Psychoanalysis--a contextual psychology: essay in memory of Merton M. Gill.
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Biomedical subjects
Publications and source records attributed to R D Stolorow.
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This paper recasts psychoanalysis as a post-Cartesian, contextual psychology, which grasps the constitutive role of relatedness in the making of all experience.
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A critique is offered of four conceptions of neutrality that have been prominent in the psychoanalytic literature: neutrality as (1) abstinence, (2) anonymity, (3) equidistance, and (4) empathy. It is argued that once the psychoanalytic situation is recognized as an intersubjective system of reciprocal mutual influence, the concept of neutrality is revealed to be an illusion. Hence, interpretations are always suggestions, transference is always contaminated, and analysis are never objective. An alternative to neutrality is found in the investigatory stance of empathic-introspective inquiry. This mode of inquiry is sharply distinguished from the prescribing of self-expressive behavior on the part of analysis, and the distinction is illustrated with a clinical vignette.
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The author presents an intersubjective view of the therapeutic process, emphasizing the investigative and interpretive tracking of the figure-ground relationships among the various dimensions of the transference as they take form within the analyst-patient system. The author proposes that a crucial ingredient of the therapeutic action of psychoanalytic interpretations can be found in their specific transference meanings for the patient.
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We have presented the intensive treatment of a young woman whose chronic suicidality had resulted from a delusional merger with a brother who had died during her childhood. The case offered a particularly clear example of derailment of the developmental process of self-differentiation, leading to the formation of a highly pathological introject and delusion of merger. Emphasis was placed on the repetitive and self-object aspects of the transference bond that became established and on how the analysis of these shifting dimensions of the transference contributed to the therapeutic process.
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