d o r subjective self have any su b sta n c e —any­ th in g to th in k a n d feel a b o u t—a p a rt fro m w h a t com es from “o u t th e re .” T h in k o f B en’s sim ple, early R IG o f “crying . . . footsteps . . . bein g picked u p . . . feeling c o m fo rte d .” It has su b sta n c e, feeling, a n d m ea n in g th a t are d e e p e r a n d fu ller th a n a sim p le se q u e n ce o f events. W e m ig h t im ag­ ine th a t it exists in sid e B en ’s m in d , a n d yet th e R IG w ith its associated feelings d o e sn ’t exist unless th e se q u e n ce h a p p en s. F u rth e rm o re , even for an in fan t, m any re p re se n ta tio n s o f in te rac ­ tio n s develop sim u ltan eo u sly ; organ izin g p rin cip les m ay dovetail o r c o n ­ flict in co m plex ways. In sh o rt, th e r e ’s a lo t to s o rt o u t a n d trac k in th is in s id e /o u ts id e place o f m ak in g sense o f in te rac tio n s. F or exam ple, w h a t if so m e th in g drastically d iffe re n t h a p p e n s to y o u n g B en so m etim es, say, “crying . . . footsteps . . . b e in g yelled a t . . . feeling o v e rw h elm ed ”? T h e n a n o th e r R IG w ill have to develop in ta n d e m w ith th e first, a n d it will be p a rt o f B en’s w ork, as h e grow s a n d develops psychologically, to organize a w orld th a t h o ld s b o th R IG s, th a t is, b o th o f th o se interactive sequences th a t have b e en generalized to in clu d e p a rticu la r, recognizable sets o f feel­ ings a n d m eanings. L ater th e you n g B en m ig h t be able to h o ld b o th R IG s sim u ltan eo u sly by k n o w in g his m o th e r as reliably loving, b u t so m e tim es m o o d y a n d stressed. O r h e m ig h t m ake sense o f feeling o v erw h elm ed by e x p erien c­ ing h im se lf as b a d w h en ev er th e u n p le a sa n t in te ra c tio n h a p p en s. If th a t’s

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th e case, h e will try to keep th e b a d away by d o in g w hatever it takes n o t to get yelled at. T h is s o lu tio n involves e ffo rts to u n d o o r cover over th e se c o n d R IG . B ut th e R IG d o e sn ’t disap p ear. It stays available to organize o th e r o v e rw h elm in g o r d isso n a n t e x p erien ce in to a n “I ’m b a d ” feeling. W e c o u ld guess th a t B en’s c u rre n t feelings o f sh a m e m ay have links to org anizing p rin cip les ro o ted th a t far back in his experience. E arlier w e w ere asking, “H ow is it th a t som e people can w ork com fo rtab ly w ith in te rp e rs o n a l co n flicts a n d d isc o n n e c tio n s, w hile o th e rs ex p erien ce th e m as th e ir ow n defectiveness?” T h e s e d iffe re n t ways o f m an a g in g d istu rb in g R IG s is w h ere su c h p a tte rn s beg in to diverge. W e h a v en ’t yet said why a ch ild m ig h t use o n e o r th e o th e r o f th o se ways o f m anaging, th e o n e th a t integ rates positive a n d negative e x p erien ce o r th e o n e th a t tries to sep arate g o o d e x p erien ce fro m b a d a n d keep th e b ad away (sto rin g th e b a d as sham e). W e ’ll r e tu rn to th is q u e stio n in th e C h a p te r 4, w h e n we investigate th e n a tu re a n d effects o f in te rp e rs o n a l tra u m a . B ut th is is a t least a s n a p s h o t o f how a p a tte rn o f feeling b a d gets p u t in to m o tio n , in flu e n c e d n o t ju st by th e o u tsid e o r by th e inside, b u t by b o th a t o n c e, by b o th th e d a ta a n d th e process o f organ izin g it. T h is “place” betw een o u tsid e a n d in sid e (probably it’s m o re a n a c ­ tivity th a n a place) is w h ere in fa n t senses o f self com e in to b e in g a n d w h ere a d u lt senses o f se lf are h e ld in being. W h e n w h a t’s b e in g p ro ­ cessed are th e m ean in g s o f in te rp e rs o n a l in te rac tio n s, th is place o f m ak­ ing sense also m akes a p e rso n a l “psychology,” full o f th e m ea n in g s a n d feelings a p e rso n has a b o u t him self. H ere th e th re e system s I’ve b e en talk in g a b o u t—self-state system s, c u rre n t in te ra c tio n system s, a n d system s o f o rganizing p rin cip les—arc c o n stan tly busy, m ak in g a n d e xchanging th e in fo rm a tio n th a t gets tu rn e d in to p e rso n a l m ea n in g a n d feeling. N ow th a t we have e stab lish ed th a t th e “feeling b a d ” w e’re discussing com es from th is com plex activity o r place w h ere o rg anizing p rin cip les are m ak in g sense o f w h a t’s c o m in g a t th e m , we can lo o k a t h o w b o th o u tsid e a n d in sid e c o n trib u te to psychological d isso n a n c e w ith o u t hav in g to choose e ith e r lo ca tio n as th e sole cause o f th e tro u b le . W e ’ll beg in w ith w h a t com es at y o u r clien ts fro m th e o u tsid e.

PROBLEM S T H A T START FRO M T H E O U T S ID E F em inists have b e e n saying for a lo n g tim e, a t least since th e p u b lic a tio n o f Phyllis C h c sle r’s W om en and M adness in 1972,5 th a t w o m e n ’s psycho­ logical p ro b lem s arc n o t in w o m e n ’s h eads; th a t they com e fro m “o u t­

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side.” T he story goes som ething like this: June Cleaver, Beaver’s mom, may look fine on camera, but really, when nobody’s looking, she’s de­ pressed. She drinks secretly to num b her anxiety, and sometimes she feels that it’s not safe to leave the house. Why? Because she can’t remem­ ber who she is or w hat she’s worth. Her value lies in w hat she does for others. She’s bored w ith repetitive, undervalued housework, she’s iso­ lated from other women, she’s starved for adult company (Ward is a good man, b u t he doesn’t talk much), and she feels empty nest coming on. Actually, she’s really quite angry that her life has come to this. But every­ thing around her tells her it’s a w onderful life; it’s exactly as it should be; she has absolutely no reason to be angry. So she squelches her anger—all o f her feelings, in fact—and she gets depressed instead. She sees a psychia­ trist who prescribes valium for her nervous problems. Mixed with a little alcohol, the pills do take the edge off, and they leave her w ith enough energy to vacuum, mop, dust, and get meals on the table. So on she goes, a woman with her psychological problems under control for now. Feminists took a good look at June Cleaver and said, she’s n ot sick! The problem isn’t inside her, it’s all the messages and pressures coming at her from the outside, telling her who she is and what she’s supposed to do. Her assigned role is a form of oppression, and she’s being kept in her place for a reason. W ard and the boys get more from her life than she does, but they never notice; th at’s just how it should be, they assume. A nd in fact a whole patriarchal establishment, including psychiatry, is making that same assumption: that a white, middle-class woman should be satisfied with her place in the home, with her role as provider of physi­ cal and em otional care. To keep things this way is in the interest of those who have more social power than she docs. T h at’s what makes the pres­ sure to conform so powerful. If June is at all aware th at she wants to do some other things, or if she has some feelings besides satisfaction, the system tells her there’s som ething wrong with her. W hat can she do but agree?—unless she finds the support of a group of women who under­ stand w hat’s being done to them , who see w hat’s coming at them for w hat it is, and who respond, “W e’re not crazy, we’re angry!” In other words, what looks like mental illness here is actually a healthy response to a sick system. Psychological dissonance builds as an oppres­ sive system forces its tru th on people, denying them the tru th of their own experience. More recently, radical m ulticultural feminists like Laura Brown add more complexity to this idea th at oppressive systems produce m ental illness. If you are a woman, they say, but also, and in special ways, if you arc a woman of color, a lesbian, a disabled woman, a single mother,

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o r a p o o r w om an, th e social system th a t privileges able-bodied, h etero­ sexual, a fflu e n t w hite males will m ake your life even harder. T h e way privilege w orks in o u r society, you d o n ’t ju st feel oppressed a n d devalued, it’s really hap p en in g to you. T h e pressures on you to feel n o t good enough, second-rate, a n d defective are pow erful. A n d even th o u g h it feels like your sham e, th e problem is w h a t’s com ing at you. It’s n o t inside you; it’s o u t there. R elational psychotherapy takes this reality very seriously. M any cli­ ents com e in to therapy feeling bad a b o u t them selves because they have b een told in th o u sa n d s o f overt a n d sublim inal ways th a t they are sec­ ond-class citizens, persons o f secondary value. T hese clients first need help to h ear those messages clearly, to sec w here th e messages arc com ing from a n d w hat effects they have o n th em . O fte n th e pressures to devalue them selves slip in un n o ticed ; w h a t these clients n otice are just th e ir ow n general bad feelings a b o u t them selves. T h e self-w ith-other contexts o f th e ir negative self-states have becom e invisible. A n im p o rta n t p a rt o f your w ork will be to trace these bad feelings back to th e everyday interactions they com e from . I’m th in k in g o f a lesbian client, “S ue,” w ho to ld m e she had a sea­ sonal depression th a t settled o n h er every D ecem ber. “Ju st a bad fu n k ,” she said. “By F ebruary it’s gone. M aybe it’s th e lack o f daylight.” I asked h e r w hat D ecem ber was like for her. For her, D ecem ber m ea n t holiday parties at th e office, seasonal cocktail parties w ith friends a n d acq u ain ­ tances from h e r “previous life,” a n d various festive m eals a n d celebra­ tio n s w ith m em bers o f h e r ow n family a n d h er p a rtn e r’s family. Luckily, she was an extrovert w ho liked socializing. “It’s my a n tid o te to depres­ sio n ,” she laughed. She also explained to m e th a t she’d b een o u t for a b o u t eight years now a n d was q u ite com fortable w ith h er o rie n ta tio n . Sue a n d h e r p a rtn e r, “Lyn,” had been together for five years, a n d each o f th e ir fam ilies seem ed to have accepted th e ir relationship. Sue w asn’t o u t at w ork, she said, because th a t d id n ’t feel entirely safe. B ut m ost o f th e old friends from h er previous life knew a b o u t h e r life now. As we m oved in to D ecem ber, we tracked q u ite carefully th e ups and dow ns o f S ue’s daily life. W e noticed th a t at th e office parties she c o u ld n ’t talk a b o u t h e r holiday travel plans w hen th e topic cam e up. In fact, to stay safely closeted, she c o u ld n ’t say m u ch a b o u t h e r life at all. So in spite o f all th e b a n te r Sue could exchange w ith w orkm ates, th o se necessary om issions left h e r feeling o n th e outsid e a n d a b it o f a stranger. “N o t a good feeling!” she said, b u t she h a d n ’t really n o tic e d it before. A t th e cocktail party reunions, she did m en tio n h er pa rtn e r a n d th eir new hom e—

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th re e d iffe re n t tim es!—a n d e ac h tim e th e c o n v e rsa tio n g o t ste e re d in a n ­ o th e r d ire c tio n . It felt like h e r o ld frie n d s w ere h a p p y to see her, b u t th ey really d i d n ’t w a n t to k n o w a b o u t h e r n e w life. “T h a t feels b a d , to o ,” S ue said . “I t’s like th e r e ’s s o m e th in g ju s t to o w e ird a b o u t b e in g q u e er, th o u g h th e y ’d n e v er say so. I d o n ’t like th e m th in k in g t h a t way a b o u t m e .” S u e d e c id e d to pay m o re a tte n tio n to w h a t sh e felt w h e n sh e a n d Lyn w e n t v isitin g fam ily. S h e n o tic e d h o w carefu lly p o lite —d ista n tly p o ­ lite—Lyn’s b r o th e r s a n d sisters w ere to h er. S h e w o n d e re d if th e ir u n fa il­ in g n ic e n e s s m e a n t s o m e th in g like, “See w h a t a g o o d , b ro a d -m in d e d p e rs o n I a m , m a k in g th is e ffo rt to b e nice to y o u .” S h e e x p la in e d , “T h e y ’re n o t in te re s te d in m e! T h e ir n ic e n e ss d o e s n ’t have any m e in it. I c o u ld be a n y o n e, any dyke th ey have to b e n ic e to! A m I tu r n in g in to a cynic?” I to ld h e r 1 d i d n ’t t h in k sh e w as b e c o m in g a cynic; sh e w as ju s t p aying m o re a tte n tio n to th e n u a n c e s o f in te ra c tio n s . T h e m o st d iffic u lt n u a n c e s fo r S u e t h a t C h ris tm a s w ere ta n g le d u p in in te ra c tio n s w ith h e r fa th e r. “ H e tre a ts Lyn like a b u d d y o f m in e ,” she said . “L ike w e’re college ro o m m a te s , n o t a g ro w n -u p c o u p le . A n d th e n h e p u ts h is a rm a ro u n d m e like he always does, a n d says I’m still his little girl.” A fter letting h erself k n o w h o w b a d th a t in te rac tio n felt, Sue trie d to u n d e r­ sta n d th e feeling. A fte r a w h ile sh e guessed, “It’s like if o n ly h e c o u ld k eep m e little , th e n m aybe I’d grow u p rig h t—g ro w u p a n d m a rry so m e b o d y ju s t like h im !” A ll th ro u g h t h a t D e c e m b e r w e k e p t n o tic in g th e h o m o p h o b ia th a t w as ju s t a n o r d in a r y p a r t o f S u e ’s so c ial life, a su b tle o p p re s s io n th a t in te n s ifie d as h e r so cial life in te n sifie d . A fte r we h a d n o tic e d , sh e w o u ld o fte n say, “It’s n o t a b o u t m e; th e y d o n ’t m e a n it,” o r “It d o e s n ’t m atter. I’m u se d to it.” B u t w h e n w c p a id close a tte n tio n , we fo u n d t h a t it w as rig h t a fte r th o s e e v en ts t h a t “d i d n ’t m a tte r ” t h a t s h e felt especially w o rth ­ less, fla t, a n d d e p re sse d . E ach tim e , as s o o n as w e ta lk e d a b o u t w h a t h a d really h a p p e n e d to her, h e r fu n k d issip a te d . W h a t s h e h a d th o u g h t w as an in n e r a ilm e n t t u r n e d o u t to b e h e r e x p e c ta b le re sp o n se s to in te ra c ­ tio n s t h a t to ld h e r t h a t sh e w a sn ’t c o m p le te ly okay, o r n o rm a l, o r a p e r­ s o n w h o s e a d u lt life-choices s h o u ld b e c e le b ra te d . I t w as th is s u b tle o p p re s s io n t h a t left h e r fe elin g iso late d , d iffe re n t, a n d w o rth le ss. S u b tle , system ic o p p re s s io n isn ’t ju s t o u ts id e o f th era p y ; it co m e s rig h t in to th e ro o m . T o p ro te c t h e rself, a c lie n t like S u e h a s to a ssu m e th a t th e th e ra p is t w ill tak e a d v a n ta g e o f h e r p o s itio n o f so cial p o w e r in re la tio n to S u e. In sy m b o lic te rm s, th e th e ra p is t c e rta in ly d o e s have m o re pow er, if o n ly b e c a u se sh e is th e p ro fe s sio n a l in th e re la tio n s h ip a n d re p re se n ts so m e k in d o f a u th o rity . S h e is m o re b la ta n tly im p lic a te d in

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systemic oppression if she is straight in relation to her client’s queerness—o r w hite in relation to her client’s color, affluent in relation to her poverty, or able-bodied in relation to her disability. Such relations o f difference enforce oppression and generate w hat’s w rong for a client o n a daily basis in her life. If a relational therapist fails to acknowledge the differences in social location and power th a t are in the room , she becom es an ongoing part o f a system o f social power th a t tries to make itself invisible w hile it c ontinues to oppress. N o t m uch real relationship can develop betw een client and therapist w hen their im por­ ta n t differences are covered over. N o t m uch can be worked o u t in a rela­ tionship th at has large pockets o f falseness, and it’s doubtful th at such a relationship can do m uch to improve a client’s sense o f self-definition and intrinsic value. So if you work w ith clients w ho com e from different social worlds th a n you do, different daily experiences o f power and privilege, it’s cru­ cial th at you acknowledge this reality and encourage th em to take as m uch tim e as they n eed to explore it. If your social location gives you a position o f m ore power, it’s im p o rtan t n o t to pretend th a t this isn’t so. As a re­ sponsible relational therapist, you w on’t m ake light o f your own privilege or downplay the social powers th a t your clients are up against. But a t the same tim e, it’s im p o rta n t th a t you d o n ’t feel guilty because o f your privi­ lege and try to make it up to your clients som ehow. T h at reaction to difference will tangle up the lines o f the relationships just as thoroughly. W h at m atters is to hear your clients’ tru th s, their experiences. As you hear them , and as you d o n ’t deny o r try to fix w hat’s w rong for them , it can becom e tolerable to have these differences betw een you. W h en they arc acknowledged tairly, differences probably w on’t stand in the way o f positive working relationships. In fact, honest work a round real, painful difference can build your clients’ confidence in the potential o f the therapy. D oing this work w ith your clients is a very im p o rta n t way for you to make clear to them th a t you believe th a t w hat’s w rong for them comes at them from the outside—even from you, and from th e powers o f your own social position.

T H E T R O U B L E C O M E S F R O M F A M IL IE S , T O O Stone C e n te r feminists add a n o th e r dim ension to the idea th a t bad feel­ ings arc responses to w hat comes at clients from the outside. T hey say th a t clicnts’ psychological dissonancc is produced by interpersonal dis­

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co n n ec tio n . D isco n n ectio n includes oppression, for o p pression is fu n d a ­ m entally th e oppressors’ refusal to co n n ec t respectfully an d m utually w ith th o se w h o m they oppress. D isco n n ectio n is also a p rim e characteristic o f a patriarchal society th a t values autonom y, power-over, a n d w in n in g m ore th a n th e fem inine values o f em pathy, co n n ec tio n , a n d c o o p era tio n . T h e S tone C e n te r th eo rists argue th a t th e pow er o f d isc o n n ec tio n can be m itigated th ro u g h experiences o f c o n n ec tio n in genuinely m u tu al relationships. Such co n n ec tio n , they m ain tain , is th e key to psychological h e alth for b o th w om en a n d m en. T hey h o p e to see th e values o f connec­ tio n a n d m utuality m ake significant differences in th e stru c tu re o f o u r society. As they focus o n th e em o tio n al w ork w om en d o to keep connec­ tio n going in fam ilies, they also look very carefully at th e d isco n n ectio n s inside o f fam ilies. T hey show how family systems o f d isc o n n ec tio n have incredible pow er to spin a p erso n ’s self-systems tow ard dissonance. Jean Baker M iller a n d Irene Stiver identify certain p a tte rn s o f dis­ co n n ec tio n in fam ilies th a t lead to severe psychological difficulties for c hildren raised in those fam ilies.6 O n e p a tte rn is secrecy in th e family, o r a conspiracy o f silence, to deny an unacceptable reality. A n extrem e ex­ am ple is th e secret o f sexual abuse in th e family, b u t fam ilies keep silent a b o u t m any o th e r kinds o f skeletons in th e closet, too, such as a b o rtio n , suicide, m en tal illness, a n d babies b o rn o u t o f wedlock. In a second p a tte rn , p arents are em otionally inaccessible; th e ir chil­ d re n d o n ’t have perm ission o r o p p o rtu n ities to get to know th em . Alco­ holic parents, for exam ple, arc absent w hen intoxicated, a n d usually they lack th e em o tio n al skills to m ake c o n ta ct w hen they are sober. Parents w h o have b een traum atized by war, d e ath cam ps, o r fam ilial violence often w ant to p u t those m em ories b e h in d th e m a n d spare th e ir c hildren know ledge o f such horro r. B ut in b lanking o u t th e ir ow n histories, they can m ake them selves strangers to th o se closest to th em . T h is black hole in th e family history th e n also becom es a n o th e r kind o f family secret. T h e th ird p a tte rn o f d isc o n n ec tio n th a t M iller a n d Stiver identify is th e o n e th a t therapists call “p a ren tific atio n .” In m any fam ilies, because o f econom ic stresses, sep a ra tio n a n d divorce, paren tal illness, o r paren tal em o tio n al fragility, ch ild ren learn to take o n responsibilities beyond th eir years. M any ch ild ren m anage these challenges well, a n d know ing th a t th e ir help is h o n o re d , welcom e, a n d im p o rta n t to th e family gives th em c onfidence a n d self-esteem. However, in m any o th e r fam ilies, th ere is no acknow ledgm ent o f th e c h ild ’s efforts, a n d even worse, th e p a ren t does n o t reciprocate by taking th e kinds o f responsibility a p p ro p ria te for a

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parent. In im p o rtan t respects this child is p u t in the role o f parent to the parent, and th en there is no interpersonal place for the child to be a child, w ith a child’s anxieties, confusions, and needs. T his is where the disconnection happens th a t later proves to be so psychologically devastat­ ing. T h e child may know a great deal ab o u t the p aren t’s feelings, b u t there is no place in the relationship for her own frightened, needy, vul­ nerable self. To keep perform ing the role o f com petent caretaker, she needs to disconnect radically from those parts o f herself. This, you m ight rem em ber, was the case for Jane, w hom we followed through different m odes o f therapy in C h ap ter 1. W hatever its p attern o r reason, if d isconnection is w hat cam e at a client from her family o f origin, it has left her w ith a certain kind of psychological dissonance: she bo th desires and fears connection. A t the very same tim e th a t she seeks to be in relationships where she belongs and is valued, she also “know s” th a t those relationships will be danger­ ous unless she hides a great deal o f w ho she is and how she feels. It may n o t even be clear to her why bringing h er whole self to relationship w ould be so risky, b u t she has to assum e th a t if her parents and family were th a t scared to be real, there m ust be a very good reason to be careful. It may seem th a t this family-systems sense o f w hat comes at clients from the outside is completely different from the m ore radical fem inist sense o f the oppression th a t comes at them . B ut these term s o f discon­ n ection can be applied usefully outside o f the family, too. W h e n social systems oppress and injure clients by failing to see them and to respect w ho they arc, they also perpetrate profound disconnection. To protect themselves from fu rth er d isap p o in tm en t a nd h u rt, clients have to p u t up th eir ow n barriers. T hese resistances and disconnections protect them while they find ways to stay connected enough to m ake a life w ithin the social systems in which they find themselves. So they carry on in a sem ­ blance o f belonging, b u t they keep them selves basically h idden and apart. W h e th e r it is happening betw een clients and th eir everyday social sur­ roundings or betw een clients and th eir families, this disconnected sem ­ blance o f co nnection can all too easily tu rn into feelings o f isolation and w orthlessness, a deeply d issonant sense o f being at odds w ith others and w ith themselves. A nd th e n they begin to feel th a t w hat’s w rong is inside them . How docs it happen th at the w rong th a t comes at people from the outside starts to feel like it’s inside them? T h a t’s the question we’ll tu rn to now.

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TH E BEDTIM E STORY CLIENTS TELL THEMSELVES T h o se therapies th a t em phasize th e social c o n stru ctio n o f self m ain tain th a t psychological dissonance is a direct effect o f social forces. W e have seen how fem inism has tak e n th e illness o u t o f m en tal illness a n d lo­ cated it in patriarchal systems o f oppression. B ut according to alm ost all th eo ries o f psychotherapy, w h a t’s called m en tal illness o r psychological distu rb an ce involves m ore th a n just a self being attacked by outside forces. Som ehow th a t self has becom e divided against itself; th e o u te r conflict has becom e an in n e r tension. H ow d o social-construction therapies ex­ p lain this in n e r ten sio n w ith o u t capitulating to th e idea o f individual psychopathology—to th e idea th a t so m eth in g is w rong inside a person? O fte n th o se therapies use th e idea o f narrative. T hey n o te th a t in systems o f oppression, people in pow er propagate pow erful stories ab o u t how th e w orld works. In th o se stories, th e losers in th e system deserve to lose because they are lazy, inferior, weak, o r p ro n e to m aking bad choices. T hese stories are woven in to th e fabric o f everyday life, p o p u lar culture, a n d m ainstream m edia a n d politics. If a clien t lives on th e “loser" side o f social difference, a n d if she d o e sn ’t have a strong c o m m u n ity a n d family speaking a n o th e r story to h er m ore insistently, she will sta rt to believe th o se stories a b o u t herself. T h e re ’s n o th in g else available to believe. A n d it’s n o t like anyone can escape living o u t a story o f h e r ow n life. T h a t’s w hat h u m a n beings do, narrative th eo rists say.7 Your client can ’t escape d o in g it, b u t she can pay a tte n tio n to w hat h er story is telling h e r a b o u t how she can live. She can listen in o n w hat L aura Brow n calls th e b ed tim e story she always tells herself.8 She m ight h ear h erself saying things a b o u t h erself th a t “they” say, th o se w ho live o n th e “w in n e r” side o f c ertain social differences. She sees herself th ro u g h th e ir eyes. She hopes for only w h a t they th in k she can achieve; she values herself by th e ir standards. She looks back over h er history w ith th e ir sense o f how sh e ’s failed, a n d she looks forw ard to m ore o f th e sam e. A n d every m o rn in g w hen she gets up, she goes o u t to live a n o th e r day o f th is p a rticu la r story, because it’s hers, th e only o n e she know s. T h is is how narrative therapy explains “internalized o p p ressio n .” T h e oppres­ sion isn’t really in te rn al, a n d even th e story keeps com ing at your client from th e outside, b u t th e re ’s n o alternative story for h e r to live. If w ith in your c lie n t’s society a n d th e confines o f h e r life, th ere is truly no alternative story to live, th e n th e re ’s n o p o in t in h e r paying at­ te n tio n to th e story sh e ’s b een given. In th e history o f h u m a n cultures, m any o f th e losers—serfs, slaves, u ntouchables, p risoners, and w om en—

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had no chance o f a d ifferent story. M any still d o n ’t. B ut if a client can afford to n otice h er story, already she has som e inkling th a t maybe som e­ th in g could be different. Besides suffering th e effects o f oppression, sh e ’s feeling ten sio n betw een th e story sh e ’s been given a n d so m e th in g else she knows, suspects, hopes, o r w onders a b o u t herself a n d h er life. T his u n co m fo rtab le psychological dissonance is th e first step tow ard change; it’s w hat gets h e r to therapy, for exam ple. T h e next step in narrative therapy is for your clien t to u n d e rsta n d th e pow er o f th e narrative she is living rig h t now. T h e longer she listens in o n th e b ed tim e story she tells herself, th e m ore she feels w h a t it does to her. It’s good for h e r to have som e help w hile she listens, som eone to p u t th e real nam es to h er experiences, nam es like “abuse,” “sexual harass­ m e n t,” “racism ,” “incest,” o r “h o m o p h o b ia .” Your e m p ath ic presence m akes it easier for h e r to bear th e pain o f u n d e rsta n d in g w h a t th e story has d o n e a n d c o n tin u e s to d o to her. She also needs som eone th ere to tell h er th a t a n o th e r story is possible. A new story w o n ’t b u rst u p o n her. It w o n ’t be easy for h e r to find h e r ow n real experience o r h e r ow n voice for speaking. B ut w hen she does, she will have u n d o n e a great deal o f th e dam age d o n e to h e r by forces o u tsid e her. T h o se forces are beyond h er control, b u t in h e r ow n voice and from w ith in h er ow n real story, she can keep o n resisting th e ir pow er over her.

RELATIONAL STRATEGIES A N D RELATIONAL IMAGES S tone C e n te r theorists, too, resist th e n o tio n th a t psychological pro b ­ lem s are in te rn al to individuals. Psychological trouble, they say, is a selfin-rclation problem . A social a n d family history o f d isconnection generates specific k inds o f self-in-relation experience. In fam ilies w here im p o rta n t things c a n n o t be said, w here ch ild ren have to grow them selves up, and w here p arents rem ain em otionally unavailable, th e ch ild ren develop th e h a b it o f em o tio n al isolation. T hey learn to keep large parts o f th e ir own experience o u t o f sight, a n d o u t o f th e ir ow n awareness, too, eventually. T h e ir lives becom e narrow , rigid, a n d joyless, b u t this is th e best they know. T hey may create elaborate in n er w orlds to w hich they can safely retreat. T hey may co m fo rt them selves w ith com pulsions, obsessions, o r substance abuse, o r they m ight sink in to depression a n d feelings o f selflo ath in g a n d despair. All o f these self-states are sym ptom s o f isolation, an isolation th a t is no longer im posed from th e outside, b u t has becom e a h a b it o f being.

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W ith th is p ic tu re as b a c k g ro u n d to w h a t goes w ro n g for th e ir cli­ e nts, S to n e C e n te r th e o rists offer tw o m o re ideas a b o u t how th is isolat­ ing d isc o n n e c tio n becom es a seem ingly in te rn al p h e n o m e n o n . T hey speak o f c lie n ts’ strategies fo r m a in ta in in g d isc o n n e c te d k in d s o f c o n n e c tio n , a n d also o f th e relational images th a t c o n stru c t th e ir c lie n ts’ self-images. As M iller a n d Stiver describe th e situ a tio n , v a rio u s form s o f selfisolating behaviors are actually clien ts’ best efforts at re m a in in g c o n n ec te d w ith o th ers. T h ese d is c o n n e c tin g /c o n n e c tin g strategies are a com p licated n e g o tia tio n o f in n e r needs a n d o u te r reality. E xp erien ce has ta u g h t a c lie n t h o w to keep a p p are n tly “b a d ” o r u n a cc ep ta b le p a rts o f h im self disguised o r far away fro m o th e rs. H e also know s how to b rin g forw ard som e acceptable p a rts o t him self, th e pa rts o th e rs will like a n d can use. In a n o n re sp o n siv c o r abusive e n v iro n m e n t, th is know ledge o n c c served h im well. B u t now h e experiences psychological d isso n a n c e —c o n stric tio n , anxiety, d e p ressio n —as h e keeps o n m ak in g th o se sam e strategic relatio n al m oves. H is strategies p ro te c t h im , b u t over th e lo n g te rm th ey leave h im q u ite isolated a n d u n k n o w n . T h u s, th e im p a c t o f th e c lie n t’s social su r­ ro u n d in g s com es to be, in a c e rta in sense, “in sid e ” h im in th e fo rm o f strategies h e le a rn e d to use to keep h im se lf o u t o f c o n n e c tio n w hile seem ­ ing to be in c o n n e c tio n w ith o th e rs. In d e sc rib in g his s itu a tio n in th is way, self-in-relation th e o rists avoid a ttrib u tin g so m e k in d o f illness o r flaw to h im , w hile also a cknow ledging th a t w h a t’s h a p p e n e d to h im has affected h im in a way th a t keeps th e p a in o f his early e x p erien ce alive. S to n e C e n te r w riters also m e n tio n “re la tio n a l im ages” as they ex­ p lain th e c o n n e c tio n s betw een e x te rn al a n d in te rn a l reality. R elatio n al im ages arc generalized p ictu res y o u r clients h o ld , p ictu res o f how they have b e e n a n d c an be in re la tio n w ith o th e rs. T h e se sclf-in-rclation pic­ tu res strongly in flu e n c e how th ey feel a b o u t them selves. S o m e tim es th e b e st access to th o se p ictu res is th ro u g h c h ild h o o d images t h a t first ap­ p e ar as frozen v ignettes o f m em ory. O n e c lie n t re m e m b e rs sta n d in g alo n e o n th e p layground, left o u t o f all th e gam es. A n o th e r recalls h u d d lin g for h o u rs a t a locked d o o r in th e w inter, h e r h o u se key lost. A th ird c a n ’t forget th e aw ful m o m e n t o f g e ttin g c a u g h t c h e a tin g in g rad e five. F or each clien t, th e im age isn’t a b o u t re la tio n sh ip , it ju st rep re se n ts so m e­ th in g b ad th a t’s tru e a b o u t herself. A s th ey tell th ese stories in therapy, how ever, y o u r clien ts beg in to sec th ese im ages in con tcx t. Y our first c lic n t was ig n o red a n d left o u t because h e r fam ily m oved a lo t a n d sh e was always th e new kid. Y our seco n d c lie n t was only eig h t th a t tim e she got locked o u t in th e cold; she was scared a n d h e r h a n d s a n d feet h u r t terribly. B ut w h e n h e r m o m

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finally h u rrie d up th e walk, she d id n ’t see h er k id ’s fear o r pain. H er m o m ’s eyes were ju st angry th a t sh e ’d lost th e key—again! For your th ird client, getting high m arks was th e only th in g she was good at. So w hen she d id n ’t know th e answers o n a test, she had to try very h ard n o t to cheat. B ut som etim es she peeked anyway. As you a n d your clients live w ith these stories, your clients begin to u n d e rsta n d th a t th e relationships in th em are w hat give th em th e ir m ean­ ing. C e rta in in teractio n s w ith people told your clients w ho they were and w hat they were w o rth . W h e n th e kids o n th e playground ignored your first client, they told h e r she was ugly a n d u nlikable—o r th a t’s w hat she could m ake of th e ir behavior. H er m o m ’s angry eyes told your client w ho had lost h er key th a t h e r troubles were all because o f h er ow n stupid m istakes. W h e n your th ird clicnt was caught cheating, th e teacher seem ed to see only th e o n e bad th in g sh e ’d d o n e . To th e teacher, rig h t th en , th ere was n o th in g good a b o u t your client—a n d th a t’s how she felt, too. In each case, th e in te rac tio n left th e clien t feeling, “T h e re ’s som e­ th in g w rong w ith m e!” T h o se kinds o f relational experiences h u rt. W h e n they h a p p en often, c hildren develop strategies to p rotect them selves. T hey d isco n n ect from people, w hile m aking sure to presen t a safe front. As adults they will strive to be seen as com petent, ho n est, reliable persons b o th at ho m e a n d at work. U n d e rn e a th they may be q u ite depressed and angry. T h a t will keep people away, too. In any case, n o o n e com es close en o u g h to discover all th a t’s w rong w ith th em . A self-in-relation th era p ist expects th a t w hen clients like this com e for help, it’s because th e ir strategics for disco n n ected , “safe” k inds o f c o n n e c tio n have isolated th e m in ways th a t arc becom ing unbearable, and becausc th e ir relational images keep o n telling th em m ostly bad things a b o u t them selves. D oing self-in-relation therapy m eans creating relatio n ­ ships w ith your clients th a t will subvert a n d u n d o som e o f th o se strate­ gies. You will talk a b o u t th e old, sh am ed pictures o f them selves a n d see th em w ith new eyes—as images o f a sm all, v u lnerable self in relation w ith o th ers w ho w eren’t able to give th e m w hat they needed. T h e “b a d ” th a t gets changed in this process is n o t so m eth in g p a th o ­ logical inside your clients. Instead, th e “b a d ” is th e pain caused by th e ir everyday self-protections and th eir everyday m em ories. They haven’t know n any o th e r ways to c o n n ec t w ith o th ers o r w ith th e ir past. N ow they have som e new ways o f co n n cc tio n . T hey can see th e ir early relational c o n ­ texts m ore clearly a n d feci m ore em pathy for th e ir younger selves. Now th o se old ways o f acting, th in k in g , a n d feeling can change, a n d they can begin to fin d them selves in relationships w ith o th ers th a t feel com pletely

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different, relationships in w hich they aren’t bad o r wrong. T hose bad feelings th a t have to rm en ted them forever can now begin to fade.

A BRIEF DETOUR THROUGH OBJECT RELATIONS THEORY W e’ve seen the Stone C e n te r picture o f how difficulties com ing at your clients from the outside tu rn into th eir own bad feelings about th em ­ selves. To see w hat relational psychoanalytic theory m ight add to this picture, we’ll first take a b rief look at the stream o f psychoanalytic theory th a t has becom e know n as object relations theory. B ehind m ost o f rela­ tional theory, th ere’s a long history o f psychoanalytic theory. W ith in th at general history, it was object relations theory th at began a m ovem ent toward m ore relational understandings o f psychological processes. As we noted in C h ap ter 1, object relations theory has influenced, in different ways, b o th self psychology and the school th a t calls itself “relational psy­ choanalysis.” In a classically Freudian scheme, a p a tie n t’s bad feelings (guilt, anxi­ ety, depression, and oth er sym ptom s o f neurosis) com e from psychic en­ ergy, usually sexual drive, w hich has been blocked or trapped by becom ing tangled up in m em ory or fantasy th a t the patien t c an n o t tolerate know ­ ing about consciously. H idden conflict benveen instinctual drives (id) and a punishing, silencing co n ta in m e n t o f those drives (superego) ex­ presses itself as sym ptoms. (In F reud’s day, the sym ptom s first addressed were not w hat we would recognize as psychological dissonance, b u t rath er the “hysterical” conversions o f psychological conflicts and blocks into physical symptoms.) A fter Freud’s death, many psychoanalytic theorists began to suspect th a t n o t all adult psychological conflicts originate from the oedipal pe­ riod (ages 4 -6 ) and from the ch ild ’s oedipal struggle to find his or her appropriate sexual self-definition in relation to bo th parents. T hey pro­ posed th a t many significant conflicts originate in earlier childhood and even in infancy. T hey located these conflicts inside the child, n o t be­ tween child and parent, and m apped them o u t as the child’s relation­ ships to “in te rn al objects.” T h e ir a d u lt clients, they reasoned, were suffering from still-unresolved problem s in the ongoing relations between themselves and their early internal objects. So in object relations theory, bad feelings are still com ing from con­ flicted, blocked, and tangled-up drives. B ut the field o f conflict has be­

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com e m ore com plicated. M ore a tte n tio n is given to th e existence o f th e in te rn al objects (images o f others) to w hom th e drives are directed, and th ere are im p o rta n t questio n s asked a b o u t th e re lationships betw een th e a d u lt p a tie n t a n d th o se in te rn al objects. T h e co n flict going on in those relationships is m ore com plex th a n a struggle a n d sta n d o ff benveen id a n d superego. O b je ct relations theorists rem ain tru e to Freud in th e ir assu m p tio n th a t th e c h ild ’s conflicts, like th e rest o f th e c h ild ’s psychological developm ent, are pow ered by drives. B ut they begin to talk o f the drives n o t just in term s o f in n ate sexual a n d aggressive instincts b u t also in term s o f th e c h ild ’s need to attach, a n d in term s o f in n ate psychologi­ cal energies th a t can be tu rn e d to adaptive, developm ental tasks. H ow w ould this theory describe o u r earlier exam ple o f th e two RIGs, o n e th a t links crying to feeling co m forted a n d th e o th e r th a t links crying to overw helm ing negative feeling? For object relations theorists, m ore is going o n in these pictures th a n a c h ild ’s pleasure-seeking instincts being gratified , o r else b ein g fru stra te d so th a t h e r aggressive in stin c ts are aroused. T h e child is also busy m aking an in te rn al m ap o f w h a t’s h a p p e n ­ ing, a n d th e c o m p o n e n ts o f th e m ap are h er drives (the passions o f love a n d h ate entan g led w ith a tta c h m e n t longings), th e in te rn al images o f th e o th ers w ho respond to h e r drives, and in te rn al images o f herself th a t c o rre sp o n d to th o se in te rn al O th e rs. So, for exam ple, th e child dealing w ith th e p roblem o f th e two R IG s has an internalized c om forting G o o d M o th e r a n d an internalized frightening Bad M other, w ith c o rre sp o n d in g images o f G o o d Self a n d Bad Self. In healthy d evelopm ent, th e intense feelings b o u n d up in th e Bad M o th e r-B a d Self relation are neutralized as th e d ifferent fragm entary good a n d bad images coalcsce in to th e image o f a consistently good en o u g h m other, in w hose presence th e child can enjoy a free range o f self-expression a n d be good eno u g h , too. O r th e c h ild ’s in te rn al objects may rem ain fragm entary, th e bad ones b o u n d up w ith intense psychic energy a n d also w rapped tightly w ithin strong defense m echanism s such as denial a n d repression. T h e n these unresolved early c h ild h o o d object relations sink o u t o f sight, in to th e unconscious. B ut they reappear in a p a tie n t’s a d u lt life as projections—as seeing th o se Bad images in th e faces a n d actions o f th e p a tie n t’s signifi­ c an t others. As object relations th eo ry describes this situ atio n , th e a d u lt p a tie n t w ho suffers these pervasive experiences o f Bad O th e r a n d Bad Self has n o idea a b o u t th e ir origins. H e know s a n d feels only th e fear, sadness, despair a n d h ate they stir u p in him . H e may also long desperately for a pow erfully G o o d O th e r w ho will tu r n his Bad Self in to G o o d . W h a t can

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he d o to h e lp him self? H e can act o u t his experiences to get so m e relief from feeling th e m , tu rn in g against o th e rs a n d ultim ately against him self. H e can flee fro m his acutely p a in fu l ex p erien ce in to th e less acu te p a in o f d ep ressio n . H e can block his feelings w ith a d d ic tio n s o r m e d ic a tio n . O r he can take his exp erien ce, w ith all o f its p a in fu l feelings, to therap y . In psychoanalysis o r th era p y g u id ed by o b jec t re la tio n s th eo ry , the th e ra p is t expects th a t as she becom es a sig n ific a n t a tta c h m e n t o b jec t to h e r clien t, his p ro je c tio n s will surely c o m e a t her, to o . As his in te n se feelings rise in to his co n scio u sn ess a n d tow ard her, sh e h elp s h im allow in to his aw areness th e in te rn a l d ra m a s o f O th e r a n d Self th a t gen erate th e feelings. A t last h e is able to revisit th e in te rn a l scene w here his early c o n flicts w ere laid do w n . A s h e feels, o n c e again, th o se early passio n s o f lo n g in g a n d fear, love a n d h ate, b u t th is tim e in th e presen ce o f so m e o n e w h o can reliably c o n ta in th e m , th e frag m e n te d im ages o f G o o d a n d Bad O th e r a n d S e lf slowly coalesce in to a m u ch h e a lth ie r p ic tu re o f a goo d en o u g h o th e r in re la tio n to a self o f m any aspects, b o th “g o o d ” a n d “b a d .” T h ro u g h th is process, a n d because th e c lie n t has o w n e d o r ta k e n back his p ro jec tio n s o f his in te rn a l c o n flicts, eventually he fin d s h im s e lf able to live in c o m fo rtab le , a u to n o m o u s re la tio n sh ip s w ith real o th e rs in th e w orld, re la tio n sh ip s now far less w eighed d o w n a n d tro u b le d by th e past. In th is m o d el, th e n , th e b a d th a t a c lie n t experiences as psychologi­ cal d isso n a n c e cam e at h im m ostly lo n g ago. T h a t’s w h e n h e in te rn alize d it. A n d it’s n o t entirely clear how b a d it really was th e n a n d how m u c h th e fra g m e n ta tio n a n d rep ressio n o f his in te rn a l objects w ere d u e to his in fa n tile inab ility to in te g rate pow erful feelings o f desire a n d rage. D iffer­ e n t o b jec t re la tio n s th e o rists take d iffe re n t p o sitio n s o n th ese issues. B ut in any case, th e psychological e n ta n g lem en ts a n d dissonance o f th e c lie n t’s p re se n t life are u n d e rs to o d as u n c o n sc io u sly d riv en re p e titio n s o f c o n ­ n e c tio n s to b a d in te rn a l objects, a n d / o r as p ro je c tio n s o f th o se p a in fu l b u t u n c o n s c io u s B ad S e lf- B a d O t h e r c o n n e c tio n s o n h is p r e s e n t re la tio n sh ip s. In o th e r w ords, a lth o u g h a t som e tim e in th e past, b ad feelings w ere th is c lie n t’s re sp o n se to w h a t cam e a t h im fro m th e o u tsid e, th ey very so o n b ecam e a n “in sid e ” p ro b lem , a p ro b le m o f in te rn a l o b jec t rela­ tio n s, w h ich th e n beg an to w reak th e ir ow n havoc o n his “o u tsid e ” w orld. T h is sense o f h o w past e x p erien ce b ecom es a pow erful force in presentday life is c a p tu re d in th e m e ta p h o r m any clien ts lea rn to use in psychody nam ic therapy: “It’s n o t my real, present-day M o th e r (or F ath er) w h o ’s th e pro b lem ; it’s th e M o th e r (o r F ather) I carry inside. A n d th e n I project,

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so th a t the people aro u n d me tu rn into my M other (or Father)!” O bject relations theory is fundam entally a theory about w hat h a p ­ pens inside clients, and about helping th em to clear up th e confusion between inside and outside. A nd yet, far m ore th a n the classic Freudian scheme does, it pays attention to interpersonal relationships, even if mostly in internalized o r projected forms. In object relations theory “se lf’ (or ego) comes into being n o t where drives are recognized and tam ed, b u t in the ongoing interface between “o utside” and “inside”—even though th at interface is internalized. It is this strong m ovem ent toward relational reality th a t makes object relations theory useful to “relational psychoanaly­ sis” and also a bridge to self psychology.

“RELATIONAL PSYCHOANALYSIS” AND OBJECT RELATIONS THEORY A BO U T “W H A T’S W R O N G ” Many analysts w ith roots in interpersonal theory and w ho now call th em ­ selves “relational” use object relations theory to u n d e rstan d w hat’s w rong for th eir clients. Sullivan him self set the stage for this w hen he included the concepts “good m other,” “good m e,” “bad m other,” and “bad m e” w ithin his transactional and interpersonal practice o f psychiatry.9 C o n ­ tem porary practitioners o f relational psychoanalysis, less opposed th an Sullivan was to “the unconscious” and “transference,” include ideas about traum a-induced splitting and about the unconscious projection o f a client’s powerful dissociated feelings on to th e therapist. T hey try to engage w ith split-off parts o f a client’s self, and th eir hope is th at the client will be­ com e able to reintegrate previously dissociated experiences, feelings, and parts o f self.10 Incorporating an object relations so rt o f theory into an interactive interpersonalist m ode o f therapy allows a relational psychoanalyst to move back and forth betw een the intrapsychic and the intersubjective, between inside and outside, always keeping an eye on how each “side” gives form a nd substance to the other. To keep this m ovem ent going, th e relational psychoanalyst constantly invites the client’s troubled psyche to engage directly w ith her: “Talk to me; connect w ith me; push me away; tell me w hat you’re th inking just now; tell me how you feel ab o u t me right now; w ant som ething from me; hate som ething about m e —w ith me—and th en together we will be able to so rt o u t w hat the ‘inside’ trouble is.” T hough such w ords may never be spoken, these are the kinds o f

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in teractio n s th ro u g h w hich th e c lie n t’s intrapsychic S e lf-O th e r conflicts becom e in te rp erso n al dynam ics. First they are lived o u t, a n d th e n they are d e co n stru c te d in th e therapy. Intrapsychic splits are healed as th e analyst draws dissociated parts o f th e clien t’s in n er experience in to h u ­ m an c o n ta ct a n d interactio n o n th e “o u tsid e.” A n intersubjective rela­ tio n sh ip w ith th e analyst creates a safe, c o n ta in in g co n tex t w here th e client can experience as safe his ow n “b ad feelings” a n d th e m ost painful parts o f his internalized history. In sum m ary, th e c lie n t’s u n co n scio u s o bject relations are slowly draw n o u t o n to an in te rp erso n al playing field w here, over th e course o f m any replays, they lose th e ir u nconscious power. In th e process o f play­ ing o n th a t field, th e clien t wakes up to new possibilities for play th a t he c o u ld n ’t have im agined before. T hose new possibilities for sclf-w ith-othcr interactio n s are internalized as new object relations th a t p ro d u ce an in­ tern a l w orld o f m ore freedom and com fort. A n d th o se in te rn al changes keep o n paying o ff as newly satisfying in te rp erso n al interactions.

BETW EEN “IN SID E ” A N D “O U T S ID E ” IN SELF PSYCHOLOGY Self psychology does som ething very different w ith object relations theory, so m e th in g th a t in a n o th e r way is ju st as radically relatio n al." It d o e sn ’t use it to m ap w h a t’s w rong in a clien t’s in n e r w orld. Instead, self psychol­ ogy has m ade a considered m ove beyond o bject relations th eo ry in ord er to explore a new locus for th era p eu tic discovery a n d change, th e space o f em pathy. It proposes th a t in this space th e significant relations o f therapy happen. O ver th e years, self psychology has com e to u n d e rstan d this shared th era p eu tic space as fun d am en tally intersubjcctivc. T h e clien t’s a n d th e th era p ist’s self-systems, conscious a n d unconscious, are p resent in th e space o f e m p ath ic u n d e rstan d in g , a n d so this is a space in w hich several kinds o f “in sid e” a n d “o u tsid e ” m eet a n d m ingle. Instead o f m oving be­ tw een an in te rp erso n al “o u tsid e ” a n d an “inside” o f object relations, self psychologists focus o n this in-between, intersubjective space o r activity in w hich senses o f self take shape. A t this p o in t in this chapter, I’m n o t giving you new in fo rm a tio n . In fact, th is is th e language I’ve b een using all along in o rd e r to describe w h a t’s w rong w hen your client is feeling bad. Intersubjective and devel­ o p m en ta l self psychological th eo ry was b e h in d my story a b o u t Ben and Jim , a n d it guided my descriptions o f self-states, RIG s, a n d organizing

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principles. It is, as I a d m itte d in C h a p te r 1, my bias w ith in relational theory. I lean tow ard th e m ost radically relational a n d systemic form s o f self psychological theory, a n d so th a t’s w hat you’ve h eard a b o u t so far. In th e follow ing section, I will talk a b o u t th e w ider scope o f w h a t self psy­ chology has to offer o n th e topic o f “W h a t’s w rong w hen your clien t feels bad?” W ith its roots in object relations, self psychology has always been d e v e lo p m e n ta l^ m in d ed . Since its earliest days, self psychology has lo­ cated th e origins o f psychopathology in a p a tie n t’s relational history. To­ day it continues to offer relational-developm ental answers to o u r question o f how th e bad experience th a t com es at a p erso n from “o u tsid e ” tu rn s in to h e r ow n bad feelings a b o u t herself. B ut in o rd e r to u n d e rsta n d w hat self psychology offers, we first n eed to u n d e rs ta n d w h a t it m eans by “selfobject experience”—w hich, paired w ith “em pathy,” is o n e o f th e m ost im p o rta n t concepts in self psychology. (T he th era p e u tic space o f em pa­ thy creates for a client a new chance for necessary selfobject experience.) As we’ve seen, in th e history o f psychoanalysis, “o b ject” has com e to m ean a p e rso n ’s in te rn al experience o f a n o th e r person. O u r object relationships are o u r relationships to in tern al images o f im p o rta n t o th er people in o u r lives. W h a t w ould a “selfobject” be, then? In self psychol­ ogy theory, a selfobject is th e internalized presence o f a n o th e r person w hen th e presence o f th a t perso n is necessary for a positive experience o f self. T h e o th e r’s presence provides th e self w ith experiences o f identity, agency, a n d value: “T h is is me; I can do it; I m atter!” It may seem th a t these feelings belong ju st to th e self in questio n , w h e th er th a t self be an infant, child, o r adult. B ut a lth o u g h they d o “b elo n g ” to th a t self, the good feelings w o u ld n ’t be th ere w ith o u t th e presence o f o th ers—b o th real a n d fantasized o r internalized others. Selfobject th eo ry also explains th e reciprocal negative p arts o f self­ experience. W h e n th e presence o f o th ers fails to su p p o rt a self’s cohe­ sion, power, a n d goodness, th e self feels weak, fragm ented, depleted, o r flawed. W ith this vision o f w here at least som e psychological dissonance originates, early self psychology add ed a w hole new arena o f bad feelings to th e psychoanalytic picture. “Feeling b a d ” can stem n o t just from in ter­ nal c o n flict b u t also from deficit, deficit o rig in atin g in self-w ith-other experience. If th a t’s th e case, th e n w h a t’s w rong for your clients com es n o t just from bad things th a t h a p p en e d to th em , b u t from good things th a t d id n ’t h a p p e n for th em . T h e ir senses o f self are n o t as co h ere n t, resilient, cohe­ sive, o r sturdy as they m ight be. T h is k in d o f “w h a t’s w rong” o ften m eans

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th a t clients are especially susceptible to disturbing episodes o f sham e th a t fragm ent th eir som ew hat fragile sense o f self. T h a t’s self psychological language for w hat happened to Ben w hen he shared his excitem ent w ith Jim and found him self deflated. Self psychology n o t only recognizes clients’ vulnerabilities in this regard, it traces these vulnerabilities to caretakers’ failures to provide the supportive, em pathic selfobject experiences clients needed w hen they were young. Self psychology also holds therapists responsible for providing the kind o f und erstan d in g th a t will help clients feel m ore cohesive, safer, and stronger, n o t m ore sham ed and fragm ented. T h e self psychological therapist becom es the selfobject, o r (m ore accurately put) the provider o f selfobject experience, th a t a clicnt needs in o rder to repair deficits in his self-structure. T his repair comes partly by way o f his new, good experi­ ence o f his therapist’s in-depth em pathy for him . It also comes partly through the strength he gains w hen the therapist’s em pathy is n o t quite right, and client and therapist have a chance to find o u t together w hat w ent w rong and to repair the “miss.” In o th er words, self psychology makes the therapy relationship a crucial scene for the reworking o f a client’s principles th a t organize his relational experience. T h u s self psychology also takes in stride the fact th a t as a therapist you will fail your clients som etim es, and th a t th en th eir bad feelings will be com ing directly from the therapy. T h eir experi­ ence o f being m isunderstood, criticized, belittled, o r a bandoned by you will set off th a t powerful psychological dissonance called sham e, th at experience o f themselves as weak, crum bled, o r severely flawed. W h en this kind o f sham e overwhelm s and silenccs a clicnt in therapy, it’s cru­ cial to look for the origins o f th e sham e in m om ents o f m isunderstand­ ing betw een the two o f you. W h e n together you are able to understan d where exactly the break in em pathy occurred, your client’s feelings of falling ap art or becom ing w orthless will quickly dim inish. A t this p o in t we m ight ask: W h e n bo th sham e and repair happen in the here and now, where are the bad feelings really com ing from —from old RIGs th at tu rn ed present disappointm ent and h u rt into “th ere’s som e­ thing w rong w ith m e”? O r from just the c u rre n t experience betw een cli­ ent and therapist? O r do the bad feelings, the fragm entations, happen only w hen old and c u rre n t experiences interact? It seems o u r answer m ust encom pass all o f these possibilities in som e way. So perhaps the question is m ore usefully p u t like this: W h at was the relationship betw een “o u t­ side” and “inside” w hen this particular clien t’s organizing principles

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a ro u n d this issue were being form ed, w h a t’s th e relatio n sh ip betw een “o u tsid e ” a n d “in sid e” now, a n d how are th o se two tim es related? W ith these questio n s we approach a m ore radically relational version o f self psychology. B ut it w asn’t u n til intersubjectivity th eo ry a n d studies o f in fa n tcaretaker interactio n s appeared o n th e scene th a t it becam e possible to ask such questio n s a b o u t co n n ec tio n s betw een past and present. A new paradigm m ade a new way o f u n d e rsta n d in g possible. In early self psy­ chology theory, a self was seen as a substantial, stru c tu re d entity th a t could be firm o r shaky, solid o r rid d led w ith deficit. In th e new para­ digm , a self is u n d e rsto o d to be a subjective w orld o f experience c o n tin u ­ ally com ing in to being a n d held in being in intersubjective netw orks. In this view, selves exist as systems interacting, w ith som e level o f self-aware­ ness, w ith o th e r systems. T his is th e case, first o f all, for th e selves o f infants a n d th e ir caretak­ ers. T h e overall feeling quality o f th e ir in teractio n s indicates w hen things are going well o r poorly betw een th em . R epeated intrusive o r discon­ nected interactio n s create dissonance in th e in fan t’s system. T h e prob­ lem shows up in th e in fan t’s distressed responses to feeling overw helm ed o r u n d e rstim u lated a n d also in th e in fa n t’s attem pts to regain equilib­ riu m th ro u g h avoiding, clinging, o r self-distracting behaviors. W h e n the caretaker’s behaviors change, so d o th e in fan t’s reactions, and w hat’s w rong can be repaired. O f course, as S tern p o in ts out, w hen in teractio n s are repeated, they begin to becom e generalized. R epeated interactio n s sta rt tu rn in g in to “prin cip les” th a t organize experience in p a tte rn s th a t have becom e predictable. Yet w hen recu rrin g problem s arc n o ticed early, of­ te n it takes only som e careful coaching to help a caretaker develop inter­ actions th a t w ork b etter in a particu lar in fan t-c a re ta k e r relationship. A clien t’s c u rre n t a d u lt relatio n sh ip s follow th e sam e kinds o f pat­ terns: affectively loaded interactio n s betw een persons, o r “self-systems,” have pow erful influences o n each perso n o r system. It could be th a t two self-systems are th re a te n in g to a n n ih ilate each o th er, o r they may be pro­ viding each o th e r life-giving su p p o rt. O r in th e te rrito ry betw een those two extrem es, a clien t’s system ic in teractio n s w ith im p o rta n t o th ers may leave him feeling disorganized, unhappy, o r vaguely o u t o f sorts. It’s im ­ p o rta n t for this client to u n d e rsta n d th e c o n n ec tio n betw een w h a t hap­ p e n ed in these interactio n s a n d how he feels afterw ard. It may also be im p o rta n t for h im to u n d e rsta n d th e rela tio n sh ip betw een w hat hap­ p e n ed yesterday to m ake him feel this way, a n d w hat h a p p en e d over and

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over in his c h ild h o o d —t h a t also left h im feelin g th is way. P ro b a b ly m o st i m p o r ta n t is t h a t th e tw o o f y ou n o tic e w h e n t h a t very sa m e b a d th in g h a p p e n s in a n in te ra c tio n w ith yo u . T h is gives b o th o f y ou a close-up view o f h o w y o u r a c tio n s e lic it c e rta in re a c tio n s fro m h im . H is p e rc e p ­ tio n s a n d re a c tio n s w ill b e o rg a n iz ed by c o n v ic tio n s re fin e d sin c e c h ild ­ h o o d , o rg a n iz in g p rin c ip le s t h a t m ak e se n se o f h o w o th e rs engage w ith h im a n d th a t also p ro d u c e c e rta in p re d ic ta b le m e a n in g s a n d feelings a b o u t w h o h e is a n d w h a t h e ’s w o rth . Y our c lie n t’s o rg a n iz in g p rin c ip le s m ig h t tell h im , fo r e x am p le, th a t in o rd e r to k e ep h is p sychological e q u ilib riu m , h e m u s t k e ep o th e r s well o u t o f h is p e rs o n a l sp ace, fo r if h e d o e s n ’t, th e ir a n x ie ty o r a g en d a s for h im m ig h t th ro w h im off k ilte r q u ite badly. A ll h e k n o w s w h e n y ou c o m c to o close w ith a “h e lp fu l” q u e s tio n o r su g g e stio n is t h a t h e m u st re tre a t a n d d isa p p e a r. B u t th e tw o o f y ou are b e g in n in g to u n d e r s ta n d t h a t y o u r an x ie ty to h e lp m ig h t be c a u sin g th is p a rtic u la r p ro b le m fo r h im . N e ith e r o f y o u k n o w it, b u t h is m o th e r ’s a n x ie ty w as th e p ro b le m w h e n h e w as a n in fa n t a n d h e le a rn e d to tu r n h is face away fro m a s p o o n a n d h e r insis­ te n c e t h a t h e e a t m o re . T h e s e days h e ’s q u ite aw are o f h o w h e w ith d ra w s to p ro te c t his p e rs o n a l sp a c e fro m w h a t h e e x p e rie n c e s as h is p a r tn e r ’s in tru s io n . H is tro u b le in t h a t re la tio n s h ip is p a rt o f w h a t s e n t h im to th era p y .

O R G A N IZ IN G P R IN C IP L E S A N D A W O R ST -C A SE S C E N A R IO L et’s lo o k m o re closely a t th is s itu a tio n fro m a n “o rg a n iz in g p rin c ip le ” way o f u n d e r s ta n d in g h o w in sid e a n d o u ts id e in te ra c t to c rca tc p ro b le m s fo r y o u r c lie n t. Y our c lie n t’s p sychological o rg a n iz in g p rin c ip le s are tell­ in g h im t h a t fo r his o w n w ell-being h e m u s t p ro te c t h is p e rs o n a l p s y c h o logical sp ace fro m his p a rtn e r. H e “k n o w s” t h a t if h e d o e s n ’t, s o m e th in g b a d w ill h a p p e n . B u t th e s e o rg a n iz in g p rin c ip le s , like all his e x p erien c e s o f self, a re n ’t a c lo sed system . T h e y can c h a n g e as e x p e rie n c e d e m a n d s o r invites a c h an g e . Y our c lie n t’s p a r tn e r loves h im a n d w a n ts to k n o w h im b e tte r. F ru s­ tra te d a b o u t b e in g s h u t o u t o f im p o r ta n t p a rts o f h is life, sh e p ro p o se s a d e a l to h im : sh e p ro m ise s n o t to w o rry o u t lo u d o r m e d d le if h e w ill sh a re w ith h e r so m e o f h is p la n s fo r a p ro je c t t h a t ’s im p o r ta n t to h im . W ith so m e tre p id a tio n , h e d o e s so, a n d h e fin d s, to h is g re a t su rp rise ,

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th a t h er interest d o esn ’t feel like a th re a t after all. In fact, now th a t she know s m ore a b o u t his hopes an d fears, he feels m ore energy an d stren g th to carry o n w ith th e project. A loneliness he h a d n ’t even n o ticed is su d ­ denly eased. In th is scenario, your clien t’s ways o f organizing in terp er­ sonal experience are, after all, quite flexible an d o p en to new in fo rm atio n . It’s n o t too m uch w ork to find ways to revise an d expand th em . B ut it m ight be th e case th a t your clien t’s earliest anxieties were so well-reinforced by ch ild h o o d experiences o f invasion o f privacy th a t he can barely risk negotiating th e deal his p a rtn e r w ants. T h e n , w h en he does try to let h er in, h er first com m ents feel like an invasion. (H er ow n organizing principles pro d u ce anxious reactions to being sh u t out.) Your clicnt retreats a n d closcs up. T h a t d o esn ’t m ean th a t his system is loeked irrevocably in to th e old organizing principle, b u t th a t his p resen t o p erat­ ing principle locks very tightly o n to suspicious in fo rm atio n in o rd er to give him quick p ro tectio n from m ajor danger. L oosening up this au to ­ m atic reaction will take lots o f exploration o f how it w orks—w h en his w ife’s som ew hat anxious approach (or yours) sets o ff his experience th a t h e ’s n o t safe. It will also take m any instances o f fin d in g o u t th a t in spite o f his fears, sharin g him self tu rn s o u t to be safe after all. T his scenario illustrates th a t som e kinds o f feeling b ad rem ain very resistant to being changed by new in p u t from th e o u tsid e, for they in­ volve very strong organizing principles. D o n n a O range, an intersubjectivist self psychologist, calls these strong organizers “convictions”—em o tio n al convictions rooted in em o tio n al m em ory.12 Powerful em o tio n a l convic­ tions th a t o th e r people are dangerous can tu rn even th e possibility for good experience in to bad experience. W h e n a clien t suffers from power­ ful negative em otional convictions, he m u st avoid real co n n e ctio n in or­ d er to avoid w hat he anticipates—inevitable h u m iliatio n , ab a n d o n m e n t, o r violation. W h e n invitations to co n n e ct com e his way, h e ’s h am stru n g by how he makes sense o f th em . W h e n a p erson w ho suffers in this way com es to therapy, your central w ork as a th e ra p ist will be patien t, persis­ tent, gentle efforts to engage h im in a relatio n sh ip th a t slowly begins to feel safe to him . In a worst-case scenario, even therapy never feels safe; a clien t’s orga­ nizing principles have set like cem ent, blocking all exits to m ore in terp er­ sonal freedom . In such a case, h er early history was probably w hat som e self psychologists call a history o f “pathological acco m m o d atio n ,” th a t is, an accom m odatio n o f herself to a pow erful other, likely a p arent, in w hich h er ow n th o u g h ts, feelings, a n d experiences were n o lunger h er ow n b u t

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were d e te rm in e d by w h a t th e o th e r needed h er to feel, w ant, a n d experi­ ence. T h e substance a n d dynam ics o f h er ow n self-system were swallowed up by th e self-system o f th e needy a n d m ore pow erful other. Your client had n o choice in th e m atter; she had to su b m it to this takeover o f h er core em otio n al self o r be psychologically a b a n d o n e d o r destroyed. W h o le ­ sale acco m m o d atio n was th e only way to keep th e c o n n ec tio n she needed in o rd e r to survive.13 T h e p roblem for her, th en , is far worse th a n inau th en ticity . S he’s n o t “th e re ” en o u g h to p re te n d to be som eone o th e r th a n herself o r to hide w ho she really is. W h o she really is has been flattened, denied, twisted, a n d obscured. W h o she th in k s she is and w hat she th in k s she feels arc m irrors o f som eone clse’s needs a n d extensions o f th a t p erso n ’s organiz­ ing principles. B eneath this ostensible self, th ere is a vague, dissociated, a n d scram bled system m ade up o f h e r ow n real experiences a n d feelings. T hey d o n ’t fit th e prescribed p icture—w hat to do w ith th em , then? H er self-system will have expended im m ense q u a n titie s o f psychological en ­ ergy to get rid o f h e r ow n experience, in o rd e r to m ake sure th a t th e rules th a t ensure h e r survival are locked into place. H er organizing principles will be especially rigid because they are designed to h o ld in place a system in w hich th ere is very little m argin for error. B ut th e n she finds herself in an o th er, later life. T h e Pow erful O th e r in q u estio n is n o longer physically present. She is free now —b u t she isn’t. T h is is w hen psychological dissonance becom es acute for her. She begins to long for freedom from anxiety a n d for supportive c o n n ec tio n in h er life. But th e rules o f w hat she m ust d o in o rd e r to survive a n n ih ila tio n rem ain in forcc. She is a p riso n e r o f h e r ow n em o tio n al convictions ab o u t w h a t’s possible for her. Yet even in th is worst-case scenario, th ere rem ains a chance th a t your clien t’s self-system a n d h e r self-w ith-other system may still have som e openings to in fluence, openings to being altered, if ever so slowly, by having differen t experiences in a th erap y th a t finally does prove itself safe enough. T hese d ifferen t experiences are m ade m ore pow erful w h e n you a n d your client notice th e m together in therapy. You’ll have to do th a t over and over, a n d you’ll also n eed to pay careful a tte n tio n to how th e old organizing principles keep trying to kill th e positive effects o f new o p p o r­ tunities and invitations. T his will be th e central work o f h er psychotherapy. It’s very h a rd w ork, b u t th e good news is th a t it’s possible—w ithin this self psychological u n d e rsta n d in g o f w h a t’s w rong for a clicnt w ho feels this bad.

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WHAT’S WRONG WHEN YOUR CLIENT IS FEELING BAD? A SUMMARY Each o f the relational theories we’ve visited has a useful angle on w hat’s w rong w hen your client is feeling bad. I believe th a t there are im p o rtan t ways in w hich these views com e together. Each m aintains th a t psycho­ logical kinds o f feeling bad d o n ’t arise from inside your client o r begin w ith her. Rather, they are her involuntary reactions and habitual responses to w hat once cam e at h e r and continues to com e at her. In o th e r words, w hat’s w rong exists at the interface o f outside forces and inside effects and responses, whatever th a t interface is called. As we have seen, the interface betw een outside forces and inside responses may be called op­ pression and resistance, or disconnection and strategies for safe connec­ tion, o r the creation and m anagem ent o f relational images, o r em pathie failure, fragm entation, and efforts to self-repair, o r organizing principles th a t su p p o rt accom m odations to the o th er th a t are sim ultaneously selfprotective and self-destructive. Each o f these explanations o f w hat happens at the ou tsid e-in sid e interface has a distinct flavor. Som e are constructed w ith a determ ina­ tion to keep the struggle located entirely outside o f the client, while o th ­ ers allow the struggle to be staged m ore internally. B ut for all o f them , the “feeling b a d ” th a t a client suffers is fundam entally a systemic phe­ n om en o n , som ething th a t happens in the reality o f self-with-other. W h at kind o f a self-with-other system can keep a client feeling bad? W e’ve seen it described as a narrative o f oppression th a t a client can’t stop telling and living, and as a practice o f strategic disconnections th at b o th protect and isolate a client. W e’ve seen it m anifested in a client’s anxious efforts to hold a sham ed and shaky self together in the absence o f support, and, in m ore desperate circum stances, as self-im m olating ac­ com m odations o f a client’s own desires, thoughts, and feelings to the needs o f a powerful other. W h a t all o f these descriptions have in com m on is th a t the systems they describe are active ways o f being, o r com plicated sets o f interactive doing, m ade up o f many aspects—thoughts, feelings, choices, and actions. C hanging the systems th a t keep in place these ways o f b ein g /d o in g in­ volves, then, m any different kinds o f change—changes in u nderstanding and nam ing w hat’s going on, changes in repetitive patterns o f thought, changes in interactions w ith others, and changes in clients’ relations to th eir ow n feelings, so th a t forbidden feelings can surface, to m otivate new thoughts and actions. W h a t’s w rong isn’t som ething finished; it’s

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so m e th in g t h a t is h a p p e n in g a n d w ill keep o n h a p p e n in g u n le ss it is in te rru p te d . C h a n g e can begin only w h e n th e o n g o in g in te rac tio n s o f th e system b e g in to ch an g e . In o th e r w o rd s, b o th w h a t’s w ro n g a n d w h a t c a n be c h a n g e d are m a tte rs o f w h a t I c alled “th e p e rfo rm a tiv e ” in C h a p te r 1. A ll o f th e s e th e o rie s s u p p o r t t h a t idea o f a p e rfo rm a tiv e th era p y . “R e la tio n a l p sy ch o an aly sis,” w ith its lin k s to in te rp e rs o n a l th e o ry , n o t o n ly believes t h a t th e r a p e u tic c h a n g e d e p e n d s o n c h an g e s in th e th era p is t- c lie n t system o f in te rp e rs o n a l in te ra c tio n , it m akes th is b e lie f th e ne x u s o f all its th e o riz in g . F ro m th is p e rsp ectiv e, it d o e s n ’t really m a tte r w h e th e r th e in te rfa c e o f in n e r a n d o u te r is called o p p re s s io n a n d resis­ ta n c e , o b je c t re la tio n s , o r m u tu a lly re g u la tin g o rg a n iz in g p rin c ip le s —as lo n g as th e p ro b le m is u n d e r s to o d to b e a re la tio n a l m a tte r, n o t a n in d i­ v id u a l m a tte r. F ro m th is p e rsp ec tiv e , w h a t m a tte rs is to c h o o se a n ex­ p la n a to ry system t h a t m akes th e b e st se n se o f h o w all th is u n fo ld s in th e th e ra p y re la tio n s h ip a n d , ev en m o re crucially, to c h o o se e x p la n a tio n s th a t fa cilitate d e v e lo p m e n t a n d c h a n g e in t h a t r e la tio n s h ip . A s any th e ra p is t d o e s, y o u w ill have re a so n s o f p e rso n a l histo ry , style o f th in k in g , w orldview , a n d p o litic s to p re fe r o n e o r a n o th e r o f th e s e re la tio n a l e x p la n a tio n s o f w h a t’s w ro n g w h e n y o u r c lie n t is feelin g b a d . A n d c lie n ts, to o , c o m e fro m m an y w alks o f life a n d th o u g h t. S o m e c o m e w ith a w ell-developed p o litic a l analysis a n d a v isio n fo r p e rs o n a l a n d so­ cial e m a n c ip a tio n . S o m e have fam ily o f o rig in c o n c e rn s a n d are see k in g m o re re w ard in g in te rp e rs o n a l c o n n e c tio n s. S o m e c o m e s h a m e -rid d e n a n d lo o k in g fo r so m e o n e to sh o re u p a sh a k y self. O th e r s b rin g w ith th e m a b u n d le o f sy m p to m s tu c k e d w ith th e m in to a n a rro w , d a rk p ris o n o f a s s u m p tio n s a b o u t th em se lv es th a t it seem s n o k in d n e s s c a n re a c h . A c c rta in k in d o f re la tio n a l th e ra p y m ig h t b e especially su ite d to e ac h o f th e s e g ro u p s o f c lie n ts. B u t fo r all re la tio n a l th e ra p is ts a n d th e ir c lie n ts, th e ra p y is a pro cess o f se lf-w ith -o th er p e rfo rm a tiv e c h an g e . It’s a b o u t le a rn in g h o w to d o a n d to e x p e rie n c e life d iffe re n tly —w ith o th e rs . T h a t ’s th e o n ly lastin g a n ti­ d o te for w h a t’s w ro n g w h e n c lie n ts are fe elin g th is k in d o f b a d . B ecause w h a t’s w ro n g isn ’t so m e k in d o f fa ilu re o r p o is o n in sid e y o u r clien ts. W h a t ’s w ro n g is w h a t th ey have le a rn e d to d o in o rd e r to m ak e th e b e st o f th e re la tio n a l e x p e rie n c e s life h a s d e a lt th e m so far.

ENDNOTES 1. S om e psychological p ro b lem s d o com e from “inside." O rg an ic a n d genetic factors are im plicated in th e d e v elo p m en t o f sch izo p h ren ic illness. H o rm o n a l im balances can p recip itate p o s tp a rn im an d m en o p au sal d ep ressio n . T h e “chem ical im balance

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2. 3. 4.

5. 6. 7.

8. 9. 10.

11.

12. 13.

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in th e b ra in ” o f manic-depressive disorder can be effectively balanced w ith lithium . But these rem ain relatively rare conditions in the context o f th e m illions o f N o rth A m ericans treated for anxiety and depression every year. M ost o f them are also treated w ith chemicals, treatm ent th a t seems to change som ething “inside.” Does this m ean, then, th a t som ething was w rong “inside”? Perhaps, bu t it can also be argued th at the docum ented alterations in brain chem istry in people w ho are chroni­ cally anxious and depressed arc an effect, not a cause, o f “feeling bad,” and th a t the prim ary causes (and best am eliorations) o f feeling bad are still to be found in inter­ actions between self and social environm ent. Intersubjectivity theory proposes th a t we th in k o f “s e l f as a world of subjective experience; see for example, Stolorow and Atwood, Contexts of Being, 2-4. Stern, The Interpersonal World of the Infant, 97-99. T he term “organizing principles” comes from intersubjectivity theory: George Atwood and Robert Stolorow, Structures o f Subjectivity: Explorations in Psychoanalytic Phenom­ enology (Hillsdale, NJ: Analytic Press, 1984). T he Boston Process ot C hange Study G roup (N. Bruschweiler-Stern, A. H arrison, K. Lyons-Ruth, A. M organ, J. N ahum , L. Sander, D. Stern, and E. Tronick) describes how interactional processes from b irth onward give rise to “procedural knowledge.” They call this knowledge, which gives unconceptualized form and m eaning to all o f a person’s further relationships, “im plicit relational knowing.” Karlen Lyons-Ruth, “Im plicit Relational Knowing: Its Role in D evelopm ent and Psychoanalytic T reatm ent,” Infant Mental Health Jour­ nal, ¡9(3), 2 8 2 -2 8 9 (1998). In the scheme I’m proposing, “organizing principles” are the (mostly unconscious) articulations o f this general procedural knowledge or implicit relational knowing. Phyllis Chesler, Women and Madness (New York: Doubleday, 1972). Jean Baker M iller and Irene Stiver, The Healing Connection: How Women Form Relationships in Therapy and in Life (Boston: Beacon, 1997). For a clear, concise explanation and example o f a narrative approach, see Epston, D., W hite, M., and Murray, K. “A Proposal for Re-authoring Therapy: Rose’s Revisioning o f H er Life and a C om m entary,” in M cNamee, S. and Gcrgen, K., Eds., Therapy as Social Construction. Newberry Park, CA: Sage Publications, 1992, pp. 96-115. Laura Brown, Subversive Dialogues, 117. H arry Stack Sullivan, The Interpersonal Theory o f Psychiatry (New York: W.W. N orton, 1953). See, for example, Darlene Bregman Ehrenberg, The Intimate Edge: Extending the Reach of Psychoanalytic Interaction (New York: W.W. N orton, 1992); Jody Messier Davies and Mary Gail Frawley, Treating the Adult Survivor o f Childhood Sexual Abuse: A Psycho­ analytic Perspective (New York: Basic Books, 1994); and Philip Bromberg, Standing in the Spaces: Clinical Process, Trauma and Dissociation (Hillsdale, NJ: Analytic Press, 1998). For an in-depth account o f the developm ent and transform ation o f object relations theory into self psychological theory, sec Howard Bacal and K enneth Newm an, Theo­ ries o f Object Relations: Bridges to Self Psychology (New York: C olum bia University Press, 1990). D onna O range, Emotional Understanding, 113-124. Since his sem inal 1993 paper, “To Free the Spirit from Its Cell,” reprinted in Rob­ ert Stolorow, George Atwood, and Bernard Brandchaft, Eds., The Intersubjective Per­ spective (Northvale, NJ: Jason A ronson, 1994), Bernard B randchaft has been develop­ ing th e idea o f pathological accom m odation and clinical approaches to th e problem .

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4 BETWEEN PAST AND PRESENT, MEMORY AND NOW

In th e last c h a p te r I ex p la in ed how a c lie n t’s psychological “feeling b a d ” com cs fro m processes th a t tak e place a m o n g his self-w ith-other system s, a n d th a t th e system w ith th e m o st pow er to m ake h im feel b a d consis­ tently is his in te rp e rs o n a l process m em ory, alo n g w ith th e p rin cip les it gen erates for o rganizing th e m ea n in g s o f his present-day in te rac tio n s. In th is way, a c lie n t’s p a st self-w ith-other system s c o m e to have far-reaching effects o n p re se n t system s, a n d th u s o n th e quality o f his re la tio n a l a n d e m o tio n a l life. T h is is how past is p re sen t, a cc o rd in g to a perfo rm ativ e, re la tio n a l m o d el o f therapy. P o p u la r c o n c e p tio n s o f th era p y lin k past a n d p re sen t, to o , o ften w ith th e a ssu m p tio n th a t th era p y is a b o u t re m e m b e rin g tra u m a tic events th a t clients have repressed. S o m e tim es it’s assu m e d th a t ju st recovering tra u m a tic m em o ries will purge o u t th e “b a d ” b it by bit. O r cure is th o u g h t to com e th ro u g h p u ttin g to g e th e r th e past like a puzzle, w ork th a t can in c lu d e fin d in g o u t ho w a c lie n t’s p ast is in flu e n c in g his p re se n t p a tte rn s o f b e h av io r a n d self-esteem . I d o n ’t disagree w ith th e f u n d a m e n ta l te n e t here: th a t th era p y is a b o u t dealin g w ith th e effects o f th e past as th ey live o n in th e p re sen t. B ut in th is c h a p te r I will try to sh o w w h a t th a t te n e t m ean s in a re la tio n a l m o d el o f therapy, sk etch in g o u t first a re la tio n a l d e fin itio n o f tra u m a a n d its effects, a n d th e n a re la tio n a l p ictu re o f th e pow er o f rem em bering-w ith.

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W H A T IS T R A U M A ? “T r a u m a ” c o m e s fro m a G re e k w o rd m e a n in g “w o u n d .” In th e w o rld o f psychology, “tr a u m a ” m e a n s s h o c k in g , w o u n d in g e x p e rie n c e th a t has last­ in g p sychological effects. T h e r e are psychologists, p sy c h iatrists, a n d psy­ c h o th e ra p ists w h o specialize in u n d e rs ta n d in g th e psychological processes se t in m o tio n by th e s u d d e n severe v io la tio n s a n d p ro lo n g e d b ru ta liz a ­ tio n s t h a t tr a u m a su rv iv o rs have su ffe red . J u d ith Lew is H e rm a n is o n e o f th o se . S h e w rites fro m a fe m in ist, re la tio n a l p e rsp ec tiv e a b o u t th e psy­ ch o lo g ic al a f te rm a th o f h a v in g su ffe red w ar, p o litic a l im p r is o n m e n t, to r­ tu r e , c a m p i n c a r c e r a t i o n , k id n a p p i n g , r a p e , d o m e s tic v io le n c e , o r c h ild h o o d physical a n d sexual a b u s e .1 A lo n g w ith m an y o th e rs in th e field, sh e p ro p o se s th e n a m e “c o m p le x p o st-tra u m a tic stress d is o rd e r” for th e aftereffects o f p ro lo n g e d s u b je c tio n to v io la tio n a n d d o m in a tio n . L o n g a fte r lib e ra tio n o r escape fro m th e sc e n e o f th e tra u m a , a su r­ vivor c o n tin u e s to su ffe r th e p a st as if it w ere p re s e n t. N ig h tm a re s a n d d a y tim e fla s h b a c k s b rin g b ack sig h ts, s o u n d s , sm ells, a n d o th e r b o d y m e m o rie s o f v io la tio n . T h e s e fra g m e n ts o f tra u m a tic m e m o ry re m a in fro ze n in tim e , fro ze n by th e te r r o r t h a t still possesses th e su rv iv o r w ith every r e p e titio n o f th e m em o ry . In th is d aily a tm o s p h e re o f p e rsiste n t re tra u m a tiz a tio n , a su rv iv o r also fears real a n d p r e s e n t d a n g e r a r o u n d every c o rn e r. E ven w h e n it’s n o t a c o n sc io u s th o u g h t, a su rv iv o r is vigi­ la n t, a le rt to th re a t. In s o m n ia , c o n s ta n t irrita b le anxiety, a n d re p e a te d surges o f fig h t o r flig h t a d r e n a lin c a n w e ar d o w n a su rv iv o r’s physical re silie n ce a n d b rin g o n physical sy m p to m s o f lo n g -te rm stress su c h as h y p e rte n s io n , g a s tro in te s tin a l disease, a n d c h ro n ic p a in a n d fatigue. W h e n severe tra u m a is in flic te d a g ain a n d again, m an y su rv iv o rs le a rn to d isso c iate th em se lv es fro m w h a t’s h a p p e n in g to th e m , so m e tim e s th ro u g h p o w e rfu l tra n c e states. In p a ralle l fa sh io n , w h e n th e tra u m a has b e c o m e h isto ry , a su rv iv o r le a rn s to m in im iz e its in tru s iv e physical a fte r­ effects by lim itin g th e risks, e n c o u n te rs , a n d d e m a n d s o f d aily life. In a v ery safe, re p etitiv e d aily ro u tin e , th e r e w ill b e less c h a n c e o f fe elin g th e k in d o f m o m e n ta ry scare t h a t m ig h t se t o ff a fla s h b a c k o r n ig h tm a re . If a su rv iv o r avoids n e w p e o p le a n d n e w s itu a tio n s , sh e d o e s n ’t have to b e so h y p e rv ig ilan t. A n d if s h e n u m b s o u t m o st o f h e r d aily feelings, s h e can also m an a g e to k e ep o u t o f h e r aw areness th e p a in fu l feelings still e n ­ ta n g le d w ith h e r tra u m a tic past. B u t a lth o u g h v a rio u s k in d s o f d isso c ia tio n allow th e su rv iv o r to k e ep th o s e p a in fu l feelings o u t o f h e r aw areness, th e feelings still k eep b re a k in g th r o u g h in fra g m e n te d , u n in te g r a te d b its o f m em o ry , a n d th ey

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are w hat generate h e r pervasive anxiety a n d physical sym ptom s o f stress. C o n strictin g h er feelings eases som e o f h er pain, b u t ra th e r th a n solving h er problem , c o n stric tio n keeps h e r pro b lem in susp en sio n , o u t o f th e reach o f help. C o n strictin g her interactio n s may also leave h e r isolated, depressed, and despairing o f any m eaningful future. T his oscillation a n d ten sio n betw een intrusive sym ptom s a n d constricting h e r life in o rd e r to cope w ith th e sym ptom s is only a sm all p art o f w h a t an abuse survivor suffers. Far w orse is th e em o tio n al anguish o f having suffered relational violatio n a n d betrayal. Especially in th e case o f c h ild h o o d physical, sexual, and em o tio n al abuse at th e h a n d s o f a caretaker w hom th e child sh o u ld have b een able to trust, such betrayal th re a t­ ens th e c h ild ’s sense o f self w ith a n n ih ilatio n . A secure self develops in response to secure c o n n e c tio n w ith carctakers w ho use th e ir pow er be­ nignly, w ith respect for th e c h ild ’s perso n a n d feelings. W h e n paren tal pow er is used to c o n tro l a n d coerce a child w ith n o th o u g h t for th e ch ild ’s perspective o r em o tio n s, th e child feels helpless, powerless, a n d often o bliterated by sham e. H er desires to explore a n d to assert herself w ith co n fid en ce fade as she w orries a b o u t keeping safe by being good. For in trying to m ake a w orld for herself th a t is tolerable, she will have decided th a t th e bad things th a t h a p p en to h e r are h e r fau lt (as she may have been told). She will know th a t she is bad a n d D addy o r M om m y is good. T his will give h e r som e sense o f control; it’s b e tte r to be a bad child in a u n i­ verse th a t m akes sense th a n a good child in a universe o f arbitrary, ra n ­ d o m pain. For an a d u lt survivor o f severe c h ild h o o d abuse, a deep, helpless sense o f “w h a t’s th e use” persists, along w ith pervasive self-blame, sham e, a n d guilt for w hatever bad h appens to her. H aving had h er personal dig­ nity sh attered , she carries feelings o f being defiled a n d stigm atized, o f being p ro foundly differen t from others. H aving h a d to m ake sense o f h er c h ild h o o d experience all by herself, she feels deeply a n d utterly alone, w ith no h ope o f ever being u n d e rsto o d . T h o u g h ts o f h er abuser brin g rage a n d desire for revenge, b u t in h er m in d , h er abuser rem ains bigger th a n life a n d still has su p e rn a tu ra l pow er over her. T h o u g h she hates w hat has b een d o n e to her, o ften she still sees herself a n d th e w orld th ro u g h th e a b u se r’s eyes and belief system, th e only view she was al­ lowed to have for a long tim e a n d u n d e r duress. W h e n she sees th e world th ro u g h h e r ow n eyes, she finds it d ifficult to see any p u rp o se o r m ean­ ing in it at all. In h er a d u lt life, an abuse survivor’s relationships are profoundly confusing an d d isturbing. H aving know n betrayal intim ately, she distrusts

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any professions o f love, care, o r com m itm ent. She know s th a t loving crosses over easily in to using a n d abusing. A n d since as a child she fo u n d herself tru stin g th o se w ho h u r t her, she also deeply distrusts h er ow n ability to tell “good p eo p le ” from “bad p eo p le ” a n d th u s keep herself safe. So som e­ tim es she ju st takes thoughtless risks, a n d o th e r tim es she w ithdraw s into isolation. S om ew here she keeps o n h o p in g against h ope th a t som eone will rescue her, even w hile she tu rn s angrily away from a w orld o f danger­ ous people. In intim ate relationships, she fears a b a n d o n m e n t desperately, a n d at th e sam e tim e, she has to pro tect herself constantly from invasion a n d em o tio n al takeover. In terp e rso n a l co n flict throw s h e r in to intoler­ able anxiety, for h er history tells h er th a t if she asserts herself, a d o m in a t­ ing c o n tro l o r rage will com e at her, a n d h e r only o p tio n s will be to rage back o r to su b m it—an absolutely no-w in situ atio n .

A C O N T IN U U M O F RELATIONAL TRAUM A T h is is b u t a b rie f sketch o f th e stress, pain, and tro u b le a trau m a survi­ vor copes w ith every day. C e rta in clients fit this p icture exactly, a n d it is clear th a t they are survivors o f c h ild h o o d abuse. For o th e r clients, th e pain in th e ir lives is n o t quite so physically an d psychologically overw helm ­ ing. T hey have c onfidence a n d initiative en o u g h to m ake d e ce n t lives for them selves, including, perhaps, good jobs o r careers a n d som e sense o f belonging to a c o m m unity or neig h b o rh o o d . In relationships w ith friends a n d family, they can learn to trust, feel m u tu a l respect and caring, a n d even m anage to w ork th ro u g h som e in te rp erso n al co n flict constructively. T hey also struggle, however, w ith pervasive anxiety a n d depression a n d w ith deep d o u b ts a b o u t th e ir w o rth and c o n n e c tio n to others. D oes th e trau m a we’re talking a b o u t have a nything to do w ith th e ir experience? In my clinical w ork b o th w ith abuse survivors a n d w ith deeply tro u b le d clients w ho have n o t b een overtly a n d severely abused, I have w ondered for a long tim e w h e th er th ere is m ore c o n tin u ity o r difference in th e ir two kinds o f experience. As I have becom e m ore a n d m ore aware o f th e relational trau m a at th e h e a rt o f a history o f abuse, I have com e to see far m ore c o n tin u ity th a n difference, a n d I find m yself placing m any clients o n a single c o n tin u u m o f relational trau m a. T his, I believe, does n o t trivialize th e atrocities d o n e to those w hose experience exists at th e m ost severe e n d o f th e c o n tin u u m , a n d it includes th e ir suffering in a larger h u m a n picture. A unifying relational d e fin itio n o f trau m a also validates th o se w hose suffering has b een m ore psychological th a n physi­

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cal, b u t n o less real. Perhaps using a single c o n tin u u m is m ost im p o rta n t for those m any clients w hose experience exists som ew here in th e m iddle, b o rd e rin g o n overt abuse. T h ey ’re n o t sure w h e th er they can call w hat h a p p en e d to th e m abusive. If it’s n o t abuse, does th e ir experience really m atter? Is th e ir pervasive psychological pain frau d u le n t, self-induced? U n d ersto o d as relational traum a, th eir experience does m atter profoundly, and th e ir pain m akes sense. A n d th e n th ere are th e m any clients w h o can’t rem em b er m u ch o f w hat h a p p en e d to th em . C a n they heal if they can ’t rem em ber? A con­ tin u u m o f trau m a based o n trau m atic relatio n sh ip ra th e r th a n o n trau ­ m atic events takes th e urgency o u t o f such questions. C lien ts usually do rem em b er th e pow erful relationships th a t h u rt th em , even if they haven’t fully rccognized th e h u rt a n d d o n ’t rem em ber m any o f th e details o f how th a t h u rt was inflicted. W h e n we focus o n relational trau m a, we can see th a t it is th e devastating context for violent, coercive en actm en ts o f abuse. W e can also see how it w reaks q u iet d e stru ctio n in its m ore covert and subtle versions. As you w ork w ith various kinds o f relational trau m a, you may have clients w ho rem em ber being abused a n d w ho can now sta rt to realize a n d integrate w h a t has h a p p en e d to th em . B ut in a d d itio n to this k in d o f rem em bering, again a n d again they’re taken aback by relational ru p tu res w ith im p o rta n t people in th e ir lives a n d w ith you, th e ir therapist. W ork­ ing th e ir way th ro u g h these im passes is th e m ost frightening and exhaust­ ing p a rt o f th e ir w o rk in sid e a n d o u tsid e o f th era p y . A re la tio n a l perspective o n trau m a reassures th em th a t these a ren ’t side issues; this is exactly th e w ork they n eed to be d o in g in o rd e r to reassem ble healthier, h a p p ie r ways o f being in th e w orld. O th e r clients may rem em ber b eing abused, b u t rem em b erin g seem s n o t to have helped th em m uch. T hey w o n d e r if th e ir previous therapy w ork has gotten to th e h e a rt o f w hat h a p p en e d to th em . From a rela­ tion al perspective, th e key to healing th e w o u n d s o f abuse is to work th ro u g h th e relational v iolations a n d betrayals th a t are at th e h e a rt o f violently abusive acts a n d threats. U n til these clients have a chance to a tte n d to th e relation al aspects o f th e trau m a they suffered, they w on’t get to th e h e a rt o f w h a t h a p p en e d to th em . T hey do need m ore help, as they suspect. T h e n th ere are th e clients w ho can ’t rem em b er w hat h a p p en e d to th em , a n d th e ones w ho are q u ite sure th ere was little overt violence o r coercion in th e ir fam ilies o f origin. Yet in th e ir daily lives w ith others, they feel frightened, isolated, angry, trapped, a n d w orthless—all evidence

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th a t so m e th in g relatio n ally d a m ag in g h a p p e n e d to th e m . You—a n d they— are rig h t to w o n d e r w h e th e r th e quality o f th e ir early c o n n e c tio n s to caregivers left th e m w ith d e ep a n d long-lasting, a lb e it h id d e n , re la tio n a l w o u n d s. I’m suggesting th a t fo r clients in any o f th ese situ a tio n s, th e ir expe­ riences c an be situ ate d o n a c o n tin u u m o f re la tio n a l tra u m a . F rom o n e e n d o f t h a t c o n tin u u m to th e o th e r, c e rta in th in g s h o ld tru e: (1) T h e in ju ries u n d e rly in g psychological p a in are at th e ir core re la tio n a l in ju ­ ries: tru s t has b e e n betrayed; leg itim ate in te rp e rs o n a l n e ed s have b e e n d e n ie d ; a c h ild ’s p e rs o n h o o d has b e e n ig n o red o r d e m e a n e d . P articu lar events o r tim es o f in ju ry have b e co m e tra u m a tic because they w ere em ­ b e d d e d in a n o n g o in g tra u m a tic re la tio n sh ip , o n e in w h ic h caretakers d id n o t n o tic e th e c h ild ’s distress o r h e lp th e ch ild recover. (2) Persons w o u n d e d in early re la tio n sh ip s p ro tec t them selves from re m e m b e rin g a n d from fu rth e r h u r t w ith a w ide range o f dissociative strategies a n d beh av ­ iors—fro m “spacing o u t,” to severing th em selves fro m th e ir e m o tio n s, to m ed ic a tin g them selves w ith su b stan ces, to losing them selves in fantasy, to giving them selves over to addictive behaviors, to fo rg ettin g them selves in n o n-stop, hectic cycles o f responsibility. (3) T h e tra u m a s o f th e past c o n tin u e in th e p re se n t n o t only in self-protective strategies b u t also in tro u b le d re la tio n sh ip s. A ll a lo n g th e c o n tin u u m o f re la tio n a l trau m a, in te rp e rs o n a l tru st is rid d le d w ith d o u b t a n d fear, th o u g h in th e ir less severe form s th o se feelings can be m asked. Still, th e e x p ec ta tio n o f bein g ig n o red o r h u m ilia te d is n ev er far away. H o ld in g o n e ’s ow n in self-asser­ tive pro jects re m a in s p ro b lem atic for o n e w h o has su ffered re la tio n a l tra u m a , a n d situ a tio n s o f c o n flic t can in d u c e p a n ic k ed flig h t o r paralysis. A ny o n e o f y o u r clien ts m ay n o t recognize h im se lf as a su rv iv o r o f overt, severe abuse, b u t h e m ay fin d h im se lf q u ite d efin itely o n th is c o n ­ tin u u m o f re la tio n a l tra u m a . H e n e ed s to h e a r th a t w ith o r w ith o u t expe­ rien ces o f severe physical a n d sexual ab u se, re la tio n a l v io la tio n s a n d betrayals c o u n t as tra u m a . H is p a in is n o t fra u d u le n t. H e can be su re th a t he isn’t d o in g it to him self. H e also needs to k n o w m o re a b o u t how this tra u m a m ig h t have h a p p e n e d a n d how it keeps o n affecting h im in his p re se n t life.

FA C T O R S C O N T R IB U T IN G T O RELA TIO N A L T R A U M A Psychologically tra u m a tic e x p erien ce begins w h e n so m e th in g h a p p e n s to a p e rso n th a t is m o re th a n th a t p e rso n ’s psychological system can h a n d le .

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Prisoners o f w ar a n d to rtu re victim s are psychologically bro k en by re­ peated assaults in te n d e d to overw helm th em w ith te rro r a n d helpless­ ness. B a tte re d wives b e c o m e p ris o n e rs in t h e ir ow n h o m e s, th e ir psychological system o f self-protection destroyed, as th e ir abuser elim i­ nates all outsid e c o n ta c t a n d su p p o rt. For a sm all child, te rro r a n d help­ lessness can be in flicted m uch m ore carelessly: th e re ’s a su d d e n explosion o f rage w hen she has m ade a m istake; she’s left alone a n d h u m iliated by h er badness in a d ark room ; she hears a n d sees abusive, h ateful exchanges betw een h er parents; she lives w ith th e c o n stan t th re a t o f violence w hich, even w hen n o t enacted, keeps h e r anxious a n d w atchful; o r she witnesses vio len t acts o r verbal abuse in flicted o n h e r m o th e r o r siblings. A clicnt may have specific m em ories o f such overw helm ing, selfdisorganizing m om ents. She m ight also guess, based o n w hat she rem em ­ bers o f how o th e r ch ild ren were treated in h e r house, th a t th ere were sim ilar m o m en ts in h er infancy, ones th a t survive in only h er m ost ru d i­ m en ta ry in te rp erso n al process m em ory. H er crying m ig h t have b een ig­ n o re d so th a t she w o u ld n ’t be spoiled—u n til she wore h erself o u t w ith helpless, overw helm ed scream ing, a n d slept. C aretakers m ight have yelled at h er a n d spanked o r shaken h er to m ake h er be q u ie t a n d “g o o d ”—un til h er system learned th e value o f giving u p a n d acquiescing. M ealtim es a n d toilet tim es may have b een experiences o f being invaded a n d con­ trolled, o f losing h e r bodily agency and integrity. All o f th e psychologically overw helm ing m o m en ts I have described are ones in flicted by caretakers. T his is a very im p o rta n t p a rt o f w hat m akes th e m traum atic. For in such situ atio n s, th e child is truly helpless. W h e n th e acts a n d em o tio n s o f h e r paren ts scare her, th ere is truly no­ w here else to tu rn . T h e child is literally at th e ir mercy, as captive as a political p riso n e r o r a battered wife, b u t she d o esn ’t even know she is captive, for this is th e only w orld she knows. If, instead, your client had lived in a safe in te rp erso n al w orld as a child, even deliberately abusive acts by strangers w ould have had less long­ term trau m atic effect o n her. T h e abuse w ould have b een a vio len t in tru ­ sion o n h er safe w orld, b u t it w o u ld n ’t have c o n stru cted a constantly frig h ten in g w orld in w hich she was trapped. In a safe w orld, if a child were h u rt, h e r paren ts w ould n otice and care a b o u t w h a t h a p p en e d to her. T hey w ould try to help h e r talk a b o u t h e r scary b a d feelings so th a t she could get to feeling safer a n d stronger again. B ut this is a n o th e r critical p o in t w here a careless traum atizing par­ e n t fails. N o t only docs he o r she shock, ignore, frighten, cocrcc, o r h u ­ m iliate a child w ith o u t th in k in g w hat th a t m ight be like for th e child,

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afterw ard th e p a re n t d o e sn ’t n o tic e w h a t’s b e e n d o n e to th e ch ild . H e o r sh e is obliv io u s to th e c h ild ’s p a in , a k in d o f o b liviousness th a t d isc o u n ts a n d o b lite rates th e c h ild ’s experience. It’s n o t th a t th e p a re n t d o e sn ’t kn o w w h a t h a p p e n e d ; in fact, h e o r she does know , b u t it ju s t d o e sn ’t m atter. It’s n o th in g . T h a t’s w h a t th e ch ild is left to believe. O r it’s so m e­ th in g o th e r th a n h e th in k s it is. T h e c h ild ’s te rro r d o e s n ’t m a tte r because th e t r u th o f th e scene is th is: his fa th e r has a rig h t to be so terrib ly angry. S o m e o n e m ade h im angry. O r it’s th e c h ild ’s ow n d isg u stin g b e h av io r th a t has g o tte n h im b a n is h e d to his ro o m , a n d h e deserves his m o th e r’s cold silence for th e rest o f th e day. T h e neglectful chaos th a t swirls th ro u g h his fam ily is ju st how it is. If his fa th e r needs his h e lp , a n d h e ’s slow a n d m akes m istakes, it’s his stupidity. If he has a h a rd tim e at school, if h e ’s an u n a th le tic geek o r overw eight o r very shy, his p a re n t has a rig h t to sh a m e h im a n d pre ssu re h im to change. C h ild re n can be h e lp e d to d eal w ith m any k in d s o f in te rp e rs o n a l h u rt. T h ey can even to le ra te a n d in te g rate th e ir p a re n ts’ failures, flaws, a n d e m o tio n s w h e n th e ir p a re n ts n o tic e th e effects o f th e ir actio n s, take responsibility for c h an g in g w hatever m ig h t be o u t o f c o n tro l, ex plain th e ir feelings, apologize w h e n necessary, a n d h e lp th e ir c h ild re n ta lk a b o u t th e ir ow n feelings “w h e n M o m m y gets m a d ,” for exam ple. B u t th e over­ w h e lm in g events w e’ve b e e n talk in g a b o u t are b u rn e d in to y o u r c lie n ts’ ex p erien ce as tra u m a n o t ju st because th ey ’re scary events, a n d n o t ju st because they cam e at th e m from p e o p le th ey n e e d e d to tru st, b u t also, a n d p e rh a p s m o st im p o rta n tly , because th o se very p e o p le d id n ’t h elp th e m d eal w ith w h a t h a p p e n e d to th e m . A fte r a ch ild h as survived a flo o d o f disorganizing, o v erw h elm in g feelings, h e is left to m ake his ow n sense o f w h a t h a p p e n e d , a sense th a t he can use to p ro te c t a n d g u id e h im th e n e x t tim e it h a p p e n s. B ut h e can m ake sense in o nly th e sim ple, c hildlike ways w e’ve already m e n tio n e d . If he has b e en sh a m e d , he is sh a m efu l. B elieving th a t h e ’s th e b a d o n e in th e re la tio n sh ip , he tries h a rd to be g ood. T h e m o re a t risk h e feels, th e m o re tightly his p e rc e p tio n o f th e w orld has to m atc h his caregiver’s per­ cep tio n , a loss o f self w e’ve seen d escrib ed as “p a th o lo g ica l a cc o m m o d a ­ tio n .” (Som e c h ild re n believe th a t th ey ’re b a d a n d d e cid e to give u p a n d ju st b e b ad , th e n . B u t for all th e ir a p p a re n t re b ellio n , they are n o less tied th a n th e ir “g o o d ” siblings to th e ir p a re n ts’ view o f th e m a n d o f th e w orld.) A n d above all, a ch ild w h o survives tra u m a repeatedly tries n o t to th in k a b o u t th e b a d tim es. T h e re ’s n o fu tu re in feeling th o se feelings; th e re ’s n o way o u t o f th e m cxccpt to w ait for it to be over. So a lth o u g h th e c h ild is ever w atchful for th e signs o f so m e th in g scary a b o u t to hap-

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p en again, w hen a bad tim e has passed, he pu ts his feelings as far away as he can. Because n o o n e acknow ledges w h at has h ap p en ed , he, too, has to tu rn th a t experience in to so m eth in g th a t hasn’t really h ap p en ed . O r even if it has h ap p en ed , he tu rn s it into som eth in g th a t d o esn ’t m atter. Since it’s “n o th in g ”—a n d also n o th in g he can m ake sense of—he tu rn s it into his ow n kind o f noth in g . B ut th ro u g h th is act o f d isco n n ectin g from it, th e “n o th in g ” is p u t w here it can begin to take o n a pow erful life o f its own.

THE DISCONNECTING EFFECTS OF RELATIONAL TRAUMA T h e technical term for th e psychological process m ost responsible for p u ttin g trau m atic experience w here it can carry o n in to th e p resen t is “d issociation.” A nd this is, o f course, a paradox an d an irony, since for th e trau m a victim th e w hole p o in t o f dissociation is to get rid o f painful feelings an d keep th e m away. In fact, w hat dissociation does is p u t p ain ­ ful feelings w here they ca n ’t be integrated in to a co h e ren t narrative o f a client’s history. T hey keep causing h im plenty o f tro u b le, b u t he can’t tell w here th e trouble is com ing from . Strong, quick, an d persisten t acts o f dissociation, th e k ind a child can learn to perform very early, keep trau m a o u t o f narrative m em ory. So it’s n o t even th e case th a t th e re ’s a w hole story o f w hat h ap p en ed to your client p ushed dow n som ew here, w aiting to be recovered. T h e picture is m ore like scattered fragm ents o f radioac­ tive m em ory—body m em ory, event m em ory, em otio n al m em ory, a n d /o r in terp erso n al process m em ory. T hese fragm ents lie strew n across your client’s in te rn al landscape, d isconnected from each o th e r an d from your client’s awareness, b u t still em ittin g pow erful, d istu rb in g signals. D u rin g an d after severe abuse, dissociation may be physiological as well as psychological. M any victim s learn to get th ro u g h trau m atic events by using self-hypnosis to detach from th e ir ow n consciousness. A fter an intense a n d terrifying experience, w h at a victim has sensed, felt, sm elled, seen, an d heard, along w ith his visceral reactions to th e abuse, may be encoded in only a p art o f th e brain th a t doesn’t link into narrative memory. T h o se fragm ents o f m em ory will rem ain th e re unaltered , eru p tin g som e­ tim es in to nightm ares o r flashbacks, b u t never com ing to g eth er as th e victim ’s ow n story. T herapy will have to include th e p ainstaking process o f g athering u p these fragm ents an d allow ing th e m to take m ore coher­ e n t p attern s an d m eanings.

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If a particular client’s traum a is m ore psychological th a n physical, o th er kinds o f dissociation will keep certain aspects o f a traum atic rela­ tionship o u t o f her awareness. She may rem em ber disturbing events, b u t w ith no real sense o f w hat was going on betw een herself an d her caretak­ ers, and w ith o u t m uch feeling. O f course those things happened, she may say, b u t they d o n ’t m atter anymore. S he’s quite sure o f that. She may even have p u t together a story for herself o f a happy childhood. N ow here in her story are the feelings th a t belong to a relationship in w hich a selfabsorbed, fragile, angry parent fails to u n d erstan d the longings, needs, and fears o f a vulnerable child. These are the radioactive m em ories th at lie scattered away from this client, unintegrated and therefore still m ean­ ingless. F urtherm ore, as we m entioned earlier, the traum atized client can use any o f a host o f ways to block th e signals com ing from those frag­ m ents: em otional num bness, self-medication, overwork, addictions, ob­ sessions and com pulsions, o r psychosom atic illness, to nam e a few. H er way o f being in the world w ith others will have a dissociative quality a bout it, for although she functions well enough, she’s quite disconnected from her ow n in n er feelings and processes. T hese particular strategies for disconnection (to use Stone C en ter language) keep her from being present to her self. She can’t be very present to anyone else, then, and so these strategies keep her o u t o f relationship, too. A traum atized client has o th er everyday ways to protect herself from being h u rt again by o thers—subtle strategies for em otional disengagem ent and safe disconnection. As we saw in C h ap ter 3, beh in d these strategies lie her interpersonal process m em ory and the principles it has produced to organize all the bits o f her daily interpersonal experience. T his is how th e self-with-other system o f her childhood gets replicated in her inter­ personal systems today. T his is w hat tells her, for exam ple, th a t she m ust please her p a rtn e r o r she will be abandoned, th a t disagreem ent betw een friends is terribly dangerous, or th a t isolation is the m ost trustw orthy kind o f safety. If any one kind o f everyday experience runs through relational traum a and its fragm enting, disconnecting aftereffects, it’s the experience o f sham e. For survivors o f relational traum a, sham e tu rn s up in m any forms. To be sham ed is to becom e a pariah, cut o ff from h u m an connection, and the reverse is also true: isolation is itself sham ing. To be cut off abruptly or ignored deliberately can induce sham e reactions even in very young children. W h en one is left alone, feeling bad, those bad feelings quickly becom e feelings about a bad self, for the feeling o f sham e carries w ith it

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the sense o f being defective. As we noted in C h ap ter 3, w hen a child can’t m ake sense o f bad feelings, one explanation is always available: “T here’s som ething w rong w ith m e.” D issociation and disconnection riddle your client’s ad u lt life w ith sham e. Since she can’t know her feelings an d m otivations from rhe in­ side out, she can’t feel whole and strong. She’s asham ed o f the disorga­ nized anxiety she carries a round, and she’s asham ed o f the obsessions and habits th a t keep her anxiety u n d e r control. N obody knows how hard she works to present a coherent, “together” front to the world. C hronic disconnection from others robs her o f the su p p o rt she needs to feel good a bout herself; here, too, isolation breeds powerful sham e. H er organizing principles quickly tu rn any interpersonal trouble into som ething she should be asham ed of. To live life in the long shadow o f relational traum a is to live h aunted and constricted by sham e in all its guises.

HOW DOES REMEMBERING HELP? B ut therapy prom ises relief for those w hose relational past has been trau­ m atic, relief through rem em bering. M ore specifically, relational therapy insists th a t to be effective, such rem em bering m ust be rem em bering with. F o r u n le ss a tra u m a tiz e d c lie n t has s o m e o n e to h e lp h e r m ake reconnections, she w on’t be able to shift o u t o f h er usual self-protective, disconnected ways o f rem em bering. She has invested a lot o f psychologi­ cal energy in p u ttin g difficult experience o u t o f sight and o u t o f m ind. W h en she was a child she needed desperately n o t to feel w hat was going on betw een herself and others so th a t she w ouldn’t feel her overwhelm ed, sham ed confusion. She still knows in her bones th a t there are very good reasons n o t to revisit those scenes and feel those feelings again. Yet there is also a very good reason to let herself feel how it was: Putting those experiences o u t o f sight has n o t really p u t them o u t o f her m ind or o u t o f her life. She struggles w ith physical and psychological sym ptoms th a t d o n ’t “m ake sense.” Som ething keeps b othering her, sap­ ping her energy and self-confidence. T hough she can’t make the connec­ tions, she suspects it’s “old stuff,” and so she has looked for a therapist w hom she feels she can trust. She th in k s th a t tru st is probably crucial. S he’s absolutely right. O nly w hen your client can feel th a t her therapist is o n her side will she be able to let herself rem em ber how it was. O nce she pushed all th e bad stuff o u t o f sight because no one saw o r cared. T here was no one to help her nam e the feelings and u n d e rstan d w hat was hap-

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pening. Just because th ere was n o o n e to help, th e trau m a was so deeply disorganizing a n d sham ing for her. To begin, now, to speak to you ab o u t th a t sham ed place will be to take a m ajor em otion al risk. H er risk starts to pay off, th o u g h , as your em pathy for h er experi­ ence eases her fear o f being sham ed again. She finds she can b rin g her ju m ble o f h u r t a n d angry feelings, a n d you help her so rt th em o u t, b it by bit. W h e n you try hard to h ear an d respond to h er experience ju st the way it was for her, th a t’s th e very opposite o f w hat h ap p en ed to m ake h er experience so traum atic. T h is tim e her feelings really d o m atter. T his tim e som eo n e is saying, “Yes, w hat h ap p e n ed really h u r t you!” As you listen and respond, you reassure h er th a t it’s okay if she can ’t be sure o f all th e details. W h a t m atters is th a t som eone is here, now, to w itness an d validate th e tru th o f h er experience. In tim e she will fin d herself n o t just speaking ab o u t her sham e and confusion, b u t speaking directly from those sham ed places in herself, in th e shaky b u t growing h o p e th a t your em ­ p athic u n d ersta n d in g will keep o n w elcom ing her back in to co n n e ctio n an d h u m a n com m unity. In th e next section o f th is chapter, w e’ll look m ore closely at how this rem em bering takes place in therapy. B ut already it’s clear th a t it’s n o t an investigative search for th e story o f w hat h ap p e n ed to your client in exact detail. In relational traum a, th e h u r t com es less from p articu lar circum stances an d events th a n from th e ongoing attitu d es an d feelings im p o rta n t people had tow ard your client. T hings th a t h ap p en ed show ed h er how o th e r people felt tow ard her. W h a t she needs to rem em b er is how it felt to be w ith tho se people. T h e p ro o f o f th a t k in d o f m em ory is im p rin ted o n all th e ways she protects herself from b eing h u rt again by people close to her. It’s also clear th a t w e’re n o t talking a b o u t revisiting scenes o f trau m a in hopes o f cathartic expressions o f em o tio n . T his k in d o f rem em bering ju st activates fragm ents o f self-w ith-other pain. If w h at h ap p en ed betw een your client an d an abusive p are n t left h er flo o d ed by helpless rage, it’s no help for her to find herself back in th a t state, even if th is tim e she can kick a n d scream ab o u t it. T h e help she needs now is th e sam e k in d o f help she needed th e n : som eone to see w hat was really h ap p en in g , som e­ o n e to care and to validate h er feelings, som eone to su p p o rt h er angry protest a n d her d em an d for fair treatm en t, an d so m eo n e to help h er integrate even unfairness an d cruelty in to a picture o f th e w orld as it is, an d in to a co h e ren t story o f w ho she is an d w hat sh e’s know n an d felt. T his k ind o f rem em bering helps h er because it adds u p slowly to new, im p o rta n t know ledge: “T his is w ho I am . T hese arc th e kinds o f

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things I had to live through. This is how I m ade myself strong enough to survive, and these are the vulnerable feelings I had to hide away. T his is how I came to be w ho I am today.” As these things fall slowly into place, she may feel as if she’s finding a lost self or as if she’s beginning to exist at th e center o f her own being. Now, because she is no longer a child, no longer alone and overwhelmed, she can say, “It’s better to feel the pain. A t least I’m here!” Rem em bering with is w hat makes the pain o f recovering herself bearable and m eaningful for your client. T he presence o f som eone w ho wit­ nesses, understands, and cares allows her pain to be transform ed into grief. W hile dissociation is the psychological process m ost responsible for keeping traum a active and destructive, grief is the opposite proccss. A tim e o f grieving is a tim e o f integrating past and present m eanings and feelings. G rief is the psychological process through w hich traum a can be laid to rest. O nly grief can begin to heal the pain of loss, b u t since grief itself is acutely painful, people w ho have suffered loss need th e close presence of others to help them grieve. Many hum an com m unities build this wis­ dom into burial and m ourning rituals. As your client’s therapist, you b ring this wisdom w ith you as you attend her grieving process. She may m ourn for the broken spirit of her young self; for the confident, optim is­ tic young adult she wishes she could have been; for the loving intimacy she avoided for too long; for so m uch o f her potential wasted; for how very hard she has worked just to keep herself together; for th e ten o r of her everyday life, far too anxious and sad; and for th e understanding, affirm ing m other and father she always longed for b u t never had—and never will have. G rieving brings past and present together into coherent meanings, dense and rich w ith feeling. From the crucible o f m o u rn in g relational losses, a once-fragm ented self emerges as a self o f integrity. In th e words o f Judith Lewis H erm an, “Integrity is the capacity to affirm th e value o f life in the face of death, to be reconciled w ith the finite limits o f o n e’s own life and the tragic lim itations o f the h um an condition, and to accept these realities w ith o u t despair.”2 A nd though grief may always h a u n t cer­ tain o f your traum atized client’s thoughts and m em ories, w hen it has done its work, it passes. T he integrating work o f grief n o t only recovers a self for her, eventually it sets th a t self free to look forward an d to go on. A t the tim e o f self-recovery and beginning to move on, it’s just as crucial th a t your client n o t be alone. D uring the long process o f rem em ­ bering, you have been present to her suffering and grief. Now you are the

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o n e in w hose presence she is n o longer fragm ented a n d sham ed. Just as th e grip o f sham e is intensely in terp erso n al, so h e r release from sham e can be fully k n ow n only in th e presence o f a n o th e r person. If th a t person was once presen t to h er sh am e as well, h er release can be exhilarating. E nergies a n d interests th a t had been blocked by sham e begin to surge forw ard. W h e n she has som eone to resp o n d to h er newly released desires and m otivations, they d o n ’t overw helm her. She is able n o t ju st to dream new dream s b u t also to m ake new plans a n d to take new actions. It was in h o p e o f this o u tco m e th a t she w ent to th e tro u b le o f find­ ing o u t how to rem em ber w ho she was. T h e p o in t o f rem em b erin g was to stop th e m indless re p etitio n o f dissonance, anxiety', and em o tio n al pain th a t plagued h e r subjective w orld. M indful reflectio n b ro u g h t h e r into th e presence o f w hat h u rt her. B ut it also gave h e r th e gift o f grief, h er integrity, a n d h e r freedom .

H O W IS TH E R A PE U T IC REM EM BERING DONE? W e com e now to an absolutely critical q u estio n for th e practice o f rela­ tional psychotherapy: How, exactly, does therapy help a client d o th e k in d o f rem em bering th a t will loosen th e co n stric tio n s o f h er past? Just th e w ord “rem em b erin g ” conjures up an image o f a th era p ist taking a detailed history a n d o f a clien t re sponding by telling all th e stories o f h er ch ild h o o d she can rem em ber. B ut as you know from earlier chapters, th a t’s n o t how relational therapy goes.

Memory Is Now and Now Is Memory In fact, a lo t o f w hat I’m calling “rem em b erin g ” d o e sn ’t look th e least bit like a trip dow n m em ory lane. I n eed to explain th a t I am using th e w ord in a very general sense: “rem em b erin g ” as m aking m en tal o r em otio n al c o n ta ct w ith so m eth in g th a t’s past a n d p re sen t at th e sam e tim e. T his sense o f rem em bering d ep en d s o n two assum ptions: first, th a t m em ory is always a here-and-now m en tal c o n stru ctio n ; a n d second, th a t o u r percep­ tio n o f here-and-now is constantly being form ed by th e sum total o f all th a t we rem em ber. Every day a n d in every way, we live o u r lives th ro u g h o u r m em ories. A n d w hen we rem em ber a specific event, all o f o u r o th e r m em ories a n d all o f o u r feelings rig h t now shape a n d color w h a t we th in k is com ing straig h t from th e past.

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T h a t d o e s n ’t m e a n o u r m e m o rie s a re n ’t tru e . B u t it d o e s m e a n t h a t w e have to th in k carefully a b o u t o u r d e f in itio n o f t r u th . P erh ap s we w o u ld b e w iser, a t lea st in th era p y , to ta lk a b o u t m e a n in g in ste a d o f tr u th , for m e a n in g in c lu d e s n o t ju s t “th e facts,” b u t also th e feelings a r o u n d th e facts, a n d h o w th o s e facts a n d feelings are w oven in to m e a n in g s w ith in o u r su b je ctiv e w o rld s o f experience. T h a t in te rp erso n al system th a t w e call a self, w ith all its love, h a te , d e sire, fear, joy, a n d sh a m e , is n o t a d a ta b a n k . I t’s a m e a n in g -m a k in g system . It d o e s n ’t m ak e a rb itra ry m ea n in g s; w h e n ­ ever possib le, it c h ec k s o u ts id e referen ces for v a lid a tio n o f th e m e a n in g s it m akes. B u t as it m akes m e a n in g s a b o u t self-w ith-other, its first refer­ e n c e is always to feeling, o r “affe c t.” T h a t ’s w hy w h a t wc t h in k o f as th e facts o f m e m o ry arc “file d ” u n ­ d e r feelings. W h a t d o I m ean? L et m e illu stra te . O n a c c rta in day a c lie n t co m e s in to th e ra p y te rrib ly u p s e t a b o u t h a v in g b e e n c h e a te d by a col­ league, a n d th e n h e sp o n ta n e o u s ly re m e m b e rs a c h ild h o o d in c id e n t w h ere h e felt b o th h e lp le ss a n d fu rio u s a b o u t h a v in g b e e n tric k e d . A n o th e r c lie n t is try in g to screw u p h is c o u rag e to ask a sp ecial p e rs o n to d in n e r, a n d h e fin d s h im s e lf re ca llin g h is stylish m o th e r ’s d isa p p ro v in g eye, a n d h o w h e felt like a h o p e le ss geek a t h is s e n io r p ro m . W h a t b r o u g h t th o s e p a rtic u la r sc en es to m in d ? In b o t h cases, w e c o u ld say t h a t a n u m b e r o f scenes o r m e m o rie s have b e e n filed u n d e r a c e rta in se lf-w ith -o th er feel­ ing. “T ric k ed , h e lp le ss, a n d f u rio u s ” o p e n s o n e file. “A n tic ip a tin g h u ­ m ilia tio n ” o p e n s a n o th e r o n e . In a c lie n t’s m ea n in g -m a k in g , th e filin g system m a tte rs m o re th a n th e m e m o rie s it c o n ta in s . T h e filin g system show s h o w a c lic n t h a s al­ re ad y c ateg o riz ed s itu a tio n s a n d e m o tio n s fro m re am s o f m e m o ry d a ta a b o u t in te rp e rs o n a l processes. C e r ta in e v e n t m e m o rie s arc k e p t a t th e fr o n t o f e ac h file as s tro n g illu s tra tio n s o f th e feeling. T h e a rra n g e m e n t o f th e files is m u c h c lo ser to th e t r u th o f w h o y o u r c lie n t is th a n any su p p o s e d facts o f his h isto ry , b e ca u se h is filin g system is how h e m akes m e a n in g o f “facts.” O b v io u sly , th is m e ta p h o r o f a filin g system c o d e d a c c o rd in g to e m o tio n s tak e s u s b a ck to o rg a n iz in g p rin c ip le s. T o e x te n d th e m e ta p h o r, we c o u ld say t h a t a c lie n t’s o rg a n iz in g p rin ­ ciples are h is a u to m a tic fact-filing a n d re triev a l p ro g ra m , especially w h e n th e facts in q u e s tio n have to d o w ith h is re la tio n s h ip w ith o th e r s a n d h is place in th e w o rld . T h e s e p rin c ip le s t h a t o rg a n iz e a c lie n t’s life o f rela­ tio n s h ip s a n d feelings arc th e m o st re liab le fo rm o f re la tio n a l m em o ry . T h e ir o rg a n iz in g a c tio n s d o n ’t d e p e n d o n ju s t a few events; o n th e c o n ­ trary , th e y have b e e n g e n era liz ed fro m very m an y sim ila r e x p e rie n c e s o f w h a t h a p p e n e d b e tw e e n a c lie n t a n d o th e r p e o p le . Ju s t o u ts id e o f his

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aw areness, th ey c o n tin u e th e ir c o n s ta n t o p e ra tio n s o f m ak in g sense, a n d as th ey retrieve files in o rd e r to d o so, th ey are th e forces th a t tu rn m em o ry in to “now .” T h ey are also th e forces th a t d e fin e new e x p erien ce by filing it in old files t h a t have fixed e m o tio n a l m eanings. M e ta p h o rs always fall sh o rt, o f course, o f th e reality th ey aim to cap tu re. B u t my p o in t is th a t any m em o ry takes place w ith in th is com plex activity o f m ak in g m ean in g . It’s h e re th a t th e re m e m b e rin g o f relatio n a l p sy ch o th erap y is u n d e rta k e n —in th is activity w here th e n a n d now m erge, w here experiences o f past a n d p re se n t c o -d eterm in e each o th er. In C h a p te r 3, we saw th a t re la tio n a l th era p y u n d e rs ta n d s p sy c h o ­ logical b a d feelings to o rig in a te from n e ith e r o u tsid e n o r in sid e a client, b u t ra th e r fro m th a t placc o r activity w h ere in n e r a n d o u te r system s in te r­ act, p ro d u c in g re la tio n a l m ea n in g s full o f feelings. H ere we have a n o th e r angle o n t h a t sam e d iffic u lt co n ce p t, a n o th e r a p p ro ac h to th e sam e te rri­ tory. In th is ch ap ter, I am saying th a t th e “re m e m b e rin g ” w ork o f th era p y is n o t a b o u t th e past as such, b u t a b o u t specific ways th e past is p re se n t in a c lie n t’s system o f living a n d m ak in g m ean in g . A c lie n t’s re la tio n a l p ast is p re se n t in active p rin cip les th a t organize th e feelings a n d m ean in g s possible for h im in his life a n d re la tio n sh ip s. T h ese are th e very p rin cip les t h a t cam e in to b e in g in o rd e r to m ake rec­ ognizable p a tte rn s o u t o f m any re p e titio n s o f in te rp e rs o n a l in te rac tio n s. T h ey cam e from th a t place th a t is n e ith e r o u tsid e n o r inside, b u t o u tsid e a n d in sid e all a t once. W h a t y o u r c lie n t re m e m b e rs is p a st a n d p re se n t all at o n c e. It’s im p o rta n t to re m e m b e r, how ever, th a t yo u r c lie n t d o e sn ’t have to th in k a b o u t all o f th a t w hile h e ’s d o in g his therapy. N o r d o you have to force o r cajole his re m e m b e rin g . It will be th e re . T h e layering o f no w a n d m em o ry w ill slowly reveal itself w h e n careful a tte n tio n is p a id to w hatever th e c lie n t is exp erien cin g , th in k in g , a n d feeling h e re a n d now.

S ta y in g A n c h o r e d in th e P resent

A ny c lie n t com es to th e ra p y because o f p ro b lem s he has living rig h t now. H is p ro b lem isn’t sim ply th a t h e ’s fo rg o tte n w h a t h a p p e n e d to h im . H is p ro b lem is t h a t th e m ean in g s o f w h a t h a p p e n e d to h im a re n ’t g o o d for him , h e ’s living th o se m ean in g s every day, a n d h e d o e sn ’t k n o w w h a t th ey are. F or th e p u rp o se s o f therapy, w h a t h a p p e n e d in th e p ast m atters only in h o w it stays w ith a c lie n t now. T h a t’s why, as a re la tio n a l th e ra ­ pist, you w ill keep yourself a n d y o u r c lic n t a n c h o re d firm ly in th e present. Even if y o u r c lie n t com cs in w o n d e rin g w h e th e r his p ro b lem s arc c o m in g

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fro m h is h isto ry , it’s p ro b a b ly b e st to say, “L et’s ta lk a b o u t w h a t’s tr o u ­ b lin g y ou now , a n d see w h a t c o m e s u p .” It’s likely t h a t w h a t w ill c o m e u p are p e rs is te n t p a tte rn s o f feelin g b a d o n a d aily basis, w h ic h c a n b e lin k e d , a fte r a w h ile, to c e rta in in te ra c tio n s y o u r c lie n t has w ith o th e r p e o p le a n d to th e m e a n in g s a n d feelings o f th o s e in te ra c tio n s . T h is w as th e case w ith “M e g a n ,” w h o c am e to see m e b e ca u se she w as fe elin g lo st a n d c o n fu se d a b o u t h e r life a n d w o rrie d a b o u t th e b e g in ­ n in g s o f a sta rv e-a n d -b in g e e a tin g p a tte rn . S h e w as ju s t fin is h in g h e r first year o f u niv ersity , a n d sh e w a sn ’t h a p p y in th e p ro g ra m sh e h a d c h o se n . T h e y o u n g e st o f th re e d a u g h te rs , sh e w as th e last o n e living a t h o m e . H e r b ra in y o ld e s t siste r w as away a t m e d ic a l sc h o o l a n d th e s e c o n d sister, m a rrie d to a n ic c guy, h a d a b e a u tifu l n e w baby. In h e r o p e n in g sk e tch o f th e fam ily, M e g a n p a in te d h e rs e lf as th e q u ie t o n e w h o n e v er really k n ew w h a t sh e w a n te d . I c o u ld n ’t get a c le a r p ic tu r e o f h e r p a re n ts u n til I b e g a n to h e a r clues t h a t th e y w e re n ’t very h a p p y to g e th e r. M e g a n to ld m e m o re th a n o n c e t h a t e ac h o f th e m loved h e r very m u c h . I b e g a n to w o n ­ d e r w h e th e r th is q u ie t y o u n g e st d a u g h te r h a d lo n g ago b e c o m e th e c o m ­ fo rt o f h e r m o th e r ’s lo n ely e x iste n ce a n d th e lig h t a t th e e n d o f every lo n g , h a rd day fo r h e r fa th e r. I w o n d e re d w h e th e r h e r e a tin g o b se ssio n h e lp e d h e r m an a g e th e a n x ie ty sh e a b so rb e d fro m h e r p a re n ts ’ re la tio n ­ sh ip . B u t m o stly w e talk e d a b o u t w h a t sh e w o u ld d o in S e p te m b e r. F irst sh e to ld m e, very h e sita n tly , t h a t sh e d id n ’t w a n t to go to univ ersity ; she w a n te d to go to a r t sc h o o l. N e x t sh e d a re d to say, “B u t o n ly p a rt-tim e .” M e g a n lik e d th e new p lace w h e re sh e w as w aitrcssing; m a n a g e m e n t w as fa ir a n d th e tip s w ere g o o d . If sh e k e p t t h a t jo b , sh e c o u ld m ak e d e c e n t m o n e y a n d still go to sc h o o l p a rt-tim e , sh e e x p la in e d . A s sh e to ld m e th e s e th in g s , sh e realized t h a t s h e w as try in g to b e c o m e fin a n c ia lly in d e ­ p e n d e n t. T h e n c am e th e bigger re a liz a tio n , q u ite h a rd fo r h e r to face. S h e w a n te d to b e in d e p e n d e n t e n o u g h to leave h o m e ! T h is w as a large p ro b le m w ith m an y p ro b le m s in sid e o f it. M e g a n k n e w t h a t h e r p a re n ts w o u ld o p p o se h e r fo r m an y g o o d rea­ so n s: th e re sp o n sib le th in g w o u ld b e to stay in un iv ersity ; th e fin a n c ia lly se n sib le th in g w o u ld b e to live a t h o m e . B u t w h a t M e g a n feared m o st w as h u r tin g h e r p a re n ts by w a n tin g to leave. S h e felt tra p p e d a n d a ngry. S h e c rie d . S h e t h o u g h t sh e w o u ld n e v er b e ab le to say w h a t s h e w a n te d to say to th e m . A g a in a n d a g ain w e d isc u sse d all th e ways sh e m ig h t e x p la in h e rs e lf to th e m , a n d all th e ways sh e th o u g h t th ey m ig h t r e s p o n d . In th e e n d M e g a n in v ite d th e m to c o m e in to a se ssio n w ith h e r—so th a t I c o u ld h e lp lo o k a fte r th e m , s h e said . M y p re se n c e also gave h e r e x tra s tre n g th

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to say w hat she had planned. It came dow n to, “I’m n o t my brainy sister Gwen or my bubbly sister Joan. I’m just me, and I really need to leave hom e in order to find o u t w ho I am. I still love you b o th very m uch, and I will visit lots, b u t I need a space and a life o f my ow n.” In th a t session, her parents were able to hear her fairly well, and in th e weeks following they were able to let her go with only sporadic guiltinducing messages. M egan was able to tolerate her uncom fortable feel­ ings in the face o f their sadness and their subtle anger ab o u t her leaving. Soon after M egan had moved ou t o n her own, she d id n ’t need to com e to therapy any longer. She told me th a t she was pretty sure th a t her eating wasn’t going to be a problem anym ore either. You could say th a t in M egan’s therapy, we never touched her past. O r you could say th a t as she experienced my listening, o ne o f th e assump­ tions she had m ade in the past, in th e shadow o f her com petent, talk­ ative, outgoing sisters, got significantly altered. She found th a t w hen som ebody was listening to her, waiting to hear w hat she really thought, she could, indeed, figure ou t w hat she w anted. She could find her voice. A nd w ith this new possibility springing to life between us, she dared to risk an even m ore radical change. Perhaps she could speak her needs, even though her needs would take her away from her parents. W e never w ent back in time; we never had to talk about th e little girl whose sense o f w orth depended on easing the pain o f b o th her par­ ents, or about the years she carried their anxieties as her own. W h a t we did was go over and over the shape and feel of the system in w hich she felt trapped, and as we did so, a new, freer system was developing be­ tween us. O u r new interactions had altered M egan’s accom m odating, care-taking organizing principles just enough to give her a crucial win­ dow o f escape from them . T hough we never spoke o f it, som ething had changed in how her past was present to her, and I could hope th at the change w ould give her freedom enough to keep on speaking her own tru th to her parents and developing m ore self-assured ways o f being in th e world. A critic m ight object th a t this was a fairly easy, straightforw ard sixm onth therapy, and th at m any adolescents, in o rder to get ready for adult­ hood, are in the process o f revam ping their interpersonal organizing principles. To do so, they d o n ’t need to explore th e past. All o f this is true. A critic m ight th e n suggest th a t adults w ho have suffered m ore extensive relational traum a arc in a different situation; they do, in fact, need to be directed to th in k about w hat happened to th em in the past, at least for a little while. In answer, I will tell an o th er story, w hich I will call

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“A Tale o f Two H ospitals.” It's only a sm all p a rt o f a long, com plicated story, for th e story’s h e ro in e , “Lucy,” has b een in psychiatric care for h a lf o f h er life, ever since h e r first suicide a tte m p t at 16. She cam e to m e from a residential tre a tm e n t facility th a t specialized in th e recovery o f m em ory, in particular, m em ories o f sexual abuse. I have been h er th era p ist for 10 years now, a n d she also keeps c o n ta ct w ith a psychiatrist w ho can pre­ scribe m edication w h e n she needs it a n d w ho still m ain tain s h e r safetyn e t link to a hospital, sh o u ld h er suicidality recur.

A Tale o f T w o H o sp ita ls W h e n she cam e to me, Lucy h a d already rem em bered th a t betw een th e ages o f 5 a n d 9 she h a d b een sexually m olested a n d perhaps raped by h er father. B ut h e r m em ories were in vague bits a n d pieces. In h er previous trea tm e n t program , sh e ’d b een to ld th a t th e key to h er healing was to recover h e r m em ories fully, along w ith all th e feelings th a t w ent w ith th em . W h a t was w rong th a t needed healing? Lucy lived m ost o f every day alone in a fog, losing large c h u n k s o f tim e, forgetting to eat, a n d sleeping irregularly. W h e n sm all things w ent w rong, she w ould feel so helpless a n d terribly alone th a t she w ould c u t herself to feel th e pain —a n d to stop th e pain. O fte n she was to o frig h ten ed to go o u t, b u t w hen she h a d to, she could sw itch in to a tough, b rig h t persona w ho could in teract w ith shopkeepers and bus drivers. S om etim es Lucy tried to w ork at m enial jobs to aug m en t h e r sm all disability pension. B ut inevitably h e r persona w ould get stretched to o far a n d crack, a n d she w ould retreat, sobbing, to h e r a p artm e n t, sure th a t everyone h a te d her, sure th a t she was ugly and disgusting, sure th a t she sh o u ld h u rt herself as p u n ish m en t. A n d at least once o r twice a year, h e r ability to keep herself fu n c tio n in g w ould also get stretched to o tar, a n d she w ould sta rt p lan n in g to die. B ut ever since h er first suicide attem pt, h er plans to die had always becom e entan g led in com plicated relatio n sh ip s w ith hospitals. So once o r twice a year, she w ould be in hospital for a week o r two, getting over th e urge to kill herself. I decided th a t my first p riority w ith Lucy w ould be to help h e r estab­ lish m ore physical safety an d co m fo rt in h e r life. I also w anted to help h e r feel safer w ith me. So for m o n th s stretching in to years we talked ab o u t th e details o f h e r everyday life—a b o u t cleaning a n d p a in tin g h e r ap art­ m ent, a b o u t sta rtin g seedlings a n d sh o p p in g for groceries, a b o u t fights w ith a boyfriend w ho treated h e r badly, a b o u t troubles at w ork, m isun­

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derstandings and fallings-out w ith friends, and negotiations w ith psy­ chiatrists and hospitals. W e talked about islands o f calm in a day or a week, pieces o f reality th at m ade sense, and we visualized linking them together w ith bridges. Lucy told me ab o u t sci-fi books she liked and b rought me tapes o f her favorite music. Som etim es she brought her pets along for a visit. “Family therapy,” she said. In and through this everyday conversation, we talked about Lucy’s past, too, b u t n o t as a special project, and n o t about w hat had been des­ ignated “the traum a.” From diaries she had saved, she read aloud to me the record o f her adolescent torm ents o f struggling to establish an iden­ tity and find friends w ho liked her. As I supported Lucy in interactions w ith her family, I felt I cam c to know Lucy’s m o th er quite well, especially her style o f oscillating betw een needy intru sio n and harsh criticism of Lucy. I cam e to have a sense o f her moody, distant father, too, and even o f the vulnerability mixed in w ith his abusive, alcoholic rages. Lucy told me th a t w hen she was little, she used to be petrified every night th at som eone was going to get killed. She told me how her m o th er dressed her up to be her pretty little girl in clothes Lucy hated, and how she scream ed at Lucy w hen Lucy d id n ’t do her chores right. I heard about the bullies in Lucy’s playground, her childhood pets, and the different houses she lived in. A nd som etim es I w ondered w hether we should be talking ab o u t “the trau m a ” instead o f all o f this. A nd then, du rin g one o f her longer stays in the hospital she had been using for suicidal emergencies, the staff there decided th a t Lucy should, indeed, talk about the traum a. She told m e about it after, about “losing it” and having to be restrained. She had heard herself scream ing ugly words at herself, she said, and in th at m o m en t she knew th at those words had been scream ed at her—she knew she had been abused—it was true! A fter the breakdow n, she felt dazed and confused for a while, b u t m uch calmer. Above all, it seem ed, she felt vindicated in the eyes o f the hospital staff: she did carry horrible stuff inside her; terrible things had really happened to her. H er pain “m ade sense.” She had a right to it. I d id n ’t u n d erstan d exactly w hat had happened to Lucy in hospital, b u t I hoped for h e r sake th a t it was the breakthrough she longed for. But sadly, it wasn’t. Very soon she was acutely suicidal again, and after three brief adm issions in quick succession, the hospital staff decided to try an o th e r approach. They und erlin ed th a t p art o f h er diagnosis th a t read “borderline,” and referred Lucy to a neighboring hospital w ith a treat­ m en t program th a t reclassified certain “borderlines” as patients w ith “dis­ sociative identity disorder” and worked w ith the dissociation. A fter m uch

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initial fear a n d suspicion, Lucy began to talk w ith staff th ere a b o u t th e differen t parts o f h er th a t had very differen t th o u g h ts a n d feelings, and especially a b o u t th a t sm all b u t pow erful p a rt w h o stepped in to take over w hen she a n d everybody else was sick o f h er “w hiny self, always in pain, always needing, never getting.” T h a t cold, furious p a rt said, “Fuck it. O n e th in g needs to h a p p e n here. T h a t w hiny self needs to d ie.” Ju st learn in g a b o u t these differen t parts and a b o u t th e dissociation th a t kept th em a p art from each o th e r was a w o nderful revelation to Lucy. S he cam e back to m e m ore excited and c o n fid e n t th a n I h a d ever seen her. “It’s th e dissociation—th a t’s th e problem ! T h a t’s always b een th e prol> lem! N o n e o f those hospitals o r psychiatrists ever got it—all th o se years! A n d it’s so obvious! O u t o f all th a t trea tm e n t, only you got it, only you knew it all along. You’ve b een saying dissociation for years!” S he gave m e m ore credit for u n d e rsta n d in g w hat I was d o in g all those years th a n I deserved. B ut it h a p p en e d th a t so o n after Lucy began h e r hospital tre a tm e n t for dissociation, I a tte n d e d a w orkshop w ith Jody M essier Davies, a relational psychoanalyst w h o specializes in treating sur­ vivors o f c h ild h o o d sexual abuse.3 I cam e away echoing Lucy: “Yes, it’s th e dissociation! B ut n o t ju st any k in d o f dissociation—w h a t m atters m ost in th e tre a tm e n t o f abused clients is th e relational dissociation. All these years, w ith so m any clients, th a t’s th e pro b lem I’ve b een trying to u n d e r­ stan d, trying to engage with! A t last som ebody is saying it, saying how to p u t relational dissociation to g eth er w ith relational tre a tm e n t.” So Lucy a n d I c o n tin u e o u r sam e style o f w ork together, b u t now we u n d e rsta n d b etter w h at we’ve d o n e. A fter all th e c h ild h o o d shattcrings, w h e n she cam e to m e she was living h e r life in d isconnected pieces. H er previous “trau m a th era p y ” had left h er w ith m ore difficult a n d d istu rb ­ ing pieces to deal w ith. A t first all she could brin g to m e were those disconnected bits an d pieces o f her experience, keeping her deeply sham ed sense o f an empty, w orthless self far away. B ut over tim e those bits o f past a n d presen t began to h o ld together, a n d she began to live in everyday tim e a n d space. A fter two o r th ree years she noticed, “It’s like I can feel a past b e h in d me, like it’s real, th e re ’s c o n tin u ity .” She said, “It’s like I can finally be here. B ut I d o n ’t like it. It h u rts a lot.” W h a t h u rt th e m ost was w hat she described as searing, overw helm ing sham e. W h e n she cam e close to feeling it w ith me, it was m ore th a n she could bear. T h ro u g h th is lo n g process o f gettin g safer a n d b e co m in g m ore present, Lucy began to approach m ore directly th e central sh atterin g in h er life, th e sp lin terin g o f h e r personality in to fragm ents o f self-witho th e r systems o f in teractio n , each o f w hich to o k o n a life o f its own.

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E ventually 1, too, h a d to fight w ith th e bru tal, o m n ip o te n t killer o f Lucy’s vulnerability, a n d I was allowed closer to th e terrified, sh am ed child-self w ho th o u g h t she deserved to be dead. T hese two fragm ents o f herself— actually two pieces o f how Lucy can experience self-w ith-other—are th e m ost im p o rta n t o f Lucy’s “parts.” B ut now th a t we know how they work, we can identify o th e r self-w ith-other systems th a t po p up to help h er deal w ith difficulties. Lucy an d h e r new boyfriend have com e in together to talk a b o u t th e parts o f them selves they each have th a t ju st react to each o th er, causing scary, repetitive fights. In spite o f th e fights a n d because o f th e talking, th a t relatio n sh ip becam e q u ite o p e n a n d safe. It has also becom e an ex­ trem ely im p o rta n t place for Lucy to notice m any fragm ents o f self-witho th c r feelings a n d link th e m together in to a grow ing sense o f a w hole self in relatio n to others. T h e m ore Lucy experiences herself as a w hole, real perso n o p eratin g w ith a psychological system she recognizes a n d regulates as best she can, th e m ore her overw helm ing sham e subsides. N ow h er sham e is tied m ostly to specific in terp erso n al events, a n d after “ru n n in g a n d h id in g ,” she can usually find ways to refram e o r repair w h a t h a p p en e d a n d th e n recon­ nect. S he a n d h e r boyfriend are talking o f getting m arried. A n d th en , they th in k , they m ight move away—away from th e ir toxic fam ilies o f o ri­ gin, away to th e m o u n ta in s o r th e coast, w here they can get a fresh sta rt together. “Leaving you will be h a rd ,” Lucy says. B ut I th in k she will m anage ju st fine, especially if she finds th e su p p o rt she needs in h e r new loca­ tio n . She know s how to develop tru stin g re lationships now; she know s how to ask for help a n d how to use it. I th in k th a t this is exactly how o u r long th erap y needs to com e to an end: Lucy will leave hom e, th e ho m e w here fragm ents o f h er being cam e together as a self. She will leave w hole a n d strong en o u g h to be able to m ake th e new re lationships th a t will su p p o rt h er in h e r ow n life in th e w orld. I will w ish h er well from the b o tto m o f my heart, a n d w henever she w rites to keep m e posted on h er progress, I’ll w rite a note o f acknow ledgm ent a n d en co u rag em en t back.4

TH E A N T ID O T E T O RELATIONAL D ISSO C IA TIO N Lucy’s story illustrates how im p o rta n t it is to keep therapy anch o red in th e p re sen t—because th a t’s w here th e past is m aking trouble. Lucy’s story also show s, q u ite graphically, w hat k in d o f tro u b le th e past m akes. As she

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a n d I b o th said, “It’s th e d isso c ia tio n !” I f th e tro u b le is d isso c ia tio n , w h a t’s re q u ire d as its c u re o r a n tid o te is a c o n ta in in g , h o ld in g , a n d lin k in g k in d o f re m e m b e rin g . B u t e v en m o re c a n b e sa id a b o u t relational re m e m b e r­ in g in th e face o f relational d isso c ia tio n . L et m e b e g in w ith a very b rie f review o f Jo d y D av ies’ p o s itio n . I w e n t to D av ies’ w o rk s h o p k n o w in g sh e w as a re la tio n a l psycho­ analyst. A s 1 h a d h o p e d , sh e p ro p o se d a re la tio n a l m o d e l o f m in d —h o ri­ zo n ta l, a sso c ia tio n a l, m e a n in g -m a k in g —a m o d e l in w h ic h u n in te g ra te d tr a u m a lives o u ts id e th e sp h e re o f w h a t c a n m ak e sen se. T h u s , for th e tra u m a tiz e d p e rs o n , th e tra u m a is tru ly “n o w h e re .” D avies c o n tra s te d th is m o d e l o f m in d w ith a v ertical, lin e a r, driv e-b ased m o d e l in w 'hich tr a u m a is k n o w n b u t is th e n re p re ssed “so m e w h e re ”—in to u n c o n s c io u s re g io n s b e n e a th c o n sc io u sn e ss. S h e a rg u e d t h a t tra u m a su rv iv o rs d o n ’t re p re ss w h a t th e y kn o w ; it is d isso c ia te d fro m th e m b e fo re th e y have a c h a n c e to k n o w it. A s I have d o n e , sh e sp o k e o f b o th physio lo g ical a n d psychological d isso c ia tio n . F o r D avies, as fo r m e, p e rso n a l psychology is all a b o u t re la tio n a l processes. In a re la tio n a l m o d e l, a c h ild ’s e x p e rie n c e b e c o m e s a se n se o f c o h e re n t se lf o n ly w ith in th e c o n siste n t, a ffirm in g , h o ld in g p re se n c e o f re sp o n siv e o th e rs . A re la tio n a l psychology, th e n , u n d e r s ta n d s t h a t d isso ­ c ia tio n h a p p e n s w h e n th o s e processes t h a t h o ld a se lf in b e in g fail. W ith ­ o u t im p o rta n t, close o th e rs to h e lp c o n ta in a n d s o o th e a c h ild ’s h u r t a n d fear, tra u m a tic e x p e rie n c e is ju s t to o o v e rw h e lm in g fo r a c h ild to in te ­ g ra te . T h is e x p e rie n c e t h e n b e c o m e s d isso c iate d ; it goes to “n o w h e re .” B u t it d o e s n ’t d isa p p e a r. It b e c o m e s a d isso c ia te d p ro c ess w ith a life o f its ow n. O t h e r se lf-w ith -o th er processes em erge as p ro te c tio n a g ain st th o se feelin g s—like L ucy’s k ille r—a n d they, to o , tak e o n a life o f th e ir o w n o u t­ sid e o f w h a t th e w h o le c h ild k n o w s. If a c h ild ’s e n tire self-w ith -o th er e x p e rie n c e is p a in fu l, c h a o tic , a n d o v e rw h e lm in g , th e c h ild ’s e n tire sys­ te m o f se lf-w ith -o th er sp lin te rs in to d is c o n n e c te d p a rts, e ac h o f w h ic h m a in ta in s iso late d , d is c o n n e c te d ways o f re la tin g to th e w o rld . B u t if th e c o re p ro cesses o f tr a u m a stay alive a n d p o w e rfu l in re p e ti­ tive lo o p s o f se lf-w ith -o th er in te ra c tio n s t h a t are iso lated fro m e ac h o th e r, w h a t d o e s t h a t m e a n fo r th e re la tio n a l tr e a tm e n t o f tra u m a ? T h is w as D avies’ n e w q u e s tio n , galv an izin g fo r m e. A ll g o o d tr a u m a th e o ry e m ­ phasizes th e im p o rta n c e o f a h e a lin g th e ra p e u tic re la tio n s h ip . T h e th e r a ­ p ist is a k n o w le d g ea b le , c alm e x p e rt w h o c a n h e lp th e su rv iv o r m an a g e th e in tru s iv e sy m p to m s o f p o st-tra u m a tic stress. S h e is a n e m p o w e rin g w itn ess w h o e m b o d ie s c o m p a ss io n a n d ju stice. S h e is a c o m p a n io n a lo n g a d a rk p a th o f m o u r n in g w h o b rin g s p e rs o n a l in te g rity to th e task o f

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facing loss, pain, a n d evil. All o f these ways o f being-w ith are im p o rta n t aspects o f a relational tre a tm e n t o f trau m a. B ut how does a th era p ist be w ith th o se repetitive loops o f self-w ith-other in teractio n s th a t com prise a trau m a survivor’s fractured sense o f self? To fin d ways to engage in those loops w ith a client w ould be to c o n ta c t th e m ost significant ways in w hich a trau m a survivor’s m em ory constructs h e r “now .” It w ould be th e best, m ost pow erful k in d o f relational rem em bering-w ith, for it w ould carry th e possibility th a t so m e th in g a b o u t th o se self-w ith-other loops could be changed as th e th era p ist a n d client lived th ro u g h th em together. Before we go fu rth er, let m e sum m arize w hat I’ve said so far a b o u t a re la tio n a l “re m e m b e rin g ” th erap y : su c h th e ra p y c o n ta in s a tra u m a su rv iv o r’s u n in te g ra te d feelings a n d h o ld s h e r fragm ents o f life a n d m em ory w hile th e survivor slowly reassem bles herself. B ut this is only a first step. To go fu rth er, th e relational dissociations th a t keep a survivor’s core self d isintegrated n eed so m eth in g m ore from a th erap ist—a lively interest in how th e clien t’s self-w ith-other systems w ork, a n d a willing­ ness to find o u t how those systems work from th e inside, th a t is, from th e experience o f being th e “o th e r” to each fragm ent o f th e clien t’s self. Tak­ ing this next step requires using two th era p eu tic techniques o f rem em ­ b e rin g th a t are th e m ost characteristic o f relational therapy. T hey are (1) rem em b erin g by way o f exploring re cu rrin g relational images o r m odel scenes; a n d (2) rem em b erin g by way o f w h a t’s o ften called transference. W e’ll finish this chapter w ith an e x p la n atio n o f m odel scenes, a n d th e n we’ll spend all o f C h a p te r 5 exploring th e com plications o f transference.

A C O N T IN U U M O F D ISSO C IA TIO N W e’re a b o u t to discuss how a relational k in d o f rem em b erin g becom es an a n tid o te for dissociation. B ut first I n eed to p o in t o u t th a t dissocia­ tio n takes m any form s. Your clients d o n ’t n eed to live in a w orld as frag­ m en te d as Lucy’s once was in o rd e r for you to u n d e rsta n d th e ir struggle in term s o f dissociation. O n ce again, I find th e idea o f a c o n tin u u m helpful: a c o n tin u u m o f dissociation th a t m irrors th e c o n tin u u m o f rela­ tional traum a. A t th e severe end o f th e dissociation co n tin u u m are traum a survivors like Lucy w hose fragm ents o f self-systems have little c o n n ec tio n w ith each o th e r a n d w hose core experience is o n e o f being “g one” o r an n ih ilated . In a rare c o n d itio n k n ow n as m u ltiple personality disorder, o r a p ro fo u n d dissociative identity disorder, each self-system operates in­ dependently, w ith little o r n o know ledge o r m em ory o f th e o th ers. A t th e

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o th e r e n d o f th e c o n tin u u m are clients like M egan. H e r dissociation is far less severe, b u t she, too, has split away from h erself a c ertain gro u p o f tro u b lin g self-wit h o t h e r experiences, m eanings, a n d feelings. A n d so th e m ost fu n d a m e n ta l p rinciples o f relational tre a tm e n t are th e sam e for b o th Lucy a n d M egan: th e th era p ist encourages th e client to brin g to therapy all th e parts o f herself th a t tro u b le her—problem s, sym ptom s, m em ories, feelings—a n d she holds all o f th a t w ith in e m p ath ic care and u n d e rstan d in g . T h e th era p ist also helps th e client trace a n d feel th e selfw ith-other scenarios th a t cause h er pain a n d sham e: critical, pow erful aspects o f h e r trouble th a t she h a sn ’t recognized o n h e r ow n. W ith a severely traum atized client, th ere are m any u n in te g rate d bits to hold a n d a very long process o f linking th e m together. W ith som eone like M egan, th e re ’s n o t as m uch m issing from th e center, a n d n o t as m any discon­ nected aspects o f self for th e th era p ist to h old. O nly p a rt o f M egan’s relational life was problem atic, a n d so th e w ork o f c o n n ectin g w ith w hat was dissociated d id n ’t take nearly as long. B ut w ith b o th young w om en, th e essential p a rt o f th e w ork was to track a n d to trace how certain tro u b lin g self-w ith-other systems w orked. Lucy’s m ost devastating experience was to tu r n to people for help and have th em disbelieve th a t she was in trouble. Every trip to h o sp ital con­ tain ed th e th re a t th a t this w ould h a p p e n to her. Even h in ts o f disbelief w ould flood h er w ith h u m ilia tio n a n d rage. O n c e, w hen th e disbelief was b lata n t, th e “k iller” p a rt o f herself to o k over, stalked o u t coldly from th e hospital, to o k th e streetcar ho m e, a n d w ith stockpiled pills nearly succeeded in an n ih ilatin g h e r “sucky, w hiny” self forever. W e cam e to call th e beginnings o f this sequence “n o t being taken seriously,” a n d for a long tim e it was so explosively sham eful th a t Lucy c o u ld n ’t rem em ber o r tell m e th e details o f how it h ap p en ed . B ut after m any instances, we began to piece together th e crucial interactions. Lucy w ould say in o n e way o r an o th e r, “I’m at th e e n d o f my rope. I ju st w ant to die. I can ’t keep m yself to g eth er a n d safe any longer.” T h e n th e people o n th e o th e r side w ould say in o n e way o r a nother, “T h a t’s n o t tru e .” T hey m ight say, in te n d in g to be helpful, th a t she was stronger th a n she th o u g h t o r th a t sh e ’d felt this way before a n d com e th ro u g h it. O r they m ight im patiently in sin u ate th a t she was m an ip u lat­ ing th e system w ith threats o f self-harm . B ut w hatever they in te n d e d , to Lucy it all m ea n t th e sam e thing: they did n o t believe th e tr u th o f h er experience. S he was trying to tell th em how it was for her, a n d they were telling h e r she was lying. W e w ould look at exactly w hat Lucy had said a n d w hat sh e ’d hoped

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to hear in response. W e’d contrast the bad tim es w ith tim es w hen Lucy had felt heard and helped. W e’d conclude over and over again th a t w hat Lucy needed at these crucial times was th at people would believe how annihilated, helpless, and “in pieces” she felt, and th a t her desperate pain would m atter to them enough th a t they would w ant to help. O f course, their belief and care would have to be dem onstrated in som e kind o f good-faith action, b u t once she felt believed w ith em pathy and care, Lucy was able to receive help in whatever form it was available to her. A t the center of M egan’s brief work, there was th a t same tracing o f a particular painful sequence o f self-with-other interactions and feelings. In her case, though, we did the tracing mostly hypothetically, as she prac­ ticed w hat she m ight say to her parents and anticipated th eir responses. She w anted to tell them she needed her own life, her own space, an d she felt sure th a t they w ould try to keep her in their space, looking after th eir needs. She w ouldn’t have been so sure o f th a t w itho u t a history o f those kinds o f interactions behind her, bur she d id n ’t need to tell me about the history. Im agining the next im p o rtan t interaction seemed to give her enough contact w ith how th a t system worked; it was all th e rem em bering she needed to do. I d id n ’t try to help Lucy and M egan change how they did th eir parts o f the interactions. T h a t w asn’t the point. W e were just rem em bering: m aking contact w ith som ething th a t was past and present at the same tim e, som ething we could be sure was im p o rtan t because n o t only did it cause such trouble, it was also very hard to know about. W h a t was the p o in t o f m aking contact w ith it? W e could hope for at least two kinds o f spontaneous changes. For b o th Lucy and Megan, im p o rtan t parts o f w ho they were and how they felt were entangled in interactions they couldn’t bear to know m uch about. As they worked through the interactions, they could reclaim those im portant lost parts of their own experience. T his reclam ation m ight stir anger and grief about w hat happened, b u t it could also eventually help them feel m uch m ore whole, centered, an d resilient. But integration o f lost parts o f self wasn’t the only payoff we could h ope for. W e could also expect th at as we traced and retraced how those interactions worked, they would lose som e o f their power to repeat th em ­ selves automatically. Just sensing how the old loops worked gave Lucy and M egan m ore freedom to try new interactions. For each o f them , th eir first experiences o f a different need-response sequence happened in th eir relationship w ith their therapist. But cach was able, in her own tim e, to take her new freedom o u t to where she needed it in her life.

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“M O D EL S C E N E ” MARKERS O F M E M O R Y /N O W If, as a relational therapist, you take seriously these two ideas—th a t th e re ’s a c o n tin u u m o f relational trau m a a n d a c o u n te rp a rt c o n tin u u m o f disso­ c iation—w ith m ost clients you will be o n th e lo o k o u t for signs o f repeti­ tive in terpersonal interactions th a t are mysteriously pow erful in th eir lives. If you th in k in self-in-relation term s, you m ay catch glim pses o f certain relational images th at, like u n p o sed snapshots, capture lasting self-defining m o m en ts betw een yo u r clien t a n d o th e r people. O r you m ight be interested in looking for signs o f “m odel scenes,” an idea recently devel­ oped as p a rt o f relational psychoanalytic tec h n iq u e.5 1 like noticing m odel scenes a n d w orking w ith th e m because they’re n o t just still-shots; they illustrate im p o rta n t sets o f feelings w ith d ram a, action, a n d gesture. T h e tru th o f a m odel scene is like th e tru th o f a pow erful scene in a film o r novel th a t catches th e essence o f a ch aracter’s com plicated exist­ ence: M a c b eth ’s dialogue w ith th e dagger; B ogart o n th e C asablanca tarm ac; th e m o m e n t o f S o p h ie ’s choice. B ut your clients’ m odel scenes w o n ’t ap p ear to you so artistically fram ed. In fact, they’ll be hard to see at first, if obvious later. I’m th in k in g o f th e client, n o t used to rem em bering h e r dream s, w h o said o n e day w ith a laugh, “I had th e w eirdest little dream . I was trying to ru n away from ho m e, a n d my paren ts were H itler a n d Eva B raun. I h a d to slide like a shadow o u t th e d o o r a n d n o t let th em see m e.” She laughed at first because h e r paren ts were hardly H itler a n d Eva; they were a well-respected clergym an a n d his wife. B ut th e m ore she th o u g h t a b o u t it, th e m ore she saw th a t th e dream c aptured critical, hid ­ d e n aspects o f h er life w ith them : she feared th e cruel tyrant h e r fath er could som etim es be; she despised h er m o th e r’s self-abnegating fixation o n him ; she felt like a p riso n e r in th e walls h e r parents h a d b u ilt a ro u n d th e family, a n d she had b een trying for a long tim e a n d in m any sm all ways to disappear in o rd e r to escape. T his scene also caught th e gist o f how, in general, she still feared a u th o rity figures, d id n ’t have m uch re­ spect for w om en, a n d kept herself invisible for safety’s sake. A dream is only o n e form a m odel scene can take. O fte n a m odel scene com es as a m em ory. H ere is an interp erso n al m odel scene th a t captures how o n e client learn ed to dissociate from pain —w hile learning n o t to n eed help from h e r m other: “I’ve h a d a bike wreck a n d c u t my knee. It’s a d eep cut, a n d it’s bleeding a lot. I’m 9 o r 10, I th in k . I get m yself hom e. My knee really h u rts, a n d I’m scared because inside th e cut I can see w hite stu ff th a t looks like bone. W h e n my m om sees all th e

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b lo o d , sh e freak s o u t, a n d all o f a s u d d e n , m y k n e e d o e s n ’t h u r t anym o re . I’m to ta lly calm a n d I calm h e r d o w n a n d I tell h e r it’s all rig h t; it’s n o t very bad ; I c a n ta k e care o f it m yself. S o sh e leaves m e a lo n e . A n d I tak e care o f it.” I t’s n o su rp ris e t h a t th e c lie n t w h o tells th is sto ry h as lo n g b e e n ab le to ig n o re a c u te physical a n d e m o tio n a l p a in ev en w h ile su ffer­ in g its effects. N o w it’s c a tc h in g u p w ith her. E ven now , how ever, sh e c a n ’t ex p ec t an y s u p p o r t o r c o m p a ss io n fro m o th e r s fo r w h a t sh e feels. M o d e l scen es o f fam ily re la tio n s h ip s o fte n t u r n u p as m e a ltim e m e m o rie s , su c h as: “I’m s ittin g a t th e s u p p e r ta b le a n d n o b o d y is saying a w o rd b e ca u se we w a ite d fo r s u p p e r u n til m y fa th e r c am e h o m e . H e c am e h o m e ju s t a little d r u n k , a n d n o w h e ’s a n g ry b e c a u se s h e ’s a n g ry a t h im . B u t n o b o d y says a w o rd a b o u t it a n d w e hav e to b e very g o o d . I c a n ’t taste m y fo o d ; I c a n ’t e v en e a t it, b u t I have to . T h e n m y b r o th e r spills h is m ilk , a n d m y d a d yells a t h im a n d s e n d s h im to h is ro o m , a n d I feel like cry in g b u t I k n o w I c a n ’t.” A d iffe re n t m o d e l sc e n e c a p tu re s a d iffe re n t fam ily system : “E very­ b o d y ta lk s a lo t a t th e tab le , a n d th e p e rs o n w ith th e b e st a r g u m e n t w ins. Y ou’ve g o t to b e s m a r t a n d a rtic u la te , o r you lose a n d feel d u m b . I’m th e y o u n g e st, so I ’m n o t q u ic k e n o u g h ; m y w o rd s g e t s tu c k in m y th r o a t. So I feel s tu p id a n d like I d o n ’t b e lo n g .” If e ac h o f th e s e m e a ltim e m e m o rie s is, in d e e d , a m o d e l sc e n e, w e ’re n o t su rp ris e d t h a t th e in te rp e rs o n a l feel­ ings c a u g h t by th e s e v ig n ettes are still alive a n d m a k in g tro u b le fo r th e p e rso n s re m e m b e rin g th e scen e. T h e o n e w h o felt like c ry in g b u t c o u ld n ’t still freezes a t th e first sig n o f c o n flic t. F e a rin g t h a t h e r feelings are ex p lo ­ sive, sh e c o n ta in s th e m tightly. T h e y o u n g e st sib lin g w h o c o u ld n ’t get in to th e c o n v e rsa tio n h a s to w o rk h a rd , as a n a d u lt, to sp e a k u p a n d believe in his o w n p o in ts o f view. T o re m e m b e r th e p a st by way o f a m o d e l sc e n e m e m o ry is to k n o w s o m e th in g im p o r ta n t a b o u t th e p re se n t. A s w e’ve n o te d b e fo re , a c lie n t c an re m e m b e r t h a t p r e s e n t p a st w ith ­ o u t even th in k in g back in tim e . H e re-a n d -n o w m o d e l scen es c a n h e lp h im d o th a t. O f te n , as a c lie n t tells y ou his sto rie s a b o u t everyday th in g s th a t b o th e r h im , y ou w ill b e g in to n o tic e t h a t m an y o f th e sto rie s are a b o u t th e sa m e k in d s o f feelings, s tirre d by v ery sim ila r in te rp e rs o n a l in te ra c tio n s . A n y o n e o f th o s e sto rie s c o u ld s ta n d fo r m an y o th e rs like it, a n d in t h a t se n se it’s a m o d e l sc e n e. It c a p tu re s a n e sse n tia l te n s io n o r d ile m m a t h a t is o fte n p re s e n t for y o u r c lie n t w ith o th e r s —fe a rin g c riti­ cism , fe elin g u n k n o w n o r m is u n d e rs to o d , re sistin g a u th o rity , o r escap ­ in g n e e d y d e m a n d s , to n a m e ju s t a few p o ss ib ilitie s . U n d e r s ta n d in g re p e titiv e in te ra c tio n s as m o d e l sc en es lin k s th e m to th e o rg a n iz in g p r in ­ ciples t h a t c o n s tru c t y o u r c lie n t’s m o d e l scen es a n d t h a t give th e m th e ir

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m eanings. W h e n you an d your client pay a tte n tio n to m any o f his m odel scenes, past an d present—th e m em ories, dream s, interactions, an d images th a t d istu rb or move him —together you will see how they all tell versions o f th e sam e interp erso n al stories. T hese are th e stories th a t, as your clie n t lives them o u t, keep o n m aking him w ho he know s h im self to be. W hy are m odel scenes so useful? Because over tim e they help link up a clien t’s past stories an d presen t stories in p attern s th a t m ake b etter sense o f m any parts o f his experience. B ut first they m atter insofar as each o n e helps h im find a link betw een feeling b ad an d w h at h ap p en ed to m ake him feel bad. In relational traum a, w hat h ap p e n ed is o ften very h ard to recognize, for w hat gets dissociated from conscious aw areness are th o se very self-w ith-other interactions th a t m ake him feel an awful k in d o f bad. W hy w ould this be? Because w h at h u rts th e m ost is precisely w hat h ap p e n ed betw een your client a n d th a t o th e r person. N o physical pain lasts like th e repeated, inescapable experience o f being co n tro lled , re­ jected, discounted, or hum iliated. So your client has tried n o t to know a b o u t th o se experiences. It’s likely th e o th e r p erso n w o u ld n ’t w an t him to know ab o u t th e m either. H e o r she w ould be happy to help your client p retend n o n e o f it h ap p en ed . F u rth e rm o re , tho se p ain fu l experiences are o ften em bedded in quite o rd in ary events, an d th a t makes th e m h ard to see—u n til they sta rt tu rn in g u p as “m odel scenes.” A m odel scene gives your client th e gist o f an im p o rta n t in teraction betw een him self a n d som e­ o n e else. It shows him , draws h im a picture, stages th e d ram a. T h en , w hen he pays a tte n tio n to how th e scene unfolds an d to w h at it seems to m ean, his feelings start to com e back to h im a n d he starts to m ake b etter sense to himself. T h e k in d o f m odel scene th a t’s m ost pow erful for m any clients is th e k ind th a t plays o u t betw een them selves a n d th e ir therapists. T his k ind o f m odel scene is o ften given th e special nam e “transference,” as if it’s a p h e n o m e n o n peculiar to psychotherapy. Actually w h at’s called tran s­ ference is ju st one m ore repetition o f a self-w ith-other in teractio n th a t has been painful for a client in m any o th e r contexts. Except th is tim e th e p ainful in teractio n is h ap p en in g w ith his therapist! W h a t could be m ore distressing? T his is th e very p erson he has been learn in g to tru st to be o n his side, to u n d e rsta n d him , an d to care ab o u t how h e feels. A su d d e n shatterin g o f his new, fragile tru st may fill h im w ith such helpless rage an d despair th a t leaving therapy seems like th e only way o ut. Sadly, in som e therapy relationships, it is th e only way out. B ut a relational th erap ist doesn’t lose h ea rt w hen th e therapy rela­

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tio n sh ip becom es frau g h t w ith pain. She know s th a t here is a chance to engage w'ith those dissociated parts o f self th a t th e trau m a survivor tries so h ard to keep u n d e r w raps—b u t can’t, really. If th e th era p ist can find ways to u n d e rsta n d th e pain she has caused a n d thereby build an understa n d in g relatio n sh ip w ith those frightened, angry “parts o f s e lf’—th a t is, w ith th o se repetitive loops o f self-w ith-other experience—she will be able to provide h e r client w ith th e m ost pow erful relational a n tid o te available for relational dissociation. Very o ften, w hen a relational th era p ist is right th ere to d o h e r p a rt o f this d ifficult transference w ork, th ere is a way th ro u g h it, a n d th e n th ere are significant rew ards for m aking it to the o th e r side. C h a p te r 5 is all a b o u t those very d ifficult b u t potentially re­ w arding passages.

ENDNOTES 1. Ju d ith Lewis H erm an, T r a u m a a n d R ec o ve ry (New York: Basic Books, 1992). 2. H erm an, T r a u m a a n d R e c o v e r y , 154. 3. Davies’ 1999 w orkshop carried forward ideas she introduced in her first book: Jody Messier Davies and Mary Gail Frawley, Treating th e A d u l t S u r v iv o r o f C h ild h o o d S e x u a l A b u s e : A P s y c h o a n a ly tic P ersp e ctive (New York: Basic Books, 1994). 4. Lucy and her boyfriend did, indeed, get m arried and move to a small coastal town far away, and she docs keep me posted o n th e new life they are m aking together. Soon after she left, I sent her a d raft o f this chapter, and she replied by p h one and th en by letter, pleased to give her perm ission for me to use her story th e way I had w ritten it. Since th a t tim e, and w ith a good su p p o rt network, she has managed pregnancy, birthing, and m othering an infant. T he family o f three is doing well. Recently she sent photos and wrote th a t even when it’s hard, she knows th a t this is the life she has always wanted. 5. Joseph Lichtenberg, Frank Lachm ann, and James Fosshage, S e l f a n d M o t i v a t i o n a l Sys­ te m s: T o w a r d a T h e o r y o f P s y c h o a n a ly tic T e c h n iq u e (Hillsdale, N’J: Analytic Press, 1992).

5 THE TERRIBLY HARD PART OF RELATIONAL PSYCHOTHERAPY

YOUR WRITER IS IN TROUBLE! I do w ant to w rite this chapter, b u t I’ve been stopped in my tracks by an uncanny tu rn o f events. I d o n ’t like this situation one bit, b u t I find myself in one o f those difficult passages I’ve prom ised to w rite about: I’m trying to get through a painful m odel scene w ith my therapist. It began two chapters ago, and I was h oping it w ould be over by now. I have no idea how I’ll get through it. It crosses my m ind th a t maybe this tim e I will have to leave therapy. M ore o f me th in k s not, rem inding myself th a t I’ve been thro u g h these hard tim es before and I’ve com e o u t all right. T h a t’s exactly w hat this chapter is about—getting through these h ard tim es. But if I d o n ’t know w hether I’ll get through or not, how can I write the chapter? I tell myself just to keep speaking in the same therapist’s voice I’ve been using. From my therapist’s chair, I’m always m ore confi­ d en t (though never sure) th at a client and I can find a way to work through difficult interpersonal feelings. But if I assum e th a t calm, know ing voice now, I’ll have to dissociate from large, loud parts o f w hat’s going o n for me. My w riting will be here and I will be elsewhere. How can I perpetrate such falseness in a chapter th a t’s supposed to be ab o u t honesty and inte­ gration? So I have decided to begin this chapter from inside my c u rre n t expe­ rience and find o u t if th a t can take me to w hat I need to say to you, my

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readers. Just now you m ight be w o n d erin g w hat I, a therapist, am doing in therapy, anyway. O r maybe m ost therapists, seasoned o r novice, u n d e r­ sta n d th a t it behooves th e m to d o th e ir ow n therapy w ork, a n d I will be preaching to th e choir. B ut in any case, let m e m ake a b rie f case for th e ra ­ pists being in therapy. In th e first place, since therapists are o rd in ary h u m an s to w hom p ainful things can h ap p en , we need help as m uch as anyone else. Second, th e jo b d em an d s large reserves o f em o tio n al presence a n d resilience, and since therapists can’t talk a b o u t th e ir w ork at h o m e o r w ith friends, we often b rin g th e tro u b le stirred u p by o u r w ork to o u r ow n therapy. In a m ore personal way th a n a supervisor o r c o n su lta n t does, a th era p ist at­ ten d s to o u r feelings o f c o nfusion, fru stratio n , a n d d ep letio n . A n d th ird , m ost o f us therapists take u p th e w ork because we know so m eth in g ab o u t em o tio n al p a in a n d psychological dissonance from th e inside. M any o f us were p arentified ch ild ren in tro u b le d fam ilies. E m otional a ttu n e m e n t com es easily to us, a n d we thrive o n providing th e em pathy we once longed to receive. B ut th is m eans, too, th a t we live som ew here o n th e c o n tin u u m o f relational trau m a, w ith a p ropensity to keep im p o rta n t parts o f o u r self-w ith-other experience o u t o f o u r ow n awareness. Som e­ tim es, for exam ple, providing care can be a very effective way to disavow a need, long-denied, to be cared for. B ut such disavowals w reak havoc w hen they keep us from recognizing w h a t m otivates o u r ow n responses to cli­ ents, especially w hen those responses becom e p a rt o f m odel scenes cli­ ents experience as destructive. T herapy can prevent a n d u n d o som e o f th o se u nconscious e n tan g lem en ts w ith clients’ issues. A n d finally, o f course, therapists are in therapy because we believe in th e process. W e therapists w ho know a b o u t feeling bad from th e in­ side are also in th e business o f help in g o th ers feel better. T herefore we are perhaps m ore o p tim istic th a n m ost people m ight be a b o u t o u r ow n chances o f being h elped to feel b etter th ro u g h a n o th e r course o f therapy. W e keep trying. For all o f these reasons, I have been in several d ifferen t ro u n d s o f therapy over th e course o f my career as a therapist. R ight now I’m th in k ­ ing th a t th e only reason good en o u g h to keep m e in this c u rre n t therapy is th e h o p e o f feeling better—w hich is as it sh o u ld be. I d o u b t anyone stays w ith this terribly h ard p a rt o f relational therapy unless it’s to try to accom plish so m eth in g really w o rth th e risk. I’m still trying for it, it seems. N ow I will tell you w h a t’s h a p p en in g as sim ply as I can.

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THE STORY BEHIND THE TROUBLE N ot long ago, after com pleting the opening chapters o f this book, I was beginning to feel quite excited about w riting it, and I spoke o f my feel­ ings in therapy. My therapist n o t only em pathized w ith my feelings, he also seem ed to th in k th a t th e book was a valuable project, and th a t it m ight make a w orthw hile co n trib u tio n to o u r shared field o f work. He seem ed genuinely interested. M ade bold (or foolish) by his interest, I b rought him a photocopied d raft o f the first two chapters o f the book. He thanked me politely. As I was talking ab o u t w hat it m eant to me to give him som e o f my work, I noted th a t it was a risk, since I knew he was a busy m an. He responded by saying th a t it would, indeed, be a while before he could get around to reading w hat I had given him . My heart sank, though I d id n ’t know how far it sank until I had left the session. But th e n suddenly I knew th a t above all else, I had to get those chapters back. I got my chapters back, unread, at the beginning o f the next session, and I began to try to talk about w hat had happened. T h e com ponents o f the m odel scene, as I had experienced it, w eren’t com plicated. I had dared to hope th a t my analyst’s interest in my work was genuine and th a t he shared my excitem ent ab o u t it. But in his response I heard no excite­ m ent, only polite and wary protection o f his b oundaries and a subtle indication th a t my request was a b urden. As soon as I heard that, I was filled w ith sham e for having asked. I knew at once th at I had asked for far too m uch; o f course, the only tim e he owed me was the tim e in session th a t he was paid for. I had m ade a terrible and hum iliating mistake. It was as if I had been caught asking him to p u t a childish drawing o f m ine on his fridge. I tried to say w hat had happened to me, b u t his silent listening felt like a cold, critical void. I ran stuck and fell silent myself. I hated having to talk to him about this; it com pleted my hum iliation. I told him , “Sham e is like a b u rn , a bad b u rn . A nd talking ab o u t it is like having to strip the dead skin away so th a t it can heal.” I w anted him at least to hear how horrible I felt. I felt flattened and grief-stricken, th ough I d id n ’t know w hat I had lost. In the first days after this rupture, I w ent for long walks, trying to calm myself. Slowly I did grow calm er, and I began to get my feet u n d e r me. My equilibrium retu rn ed as I was able to th in k th a t I d id n ’t need his approval. I d id n ’t need him to share my excitem ent. My book

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was an a d u lt project in th e real w orld, a n d w h a t m attered was to do it well a n d find a publisher. I w ould d o th at. He w ould never h ear ab o u t th e b o o k again u n til it was a fin ish ed project. O r if it tu rn e d o u t to be a failed project, he w ould never h ear a b o u t it again. I could feel myself g ath erin g u p my angry h u m iliatio n a n d using it as fuel to keep my project going a n d th u s to keep m yself going. Indeed, th a t was th e m ove I had b een m aking from th e very m o m e n t w hen I knew, “I have to get those chapters back.” I can u n d e rsta n d th a t from th e outsid e my feelings look like a huge overreaction to my th era p ist’s expectable, reasonable response to my request. T h a t in itself is em barrassing. B ut those feelings becom e m ore co m prehensible if I provide a b it o f back g ro u n d th a t explains why this sim ple interchange was actually a p o te n t m odel scene for me. My fath er was a th eo lo g ian in a religious tra d itio n th a t d id n o t ah low w om en to be leaders o r thinkers. T his m ight n o t have m attered a lot to m e, except th a t as his oldest child, I identified w ith h im a n d c o u ld n ’t help b u t w a n t to follow in his footsteps. O u rs was a com plicated relation­ ship, because th e re was also deep tro u b le in his personal relationships w ith w om en, especially th e w om en he loved. A n d so I trie d to fin d a place w ith him as a pseudo-son. I learned from him how to h a m m e r a nail, p a in t a room , drive a m ow ing tractor, sh o o t a rifle, a n d p itch a te n t in th e rain. I developed, d u rin g th e years o f listening to his preaching, a passion o f my ow n to p u t w ords together in ways th a t w ould m ake people th in k . B ut I was never invited in to my fa th e r’s study. In my second year o f university, I w rote my first philosophy paper, and I b ro u g h t it hom e to h im in hopes th a t he w ould read it. H e never m e n tio n e d it again to m e. W eeks later I fo u n d it lying cru m p led b e h in d th e couch. As I u n d e rsta n d my ow n history a n d how it stays w ith me, th a t philosophy-paper m odel scene is itself a c o n d en satio n o f m any ear­ lier experiences th a t convinced m e th a t w hat I felt a n d had to say as my ow n person d id n ’t m atter m uch to my father. W h a t d id m atter was w hat­ ever he w an ted m e to th in k , feel, say, a n d do. H e was easily troubled, easily angered, a n d I learned very young to d o w hatever I could to keep him happy. I also learn ed th a t I sh o u ld never ask for to o m uch from him —o r from anyone. In fact, I sh o u ld n ’t really ask for anything; I sh o u ld always ju st be grateful for w hat I h a d b een given. A n d now, as an ad u lt w ith th a t history, I have chosen to be in therapy w ith a m an w ho is n o t just my sen io r b u t also a psychiatrist train ed as an analyst. T his puts h im well “above” m e, for a lth o u g h I w ork as a psycho-

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th e ra p is t, I a m a so cial w o rk e r by p ro fe s sio n —o n e o f th e fe m in iz e d pro fes­ sio n s w ell d o w n in a m e n ta l h e a lth h ie ra rc h y d o m in a te d by m o stly m ale p sy c h iatrists. In m y p ro fe ssio n a l life, I have lived in th e sh a d o w o f th e tall to w ers o f psychoanalysis, b u t I have b e e n b a rre d fro m th e castle. O r so it seem s so m e tim e s. A s a n a ca d e m ic , I have w ritte n a b o u t psychoanalysis, b u t I re m a in o u ts id e th e fra te rn ity , I believe, a n d always w ill b e o u tsid e . A n d p a r t o f t h a t is by c h o ic e, b e ca u se I d o n ’t w a n t “th e m ” to o w n m e. I w a n t to t h in k a n d sp e a k fo r m yself. M y c o m p lic a te d in te re s t in p sy c h o ­ analysis is like tiltin g a t w in d m ills, o r so m y o rg a n iz in g p rin c ip le s say. I c o u ld ju s t as w ell have trie d to b e a w o m a n th e o lo g ia n try in g to sp e a k m y t r u t h in m y fa th e r ’s p a tria rc h a l re lig io u s tr a d itio n . (O r I c o u ld ju s t as well have trie d , as a very sm all c h ild , to resist h is p o w e rfu l n e e d to c o n tr o l m y feelings a n d c o n s tr u c t m y b e in g in ways t h a t w o u ld m ir r o r h im .) T h is w as th e fra u g h t re la tio n a l c o n te x t in w h ic h I b e c a m e brave e n o u g h to ta lk to m y a n aly st a b o u t m y o w n p lac e in th e w o rld o f rela­ tio n a l psychotherapy. A fte r co u n tle ss tests o f his em pathy, in c lu d in g careful re p a irs o f p re v io u s m is u n d e rs ta n d in g s a n d r u p tu re s in o u r r e la tio n s h ip , I w as se c u re e n o u g h to risk it. I c o u ld d a re to say to h im t h a t m aybe w h a t I h a d to o ffe r w as v a lu a b le even if it w a sn ’t psychoanalysis, t h a t m aybe m y w ritin g c o u ld say s o m e th in g t h a t w as b o th q u in te ss e n tia lly m e, in my o w n voice, a n d also u se fu l. I h a d re a so n to h o p e t h a t th is p a r tic u la r m a n / p s y c h ia tris t/a n a ly s t m ig h t see t h a t m y ways o f th in k in g a n d feeling, o f b e in g a n d e x p ressin g m yself, w ere w o rth s o m e th in g ju s t as th e y w ere. I w a n te d m y self to m a tte r in h is eyes—a n d in h is feelings, I th in k . T h a t ’s h o w m u c h w as rid in g o n m y casu al re q u e s t t h a t h e re a d w h a t I h a d w ritte n a b o u t th e w o rk we h a d in c o m m o n . In re tro s p e c t I c a n see th a t th e s itu a tio n w as far to o fra u g h t fo r m y n e e d s to b e sim p ly m et. T h e s itu a tio n h a d to s h a tte r—so t h a t I c o u ld e x p e rie n c e w h a t it w as all a b o u t. F o r a w h ile I th o u g h t t h a t if o n ly h e h a d re s p o n d e d w ith ju s t th e rig h t deg ree o f e n th u s ia stic p lea su re w h e n I gave h im m y w ritin g , th e n all w o u ld have b e e n w ell, ev en if h e h a d n ’t b e e n ab le to re a d it fo r a w h ile. B u t t h a t re sp o n se w o u ld have ju s t k e p t th e m o d e l sc e n e m o v in g , fra u g h tn e ss in ­ tac t, to w a rd so m e o t h e r m o m e n t w h e n his re sp o n se w o u ld fall s h o r t o f m y h o p e s. I d o u b t h e c o u ld have k e p t o n b e in g “p e rfe c t” e n o u g h to p ro ­ te c t us fro m th e im p lo sio n o f s h a m e t h a t h a p p e n s a t th e h e a r t o f th e m o d e l sc e n e I a m reliv in g w ith h im . T h a t s h a m e is to o large a p a r t o f m y life e x p e rie n c e , w ith to o m an y trip w ires r u n n in g o ff in every d ire c tio n . F u rth e r m o re , th e s itu a tio n I set u p seem s, in re tro s p e c t, u n c a n n ily calcu ­ la te d to b r in g th e o ld m o d e l sc e n e to life b e tw e e n us. T h e im p lo sio n o f

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sham e was hardly an accident. I m u st have know n th a t 1 w ould see som e h esitatio n if I asked him to read a long piece o f my w ritin g o n his own tim e a n d rig h t before his holidays. As I have said to h im bitterly since, “I knew better.” Readers m ig h t well w onder, “W hy did you d o it th en ? ” First o f all, 1 d id n ’t know ingly choose to do it. I chose my sm all action, o f course, b u t 1 d id n ’t see th e large picture w ith its quality o f m odel scene before I chose, o r notice th e clues th a t I m ig h t be setting m yself up for sham e. It seem s I was com pelled to set up th a t p a rticu la r o ld /n e w scene a n d risk th e sham e. S o m e th in g drew me, an u n ch o se n “why.” I th in k it was a com pelling hope, just o u t o f my awareness, th a t my th era p ist’s positive response to m e w ould w ipe o u t th a t w hole o th e r system o f self-w ith-othcr feelings a n d m eanings th a t h a d b een con strictin g a n d to rm e n tin g m e for years. I believe I th o u g h t, w ith o u t really th in k in g it, “If I set it all up again a n d he is th e exact a n d perfect op p o site o f my father, I can at last be free.” T h e re ’s a pow erful logic there, a n d in fact, in very sm all, im perfect increm ents w orked o u t over tim e, th a t’s exactly how relational psycho­ therapy works. B ut this m odel scene, w ith all it stands for, is far to o pow erful a n d to o tho ro u g h ly en tangled in my personality to destroy w ith o n e blow. I can’t vaporize th e fraughtness; I n eed to feel it. As I was saying in th e last chapter, integration m eans to reconnect w ith th e core self-with-other events and feelings th a t are at th e h e a rt o f relational trau m a. A n d th a t’s a th ird answ er to th e q u estio n , “W hy did you d o it?” I guess I needed to recon­ n ect w ith a p a rt o f m yself w ho has b een too painfully h u m iliate d to reach o u t o r to be em braced. I’m n o t sure I w a n t to know' h e r now o r th a t she w ants to be know n. For in th a t split-off relational w orld w here she lives, o th ers have n o tim e o r space for her. She feels like n o th in g , a nobody, to th em , a n d th e n she feels greedy a n d disgusting for w anting m ore. T h a t’s th e core relational tru th at th e h e a rt o f my m odel scene, th o u g h the scene takes th e shape o f an effort to change th a t tr u th a n d th e inevitable failure o f th a t effort. O th e r scenes are clustered a ro u n d th a t relational tr u th b u t fu rth e r from th e cen ter a n d m ore protective o f it. I could m en tio n w in n in g a prize, w hen I was 6, for th e second highest m arks in my B ritish grade one class, a n d my bew ildered su rp rise at my p a ren ts’ pleasure. A n d th e n the penny d ro p p ed : “O h , this is how I can m atter!” My fa th e r d id n ’t read th a t philosophy p ap er o f m ine, b u t 1 finished my philosophy m ajor w ith h o n ­ ors. I can feel m yself d o in g it again, typing away at this project, looking for a publisher, d e te rm in e d to get it d o n e in spite o f my therapist.

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T h e last tim e I saw h im I sa id , “I ’m bigger th a n w h e th e r th is th e ra p y tu r n s o u t okay o r n o t. I c a n leave it if 1 have to . It feels really g o o d to say th a t. M y life, m y self, is b igger t h a n th is. You c a n ’t d e stro y m e. I will survive. N o , I’ll d o b e tte r th a n su rv iv e .” B rav ad o . B u t also a w ay to k eep m y b a la n c e —to k eep fro m fallin g in to t h a t p o w e rfu l se lf-w ith -o th er fra g m e n t o f n o t m a tte rin g , t h a t p it o f s h a m e . A fte r a life tim e o f p ra ctic e , I d o it w ell. I also k n o w it’s o n ly a se c o n d -b e st s o lu tio n . B u t it m ig h t b e all I have, a n d if so, it’s fa r b e tte r t h a n n o th in g . I im a g in e re a d e rs w o n d e rin g , “If you c a n see all o f th is so clearly, w hy a re n ’t yo u over th e s h a m e already? W h y d o you have to k e ep playing y our gam e o f ‘I d o n ’t n e e d you’?” T o tell th e tru th , I d o n ’t k n o w for sure. I th in k it’s because I feel all alone in this. I w ish insight were th e cure. I w ish t h a t ju s t th e re p e titio n , th e p o w e rfu l e x p e rie n c e o f “o ld ” feelings su rg in g th ro u g h m e, a c a th a rs is o f p a in a n d grief, w o u ld release m e. I w ish th e re was so m e th in g I co u ld d o to change how I feel. Even w riting d o e sn ’t h elp . B u t a lth o u g h I c a n ’t see m y way o u t, I’m n o t w ith o u t h o p e . My h o p e is t h a t I w o n ’t b e a lo n e in th is forever. I c a n ’t feel t h a t it’s h a p p e n ­ in g yet, b u t m aybe if I k e ep o n te llin g m y th e ra p is t w h a t I feel, I’ll b e g in to k n o w t h a t h e ’s still th e re . T h a t w o u ld h e lp . A n d m aybe if I ’m c alm e r I’ll b e ab le to m ak e th o s e b rief, c are fu l visits to t h a t u n b e a ra b ly h u m ili­ a te d little girl a n d fin d o u t th a t we c a n su rv iv e th e c o n ta c t. B u t m y feelings go b a ck a n d fo rth , u p a n d d o w n . R ig h t n o w I c a n ’t sh a k e th e c o n v ic tio n t h a t m y th e ra p is t is a g a in st m e. W h a te v e r h e says is d a n g e ro u s; his voice m akes m e a n g ry a n d a fra id t h a t I’ll lose m y sh ak y b a la n c e . Yet I still w a n t to k e ep o n h e a rin g fro m h im . I w a n t th e d a n g e r to w e ar off. I w a n t to b e ab le to su rv iv e t h a t c o n ta c t, to o , especially th e p a rt w h e re m y u n b e a ra b ly h u m ilia te d se lf is r ig h t th e re b e fo re his eyes. R ig h t n o w t h a t ’s w h a t I c a n ’t sta n d . I w a n t to be very far away. B u t I keep c o m in g b ack , b e ca u se I believe in th e slow, p a tie n t w o rk o f in te g ra tio n . S u rely th e feelings w ill b e c o m e less in te n se w ith e ac h v isit to th e site o f s h a m e . B it by b it, a ck n o w le d g ed a n d re sp ec ted , th e d a n g e r w ill d im in is h . M y th e ra p is t c a n ’t b e a p a re n t I n e v er h a d ; h e c a n ’t even c o m p le te o n e p e rfe c t g e stu re to rig h t a w ro n g d o n e to m e. B u t h e will k e ep o ffe rin g m an y sm a ll a n d im p e rfe c t, b u t c o n s is te n t a n d in te n tio n a l m o m e n ts o f u n d e r s ta n d in g , a n d th ey w ill h e lp m e fin d m y way b a c k to th e se c u rity o f th e re la tio n s h ip . T h a t ’s th e th e o ry . T h e p ro b le m is t h a t I still c a n ’t feel t h a t h e u n d e r ­ s ta n d s.

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But as I’ve said, I still w an t to hear from him . I w an t th o se m o m en ts o f u n d e rsta n d in g again; I miss how they feel. In spite o f everything, it m ust he tru e th a t I still tru st him , because I’m co u n tin g o n him to hear, w ith o u t defenses or explanations, how I hate being w ith him , how I de­ spise w hat I feel, and how I w on d er w h eth er I can ever rrust him again. As th e danger w ears off, perhaps I’ll once again feel his u n d e rsta n d in g an d my trust. I can say all o f this hopefully, b u t I can’t im agine how my next h o u r o f therapy will feel m uch better.

A WAY TH ROU GH In fact, after I h ad w ritten tho se w ords o f m ixed-up feelings a n d g uarded h ope, I sp en t m ost o f th e next session locked in a sham ed, angry silence. I h ad m ade a terrible mess for myself, it seem ed, an d n o th in g I could say w ould h elp —yet he still w aited for m e to speak. By now th is felt alm ost like a ta u n t to me, a m ockery o f my helplessness: Surely I could do this analysis properly a n d fin d w hat I needed to say! Clearly I was just n u rsin g a childish ta n tru m ! B ut I c o u ld n ’t speak these th o u g h ts; I could only retreat further. Finally, after six sessions, two before a n d fou r after a holiday break, my analyst to o k th e initiative to say, “I th in k it m ig h t help if we w en t back and talked ab o u t w h at h ap p e n ed .” I w ondered why he h ad w aited so long to intervene, to say som ething. B ut I rem em bered my angry, scared reactions to any w ords from him in th e very first sessions after th e ru p ­ ture; perhaps h e ’d just b een w aiting for tim e to ease things a bit. I could also im agine th a t h e h ad b een offering his silence as o p en , n o n in tru siv e acceptance w hile I was experiencing it as cold disco n n ectio n a n d a ta u n t. But by th is tim e I co u ld n ’t go directly back to talk ab o u t w h at h ap ­ p ened. First I n eeded to say w h at was silencing m e now: “I feel stupid a b o u t n o t being able to talk because it’s like I got myself into this tro u b le an d I sh o u ld be able to get myself o u t. B ut I can’t.” H e said it m ade sense to him th a t I co u ld n ’t talk: “It’s clear to you, partly because o f w hat your history tells you, b u t also because o f things th a t have h ap p en ed betw een us, th a t I w on’t listen to you o r u n d ersta n d you. “Yes,” I said. “B ut it’s worse th a n th a t. You’ll be angry an d disgusted, too. “All th e m ore reason, th e n , th a t you can’t talk!”

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T h e n I felt safe e n o u g h say, “W h a t 1 c a n ’t get over is th a t p ictu re I have o f m yself a sk in g y ou to read s tu ff I’ve w ritte n . It m akes m e so ash am ed . Because I s h o u ld n ’t have asked. I was asking you to sp e n d tim e o u tsid e o f th e tim e I pay for.” “W ell, first o f all,” he answ ered, “th is re la tio n s h ip isn ’t lim ite d in th a t way. It has its o w n m ean in g s a n d feelings, a n d it stirs u p new feelings like w a n tin g so m e th in g . T h e r e ’s n o th in g w ro n g w ith a sking for som e­ th in g extra. You ju st m ig h t get it. It was g o o d to ask—a positive step for you.” T h is d id n o t feel fine at all, even th o u g h I knew w h a t h e m ea n t. “N o , th e re has to be so m e th in g very w ro n g a b o u t w a n tin g a n d asking, because o f how I feel a fterw ard . A sking m akes m e feel th a t th e re ’s so m e­ th in g really w ro n g w ith m e.” “T h e n th e re m u st have b e en so m e th in g in my resp o n se to yo u r ask­ ing th a t m ad e it go w ro n g fo r y ou,” he suggested. “W h e n you said you w o u ld n ’t be able to get a ro u n d to it for a w hile, th e n it se e m e d th a t it was a b u rd e n a n d a ch o re, a n d I s h o u ld n ’t have asked.” H e n o te d th e irony th a t in try in g to p re v en t my d is a p p o in tm e n t a b o u t a delay in his reading, h e h a d d isa p p o in te d m e m u c h m ore deeply. H e asked w h a t k in d o f re sp o n se w ould have b e e n m o re w h a t I n e e d e d . I h a d th o u g h t a b o u t th a t. “If only you h a d b e e n excited to get it, like I was excited to give it to you—th e n I d o n ’t th in k it w o u ld have m a tte re d how lo n g it to o k you to read it.” B u t I to ld h im th e rest o f my th o u g h t, too: th a t th e s itu a tio n was ju st to o frau g h t a n d probably h a d to sh a tte r, so o n e r o r later. H e disagreed a b o u t th e s itu a tio n h aving to sh a tte r. W as he ju st try­ ing to keep m e from still m ak in g it my ow n fault? Som eday, in a n o th e r k in d o f space, I’ll ask h im w h e th e r m y c o n c e p t o f “fra u g h tn e ss” m akes sense to him , w h e th e r he d o e sn ’t agree th a t som etim es w h a t’s being w orked o u t betw een tw o p e o p le is so lo ad ed w ith d iso w n e d stu ff fro m th e past t h a t it needs to “go w ro n g ” a n d b re ak o p e n —so th a t th e diso w n ed stu ff com es clear a n d new in te g ra tio n s c an s ta rt to h a p p e n . N ow th a t we w ere talking, I c o u ld tell h im ho w I was u sin g my h u ­ m iliated anger to fuel b o th m y w ritin g a n d my d e te rm in a tio n to get my w ork p u b lish e d in th e real w orld. “T h a t’s a goo d p la n ,” h e said. “B u t th e re ’s ju st o n e w rin k le in it. W h e n you c o m e in here, you still feel bad a b o u t yourself.” “Exactly!” I th o u g h t. “So how w ill I feel b e tte r a b o u t myself? N o t u n til we w ork th is th in g o u t b e tw ee n us!” T h a t d id n ’t seem im possible

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anym ore, b u t I still h a d my d o u b ts. R e m e m b erin g th e in te n sity o f my re ac tio n s still m ad e m e flin c h w ith sh am e. H is lo n g silence h a d m ad e th e sh a m e w orse, a n d so m e h o w th a t silence h a d felt in te n tio n a lly sh am in g . I began th e n e x t session by asking h im w hy he h a d w aited so long to suggest th a t we talk a b o u t w h a t h a p p e n e d . I to ld h im my idea o f why: th a t in his m in d th e b e st way to d o analysis is fo r th e p a tie n t (m e) to d o all th e associating. T h e analyst s h o u ld n ’t have to h e lp th e p a tie n t. It w ould be second-best analytic w ork if I w ere to be h e lp e d —bailed o u t o f my ow n m ess, as it w ere. I sh o u ld be able to get m yself o u t o f it. (T his isn’t w h a t I believe a b o u t my ow n w ork w ith clients, b u t in so fa r as analysis is so m e­ how d iffe re n t fro m “o rd in a ry ” therapy, p e rh ap s th is w o u ld b e p a rt o f th e difference: “N o b e in g h e lp e d !”) A s I sp u n o u t th is th eo ry , I c o u ld sec how it re p lica ted th e basic m o d e l scene: In th e given n a tu re o f things, I’m in fe rio r to h im (in th is case as a n o rd in a ry th e ra p is t is in fe rio r to an analyst); if h e th in k s o f m e, it’s w ith so m e k in d o f disgust o r d e risio n ; a n d my b e st efforts w o n ’t change w h a t h e th in k s . H e h e ard m e o u t a n d th e n asked if I’d be in te rested to kn o w th e real reaso n w hy he w aited so long to suggest th a t we talk a b o u t w h a t h a d h a p p e n e d . Yes, in d ee d , I was interested! “I really th o u g h t you w o u ld never w a n t to go back to it again,” he said. “I th o u g h t it was so p a in fu l, you w o u ld n ’t w a n t to to u c h it.” I was s tu n n e d . H ow c o u ld h e t h in k that? D id n ’t h e kn o w m e b e tte r th a n that? D o n ’t I always try to talk a b o u t h a rd things? As I re m in d e d h im a t once, in my family o f o rig in n o th in g can ever be talk ed a b o u t, a n d th a t’s ju st h o rrib le . Feelings b u ild , te n s io n m o u n ts , nerves fray, a n d even a fte r it all goes u n d e rg ro u n d , th e re ’s n o ch an c e o f easy, frien d ly close­ ness. A g ain st th a t b a ck g ro u n d , for so m e o n e ju st to say, “I w o n d e r if we co u ld talk a b o u t w h a t h a p p e n e d ,” is a n am azing relief . H ow co u ld he n o t know that? H e d id n ’t answ er th a t q u e stio n , a n d I’m still puzzled th a t he th o u g h t I w o u ld n ’t w a n t to go back a n d talk a b o u t w h a t h a p p e n e d . M aybe he was o p e ra tin g fro m his ow n h isto ry a n d organ izin g p rin cip les, a n d m aybe in th is respect th e y ’re very d iffe re n t from m in e. B u t it seem s I d id n ’t n e ed for h im to answ er th a t q u e stio n . N ow th a t his re aso n for silence a n d o u r d iffere n ce is in th e o p e n , it m ay b e puzzling, b u t it’s n o t a th re a t. W e can m ove ah ead anyway. M oving a h ea d , I n e e d e d to tell h im w h a t was b e g in n in g to feel like a secret: th a t in o rd e r to keep w ritin g , I h a d b e g u n to w rite th e tw o o f us in to C h a p te r 5, a n d th a t I m ig h t ju st keep us in th e b o o k as goo d m ate­ rial. N ow it felt th a t if I d id n ’t talk to h im a b o u t it, th e w ritin g w o u ld be co m e a silen t th ird presence in o u r w ork to g eth er, a n d I d id n ’t w a n t

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th at. “A n d if you’re very good a n d ask nicely,” I added, “som eday I m ight let you read w hat I’ve w ritten a b o u t you.” I quickly ad m itte d th a t this was a backw ard way to draw a tte n tio n to th e biggest unresolved p a rt o f th e tro u b le betw een us. “I’m sure th a t I will never, ever again ask you to read so m eth in g th a t I’ve w ritten !” “You’d have to be com pletely convinced th a t I was interested a n d w anted to read it before you could ask.” “T h a t’s rig h t,” I said. “A n d I really c an ’t im agine th a t ever h a p p e n ­ ing.” “B ut you’re playing w ith th e idea,” h e replied. “W ith th a t b it ab o u t if I’m good a n d ask nicely.” I h a d to g ra n t h im th at, b u t I still can’t im agine asking again. W h e n I looked a b o u t for o th e r u n fin ish ed , unresolved bits to talk abo u t, I expected to find my earlier sham e a b o u t th e intensity o f my reactions a n d feelings. B ut it was gone. H ad it van ish ed once I knew th a t his silence h a d n ’t b een to sham e me? All I could know for sure was th a t in this calm er, m ore co n n ected self-state, I fo u n d m yself satisfied (alm ost pro u d ) o f th e way I h a d seen o u r relational tro u b le th ro u g h . “It’s like w h e n I play a sp o rt,” I said. “I always play hard; I w ant to do it th e best I can. T h a t’s how I feel a b o u t this therapy: I like th a t I do it hard. I like th a t a b o u t myself.” S uddenly I had th e briefest o f visions: a little blue b o o k in my h a n d and th e n in my th era p ist’s h a n d . I knew w hat it was. “It was my book, all finished, p u b lish ed ,” I told him . “If it got th a t far, th e n you m ight look at it; th e n it w ould be im p o rta n t en o u g h to m atter.” “I’d be w illing to w atch you score goals b u t n o t w atch you play.” “Right. A n d you sure w o u ld n ’t w ant to w atch m e practice!” He laughed, a n d in th a t m o m e n t I liked th e feeling betw een us. T h e n th e session was over.

COM M ENTS W ith detailed transcripts o f o u r conversations, six relational analysts could w rite six q uite differen t articles a b o u t how my th era p ist a n d I w orked o u r way th ro u g h this in terp erso n al crisis. I’m in n o p o sitio n to m ake a final sta te m en t a b o u t w hat h ap p en e d . I’m including th e story in this chapter because it illustrates som e im p o rta n t p o in ts I w a n t to m ake a b o u t how to u n d e rs ta n d a n d m an ag e th o se tim e s w h e n re la tio n a l th e ra p y feels relationally terrib le to your clicnt a n d also, th e n , to you.

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First o f all, although I was able to m ain tain my co m m itm ent to my own therapeutic project and to believe th a t my therapist w ould stay w ith it too, my strong, consistent feelings were: “I hate how I feel; I hate w hat you’re doing to me (even if you d o n ’t m ean to); this relationship is hope­ less; I’m bitterly angry, and I w ant out!” I w ant you to know th a t I truly could n o t see my way through. As a relational therapist, you need to u n d erstan d th a t this kind o f hopelessness, rage, and despair can be held w ith in a constructive therapeutic process. T hose feelings can all be com ­ pletely true for your client—and yet n o t the end o f things. If you can hold this knowledge w ith relative calm, you will provide fundam ental safety and security for your client, even as she despairs and rages at you. Your calm confidence in the proccss o f working things o u t betw een you will probably help her decide to stay w ith the process rather th a n leave it precipitously. Leaving m ight seem to her like th e only way to take care o f herself. But at the same tim e, if she leaves, she m ight take w ith her just one m ore retraum atizing experience o f a painful m odel scene, w hereas if she stays, she m ight experience the benefits o f getting to the oth er side o f it. Consciously or unconsciously, she may know th a t these are the stakes for her. Som etim es it’s helpful to talk directly w ith your client ab o u t the process o f w orking through a repetition o f traum a, ab o u t w hat’s at stake, a nd the pros and cons o f h er staying o r leaving. You m ight tell her th at you believe very firmly in the value o f this hard work, th a t you’re com m it­ ted to doing your p art o f it, and th a t you really hope she w on’t have to leave the relationship. You will ccrtainly encourage her to help herself in any way possible—especially by speaking whatever tru th she can about h er experience, no m atter how bitter, angry, confused, contradictory, and despairing it may be. Second, I w ant to emphasize th a t a difficult tim e like this is only p art o f a m uch larger process o f relational therapy. I w ouldn’t have gotten through it—o r even dared to get into it—w ith o u t having spent a long while developing a relatively secure and resilient relationship w ith my th era­ pist. I expect th a t the benefits o f getting through it will emerge only slowly in o u r ongoing relationship now th a t the crisis has passed. A lthough w orking through these kinds o f relational ruptures can be a very im p o rta n t p art o f the larger therapy process, I’m n o t suggesting th a t it’s the m ost im p o rtan t or m ost powerful work to do in therapy. M ost relational psychoanalysts, including self psychologists, w ould say th at working th ro u g h breaks and impasses is crucial if change is to hap­

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pen in therapy. It seem s th a t fem inist self-in-relation theorists w ould m ake these repetitions o f negative experience secondary to developing healthier, m ore positive self-w ith-other p a tte rn s in therapy. I lean tow ard th e form er position: these negative self-w ith-other m odel scenes are invaluable w hen they play them selves o u t so strongly because they m ake plain exactly w h a t’s getting in th e way o f h ealthier, h a p p ie r relationship. W h e n they appear, they m ake possible th e conscious in teg ratio n o f previously dissociated feelings a n d m eanings. T his process clears th e way for developing m ore positive self-w ith-other pattern s. B ut in th e e n d , th e p o in t a b o u t th e th era p eu tic value o f relational ru p tu res is m oot. N obody, n e ith e r client n o r therapist, w ould ever in te n ­ tionally instigate th em . T hey just h a p p en som etim es. T h e n , w h e th er a c ertain c lie n t’s therap y is rife w ith relational tu rm o il o r it h ap p en s only rarely a n d quietly, it’s crucial to h er entire therapy project th a t she and you fin d a way to deal w ith th e tro u b le honestly a n d thoroughly. A n d finally, I w ant to m ake very clear th a t dealing honestly w ith relational trouble a n d thereby getting to th e o th e r side o f a negative m odel scene d o e sn ’t all by itself “fix” anything. I had to im pose an a rbitrary e n d in g o n my ow n story because it d id n ’t tie itself u p neatly; n o th in g was finished o r fixed for good. I’m still convinced th a t I will never again ask my th era p ist to read so m eth in g I have w ritte n —at least n o t o n his ow n tim e. W h a t a b o u t th a t happy ending, th e n , w here I finally give h im my w riting, he likes it, a n d I am never again afraid o r asham ed? If I can ’t have th at, w hat was th e p o in t o f going th ro u g h all o f th a t angst? B ut so m eth in g has changed a n d is changing. I can feel it already, especially in the quality of the con n ectio n betw een my therapist a n d myself. It’s easier, lighter, less w eighted a n d freighted th a n it was before. W h a t happened? I reco n n ected (unwillingly!) w ith a tightly w o u n d b u n d le o f hum iliated feelings, a n d I did so (hating every m in u te o f it!) in the pres­ ence o f som eone w ho offered steady p atience a n d u n d e rstan d in g . I sur­ vived to tell th e tale. A n d now it seem s th a t I am n o t so frig h ten ed o f my w antings o r o f my sham e. I can talk a b o u t w a n tin g a n d sham e m uch m ore freely in therapy; it’s n o t such an unspeakable secret. A n d it’s a good bet, I th in k , th a t outsid e o f therapy, I w on’t have to struggle so o ften to p re te n d th a t my w an tin g isn’t th ere o r w ork so hard to avoid situ atio n s w here sham e m ight b reak th ro u g h . N o th in g is “fixed” o r fin­ ished. B ut instead, new possibilities o p e n up, new chances to be in the w orld w ith m ore e n title m en t, case, a n d freedom . I’ll take th a t instead o f a happy ending.

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H O W D O THESE BAD EXPERIENCES BELONG T O G O O D THERAPY? It’s tim e, now, to step back a few paces and set my story w ithin a larger context. My telling o f it assumes th a t these relationally h ard tim es belong to good therapy, b u t I should clarify th a t they belong only to good rela­ tional therapy. In som e kinds o f therapy, relational ruptures cause n o th ­ ing b u t trouble. W h en a m ode o f therapy carries no m andate to explore and w ork th ro u g h the relational dynam ics betw een client and therapist, the work usually stays “cooperative”—played o u t as a com fortable exchange betw een the therapist’s benign, helpful authority and the client’s com pli­ ance. In this context, if relational trouble happens, a client probably does well to get o u t o f the therapy. If he stays, he will either bury the trouble, which will sabotage his therapy work, o r h e ’ll em bark o n a struggle to find o u t w hether it’s he o r his therapist w ho’s doing therapy wrong. T h at kind o f win-lose situation can only replicate a destructive relational m odel scene for a client, and one w hich a n o nrelational therapy can’t tu rn to­ ward constructive learning. I’m arguing, in o th er words, th a t only a relational perspective makes therapy a safe enough place for working o u t relational trouble betw een client and therapist. Let’s review the m ain points o f th a t perspective. First, as a relational therapist, you u n d erstan d th at the bad feelings about him self th a t a client brings to therapy have th eir origins in how he expe­ riences him self in relation to others in his life. Second, you expect th a t as the therapy relationship becom es m ore significant to your client, these very fears and anxieties will com e to life betw een the two o f you. As we saw in the last chapter, a relational therapist hopes to m ake contact w ith even the m ost traum atized, isolated, and destructive parts o f a client’s self-with-other experience. T hird, your therapeutic in ten tio n is not to change how your client interacts w ith others, b u t rath er to help him experience the m eanings and feelings o f his interactions m ore directly, and always w ith a com passionate kind o f understan d in g for his subjec­ tive experience an d the dilem m as o f his life. You know th a t his lifelong principles o f self-protection will soften only in the w arm th o f com pas­ sionate em pathy, and th a t only th en , as his organizing principles slowly change from the inside out, will he start to experience new kinds o f con­ nections w ith others. B ut it’s this com passionate em pathy that, in the therapy relation­ ship, also draws your client into m ore painful dilem m as th a n he had ever anticipated. As he spends tim e w ith you, he begins to glimpse and desire

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e m o tio n a l goo d s he h a d lo n g ago given up. H e begins to enjoy interested, sym p ath etic a tte n tio n , he w a n ts to he k n o w n a n d re m e m b e re d for ex­ actly w h o h e is, a n d h e longs to m a tte r deeply to so m e o n e, to b e special. A t th e very sam e tim e he is c e rta in th a t th ese w an ts will be d e n ie d o r tu rn e d ag ain st h im in so m e way so t h a t h e ’ll e n d u p even m o re disap ­ p o in te d a n d h u m ilia te d fo r hav in g w a n ted . H e “k n o w s” th is will h a p p e n because it’s a self-w ith-other e x p erien ce t h a t has fo rm ed his way o f b e in g in th e w orld a n d o n e against w h ic h h e p ro tects h im self carefully. As he lives o n th is knife-edge o f anxiety in therapy, h e a lte rn a tes betw een care­ ful re tre a t a n d d a rin g to try for new exp erien ce. A s I d id , h e m ig h t d are to ask for s o m e th in g h e w o u ld never have asked for before. A n d th e n so m e tim es th e w orst docs h a p p e n . T h e d o o m falls, ju st as h e knew it w ould, a n d h e fin d s h im se lf sw am ped by helpless rage a n d b leak despair. T h e sh a m e h e ’s b e e n d o d g in g a n d m ask in g o u t in th e w orld has exploded, full force, in th is re la tio n sh ip . T h e self-loathing voices are lo u d in his ears, a n d he takes d e sp e ra te m easures to silence th em . W h y does th e w o rst h a p p e n som etim es? N o t because th e c lie n t brin g s it o n him self, b u t ra th e r, because you, his th e ra p ist, are a h u m a n b e in g w h o d o e s n ’t always get exactly w h a t’s g oing o n betw een y o u rse lf a n d your client. O n c e rta in days, you m ig h t be ju st tire d o r d istrac ted , o r m aybe w h a t y o u r c lie n t is talk in g a b o u t is h a rd for you to h e a r for reasons th a t have n o th in g to d o w ith h im . B u t in any case, you fail to pick u p his cues th a t tell you w h a t h e n e ed s rig h t now. A n d because o f th e in te n tio n a l in te n sity o f th e th era p y situ a tio n , th is “m iss” o f yours su d d e n ly sta n d s in for all th e m isses h e ’s k n o w n in his life a n d all th ey ’ve m e a n t to h im a b o u t b e in g “to o m u c h ” o r w o rth less o r forgettable. I’m suggesting, o n c e again, th a t in th e re la tio n a l th e ra p y situ a tio n , th e re ’s p ro b a b ly so m e th in g inevitable a b o u t th e se “m isses” a n d ru p tu re s o f u n d e rs ta n d in g th a t sp in you a n d y o u r c lie n t in to u n w ittin g replays o f p a in fu l m o d el scenes. B u t to say th ey are inevitable is n o t to say th a t they are y o u r c lie n t’s fau lt—o r y o u r fault. F o r th e client, th e inevitability o f b e in g m is u n d e rs to o d isn’t fu n d a m e n ta lly a p ro d u c t o f his n eed in ess o r sensitivity; n o r is th e inevitability o f y o u r failure to u n d e rs ta n d h im a p ro d u c t o f yo u r ow n u n reso lv ed issues. M o st fu n d a m e n ta lly a n d sim ply p u t, m is u n d e rs ta n d in g belongs to th e h u m a n n e ss o f th e th e ra p is t-c lie n t exchange. T h a t’s n o t goo d a n d it’s n o t bad ; it’s ju st life. T h is im p o rta n t p o in t—th a t “th e w o rst” befalls th e tw o o f you to­ g e th e r—can so m e tim es get lost in talk o f reactivated m o d el scenes a n d o rganizing p rin cip les. S u c h talk can m ake it seem as th o u g h w h a t th e c lic n t b rin g s to th e th era p y re la tio n sh ip is w h a t m akes it go w rong. B u t a

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relational therapist knows th a t w hen things go w rong in therapy, something happened in the therapy. T he problem isn’t just a p roduct o f the client’s history o r relational incapacities; something happened. In my story, though I m ight still suspect (given my tenacious organizing principles) th a t w hat happened was th a t I asked for too m uch, my therapist insists th a t “w hat h a p p en e d ” was set o ff by his response to my legitim ate asking. I was doing fine, he says, feeling stronger, hoping for new things, even daring to ask for th em —som ething like a small child getting her feet u n ­ der her, learning to walk o n her own. But th en , as he puts it, he hap­ pened to p u t a chair in my path. W h e n my particular desire and striving m et his particular response, w hat happened was a ru p tu re in o ur rela­ tionship. In traditional psychoanalytic psychotherapies, it w ould be im por­ ta n t th a t my therapist exam ine his response for signs o f his own con­ f lic te d o r o v e rin v o lv e d fe e lin g s —t h a t h e se a rc h fo r th e “countertransference” feelings th a t m otivated his response to me. T he p o in t w ould be to neutralize those feelings and “clear the field” for my feelings. But in a m ore relational therapy, the p o in t o f such self-scrutiny is th a t he is able to acknowledge, w ith o u t defensiveness, w hat happened betw een us and to stay openly engaged in the relationship. Relational theory changes the shape and m eaning o f the classic psychoanalytic con­ cepts o f “transference” and “countertransference.” Explaining how a re­ lational therapist handles these concepts is com plicated enough to require a section o f its own.

RELATIONAL TAKES ON TRANSFERENCE It m ight be said th a t this chapter is all about w orking through the effects o f a client’s transference o f negative feelings from her past into the present relationship w ith her therapist. A relational perspective, however, doesn’t m atch up well w ith this traditional idea o f negative transference. Tradi­ tional concepts o f transference and countertransference imply psychic messages and influences th a t client and therapist launch at each o th er from bastions o f isolated individuality. But we have seen how relational theory insists o n the “unbearable em beddedness o f being.” In this rela­ tional view, anyone’s ongoing sense o f self is continually being created by relationships, relationships h appening right now and those carried as the generalized principles th at m ake sense o f w hat’s happening right now. So w hen any two people are together, two subjectivities o r com plex senses

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o f self, w ith th eir respective organizing principles, are being elicited and regulated by one another. Each subjectivity is intim ately involved in the shape and feel o f the relationship and in how each experiences self and o th er in it. T herefore, as the relationalist Lewis A ron argues, any analysis of w hat’s going on in therapy m ust be an analysis o f th e relationship, not just o f o ne person’s con trib u tio n s to it.1 T h e n w hat was once called the client’s resistance to therapy will be seen as her legitim ate self-protection against certain aspects o f the therapist’s personality th at she recognizes as threatening to her. “Resistance” comes into being where this particular therapist and clicnt meet. Likewise, her so-called negative transference is an interpersonal event—an integral p art o f all the ways she and her thera­ pist, w ith th eir respective organizing principles, m utually construct and regulate their relationship.2 It’s possible, th en , to see transference and countertransference as the idiosyncratic ways in w hich a certain client and therapist attem pt a relationship as best they can. As Stephen M itchell puts it, transference is b o th contextual and constructed: it’s the client’s response to particular interpersonal circum stances, and it’s produced for a particular purpose. T hough it may be based on past experience, the prim e purpose o f trans­ ference is to provide the client a p o in t o f entry into this relationship. Likewise, countertransference is the (largely unconscious) form through w hich the therapist tries to reach th e client, using her ow n experience as a way to enter the client’s story.’ W ith all o f this in m ind, it’s clear th at w hen things go w rong in therapy, it doesn’t m ake sense to explain it in term s o f w hat the client is bringing from her past. It makes far m ore sense for the therapist to ask, “W h at just happened? How d id I miss you? W here did I m isunderstand you? W h at did you hear in my response to you?” W e m ight well w onder why relational therapists persist w ith the language o f transference w hen they use it to describe such norm al inter­ personal events. It’s probably always th e case th a t key concepts in a strong tradition die hard. It’s also the case th at the language o f transference is a kind o f symbolic sh o rth a n d for the initiated th at captures w hat I have called the inten tio n al intensity o f the therapeutic relationship, th a t par­ ticular quality o f therapy th a t makes it b o th frightening and a powerful agent for change. T h e relational therapist D onna O range suggests the w ord “cotransference” as a way b o th to h o n o r the intense com plexities o f the therapeutic relationship and also to emphasize th a t therapists partici­ pate w ith clients in the intersubjective field o r “play space” o f the therapy

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conversation. In th a t space, she says, th e organizing activity o f th e client a n d th e th era p ist are two faces o f th e sam e com plex, (ingoing dynam ic betw een th em . N e ith e r activity needs to carry th e negative c o n n o ta tio n s associated w ith b o th transference a n d c o u n te rtra n sfe ren c e .4 As therapists, we all know th a t som etim es a com plex, o ngoing dy­ nam ic betw een client a n d th era p ist does becom e toxic. N o discussion o f th e relationally painful passages o f therapy w ould be com plete w ith o u t an acknow ledgm ent th a t som etim es even a relational therapy self-destructs. It goes m ost w rong w hen n o t only th e client b u t also th e th era p ist be­ com es frightened by th e intensity o f th e feelings in th e re lationship. In trad itio n a l term s these failures w o u ld n ’t be seen as relational failures; instead, they w ould be blam ed o n m alig n an t o r psychotic negative tran s­ ference: clearly th e client b ro u g h t im possible d em an d s a n d responses to th e c o n su ltin g room . M ore relatio n ally -m in d ed tra d itio n a l th era p ists m ight a d m it to a tran sfe re n c e -c o u n te rtra n sfe re n c e im passe: they just c o u ld n ’t get past th e ir ow n reactions in th e face o f d ifficult d em an d s and chaotic storm s o f feeling. Radically relational theorists suggest th a t therapy relationships d o n ’t n eed to com e to such a b itte r standoff. D ow nw ard relational spirals can be sto p p ed early. T h e ir arg u m en t goes like this: C lie n t a n d th e ra p ist are always c o m m u n ica tin g from necessarily dif­ ferent organizations o f experience. W h e n this c o m m u n ica tio n is success­ ful, th e ir differences are invisible. However, w hen e ith e r p erso n feels th rea te n e d by th e o th e r’s organizing o f th e ir m u tu a l experience, in te rp er­ sonal protective o p e ratio n s suddenly appear. Feeling am b u sh ed , ignored, o r helpless, th e th era p ist may “diagnose” th e clien t’s self-protections as resistance, negative transference, o r som ething m ore fundam entally w rong in th e clien t’s psychological m akeup. T h e n at least th e th era p ist know s w h a t’s going on! As you m ight rem em b er from C h a p te r 4, this was w hat often h a p p en e d to Lucy in hospital em ergency room s. B ut w hen a c lie n t’s feelings are in te rp rete d as a d isto rtio n o f reality, she has only two choices. She can give in a n d let h er reality be a n n ih i­ lated. O r she can fight back. B ut by now fighting back can only m ean trying to destroy h e r th era p ist’s belief a b o u t w h a t’s going o n betw een them , h e r th e ra p ist’s reality, w hich is th rea te n in g to a n n ih ila te h er ow n reality. T his is how th e stage is set for a tran sfere n ce -co u n te rtra n sfe ren c e crisis a n d a dow nw ard spiral tow ard relational impasse. N e ith e r client n o r th erap ist can afford to give u p h e r desperate attem pts to m ain tain h er ow n organization o f experience against th e th re a t posed by th e other. However, things w o n ’t disintegrate so badly it th e th erap ist can rec­ ognize a n d re sp o n d to th e core o f experienced, subjective tr u th in w hat

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the client is first trying to say, no m atter how th at tru th comes w rapped in h u rt and angry feelings. But to do so, the therapist has to believe th a t although w hat’s com ing at her has roots in th e client’s painful past expe­ rience, it is, nevertheless, n o t a distortion o f reality. It is reality—the client’s real feelings ab o u t som ething th a t’s actually happening right now in the relationship betw een the two o f them . Even relational therapists prefer to believe th a t they’re n o t im plicated in th eir client’s distress. T hey feel, “I d id n ’t do anything! I d o n ’t deserve this! i ’m being m isunderstood!” A nd even they can be surprised at how well things tu rn o u t if they can p u t their own tru th on hold just long enough to believe the tru th th at th eir client is telling them .

H O W DOES A RELATIONAL TAKE ON TRANSFERENCE HELP A CLIENT? So w hat docs this relational revision o f transference, and especially o f negative transference, m ean for a client in relational therapy? It m eans, first o f all, th a t w hen he feels th a t his therapist has m isunderstood, criti­ cized, belittled, o r ignored him , he can be sure th a t his therapist w ants to hear about it. He can be co nfident th a t he’s doing good work w hen he talks honestly about w hat he feels in the therapy relationship, and this confidence will help him keep his bearings w hen the feelings in question are chaotic o r hopeless. As his therapist, you w ant to hear a b o u t his expe­ rience n o t in o rder to m ake a diagnostic m ap o f his psyche, b u t because you believe th a t know ing w hat happened for him is a first step in under­ standing and righting w hat’s gone w rong betw een you. Just as im portantly, this relational rein terp retatio n o f negative trans­ ference ensures th at it’s safe for a clicnt to speak his feelings, his protests, his questions, and his thoughts. “Safe” m eans th at as his therapist you w on’t blam e, sham e, or pathologize him for w hat he feels and says. In­ stead, you will work w ith him to find o u t w here the two o f you were first at odds, paying special attention to where you missed the cues he gave you about the kind of response or understanding he needed. If relational ru p ­ tures are, indeed, the product o f “cotransference,” or the interaction of your client’s and your own relational organizing principles, th en whatever is happening cannot be your client’s fault, alone. In fact, it can’t be anyone’s fault, alone. T he organizing principles o f two people can be so different as to miss each other, scare each other, and set each o th er o ff in all kinds of unpredictable ways. But as I said above, th a t’s just life—in relationship.

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“B ut w h a t a b o u t how my clien t’s organizing p rinciples com e from his past?” you m ight ask. “D oesn’t this focus on w h a t’s h ap p en in g right now deny th e pow er o f th e past?” W ell, as we explored at length in C h a p ­ ter 4, th e presen t is exactly w here th e past is alive a n d pow erful; th e presen t is w here we can see th e past in o p e ratio n . B ut you’re n o t finished w ith your q uestion: “D o n ’t o u r clients have to m ake conscious links be­ tw een w h a t’s h a p p en in g now and th e ir past, th e ir history, so th a t they can integrate dissociated experience a n d grieve th e ir losses? Isn’t th a t w h a t you said before? W h a t a b o u t your ow n re co n n e ctio n to th o se ‘little girl’ h u m iliated feelings?” T hese are very good q uestions—because they p u sh m e to find a way o u t o f th e c ith e r/o r dilem m as they set up. It seem s to m e th a t th e best way o u t o f having to choose betw een th e pow er o f th e past a n d th e pow er o f th e p re sen t o r betw een th e value o f insight a n d th e value o f experience is to talk a b o u t th e sequence o f processes in relational therapy. You m ight rem em b er th a t in my ow n story, I w ished very hard th a t just m aking c o n ta ct w ith my h u m iliated self w ould be my cure. B ut ju st th e break­ dow n o f th e dissociative wall, ju st th e re co n n e ctio n w ith th e old and p resent pain, could n o t m ake m e feel better. R eexperiencing trau m a, even in th e form o f negative transference, can ’t m ake anyone feel better. G e n u ­ ine in teg ratio n a n d healing h a p p e n only w hen a new experience o f rela­ tio n sh ip allows th e old feelings to be u n d e rsto o d m ore gently a n d th u s be laid to a b e tte r rest. T h a t’s why relational therapy begins by focusing o n th e here-andnow therapy relatio n sh ip a n d o n changes for th e b e tte r in th a t relatio n ­ ship: in o rd e r to create a space w ith in w hich in te g ratio n a n d insight will eventually find a ho m e. T h a t’s why after a clicnt reconnects w ith tra u ­ m atic relational experience, relational therapy expends so m u ch tim e a n d energy rew orking th e relational context o f th a t experience. R elational therapy know s th a t th e bum ps a n d g rinds o f life a n d th e therapy rela­ tio n sh ip will p roduce plenty o f n e w /o ld m em ories, transferences, feel­ ings, a n d th o u g h ts to integrate, b u t unless th e re ’s a new relational way to be w ith it all, n o th in g will change in how a client can feel a n d th in k a b o u t herself. In a n utshell, th e n , th e good news th a t com es to your clien t w hen “negative transference” is re in terp re ted as a process o f m u tu a l regulation o r “cotransfercnce” goes as follows: It’s good news th a t th e tro u b le she th o u g h t was only inside h e r a n d com ing only from h e r p ainful past is actually so m eth in g th a t’s h ap p en in g right now betw een h er an d h er th era ­ pist. It’s even b etter news th a t th e tro u b le th a t’s h ap p en in g right now

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isn’t ju st h e r fault, h er d isto rtio n o f reality: th e two o f you are d o in g it together, som ehow . B ut th e best news o f all is th a t since you’re d o in g it together, you can probably fin d a way to u n d e rsta n d w h a t you’re doing a n d th e n d o it differently together. T h a t’s how your client will be able to get to th e o th e r side o f painful old m odel scenes w ith you. T h a t’s how th e therapy starts to h o ld o p e n space for new organizing principles to emerge. In an evolving relational process th a t som etim es seem s to have a life a n d a m in d o f its ow n, relational therapy becom es first a place w here a client feels b e tte r as she feels u n d e rsto o d , th e n a place w here she sometim es feels worse th a n ever (but finds herself, in th e end, still u n d e r­ stood), a n d finally a place w here new in terpersonal confidence can emerge, along w ith new insight a n d self-integration—providing a sturdier, m ore d u ra b le k in d o f feeling better.

HARD TIMES FROM A THERAPIST’S PERSPECTIVE A t th is p o in t, it goes w ith o u t saying th a t w hen negative transference is redefined in th is way, it’s n o t just u p to th e client to take responsibility for h er feelings a n d to ow n h er p rojections in o rd e r to find h e r way o u t of a relational dilem m a. In fact, th e re ’s n o way she can find h er way o u t by herself. As h er therapist, you have to help her. You m u st be as engaged as she is in a cooperative process o f trying to discover w h a t h a p p en e d and w hat could change betw een you. T his is different, o n your part, too, from taking responsibility for w hat h ap p en e d . T h e w hole n o tio n o f taking responsibility shifts w hen transference is n o longer a m atter o f “your baggage” a n d “my baggage,” b u t ra th e r a m atter o f m utually co n stru cted relational dynam ics. Now “taking responsibility” looks n o t like a d m ittin g to fault, o r even to “bag­ gage,” b u t like keeping o neself ho n est, present, a n d o p e n in th e relation­ ship. It’s w ith this sense o f response-ability th a t you can ow n w hat you have d o n e in th e rela tio n sh ip w ith o u t feeling defensive a n d guilty a b o u t th e effects o f your u n in te n tio n a l m istakes a n d om issions. In th is sam e spirit, you w o n ’t blam e your client o r h er “transfer­ en ce” for w h a t’s h ap p en in g . You w o n ’t try to explain it away by talking a b o u t yo u r good in te n tio n s. In fact, you will do your best to step inside your clien t’s negative experience o f you, even w earing, for th e tim e being, th e h u rtfu l in te n tio n s a n d feelings she a ttrib u te s to you, th e b e tte r to u n d e rsta n d how th e relatio n sh ip feels to her. All th e w hile th a t th e two

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o f you are trying to get th ro u g h this h ard tim e together, you will be espe­ cially careful to pay close a tte n tio n to th e details a n d th e m ovem ents o f h er on g o in g experience o f you. T h e th era p eu tic tasks th a t I have ju st described add u p to a very tall order. T h is w ork is n o t easy. D e p en d in g on th e n a tu re o f th e m utually co n stru cted m odel scene you a n d your client are living o u t together, th e follow ing are ju st som e o f th e ways in w hich she m ight be experiencing your presence. A ny o n e o f these phrases m ight capture exactly w ho you are to a p a rticu la r client in a given m om ent. • You’re going to th in k badly o f m e for w hat I’m saying now. N o, you are th in k in g badly o f me. • You d o n ’t have problem s like this; your life is perfect. N ext to you, I’m a real loser, a n d I h ate telling you th is loser stu ff a b o u t my life. • Sure, you u n d e rsta n d w hat I’m saying, b u t you d o n ’t really care. • If I tell you my secrets, you’ll use th e m against m e later. You’ll bring th e m back w hen I’m vulnerable. • W h e n you a d d so m e th in g to w h a t I say, th a t m eans I have to th in k w hat you th in k . You w a n t to take over my thinking. • You cong ratu late me, b u t you’re really p ushing m e away. All th a t m at­ ters is how I perform . • If I do well, it’s really so m e th in g a b o u t you—you’re th e th era p ist w ho m ade this possible. It’s your success, n o t m ine. • You’re feeling sorry for me. T h a t m eans I’m p athetic. You th in k I’m p athetic. • If I believe you care ab o u t m e, I’ll find o u t differently later a n d be terribly hum iliated for having b een gullible. H um iliatin g m e feels good to you. • If I get close to you in any way, you’ll h u r t m e, use m e, in ways I can ’t even im agine. I d o n ’t know w h a t’s going to h ap p en , b u t th e th re a t is real, all th e tim e. • If I sta rt to c o u n t o n your u n d e rsta n d in g and need you, you’ll feel like I’m clinging; you’ll scrape m e o ff w ith disgust. As a therapist, your first n a tu ra l im pulse will be to disagree w ith any such conviction w h e n you sta rt to recognize it. T his isn’t w hat you feel tow ard your client! T h is isn’t w ho you arc! T h is just isn’t th e tru th , a n d fu rth e rm o re , it feels ro tte n to be in a relatio n sh ip sh ap ed by such a tru th . D o esn ’t your client n eed to h ear th a t you actually feel q u ite differently from w hat he o r she expects?

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Reassuring your clients th a t you do care for th em and accept them does seem like a natural approach to take w hen em otional convictions as negative as these emerge in therapy. As a relational therapist, however, w hen such feelings start to surface, you will do som ething th a t doesn’t seem natural. R ather th an protesting and disagreeing w ith your clients’ distressing relational experiences o f you (and rath er th a n trying desper­ ately to be such a good therapist th a t the distress will disappear) you will try to u n d e rstan d how it feels for th em to be in those painful self-states and to have such troubling fears and dire expectations o f you. As you do the work in this way, you will have to co u n t o n one o f the m ost counterintuitive b u t reliable principles o f relational work w ith rela­ tional problem s: T h ere’s no way th a t you can change a client’s pervasive negative experience o f you directly. N one o f your reassurances will make any difference. But if you consistently u n d erstan d th a t experience from your client’s p o in t o f view, eventually you becom e n o t only the one w ho is feared a n d m istrusted, b u t also the one w ho u nderstands your client’s fear and m istrust. A nd th a t’s the pivot for change. For your client, to have her negative feelings simply accepted and understo o d is a very par­ ticular and unexpected form o f being understood, and it lays a founda­ tio n for the eventual developm ent o f a different kind o f relationship betw een your client and yourself. My own story probably illustrates quite well how this kind o f work was done w ith me. B ut in order to talk fu rth er ab o u t relational hard times from a therapist’s perspective, I w on’t presum e to know my therapist’s m ind. Instead I will tell you a story draw n from my therapy practice. T he relational dynam ic is sim ilar here, b u t this tim e I’m on the o th e r side of it, w ith a m uch better view o f w hat the therapist is feeling and thinking.

A STORY FROM THE THERAPIST’S SIDE OF RELATIONAL TROUBLE O n e day a quite fiercely independent, professionally successful, and rather lonely client (I’ll call him Dave) was telling me ab o u t one o f his recent accom plishm ents. Earlier in the session he had been edging into the pos­ sibility o f m aking b etter interpersonal connections in his life, som ething I really hoped would h appen for him . So I responded to his story o f achievem ent by suggesting th at eventually he would be able to feel bo th accom plished and connected w ith others; he would be able to “p u t it all together.” Dave w ent q uiet th en , b u t it was close to the end o f the session

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a n d I d id n ’t know a nything was w rong u n til he cam e back th e next week. T h e n he was so agitated th a t he c o u ld n ’t even sit dow n for a while. He to ld m e th a t after th e last session h e ’d b een so angry h e ’d had to go for a walk, a n d th e n he e n d ed up in his ow n backyard, h u rlin g snow balls at th e garage. Dave had n o tro u b le know ing w h a t I had d o n e, a n d exactly w hen I did it. My “suggestion” o f p u ttin g it all together totally u n d e rc u t th e good th in g he was trying to tell me; it said th a t his good th in g w asn’t good eno u g h , in fact, th a t it w asn’t good at all, because it w asn’t up to my sta n d ard . “W h a t’s th e p o in t o f telling you so m e th in g good a b o u t myself, if w hat you’re going to d o is criticize!” h e said. “It’s like you’re telling m e th e re ’s so m eth in g w rong w ith being p ro u d o f myself!—a n d th a t’s exactly how I feel now. It is w rong. T h ere arc these voices in my h ead th a t keep telling m e I’m stupid, I’m childish, so I deserve this. 1 w ant to sm ash so m ething. I w a n t to sm ash myself.” O bviously Dave had learn ed in th e process o f o u r w ork together th a t w hatever his feelings were, I w anted to h e ar a b o u t th e m —especially if they were a b o u t w hat was going o n betw een us. “Negative transference” had ju st com e to rolling boil in th a t room . N ow w h a t w ould I do? H ow w ould I respond? I’ll leave th e im m ediacy o f th e scene for a m o m e n t to com pare how differen t takes o n transference w ould lead m e to resp o n d to Dave in differen t ways. If I w orked w ith a classical d e fin itio n o f negative transference, I m ight have said to him , “I u n d e rsta n d th a t’s w hat you feel I d id to you, a n d th a t it’s very painful. In fact, I did so m eth in g q u ite different, a n d th a t lets us know th a t these pow erful, p ain fu l feelings arc com ing from som ew here else, probably from som ew here in your past. I’m w on­ derin g if these are fam iliar feelings, w h e th er you’ve b een here before— perhaps w ith your m o th e r o r your fa th e r.” If I w orked w ith a slightly m ore progressive, interactive view o f tran s­ ference, I m ig h t have said, “I can see how my suggestion felt critical to you. T h a t’s a very plausible c o n stru ctio n o f w h a t my w ords m eant. B ut th ere were o th e r ways you could have heard me, too. So I w o n d e r why you u n d e rsto o d m e in th a t particular, very p ainful way.” In o th e r words, I’d a d m it th a t Dave’s feelings d id n ’t com e from now here, b u t from som e­ th in g I really did. Yet I’d em phasize th e pow er o f his past to c o n stru ct o u r in te rac tio n in this p a rticu la r way. In a m ore in tc rp crso n alist m ode o f w orking w ith transference, I m ight have said, “It’s h a rd for you th a t o u t o f a w hole session, w hat stays w ith you is so m e th in g th a t feels critical a n d u n d e rcu ttin g . As we’ve no­ ticed before, all you can d o at a tim e like th a t is w ithdraw , taking your

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an g er away w ith you. B ut I th in k s o m e th in g is c h an g in g fo r you, to o — y o u ’ve com e back to tell m e a b o u t it. M aybe n o w we can get a bigger p ictu re o f y o u r o p tio n s .” In th is m o d e, m y p o in t is th a t th e re ’s so m e­ th in g lim itin g a b o u t D ave’s in te rp e rs o n a l style, b u t it’s getting less c o n ­ strictive. M y o n g o in g task is to engage w ith h im so th a t I can let h im know , w ith o u t blam e, how his style w orks. S ince th is k in d o f le a rn in g is driv en by im m e d ia te, e m o tio n a l exp erien ce, it is p o te n t im p e tu s for Dave to e x p an d his re la tio n a l re p erto ire . B u t I’m a re la tio n a l th e ra p is t w h o actually th in k s m o re in term s o f org a n iz atio n s o f e x p erien ce th a n in term s o f tran sfere n ce . A n d so I sim ­ ply accept th e tr u th o f my c lie n t’s exp erien ce. Dave h a d b e e n feeling expansive a n d I h a d p u n c tu re d his g o ld en b u b b le w ith a sly criticism . N ow h e n e e d e d to hear, “Yes, t h a t ’s w h a t I d id to y ou,” as h e struggled to cope w ith th e in te n sity o f his reactio n s. D istu rb e d a n d sh a m e d by th a t intensity, Dave n e e d e d to kn o w t h a t his re ac tio n s m ad e sense. T h a t’s w h ere we h a d to begin. I knew th a t. A n d yet, after D ave’s o p e n in g ex p lo sio n , I fo u n d m yself try in g to exp lain w h a t I h a d b e e n in te n d in g to d o in th e previous session, h o p in g Dave w o u ld u n d e rs ta n d th a t I h a d b e en try in g to help , n o t h u r t him . F o rtu n a te ly h e h a d th e g u m p tio n a n d th e re la tio n a l h o n e sty to say to m e, “I c a n ’t h e a r th a t from you rig h t now .” “N o , o f c o u rse you c an ’t,” I said, a n d I b ro u g h t m yself back (sharply) to th e w ork a t h a n d . I w a n ted to say I was so rry for w h a t I h a d d o n e , b u t I knew th a t a n apology w o u ld n ’t h e lp e ith e r. It w o u ld be ju st o n e m ore way for m e to try to feel better, to get my g o o f b e h in d us. W h a t we n e ed e d , instead , was to b e rig h t in th e m id d le o f all th e tro u b le my m istake h a d caused. First o f all I h a d to h e a r it, a n d I h a d to h e a r it th o ro u g h ly a n d well. T h e re w ere tw o k in d s o f tro u b le —w h a t was betw een us a n d w h at, as a c o n se q u en c e, Dave was su fferin g o n his ow n. C u t o ff fro m su p p o rtiv e c o n n e c tio n w ith m e, he k e p t d e rid in g h im se lf for his ow n stupidity, a n d th e n he w o u ld c o u n te r th is “w h in y ” self-loathing w ith w h a t h e called a sw ift kick in th e b u tt: “Forget it. D o n ’t be su c h a loser. G e t o n w ith th in g s.” Dave was sleep in g poorly, a n d h e sp e n t his days in a fu n k , try in g n o t to sn a p a t colleagues. As h e to ld m e how b ad th in g s w ere, I listen ed attentively a n d carefully, e n co u ra g in g h im to say m o re a n d h o p in g th a t my responses w o u ld let h im h e ar a n d see th a t I to o k his distress seriously. Dave h a d to tell m e forcefully a n d in detail how h o rrib le h e was feeling, a n d h e h a d to be sure th a t I got it. T h a t to o k o n e session. O n ly after he know h e ’d b e e n h e a rd o n th a t score co u ld he re tu rn , in th e nex t

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session, to th e “scene o f th e crim e” in o rd er to try to fin d o u t m ore ab o u t w h at had hap p en ed . H e was calm er now, a n d we could go directly to his first experience o f my lapse an d w alk th ro u g h it slowly, know ing th a t we were o n th e rig h t track. Dave said th a t it had been such a cold, ru d e shock to him . H e had com e to tru st th a t I w ould be o n his side, an d th e n I w asn’t. I n oted w h at a risk he had taken, just to tell me th a t he was feeling good ab o u t him self. T h a t was an u nguarded, hopeful, o p en m o m en t. I agreed th a t I h ad, indeed “set h im up for it” by b eing a good listener. I h ad led h im to believe th a t it was safe to be p ro u d o f h im self w ith m e— a n d th e n W H A M ! 1 h ad delivered a betrayal o f th a t new, tender, fledg­ ling trust. A n d for all those reasons, this was a serious injury, I said. As Dave grew m ore co n fid e n t th a t I w o u ld n ’t disregard o r belittle his experience, he could tell me m ore. In th e th ird session after th e ru p ­ ture, he m used, “It’s like you w ant m e to be good, b u t n o t to o big for my b ritches. It’s like my being good sh o u ld m ake you feel pleased a b o u t your­ self—‘Look w hat I m ade h ap p e n here!’ B ut it can’t be d ifferen t from w h at you w ant. I have to be your kind o f good. A n d you w an t m e never, ever, to show you up. You’ve gotta keep me in my place, keep rem in d in g me w h o ’s boss, w ho really know s things a ro u n d here.” T h a t’s w hen he m ade th e co n n ectio n , “R ight after I left th a t bad session, w hen I was angry, o u t o n th e street, I felt like I used to w h en I’d show som eth in g I m ade to my dad. H e always fo u n d so m eth in g n o t qu ite right w ith it, som ething to improve. A nd I’d just w ant to destroy it, crum ple it up, sm ash it.” “I did to you th e sam e so rt o f th in g th a t your d ad d id m any tim es— I u n d e rc u t you in th e guise o f being helpful.” “Yes! A n d for som e o f th e sam e reasons.” “Because I d o n ’t w an t th e co m p etitio n ,” I v en tu red (wearing w h at he was attrib u tin g to me). “B ut it’s m ore com plicated th a n th at, isn’t it? T h e re ’s a dou b le message com ing from me: ‘G row up, be strong like me. B ut you’ll never d o it rig h t.’” T his fit for Dave. B ut even m ore im p o rta n t th a n th e accuracy o f my u n d e rsta n d in g was his huge relief to be u n d ersto o d from inside o f his ow n experience. T h e sym ptom s th a t had followed his experience o f be­ ing badly m isu n d ersto o d a n d cu t o ff from m e—anger, irritability, anxiety, depression, self-loathing, a n d sleeplessness—faded rapidly. A n d th e n o u r relationship began to feel m uch sturdier, m ore trustw orthy an d secure, th a n it h ad felt before th e break. I u n d ersto o d this as follows: d u rin g th e repair o f th e injury, Dave

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was having two experiences o f m e at once: th e h u rtfu l one, w hich we w orked to u n d e rsta n d as fully as possible, a n d th e experience th a t I was com pletely c o m m itted to u n d e rsta n d in g him w ith o u t p rotecting myself at his expense. T his latter experience was now eclipsing th e first one. However, Dave will always have a realistic m em ory o f getting h u r t by my clum siness, w hich m ight h a p p en again. B ut we can deal w ith it if it hap­ pens; Dave know s th at, too. T h is is a n o th e r sign o f a m ore com plex, resilient, a n d d ifferentiated relationship, a rela tio n sh ip being p erfo rm ed differently betw een us.

FINAL C O M M E N T S In sum m ary form , I’d like to note co n n ec tio n s betw een th e m ain p o in ts o f this c h ap ter a n d th e story I’ve just told. For Dave a n d m e, this episode was b u t o n e p a rt o f a long process o f relational grow th a n d change. W e c o u ld n ’t have g o tten th ro u g h it w ith o u t having first developed som e reli­ able m u tu a l ra p p o rt, a n d th e o u tco m e o f th e episode was a subtle b u t p ro fo u n d stre n g th e n in g o f m u tu al tru st th a t we can now carry forw ard. T h e episode was generated n o t by Dave’s pathology, b u t by an interac­ tio n th a t w ent w rong betw een us. Something happened. D raw n by th e expe­ rience a n d prom ise o f e m p ath ic u n d e rstan d in g , Dave to o k an im p o rta n t relational risk. A n d th e n I failed to u n d e rsta n d w hat was going o n be­ tw een us a n d w h a t h e needed from me. H is risk a n d my failure created a com pressed version, a “m odel scene,” o f a very im p o rta n t aspect o f his relational life, a n d it stirred m em ories o f tim es in his form ative years w hen he h a d b een m isu n d ersto o d a n d u n d e rc u t in sim ilar ways. B ut by itself, Dave’s su d d e n , p ain fu l c o n n ec tio n w ith disow ned feel­ ings a n d m em ories w o u ld n ’t have h elped him . W h a t he n eed ed was to feel his h u rt in a relational context th a t was radically differen t from th e o n e w here th e original h u rt h a d b een inflicted. As so o n as I realized th a t Dave was injured, I knew it was critical th a t I, th e very p erso n w ho had h u rt him , d o all th a t I could to u n d e rsta n d how he felt a n d w hat had h a p p en e d to him . It was this steady in te n tio n to u n d e rsta n d him th a t m ade th is a radically differen t relational experience for him . W h e n his h u rt feelings m attered, they were n o longer overw helm ing o r sham eful. H e could carry th em m uch m ore easily. H e could explore th e ir history a n d th e ir m eanings. H e could let th em go, too. B ut w hat a b o u t my feelings? Before I e n d this chapter, I sh o u ld at least ask th e trad itio n a l questio n s a b o u t my “c o u n te rtra n sfe ren c e ” in this

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re lationship. W hy did I resp o n d to Dave’s p ro u d sense o f accom plishm e n t by suggesting th a t he could be b o th accom plished a n d connected? Probably because I like being w ith h im b etter w hen h e ’s “c o n n ec tin g .” A n d my h ope (my agenda) for him lies in th e directio n o f a fuller, richer relational life. I th in k I was d isa p p o in te d w hen he fell back on his achieve­ m ents in o rd e r to feel good, a n d perhaps a bit im p a tie n t w ith him , too. T h e re ’s also a good chance th a t I was feeling p u t in th e shade by his professional success, so th a t my w ords were, indeed, in te n d e d to “keep him in his place,” as h e suspected. N ow it’s a good th in g th a t I know a b o u t my tendencies to w ant certain things for my clients, to be im p a tie n t som etim es, a n d at o th e r tim es to feel inferior. It’s im p o rta n t th a t I m o n ito r th o se tcnd cn cics so th a t I d o n ’t throw a ro u n d a lo t o f im paticnce a n d co m p e titio n in my th era p eu tic relationships. O n th e o th e r h a n d , th o se tendencies are a p a rt o f me. If I interact, eventually they, along w ith m any o th e r parts o f me, may em erge. I can’t prevent th a t h appening; I can only be ready to deal w ith th e effects o f my h u m a n fallibility. A m uch m ore dangerous k in d o f cou n te rtra n sfe ren c e is th e kind th a t h appens right after th e re ’s been a su d d e n ru p tu re in therapy. W h o likes to m ake a mistake? I’m a therapist, m aking a life’s w ork o u t o f help­ ing a n d caring; I hate to be experienced as an in flic to r o f pain. It’s as­ to u n d in g a n d d istu rb in g to see an ap parently sm all “m iss” becom e so hugely destructive. How, th e n , can I escape feeling guilt o r anger o r de­ spair? H ow can I avoid defensive responses th a t p it my ow n reality a n d my clien t’s reality against each other? W h e n things go terribly w rong, how can I n o t w orry m yself sick o r th ro w up my h an d s a n d walk away? T hese arc th e crucial “co u n tertran sfercn ce” questions. I can’t escape them , for it’s relational therapy th a t I do. T h a t m eans I’m really in these rela­ tio n sh ip s—w hen they go well, b u t also w hen they go badly. I reiterate: for relational therapy, it’s n o t a p roblem th a t a th era p ist’s feelings are p re sen t a n d invested in th e th erap y he o r she does. As I’ve b een saying all along, th a t’s w h a t you, as a relational therapist, offer your clients: a real person, w illing to be in relatio n sh ip w ith th em . B ut it does m atter a great deal how you “p e rfo rm ” your feelings in th era p eu tic rela­ tion ships, especially once th e re ’s trouble. You m u st know en o u g h ab o u t w h a t you’re feeling to be able to so rt o u t w h a t to p u t aside for now a n d w hat to use. W h atev er you use m ust be p u t in th e service o f th e task at h a n d , w hich is always to u n d e rsta n d th e clien t’s experience as fully as possible. You can tru st th a t w hen you do th at, you a n d your clicn t may have a rocky ride, b u t you will probably com e th ro u g h th e tro u b le to­

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gether. You will be try in g ju st to c o n c e n tra te o n d o in g th e best e m p a th ic w ork you can d o in th is to u g h situ a tio n . T h a t’s h o w you can p u t aside y o u r g u ilt o r anger for th e m o m e n t, a n d if it’s still th e re later, you can talk gently w ith y o u rse lf o r w ith a colleague a b o u t it. T h is m ay so u n d like a co n v o lu te d process, b u t it’s n o t so d iffere n t in stru c tu re fro m w h a t goo d p a re n ts d o . P arents, to o , strive to be em o ­ tio n ally p re sen t, available, a n d g e n u in e , a n d a t th e sam e tim e th ey co n ­ ta in a n d m anage th e ir feelings in ways th ey believe will be best for th e ir ch ild re n . R elatio n al th era p y d id n ’t in v en t th e use a n d m a n a g e m e n t o f se lf for th e g o o d o f th e o th e r. R e la tio n a l th era p ists b o rro w th e self-foro th e r w isdom th a t goo d p a ren ts, m en to rs, teachers, a n d sp iritu a l guides have always c o u n te d o n , a n d they t u r n it to a very p a rtic u la r p u rp o se : u sin g self to c o u n tc r th e effects o f th e ir c lie n ts’ toxic self-w ith-other expe­ riences. All o f us in therapy, clien ts a n d th e ra p ists alike, w a n t never again to taste th e b itte rn e ss o f toxic re la tio n sh ip . It’s o u r h e a rtfe lt desire n o t to have to go th ro u g h ro tte n tim es w ith each o th er. If w e’re lucky, it w o n ’t h a p p e n o fte n . B u t w h e n it d o es h a p p e n , we have reasons to h o p e th a t g e ttin g th ro u g h th ese h a rd tim es h o n estly a n d to g e th e r will be w o rth th e tro u b le . T h is c h a p te r has b e en a b o u t th o se reaso n s to h o p e .

ENDNOTES 1. 2. 3. 4.

Lewis A ron, A Meeting o f M i n d s , 8 2 . Lewis A ron, A Meeting o f M i n d s , 127, 77. S tep h en M itchell, I n f l u e n c e a n d Autonomy in P s y c h o a n a ly s is , 146. D o n n a O range, E m o t i o n a l Understanding, 6 7 -6 8 .

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6 THE WONDERFULLY GOOD PART OF RELATIONAL THERAPY

A B O U T O R D IN A R Y (B U T W O N D E R F U L ) G O O D N E S S “W onderfully good”? Isn’t th a t a b it over the top? H ow does som ething as u ndram atic and unassum ing as relational talk therapy get to be “w on­ derfully good”? W ell, I’ll try to tell you. I m ean th e w ords literally, and I’ll start w ith “good.” W h a t does it m ean to say th a t life is good? It m eans different things to different people, b u t for m ost o f us, it probably begins w ith an ordinary, everyday sense o f well-being. W e can welcom e a new day w hen we get up in the m orning. Probably we’re physically well enough to be com fortable in o u r bodies and to m eet the challenges o f the day. W e know w hat we do well and w hat people like about us. W e have a sense o f belonging w ithin family, com m unity, workplace, and a netw ork o f friends. W e’re satisfied w ith som e o f o ur accom plishm ents, and we can look forw ard to new adventures, chances to try new things. W e’re finding constructive and productive ways to take o u r place in the world, creative ways to express ourselves. T h ere ’s a m atch betw een o u r values and o u r lives as we live them . If life is good, m ost likely o u r significant relationships are w orking fairly well. W ith the people close to us, we can feel know n, understood, and loved, and we know th a t others co u n t o n o u r su p p o rt and love, too. W h en there are problem s, we can talk about them . W h e n we’re h u rt, it’s safe to be angry. In fact, we can speak about a nd hear all kinds o f feelings

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in these closer relationships o f ours. W ith this kind o f security w ith o th ­ ers, we feel secure and balanced w ithin ourselves. D isappointm ents get us dow n, b u t we’re able to bounce back. Losses hu rt, b u t we’re able to share the h u rt and let others help us grieve. We can accept o u r failings and mistakes, and we’ve learned th a t laughing at ourselves can help. O n the whole, we like ourselves pretty well. T his is the kind o f “goo d ” I m ean. It’s ordinary. Feeling this kind of well-being doesn’t depend on accom plishing m ajor achievem ents o r amass­ ing m aterial wealth. People w ho experience such goodness in th eir lives aren’t stars o r heroes o r saints. They probably haven’t grasped the m ean­ ing o f the universe, and they can’t rise above the hurts, conflicts, and confusions o f everyday life. But they are able to be here, okay in th em ­ selves and connected w ith others. All o f this is w hat 1 m ean by goodness. We may n o t be able to have it all the tim e, b u t it’s certainly w orth desiring. T his u nrem arkable goodness o f o rd in ary life is often taken for granted by people w ho enjoy good physical and em otional health. But it’s the very kind o f well-being th a t eludes o u r troubled, anxious, and depressed clients. Now if a client has been in therapy for a while to try to ease th e pervasive, insidious bad feelings we began to talk about in C hap­ ter 3, and th e n she starts to feel this quiet, connected kind o f well-being, it will probably com e as a surprise to her. She will feel it w ith a sense o f w onder, perhaps even disbelief. C hances are she has never experienced this kind o f well-being before—feeling okay in herself and connected w ith others. Since she never had it before, she d id n ’t know th a t this kind of feeling was possible. W h e n she cam e to therapy, all she w anted was relief from feeling bad. She couldn’t im agine w hat “good” w ould feel like; she d id n ’t even know to hope for it. But w ith no fireworks or g rand illum ina­ tions, no sudden breakthroughs or transform ations, this w onderful sense o f well-being has sneaked up on her a n d surprised her. T his everyday kind o f “w onderfully good” is the opposite o f the terribly hard p a rt o f relational therapy th a t we discussed in C h ap ter 5. T he painful feelings o f those difficult tim es may be connected to trau­ m atic m odel scenes, b u t they are stirred up by quite ordinary, everyday failures o f em pathy and understanding. W h e n relationship goes w rong in everyday ways, the pain is no less bad for being ordinary. Likewise, w hen relationship goes right in ordinary ways, the well-being it brings can be unexpectedly w onderful.

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T H E C O N N E C T IO N B E T W EEN H A R D TIM ES A N D G O O D TIM ES IN T H ER A PY T h e h a rd tim es o f th e last c h a p te r a n d th e g o o d tim es o f th is c h a p te r are closely c o n n e c te d in re la tio n a l therapy. B oth k in d s o f ex p erien ce are set in m o tio n by a th e ra p is t’s em pathy. Your e m p a th y invites a c lie n t to be m o re o p e n , tru stin g , a n d v u ln e ra b le th a n w o u ld n o rm ally be c o m fo rt­ able for her. As we saw in C h a p te r 2, getting in to re la tio n a l th e ra p y is like ste p p in g in to e m p a th y —in to th e e x p erien ce o f b e in g u n d e rs to o d from o n e ’s ow n p o in t o f view, fro m w ith in o n e ’s ow n fram e o f reference. Y our c lie n t d o e s n ’t have to a d ju st h e r th o u g h ts a n d feelings to y o u r expecta­ tions; instead , y o u r m ain c o n c e rn is to “get” exactly w h a t sh e ’s saying to you, w h a t she m ean s a n d h o w she feels. W h e n sh e is m e t in th is way, she can sta rt to believe in h e r ow n p e rc e p tio n s a n d e m o tio n s. S h e begins to realize sh e ’s n o t crazy o r w eak o r flaw ed. She sta rts to feel n o t so isolated, less a ngry a n d sad, a n d sh e begins to have so m e g e n u in e , respectful em ­ p ath y for h e r o w n struggles. A n d ju st because th is new re la tio n s h ip m akes a c lie n t feel b e tte r u n d e rs to o d a n d m o re okay in h e rse lf th a n sh e usually feels, th e re la tio n ­ sh ip becom es m o re a n d m o re im p o rta n t to her. Feeling safer yet, she begins to explore m o re o f h e r th o u g h ts a n d feelings; sh e b rin g s forw ard m o re o f w h o sh e is; sh e lets h e rse lf m ake c o n ta c t w ith experiences a n d e m o tio n s sh e usually keeps well h id d e n , even from herself. As sh e does all o f th is, sh e begins to realize th a t n o t only d o es she feel safe in th is re la tio n sh ip , sh e also feels frig h te n e d . T h e risks she is ta k in g scare her. S o m e th in g tells h e r th a t th is is g oing to go w rong, a n d sh e ’ll be disap ­ p o in te d a n d h u rt. A s we saw in th e last ch ap ter, so m e tim es th o se fears b e co m e reality, a t least for a w hile, w h e n th e th e ra p is t w h o has b e en co n sisten tly p re se n t a n d u n d e rs ta n d in g su d d e n ly fails to be th e re o r to get it. A s we have seen, th o se b reak s are p a in fu l a n d th ey m a tte r a lo t because th e re ’s so m u ch rid in g o n th e re la tio n sh ip . In th is ch ap ter, we will sp e n d m o re tim e ex­ p lo rin g ju st w h a t is rid in g o n th e re la tio n sh ip . In brief, th e th era p y rela­ tio n s h ip offers to u n d e rs ta n d , respect, a n d to a c e rta in e x te n t fulfill som e o f a c lie n t’s m o st basic h u m a n n e ed s for psychological a n d e m o tio n a l well-being. T h ese are c u rre n t n e ed s th a t a client, alo n g w ith all th e rest o f us, carries a ro u n d every day. H ow ever, for yo u r c lie n t th ey are co m p licated

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a n d sh ro u d e d by d o u b t because th e circum stances o f h e r life haven’t helped h er get those n eeds m et. In fact, th e circum stances o f h er life have tau g h t h er th a t th o se needs are to be squelched because they are sham e­ ful. A n d so she d o e sn ’t really know th a t she carries th em a ro u n d every day. She th in k s th ey ’ve gone away. B ut they’ve ju st gone u n d e rg ro u n d . If your clien t does n otice these needs, she probably th in k s th ey ’re child­ ish, because it was probably back in h e r c h ild h o o d th a t she first m ade th e m go away. Som etim es these very im p o rta n t c o m p o n e n ts o f a d u lt em o tio n al a n d relational life—needs to belong, to m atter, to be respected a n d h o n ­ ored for o n e ’s uniqueness, to express a n d create, to have feelings received, to feel safe a n d secure—have childlike qualities to th em w hen a clicnt first m akes c o n ta ct w ith th e m as an ad u lt. T h a t’s because these c o m p o n e n ts haven’t had th e everyday life-exposure th a t tu rn s th e m in to th e ir a d u lt form s. B ut as so o n as they are “o u t,” they can tu rn into th e ir a d u lt form s q u ite quickly. However, these o rdinary, good needs d o n ’t m ake it in to th e light o f day w ith o u t trouble. Since th ey ’ve been squelched for so long, they have a lot o f urgency a b o u t th em , a n d th is urgency heightens yo u r clien t’s fearful anxiety th a t sh e ’ll ju st be d isa p p o in te d again. F u rth e rm o re , she had very good reason, as a child, to decide th a t these needs were w rong a n d sh o u ld be silenced. T hese very needs once caused h er a lo t o f c onfu­ sion. T h in g s scared h e r a n d m ade h e r sad, a n d she needed help; she needed som eone to u n d e rsta n d w h a t life was like for her; she needed to m atter, to be seen a n d to be special. But she d id n ’t get w hat she needed. W h e n h e r e n v iro n m en t failed to m eet h e r basic em o tio n al needs, your client tu rn e d h er h u rt, em pty w anting in to feeling badly a b o u t her­ self. Now, in th e principles th a t organize h e r psychological life, w an tin g a n d n eed in g are tightly linked to feeling badly a b o u t herself. In o th e r words, it’s n o t ju st h ard for h e r to receive th e ordinary, everyday good­ ness th a t relational therapy prom ises; it’s h ard for h e r even to let herself w a n t it. Since th e first session o f her therapy, you have trie d to m eet this clien t’s needs for c ertain k inds o f respect, su p p o rt, and u n d e rstan d in g . A n d from its very beginnings, th e good th a t relational therapy prom ises and offers h er has b een tho ro u g h ly en tangled in m odel scenes a n d orga­ nizing p rinciples th a t tell h e r th a t she can’t have this goodness, a n d th a t w an tin g it is w rong o r stupid. A lth o u g h early in therapy your em pathy starts to wake u p a clien t’s strong self-w ith-other needs, along w ith th e anxieties th a t a tte n d th em , it

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tak es a w h ile fo r th e s e n ew feelings to ta k e reco g n iza b le fo rm s a n d m ove o u t o f th e sh a d o w s a n d in to a c lie n t’s aw areness. T h e n , o n c e sh e sta rts to feel b o th th e g o o d a n d th e b a d , th e p ro m is e o f even m o re c o n n e c tio n a n d th e fear o f w a n tin g it, it’s m o re th a n sh e can feel all a t o n c e . H e r feelings a lte rn a te , giving w ay to e ac h o th e r ag ain a n d again. I t’s a lm o st in e v ita b le t h a t a fte r sh e has felt g o o d fo r a w h ile —c o n n e c te d , u n d e rs to o d , self-respecting—e ith e r you w ill “m iss” h e r in a th e ra p y se ssio n or, se e m ­ ingly o f its o w n a cc o rd , h e r m o u n tin g a n x ie ty w ill b re a k th r o u g h from th e negative sid e o f h e r e x p e rie n c e . T h e n “w a n tin g ” feels im p o ssib le , fu ­ tile, a n d d a n g e ro u s to h e r; sh e feels d is c o n n e c te d fro m y ou a n d d o w n o n h erself. T h o u g h so m e o f th e s e b re ak s c a n b e large a n d d istressin g , as th e last c h a p tc r illu stra te s, m o st o f th e s e m isses a n d w o rrie s arc relatively sm a ll a n d c a n b e easily ta lk e d th ro u g h in a se ssio n o r tw o. S o m e tim e s th e s e sm all m isses are o b v io u s. I re m e m b e r a c lie n t w h o w as te llin g m e h o w a n g ry s h e w as w ith h e rs e lf t h a t sh e c o u ld n ’t tell, in ad v an c e, w h e th e r a p a rtic u la r m a n w as g o in g to h u r t h e r o r n o t. 1 k n e w th a t sin c e c h ild h o o d sh e h a d b e e n in re la tio n s h ip s w ith so m e very m a ­ n ip u la tiv e m e n , a n d I d i d n ’t like to h e a r h e r h o ld in g h e rs e lf re sp o n sib le fo r th e ir d e v io u sn ess. S o I to ld h er, “I k n o w you feel re sp o n sib le fo r n o t b e in g ab le to ‘tell in a d v a n c e ,’ b u t it really isn ’t y o u r fa u lt w h e n th e m e n in y o u r life are trick y a n d d e v io u s .” S h e re p lie d , “W e ’ve b e e n h e re b efo re, Pat. You try to tell m e so m e ­ th in g isn ’t m y fa u lt, b u t t h a t m akes m e feel p o w erless.” I w as re s p o n d in g o u t o f so m e se n se o f th e b ig p ic tu re o f h e r life, b u t in fact, I h a d m isse d th e e m o tio n a l p o in t o f h e r story. I a n sw e red , “Yes, I sec w h a t y o u ’re saying. O f c o u rse t h a t ’s h o w it w o rk s. You n e e d to feel like you s h o u ld b e ab le to tell in a d v a n c e b e c a u se t h a t w o u ld give you s o m e p o w e r in th e s itu a tio n .” It seem s t h a t th is w as th e re sp o n se sh e n e e d e d b e ca u se s h e n o d d e d a n d w e n t r ig h t o n . S h e h a d c o rre c te d m y “m iss,” b rin g in g m y e m p a th y b a ck to h e r e x p erien c e , a n d n o w sh e w o u ld th in k a n d feel h e r way th ro u g h th is issue in h e r o w n way, w ith m e p aying a tte n tio n to w h a t she m e a n t. A n o th e r c lie n t, w h o h a d to d e v e lo p v ery p o w e rfu l in te rp e rs o n a l ra­ d a r as a c h ild in a v io le n t fam ily, o fte n asks m e to w a rd th e e n d o f a se ssio n w h e th e r h e r ta lk in g h a s b e e n to o m u c h fo r m e, h e r sto rie s to o h a rd to h ear, o r to o b o rin g . W e have o f te n e x p lo re d w h a t lies b e h in d h e r q u e stio n : h e r lo n g in g to b e h e a rd a n d h e r c o n v ic tio n t h a t o th e rs are e ith e r to o fragile o r to o d is in te re s te d to h e a r h e r. T h e re fo re , sh e d o e s n ’t m a tte r a n d s h o u ld n ’t b e h e a rd . T h a t ’s w h a t tu r n s u p ag ain a n d again.

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B ut w hen she asks h e r questions, it’s also im p o rta n t th a t I scan my own behavior a n d feelings in o rd e r to resp o n d honestly. If I have been a bit distracted by personal w orries, o r I haven’t had a good n ig h t’s sleep, it’s im p o rta n t th a t I say so, sim ply a n d briefly. Because if I d o n ’t, sh e ’ll still know th a t so m eth in g is o ff betw een us, a n d she will take th a t to m ean th a t so m eth in g is w rong w ith her. T h a t’s how subtle a “m iss” can be. B ut in a therapy th a t’s w orking well, w hen these inevitable misses a n d w orries h a p p en , talking th em th ro u g h brings your clien t back to the positive side o f w an tin g a n d conn ectin g . Each talking th ro u g h a n d re­ c o n n ectin g reinforces h e r belief th a t this relatio n sh ip is safe a n d th a t it will give h er m ore th a n she’s h o p e d for before. Just to be able to say “O u c h !” o r “I’m w o rried ,” o r “You’re n o t getting it,” is m ore th a n she ever th o u g h t possible at first. A n d th e n , as she carries o n talking a b o u t h er life, th o u g h ts, and feelings, she will becom e aware o f som e new fro n tie r signaled by a new edge o f anxiety in th e relatio n sh ip w ith you. T h e re ’s so m eth in g else th a t she w ants from you, perhaps, a n d she “know s” she can’t have it. O r sh e ’s sure you’re th in k in g so m e th in g bad a b o u t her. O r th e re ’s so m eth in g she w ants to tell you a b o u t herself, a n d sh e ’s sure you w o n ’t like it o r even u n d e rsta n d it. W h atever th e p roblem is, it’s a n o th e r chance for h e r to talk h er way through bad feelings and back to good connection. So it goes, over a n d over, a n d th e cum ulative effect is a relatio n sh ip o f m ore com ­ plexity a n d security, a n d m ore possibilities for interesting, good surprises.

T W O D IM EN SIO N S O F TRANSFERENCE: SELF PSYCHOLOGY T h e self psychologists S tolorow a n d A tw ood call th is m ovem ent betw een d ish e arten in g a n d encouraging feelings in therapy a sh ift betw een two d im e n sio n s o f transference. T hey call your c lie n t’s fears a n d tro u b led expectations “repetitive transference”—a re p etitio n o f th e past. T h is kind o f transference, laid dow n as psychological organizing principles, tu rn s up over a n d over again in m any guises, and it needs countless c o u n te r­ rep etitio n s o f u n d e rsta n d in g ju st how it feels. T hese rep etitio n s o f u n d e r­ stan ding, along w ith o th e r k inds o f u n d e rsta n d in g a n d su p p o rt, add up to good relational feelings th a t self psychologists call “selfobject transfer­ ence.” A ccording to S tolorow a n d A tw ood, these p ain fu l a n d helpful relational feelings, this “repetitive transference” a n d “selfobject transfer­ ence,” arc n o t two separate k inds o f transference, b u t ra th e r two differen t

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d im en sio n s o f o n e com plex transference th a t develops a n d changes over tim e betw een clien t a n d th e ra p is t.1 C h a p te r 5 was all a b o u t w h a t self psychology calls repetitive tran s­ ference. In th is chapter, because w e’re trying to u n d e rsta n d how therapy c o n trib u tes to experiences o f em otio n al well-being, we’ll sp en d tim e w ith w h a t self psychology calls selfobject transference. (You m ight rem em ber th a t “selfobject ex perience” refers to th e c lie n t’s o ngoing o r internalized experience o f th e th era p ist’s supportive presence.) Self psychologists such as S tolorow a n d A tw ood believe th a t as a clien t com es to u n d e rsta n d how th e repetitive transference plays o u t betw een h im self an d his th era ­ pist, he will com e to u n d e rsta n d how his psychological organizing p rin ­ ciples m ake sense o f his in te rp erso n al cxpericnce for him . T his is th e m ost significant aspect o f his “u n co n scio u s” for h im to investigate in therapy.2 B ut w hile he is d o in g this, a n d also in th e quiet, com fortable spaces betw een b outs o f th is u n co m fo rtab le repetitive transference w ork, som eth in g ultim ately m ore im p o rta n t is h a p p en in g for him . His shaky, insecure, fragm ented self is being stre n g th e n ed th ro u g h th e selfobject transference. Som e self psychologists prefer to d ro p th e w ord “transference” and ju st speak o f a clien t’s selfobject needs a n d his selfobject experiences. N o t only d o these needs deserve respect and u n d e rsta n d in g as he begins to feel a n d express th e m in therapy, they also deserve to be m et as well as they can be w ith in th e lim its o f th e therapy situ atio n . H ow ard Bacal calls this th era p eu tic stancc “optim al responsiveness,”’ a n d he and K enneth N ew m an list th e follow ing exam ples o f how therapists provide selfobject experiences: by “a ttu n e m e n t to affective states; valid atio n o f subjective experience—including tem porary identification w ith th e ‘rightness’ o f the c h ild ’s o r p a tie n t’s perceptions; affect c o n ta in m e n t, ten sio n regulation, a n d so othing; sustaining a n d organizing o r restoring a w eakened sense o f self d isru p ted by selfobject failure; a n d recognition o f u n iq u en e ss and creative p o ten tial.”4 T hese are all m om ent-to-m om ent ways in w hich a th era p ist m ight try to provide op tim al responses to clients’ needs to have c ertain selfobject experiences in particu lar m om ents.

G O O D EXPERIENCE AS “SELFOBJECT TRA N SFEREN CE” Sim ply p u t, a selfobject experience is a self-w ith-other experience th a t feels supportive, enlivening, com fortable, freeing, and life-enhancing. T h e

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experience o f th e o th e r’s being w ith you is so “ju st rig h t” th a t you hardly n otice it. T h in k o f how you feel m ost yourself w ith a close friend, how good in yourself th a t kind o f being-w ith can m ake you feel. A n d th in k o f th e prototype o f th a t experience—a secure, happy, c o n fid e n t infant, to d ­ dler, o r young child, w h o d o e sn ’t realize th a t h er happiness a n d security is b eing created for h er by th e o th ers a ro u n d h e r o n a daily basis, a n d even m o m e n t by m o m en t. H er selfobject su rro u n d in g s allow h e r ju st to be—to explore, do, feel, relate, grow, a n d develop. Sadly, som e ch ild ren d o n ’t receive m u ch o f this co n ce n tra ted a tte n ­ tio n to th e ir needs, a n d som e receive som e kinds o f it a n d n o t o th e r k inds—for exam ple, lots o f safety a n d p ro tectio n , b u t n o t m uch adm ira­ tio n for th e c h ild ’s accom plishm ents, o r lots o f prid e, b u t little co m p an ­ io n sh ip o r u n d e rsta n d in g . If a c lie n t has su ch gaps in his relatio n al experience, they may lead to w hat self psychologists call deficits in his self experience. A large p a rt o f his therapy can be a repair o f th o se deficits, w hich will give h im a seco n d chance to develop a cohesive, c o m p eten t self in secure relationship w ith others. T h e therapist provides th e selfobject experiences th e client uses for such repair. In ord er for th e repair to “take,” th e therapy relatio n sh ip has to have significant intensity, an intensity su m m ed u p in th e w ord “transference.” W h e n th ere is en o u g h intensity, th e selfobject d im e n sio n o f th e therapy relatio n sh ip can p u t in to m o tio n m ajor changes in w hat a clien t expects a n d experiences in th e rest o f his life. H einz K ohut, th e fath er o f self psychology, identified th ree m ajor form s o f sclfobjcct transference. In idealizing transference, th e clicnt needs to feel c o n n ec te d w ith a n d p rotected by som eone good, strong, a n d wise, so m eo n e he can trust, idealize, a n d h o p e to em ulate. A m irro rin g tran s­ ference is stru c tu re d by th e c lie n t’s n eed to be noticed, accepted, a n d affirm ed in his strengths, a m bitions, a n d creativity. He needs som eone to ad m ire a n d sm ile, to back up his dream s a n d plans. A n alter ego o r tw inship transference focuses on an essential alikeness betw een clien t a n d th erap ist. “Being like” is an im p o rta n t kind o f belonging; it c ounters feelings o f b eing alone a n d alien in th e w orld.5 In a textbook o n self psychology w ritte n after K o h u t’s d e ath , a close colleague, E rn est W olf, identified th ree m ore im p o rta n t needs th a t are m et in w h a t h e calls a self-sustaining selfobjcct am bicncc. In a m erger transference, th e client needs th e th era p ist to be exactly a n d finely at­ tu n e d to h e r experience. A ny difference is perceived as a th reat. Q u ite d ifferent needs lead to an adversarial transference, w hich gives th e client a chance to assert difference tow ard so m eo n e w h o will take a firm o p p o ­

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site s ta n d b u t w h o will also c o n tin u e to be su p p o rtiv e, responsive, a n d a ffirm in g o f th e c lie n t’s self. W o lf also n o tes th e c lie n t’s n e e d to feel h e r ow n efficacy in th e re la tio n sh ip . In p articu lar, sh e n e ed s to k n o w th a t she has an im p a c t o n th e th e ra p is t a n d can evoke th e k in d s o f responses th a t will h e lp h er.6 To th is list o f se lfo b je ct n e ed s a n d tra n sfe re n c e s, S to lo ro w a n d A tw o o d a d d w h a t th ey call self-delineating selfobject tran sfere n ce . T h is tran sfere n ce takes sh a p e w ith th o se clients w h o se caregivers gave th e m so little early e x p erien ce o f v a lid a tin g a ttu n e m e n t th a t th ey have b e e n able to p u t to g e th e r o nly a sketchy sense o f self. T h ey have a shaky h o ld o n th e ir ow n p erce p tio n s a n d o p in io n s, w h ich arc easily u su rp e d by th e o p itv ions o f o th e rs. T h e ir affects arc real to th e m as b odily se n sa tio n s, even as pow erfully felt e m o tio n a l sto rm s, b u t they c a n n o t p u t th ese feelings in to w ords o r sym bols to m ake sense o f th e m . In th e th e ra p y re la tio n sh ip , a c lie n t w ith th is k in d o f a m o rp h o u s o r c h ao tic self-experience will d e p e n d o n th e th e ra p is t’s resp o n ses to help h im d e lin e ate th e shapes a n d feel­ ings o f his ow n e x p erien ce u n til he begins to have a d u ra b le sense o f be in g p re se n t as a valid, feeling, ex p erien c in g se lf in his ow n rig h t.7

W H A T D O ES A SELFO BJECT T R A N SFE R E N C E M EAN F O R Y O U R CLIENT? T h e language o f selfobject tran sfere n ce cap tu res so m e im p o rta n t aspects o f th e everyday g o o d n ess a c lie n t c an e x p erien ce in th e re la tio n sh ip w ith his th e ra p ist, a n d th a t’s w h a t I w a n t to talk a b o u t here. T h e m o st basic k in d o f goo d n ess, o r w ell-being, is a c lie n t’s c o n fid e n c e th a t his existence is real a n d valid, th a t his feelings m ake sense, th a t his th o u g h ts can w ith ­ sta n d o th e rs ’ d ifferences o f o p in io n , a n d th a t his u n iq u e self is p resen t, recognizable, a n d d u ra b le over tim e. If h e is o n e of th o se survivors o f re la tio n a l tra u m a w h o has lived w ith m any k in d s o f d isso ciatio n , he has struggled h a rd to know , “I am h e re a n d I am m e.” In th e c h a p te r o n tra u m a , we saw h o w im p o rta n t it was for you, as th is c lie n t’s th e ra p ist, to a tte n d carefully to all th e m any scattered details o f his exp erien ce, beco m in g , fo r a w hile, a c o n ta in e r o f pieces to o p a in fu l o r to o chaotic for h im to m anage. T h ro u g h y o u r here-and-now a tte n tio n to all o f his th o u g h ts a n d feelings, h e can begin to e x p erien ce th e shape, feel, a n d reality o f a self a t th e c e n te r o f his frag m e n te d exp erien ce. In tim e, h e becom es able to in te g rate th a t exp erien ce, past a n d p re sen t, in to a reliable sense o f “T h is is th e ro a d I’ve traveled to be here. T h is is w h o I

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am now .” In th e language o f self psychology, his selfobject experiences w ith you have helped him delineate a self. If th a t’s w here your client is com ing from , getting here in o n e piece (self-delineation) is ju st th e beginning o f th e good experiences possible for him ; th e re ’s m uch m ore th a t he m issed o u t on . For th o se clients w ho are n o t so fragm ented, tho se w ho have som e clear sense o f self b u t d o n ’t like th a t self very m uch, th e re ’s probably also a w ealth o f positive relatio n sh ip they m issed o u t on . Let m e describe w hat else your clients may be missing, m ost likely first o f all m issing it from p are n t figures. A client may be m issing som ebody w ho can ju st be close w henever he needs h er to be there. H e w ants som eone to w rap h er caring a ro u n d him , som eo n e to u n d e rsta n d him a n d help calm a n d so o th e w hatever trouble h e ’s feeling. A n d even w hen h e ’s n o t in trouble, he w ants th e reassurance o f know ing th a t sh e ’s there, ready to listen. A n o th e r client may be m issing som ebody w ho can be stro n g for h er in ways she’s n o t, som ebody capable a n d wise. So if so m eth in g difficult tu rn s up, she w o n ’t be o n h er ow n w ith it; she can look to him for help to figure o u t w h at to do. She can c o u n t o n him to back h er up, lending h er his pow er a n d insight so th a t she feels stro n g an d capable herself. A client m ight need som eone w ho sees exactly w h at’s good ab o u t him an d w ho smiles at him ab o u t th a t. It’s a k ind o f approval an d adm i­ ratio n w ith no strings attached, so he can take it in: “Yes, th a t’s me. I am good at th a t. I can shine. It’s good to shine, to p erfo rm an d be th e best I can. H e sees m e a n d he likes w hat he sees. H e sm iles a n d h e ’s p ro u d to know me. A n d I’m happy to be able to be myself, accom plishing this!” O r a client m ight be desperate for a best friend, a soulm ate, som e­ o n e w ho sees th e w orld just like h e docs, w ho know s ju st how it is be­ cause it’s a lot th e sam e for her. H e can see h im self in her, so he m u st be okay. H e w ants som eone w ho shares his interests; som eone w ho can w ork w ith him o n a project th a t m eans a lo t to b o th o f th em . W h e n h e ’s alongside her, he belongs in th e w orld. A client m ight be m issing som ebody w h o ’s glad to h ear th e strong things she has to say, w ho enjoys taking h er o n . H er anger an d h er edges are fine w ith him , because he likes how she w ants to change things an d m ake things h ap p en . H e likes it w h en she pushes against his ideas, an d he enjoys p u sh in g back. T his client w ants som eo n e w ho can play hard, as h ard as she likes to play, an d som eone w ho’s n o t a b it scared o f th e bum ps. T h e n she can be as assertive as she w ants to be—an d safe, too, w ith him . U n d e rn e a th all o f these d ifferent a n d particu lar ways th a t clients long for som e “h e ” o r “sh e” to respond to th em , th ere ru n s th e ir com ­

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m o n h o p e th a t som ehow they will be able to m ake th e response h ap p en , th a t they can d o w hatever it takes to get w hat they n eed from th e o ther. T hese are selfobject transferences in th e language o f everyday w ant­ ing. In th e ir sim ple form s, they can so u n d like childishness exposed. Per­ haps th a t’s why it’s so hard for clients to a d m it to them selves a n d to you th a t these are, indeed, th e experiences th a t they crave. Perhaps th a t’s why it can be h ard for you to respond com fortably as clients find som e o f these needs m et w ith you. T h e tru th , however, is th a t all o f these desires, in various form s, belong n o t only to healthy in fan t a n d child experience, b u t also to healthy a d u lt relational experience. O r maybe you’re com fortable w ith th e idea o f m eeting som e o f these basic relational needs in therapy, b u t w hat b o th ers you is calling th em “transference.” In my o p in io n , it d o e sn ’t m atter if you p u t th e nam e “ide­ alizing tran sferen ce” o n your clien t’s d eep e n in g tru st in you o r “m irro r­ ing transference” o n how m uch it helps him w hen you sm ile at his success. W h a t m atters is th a t yo u r client is having th o se experiences—and, yes, it’s im p o rta n t n o t to chill th a t w arm personal reality w ith a cold technical term . B ut th e “transference” idea m ight tu rn o u t to be useful to b o th you a n d your client in th e end. T h e re ’s a co m plication a b o u t how th is good re la tio n a l e x p erien c e w orks in th era p y . It’s n o t clear w h e th e r good selfobject experiences, all by them selves, can accom plish th e w ork o f “heal­ ing” o r change for a client. It m ight seem so. I’d suggest, however, th a t even w hen it seem s th a t o u r k indness cures, w h a t’s help in g m ost is th e in flu en ce o f th o se new selfobjcct experiences o n th e c lie n t’s organizing principles. W h a t’s help in g h im is a change in how m any p arts o f his relational experience can be processed, o r a change in his self-structure, as som e self psychologists w ould say. N ow it’s tru e th a t clients d o n ’t have to be able to see o r u n d e rsta n d those changes to p ro fit from th em . O n th e o th e r h a n d , self-understanding usually speeds up a n d stren g th en s th e processes o f change. H ere’s w here th e idea o f transference can be helpful in th e therapy. R eferring to it allows b o th you a n d your client to step back just a b it from your rela­ tio n sh ip to u n d e rsta n d m ore clearly w h a t’s h ap p en in g . T ogether you can acknow ledge th a t your clien t is feeling b e tte r n o t ju st because you are a nice person, b u t because o f specific new kinds o f interactions taking place betw een you, interactio n s th a t have very p a rticu la r a n d pow erful m ean­ ings in th e context o f th e c lie n t’s life a n d history. Probably th erap y w orks best w h e n new ex perience in re la tio n a l therapy is accom panied by a clien t’s significant new insights a b o u t how

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his ow n self-w ith-other system works. T h e insights are im p o rta n t, and perhaps even m ore im p o rta n t is th e c lie n t’s experience o f c o n n ectin g w ith you in an engaged a n d cooperative way as th e two o f you w ork o n w h a t’s going o n betw een you a n d w h a t’s going on for him . A client do esn ’t have to struggle to rem em b er th e learn in g th a t h appens in an experien­ tial relational therapy. It goes to his psychological bones. B ut it’s also possible, a n d very useful in such a therapy, for a clien t to know a lot a b o u t w h a t has h a p p en e d , and to claim it, cognitively, as his own. Such experiences o f self-reflection a n d self-understanding a d d con­ text a n d d e p th to a c lie n t’s experiences o f getting relatio nal needs m et. “T ransference” is o n e o f th o se concepts th a t can help h im w ith his pro­ cess o f self-reflection. T h e w ord rem in d s b o th you a n d h im o f th e in te n ­ tio n al w ork you’re d o in g together: you’re allowing deep, im p o rta n t needs to em erge in th e therapy relatio n sh ip , along w ith all th e co n flict and tro u b le they may cause him . In th e m idst o f these com plex, pow erful experiences, you’re w orking together to find w ords an d m eanings for them , u n til your clien t com es to u n d e rsta n d m ore fully: “So this is how my selfw ith-other system w orks!”

O T H E R DEVELOPM ENTAL STORIES Self psychology says th a t therapy sh o u ld be a su stain in g selfobject m ilieu for your clients. T h ro u g h selfobject experience th e ir subjective selves can becom e delin eated a n d cohesive, they can be su p p o rte d in th e ir am bi­ tio n s a n d affirm ed in th e ir values, and they can develop in to respectful, self-respecting m em bers o f th e h u m a n com m unity. B ut self psychology’s story o f how a self develops is a speculative o n e w orked o u t from th era ­ pists’ transference experiences w ith a d u lt clients. T h ere are o th e r inter­ esting stories a b o u t th e pow er o f rela tio n sh ip in h u m a n developm ent th a t begin w ith in fan t a n d child studies. I’ll briefly look at som e o f th em because they, too, su p p o rt th e idea th a t a relational therapy can brin g som e healing to d ev elopm ental dam age clients have suffered, a n d th u s help th em experience a new sense o f well-being in th e w orld.

Attachment Theory M ary A in sw o rth a n d Jo h n Bowlby have identified a n d d o c u m e n ted three m ain p attern s o f a tta c h m e n t betw een infants a n d caregivers.8 A caregiver’s

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c o n s is te n t availability a n d se n sitiv e re sp o n se s to a c h ild ’s c o m m u n ic a ­ tio n s lead to secure a tta c h m e n t a n d th e c h ild ’s c o n f id e n t a b ility to v e n tu re o u t a n d e x p lo re. In anxious resistant a tta c h m e n t, th e c h ild d o e s n ’t k n o w fo r su re t h a t th e caregiver w ill b e available a n d re sp o n siv e —so m e tim e s sh e is, b u t s o m e tim e s sh e is a b s e n t o r th r e a te n s a b a n d o n m e n t. T h e c h ild te n d s to w o rry a b o u t se p a ra tio n s , cling, a n d b e a n x io u s a b o u t e x p lo rin g th e w o rld . W h e n a n in c o n s is te n t caregiver a lso re b u ffs th e c h ild ’s a d ­ v a n ces, a n anxious a vo id a n t a tta c h m e n t is se t in m o tio n . E v en tu ally th is c h ild avoids c o n ta c t in o rd e r to h id e h e r n e e d s . O f te n a self-sufficient, c o m p e te n t v e n e e r m ask s th is c h ild ’s perv asiv e a n x ie ty a n d anger. A fte r th e first tw o o r th re e years o f a c h ild ’s life, Bow lby says, th ese p a tte rn s b c c o m c h a b itu a l, o r “w o rk in g m o d e ls ” o f h o w all in te ra c tio n s w o rk . A securely a tta c h e d c h ild w ill u p d a te h e r w o rk in g m o d e ls as she grow s b e c a u se o f th e free c o m m u n ic a tio n b e tw e e n h e rs e lf a n d h e r p a r­ e n ts. S h e c a n m ove o n to m o re m a tu re fo rm s o f se c u re a tta c h m e n t as a b a se fo r m o re m a tu re fo rm s o f c o n fid e n c e a n d e x p lo ra tio n . S in c e a n in se cu re ly a tta c h e d c h ild lives in a less c o m m u n ic a tiv e , re sp o n siv e envi­ r o n m e n t, h e r w o rk in g m o d e ls o f o th e r a n d se lf are likely to p e rsist u n ­ c h a n g e d , first w ith h e r o rig in a l caregivers, a n d th e n w ith o th e rs , even w h e n th e y tre a t h e r q u ite d iffe re n tly t h a n h e r o rig in a l caregivers d id . “W o rk in g m o d els o f p a re n t a n d self” are sim ila r to w h a t I have called se lf-w ith -o th er o rg a n iz in g p rin c ip le s . B ow lby h o ld s o u t th e h o p e t h a t al­ t h o u g h c h a n g e b e c o m e s m o re d iffic u lt as w e age, th e r e are always c h a n c e s t h a t o u r w o rk in g m o d e ls o f a tta c h m e n t c a n b e in flu e n c e d for th e b e tte r. W h e n w o rk in g m o d e ls o f se lf-w ith -o th er a r e n ’t h e ld to o tightly, life ex p e­ rie n c e c a n c o n tin u e to a lte r th e m to m a tc h n e w re la tio n a l life s itu a tio n s. B u t th e m o re a n x io u s a n d in sc c u rc a w o rk in g m o d e l is, th e m o re likely it is to b e q u ite rigidly re p etitiv e o f early e x p e rie n c e . H e re th e ra p y can h elp , B ow lby says. T h e ra p y b ecom es a n e w a tta c h m e n t in w h ic h a c lie n t’s w ork in g m o d el o f a tta c h m e n t c a n b e su b v e rte d , if ever so slowly. H o w can th is h a p p e n ? In h e a lth y p a r e n t- c h ild re la tio n s h ip s , w o rk in g m o d e ls c h a n g e th ro u g h w h a t B ow lby describ es as free-flow ing, w arm ly p e rso n a l c o n v ersa tio n , laced w ith feeling. T h is is th e k in d o f c o n v e rsa tio n re la tio n a l th e ra p y w o rk s to w a rd . In th e b e g in n in g stages o f th e ra p y , a c lie n t m ay b e q u ite a fra id to b rin g m u c h o f h e rs e lf fo rw a rd . B u t e ach tim e sh e d o e s, th e re isn ’t th e d is in te re s t o r re je c tio n sh e a n tic ip a te s. Slow ly sh e fin d s sh e c a n sp e a k m o re freely o f h e rs e lf a n d h e r feelings. E v en d iffic u lt tim e s o f m is u n d e r­ s ta n d in g e v en tu ally prove th e re liab ility o f th is n e w m o d e l o f a tta c h m e n t. N ew se c u rity gives th e c lic n t a base fo r n e w e x p lo ra tio n s a n d u n d e r ta k ­

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ings. A n d all th e w hile, th is new w ork in g m o d el o f re la tio n s h ip is b e co m ­ ing m o re e x p o rta b le to o th e r re la tio n sh ip s in th e rest o f h e r life. A tta c h m e n t th e o ry o ffers th is p ic tu re o f th e d e v elo p m en tal rep air th era p y can m ake possible for clients. It suggests t h a t a secure base will allow th e m to explore life w ith m o re c o n fid e n ce . B u t bey o n d th a t, th e “g o o d s” are all in th e negative: clien ts w o n ’t feel so an x io u s, angry, o r depressed. F o r a m o re positive d e sc rip tio n o f th e “g o o d s” o f health y de­ v e lo p m e n t a n d re d ev e lo p m e n t, w e’ll look briefly a t th e w ork o f D aniel S te rn a n d Jo sep h L ich ten b erg , w ork o fte n lin k e d w ith re la tio n a l psycho­ analytic theory.

Daniel Stern S te rn describes fo u r d iffere n t k in d s o f relatedness th a t em erge in sequence betw een a n in fa n t a n d h e r p a re n ts a n d th a t th e n carry o n in to th e c h ild ’s a d u lt life: e m e rg en t related n ess, core relatedness, in tersu b jectiv e re la te d ­ ness, a n d verbal rela te d n e ss.9 E ach k in d o f related n ess develops as a n in tric a te m a tc h in g o f cues a n d resp o n ses betw een p a re n t a n d child; each req u ires an in fa n t c o n stitu tio n a lly able to give a n d re sp o n d to cues, a n d a p a re n t w h o can d o th e sam e, o fferin g n o n in tru s iv e , in te rested , consis­ te n t a n d relatively accu rate a ttu n e m e n t to th e c h ild ’s signals. E m e rg en t related n ess is th e self-w ith-other system w ith in w h ich an in fa n t so rts a n d cross-m atches p e rce p tio n s a n d stim u li to m ake p a tte rn e d sense o f th e w orld, especially o f h e r social w orld. T h is e m e rg en t d o m a in o f related n ess a n d o f self carries o n in to a d u lth o o d as capacities to lea rn , to m anage stim u la tio n a n d anxiety, a n d to m ake c o n ta c t w ith o th ers. C o re relatcd n css is th e re la tio n s h ip betw een th e in fa n t’s energy a n d c x citem cn t p a tte rn s a n d h e r p a re n ts ’ re sp o n ses to th e m . T h ro u g h re­ spo nses ric h w ith m a tc h in g a n d c o m p lim e n ta ry energy, p a re n ts pro v id e a reliable c o n te x t in w h ich a n in fa n t can e x p erien ce co re senses o f se lf su ch as agency, affectivity, c o h ere n ce , a n d c o n tin u ity . M ore im p o rta n tly , she com es to e x p erien ce a b a la n ce d w ell-being in th a t core sense o f self, an e q u ilib riu m th a t d e p e n d s o n h e r p a re n ts’ interactive presen ce w ith her. L ater in life, th e d o m a in o f core relatedness has to d o w ith how well a p e rso n c an use v a rio u s re la tio n sh ip s to m a in ta in a cohesive, b alan ced , re silie n t sense o f core self. In in tersu b jectiv e related n ess th e focus o f th e in f a n t- p a r e n t rela­ tio n s h ip m oves to th e sh a rin g o f subjective exp erien ce. In in te ra c tio n s b etw een tw o selves, p a re n t a n d ch ild , m ea n in g s a n d feelings are c o m m u ­

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n icated a n d u n d e rsto o d . Affective a ttu n e m e n t m akes th is sh a rin g pos­ sible. P arents’ capacities to a ttu n e a n d to em pathize d e term in e, in large part, w h a t kinds o f affective experiences can be safely inclu d ed in th e c h ild ’s sense o f self, a n d they in flu en ce th e feeling to n es o f th e c h ild ’s self-states. T h ro u g h o u t life, th e d o m a in o f intersubjective relatedness is th e “place” for th e giving a n d receiving o f em pathy a n d u n d e rsta n d in g and th u s for m a in tain in g self-esteem and com fortable self-states. For S tern, verbal relatedness is th e b eg in n in g o f th e possibility o f false relatedness, for a child can be spoken to a n d tau g h t to speak in ways th a t deny w h a t th e c h ild ’s body a n d em o tio n s tell h e r is really h appening. E verything th a t is n o t inclu d ed in this social world o f language becom es either “private” o r “disavowed” o r “not-m c” experience, according to Stern. In a d u lth o o d , these experiences th a t lie outsid e o f w h a t’s socially sanc­ tio n e d often generate feelings o f inau th en ticity , anxiety, a n d a lienation. B ut if o n e can share th e private experiences a n d integrate th e disavowed a n d “not-m e” experiences o f o n e ’s life, verbal relatedness can becom e a d o m ain in w hich o n e is know n a n d affirm ed as contrad icto ry a n d im per­ fect, b u t also as a u n iq u e a n d valuable self. It’s clear th a t this could be a jo b for therapy. In S te rn ’s schem e, however, th e therapy relatio n sh ip is able to to u ch a n d shape each k in d o f a d u lt relatedness, n o t ju st verbal relatedness. In S te rn ’s term s, a clien t’s secure therapy relatio n sh ip can som e­ tim es take th e form o f em ergent relatedness, help in g h im m ake better c o n ta ct w ith th e w orld a n d tu rn som e o f his life’s chaos in to p a tte rn s he can m anage. As core relatedncss, a clien t’s being w ith his th era p ist will su p p o rt th e dynam ic balance o f his core senses o f self—his em o tio n s, will, a n d agency, a n d w ho he feels h im self to be in space a n d tim e. In th e d o m ain o f intersubjective relatedness, em o tio n al a ttu n e m e n t a n d em pa­ thy will b ro a d en a n d deepen a c lie n t’s sense o f w ho he is “in sid e” and invite h im in to th e positive feelings o f in te rp e rso n a l s h a rin g a n d c o n ­ n e c tio n . A n d as verbal re la te d n e ss, th e ra p y m akes space fo r co n v ersa­ tio n s t h a t b rid g e th e gap b etw een w h o th e c lie n t know s h im s e lf to be a n d th e social se lf h e believes h e m u st p re se n t to th e w orld.

Lichtenberg and Motivational Systems Joseph L ichtenberg proposes a th eo ry o f stru c tu re d m o tivation (instead o f a th eo ry o f stru c tu re d self) as a way to explain th e behavior o f infants observed in th e ir n a tu ra l su rro u n d in g s a n d also th e behavior a n d feel­

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ings o f adults in therapy. He says th a t h u m a n m o tiv atio n is best concep­ tualized as a series o f systems designed to p ro m o te th e fulfillm ent and regulation o f basic needs, w hich he sorts into five categories: (1) th e need for psychic regulation o f physiological req u irem en ts (for food, w arm th , a n d sleep, for exam ple), (2) th e n eed for a tta c h m e n t a n d affiliation, (3) th e need for e x p loration a n d assertion, (4) th e need to react w ith aver­ sion, e ith e r fight o r flight, w hen in danger, a n d (5) th e need for sensual and sexual e n jo y m e n t.10 Exchanges betw een p a re n t a n d child give each m otivational system its robustness, c o n to u rs, lim its, a n d feeling-tones. T h e p a re n t’s feelings arc a pow erful regulator o f th e c h ild ’s cxpcrience o f his ow n m otivations. If, for exam ple, a caregiver responds to e x p loration w ith encouragem ent, th e child will explore m ore c o n fidently and his exploratory system will be stren g th en ed . If th e responses to a c h ild ’s a tta c h m e n t strivings are w arm , reaching o u t to o th ers feels good to him , n o t sham eful. If th ere is a b lank in caretaker response w hen it com es to a c h ild ’s sensuality a n d sexuality, he will be lim ited in this area o f self-knowledge a n d self-expression. P a re n t-c h ild in teractio n s th a t are loaded w ith a lo t o f feeling be­ com e clustered together in w hat L ichtenberg calls m odel scenes. In therapy w ith adults, as we have seen, m odel scenes tu rn u p as stories, dream s, a n d m em ories th a t rep resen t em otionally loaded form ative experiences fro m infancy, c h ild h o o d , a d o le sc e n c e , a n d e a rlie r a d u lt h o o d .11 In L ichtenberg’s schem e, th e m odel scenes th a t em erge in a c lie n t’s therapy will be linked to th e ways in w hich caregivers resp o n d ed to his basic needs, w hich in tu rn shaped th e m otivational systems th ro u g h w hich he c o n tin u e s to try to stifle o r take care o f th o se needs. Som etim es th e therapy process can show a clien t new ways to take care o f th o se needs: th e th erap y ro o m may becom e a place for a special kind o f relaxed well-being; in your presence, a clien t can explore previ­ ously fo rb id d en areas o f feeling a n d new ways o f being w ith a n o th e r per­ son; a client may learn to assert h im self in therapy, a n d to fight back o r w ithdraw in useful self-protection if you inadvertently h u rt him . T h e cli­ e n t will n o t only be having these new experiences, he will be talking a b o u t how his m otivational systems w ork for him b o th in a n d o u t o f therapy. T alking a b o u t th e m w hen th ey ’re “h o t,” th a t is, w hen h e ’s em ­ b roiled in a m odel scene in w hich h e is w orking to get th e best outco m e he th in k s he can have, has significant pow er to change how his m otiva­ tio n al systems w ork for him , especially w hen th a t k in d o f talking is em ­ b e d d e d in o n g o in g s e lf-re fle c tio n w ith in a s u p p o r tiv e se lfo b je c t relationship.

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The Boston Process of Change Study Group In 1995 a group o f in fan t a n d child clinicians a n d researchers, practicing psychoanalysts, a n d analytic th eo rists (including D aniel Stern) cam e to ­ g ether in B oston to study th e q u estio n o f how change takes place in psy­ chotherapy. From th e beginning, they in te n d e d to develop a m odel o f change th a t w ould be based o n in fan t research a n d th a t w ould explain th e “so m eth in g m ore th a n insight” th a t produces change in therapy. T h u s th e ir w ork a tte n d s m ore to questio n s a b o u t dyadic process th a n to ques­ tio n s a b o u t th e stru c tu re o f self o r o f m otivation. T h e gro u p explores th e interactive, m utual, n o n-linear processes th a t organize an in fa n t’s em o­ tio n al states a n d also his sense o f how to d o things w ith in tim ate others, a k in d o f know ledge th a t th e gro u p calls “im plicit relational know ing.” T h e n they m ake links betw een these processes a n d processes o f changc in th era p y .12 C lien ts b rin g im plicit relational know ing to th e th era p eu tic rela­ tio n sh ip , th e B oston G ro u p says, a know ing th a t profoundly affects th e quality o f th e ir relational lives inside a n d outsid e o f therapy. T herapists, o f course, brin g to th e ir w ork th e ir ow n im plicit know ledge a b o u t rela­ tional procedure. O ver tim e, th e n , a client a n d th era p ist will find th e m ­ selves w ith in a way o f “getting along” influenced by b o th p a rtn e rs’ im plicit relational know ledge. H ow can this lead to change for a client? H ere th e c o n n ec tio n is m ade to in fan t developm ent. Just as a p aren t can provide a m en ta l/em o tio n a l context for expanded a n d m ore com plex states o f sh ared consciousness w ith a child, so a th era ­ pist can engage w ith a clicnt in ways th a t p roducc for b o th o f th e m an e xpanded sense o f how they can be in th is re lationship. A clien t’s states o f consciousness can be e xpanded in to m ore c o h ere n t a n d com plex states in collaboration w ith a self-organizing system th a t is already m ore coher­ e n t a n d com plex. In o th e r words, th e th era p ist brings to th e relatio n sh ip ways o f interacting a n d o f exploring interactio n th a t th e client w o u ld n ’t have know n abo u t. A t th e sam e tim e th e clien t is brin g in g challenges in to th e relational system th a t require th e th era p ist to expand his ow n repertoire o f u n d e rsta n d in g a n d response. As th e c lie n t-th e ra p ist rela­ tio n sh ip expands, new form s o f agency a n d shared experience becom e available w ith in it. T hese new p a tte rn s o f organization can also be p u t in to o p e ratio n in o th e r relationships. T h e B oston G ro u p believes th a t changes in such im plicit relational know ing are w hat p roduce th e im p o rta n t changes in therapy th a t can’t be a ttrib u te d to insight. Such changes com e a b o u t th ro u g h u n p la n n e d

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events in therapy. In a n im p ro v isa tio n a l m o d e o f talk in g a n d b e in g t o ­ g ether, a t u n p re m e d ita te d tim es, w h a t th e g ro u p calls “n o w m o m e n ts” h a p p e n betw een c lie n t a n d th e ra p ist. T h ese are th e m o m e n ts w h e n so m e­ th in g new c o u ld em erge t h a t w o u ld ch an g e w h a t b o th c lie n t a n d th e ra ­ p ist k n o w a b o u t th e p o ssib ilitie s o f re la tin g to o n e a n o th e r. If now m o m e n ts are h a n d le d in a th e ra p e u tic way th a t fosters a “specific m o­ m e n t o f m eetin g ,” th e re la tio n s h ip d o es change (if ever so slightly), a n d th e im p licit know ledge o f each p a rtn e r is altered by th e new a n d differ­ e n t intersu b jectiv e c o n te x t betw een th e m . T h ey th e n re tu r n to “m oving along” in therapy, a process consisting o f m any sm all m atch es-m ism atch es, ru p tu re s , a n d repairs th a t p u t th e new sh a p e o f im plicit k n o w in g in to play—u n til a n o th e r “no w m o m e n t” offers new possibilities for e x p an d in g th e ir sh a re d a n d in d iv id u a l c onsciousness.

TH E LIMITS OF A SELF-FOR-OTHER PERSPECTIVE IN THERAPY T h e gen iu s o f all o f th ese th era p ie s th a t c o n n e c t a d u lt h e a lth to in fa n t d e v e lo p m e n t is th a t th ey recognize t h a t “h e a lth ” o r “goo d e x p erien c e ” isn’t w h a t’s left over w h e n co n flicts are w orked th ro u g h in therapy. T h ey see th era p y as m o re th a n tre a tin g disease o r d y sfu n c tio n so th a t clients can r e tu rn to “n o rm a l.” F o r th ese th era p ie s, psychological h e a lth o r e m o ­ tio n a l w ell-being is itself a n in te rp e rs o n a l c rea tio n . T h ey kn o w w h a t ef­ fective p a re n ts, tea ch e rs, m e n to rs, a n d coach es know : it takes a rtfu l, in te n tio n a l, c arin g activity to pro v id e th e in teractiv e co n tex ts th a t sus­ ta in m any d iffe re n t k in d s o f goo d le a rn in g experiences for th o se w h o c o u n t o n you to h e lp th e m develop. H ow ever, sclf-for-othcr re la tio n a l th era p y needs th e chcck a n d bal­ ance o f a self-w ith-other perspective. Seeing th e th e ra p is t as only th e p ro ­ v id e r o f ex p erien ce th a t rep airs d e v elo p m en tal deficits, stre n g th e n s new self-structures, a n d facilitates ex p an d e d k in d s o f relatio n al kno w in g w o u ld seriously lim it a re la tio n a l perspective. In th e first place, th e a ssu m p tio n th a t th e th e ra p is t uses e m p a th y ju st to k n o w w h a t th e c lie n t n e ed s a n d how to m ee t th o se need s sh ifts th e th e ra p is t away fro m th e m u tu a lity o f e m p a th ic exchange w ith th e client. In su c h “k n o w in g ,” th e th e ra p is t takes th e p o sitio n o f an e x p ert w h o observes a n d acts fro m o u tsid e th e im m e­ diacy o f th e c lie n t-th e r a p is t in te rac tio n s. T oo m any o f th o se m o m e n ts o f k n o w in g a d d u p to th e th e ra p is t’s exit from m u tu a l, recip ro cal re la tio n ­

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ship. Too m uch focus on providing w hat clients need blocks a therapist’s ability to be a real o th e r person engaged w ith her clients. T herapies th a t script the therapist as just a provider subtly patronize a client. All the while, however, she knows th a t she is an ad u lt in therapy. If she has th o u g h t a b o u t her history in this way, she has probably recog­ nized th a t her organizing principles for attachm ent, achievem ent, and taking care o f herself are thoroughly woven into her ad u lt personality. T hey make her w ho she is now, and she can’t go back in tim e and u n d o them , no m atter how well her therapist m ight m eet her needs. F urther­ m ore, she doesn’t w ant to find herself feeling like a perpetual victim of her own history. T his client needs a therapist w ho is as present with her, here and now, as she is a provider o f em pathy for her. A self-with-other focus offers therapy in which it’s very clear th a t a client is n o t a regressed child or a victim , b u t rath er an active explorer o f the intensities o f how relation­ ship works for her right now and how it could be different. In such therapy, she will do this exploring w ith you, her therapist, and you will be chal­ lenged to explore your ow n experience, too, and to devise no subtle es­ capes from th e im m ediacy o f the relationship. In this m ode, relational therapy gives a client the chance to experi­ ence her unfulfilled neediness as desires th a t are completely appropriate in a here-and-now ad u lt relationship. H er problem is th a t these desires have b een twisted into opaque, dense impossibilities by powerful anxiety. H er anxiety comes from the past (“I m ustn’t w ant, m ustn’t ask; if she says no, th a t m eans I’m disgusting”). But th e po in t o f her therapy is n o t th at this “she” (you, her therapist) will say yes in order to m eet her need, b u t th at your client will have the chance, here and now, to cxpcricncc and to th in k about bo th her legitim ate adult desires for connection and the longstanding anxieties th a t tu rn them into trouble. It’s useful for her to u n d erstan d those longstanding anxieties in term s o f her own history, b u t liberation comes as she finds the courage to accept her ad u lt desires and to act o n them in new ways.13

T H E “G O O D S ” A S E L F -W IT H -O T H E R P E R S P E C T IV E O F F E R S W ith its developm ental and intersubjective em phases, self psychology is b o th a self-for-other and a self-w ithother therapy. Relational psychoanalysis

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also c o n ta in s b o th them es, b u t it puts a stronger em phasis o n th e c u r­ ren t, m u tu a l d ance o f self w ith o ther. A ro n and M itchell describe posi­ tive o u tco m e s in th e ra p y n o t as a self b e co m in g stro n g e r a n d m ore cohesive, enjoying e n h an c ed capacities to self-right a n d self-reflect, n o r as changes in organizing p rinciples o r in m otivational o r self-structures. Instead, they speak o f m eanings th a t client a n d th era p ist negotiate ab o u t w h a t’s h ap p en in g betw een th em , a n d o f th e larger, related m eanings th a t these two p a rtn e rs in therapy co-construct and th a t tu rn o u t to be prag­ m atically useful narratives o f th e c lie n t’s life ex p erien ce.14 “Pragm atically useful” m eans th a t therapy has generated a sense o f self and relationships th a t a clicnt feels to be im p o rta n t, m eaningful, a n d “a u th e n tic ,” th a t is, deeply his o w n .15 If a c lie n t’s life is stuck bccausc old co n strain ts keep foreclosing pos­ sibilities for new experiences, o n e could say, as M itchell puts it, th a t his life is stuck because o f a failure o f im agination. His therapy relatio n sh ip is w here new things can h a p p e n to prim e his im agination, things in­ vented n e ith e r by you n o r by him , b u t b ro u g h t to b irth by w h a t h appens a n d w hat m ight h a p p e n next betw een y o u .16 T hese new things m ight feel good o r they m ight not; w h a t m atters is th a t they will feel m eaningful a n d a u th e n tic to him , a n d th a t they will be w indow s for his im agination a n d pathw ays to fu rth e r im p o rta n t m ovem ent—th e o pposite o f his h ab it o f sh u ttere d , constricting stuckness. T his m ore p h ilosophical version o f relational psychoanalysis d o e sn ’t focus o n am elio ratin g life’s agonies w ith care a n d u n d e rstan d in g . It in­ vites a clien t to em brace th e inevitable clashcs, im possibilities, a n d trag­ edies in h e re n t in h u m a n life. It resonates w ith an existential sense o f th e c o n tra d ic tio n s and c o n u n d ru m s o f everyday experience, w hich at best becom e creative dialectic ten sio n s to live o u t w ith courage and im agina­ tio n . In this view, th e m eanings th a t a clien t m akes o f his life experience are n o t only c o n stru cted in relatio n sh ip w ith o th ers (especially his th e ra ­ pist), they are also dialogical m eanings, th a t is, th o u g h they belong to him , they are also shareable w ith o th ers in th e h u m a n com m unity. E n­ gaging in such dialogical relatio n sh ip is p a rt o f a clien t’s m ovem ent be­ yond th e lim its o f victim a n d d o m in a to r p ositions in social relations. A relational therapy en h an ces his ability to becom e, instead, a player en ­ gaged m utually w ith others, enjoying th e m eeting o f m in d s .17 Jessica B enjam in, a fem inist relational psychoanalyst, has p u t for­ w ard a d e fin itio n o f intersubjectivity th a t highlights self-with-other. She begins w ith th e fem inist insistence th a t psychoanalytic discourse treat w om en as full subjects, n o t ju st as lo v e/h a te objects for m ale subjects,

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a n d she goes o n to argue th a t all relationships sh o u ld be “intersubjective,” th a t is, pro d u cts o f n egotiations betw een persons w ho m utually recognize o n e a n o th e r as subjects. B enjam in is saying th a t intersubjectivity is som ething m ore th a n th e situation created w hen two o r m ore subjectivities share a field o f existence. (This is th e field th eo ry o f intersubjectivity developed by self psychological intersuhjectivists like Stolorow , A tw ood, a n d O range.) B enjam in reserves th e term intersubjectivity for th e m u tu al re cognition th a t can be negotiated betw een any w o subjects, including in fan t a n d p arent. In this k in d o f intersubjectivity, n e ith e r subject exists for th e o ther. In m o m en ts a n d m odes o f intersubjectivity, each p a rtn e r is engaged in m u tu a l a n d reciprocal processes o f asserting self a n d recogniz­ ing th e o th e r’s self-assertion. B enjam in highlights th e necessary instability o f such intersubjectivity as it m akes space for aggression, co m p etitio n , a n d th e inevitable break­ dow ns a n d repairs o f recognition th a t h a p p en in th e course o f a relatio n ­ ship. T h e d e m a n d s o f em pathy becom e conflictual w hen em pathy m ust ru n two ways. D o m in atio n o f o n e person by th e o th e r is always a possibil­ ity. B ut relational analysis is d o in g its best w ork, B enjam in proposes, w hen it helps its analysands develop th e capacity for achieving a n d sus­ tain in g th e “intersubjectivity” o f two-way recognition. T h e o th e r side o f this w ork is h elping analysands develop capacities to c o n ta in and w ork w ith w hat h ap p en s w hen intersubjectivity breaks dow n: w ith th e inter­ nal tensions generated by clashes o f wills a n d frustrated aggression, and w ith fantasies o f reversals anti rep risals.18 T h e w om en o f th e S to n e C e n te r also speak to th e ideal o f m u tu a l­ ity in re lationship. In p a rt, they do so by ascribing to w om en in n ate ca­ p a c itie s fo r e m p a th y a n d re c o g n itio n , w h ile lin k in g a g g ressio n to m asculinity a n d patriarchy. T h e ir version o f relational th erap y is based o n a developm ental m odel in w hich th e develo p m en t a n d exercise o f w om en’s ways o f c o n n ec tio n becom e th e paradigm for all healthy h u m a n developm ent and psychology. Like th e o th e r relational therapies we have considered, this self-in-relation m odel is also a psychodynam ic therapy. It d ep en d s o n em otionally “c o n n ec tin g ” relational experiences betw een cli­ e n t a n d th era p ist to generate insight a b o u t relational pattern s. T hese relational p a tte rn s arc c o n d en sed in transference feelings a n d old rela­ tional images. S to n e C e n te r th eo ry m ain tain s th a t this c o m b in a tio n o f experiencing c o n n ec tio n a n d developing insight will p roduce change in clients’ c u rre n t relationships a n d in th e ir well-being. In o th e r words, som e o f th e goods o f th is th erap y are like th e goods o f th e o th e r developm entally o rien ted relational therapies we’ve discussed.19

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T h e S to n e C e n te r th eo rists, how ever, strive to locate m o v em e n t a n d change w ith in th e th e ra p y re la tio n s h ip itself, w h ich th ey ch aracterize as m u tu a l, as A ro n a n d B en jam in d o . “Self-in-relation” is th e p rim a ry h u ­ m an reality, th ey say, w ith in w h ich we m ig h t have fantasies a b o u t o u r a u to n o m y a n d in d e p e n d e n c e , b u t th ey are o nly fantasies. T h e ra p y c a n ’t be a fully m u tu a l re la tio n sh ip , in so far as a th e ra p is t m u st p u t th e c lie n t’s subjective e x p erien ce a t th e c e n te r o f th e th e ra p y a n d speak o f h e r ow n ex p erien ce o n ly as it m ig h t be h e lp fu l to th e clien t. H ow ever, w ith in th is co n te x t, th e re can be real c o n n e c tio n , m u tu a l respect, e m o tio n a l avail­ ability, a n d o p e n n e ss to change o n b o th sides o f th e re la tio n sh ip . T h ese experiences o f m u tu a lity o fte n d e e p e n a n d grow w ith th e th erap y .20 T h u s, as o th e r m u tu ally e m p a th ic re la tio n s h ip s do, th e th e ra p y re la tio n sh ip p ro d u c es for b o th p a rtn e rs w h a t M iller a n d Stiver call th e five c o m p o ­ n e n ts o f e m p o w erm en t: “zest,” a ctio n , know ledge, w o rth , a n d a desire for m o re c o n n e c tio n —five pow erful, in-relation “g o o d s.” Zest in-relation is th e o p p o site o f isolated d e p ressio n . It’s th e vitality a n d energy o n e feels in m o m e n ts o f m u tu a l c o n n e c tio n , w h e th e r th o se m o m e n ts be filled w ith sadness, fear, anger, o r joy. T h o se m o m e n ts o f m u tu a l c o n n e c tio n are them selves m o m e n ts o f m u tu a l a c tio n in w h ich each p e rso n affects th e o th e r. W h e n a p e rso n know s sh e has a pow erful o r m ea n in g fu l effect o n so m e o n e , sh e feels all th e m o re em pow ered to take f u r th e r a c tio n a n d to believe it will b e effective. A th e ra p y re la tio n ­ sh ip th a t’s w orking well will stir su c h energy in b o th you a n d yo u r client. F u rth e rm o re , sh a rin g w ith in m u tu a l re la tio n s h ip p ro d u c es a lo t o f new know ledge for th e sharers. In th e th e ra p e u tic re la tio n sh ip , you a n d yo u r clic n t le a rn a b o u t h e r as you speak. F ro m y o u r re sp o n ses to her, she learn s im p o rta n t th in g s a b o u t you; a n d you are b o th co n stan tly gain in g new know ledge a b o u t how th e re la tio n sh ip w orks for you. T h e re ’s also s o m e th in g a b o u t b e in g re sp o n d e d to , having so m e o n e engage w ith h e r feelings a n d stay w ith h e r process, th a t m akes yo u r c lie n t feel w o rth w h ile. In m u tu a l re la tio n sh ip s betw een peers, b o th p a rticip a n ts feel like th ey m a tte r m ore in th e w orld w h e n th ey have m attere d to each o th e r in th e ir in te rch a n g e . W h e n th era p y w orks well, y o u ’ll feel th a t yo u r presence th e re has b e e n im p o rta n t. W h a t m atters m o re in therapy, o f co u rse, is th a t y o u r c lie n t’s sense o f w o rth in e ss increases as she feels yo u r h o n e st a n d in te rested e n g ag e m e n t w ith her. A n d finally, th ese “g o o d s” o f zest, e m p o w erm en t, know ledge, a n d w o rth stir w ith in b o th o f you a desire fo r m o re c o n n e c tio n . Y our c lie n t’s re la tio n a l life im proves as she acts o n th is desire w ith you, w ith h e r p a rt­ n e r in a n in tim a te re la tio n sh ip , w ith frien d s, a n d even w ith p e o p le be­

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yond h e r circle o f close co n n ec tio n . All o f these positive outcom es o f therapy flow from w hat goes o n betw een you a n d your client. N o n e o f these “g oods” can be abstracted from th e relatio n sh ip a n d tu rn e d into purely personal gains. T hey exist for your clien t because she is a self-inrelation a n d w hile she is a self-in-relation. It’s interesting th a t a lth o u g h interpersonalist, dialectical, a n d fem i­ n ist versions o f relational therapy differ in th e ir expressions o f philoso­ phy, politics, a n d ethics, they agree o n this po in t: T h e well-being o r th e “goods” th a t therapy produces are prim arily self-w ith-other p h e n o m e n a, even th o u g h they em erge in th e context o f a th erap y th a t is clearly for the client.

W H A T IF Y O U R CL IE N T FALLS IN LOVE W IT H YOU (O R YOU FALL IN LOVE W IT H Y O U R CLIENT)? As you read a b o u t all these benefits o f in tim ate c o n n ec tio n in therapy, th e th o u g h t m ight cross your m ind: D o n ’t these positive feelings in an intense in te rp erso n al rela tio n sh ip increase th e chances th a t som e kind o f falling in love m ight h a p p en here? I know o f n o studies th a t address this questio n , b u t th e answ er to it may well be yes. Falling in love hap­ pens in all kinds o f therapy, a n d maybe it h appens especially in relational therapy, w here a client learns to brin g herself m ore fully a n d deeply into c o n n ec tio n th a n she ever has d o n e before. As you listen to her, you are consistently w arm , attentive, a n d responsive. She shares th e longings o f h er h e a rt a n d th e troubles o f h e r soul w ith you, a n d you are th ere for h er w eek a fter week. In this situ atio n , a c ertain k in d o f falling in love is alm ost inevitable—she will develop a heig h ten ed awareness o f your ways o f being a n d speaking, intense feelings o f various kinds w hen th e two o f you arc together, a n d m any th o u g h ts a n d fantasies a b o u t you w hen you’re apart. Som e o f those feelings, thoughts, a n d fantasies may be sexual. T h a t’s n atu ral, too. As we know from o u r everyday a d u lt lives, it’s n a tu ra l th a t feelings o f em o tio n al intim acy lead to desires for physical a n d sexual intim acy. W e also know th a t having th o se feelings a n d acting o n th em are tw o very differen t things. So it is in therapy. B ut th ere are som e special consider­ ations a ro u n d th e issue o f falling in love in therapy. First o f all, alth o u g h a clien t’s loving a n d sexual feelings are fine a n d o ften helpful in therapy, u n d e r n o co n d itio n s is it fine o r helpful for you to resp o n d to those feelings w ith a ro m an tic o r sexual interest o f your ow n. It may be th e case

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th a t you feel loving and sexual toward her, b u t if you act on those feel­ ings, you are taking advantage o f your client’s vulnerability in the rela­ tionship—a clear breach o f your ethical responsibility to her. So says every code o f professional ethics for psychotherapists. T h at being said, let’s return to how it m ight be helpful for your client to fall in love w ith you, and to how you m ight m anage th a t situa­ tion in her best interests (w hether o r n o t your own feelings are involved). Falling in love is just one m ore variety o f the kinds o f intensity th a t make relational therapy work. It can be described as a particular kind o f trans­ ference, often called “erotic transference.” Like the o th er varieties o f trans­ ference we’ve talked about, it has a negative, repetitive dim ension, w hich m ight be your client’s fear th a t her love will be coldly rejected or, on the o th er hand, th at her love will be snatched greedily and th e n twisted to abuse her. In the positive, helpful dim ension o f erotic transference, her experience o f having her love treated respectfully can lead to new depths o f self-respect and stronger capacities for safe, m utual connections w ith others. So a lthough falling in love is n o t to be acted o u t in therapy, if it happens, it’s best for your client n o t to hide it from you. All the thoughts and feelings your client has about her relationship w ith you are im por­ tant, and her loving and sexual feelings are certainly no exception. It’s your responsibility n o t to becom e entangled, eith er positively or nega­ tively, in h er feelings, b u t to listen to them carefully in order to un d er­ stand h e r world and her feelings m ore fully and deeply. In short, it’s your job to receive her loving feelings, and all the conflicts aro u n d them , w ith the sam e em pathy you bring to anything else she talks about. So if your clicnt falls in love w ith you and is terribly anxious and asham ed about th e situation, you can reassure her th a t this is a natural th in g to happen, quite com m on in therapy, and therefore n o th in g to be asham ed of. A nd th en you will help her find ways to talk about her feel­ ings w ith you. T h a t’s how you can help her tu rn her feelings o f love and attraction into som ething positive for her grow th beyond therapy and her relationship w ith you. If she takes th e risk o f talking about her feel­ ings, she (and you) will probably be surprised how easy it tu rn s o u t to be, and how simply okay it is to let these feelings be p art o f w ho she is right now in this relationship. (Please note: if you find yourself having strong, persistent rom antic and erotic fantasies about a client, w hether o r n o t the clicnt has expressed loving and sexual feelings toward you, you m ust get yourself to a supervi­ sor you trust, and try to u n d erstan d the m eaning o f your feelings—n o t

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only in th e context o f th e therapy, b u t also in th e context o f your own personal life. As a relational therapist, you will have b een train ed to e n te r in to em otio n al intim acy th a t you d o n ’t m istake for falling in love. If you’re m aking th a t m istake now a n d feeling th e pull to cross a professional e th i­ cal b oundary, chances are th a t so m eth in g is w rong o r m issing in your personal in tim ate relationships.)

W H A T A B O U T DEPENDENCY? T h e good feelings o f therapy can also give rise to a n o th e r k in d o f fear, fear o f dependency. W e ’ve com e up against realistic, a u th e n tic form s o f this fear elsew here in this book. C lien ts w ho were never able to c o u n t on th e ir paren ts to su p p o rt th em , for exam ple, will fear sta rtin g to c o u n t o n you, because they expect th a t you will only d isa p p o in t th em in th e end. As we’ve seen, these repetitive fears n eed to be treated w ith repetitive, gentle u n d e rstan d in g . B ut th e re ’s a n o th e r kind o f “fear o f d e p en d e n cy ” I’d like to address now, a n d it’s n o t really a fear, it’s a judgm ent. S om etim es clients are advised by w ell-m eaning friends a n d loved ones n o t to rely to o m u ch o n a th era p ist for com fort, su p p o rt, advice, a n d help in daily living. Such reliance, they’re told, will n o t d im in ish w ith tim e. It’s a d ep en d en cy trap in d u ced by th erap ists to line th e ir pock­ ets o r feed th e ir egos. Sadly, as in any profession, th ere are som e therapists w ho are poorly trained, less th an com petent, o r even unscrupulous, and som e o f th e m d o m an ip u late th e ir clients in to long-term d e p e n d e n t relation­ ships. B ut people w ho are deeply suspicious o f depen d en cy d o n ’t usually d iscrim inate betw een good a n d p o o r therapy. To th em , it’s all suspect. B eh in d such suspicions sta n d c ertain cultural assum ptions: d e p en ­ dence is th e o pposite o f in d ep en d en ce; in op tim al d evelopm ent, one grows o u t o f depen d en cy a n d in to autonom y; d ependency o n o th ers is a less healthy situ a tio n th a n a u to n o m o u s in d ep e n d en c e from others. All o f th e relational therapies we’ve looked at take issue w ith th o se assum p­ tions. T h e core project o f th e S tone C e n te r theorists is to tu rn these assum ptions upside-dow n. T hey argue th a t d ep en d e n ce is n o t th e o p p o ­ site o f in d ep en d en ce, for th e two kinds o f being-w ith are com pletely en ­ tw ined in social relationships. Being able to c o u n t o n o th ers is w h a t gives any on e o f us self-confidence a n d th e pow er to move forw ard. W ish in g o r p re te n d in g to grow o u t o f th e h u m a n c o n d itio n o f in terdependency, like denying o n e ’s ow n vulnerability a n d em otions, is a recipe for relational a n d psychological disaster.21

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T h e S tone C e n te r m odels healthy dev elo p m en t o n healthy m o th e rd a u g h te r re lationships in w hich a daughter, u n d e r less social pressure th a n h er b ro th e r to becom e “a u to n o m o u sly ” separate from th e ir parents, differentiates w ithin th e rela tio n sh ip w ith h er m o th er. As b o th she and h er m o th e r develop a n d c o n tin u e to a d ap t to develo p m en t in th e other, th e ir relatio n sh ip offers m ore com plexity, fluidity, a n d choices to b o th o f th em . As they take th e risks o f expressing a full range o f feeling w ith each o th e r and negotiate changes in w hat they each w a n t from th e relation­ ship, b o th m o th e r a n d d a u g h te r feel m ore em otionally “real,” vital, and p u rp o sefu l in re lationship. T his au thenticity-in-relationship is th e c o u n ­ te rp a rt o f th e ir differentiation-in-relationship, a n d b o th o f these kinds o f c o n n ec tio n belong to a vision o f m aturity for b o th m en a n d w om en th a t has n o th in g to d o w ith an isolated, freestanding auto n o m y .22 A n d finally, th e S tone C e n te r says, d ep en d en cy o n o th e rs isn’t u n ­ healthy; it’s just a fact o f interp erso n al life th a t som etim es you have to c o u n t o n o th ers to help you cope w ith things you d o n ’t have th e experi­ ence, tim e, o r skill to m anage as well for yourself. O th e r tim es you are th e lender o f help, expertise, a n d su p p o rt. T h e “h e lp in g ” them es and m o­ m ents o f re lationships becom e u n h e alth y only w hen o n e person needs to keep a n o th e r person subservient o r powerless in th e re lationship. O th e r­ wise, depen d en cy is n o rm al a n d grow th p ro m oting. In Stiver’s words, depen d en cy allows you to experience yourself “as being enhanced and em­ powered through the very process o f counting on others for help.”2}

T h e S tone C e n te r theorists w ould tell your client th a t it’s n o t just all right for h er to c o u n t o n you for your responsive u n d e rstan d in g , it’s th e only way to grow. E m otional self-differentiation a n d self-authenticity sim ply d o n ’t h a p p en o u tsid e o f th is kind o f em p ath ic co n n ec tio n . Self psychology, too, refuses to see n o rm al psychological developm ent as move­ m e n t from d ep en d e n ce to autonom y. T h a t m ovem ent, says K ohut, is im possible. Instead, healthy grow th a n d developm ent is a story o f changes in th e relationships betw een yourself an d th e o th ers you have relied on, a n d c o n tin u e to rely o n , in your life.24 T h u s, in b o th o f these develop­ m en tal m odels o f relational therapy, as you get stronger (in relatio n sh ip o r in your self), you c o n tin u e to need others, b u t you need th em in differ­ e n t ways. You find new ways—outsid e o f therapy, to o —to e n te r a n d to enjoy cm pathic, enlivening, m u tu a l relationships. W h e n a relational therapy em phasizes self-/or-other, “w h a t’s w rong” has to d o w ith failures in a c lie n t’s e n v iro n m en t, a n d as his th era p ist you provide a healthy relational e n v iro n m en t th a t can alter his w hole experi­ ence o f re lationship, self, a n d life. It can take som e tim e for th is stre n g th ­

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ening o f his self (-in-relation) to take root and grow. But he is steadily growing n o t o u t o f dependency, b u t into m odes o f dependency th a t are m ore and m ore reciprocal and fluid, m ore em pow ering and useful to him in his life. He is slowly m aking his peace w ith how m uch he needs to depend on others for his everyday happiness and success. W h en this gets settled, he’ll be able to recognize how m uch he has to offer, too, in healthy in terd ep en d en t relationships. W h en relational therapy emphasizes self-unth-other, it seems at first glance less vulnerable to a dependency critique. In this m ode, the thera­ pist is less a provider o f good experience th a n a p a rtn e r in a challenging project. But the client can still becom e deeply em broiled in this powerful relationship th at brings to life his m ost painful ways o f being in the world. Som ething looks like dependency after all, b u t it’s his deep investm ent in th e project and the tim e it takes for the two o f you to w ork yourselves into a better way o f being together. T herapy has to be long enough and intense enough to get through to his repetitive destructive ways o f being. In such therapy, he gets caught in relational impossibilities—b u t he starts to see th em for w hat they are. Each “aha!” makes a crack in the rigidity o f his repetitions, and it sets som e im agination loose in the relationship. A lthough a client may com e to co u n t on this relationship for an intense kind o f engagem ent he’s know n now here else, the word for this intense, shared adventure o f discovery is hardly “dependency”! All the different versions o f relational psychotherapy we’ve looked at offer clients double protection against being draw n into a kind o f de­ pendency th a t w ould belittle o r control them . First, each o f these thera­ pies acknow ledges u p fro n t th a t th is k in d o t th era p y is all a b o u t relationship. W h en you agree to engage in a therapeutic relationship w ith a client, you are fully aware o f the power she is choosing to invest in you and o f the responsibilities th a t go along w ith th a t power. Her “depen­ dency,” such as it is, is voluntary, and she enters into it for reasons th a t b o th o f you respect. T his project will require th a t you will c ontinue to respect the m any relational powers th a t will be awakened in your work together, and th a t you find ways to keep trusting each o th e r’s good-faith c om m itm ent to the work. T his is the relational fram e or structure o f the w ork you hope to do, and it is your client’s first protection against u n ­ healthy dependency in therapy. T h ere’s a second protection against discm pow ering dependency in relational therapy, and it happens th ro u g h o u t the therapy process: rela­ tional therapies p u t the dynamics o f the therapy relationship o n the table and keep th em there. T he client is always encouraged to talk a bout w hat­

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ever she feels is going o n betw een herself and her therapist. T here are no strings attached to th a t encouragem ent, n o unspoken b u t p articular rules a bout w hat she m ust say in order to keep the relationship safe and her therapist happy w ith her. Since th ere ’s noth in g about the therapeutic relationship th a t can’t be noticed and questioned, if your client is feeling at all trapped o r belittled or d e p en d e n t—th a t’s exactly w hat she needs to talk about! As her therapist, you can prim e the pum p for such talking and you can respond to it receptively. T h e n your client can find her way back to active p artnership in everything th a t’s going on.

“I ALMOST SMILED AT YOU TODAY!” (A STORY A BO U T ORDINARY G OODNESS) To end this chapter on w hat ordinary goodness in therapy can be, I’d like to tell a story about a surprising little “good” th a t sneaked up on a client o f m ine. T ho u g h apparently small, this m o m en t o f (almost?) well-being tu rn s o u t to illustrate alm ost every account o f well-being th at, in this chapter, we’ve seen relational therapies p u t forward. “Kim” cam e in one day and sat silently for a few m om ents, as she often did. T hen she said quietly, her eyes on the floor, “I alm ost sm iled at you today w hen I was com ing in the d oor.” I was puzzled, because during the course o f o u r sessions she had sm iled at m e before. Yet w hat she was saying seem ed very im portant. W h a t did it m ean to her? W h a t was going on betw een us th a t she alm ost sm iled at m e (and th en she d id n ’t)? By this tim e, we’d been in therapy together for m ore th a n three years. I th o u g h t she’d tell me all she could ab o u t w hat was happening. She did, and as she did, I also knew enough about her history and o u r history together to have the following ideas about the goodness o r the well-being th a t was em erging here. T h in k in g like a self psychologist, I had learned over the years th at one o f the selfobject experiences Kim needed m ost from m e was evi­ dence th a t I paid very close a tten tio n to her, evidence like responsive facial expressions, u n d e rsta n d in g so u n d s, an d s h o rt sen ten ces th a t sum m ed up w hat I was getting. Any blankness o r extended silence on my p art m eant to her th a t I was disinterested o r n o t even there w ith her. A nd that, in tu rn , m eant to her th a t she was utterly w orthless. However, w hen she could feel my interest, she felt well-being: a sense o f connection w ith h e r in n er thoughts and feelings and a sense o f m attering b o th to me and to herself.

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T h e p a rtic u la r selfobject re la tio n sh ip th a t so far h a d co m e m o st to life betw een us was th e o n e K o h u t w ould have called “alter ego” o r “tw insh ip .” H er ways o f seeking c o n n e c tio n w ith m e asked m e to relate to h e r as a fellow h u m a n being w ith experiences th a t were in som e im p o rta n t ways essentially like hers. S he longed to ex p erien ce h erse lf as “n o rm a l,” as “b elo n g in g ,” a n d less like a n alien o n e a rth . As o u r c o n n e c tio n grew aro u n d various kinds o f alikeness, Kim felt less like an o u tsid er in h er ow n life. It w asn ’t su rp risin g , th e n , th a t sh e co u ld sm ile m o re easily w ith me. B u t K im was telling m e th a t a t stake h ere w asn’t ju st any k in d o f sm iling, it was smiling as she came in the door. T h a t m ad e m e th in k in m o re p a rtic u la r ways a b o u t h e r a tta c h m e n t history. I knew th a t she h ad experi­ en c ed b o th o f h e r p a re n ts as d ista n t a n d d isin terested , w h ich ex p lain ed to m e h e r n ee d th a t I be so reassuringly p rese n t. T h ey also n ever sh a re d w h a t w e n t o n inside th e m , w h a t m oved th e m o r m a tte re d to th e m . T h is d ep riv ed K im o f experiences o f b ein g like th e m in im p o rta n t ways, o f b elo n g in g to th e sam e social a n d e m o tio n a l w orld th ey d id , a n d it also g en e rate d th e in te n sity o f h e r search for m e an in g fu l likeness w ith me. B u t w h a t in h e r h isto ry m ad e it d an g e ro u s to sm ile as sh e cam e in th e door? In Bow lby’s term s, h e r w o rking m o d e l o f a tta c h m e n t was in secu re a n d av o id an t. S he h ad ex p e rien c ed n o t o nly d e ta c h m e n t fro m b o th p ar­ ents, b u t also rejectio n s an d rebuffs o f h e r advances. As sh e m u sed o n this, she said, “W ell, my d ad h a d th o se p a ra n o id te n d en c ies, so fro m h im it was like, ‘W h a t d o you w a n t from me?’ A n d my m o m was so self-con­ scious, it was like w an tin g to k now h e r was ju st go in g to expose h e r so m e­ how. My w a n tin g to c o n n e c t ju st scared th e m b o th , I guess. It still do cs!” A n insecu re av o id an t p a tte rn was clear in stories K im to ld a b o u t everyday events th a t tro u b le d her: how sh e ’d so m etim es cross th e street n o t to have to say “H i” to a colleague; h ow th e m o re sh e liked a n d ad ­ m ired c e rta in peo p le, th e m o re sh e avoided th e m , for it b ecam e im p o s­ sible to im agine m ak in g c o n ta c t th a t w o u ld feel g o o d to her, n o t sh am in g . W ith m e sh e was always p le a sa n t a n d respectful, a n d social sm ilin g was p a rt o f th a t package. B u t I also felt th a t she h eld back, ex p ectin g very little in re tu rn , fearing to offer to o m u c h o r to w a n t to o m u ch . In th is co n tex t, I could u n d e rs ta n d th a t sm ilin g a t m e to g reet m e w o u ld b e a n e n o rm o u s risk to take. As K im explain ed , “T h e n it w o u ld be ju st m e in y our face, saying, ‘H ere I am! S m ile back! O r something!’ It seem s like way to o m u c h to ask. I’ll be in tro u b le for su re.” T h e tro u b le she an ticip ate d , I th o u g h t, w o u ld be th a t stin g o f an a lo o f reb u ff, a n o n ­ resp o n se, a n d th e sickening slide in to sh a m e th a t w o u ld follow, a se­

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q u e n c e sh e k n e w w ell in h e r b o n e s, if n o t in h e r c o n sc io u s m in d . B u t o n th e o th e r h a n d , a fte r m o re th a n th re e years o f m y c o n s is te n t, a tte n tiv e re sp o n siv e n ess, s o m e th in g w as g e ttin g th ro u g h to t h a t in se c u re , a v o id a n t w o rk in g m o d e l o f a tta c h m e n t. S h e ’d h a d th e im pulse to sm ile. S h e w as te llin g m e a b o u t it! S h e w as th in k in g a b o u t it fro m every angle. In te rm s o f S te r n ’s d o m a in o f c o re re la te d n e ss, K im n e e d e d to fin d o u t w h e th e r I w o u ld m a tc h m y e n erg y to h e rs, o r w h e th e r p re o c c u p a tio n w ith m y o w n n e e d s o r m y o w n d e p re ss io n w o u ld leave h e r s tra n d e d w ith h e r “u p ,” in te ra c tiv e striv in g s, a n d t h e n d iso rg a n iz ed a n d a lo n e w ith a struggle to re g ain h e r e q u ilib riu m . In th e d o m a in o f in te rsu b je c tiv e re la t­ ed ness, th e q u e s tio n w o u ld b e m o re a b o u t w h e th e r w e c o u ld sh a re th e feelings a n d m e a n in g s o f o u r in n e r w orlds. W o u ld sh e see in m y eyes a n d in m y face p le a su re a b o u t o u r c o n n e c tio n , a n tic ip a tio n o f ta k in g it furth e r a n d d e e p e r in to k n o w in g e ac h o th e r? O r w o u ld s h e see “Stay away fro m m e!”—h e r f a th e r ’s p a r a n o id fear o f b e in g ta k e n o ver a n d u se d o r h e r m o th e r ’s fear o f exposure? “I a lm o s t sm ile d a t y o u today!” w as a m o m e n t fu ll o f g o o d n e ss be­ c au se n e w R IG s, n e w se q u e n c e s o f in te ra c tio n s a n d p o ssib le in te ra c tio n s , w ere jo stlin g fo r space w ith th o s e o ld R IG s. O u r in te rac tiv e c o re relatedn ess m ig h t have a lre ad y h e lp e d K im e x p e rie n c e a se lf o f m o re lively, b a l­ a n c e d p re se n c e a n d energy; o u r in te rsu b je c tiv e re la te d n e ss m ig h t have h e lp e d K im e x p e rie n c e th e v a lu e o f h e r in n e r w o rld a n d th e g o o d n e ss o f h e r u n iq u e th o u g h ts a n d feelings. F u rth e rm o re , th is u n s e ttlin g pro cess o f R IG s jo stlin g fo r space w as b e c o m in g a sto ry th a t h e lp e d K im re fle c t deep ly a b o u t th e p a tte rn s a n d m e a n in g s o f h e r everyday c x p cricn c e . In K im ’s m o m e n t o f a lm o st sm ilin g , a tta c h m e n t- a f f ilia tio n w as th e m o tiv a tio n a l system m o st actively in o p e ra tio n . D e sp ite th e re b u ffs sh e s u ffe re d as a c h ild , h e r p a re n ts m u s t have p ro v id e d e n o u g h affective re­ sp o n s e to h e r early n e e d s fo r clo sen ess to a ctiv ate t h a t system w ell. T h e g o o d new s is t h a t h e r u rge to sm ile a n d m ak e frie n d ly c o n ta c t h a s su r­ vived, in sp ite o f th e forces t h a t re gularly sq u e lc h th e urge. A s sh e c am e th r o u g h m y d o o r, w h a te v e r h a p p e n e d —s o m e th in g sh e saw in m y face o r m a n n e r c o m b in e d w ith o th e r m o d e l scen es o f re je c tio n —a ctiv ated a sec­ o n d a ry m o tiv a tio n a l system , a v ersio n . T o p ro te c t h e rs e lf fro m r e b u ff a n d sh a m e , sh e w ith d re w fro m th e so u rc e o f th re a t. T h e a b ility to self-p ro tect is also g o o d . B u t th e “h ig h e r,” th e r a p e u tic g o o d a b o u t all o f th is , a c c o rd ­ in g to a m o tiv a tio n a l system s v e rsio n o f th era p y , is K im ’s n e w a b ility to n o tic e it all, ta lk a b o u t it, a n d th u s m ove b e y o n d u n c o n s c io u s , d e s tru c ­ tive re p e titio n s o f w h a t’s h a rm fu l to h e r in th e p re se n t. T h e m o m e n t o f a lm o st sm ilin g w as a “n o w m o m e n t” b e tw e e n us,

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a n d in th is instance it was Kim w ho began to tu rn it in to a m o m e n t o f m eeting by telling m e a b o u t it. As we sh ared together th e m eanings and feelings o f an alm ost-sm ile betw een us, so m e th in g shifted in how we each knew each o ther, a n d we could h ope th a t K im ’s sense o f th e possibilities o f relatio n sh ip , h er “im plicit relational know ing,” m ight have been d eep­ ened a n d e xpanded th ro u g h th a t m eeting. So far all o f o u r descriptions a n d explanations o f th e goodness in­ h e re n t in K im ’s “I alm ost sm iled at you today!” are goods th a t accrue to Kim: stronger, m ore cohesive self-structure, a b etter w orking m odel o f a tta ch m en t, R IG s th a t b e tte r su p p o rt K im ’s e q u ilib riu m a n d vitality, th e retooling o f aspects o f h e r m otivational systems, th e expansion o f h er im plicit relational know ledge, and, th ro u g h all o f this, new capacitics to reflect o n how h e r self-w ith-other systems w ork for her, reflection th a t stim ulates fu rth e r changes in how th o se systems work. W h a t a b o u t those explanations o f goodness th a t try to keep th e “goo d s” located in th e rela­ tionship? W ell, in S tone C e n te r term s, th ere was “zest” betw een us w hen Kim spoke o f alm ost sm iling. O u r fruitful dilem m as—W h a t am I d o in g to in h ib it h e r smiling? W ill she be able to smile? H ow will I respond? W h a t will we d o then?—exist in th e form o f reciprocal actions we each desire and fear. As we w ork o u r way th ro u g h th e m eanings o f o u r dilem m as, th e re ’s lots o f new know ledge to be had; as we b e tte r u n d e rsta n d each o th e r a n d ourselves in relation, we feel m ore secure a n d w orthy; a n d we find ourselves w an tin g to pu rsu e this, w anting m ore m u tu a l a u th en ticity a n d m eaningful c o n n ec tio n . O u r relatio n sh ip has grow n to this p oint; th e m utuality o f o u r cxpcricncc has d eep e n ed w ith th e therapy, a n d as it c o n tin u e s to d eepen, wc can cxpcct m ore well-being w ith in th e re la tio n ­ ship. From a m ore in te rp erso n alist perspective, “I alm ost sm iled at you!” was a flash o f im agination, a th o u g h t u n th in k a b le before, som eth in g new betw een Kim a n d m yself after a long tim e o f th e sam e old th in g going on betw een us. W e may never know how o u r w ork together re­ leased th a t im pulse in to K im ’s awareness, b u t now th a t it’s betw een us, m any “sm all” things are changing. Now, instead o f just being sure th a t h er advances will be trouble, Kim w onders, “W h a t if my sm iling at you m eans so m eth in g else to you, so m e th in g I’d never expect, so m eth in g I d o n ’t even know about?” Possibilities expand, w ith new fears a n d new excitem ent, for b o th o f us. I w onder, “W ill she ever actually sm ile at me? O r is talking a b o u t it ‘sm iling’ enough? W h a t w ould it be like to feel h er sm ile a n d respond to it? W h ere m ight wc go th en ? ”

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Kim says, “My sm ilin g a t frie n d s feels d iffe re n t now. It m ean s differe n t.” S h e d o e sn ’t kn o w w h a t it m eans, exactly. S he d o e s n ’t k n o w w here th is “sm ilin g ” (m ore reach in g o u t to o th e rs w ith m o re e x p ec ta tio n o f frien d ly response) will take h e r in th e w orld. W e d o n ’t kn o w w h ere re c ip ­ rocal sm ilin g m ig h t take us. In a sense, we h a v en ’t even d o n e it yet! B ut we can feel betw een us th e sa tisfac tio n o f so m e th in g o ld a n d stu ck giving way to so m e th in g m u c h m o re w arm , alive, a n d m oving even w h e n we ju st talk a b o u t w h a t sm ilin g (a n d n o t sm iling) m eans. M a k in g th is m ea n in g to g eth e r feels g o o d . “W e-ness” feels stu rd ier; giving a n d receiving w orks b etter; m u tu a l e n jo y m e n t a n d m u tu a l v u ln era b ility have b eco m e m o re possible b e tw ee n us. D ocs th is gro w th in th e re la tio n s h ip , o r th is in te n se m u tu a lity o f th e re la tio n sh ip , m ea n th a t K im is d e p e n d e n t o n m e in a n u n h e a lth y way? T h e sam e day th a t Kim to ld m e, “ I a lm o st sm iled at y o u ,” she said late r in th e h o u r, “I b u m p e d in to a frie n d o n th e street. I saw h e r c o m in g a n d I d id n ’t d u c k away. In stead I said, ‘H i, D o n n a ! H ow arc you?’ I said h e r n am e; I spoke first, w ith enthusiasm! I felt like I m e a n t it. It felt g o o d .” In th e follow ing session, as we k e p t talk in g a b o u t th e m ean in g s o f sm il­ ing a g reeting, Kim listed all th e ways sh e h a d b e en p u ttin g h e rself for­ w ard a b it m o re in h e r life. “I t’s all a b o u t e x p ectin g th a t w h e n I p u t m yself o u t th ere , s o rt o f in th e ir faces, th ey w o n ’t fin d m e a b o th e r o r a b u rd e n ,” she ex p lain ed . “It’s fin d in g o u t I’m n o t a b o th e r o r a b u rd e n ; I can be enjoyed.” A n d th e n sh e g o t scared. “B u t I’m n o t sure a b o u t th a t. W h a t if I’m wrong? T h a t’s th e risk I take if I sm ile a t you. So I d o n ’t. N o t yet.” I believe th a t if K im w ere d e p e n d e n t o n m e in a n u n h e a lth y way, th e su p p o rtiv e aspcct o f o u r re la tio n s h ip w o u ld n ’t h e lp h e r e x p a n d h e r stre n g th , in te rp e rs o n a l security, vitality, a n d sense o f self-w orth in c o n ­ n e c tio n w ith o th e rs. “S u p p o rt” w o u ld keep h e r w eak, scared, a n d sm all. B ut th a t’s n o t w h a t’s h a p p en in g . Instead, Kim fin d s h e rse lf try in g o u t new ways o f b e in g in th e w orld at th e very sam e tim e th a t s h e ’s try in g th e m o u t w ith m e. In a situ a tio n o f u n h e a lth y d ep en d e n cy , K im a n d I w o u ld d u c k away fro m challenging, d istu rb in g q u e stio n s a b o u t w h a t’s g o in g o n betw een us in o rd e r to h o ld o n to a relatively c o m fo rtab le , re­ petitive sta tu s q u o . How ever, t h a t’s n o t w h a t w e’re d o in g . In stead , even now , we kn o w b e tte r th a n to im pose nice “c lo su re ” o n th is alm ost-sm il­ ing e pisode. W h a t wc get o u t o f th is d o e sn ’t d e p e n d o n w h e th e r wc sm ile at each o th e r exactly “rig h t” in th e e n d . W h a t m atters is th e change th a t gets p u t in m o tio n w h e n wc stay tru e to th e q u e stio n , “W h a t’s g oing o n b etw een us?” U n lik e th e elosed lo o p o f d ead -e n d d ep en d e n cy , th is k in d

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o f th e ra p e u tic re la tio n sh ip sets in m o tio n in te ra c tio n s th a t m ove outw ard, o p e n in g u p re la tio n sh ip s a n d th e selves w h o live th e m . It asks q u es­ tio n s th a t d o n ’t have endings. T h erap ies, how ever, d o have en d in g s. A n d bey o n d th e en d in g s w aits th e final p ro o f o f th is “g o o d n ess” p u d d in g : D oes th e w ell-being last w h en th e th e ra p y is over? T h a t’s a q u e s tio n for th e n ex t (an d last) c h a p te r o f th is b o o k .

EN DNO TES 1. 2. 3. 4. 5. 6. 7. 8.

9.

10. 11.

12.

13.

14. 15. 16. 17.

Stolorow and Atwood, Contexts o f Being, 82-83. Stolorow and Atwood, Contexts o f Being, 34. Bacal, Ed., O ptim al Responsiveness. How ard Bacal and K enneth Newm an, Theories of Object Relations: Bridges to Sel/ Psy­ chology (New York: C olum bia University Press, 1990), 229. Kohut, How Does Analysis Cure?, 192-194. Wolf, Treating the Self, 124-126. Stolorow and Atwood, Contexts o f Being, 34-35. Mary A insw orth, Patterns o f A ttach m en t: A Psychological Study o f the Strange Situation (Hillsdale, NJ: Lawrence Erlbaum Associates, 1978), and John Bowlby, A Secure Base: Parent-Child Attachm ent and Healthy H um an Development (New York: Basic Books, 1988), especially Lecture 7, “T he Role o f A ttachm ent in Personality D evelopm ent,” 119-136. T hese four dom ains o f relatedness and th eir connection to clinical issues are sum ­ marized in Stern’s The Interpersonal World of the Infant, C hapter 9, “T he ‘O bserved In fan t’ as Seen w ith a C linical Eye,” 185-230. Lichtenberg, Psychoanalysis and Motivation. Lichtenberg, Lachm ann, and Fosshage, Self and M otivational Systems. In this sequel to Lichtenberg’s earlier work, the authors develop a m ode o f therapeutic work th at is based on working w ith m odel scenes th a t have been developed around certain patterns of needs and responses w ithin certain m otivational systems. T he Boston G roup (Nadia Bruschweiler-Stern, Alexandra M. H arrison, Karlen LyonsR uth, Alexander C. M organ, Jeremy P. N ahum , Louis Sander, Daniel Stern, and Edward Z. Tronick) presented a first ed ition o f their study-in-process to a conference in Finland in 1996. T hose papers arc collected in a special issue o f th e Infant Mental Health Journal, 19(3), 1998. See Stephen Mitchell, Relational Concepts in Psychoanalysis: An Integration (Cambridge, MA: Harvard University Press, 1988), C hapter 5, “T he M etaphor o f the Baby,” 127— 172. A ron, A Meeting o f Minds, 262-263. Stephen Mitchell, Hope and Dread in Psychoanalysis (New York: Basic Books, 1993), 37. Mitchell, Hope and Dread, 222-224. A ron, A Meeting of Minds, 150-154.

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18. Jessica Benjam in, The Bonds of Love and Like Subjects, Love Objects, especially “Recog­ nition and D estruction: An O utlin e o f Intersubjectivity,” 27-48. 19. M iller and Stiver, The Healing Connection, 121-147. 20. Ju d ith Jordan, “T he M eaning o f M utuality," in Ju d ith Jordan et al., Women's Growth in Connection, 95. 21. Sec Irene Stiver, “T he M eanings o f D ependency in Fem ale-M ale R elationships,” in Jordan et al., Women’s Growth in Connection, 143-161. 22. Janet Surrey, “T he Self-in-Relation: A T heory o f W om en’s D evelopm ent,” in Jor­ dan et al., Women’s Growth in Connection, 59-61. 23. Stiver, “T he M eanings o f Dependency,” 160, italics in text. 24. K ohut, How Does Analysis Cure ?, 52, 208.

7 ENDING AND GOING ON

W h en a person is ab o u t to end som ething th a t’s been im p o rtan t to her— som e schooling, a long road trip, a job she’s loved and hated, a difficult relationship, a therapy—before she goes o n to oth er things, it’s im p o rtan t th a t she looks back over the terrain she’s traversed in order to fix in her m ind a sense o f the whole experience. W h ere has she been? W h a t has it m eant? W h at has she accomplished? W e could undertake th a t same sort o f review as we approach the end o f these chapters about relational therapy. T hey’ve been structured along th e lines o f how a therapy m ight develop. Wc began w here every­ body begins therapy: w ondering w hether a particular kind o f therapy, in this case, relational therapy, m ight be helpful. I laid o u t a brief, sim ple answer to the question, “W h at does relational therapy have to offer?” T he answer held w ithin it hints o f m uch m ore to be said, along w ith the suggestion th a t the experience o f relational therapy can’t ever be cap­ tured entirely in words. But before moving into exploring the experience o f relational therapy, I explained w here this therapy fits am ong o th er therapies. To clarify w hat I m eant by a therapy th a t’s all about “self-with-other in action,” I talked a bout w hat relational therapy isn’t: it’s n o t a m edical m odel o f therapy, n o t a rationalistic o r an individualistic m odel. In those term s, I devel­ oped contrasts betw een o th er therapies and relational therapy th a t would b ring the relational m odel into sharper focus. T h en I introduced several relational schools o f therapy, schools th a t w ould give me concepts and words for all my fu rth er forays into describing th e experience o f rela­ tional therapy. 1 noted differences between these schools, b u t I tried to

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draw th em together into a com prehensive picture o f w hat’s unique about the philosophy and practice o f relational psychotherapy. A nd th en , as is the case in any therapy, it was tim e to step into the experience, beginning w ith the m om ent the client contacts you by phone. I talked about w hat makes th e start-up o f therapy feel as safe and com ­ fortable as possible for your clients: clarity ab o u t the boundaries, the ethical principles, and the m utual expectations o f doing this kind o f work. B ut the am bience and soul o f relational w ork is empathy, I said, as I tried to p u t words to its com plex and subtle workings. W h at helps your clients m ost is th eir experience o f your em pathy—and how th a t experience can develop into their feeling know n, accom panied, and cared for. I suggested th at this change, this m ovem ent from aloncncss to conncction, can have a powerful im pact o n many kinds o f psychological suffering, and th at therefore relational “em pathy w ork” can move com petently across a wide range o f pain and trouble. W h a t is the trouble for your clients? All they know is th a t they feel bad. W here does their “feeling b a d ” com e from? I said th a t it’s n o t likely to be com ing from som ething simply outside o f them , n o r from som e­ th in g simply inside them , b u t th a t it probably comes from th a t place th at produces all th eir feelings and self-images, th a t b o u n d ary place where from -the-outside in p u t and from -the-inside organizing patterns com e to­ gether to create m eaning. D ifferent relational theories describe this place o f m aking self-with-other m eanings and w hat goes w rong for your clients there. Each theoretical system accounts for how th e oppression, discon­ nection, violation, neglect, and m isunderstanding th a t com e at your cli­ ents from the outside seem to take rcsidcncc w ithin them . T his m ovem ent from outside to inside brings up the question of the relationship betw een past and present in your clients’ personal psy­ chology a nd em otional well-being. T he n o tio n o f “psychological trau m a” suggests th a t your clients’ painful histories will keep reverberating w ithin their present-day lives. As I discussed traum a and dissociation, I suggested th a t in relational therapy, you will be especially alert to the relational dim ensions o f the traum a your clients have suffered, ready to rem em ber w ith th em all the m any aspects o f how it was for th em to be w ith the dangerous, frightening, and confusing people they m ight have lived w ith every day, earlier in th eir lives. T he p o in t o f this shared rem em bering is n o t the reconstruction o f history, I said, b u t rath er the gathering up o f a client’s broken, scattered bits o f self so th a t they may be reintegrated, w ith grief and love, into a

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“se lf’ w ho can be here relatively centered and whole. I reiterated th at access to the past is always through the present, and especially th ro u g h “m odel scenes”—dream s, m em ories, and interpersonal sequences th a t all enact th e same group o f self-with-other organizing principles. Relational therapy sees w hat’s often called “transference” as the m ost powerful kind o f m odel scene, I said, and I prom ised to devote an entire chapter to the difficulties o f working th ro u g h negative m odel scenes. A nd th e n w hat happened in o u r conversation m irrored in an u n ­ canny way w hat often happens in this next phase o f therapy: I got stuck. T here was no way o u t except—maybe—to stay honest and keep talking. T h a t’s how it is in these terribly hard parts o f relational therapy, at tim es like this w hen your client feels let down, sham ed, betrayed, and m isun­ derstood by the very therapist she has com c to rely on. W h e n th e doom she expects has befallen her (even w hen she knows it’s an o ld /n e w m odel scene), she truly can n o t see her way back to reconnection and trust. But th e n we saw how such a crisis can be resolved w hen you attend w ith careful, patient, nondefensive und erstan d in g to your client’s tru th , pre­ cisely as th a t tru th is felt and spoken. O u r journey moved o n from crisis to d enouem ent, from the “terri­ bly h a rd ” to th e “w onderfully good” part o f relational therapy, a transi­ tion th at happens m ore easily in a text o n relational therapy th a n it does in therapy itself. But although progress is m ade along circuitous routes and in fits and starts, each impasse broken, each crisis resolved, and each new m utual u n d erstan d in g achieved brings w ith it a quiet kind o f well­ being th a t your clicnt may never have cxpcctcd. T he good feelings sneak up o n her and slowly build into the quite w onderful, everyday goodness o f being able to be here, okay in herself and connected to others. T he rest o f the chapter explored the various ways relational therapies account for this sense o f well-being—from stories o f selfobject needs m et, to sto­ ries o f attachm ent and developm ent patterns reworked, to stories o f imagi­ n ation rekindled, to stories o f “zestful” connection fostered. T h e question came up: “W h a t ab o u t falling in love in relational therapy?” I said th a t for a client, falling in love w ith you sh o u ld n ’t be considered a problem ; in fact, exploring her experience o f loving and of having th a t love simply received could be very im p o rta n t to her healing and grow th. O n the o th er hand, I advised, if you notice any inclinations in yourself to cross a boundary o f professional ethics w ith a clicnt, run, d o n ’t walk, to your nearest supervisor and find o u t w hat’s going o n w ith you.

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T he next q uestion was: “C o u ld all this goodness be just th e product o f unhealthy dependency?” I answered: “N o.” D ependency is n o t by defi­ n ition unhealthy; a truly unhealthy dependency can’t produce well-being; and relational therapies, w ith th eir constant honest scrutiny o f w hat goes on in the therapy relationship, have strong built-in protections against the misuse o f th a t relationship. A nd th e n I ended th a t chapter o n good­ ness w ith a story rem arkable n o t for its massive breakthrough, n or for its grand illum ination, b u t for its sneaky, quiet, unfinished self-with-other goodness: “I alm ost sm iled at you today.” N ow we’ve com e to the last o f these chapters, w hich is about the ending o f therapy. Clearly, this chapter is a phase and a process, too. A nd th a t’s just like the ending o f therapy. You and your clicnt d o n ’t just end therapy one day. You begin to end, and th e n later you finish ending. W h at is it th a t you do d uring all this ending?

LETTING THE STORY TELL ITSELF OUT First o f all you and your client realize th a t the story o f her therapy is approaching its own natural end. Despite th eir different political stances a nd languages, all o f the relational therapies suggest th a t th e therapy story, played o u t w ith m any disguises and reversals, has one basic plot: W h a t’s m aking your client feel bad will move from her life, from her history o f subjugation, disconnection, and violation, from her interper­ sonal conflicts and debilitating symptoms, right into the relationship w ith you, her therapist. T here her story (her self-with-other history) will be transform ed into a new two-person story, structured and powered by all the m ajor rela­ tional them es of her life, b u t played o u t in a different way. T he diffcrcncc is inescapable, for you are a new and different person and no two rela­ tional stories can be the sam e. But the difference is also intentional, and the m ost im p o rtan t intentional difference is th a t bo th you and your cli­ e n t pay careful atten tio n to w hat’s going on. It’s this a tte n tio n th a t makes this story therapy and th a t also makes it a story full o f m eaning, n o t a series o f random , unrelated events. T he story begins to end as the very conflicts th a t have m ade it a coherent and powerful story begin to find resolution. By resolution, I d o n ’t m ean solutions or a cure. 1 m ean the kind o f resolution th a t be­ longs to a story well told: m eaning emerges from chaos. H orrible events, painful recurring them es, lasting damage—none o f this can be erased.

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B ut a tragedy w ell-understood a n d well-told moves us w ith its m eaning. W ith in it, we m atter. A n d w hen we m atter, w hen th ere is m ean in g for us, so m e th in g changes. T h e change may be as h ard to n a m e as w h a t h appens w ith in us as a last series o f chords brings to an e n d th e com plex them es a n d v ariations o f a pow erful piece o f m usic, b u t we know, we feel, th a t all th a t m atters m ost in this story has b een aired, a n d th ere is resolution. It’s n o t easy to e n d w h e n th e re ’s always so m eth in g m ore to ad d , lots o f epilogue m aterial. Yet it’s epilogue to a story you a n d your clien t b o th know now. T h e story you b o th know takes som ew hat d ifferen t form s for d ifferent clients. For on e client, th e story has b een all a b o u t fin d in g som e­ one trustw orthy w ho could help h e r w ith th e delicate gath erin g a n d slow reassem bling o f scattered fragm ents o f herself. T h e story m oved from lonely, b a ttlin g , chaotic pain to m eaningful g rief sh ared w ith som eone w ho w itnessed a n d u n d e rsto o d . In th e caring presence o f an o th e r, she has fo u n d h er ow n presence. T h e w holeness she feels lets you b o th know th a t h er story is w hole now, too, fin ish ed en o u g h so th a t she can move on in to a life th a t belongs to h er a n d in to relationships w here she can know a n d be know n, love a n d be loved. A n o th e r clien t has unpacked m ost o f h e r story by going th ro u g h painful troubles in h e r relatio n sh ip w ith you. H o p in g for goodness w hile dread in g d o o m was a subtle, neverending to rtu re for her. She b o re th e havoc and despair wreaked by your misses and m istakes, som etim es m o u n t­ ing b itte r retaliatory strikes, som etim es h u n k e rin g dow n, waiting for som e­ th in g to set h e r free. Every tim e she was su rp rised th a t your persistent, p a tie n t em pathy could set th e relatio n sh ip free, eventually, a n d w ith ev­ ery release b o th o f you could feel th e story d eepening, m aking m ore pow ­ erful sense. You b o th know th a t this story is com ing to reso lu tio n now because h e r desperate hopes have quieted in to c onfidence th a t you are on h er side even w hen you goof, a n d you n o longer seem to have such deadly pow er to h u rt her. In fact, she says th a t you look a lo t like a n o r­ m al, everyday person to h er now, som eone w ith your ow n troubles, joys, a n d challenges, som eone w hose life she d o e sn ’t know at all, b u t w hose person she know s very well. For you’ve b een th ro u g h th e w ars together a n d com e o u t th e o th e r side. A th ird client has com e to know h e r story th ro u g h fin d in g in you som eone w ho could u n d e rsta n d h e r a n d be th ere w ith h er in sim ple ways she never th o u g h t possible. Your strength su p p o rted her, your sm ile bright­ ened h er accom plishm ents, a n d your everyday h u m an n e ss m ade h e r feel h u m a n too. B ut this new a tta c h m e n t threw in to stark relief th e depriva­ tio n she cam e from . Taking in this goodness m ea n t know ing how b a rre n

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life has b een for h e r a n d grieving th e loss o f w hat she has never had. T h e story o f h e r therapy has becom e th is tapestry o f b rig h t against dark. You a n d she know th a t th e story is e n d in g n o t only because th e tapestry is rich, com plex, a n d com plete, b u t because she know s she can take it hom e w ith her. T h a t is to say, th e m any things you have been for her all belong to h e r now. W h en e v er she w ants to, she can look at th e tapestry you wove together; she can th in k a b o u t it o r w rap it a ro u n d h erself for strength, courage, a n d com fort. A n o th e r c lie n t’s story has b een all a b o u t m oving from a lonely, disem pow ered, disco n n ected place, a p riso n cell o f “safety,” tow ard th e risks a n d rew ards o f co n n ec tio n . C o n n e c tio n w ith your em pathy m ade em o tio n al space for h im to c o n n cc t m ore lovingly w ith h im self a n d it gave h im th e stren g th to seek a n d to fin d em pow ering, enlivening new c o n n ec tio n s w ith o th ers. T h is p lo t w orks to shape a good, stro n g story, too. In fact, all o f these are good plots for tra n sfo rm a tio n a l relational stories, a n d som e clients’ stories borrow so m eth in g from all o f them . As a relational th era p ist you know th a t it really d o e sn ’t m atter how a c lie n t’s story tells itself to you a n d your client. W h a t m atters is th a t you’ve b o th b een paying a tte n tio n , looking for m eaning, a n d you haven’t b een d isa p p o in te d . A story has indeed u n fo ld ed . T h e re ’s a trajectory, a b e g in n in g , m id d le , a n d an e n d . W h e th e r it tells itself in term s o f fragm entated, dissociated experience reintegrated, transferences resolved, deficits filled, o r relational strategies tran sfo rm ed , w hat m atters is th a t your client now has m eanings for w hat was w rong in his life, w ords for how you b o th held th a t w rongness a n d w orked it o u t betw een you, a n d w ords for how it’s n o t so w rong anym ore. Above all, in w hatever way any c lie n t’s story is told, it’s a story th a t could have u n fo ld ed only in this re lationship. W ith nob o d y to live it o u t w ith him , th ere w ould have been n o story at all; a n d th e story has taken this p a rticu la r form because he has lived it o u t w ith you, a u n iq u e, par­ ticular person. T h e m eanings o f his ex ten d ed in te rac tio n w ith you have b een created by two w orlds o f subjectivity, two different, u n iq u e ways o f organizing experience a n d relationship. A n d so your therapy is a first a n d last e d itio n o f this story, a one-of-a-kind creation never to be repli­ cated. T h e shape o f your jo in t story is n o t th e shape o f your client’s “stuff.” It’s th e shape o f how his stu ff m et a n d clashed a n d m elded w ith your stuff, a n d how th e two o f you sorted o u t th e m eanings o f all o f that. As a relational therapist, you b rin g in to every therapy relatio n sh ip n o t only your convictions a b o u t how therapy w orks a n d your capacitics for em pathy, u n d e rstan d in g , a n d insight, b u t also th e strengths, gifts,

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needs, and quirks o f your personality. If this therapy has been m eaning­ ful and powerful for a client, it’s because you have been there w ith him as a person. A nd it is this particular person to w hom your client will now, soon, say good-bye.

SAYING GOOD-BYE Saying good-bye hurts. G rief hurts. B ut to be allowed to say good-bye w ith gratitude and love as well as w ith sadness and loss is a privilege. N ot long ago, thousands o f C anadians lined up for the privilege o f taking a few brief m om ents to stand before the casket of Pierre T rudeau an d say good-bye. M any m ore across the country signed books o f condolences— finding words to express w hat T rudeau m eant to them , paying heartfelt respects, saying m eaningful farewells. T housands o f C anadians wept w ith Justin T rudeau w hen he ended his father’s eulogy w ith th e words, “He has kept his prom ises and earned his sleep. Je t’aime, papa.” A nd som e o f those w ho wept w ent to their therapy later th a t week and w ept again, suddenly and profoundly aware o f th eir longing to be able to say “Je t’aime, papa,” and know ing th a t they w ould never be able to say th a t kind o f good-bye to a parent. D uring th a t week, a colleague and I sat m using about w hat seems to be a powerful hum an longing for a clean, deep, uncom plicated grief for som eone loved and honored. W e d o n ’t w ant to lose such a person; the loss causes us pain. But we need the grief, it seems. W e move toward it. Why? Because feeling grief is a way to make loss m ore th a n just absence and em ptiness; it’s a way to let loss strengthen us. W e grieve in o rder to be able to take the m em ory of a loved one w ith us and to let it keep on teaching us w ho wc arc. We hear o u r clients saying, “I will never be able to grieve my father o r m other like that. W hen they die, I will be grieving for th e relationship I never had, the love I will never share w ith th em .” W h a t are o ur clients telling us? They seem to be saying th a t they, too, need and w ant a clean, deep, rem em bering, strengthening kind o f grief. To be robbed o f such grief is an o th er grievous loss. “Do you think th at w hat we w ant is a grief th a t ends instead o f grief th a t never ends?” my colleague asked. “I m ean, maybe grieving for w hat you never had means th a t the grief can never really en d .” I had been trying to write this chapter, and I disagreed. I said, “I

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th in k th a t w hen you d o n ’t know w hat you’re m issing a n d w h a t’s h u rtin g you, th e n th a t pain never ends. B ut w hen you sta rt to know w h a t it is th a t you never had a n d you’ll never have, th e n it becom es a something. It becom es n o t ju st nam eless pain b u t a something you can truly grieve, and th e n th a t g rief can com e to an en d , som etim e, to o .” I th o u g h t to myself, “Som ew here in this conversation th e re ’s th e essence o f w h a t I th in k it m eans for a client to say good-bye to h e r th era p ist w hen a deep a n d m ean­ ingful therapy is com plete.” I th in k th a t w hen therapy has gone well a n d it’s tim e to finish, saying goodbye will evoke b o th o f th o se kinds o f grief for a client, g rief for w hat she never had, a n d g rief for w hat she’s losing. In this therapy in w hich she has reflected at length o n all th e m ajor relationships a n d them es in h e r life, she already will have grieved for w h a t she never had . T h e nam eless p a in o f w an tin g will have becom e a so m eth in g for her. S he does know w hat she m issed, w hich w ould have rem ained a mystery if she h a d n ’t felt som e o f th a t m issed goodness w ith you, h er therapist. O ver th e course o f th is therapy, you have been th e e m b o d im e n t o f m any differen t aspects o f w h a t she never had a n d w h a t she can ’t go back a n d have now. She has w orked h er way th ro u g h th o se longings a n d losses o n e by one. B ut a final good-bye will stir th o se feelings again, for it m eans sh e ’s giving up th e last vestiges o f h o p e th a t you m ig h t give h e r w hat she needs in o rd e r to change th e story o f h e r life a n d erase h e r pain. Leaving therapy faces h e r once again w ith th e fact th a t h e r ow n story is th e only story sh e ’ll ever have. A lth o u g h she can be grateful th a t this is at least som e­ th in g to grieve now, a n d th a t therefore th e g rief will en d , every tim e she does this k in d o f grieving, it just h u rts. T h e re ’s n o th in g good to carry away from it cxccpt a d eeper know ing th a t she can bear being presen t in h er ow n skin a n d in h e r ow n life. B ut th e re ’s also a second kind o f g rief for your client as she ends therapy, g rief for so m eth in g she has had a n d is losing. If th erap y has gone well a n d it’s tim e to finish, she will be saying good-bye to som eone w ho has becom e a very im p o rta n t p a rt o f her life. Your interest a n d care have b een g enuine. In c ertain ways, you know h er m ore deeply th a n anyone else does, a n d she know s a great deal a b o u t your presence a n d being, too. T h e two o f you have felt m any feelings together, from fear to pain to joy, a n d you’ve w orked h a rd to be h o n e st w ith each o th er. In this relation­ ship sh e ’s learn ed m ore a b o u t herself th a n she ever th o u g h t possible, n o t because you have acted as a teacher, b u t because you have b een w illing to engage a n d resp o n d as a full p a rticip a n t in h er proccss o f self-discovery.

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Now she will be losing contact with you, giving up the regular experience of being together. T hat’s what she’s losing, and it’s something like losing a loved one in whose presence she always felt loved and valued. She will miss your presence. The thought of life w ithout you feels lonely and sad. But if, with your encouragement, she allows herself to move toward these feel­ ings, to feel, for perhaps the first time in her life, a clean, deep, uncompli­ cated grief about losing someone she loves and respects, she will find herself strengthened. She will probably find words for some of what you have meant to her. Perhaps she’ll speak those words directly to you. The two of you will reminisce about the hard times and high points you both remember, and you’ll acknowledge the good work you’ve done together. You will help her realize that keeping herself open to memories and feel­ ings about ending will make her loss more than just absence and empti­ ness. It will help fill the emptiness with a living, moving, many-faceted image of your relationship to carry with her, a vital memory that will keep on helping her know who she is. As in so much of the rest of your client’s therapy, what you do to­ gether is for her well-being, and yet, as you participate in your mutual process, you can’t help but be moved, challenged, and strengthened your­ self. So it goes with a good ending. There’s grief in it for you, too, and sharing memories and feelings about ending will be as good for you as for your client.

W H A T W ILL STAY W IT H Y O U R C L IE N T A FTER THERAPY? Memory is now and now is memory. If this is true about the cffects of trauma in our lives, it is also true about the cffccts of love, care, and understanding. In other words, not only will you stay with your client as a remembered voice of compassionate understanding and as reliable pres­ ence backing her up, not only will she have clear, lasting images of how it felt to be with you, she will also carry with her many effects of your rela­ tionship that will never cross her conscious mind. If memory is now and now is memory, that is, if memories are filed on account of their interpersonal emotional potency and according to their emotional meanings, and if, although this whole filing system re­ mains mostly out of her awareness, it’s constantly making sense of all of

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a clien t’s c u rre n t experiences o f self a n d self-with-other, you can be sure th a t th e p o te n t em o tio n al experiences o f your therapy w ith h e r will have infiltrated h er w hole m eaning-m aking system. She w o n ’t have to rem em ­ b er th o se im p o rta n t experiences, for they will be in h er psychological bones, in h er R IG s, in h er organizing principles. T h e ir effects will have already sneaked u p o n h er as goodness th a t she never, o f course, could have expected. W e’ve already talked a lot a b o u t th e differen t form s such goodness takes: how she has absorbed your supportive a n d ad m irab le qualities so th a t she feels w hole, self-aware, a n d strong in a flexible, resilient so rt o f way; how she has developed new, m ore secure form s o f being attach ed to o th ers a n d new “m odel sccncs” for speaking a n d fin d in g w hat she needs; how she has fo u n d herself reco n n cctcd w ith o th ers in ways th a t em pow er a n d enliven her; how she has discovered possibilities for m eaning-m ak­ ing a n d creative self-expression th a t she could n o t have im agined before. Each o f these k inds o f goodness is an o ngoing process, n o t a finished accom plishm ent o r cure. As I’ve said m any tim es, relational therapy is all a b o u t self-w ith-other in action; each o f these form s o f goodness com es dow n to a radically revised sense o f how a client can be h e r self, w hich also m eans, sim ultaneously a n d inescapably, how she can d o o r “per­ fo rm ” herself in relatio n sh ip w ith others. So th e relational answ er to this questio n , “W h a t stays w ith a client w hen therapy is over?” changes th e term s o f th e questio n . T h e answ er isn’t a m atter o f p a rticu la r insights o r skills sh e ’ll have after therapy is over; it’s a b o u t changcs in th e ways she can be a n d feel herself w ith o th ­ ers. T hese changcs w on’t be so m e th in g she has learned a n d will n eed to rccall. T hey will be systemic, organic, a n d sclf-pcrpctuating. H er life will probably be m u ch th e sam e, b u t th e way she walks it a n d feels it will be significantly different. B ut w h a t a b o u t all th e old stu ff in th o se old files? Has it b een dum ped? W h a t a b o u t th o se pow erful m odel scenes th a t for years have b een telling your clien t w ho she is a n d w h a t’s possible for her? W h a t a b o u t th o se strategies she has used for so long to m ake a sem blance o f c o n n ec tio n w hile pro tectin g h erself from inevitable violation? D o th e changes I’m talking a b o u t m ean th a t she has b een able to replace h er destructive old in te rp erso n al softw are w ith a com pletely new version? Sadly, no. T h e old stu ff never goes away. It can’t be d u m p ed o r erased. T h e changes I’m talking a b o u t m ean th a t th e old stu ff gets relativized; now (to play w ith th e m etap h o r) your clien t’s system has th e capacity to ru n m ore th a n o n e program . M ost im p o rta n t, now she can noticc w hen

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th e p ro g ram b e in g ru n is cau sin g p ro b lem s, a n d o fte n ju st n o tic in g gives h e r access to a n o th e r possibility. O r to p u t it a n o th e r way, th e o ld m o d el scenes a re n ’t th e o nly t r u th a b o u t life anym ore. T h ey hav en ’t b e e n sim ply rep laced by a n o th e r tru th , b u t th ey are n o w v u ln e ra b le to h e r new know l­ edge o f alte rn a tiv e self-w ith-other tru th s th a t she has e x p erien c e d from th e inside o u t. T h e d iffe re n t re la tio n a l th e o rie s w e’ve lo o k ed a t w o u ld express th is state o f affairs in d iffe re n t ways. S elf psychology w ould say th a t o n g o in g e m p a th ic processes betw een y o u r c lie n t a n d o th e rs are necessary forever. It’s always possible, u n d e r stress, for h e r to fall back in to th e old est, m ost p a in fu l a n d frag m e n tin g ways o f ex p erien c in g self-w ith-other. H ow ever, bccausc o f y o u r c lie n t’s goo d therapy, she has b e e n able to m ake d iffere n t k in d s o f re la tio n sh ip s w ith o th e rs, a n d it is th is d iffere n t, hcrc-and-now experience o f “selfobject s u p p o rt” th a t helps p u ll h e r o u t o f th e o ld places. In th e S to n e C e n te r story, th e effects o f yo u r c lie n t’s d isc o n n ec te d , lonely past have b e e n o v e rrid d e n by th e e m p o w e rm e n t a n d zest o f g e n u ­ ine c o n n e c tio n . B ut h e r o ld d o u b ts a n d anxieties w ill still lurk in th e shadow s, to em erge w h e n th in g s go w rong. H ere again it’s essential for h e r n o t to deny th e o ld b u t to b rin g it in to th e presen ce o f th e new, in to a newly su p p o rtiv e circle o f social re la tio n sh ip s. In th is new place o f be­ ing c o n n e c te d , y o u r c lie n t’s old re la tio n a l im ages d o n ’t disap p ear, b u t sh e fin d s h e rse lf in d iffe re n t re la tio n to th e m . T h e e m p a th y sh e lives w ith no w has so fte n ed th e edges o f th e o ld im ages a n d lo o se n ed th e ir grip , even w h e n th ey still b o th e r her. A n d staying in goo d c o n n e c tio n w ith o th e rs h elp s h e r stay w ith a new set o f re la tio n a l im ages, o n e th a t does h e r far m o re goo d o n a daily basis. R e la tio n a l psychoanalysis d o e sn ’t p ro m ise to h e lp yo u r c lic n t w ipe o u t th e o ld o r in v en t so m e th in g b ra n d -n e w e ith e r. In stead , it h elp s h e r grasp a n d exercise h e r free d o m to m ake new m ean in g s o u t o f o ld experi­ ences, o n c e th e ir p a tte rn s have c o m e to life in th e give a n d take o f th e th era p y re la tio n sh ip . It’s a free d o m she discovers in c o o p era tiv e engage­ m e n t w ith you, h e r th e ra p is t, a n d th is n o n h ie ra rc h ic a l, creative en d eav o r o f m u tu a l re co g n itio n beco m es a p a rad ig m fo r living a life m o re o p e n to o th e rs, a n d m o re o p e n to possibilities, im a g in atio n , a n d creative selfexpression. O f co u rse it’s always possible th a t she will fin d h e rse lf o n c e again sh u n te d o ff in to a repetitive lo o p o f stultifying in te rp e rs o n a l p a t­ tern s. B ut hav in g b ro k e n free oncc, n o w sh e will kn o w how to try to fin d o u t w h a t’s g oing o n ; she know s h o w to talk it o u t, act it o u t, pay a tte n ­ tio n , a n d p u sh o n it—u n til so m e th in g gives. W h a t stays w ith y o u r c lic n t a fte r th e e n d in g o f a n cffcctivc rcla-

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tional therapy? In short, she does—a “she” w ho has experienced signifi­ cant changes in how she can be in the world. T hese changes will be present w ith her in her daily perform ance o f self-with-other and her daily experi­ ence o f self.

RELATIONAL CHANGES CARRY O N . . . AND O N If at the close o f therapy, a client has changed in how he can perform and experience him self w ith others, these changes will sta rt to show th em ­ selves in all o f the im p o rta n t relationships o f his life. He will have no­ ticed som e changes long before therapy is over. N oticing change will have been an im p o rtan t p art o f understan d in g how things were before the change and th en envisioning new possibilities. O n e o f the things th a t happens in the process o f relational therapy, in any o f its m odels, is th a t a client’s capacity for conversation w ith an­ o ther person and for understanding another person is improved. He learns from you n o t only how to be listened to, b u t also how to listen. He picks up how to “make sense” w ith som eone else, m utually. He learns how to tolerate differences and talk about them . He has found out, by m aking his way through difficult m odel scenes w ith you, th a t it can pay to stay in connection and work on “w hat’s h appening” even w hen his desire to q u it and ru n away is strong. All o f this pays o ff m ost in his m ost significant relationships. He can’t expect his p a rtn e r or his best friend to listen to him w ith your kind o f one-way sustained a tte n tio n and unflagging empathy. T h at w ouldn’t be an equal p artnership o r a m utual friendship. But it often happens th a t once he knows from talking w ith you th a t h e ’s w orth listening to, he starts to open up and talk a little m ore w ith his significant others. Sincc h e’s less afraid he’ll be discounted, h e ’s less defensive and prickly at the first sign o f m isunderstanding. O ften this creates m ore space for his p art­ ner o r friend to un d erstan d him . Furtherm ore, th e good feeling o f hav­ ing been und ersto o d by you becom es a kind o f settledness w ithin him , a space where he has tim e to listen to a n o th e r’s worries. He knows now w hat he’s giving w hen he gives undivided a tte n tio n and the m ost accu­ rate em pathy he can find w ithin himself. W h en two people in an im p o rta n t relationship talk openly w ith each other, each focusing o n understan d in g the o th e r’s m eanings and feelings, th e relationship can break free o f the fears and expectations each person has brought to it from the past. T his co m m itm ent to having

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em pathy for each o th e r’s experience (which isn’t the sam e as com m it' m en t to agree w ith each other) can carry a couple th ro u g h very difficult tim es o f conflicting w ants and bitter frustrations. As they keep talking, as they each keep saying where they stand and w hat they th in k and feel, and as they each keep listening to the oth er w ith the in te n tio n o f understanding and finding a way thro u g h together, they are bringing som ething new into being, a relationship th at in its own way can be as powerful as a therapeutic relationship to change how bo th participants can be a self and a self-in-relation. If your client is a parent, com ing to understan d his ow n childhood and the relationships betw een him self and his parents will have a pro­ found cffcct on his relationships w ith his children. A study by attach­ m en t th eorist Mary M ain suggests th at parents w ho have com c to term s, in th o u g h t and feeling, w ith th eir own histories o f insecure attachm ent are far less likely to repeat the behaviors th a t w ould replicate insecure attach m en t for th eir ch ild ren .1 In short, your client’s u nderstanding of his childhood relationships can free him to be him self w ith his children, ra th e r th a n an unconscious copy o f his parents. If th ere ’s anything your client has learned in therapy a b o u t his own child-self, it’s about the im portance o f empathy. He knows he could have survived everything th a t happened to him far b etter—he m ight even have thrived despite m ajor losses and frustrations—if only som eone had taken the tim e to pay a tten tio n to his reality and his feelings. Now th a t his em pathy for his own child-self has opened up his empathy for his children’s cxpcricncc, and now th a t he’s com c to know w ith you how paying atten­ tio n is done, he can relax and just be there w ith his very small children. W ith his older children, he can enter the world o f school, friends, h o b ­ bies, and sports w ith his care and affirm ation, b u t w ith o u t having to m ake things right for them . He can approach his adolescents w ith confi­ dence, knowing th a t he can both h o n o r th eir privacy and offer them an im p o rtan t listening ear. If his parents are alive and if he has brothers and sisters, h e ’ll prob­ ably find him self hoping th a t his relationships w ith them can change, too. H e has realized th a t he learned disconnected forms o f relationship at hom e. Since he has spent therapy tim e dealing w ith painful relational images and m odel scenes from the past, they have lost a lot o f th eir power to disturb him . It makes som e sense for him to th in k th at if he could conncct better w ith his parents and siblings now, he would be able to shake o ff m ore o f the effects o f those bad old disconnections. A nd it’s true th at if a client’s family, despite its “dysfunction,” still has som e healthy

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flexibility, som e open-ended, self-reflective h u m o r a b o u t itself, a n d som e capacity to foster talking a b o u t hard things, a client m ay be richly re­ w arded for his efforts to reco n n e ct w ith family. H e m ight be able to find his way tow ard m u tu al a d u lt re lationships n o t only w ith his siblings b u t also w ith his parents, a n d all o f th a t w ould in d eed d o him a w orld o f good. However, th e forces for sam eness and against change are pow erful in m ost fam ilies, and th e m ore dam aged, frightened, angry, a n d defen­ sive th e family m em bers are, th e m ore tightly they will cling to th e ways they have always used to pro tect them selves. T h ere were reasons your client could never c o n n ec t m u ch w ith his family before, a n d th o se rea­ sons probably haven’t gone away. H e may possess an ex p an d ed repertoire o f relational organizing p rinciples—b u t they may not. As a colleague oncc said to m e ab o u t h er efforts to com m unicate w ith th e isolated, fragm ented people in h er family: “I’ve ju st realized th a t I’m d o in g all th e rig h t things— b u t w ith th e w rong p eople.” It can be difficult for a clien t to accept th a t these people w hom he always w anted to know a n d love m ig h t be th e w rong people for him to try to be close to now. B ut m ixed in w ith his d isa p p o in tm e n t an d grief, th ere can still be an im p o rta n t difference in how he can be w ith th em : H e can know ingly choose to give up th e struggle to c o n n ec t “for real.” H e can find th a t m ix o f closeness a n d distance th a t w orks best b o th to p rotect h im from fu rth e r h u rt a n d also to express his com passion for th e ir isola­ tio n a n d his respect for th e com plex persons th a t they are. It’s sad, b u t also good, he finds, n o t to n eed th e m to be d ifferent anym ore. Your clien t’s d iffere n tia tio n o f a self in relatio n to his family has n o t b een an easy process. T hey haven’t h elped it along m u ch by changing w ith him . A n d yet even in these d ifficult family-of-origin relationships, his m ovem ent h a sn ’t been tow ard “a utonom y,” tow ard being c u t loose. It’s been tow ard know ing how to be this so n a n d b ro th e r in this family, this self w ith th is p a rticu la r history a n d heritage, a n d also th is self w ho d o e sn ’t have to replicate th e pain o f previous generations. Your clien t’s capacities to be a differentiated self-in-relation a n d to c o n n ec t w here c o n n ec tio n is possible will serve h im well in all o f life, n o t ju st in close social a n d fam ilial relationships. In relational theory, healthy self-w ith-other experience is th e g ro u n d o u t o f w hich all o th e r com pe­ ten t, generative, creative capacities grow. Self psychology' tells us th a t selfobjcct needs, w hen m et, develop in to c o n fid e n t a m b itio n , a co m m it­ m e n t to ideals a n d com m unity, a n d th e capacity to feel a n d express em ­ pathy for o th ers a n d to provide, in tu rn , for th e ir grow th a n d security.

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R elational psychoanalysis leans tow ard a vision o f existential a u th e n tic ­ ity, b u t th a t dream is g ro u n d e d by th e relationality o f its vision: a u th e n ­ ticity as w h a t k in d o f response to th e o ther, in responsible relatio n sh ip w ith w hom ? A cknow ledging his in d eb ted n ess to B e n ja m in ’s fem inist th eo ry o n th is p o in t, Lewis A ro n says th a t o n e o f th e m ajor goals o f relational psychoanalysis is th a t analysands achieve th e ability to partici­ pate, in all o f life, in re lationships o f n o n d o m in a tin g m u tu a l recogni­ tio n .2 S tone C e n te r theorists insist, o f course, th a t individual relationships o f m utuality are th e g ro u n d for all healthy, m utually respectful a n d em ­ pow ering social relations. O n th e global sccnc as well as o n th e in te rp er­ sonal sccnc, w hat m atters is n o t how individuals develop autonom y, b u t rather, how individuals o p e n them selves to m utually em pow ering rela­ tio n sh ip s th a t extend outw ard in netw orks o f respect a n d em pow erm ent. S tone C e n te r th eo rists h ope to raise th e profile o f th e re lationships th a t foster such grow th, a n d in so doing, to redefine public visions a n d goals. T hey believe th a t w om en in particular, because o f th eir relational strengths, n eed to provide th e leadership to m ove all o f o u r societal stru ctu res away from systems based o n violence a n d coercion a n d tow ard systems based o n m u tu a l c o n n e c tio n a n d em pow erm ent. In sum m ary, and p u t briefly, this relational therapy is n o t prim arily a jo u rn ey inw ard. From th e m o m en ts o f “d iagnosis” (w hat’s wrong?), to th e th era p ist’s in te n tio n to be-with as fully a n d deeply as possible, to the k inds o f goodness th a t flow from this c o n n cc tio n , relational therapy is always m oving away from th e fantasy of in dividual sclf-sufficicncy and tow ard th e realities of h u m a n in te rd ep e n d e n ce . R elational therapy offers n o recipe for tran scen d en ce, n o escape from th e realities o f history, cul­ ture, conflict, a n d oppression, n o exit to a b etter life, n o rising above pain. It offers only a b etter ch an ce o f being linked w ith o th ers in th is life, o f know ing th e joys o f kindness, respect, a n d love, a n d o f tru stin g th a t w hatever befalls us, we d o n ’t have to be alone. A n d now we have com e to th e e n d o f o u r final chapter. As I said earlier, e n d in g is a phase, a conversation o f its ow n. B ut it isn’t a long phase. So it goes in therapy. W h e n all th e e n d in g is over, w h e n you’ve rem inisced a n d sum m ed things up, w hen your client has spoken h e r grati­ tu d e a n d you have spoken your app reciatio n o f her, a n d w hen you have a tte n d e d to regrets a n d good-byes, th e re ’s n o th in g m ore to do b u t to let your clicnt go o n h e r way, ready a n d able to live th e changcs th a t therapy has set in m o tio n . She is still th e sam e person, living th e life sh e ’s always had, a n d yet you can b o th h o p e th a t h e r life can be p ro foundly (if quietly)

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differen t now —ju st because sh e ’s finally m ore present, m ore com fortable a n d secure in herself, a n d m ore deeply c o n n ec te d w ith th e people in her life w ho are o n this jo u rn ey w ith her. W h a t you can do now is w ish h er “B on voyage!”—a n d rem em ber her. I w ish you a good journey, too, as you u n d e rta k e th e challenging, difficult, a n d yet pro fo u n d ly satisfying w ork o f relational psychotherapy. May you find co m m u n ity th a t su p p o rts your c o n tin u e d develo p m en t as a perso n a n d as a therapist.

ENDNOTES 1. Mary M ain, “Recent Studies in A ttachm ent: Overview w ith Selected Im plications for C linical Social W ork,” in Attachment T h e o r y : S o c ia l, D e v e lo p m e n ta l, a n d C li n i c a l P ersp e ctives, Eds. S. Goldberg, R. M uir, and J. Kerr (Hillsdale, NJ: Analytic Press, 1995), 407-474. 2. A ron, A Meeting o f M i n d s , 148-154.

REFERENCES

A insw orth, M. (1978). Patterns of attachment: A psychological study o f the strange situation. Hillsdale, NJ: Lawrence Erlbaum . A ltm an, Neil. (1995). The analyst in the inner city: Race, class, and culture through a psycho­ analytic lens. Hillsdale, NJ: Analytic Press. A ron, L. (1996). A meeting o f minds: M utuality in psychoanalysis. Hillsdale, NJ: Analytic Press. Atwood, G., &. Stolorow, R. (1984). Structures o f subjectivity: Explorations in psychoanalytic phenomenology. Hillsdale, NJ: Analytic Press. Bacal, H. (Ed.). (1998). Optimal responsiveness: How therapists heal their patients. Northvale, NJ: Jason A ronson. Bacal, H., &. N ewm an, K. (1990). Theories o f object relations: Bridges to self psychology. New York: C olum bia University Press. Beebe, B., Jafte, J., Lachm ann, F., Feldstein, S., Crow n, C., &. Jasnow, M. (2000). Sys­ tems m odels in developm ent and psychoanalysis: T he case o f vocal rhythm coordi­ nation and attachm ent. In/ant Mental Health Journal, 2 1(1-2), 99-122. Benjam in, J. (1988). The bonds of love: Psychoanalysis, feminism, and the problem o f domina­ tion. New York: Pantheon. Benjam in, J. (1995). Like subjects, love objects: Essays on recognition and sexual difference. New Haven and London: Yale University Press. Boston Process o f C hange Study G roup. (1998). (Nadia Bruschweiler-Stern, A lexandra M. H arrison, Karlen Lyons-Ruth, A lexander C. M organ, Jeremy P. N ahum , Louis Sander, Daniel Stern, ik Edward Z. Tronick). Special issue o f Infant Mental Health Journal, 19(3). Bowlby, J. (1988). A secure base: Parent-child attachm ent and healthy human development. New York: Basic Books. Brandchaft, B. (1994). To free the spirit from its cell. In R. Stolorow, G. Atwood, &. B. B randchaft (Eds.), The intersubjective perspective (pp. 57-76). N orthvale, NJ: Jason A ronson. Bromberg, P. M. (1998). Standing in the spaces: Clinical process, trauma and dissociation. Hillsdale, NJ: Analytic Press. Brown, L. (1994). Subversive dialogues: Theory in feminist therapy. New York: Basic Books. Chesler, P. (1972). Women and madness. New York: Doubleday. 213

214

References

Davies, J. M., & Frawley, M. G . (1994). Treating the adult survivor o f childhood sexual abuse: A psychoanalytic perspective. New York: Basic Books. E hrenberg, D. B. (1992). The intim ate edge: Extending the reach of psychoanalytic interaction. New York: W.W. N orton. Freud, S. (1953- 1966). The standard edition o f the complete psychological works o f Sigmund Freud ( J a m e s Strachey, Trans.). London: H ogarth Press. H erm an, J. L. (1992). Trauma and recovery. New York: Basic Books. Jordan, J. V., Kaplan, A. G., Miller, J. B., Stiver, I. P., &. Surrey, J. L. (1991). Women's growth in connection: Writings from the Stone Center. New York: G uilford Press. Jordan, J. (1991). Em pathy and self boundaries. In J. Jordan et al. (Eds.), Womens growth in connection: Writings from the Stone Center (pp. 67-80). New York: G uilford Press. Jordan, J. (1991). T he m eaning o f m utuality. In J. Jordan et al. (Eds.), Womens growth in connection: Writings from the Stone Center (pp. 81 -96). New York: G uilford Press. Jung, C ., &. von Franz, M. L. (Eds.). (1964). Man and his symbols. New York: Doubleday. K ohut, H. (1984). How does analysis cure! Chicago: University o f Chicago Press. Lichtenberg, J. (1989). Psychoanalysis and motivation. Hillsdale, NJ: Analytic Press. Lichtenberg, J., Lachm ann, F., &. Fosshage, J. (1992). Self and m otivational systems: Toward a theory o f psychoanalytic technique. Hillsdale, NJ: Analytic Press. Lyons-Ruth, K. (1998). Im plicit relational knowing: Its role in developm ent and psycho­ analytic treatm ent. Infant Mental Health Journal, 19(3), 282-289. M ain, M. (1995). Recent studies in attachm ent: Overview w ith selected im plications for clinical social work. In S. Goldberg, R. M uir, & J. Kerr (Eds.), Attachment theory: Social, developmental, and clinical perspectives (pp. 407-474). Hillsdale, NJ: Analytic Press. M cNamee, S., & Gergen, K. J. (Eds.). (1992). Therapy as social construction. Newbury Park, CA: Sage. Miller, J. B., &. Stiver, I. P. (1997). The healing connection: How women form relationships in therapy and in life. Boston: Beacon. M itchell, S. A. (1988). Relational concepts in psychoanalysis: An integration. Cam bridge, MA: Harvard University Press. M itchcll, S. A. (1993). Hope and dread in psychoanalysis. New York: Basic Books. M itchell, S. A. (1997). Influence and autonomy in psychoanalysis. Hillsdale, NJ: Analytic Press. M itchell, S. A. (2000). Relationality: From attachment to intersubjectmty. Hillsdale, NJ: Analytic Press. Orange, D. M. (1995). Emotional understanding: Studies in psychoanalytic epistemology. New York: G uilford Press. Pérez Foster, R., Moskowitz, M., & Javier, R. A. (Eds.). (1996). Reaching across boundaries of culture and class: Widening the scope o f psychotherapy. N orthvale, NJ: Jason A ronson. Renik, O . (1966). T he perils o f neutrality. Psychoanalytic Quarterly, 65, 495-517. Rogers, C. (1942). Counseling and psychotherapy. Boston: H oughton M ifflin. Rogers, C. (1961). On becominga person. Boston: H oughton M ifflin. Stern, D. (1985). The interpersonal world of the infant: A view from psychoanalysis and develop­ mental psychology. New York: Basic Books. Stiver, I. (1991). T he m eanings o f dependency in fem ale-m ale relationships. In J. Jor­ dan et al. (Eds.), Womens growth in connection: Writings from the Stone Center (pp. 143-161). New York: G uilford Press.

R eferences

215

Stolorow, R. D., & Atwood, G. E. (1992). Contexts 0/ being: The intersubjective foundations o f psychological life. Hillsdale, NJ: Analytic Press. Stolorow, R. D., Atwood, G . E., &. Brandchaft, B. (Eds.). (1994). The intersubjective per­ spective. N orthvale, NJ: Jason A ronson. Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York: W.W. N orton. Surrey, J. (1991). T he self-in-relation: A theory o f w om en's developm ent. In J. Jordan et al. (Eds.), Women’s growth in connection: Writings from the Stone Center (pp. 59-61). New York: G uilford Press. W hite, M., & Epston, D. (1990). Narrative means to therapeutic ends. New York: W.W. N orton. Wolf, E. (1988). Treating the self: Elements o f clinical self psychology. New York: G uilford Press.

INDEX

C onstructive empathy, 55 “C onvictions,” 97 C ore relatedness, 176, 177 “C otransference,” 151, 152 C ountertransference, 8, 15, 148-151, 159-160 C ouples therapy, relational work in, 6 5 -6 6

A ddictions, relational work in, 6 3 -6 4 Ainsw orth, Mary, 174 Anxious avoidant attachm ent, 175 Anxious resistant attachm ent, 175 Aron, Lewis, 26, 30, 149, 182, 184, 211 Assessment of patterns in interactions, xiv, 45 50 A ttachm ent theory, xvii, 174-176 Atwood, George, 34, 168, 169, 171, 183 A uthenticity in therapy, 52, 54

Davies, Jody Messier, 123, 125 D ependency in therapy, 48, 187-190, 200 D isconnection, effects of, 111-113 Dissatisfaction, feelings of, 70 Dissociation continuum of, 124-128 response to traum a with, 104, 111-113 traum atic effects of, 122-123 Dissociative identity disorder, 126 Downward relational spirals, 150-151 Dreams, role in Jungian therapy of, 11-13, 23

Baby studies, interpersonal activities in, 5354, 5 8 -59, 95 Bacal, Howard, 35, 37, 38, 169 Bedtime story o f a client, 8 4 -85 Benjam in, Jessica, 30-31, 32, 182-184, 211 Boston G roup, 179-180 Boundaries of therapy, 47, 4 8 -4 9 , 198 Bowlby, John, 174, 175, 191 British independent school o f psychoanalytic therapy, 26 Brown, Laura, 20, 21, 22, 24, 31, 78, 84

Ehrenberg, Darlene, 30 Emergent relatedness, 176, 177 Em otional abandonm ent, 58 Em otional abuse, 105 Em otional intim acy in therapy, 185-187 Em otional takeover, 58 Empathy benefits to the client of, 56-61 com m unication of, 52-54 definition of, 50-51 m aking connections in therapy with, 165— 168, 199, 206 in relational therapy, xiii-xiv, 50-68, 146— 147, 198 in self psychology therapy, 27, 9 2 -9 6

Chesler, Phyllis, 77 C h ildhood abuse, survivors of, 105-108 Client-centered therapy, 15 Cognitive-behavioral therapy, xii, 13 C om m itm ent to being present, 47-48, 181, 184, 190, 201, 202, 208 C om m unication o f empathy, 52—54 “Com plex post-traum atic stress disorder,” 104 C onnections/disconnections, xvii, 81-83, 86, 111-113

216

217

In d ex

Empow erm ent, com ponents of, 184 E ncounter groups, 16 E nding therapy, xviii, 197-212 “Erotic transference,” 186 Falling in love in therapy, 185-187, 199 Family systems disconnection in, 81-83 m odel scenes of, 130 relational work in, 65 Fear, influences on therapy of, 67-68 Fem inist theory of psychotherapy, xii, 20-26, 78-81 Freud, Sigm und, 7, 8 Freudian therapy, 8-11, 22-23 Gestalt therapy, 15-16 G oal-oriented therapy, 13 Goodness of ordinary life, 163-168, 199, 206 Grieving and relational therapy, 62, 203-204 G roup therapy, 18, 66 H erm an, Judith Lewis, 104, 115 H um anist therapy, 15-18, 53 “Im plicit relational knowing,” 179 Individualistic m odel o f therapy, 6 Infants, interpersonal world of, 5 3 -54, 5859, 95 Integration, 111, 114-115, 126-128, 139, 152 Interactive system of self, 71, 72-74, 77 “Internalized oppression,” 84 Interpersonalist theory, 26-27, 29, 30 Interpersonal process, system of, 72-74 Intersubjective relatedness, 176-177 Intersubjective theory, 34-35, 38 Intersubjectivity, feminist definition of, 182— 183 “Isolated self,” 2 Isolating behaviors, 8 5 -88 Jordan, Judith, 55 Jung, Carl, 11 Jungian therapy, 11-13 “Kim,” case of, 190-195 Kohut, Heinz, 27, 34, 35, 50, 52, 170, 188, 191 Lichtenberg, Joseph, 176, 177-178 “Lucy,” case of, 121-125, 127-128

Main, Mary, 209 Marxism, 19 Medical m odel o f therapy, 5 “Megan,” case of, 119-120, 127, 128 M em ory/m em ories, 9, 113-124, 205-208 Miller, Jean Baker, 82, 86, 184 M itchell, Stephen, 30, 32, 149, 182 “M odel scenes,” 129-132, 135, 136, 138, 159, 178, 199 M otivation, systems of, xvii, 177-178 M ultiple personality disorder, 126 N arrative therapy, 18-20, 8 4 -85 Negative transference, xv-xvi, 9, 149-153, 156-160 Newman, K enneth, 169 O bject relations theory, 28, 8 8 -92 Obsessive-compulsive patterns, relational work in, 63 “O ptim al responsiveness,” 35, 37, 169 O range, D onna, 34, 97, 149, 183 “Organizing principles,” system of, 73-75, 77, 9 6 -9 8 , 117-118 Outside-inside interface, 76-100 “Parentification,” 8 2-83 “Pathological accom m odation,” 9 7 -98 Performative therapy, 4, 100 Phobias, relational work in, 63 Physical abuse, relational work in, xv, 64, 105 “Play space,” 149-150 Positive transference, 9 Process memory, system of, 73-74 Professional ethics, 49, 186-187, 198, 199 Psychoanalytic Dialogues, 28

Psychoanalytic therapy, 8 Psychodrama therapy, 16 Psychodynamic theory, xii Psychological dissonance, 70, 73-75, 77, 86 Radical fem inist therapy, 19, 20-22 Rationalism , 6-7, 17 Relatedness, sequence of, 176-177 Relational dilem ma, 68 Relational failures, 150-151 Relational group therapy, 66 Relational images o f self-image, 86-87 Relational psychoanalysis, 2 6 -33

218

Relational ruptures in therapy, 144-148, 150-151, 155-160 Relational traum a continuum of, 106-108 effects of, xv, 104-106, 111-113 factors contributing to, 108-111 role o f rem em bering in, 113-124, 198199 Rem em bering, relational work with, 113-124 Renik, Owen, 30 “Repetitive transference,” 168-169 “Resistance,” 149 RIGs (Representations o f Interactions which have been Generalized), xvii, 72-73, 76-77, 89, 192 Rogers, Carl, 15, 5 0 -5 1 ,5 2 ,5 3 Rom antic interests in therapy, 185-187 Saying good-bye in therapy, 197-212 Secrecy, 82 Sccure attachm ent, 175 “Sclf-in-relation,” 184 “Selfobject,” xvii, 27, 34, 93 “Selfobject transference,” 168, 169-174 Self psychology on defining a client’s problems, 9 2 -9 6 empathy as a tool in, 52-53 influence on relational therapy by, 26-28, 3 3-38, 40 on “repetitive transference,” 168-169 Self-state systems, 71-72, 77 Self-sustaining selfobject ambience, 170 Sclf-with-other, focus of, 1-5, 180-185 Sexual abuse, relational work with, xv, 64, 82, 105, 121-124 Sham e, feelings and effects of, 74-76, 94, 112-113, 115-116, 137 Short-term therapy, 13-14 Social-construction therapy, 84 Social location, influences in therapy by, 81 Solution-focused theory, xii, 13—14 Spiritual work in relational therapy, 6 2 -63

In d ex

Stern, Daniel, 53, 72, 95, 176-177, 179, 192 Stiver, Irene, 82, 86, 184, 188 Stolorow, Robert, 34, 168, 169, 171, 183 Stone C enter for Developm ental Services and Studies on dependency in therapy, 187-188 on dissonance in family systems, 81, 82 on empathy in therapy, 55, 60 on m utuality in relationships, 183-184,

211 on psychological problems, 85, 86 theory of psychotherapy of, 2 3 -26, 31, 32, 34, 35, 37-40 on the zest in connections, 193, 207 Strategic therapy, 13 Strategies of connection/disconnection, 86 Subversive Dialogues (Brown), 20 “Sue,” case of, 79-81 Sullivan, H arry Stack, 26, 27, 30, 91 Survivor health, 10 Systems of “self,” 71-74 “Tale o f Two Hospitals, A,” 121-124 T erm inating therapy, xviii, 197-212 Therapists in therapy, 133-145, 148 Transactional analysis, 16 Transference definition of, 8 in relational therapy, xv, 15, 126, 131, 148-153, 199 in self psychology therapy, 168-174 Traum a, continuum and effects of, 104-108, 111-113 Verbal relatedness, 176, 177 W illiam A lanson W hite Institute, 27, 28 Wolf, Ernest, 170-171 Women and Madness (Chesler), 77 “W orking models o f parent and self,” 175 Zest in-relation, 184