Saturday, May 25, 2013

Emotional Competence, Self-Experience and Developmental Patterns


The parent's job is to facilitate their child's growth toward a "good enough" version of what is possible.

What is emotional competence? How is it developed? How does trauma and deprivation interfere?

I teach a course introducing psychodynamic theory to clinical psychology doctoral students, taught from the perspective of Descriptive Psychology. When we go over "The Essentials of Psychoanalytic Theory and Practice", I remind students of the historical shift in the theory's focus on what an infant or child needs to manage and tolerate. For the early Freudians, the central problem was the management and toleration of sexuality and aggression. For later theorists, attention shifted to the infant and child's ability to handle the complexity of dependent relationships with their ambiguities and ambivalences. These later theorists were also interested in the self that experienced these complex relationships and tensions. How are these feelings and relationships to be managed?

The development of any personal characteristic requires a prior capacity and an appropriate intervening history. Self-experience concerns feeling of continuity, coherence or fragmentation; a person's sense of authenticity and agency; and a host of related themes. The development of one's sense of self has patterns and through-lines with characteristic outcomes.  For children with ordinary or exceptional initial capacities, the nature of their parenting and circumstances, fortuitous or not, is relevant.  Self-experience and emotional maturation are interwoven themes. A person's toleration of affect and their expression of emotion go hand in hand. 

The chart below attempts a summary of major developmental achievements the good enough parent in the good enough environment fosters in the average expected child in contrast to what follows in the wake of deprivation and trauma. A person's developmental history fosters or elicits an ongoing pattern of life. I use this sort of language in an attempt to avoid implying causality, since there is no reason these patterns necessarily result in a specific outcome, but are understandable when they do. We are not surprised by the result even if it did not have to turn out as it did. This is not a deterministic model of development, but rather a Dramaturgical pattern that makes sense in retrospect. To paraphrase Adam Philip's summary of Freud's theory of development, childhood informs everything but predicts nothing. 

For methodological purposes, I am defining self-experience on an axis of "cohesion" and "fragmentation". I am not all that happy with the images implied by this language. But for now, I don't have better images or concepts available, and this language does have an established use in the Self Psychology and Object Relations literature. I welcome a better conceptualization.  By "cohesion", I am referring to the sense of a person having it together, feeling whole or comfortable in their skin. This is in contrast to a condition of "fragmentation", of falling apart, cracking up or not being able to keep it together.  I suspect you know what I mean. 





Some further elaboration and clarification:

Problematically obscured, if not articulated, is what we commit ourselves to when we talk about emotion. "Emotion" covers a lot of ground and is one of the most varied and conceptually muddled terms in psychology. (This, as Wittgenstein reminds us, is the condition of conceptual confusion that plagues psychology).  In the tradition of Descriptive Psychology, when I use emotion concepts, I refer to a family of intentional actions in which the actor has a learned tendency to immediately act on an appraisal without deliberation. Fear, anger, guilt, jealousy, envy, sadness and joy are paradigm examples. Sympathy, admiration, and many other relational stances bear a family resemblance to emotions although not everyones will agree they should be called emotions. But they do, more or less, share the quality of an immediate response to a recognized circumstance.

Mostly, we don't decide to feel emotional, we automatically respond to our appraisal of what we take our circumstances to be. When I recognize immediate danger, I act fearfully; when suddenly provoked, I act with hostility; and so on. "Unless clauses" are also central in clarifying emotional behavior since I will act with immediacy toward my circumstances unless I have a stronger reason not to. For example, I will act with hostility to provocation unless I see it as too dangerous to act, or ethically wrong, or I am unable to act at that time, or I am unable to see the provocation for what it is, and so on. This holds for all of our emotion terms coupled with the appropriate unless clause reminders.

Understanding emotional competence also hinges on the meaning of competence. Competence is a matter of effectiveness, something achieved by relevant practice and experience over time. Whereas knowledge or insight can be achieved in an instant, competence or know-how generally must be practiced under varied circumstances before it feels natural.


Certain patterns of emotional behavior are more apt to result in a successful outcome than others. Anger versus rage or fear versus panic are cases in point. Anger and fear may result in a highly specific and well targeted response, whereas rage and panic suggest a poorly modulated, flailing reaction. Similarly, some emotional behaviors are more likely to have pro-social than anti-social implications and will be valued accordingly. One's expression of sympathy or gloating in response to another's loss may result in different reactions from the community. 

Some other implications: 



1. Central aspects of emotional competence concern a person's accurate recognition of the emotionally appraised state of affairs, the ease of expressing the emotion, and the reversibility, closure, resolution, and termination of the emotional action.  Am I provoked by what is appropriately provocative? Am I able to tolerate being angry in response to what I see? Can I adequately adjust my behavior to a revised understanding of the circumstances? Can I let it go and get on to other business? Emotional behavior can be competent or incompetent. This reminder undermines the false distinction between rational behavior and emotional behavior. Neither its immediacy nor its absence of deliberation make emotional behavior an irrational response to a person's circumstances. Emotional behavior is rational when it is an accurate and effective response. It is irrational when, like any other response, it follows from an inadequate or distorted appraisal of the relevant circumstances. 


Here's the logical form of emotional behavior as an intentional action:





W:  What the actor Wants to accomplish.
K:  What the actor Knows, distinguishes, or recognizes in the circumstance that is relevant to what the actor Wants.
KH:  What the actor Knows-How to do given what the actor Wants and Knows about the relevant circumstance.
P:  The procedural manner or Performance of the action in real time.
A:  The Achievement of the action.

And an example that highlights the appraisal and competence needed to act effectively:



Notice it is the automatic and immediate tendency to escape the Zombie that gives us reason enough to label this as fear.

Hence the reality or cognitive basis of emotion:




Further,

2. A person's empathic skills are a crucial aspect of their ability to adequately appraise the actions of others and respond appropriately. 

3. A person’s ease or skill at emotional closure is a fundamental quality of emotional competence as is:  

5. The ease and accuracy of recognizing emotion in one's self and others.

6. Developmentally, the social experiences that foster the creation and development of the values, knowledge, and skills required for competent emotional behavior are those that provide adequate practice and experience in the effective and immediate response to danger, loss, provocation, wrongdoing, and so on.  The ability to act effectively and immediately is fundamental in demonstrating emotional competence.  The ability to refrain from emotional expression is equally salient. It is negligent to not pause and deliberate under certain circumstances and this is required of the competent person if they are to remain in good standing with others.

7.  Emotionally competent behavior effectively restores or enhances a person’s status or place in their world. 
Incompetent emotional behavior is ineffective at restoring or enhancing one's position.  

8. Emotionally competent actions are judged by the community's sense of the shelf life of reasonably enduring or putting up with a person’s emotional actions, traits, states, and moods.  The shelf life is the actual but varied duration it takes for others to decide that a person should have resolved their situation or reconciled with an incomplete or failed resolution.  Social norms and idiosyncratic values apply. A community has stated and unstated expectations for when its members need to "get over it, already". This can be complicated by the fact that a person is a member of a variety of communities not all of which will have the same standards. 

9. The classic psychoanalytic observer might notice that the axis of cohesion to fragmentation somewhat resembles the tradition of grouping issues as Oedipal to pre-Oedipal. About this, I remain silent. 




THIS BE THE VERSE


(but have kids and teach your children well.)

     




Saturday, May 18, 2013

Empathy, Improvisation and the Growth of the Therapist

a continuation of On Getting Unstuck



Therapists, more often than they wish, find themselves trying to be empathetic with people they would not otherwise spend time with.  This often means being open to the thoughts and experiences of very difficult people who may have been terribly damaged and grievously hurt. This necessary attempt at an empathic engagement often evokes the therapist’s own vulnerability, the sort of feelings one would not open up or consider except with trusted companions. Especially for the new or young therapist, this confrontation with vulnerability has important consequences. Simply asked, does the therapist acquire a greater capacity for toleration and self-reflection, or close off and avoid what is too tender and painful to acknowledge? In my own practice, I know I have done both. This is an important lesson I offer my students; it remains a work in progress for myself, a vital concern of theirs.

I start the lesson, hopefully enough, with the promise that the work they will do will make them better people. A more honest correction, with its attendant "unless clauses”, will come later. Not all of them will mature with an increased toleration and capacity for understanding, but many will. Most will discover where this growth is possible and desirable and where it is not.  If they are lucky and careful, this self-knowledge will help guide their careers.

Why do I confidently start with the claim that the ordeal of conducting intensive psychotherapy will make the therapist a better person? Again, simply put, because to engage in such a relationship, to accept the openness to the other that therapeutic improvisation requires, necessarily means both participants, the client and the therapist, will change.  Both will acquire a degree of new competence and knowledge that would not have been achieved had they not entered into this otherwise unlikely arrangement.  At least for the therapist, there might have been no need to.

I have seen data that indicates that an important outcome of psychodynamic psychotherapy is that the client becomes somewhat more insightful about him or herself, considerably more insightful about their intimates and neighbors, and generally more tolerant.  I am sure this is the case for all of the intensive, non-directive therapies where the therapist is deliberately mindful about being judgmental. Therapists become experts in the many ways a person can be accepted or degraded. Clients become aware of this beneficial attitude and method of understanding and may acquire the ability to practice it with themselves and others. I think it is reasonable to say the world is a better place when this is possible.

I am suggesting that therapy improves the world. In an intensive psychotherapy, the client learns how to handle difficult emotions, relationships and thoughts, because they repeatedly practice this in the company of their therapist.  The therapist’s non-coercive and empathetic attention to the boundaries of toleration make this practice possible. The client becomes more competent in thinking over difficult issues.  If the practice is sufficient, the client is now in a better position to make informed choices with less desperation, or perhaps no desperation at all.   Basically, the client achieves the needed skill to manage and accept what does not actually violate their integrity, now knowing what is real violation and what is not.

I think this holds for the therapist as well, and makes some therapists, over time, better people. Therapy’s required openings, this necessity to affirm and incorporate an exploration of suffering and difficulty into an ongoing improvisation, means the therapist has encountered and handled something difficult they might have avoided. By not escaping into avoidance, the therapist develops empathy and compassion and becomes a better person.  



Therapy, as I understand it, requires cultivating and tolerating what I think of as a sort of Mindful Uncertainty. 



Saturday, May 11, 2013

On Getting Stuck and Unstuck: Empathy and Improvisation in Psychotherapy




Therapy can feel stuck, stymied and aimless, but fits and starts may be a necessary aspect of transformative therapeutic processes.  

Therapy feels stuck when the domains of choice are too restricted or rigid, when the people involved are unable or unwilling to engage in the options each party invites and attempts.

How does the process of being stuck and unstuck proceed?  This depends partly on how and whether the therapist and client can engage in a co-constructed improvisational activity. Empathy is necessary since its absence may be why the therapy is stuck in the first place. Empathy is required for therapeutic improvisation.

Some of the therapist’s activity might be seen as setting the stage for improvisation to be possible.  A way of thinking about the therapist’s stance of patience, empathy, waiting and toleration is that it serves attempts at getting unstuck.

Improvisation involves an expansion of possibility and requires flexibility. (Your move 1 invites and is incorporated into my move 2, and your move 3 incorporates what has just transpired and so on.) If improvisation is successful both people have done something they have not done before. They have incorporated aspects of the other’s behavior into their own.

In improvisation, a space is created for moves and choices, spontaneous gestures, that neither party has made before.  Winnicott called this the transitional phenomena. Since the improvisation is something already accomplished, it becomes behavior potential, something a person might want to do again.  

I take for granted that we get something of value from improvisational interaction. At the very least, we now have done something we might not have done otherwise.  

Change may involve fundamental, profound or trivial alterations in a person’s powers and dispositions. Usually real change is slight and hardly noticed to the point of being, practically speaking, not much change at all.  But part of the therapist’s job is to notice and accredit these shifts. This doesn’t need to be said out loud but it must find its way into action so that it has a chance of being incorporated into the next set of unfolding acts.

Therapy is difficult since it may require establishing empathy and developing an improvisation with a person one would not ordinarily choose as a companion.  This holds for both participants.  Empathy is easy when the going is easy.  This is often not the case in therapy. Therapy frequently involves difficult people under difficult conditions. This is why people are in therapy rather than successfully working matters out with friends, lovers, parents, and so on.

Therapy brings together people who under other circumstances might not easily understand each other. This is the therapeutic dilemma and opportunity. An empathic relationship requires negotiation, a moral dialogue, for misunderstanding to be corrected. Knowing how to accomplish this reaching out in the service of being understood is a valuable skill.  But this is difficult.

The participants in therapy will be changed when they accomplish something difficult because the players themselves have to overcome the difficulty of getting along. Freud, long ago, knew this and saw it as essential for progress. He called it the “transference neurosis”.  Working it through may require change in values, knowledge and competence for each participant.  Since one or both parties may not yet have what is needed it is no surprise they find themselves, from time to time, stuck.

Getting unstuck has a liberating effect.  We were lost but now are on our way. If this occurs we may have faith and competence not present before.  It is good to know we can weather a storm.



(In weathering the storms of difficult engagement, therapist and client are both transformed: Empathy, Improvisation and the Growth of the Therapist.

For a method of regaining empathy, see April’s Regaining Empathy

For the behavioral logic of how improvisation can facilitate each party acquiring strength from the other, see April’s Play and Therapy.)




Thursday, May 9, 2013

Resilience and World Reconstruction after Trauma. The Vital Factors.


Resilience is a complex concept. Practically speaking, here are some of the major factors that are significant in a person's "natural" recovery from trauma. By “natural” I am trying to get at what facilitates the average expected person's average expected recovery. I believe it is useful to say that trauma disrupts, degrades, and/or distorts some set of significant "through-lines" in a person's life, in their "dramaturgical pattern".  I am suggesting that "through-lines" is a useful organizing concept when employing the concept of "the dramaturgical pattern".  This comes from Peter Ossorio’s conceptualization that a person is an individual whose history involves a pattern of deliberate actions in a dramaturgical fashion. (See, The Behavior of Persons, Peter Ossorio, 2006/2013, The Descriptive Psychology Press).


As a clinical observer I think the following biological and social factors are important in the natural recovery from trauma.

1. Sleep is almost universally recognized as important but often difficult to comfortably achieve after trauma. The manner of recovery is different when sleep is accompanied with or without nightmares.  It is harder when nightmares are present. Also important is whether the dreams involve successful story resolution. Successful resolution helps. The presence or absence of metaphor in the dream narrative is also predictive of whether the trauma becomes more tolerable and amenable to resolution. Metaphor is significant since it knits a variety of through-lines into a common image. I think that metaphor connects themes in the service of mastery. On the other hand, direct representation of the trauma negatively correlates with recovery and impedes toleration of the traumatic memory.

2. The significance and extent that vital through-lines have been disrupted, distorted, degraded or lost is central in assessing the damage to a person's self and world. These can be extracted as developmental lines, role patterns, linked and valued social practices, the usual "done thing" and so on.  Said another way, what is the significance and extent of the damage?

3. Parallel to #2 is the person’s remaining serviceable powers and dispositions available for effective engagement with the problematic circumstances.

4. Of further significance is the availability of communities to help the traumatized person reengage in valued social practices.

5. Engagement also involves the faith, hope and expectation that the communities "will meet the need and make the difference" and that the traumatized person believes they will recover with or without assistance.

I wrote about this in a somewhat different fashion in April's Resilience and World Reconstruction.  A beautiful exploration of world reconstruction, on living in a radically changed world, can be found in work by Anthony Putman: A Descriptive Psychologist Looks at the World of Persons and their Ways

Saturday, May 4, 2013

Essentials of Psychoanalytic Theory and Practice


For many years, I have taught “Introduction to Psychoanalysis” from the vantage point of Descriptive Psychology. The policy I try to follow is to use ordinary language and to avoid concepts and theory that does not actually inform my day-to-day practice. Each semester, given input from my students, this is revised.  Early in my training, I was strongly influenced by George Klein’s effort to separate clinically useful theory from Freud's metaphysics. Accordingly, I present theory in non-deterministic language.  What follows reflects my adaptation of his project and a liberal stealing from his work.

Below you will find 15 statements that I take to be basic beliefs and choice principles that are commonly shared within the psychoanalytic community. When the statement is in the form of theory or belief, the essential  questions the reader should ask are empirical: is the development of personality or the understanding of behavior accurately or usefully articulated? Does it actually happen this way? When the statement is in the form of a maxim, the essential questions are conceptual:  is the statement well formed, logically correct, and where should it be applied?  Following most statements is a brief note describing how the belief, theory or maxim is put into clinical practice.

As a work in progress, frequently updated for clarity and inclusion, your thoughts, comments and recommendations are welcome and valued.


           The Pragmatic Essentials of Clinical Psychoanalytic Theory and Practice


1.  A person's character or personality develops through natural maturation and creative improvisation. Development or maturation is a creation, reaction, and response to the experiences, opportunities, and demands of the person's social and natural world. 

(The therapist's job is to facilitate fortuitous growth though the empathic provision of tolerable opportunity, interpretation, support, and caring non-interference. The therapist welcomes appropriate spontaneity. This requires what is classically called analytic neutrality: empathy, safety, and careful attention to the consequences of giving advice, taking sides, and passing judgment.)

 2.  The formation of personality or character, whether healthy, normal, or pathological develops, in part, from attempts to resolve incompatible intentions and dispositions. This starts very early in the family. Character or personality is to a significant extent a compromise formation, a compromise among competing motivations and interests.  Since people have hedonic, prudent, ethical, and aesthetic reasons for action, intra-personal and social conflict is inevitable. At times, we cannot help but to be at odds with ourselves and others. Not all conflicts are resolvable. Conflict and crisis are expected and provide conditions for ordinary maturation. Neuroses and personality disorders are ways this process can go wrong. Maturation involves, in part, the incompatibility of old and new demands precipitating crisis, impasse, and possible resolution.  

(The therapist recognizes that resolution and recovery from personal and social conflict, including conflicts between therapist and client, are central to the process of individuation and maturation. The therapeutic session allows practice and experience in identifying, tolerating, and resolving conflict. Therapists recognize that some conflicts are not resolvable and require toleration.  The development of toleration is a significant therapeutic and maturational goal. For conflict to be managed, the therapeutic session must be safe enough for this to happen.)

3. Pleasure, pain, anxiety, and the experience of satisfaction are central in the development of a person's self-concept and in structuring motives. Pleasure, pain, anxiety, and satisfaction are generated in encounters with people, events, and objects and guide the acquisition of knowledge, competence, and the development of ambition and talent. 

Pleasure, pain, and anxiety are sensations (primary affects), felt viscerally, that may accompany an action, whereas satisfaction is a psychological state dependent on the personal significance of an action. States of satisfaction are produced during competent participation in intrinsically valued practices. 

Commonly, pain denotes dangerous or damaging contact and anxiety the expectation of incompetence, failure, or danger, often without a clear object. Pain and anxiety provide reasons for avoidance. In contrast, pleasure is ordinarily informative of accord and wellbeing, motivating contact and continuation.  Pleasure, however, is not always satisfying, nor is anxiety and pain always a source of avoidance and dissatisfaction.  

Coerced and compulsive behaviors that elicit pleasure might temporally relieve tension, but seldom will that relief be satisfying. Pleasure connected to forced, devalued or degrading practices elicits anger, fear, resentment, demoralization, shame, and/or guilt. Similarly, pain and anxiety connected to challenging but intrinsically valued practices and goals can be followed by rewarding satisfaction, when the valued goal is achieved or is felt within one's grasp.

(Therapeutic engagement can elicit pleasure, pain, anxiety, and satisfaction. With this may come opportunities for observing and interpreting characteristic patterns of approach and avoidance. Therapists attempt to stay empathically attuned to their client's feelings of satisfaction, pleasure, pain, and anxiety in helping them develop self-understanding and appropriate toleration.)

4.  Conflict provides a motive for resolution, clarity, compromise, and self-integration.  Behavior requires a coherent-enough sense of one's self and one's world.  People generally want their abilities and dispositions to result in self-understandable behavior (and this may result in defensive self-deception in acknowledging complex, conflicting, and inconsistent values). Although the "self" is a referent for the experience of coherence, continuity, and integrity at every stage of life, the integration and compromise that is serviceable at one stage of life may prove problematic at later stages.

(A goal of psychoanalytic interpretation is to provide clarity and understanding of how past compromises and integrations, for better or worse, are manifested in current actions and patterns of life. The interpretations constructed in the negotiated dialog between therapist and client provides a map in the service of increasing mastery and as an indication of the therapist's empathic understanding. When appropriate, the therapist attributes to the client some degree of intentionality or agency in bringing about an analyzed or problematic state of affairs. The therapist is aware that badly timed or worded interpretations of agency can result in the client feeling blamed or degraded. Empathic interpretations and confrontations require an appreciation of what the client can tolerate. The therapist is interested in helping the client examine self-deception and other problematic unconscious, under-socialized, or poorly understood behavior with the goal of enhancing the potential for deliberation, negotiation, and more serviceable choice.)

 5.   Four maxims regarding non-cognizant and defensive action: 

People take it that things are as they seem, unless they have reason enough to think otherwise.

What people take to be real are what they are prepared to act on.

A person acts to maintain or enhance their status given their appraisal of their options. 


It is also a maxim that if a situation calls for people to do something they can’t do, they will do something they can do instead, i.e., something that their values, knowledge, and competence allows. Faced with something a person can’t do, their resulting action follows from their appraisal of what is real and what helps them maintain or improve their position.  This may involve self-deception or defensive distortion from the perspective of the observer. The various manners of distortion correspond to the ego defense mechanisms.


(The therapist must supply from the client’s history, memory, and associations reasons that things might not be as they appear to the client. The therapist attempts to build a case for alternative points of view fully recognizing the uncertainty of their own understanding. The therapist recognizes that what appears from their vantage point to be the client’s defensive distortion is from the client’s perspective the way things are. The therapist carefully acknowledges the client’s perspective by interpreting or re-describing tactfully and close to the client’s current awareness and toleration. Baby stepsso to speak.)

6.  Two major components of a person's life are the assertion of personal autonomy and the need for being an integrated and desired member of a more encompassing social unit. People require autonomy, family, and community and this inevitably creates conflict.

(The therapist recognizes the client’s struggles for autonomy and dependency and accepts, fosters, and analyzes both given the interdependent nature of the therapeutic relationship.)


7.   During any developmental period, a person’s abilities to bear the incoherence and anxiety of conflict, deprivation, trauma, urge, fantasy, and memory are limited. Overwhelming deprivation, conflict, and trauma may result in dissociation:  This is not happening to me.  Overwhelming fantasy or urge may result in repression:  This is not coming from me. Unmanageable memory may result in avoidance and reluctance to self-examine: I won’t think about this.

(The therapist attempts to foster a sense of safety in which fantasy, memory, and urge are tolerable and can be examined in the service of breaking free from a compulsion to avoid, constantly revisit and repeat.  Since defensive activity occurs when an immediate circumstance is recognized as unmanageable, the therapeutic session provides a safe place to develop skill in working with the problematic circumstance with the goal of developing emotional competency. Emotional competency facilitates effective action in circumstances that otherwise would be defensively distorted, restricted or avoided.)

8.  The mastery of passively endured traumatic circumstances (the experience of being a victim) are, at times,  attempted through active reversals, i.e., engaging in behaviors that resemble those perpetrated on the victim:  What I have experienced as being done to me, I make happen compulsively and repeatedly to myself or others. Active reversal, along with repression, dissociation, and avoidance are basic modes of confronting and resolving conflict, impasse, and crisis, for better or for worse.


(The therapist recognizes the power of the repetition compulsion, in some cases, to motivate a return to a traumatic issue in an attempt to resolve it. Unconscious attempts to develop mastery, e.g., the repetition compulsion, and conscious attempts to achieve competence both involve repeated practice and experience.  Cognizant attempts to develop mastery have the advantage of deliberation and the reality testing of effective alternatives. Unconscious or unacknowledged attempts to develop mastery lack the corrective feedback that comes from self-awareness and social negotiation. The therapist tends to value self-awareness and cognizance as providing options that unconscious reactions lack, e.g., navigating circumstances that call for renunciation, ethical judgment or informed choice. Enhancing this awareness is a central goal of therapeutic interpretation.)

9.  When in crisis, people tend toward regressive repetition. Crises are often the occasion for the enactment of earlier patterns of expectation, conflict, anxiety, satisfaction, pleasure, and resolution. Both growth and pathology may involve repetition. When a person’s current context sufficiently resembles earlier states of affairs, e.g., those that involve the person’s family, it is unsurprising that past themes are reenacted consciously or unconsciously as transference.

(Therapists recognize they evoke both old and new ways of relating that include maternal, paternal, and sibling themes along with opportunities to act in ways not constrained by the past.The therapist expects and welcomes the client’s in-session transference as part of the client's response to the comfort and ordeal of treatment.  The therapist approaches the transference as an opportunity to work through earlier fixations, symptoms, and character formations.  The therapeutic relationship establishes forms of intimacy specific to the therapeutic dyad colored by the transference. When treated in ways that resemble the client’s father, mother, sister or brother, the therapist is mindful not to respond automatically in kind.)


10.  Another maxim: A person acquires a given personal characteristic by virtue of having the prior capacity and the relevant intervening history.  Some intervening experiences may lead to active reversal, dissociation, repression, or avoidance.   Repression and dissociation create introjects, i.e., unassimilated, uncomfortable or anomalous personal characteristics with confusions of agency:  Is this me, or is this something that is happening to me? Where is this intrusive thought coming from?  Avoidance may result in phobia:  Keep that away from me!  In contrast, active reversals may establish identifications, resulting in behaviors recognized as one’s own:  This is who I am, this is what I do, for better or for worse.

(The therapeutic policy of attempted neutrality and abstinence, along with acts of empathic confrontation, re-description, and interpretation, promote and model self-observation and toleration as object-lessons available to the client.  As a therapeutic goal, unconscious and problematically enacted repetitions are made conscious in the service of the actor developing more appropriate competencies through self-aware practice.  Under-examined problematic repetitions are tactfully confronted.)

11.  The foundations of a person's emotional competence  to manage, tolerate or enjoy sexuality, conflict, competition, hostility, intimacy, separation, solitude, and loss develop during infancy and childhood, largely from having parent-caretakers willing and able to provide a secure holding environment.  The key parameters of the holding environment are the good-enough parent’s qualities of authenticity, spontaneity and self-reflection and their attunement to their child:  their empathy, availability, reliability, and containment or firmness. Good-enough parents help their child recognize appropriate boundaries and provide support, when needed, to tolerate and express emotion. The good-enough parent celebrates and supports their child's appropriate spontaneity while mindful of the effects of parental intrusion (Donald Winnicott, John Bolby, Heinz Kohut, and Peter Fonagy).

(The good-enough therapist creates a safe place and attempts to remain nonjudgmental, empathic, reliable, and available while allowing tolerable frustration and disappointment. Therapists are open to surprise and affirmative engagement with their client's appropriate spontaneity and assertion.)

12.  Fixations or insistent manners of relating may occur when a fundamental need has been overly gratified or meets unpredictable or rarely gratifying response. Fixation and the compulsion to repeat indicate problems in mastery.

(Therapists are sensitive to the manner in which their response to their clients may be overly gratifying or unmanageably frustrating.  While generous with their in-session attention, tolerable frustration is maintained in the service of the client practicing the skills needed to achieve appropriate satisfaction. Accomplishment and competence require working through periods of frustration.)

13.  Autonomy grows out of successful dependency at its own rate.   Unsuccessful dependency may yield a defensive isolation and clinging neediness, along with a sense of inherent personal badness and a dangerous world. Unsuccessful dependency often sets a stage for envy, rage, panic, and depression. It may also foster a tendency to rigidly idealize or devalue others and to repetitively seek those who resemble the bad objects of early dependency in an attempt to satisfy the unresolved needy love that resulted in feelings of personal badness (Ronald Fairbairn's "moral defense"). Autonomy is mature interdependency.

(Therapists allow and foster an interdependent relationship and recognize that therapy takes as long as it takes, often a long time. Ideally, psychotherapy begins as an open-ended process.  Therapists also recognize that real world constraints will likely interfere with the open-ended process. Knowing that therapy might end too soon, therapists do not promise what is not likely to be accomplished, and try to cultivate the potential for future progress with or without treatment. Therapists are mindful of their own reactions to being idealized and devalued and can competently manage being treated as such. The manner in which the therapist deals with idealization and devaluation provide an object-lesson for the client.)

14.  Maturation and the development of personal characteristics often involve relationships beginning in a dyad and then moving to the triangular in the fashion classically described as Oedipal. Identifications start with a significant dyadic attachment followed by an appreciation of the Other’s key values and relationships. The social triangle consists of Self, Other, and the Other’s Other: I begin by identifying first with you and then identify with or take into significant consideration your other defining relationships that are not about me. Especially significant in the development of personal characteristics are repeated dyadic and triangular experiences that occur during periods of developmental growth and vulnerability.

15. The development of a child’s ambitions and talents are facilitated when the child is empathically admired by parents who are available for appropriate idealization along with a community of peers who value the child’s ambitions and facilitate the practice of his or her talents (Heinz Kohut).

(The therapist may be experienced in a manner that resembles parent and peer. Therapists are aware that their self-presentation and the various communities, values, and choice principles they represent are attributes their client will encounter. Knowingly or not, the therapist might affirm or degrade the client. Therapy is quintessentially a period of growth, change, and vulnerability.)

Akin to the job of a parent, the psychotherapist's job is to help their clients become better versions of themselves, freer to make effective and revisable choices that facilitate satisfaction with the course of life. 


(Adapted from George Klein’s, Psychoanalytic Theory: an exploration of essentials, 1976, and Peter Ossorio’s, Place,
George S. Klein
1998/2012. The maxims are found in Ossorio's writings. The theory is taken largely from George Klein and others as noted.)


Background information on Descriptive Psychology and the work of Peter Ossorio can be found in A Short Course in Descriptive Psychology and The Person Concept.