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After a short time, of course, this adaptation needs to be something less than a hundred per cent, but for a very long time it must be tilted in favor of the more helpless member of the dyad. A self-centered me-me-me approach to others and to life is not only frowned upon by society; it is also a pathological perspective that indicates the presence of emotional wounding.

But a related approach is a vulnerable one, while a selfish stance offers the illusion of safety. Holding one's own perspective along with the other's means accepting a world in which the ground upon which one stands is never reliable. I cannot take refuge in the assumption that my eyes see clearly while yours are clouded.

If ten of us see one thing and the eleventh another, probably the general perception is reliable, but even this is not always true. A related approach is dangerous; taking a selfish stance is like living inside a fortress. If I know what is out there because my eyes do not distort, I am safe and secure. You may be crazy, but I am not. Thus it is not surprising that faced with the terrifying depths of the psyche and told to contain those depths and transform them, therapists hang onto their theoretical instructions as though they were life preservers.

It is dangerous to face the suffering patient as one person to another, where both of us are subject to confusion and error, and the therapist's "mental health" is not presumed superior at any given moment. Plain relatedness seems too simple, although this assessment is a defense against the reality: it is harder for a clinician to sit with a patient and share his distress than to imagine that she can zap away his pain with transformative interpretations. To sit still and hear the patient's pain means to recognize that emotional pain like the patient's can overcome her, too.

It also means accepting that in the face of pain the practitioner is helpless to do anything to make it go away.

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It is much more comfortable to hang onto a theoretical bible and to imagine herself strong, capable and mentally healthy, healing her disturbed and needy patient. At the heart of this book is my attempt to raise therapists' consciousness about the nature and importance of relatedness.

It is widely accepted in the depth theoretical world that the self exists only in relationship. Winnicott suggested that in the absence of a mother, there is no such thing as an infant. As we shall explore in the pages of this book, the human being cannot think or feel the prerequisite for the self's existence in isolation.


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The self exists only in relationship and the self varies from one relationship to another. I am a different person with my husband than I am with my best friend or my daughter or any given patient. There is no "me" in isolation. The quality of each relationship structures who it is possible for me to be.

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The quality of the therapeutic relationship determines how much the patient will be able to grow inside its container. We certainly know that the quality of the parent's bond with his or her child is infinitely more important than what bedtime she sets or the age at which she allows her daughter to wear make-up. The teacher who adjusts her way of being to accommodate her student's idiosyncratic learning style will be much more successful in facilitating his intellectual development than will the teacher who approaches all her students in one standard way. Why should it be such a leap to recognize that the quality of the analytic bond rather than some standardized analytic approach is the most important element in psychotherapy, too?

My dictionary Gove, defines "relate" and "relatedness" in rather solipsistic terms. The definition of "related" is slightly more suggestive: "having relationship," "allied by kindred," or "having similar properties. Inside or outside the analytic situation, a related approach opens one to the other's pain and stirs one's own. Relatedness hurts.

And then it nourishes. First the pain of embodied existence is experienced and then the compassionate atmosphere of relatedness assuages the pain. But often the looming danger of the pain thrusts aside the healthy related energies and constellates the narcissistic anti-related forces of the psyche. The etymology of "relate" is also interesting. It comes from the Latin relatus, from re- "back, again" and latus, the past participle of ferre "to bear" , thus meaning "carried or borne back. I believe that this particular etymology developed from the fact that when we are in relationship to another, parts of ourselves that we have lost touch with are carried back into connection with us.

And if we add to this the Greek talantos "suffering, bearing" , which is also connected to the Latin latus, we have the implication that a relationship with another arouses suffering — intense emotional distress — for it brings us face to face with aspects of ourselves that we have disowned. Although "relatedness" rests on sensitivity to the other's subjective experience, in therapeutic work it does not imply attempting to create a "nice" experience for the other, especially since the other's unconscious immediate experience must be included in the analyst's understanding of the present.

But an attempt to adapt to the other's experience in the most related way possible is a most important dimension of the practitioner's approach. In the unique container of the therapeutic relationship a "loving" approach will lead to behaviors that might seem quite unloving in other situations. But when a related therapist behaves in ways that her patient finds disturbing, she tries to soften that, to speak to it, at least to hold in her awareness the central importance of the patient's distress.

Too often the more depth-oriented the clinician's training, the less it concerns itself with this dimension and the more it values clinical behavior that adheres to the particular school's theoretical orientation. Behavior that accommodates itself to this peculiar patient's receptive channels may be criticized as "unanalytic" instead of being analyzed.

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How is the therapist's unusual behavior impacting this person's process at this singular moment? While the same behavior might often cover up or avoid something difficult, perhaps just now it is opening up something that needs attention. In this book, I explore a variety of points of view concerning the nature of the psyche, how it processes emotional experience and how it develops. My central focus is on using whatever understanding we can muster to enhance the clinician's effectiveness in the consulting room. Because the most fundamental determinant of the patient's capacity to use his analyst constructively is the quality of their relationship, one core question that this book asks is, "what makes the therapeutic relationship therapeutic?

The analyst, of course, is only half the equation; how related she is able to be will depend on how related her patient can be as well as on her own capacities. What does relatedness look like in the analytic consulting room and how might it differ from social relatedness? Can we approach our patients therapeutically without forgetting everything that we know about how to approach people with the compassion and respect from which love can develop? The first section of this book looks at the nature of the human psyche.

What hunches can we develop about the unconscious, the foundation on which everything else rests, given that we can never have direct access to it?

Remembering that unprocessed emotions destroy the possibility of rational thought, what can we say about how the psyche processes emotions? What underlying templates structure the emotional woundedness we each carry and how does the tension play out between someone's healthy, growing side and her resistant, injured aspect?


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Developing ideas about these issues provides a ground from which we can approach our patients in a related fashion. In the second section of the book, we will look explicitly at how these understandings will guide us in interacting with our patients. I had, of course, been working on myself in various ways, so that Symington's ideas fell on fertile ground — I was ready for them. Reading the book burst open my psyche in a way I had never imagined a book could.


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  • This supposedly intellectual experience set in motion a fruitful train of development that has led me to a new level of integration in my work. From Symington's inspired work on narcissism, I was drawn into the work of W R. Bion, a British psychoanalyst, whose perspective informed Symington's. Bion's utterly original point of view has now strongly influenced my thinking.

    Ebook The Mystery Of Analytical Work: Weavings From Jung And Bion 2009

    If I could summarize Bion's creative perspective, I would say that he has helped me to see that people are verbs rather than nouns. Like the universe, every object, living or non-living, is in constant motion, both developing and deteriorating all the time. Bion communicates an ability to swim in the new order that his work illuminates, an ability to keep one's head above water in an endlessly mysterious and always shifting world.

    Who I am changes from moment to moment; my history is unknowable and my understanding of it. The other is similarly volatile. We must find new ways to think about what any of our realities consist of, for every "fact" we know is at most an approximation of reality. Perhaps we can be certain of the year in which the Boston Massacre occurred. But how it was triggered, what emotional or material elements "caused" it we can never know in any definitive sense. Everything and everyone is always moving and changing.

    We will explore many aspects of this radical perspective in the following pages, seeking to imagine how it impacts our work with individual patients. One element of that exploration involves my attempt to integrate Bion's point of view with that of C. Jung, for the two men share a deeply congruent vision of the nature of the psyche and of reality. Like Bion, Jung describes a largely fluid universe, where the laws of science, the facts of history or politics, and most especially the human beings working to understand them, can never be known in any definitive sense.

    Instead, exploring reality becomes endlessly fascinating; mysteries proliferate, opening new lines of investigation rather than leading to firm solutions or understandings.

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    Bion's work grounds Jung's in the clinical situation, for although Jung wrote a great deal about psychology, he wrote very little about psychotherapy, and his most valuable work on the analytic situation is hard to understand. Just as Bion's work expands the reach of Jung's, Jung's perspective illuminates Bion, making this impenetrable writer more comprehensible. Finally, taking a stance that is developed from integrating the philosophical outlooks of both men opens up the clinical situation dramatically. The clinician's capacity to hear is greatly enhanced and new implications and levels in the patient's material are revealed, thus expanding the therapist's capacity for relatedness.

    And, of course, these two geniuses had differences. Often their differences can fertilize our thinking about the analytic or therapeutic ,1 situation. In this book I develop a clinical perspective based on my understanding of psychological growth. In the fifty-minute hour, the therapist is under constant pressure to respond to the patient's distress, even if that distress lies well under the surface. Two personalities come together in a first hour and "an emotional storm" ensues Bion, We know that the patient is caught in an emotional storm; if he were not, he would not have called a therapist.