Summary of Chapters 2 and 3

In Chapters 2 and 3 we present narratives of the successful analysis of two patients who experienced deeply painful struggles with an identity formed in childhood that was incongruent with their sense of themselves as adults. We use the clinical stories of the treatment of Eileen and Samantha to illustrate our experience-based revision or restatement of analytic theory. Rather than sexual or aggressive instinctual drives, we regarded seeking as the spark for the activation of the effects, intentions, and goals of each motivational system. Rather than ego and superego, we describe three developmental pathways for seeking: one to seek human relatedness and intimacy; one to seek mastery of the environment and confidence in one’s skills, learning, creativity, and ability to play; and one to seek bodily health and a satisfying appearance. From the beginning of life, values and goals are drawn from the social and ethical context of the individual’s daily life. Values emerge from interacting and intersubjective experiences with others. Three-month-old infants are drawn to those who help and avoidant of those who hinder them in achieving their intentions and goals. Information is organized as conscious symbolic and presymbolic sensor-motor narratives and as out-of-direct awareness underlying pervasive affect tones that emerge from the success or failures of each pathway for seeking. A parallel to the underlying affect tone is the ambiance, the tone that emerges between the analysand and patient.

Consequently, the analytic treatment comprises multiple facets; most well-known from the brilliance of Freud is understanding and insight into the nature of influences that have resulted in adaptive and maladaptive trends in identity, expectations, and intentions in each motivational system. The analyses described in Chapters 2 and 3 provide rich details of the patients’ traumatic past.

Patient’s and analyst’s interlocking associations, reveries, and reflections on memories, dreams, and model scenes become recognized sources of discontent and shame, debilitating failed attempts to expose and repair an entrenched maladaptive sense of self. The success that each analytic pair achieves in gaining insight and integrating past experience with present distress and ineffectual approaches to being a doer doing bind analyst and patient as a trusted working pair who share moments of affirmation, twinship, and ideals. This familiar mode of therapeutic process is nicely illustrated in these two clinical stories. All of this achieves well-deserved levels of conscious and preconscious formulation and reflective recognition, as illustrated in Chapter 2 and 3 (see also The Clinical Exchange and many other studies and books).

In Chapters 1, 2, and 3, we hope to have illustrated that something more than interpretation and insight is occurring in parallel with the more defined presymbolic and symbolic processes leading to explanation and meaning. A more diffuse generated affect tone emerges in any successful ongoing exploratory treatment as the mutual interplay of patient and therapist forms, consolidates, and changes. We emphasize that we are referring to an ambiance that develops between analyst and analysand. Ideally, we believe that as trust, caring, and mutual understanding increases, positive change will be reflected in the patient’s underlying affect tone. Often, however, an analyst’s underlying affect tone is vulnerable to a response in kind and picks up on a patient’s tendency for irritability, depression, pessimism, denial, provocativeness, seductiveness, and withholding, and the way in which the analyst’s own underlying affect tone tendencies coincide. One ambiance will develop if the analyst can sense into the patient’s feeling state and share it to a degree, but permits a goal of seeking success in inquiry and change is retained. Or does the analyst get caught up in a countering affect response: anger, defensiveness, shaming, and put-downs often expressed in enactments? Or is goodwill retained and expanded? Is a generalized tone of trust, sensual sharing, and inquiry able to be developed and expanded? If so, the patient’s underlying tone of negative affects and pessimism will gradually be modified. Alternatively, if the treatment leads to erotic outlet being resorted to or dominant - in-submission power struggles becoming predominate in the relationship - the patient’s underlying affect tone will remain unaffected. The clinical narratives of Chapters 2 and 3 present clear examples of success, with the difficult task for the analyst entering motivation disturbances of each of the three pathways being to be richly involved while maintaining goodwill, a spirit of inquiry, and a sensual connectedness. Developments in the ambiance between them then becomes a vehicle for changes in Eileen’s and Samantha’s underlying affect tone.

Reflections

We have presented several variants of familiar analytic concepts: seeking is the fundamental spark for being a doer doing feeling, intending, and meeting goals. Three developmental pathways form to seek human relatedness and intimacy; mastery of the environment and confidence in one’s learning, skills, and ability to play; and bodily health, physiological regulation, a satisfying appearance, and a good body-mind connection. An underlying generalized affect tone develops that reflects success or failure in seeking in each pathway, and contributes to the individual’s disposition, sense of self, and identity. Successful exploratory therapies contribute to modification of the underlying affect tone through interpretation, insight, and empathy, and especially from changes in the ambiance between patient and therapist. Sensuality, a spirit of inquiry, and a sense of power as doer are each a major component in the development of a positive affect tone in the ambiance and in the formation and heightening of goodwill, in and out of treatment.

Chapter 4

 
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