At the institute we explore the human mind integrating four contemporary theories: Psychoanalytic Infant Research, Attachment Theory, Contemporary Psychoanalytic Self Psychology, and Psychoanalytic Intersubjective Theory.
Psychoanalytic Infant Research provides a map of how to understand the emotional expressions of our patients. We have come to understand that the infant/caregiver relationship shapes development in physiological, emotional, and psychological dimensions (Rustin, 2013). Contemporary psychoanalysis seeks to find patterns and meaning in the clinical relationship which reflects the interaction between infant and caregiver. Studying these dyadic systems’ view of face-to-face communication sets the stage for an understanding of non-verbal communication and treatment across the lifespan.
Attachment Theory was first described by John Bowlby, a psychoanalyst who researched the impact of separation between infants and their parents. Through his research Bowlby demonstrated that infants showed an “attachment behavioral system” that guides us in our patterns and habits of forming and maintaining relationships. Since Bowlby, attachment theorists have been able to identify four attachment classifications. Understanding these characteristics sensitizes therapists to the kind of connection the client can tolerate at the beginning of treatment and offers us guidance on how to proceed in forming the therapeutic relationship. Attachment theory has also provided us with an understanding of the psychological benefits of having a secure attachment vs. an insecure attachment. The theory guides us in understanding how these insecure attachments promote emotional deficits for clients in the therapeutic relationship and how to begin working with them.
Heinz Kohut, the founder of Psychoanalytic Self Psychology developed his theoretical positions in part due to his belief that psychoanalytic theory had ventured too far away from understanding the subjectivity of the patient. He emphasized the development of an “empathic-introspective stance”, promoting the central role of empathy and attunement in healthy development and in the therapeutic process. Empathy was defined by Heinz Kohut (1959) as “vicarious introspection,” feeling and thinking oneself into another person’s subjective experience.
At the heart of Psychoanalytic Self Psychology lies the “Self,” conceptualized as a mental system that organizes a person’s complex set of experiences, made up of feelings, thoughts, beliefs, and attitudes (Kohut, 1977). The development of the self depends on the caregiver’s lending the child psychological functions that they have not yet acquired. These psychological functions are known as “self objects.” Self object functions provide psychological safety and regulation, a sense of twinship (feeling a part of one’s community), and a sense of being mirrored or feeling unique, building self-esteem and self-regard. Contemporary Psychoanalytic Self Psychology hypothesizes that the source of most human suffering is the absence of reliable, emotionally attuned others.
Fundamental areas that we work on in therapy center around 1) providing the patient with the experience of having self object needs met in the therapeutic relationship, 2) analyzing and managing (offering repair) ruptures that occur in the therapeutic relationship, 3) illumination of problematic themes and organizing patterns and their genesis that come up in the therapeutic relationship, and 4) helping the patient develop and reflect upon new experiences that enliven their sense of self and defeat old ways of relating (Fossage, 1998).
Robert Stolorow and George Atwood (1987) integrated Psychoanalytic Self Psychology with Psychoanalytic Intersubjectivity Theory. The theory states that our experience of ourselves is fundamental to how we operate in the world. Intersubjective systems theory brings into focus both the individual’s world of inner experience and its embeddedness with others. Therapists pay close attention to the continual flow of reciprocal mutual influence between themselves and their patients. Gone is the notion that the therapist holds a privileged, objectively true perspective on reality (Buirski, 2000).
These patterns of experience that center around our sense of self and the world describe our subjective personal reality. They are known as “organizing principles” and with key affects carry forward into the present and serve as a filter through which we identify and articulate the present. One of our key tasks in intersubjective psychoanalytic psychotherapy is to identify the organizing principles and the underlying affects that structure people’s unique experiences of themselves and others. Intersubjective Psychoanalytic Psychotherapy focuses on understanding another person’s subjective experience, keeping in mind that our own organizing patterns of experience impact their reality as well as our own.
Organizing principles that one time made adaptive sense and kept the patient safe may now be creating self-defeating emotional or relational problems. Patients’ symptoms or presenting problems are seen as dynamic solutions to the universal problems of managing affect within their individual developmental context. In this way subjective experience can be transformed and new meaning can be constructed. Successful treatment leads to new organizing experiences developed within the therapeutic relationship and transferred to other relationships. People develop new ways of relating to themselves and others. They develop new expectations of themselves and others around them. They are capable of relating differently because they experience themselves and the world differently.
References
Beebe, B. & Lachmann, F. (2002) Infant Research and Adult Treatment: co-constructing Interactions. Hillsdale: The Analytic Press.
Buirski, P. & Haglund, P. (2000) Making Sense Together: The Intersubjective Approach to Psychotherapy. New York: Jason Aronson.
Doctors, S. (2007) on Utilizing Theory and Research in Self Psychology/Intersubjectivity Clinical Work. Ed. P. Burski & A. Kottler, New Developments in Self Psychology Practice. pp 23-48. New York: Jason Aronson.
Fosshage, J. (1998) Self Psychology and its Contribution to Psychoanalysis: An Overview. Journal of Analytic Social Work. 52, 1-17. Clinical Repertoire. New York: W.W. Norton & Company.
Kohut, H. (1959) Introspection, empathy, and psychoanalysis an examination of the relationship between mode of observation and theory. Journal of the American Psychoanalytic Association. Vol. 7. 459-483.
Kohut, H. (1971) Restoration of the Self. New York: International Universities Press Kohut, H. (1977) The Search for the Self. New York: International Universities Press Kohut, H. (1884) How Does Analysis Cure? Chicago: University of Chicago Press.
Rustin, J. (2013) Infant Research and Neuroscience at Work in Psychotherapy: Expanding the Clinical Repertoire. New York: W.W. Norton and Sons.
Stolorow, R., Brandchaft, B., Atwood, G. (1995) Psychoanalytic Treatment: An Intersubjective Approach. New York: Routledge.