Distance And Relation: Emerging From Embeddedness In The Other.

Inspired by an essay by Martin Buber (1950), and then by the work of Ernest Schachtel (1959) on the idea of "embeddedness" and emergence from it, this essay is an account of the role of "distance" or "separateness" in clinical psychoanalytic work. We tend to assume that the capacity to appreciate otherness is always already present. We often lose track of the necessity to "set the other at a distance" (Buber), the prerequisite for emergence from embeddedness in the other. The entire process-i.e., setting the other at a distance and then emerging from embeddedness in the other-must take place over and over again in any treatment, and in both directions: patients must disembed from analysts, but it is just as necessary for analysts to disembed from patients. It is the emergence from embeddedness that allows the analyst's appreciation of the patient's otherness. Embeddedness in the other is discussed as mutual enactment. This use of these phenomena in treatment is articulated in the theory of witnessing presented elsewhere in recent years (Stern 2009, 2012, 2022b, in press). A detailed clinical illustration is presented.

Interpretation: Voice of the Field.

To patients, the most memorable moments in psychoanalytic treatment are seldom the contents of the analyst's interpretations, but the feeling of being understood. Interpretations are most meaningful not because of what they say but because each one is evidence that the analyst, who generally becomes someone of great significance to the patient, knows the patient more than before the interpretation was made. As a result of this process of "witnessing" patients not only know and feel-they also "know and feel that they know and feel." They can feel their roles in authoring their own experience. Therapeutic action results: patients "come into possession of themselves." Interpretations are the outcome of shifts in the interpersonal field, which reveal this new freedom to think and feel. This new freedom allows the creation of the analyst's interpretations, which therefore serve as a sign of a new way of being in one another's presence that has now become possible between analyst and patient. Field shifts are jointly created, without conscious intention, and interpretations arise from these shifts. Thus, interpretations are not really created independently by the mind of the analyst, but are instead the voice of the field. A clinical vignette illustrates these ideas.

On Coming Into Possession of Oneself: Witnessing and the Formulation of Experience.

In this paper I use clinical theory and illustration to explore details of the formulation of experience, which depends upon the metamorphosis of experience from not-me to feels-like-me. I take the position that the movement from not-me to feels-like-me, with the accompanying possibilities for formulating new meaning that open at such moments, happens when we not only know or feel something, but also, and simultaneously, sense ourselves in the midst of this process-that is, when we know and feel that it is we who are doing the knowing and feeling. When these two events co-occur, which depends upon the process of witnessing and the breach of dissociation, we come into possession of ourselves. Witnessing of one person by another is a process of recognition, but it is also a kind of affirmation performed by "someone who is trusted and justifies the trust and meets the dependence" (Winnicott 1971, p. 60).

Unformulated experience, dissociation, and Nachträglichkeit.

The paper is divided into two parts. The first part is an interpersonal/relational psychoanalytic account of some relationships between dissociation, time, and unformulated experience. Trauma, and the dissociation to which trauma leads, freezes time, which makes it impossible to formulate certain kinds of new experience. Instead, potential new meanings remain unformulated. The route of clinical access to frozen time is the interpersonal field: to thaw time and allow new experience, the ways in which the interpersonal field is itself frozen need to be addressed. A clinical illustration of these ideas is offered. The second part of the paper presents and explores a point of confluence between the views in Part 1 and certain aspects of French psychoanalysis, with particular reference to the concept of Nachträglichkeit in the work of Jean Laplanche and Haydée Faimberg.

Relational freedom and therapeutic action.

Therapeutic action depends on our freedom to allow ourselves novel, unbidden experience. How does this novelty arise? What is the process by which some portion of the possibilities inherent in any moment's unformulated experience are created or selected and emerge in consciousness? And what does it mean to think of freedom in this context? What does it mean for the formulation of experience to be free? In the frame of reference adopted here, the formulation of experience depends on the conscious and unconscious events of the interpersonal field. The field facilitates some formulations of experience and prevents others. Thus, whatever we can do to make it possible for the analytic relationship to evolve freely, without constraint or constriction, is the best way we have to encourage the freedom to experience. "Relational freedom" underpins therapeutic action. A clinical case is described at length to illustrate these ideas.

Witnessing across time: accessing the present from the past and the past from the present.

We are used to the idea that trauma in the past interrupts our capacity to grasp the present. But present or recent trauma can have a similar dissociative effect on our capacity to experience the more distant past. Contemporary trauma can rob the past of its goodness, leaving one feeling as if the past is gone, dead, separated from the present. The vitalization of the present by the past or the past by the present requires that experiences be linked across time. These links are created, in both directions, via categories of experience characterized by shared affect (Modell 1990, 2006). Such categories are created, in turn, by metaphor; and the construction of these metaphors across time requires that one be able to occupy self-states in both the past and the present that can then bear witness to one another. Trauma can result in the dissociation of these self-states from one another, leading to a disconnection of present and past.

Partners in thought: a clinical process theory of narrative.

Even in the absence of others, we learn about ourselves by imaginatively listening to our own thoughts through the ears of the other. At the beginning of life, we need a witness to become a self. Later, patients listen to themselves as they imagine their analysts hear them, and in this way create new narrative freedom. The resolution of enactments is crucial in psychoanalytic treatment, not only because it expands the boundaries of the self, but also because it reinstitutes and broadens the range within which patient and analyst can witness one another's experience. Narrative is not the outcome of the analyst's objective interpretations, but an emergent, co-constructed, unbidden outcome of clinical process.

Words and wordlessness in the psychoanalytic situation.

The difference between words and wordlessness in the psychoanalytic situation is examined in the context of a detailed clinical example. Various pairs of terms that have been used to account for this difference are mapped onto it: word and act, thought and feeling, public and private experience. Each of these sets of differences suggests certain relations between consciousness and the unconscious, and each implies a position about the nature of language. All three prove to be incomplete or inadequate ways of accounting for the difference between words and wordlessness in the clinical setting. The divergence, though, is well described by the difference between self-reflection and unformulated experience. Reflection is then presented as situated in the unformulated background meanings that contextualize it. It is because of this contextual embeddedness that self-reflection can have the kind of depth, resonance, power, and nuance more commonly associated with the nonverbal. In the creation of an explicit meaning, we simultaneously reconfigure the wordless background, thereby creating new possibilities for other meanings.