Building Bridges

The Negotiation of Paradox in Psychoanalysis

Stuart A. Pizer

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781134888931
• Edition: 1
• Topic: Psychology
• Subtopic: Interpersonal Relations in Psychology
• Index: Psychology

In Building Bridges, Stuart A. Pizer gives much-needed recognition to the central role of negotiation in the analytic relationship and in the therapeutic process. Building on a Winnicottian perspective that comprehends paradox as the condition for preserving an intrapsychic and relational "potential space, " Pizer explores how the straddling of paradox requires an ongoing process of negotiation and demonstrates how such negotiation articulates the creative potential within the potential space of analysis.Following careful review of Winnicott's perspective on paradox-via the pairings of privacy and interrelatedness, isolation and interdependence, ruthlessness and concern, and the notion of transitional phenomena-Pizer locates these elemental paradoxes within the negotiations of an analytic process. Together, he observes, analyst and patient negotiate the boundaries, potentials, limits, tonalities, resistances, and meanings that determine the course of their clinical dialogue. Elaborating on the theme of a multiply constituted, "distributed" self, Pizer presents a model for the tolerance of paradox as a developmental achievement related to ways in which caretakers function as "transitional mirrors." He then explores the impact of trauma and dissociation on the child's ability to negotiate paradox and clarifies how negotiation of paradox differs from negotiation of conflict. Pizer also broadens the scope of his study by turning to negotiation theory and practices in the disciplines of law, diplomacy, and dispute resolution.Enlivened by numerous clinical vignettes and a richly detailed chronicle of an analytic case from its earliest negotiations to termination, Building Bridges adds a significant dimension to theoretical understanding and clinical practice. It is altogether a psychoanalytic work of our time.

Part I

Paradox and Negotiation in Development and Analysis

1

The Negotiation of Paradox in the Analytic Process

A patient reports the following incident in the course of a “good-enough” analysis with a good analyst. He was lying on the couch, in the midst of whatever associations, when he was distracted by a smell as if someone were spraying trees in the neighborhood. He registered this impingement by saying, “I smell insecticide spray.” From behind the couch, the analyst's voice replied, “It is neither insecticide nor spray. It is something burning.” The patient shrugged internally and went on with whatever his associations had been. At the end of the session, when the patient walked out to the street, he saw a tank truck from a nursery service, such as might spray insecticide, parked in front of his analyst's house. He muttered, “Sonofabitch,” not being certain at that moment whether he was referring to his analyst or himself. The patient began the following day's session with reference to this experience. A psychotherapist himself, the patient raised the issue of the analytic frame defined in terms of psychic reality and external reality as interpreted by analytic authority. He questioned his analyst's attitude of certainty and his own attitude, as patient, of uncertainty. The patient further noted that whatever he had been implicitly communicating by saying, “I smell insecticide spray,” whatever he had been seeking to bring into play—particularly with an analyst whom he knew to be an avid gardener—had been derailed by the analyst's peremptory response. At this point, the analyst affirmed, “This is the danger of too much certainty in the countertransference. I recognize that my remark served to close exploration rather than open it.”

For me, this analytic moment illustrates the feeling of being up against a nonnegotiable stance on the part of one's analyst. Notably, the patient's protest had served to initiate a return to negotiation between them, as the analyst was able to recognize and acknowledge how he had ruptured analytic potential space. This chapter is about the process of negotiation as an intrinsic vehicle of the therapeutic action of psychoanalysis. I examine the nature of analytic negotiation and its relationship to paradox, with particular focus on the implicit place of this concept in the writings of Winnicott. I conclude with clinical material that illustrates the negotiation of paradox in the course of a treatment.

Negotiation is intrapsychic, interpersonal, and intersubjective, and it is vital to our biological existence.¹ Negotiation is intrapsychic in the sense that we must each mediate within ourselves the containment and expression of drive and affect, or inner contradiction and multiplicity, as well as the tension in living between engagement in the fresh potentials of the present moment and enmeshment in the conservative grip of repetition of our past experience; thus, negotiation is an ego function necessary for the internal management of paradoxical experience. Negotiation is interpersonal in the sense that we are always arranging with one another matters of desire, safety, anxiety, power, convenience, fairness, and so on. Negotiation is intersubjective in the sense that we constantly influence one another, consciously and unconsciously, from infancy onward in a myriad of ways, from minute adjustments to gross adaptations. So it is that we experience the fine choreography of infant and mother attaining, rupturing, and repairing states of attunement and affective communion (Stern, 1985; Beebe and Lachmann, 1992) or, in adulthood, the intersubjective exchange of the forces of projective identification by which we shape, and, in turn, are shaped by, our partners. In these ways, collusive relationships are forged around the negotiation of mutually invested defenses and repetitions, and therapeutic or mutually enhancing relationships are created and evolved through an ongoing negotiation that allows for self-expression, spontaneity, and self-realization in a context of safety, respect, and reciprocity.

I believe that, in the psychoanalytic process, the transference-countertransference tapestry is woven between analysand and analyst through a process of intersubjective negotiation. Much of what is essentially mutative in the analytic relationship is rendered through mutual adjustments that occur largely out of awareness in both parties. Only some of this process need ever become conscious to patient or analyst or be explicated through interpretation. The moments of explicit or implicit negotiation between analyst and patient may mark a discernible unit within the analytic process, as distinct from the analytic modes of historical narrative, reconstruction, interpretation, and reflection (although, as we shall see, even interpretation is a matter always subject to negotiation between both parties to the process).

The analyst, as he or she receives a patient's transference communications, is continually monitoring within himself or herself such questions as, What are you making of me? Can I accept this or that construction of me based on my own subjective sense of myself, my integrity, my commitment to the analytic framework as I see it, and my sense of our analytic mission? As a result, the analyst, whether making genetic or here-and-now interpretations (which, in themselves, have importance), is recurrently saying to the patient, “No, you can't make this of me. But you can make that of me.” In turn, the patient receives the analyst's response with relief, gratitude, frustration, hurt, and the like and proceeds to generate further associations that seek to negotiate among past impressions, current experience, and future potential in this field of interplay between two subjectivities. Indeed, it may be the patient who, in response to an analyst's genetic or transference interpretation, declares, “No, you can't make this of me. But you can make that of me.” In short, the very substance and nature of truth and reality—as embodied both in transference-countertransference constructions and in narrative reconstructions—are being negotiated toward consensus in the analytic dyad. The important therapeutic yield of these ongoing and recurrent negotiations goes beyond such products of negotiation as an accepted insight, a retrieved recollection, or a self-analytic reflection on the mind's defensive patterns. Essential as these analytic products surely are, I believe they are secondary to the therapeutic action of psychoanalysis, which is the engagement of two persons in a process of negotiation that, to borrow a phrase from Loewald (1960), is “an intervention designed to set ego development in motion.”

I further believe that people looking back on their successful analyses commonly recall as particularly significant those moments in which their analyst seemed to step outside his or her accustomed position in a way that registered arrival at a deep recognition of the patient's essential being, an epiphanic state of rapport (perhaps marked by humor or sadness), or an affirmation of the personal caring that had spanned the vicissitudes of their relationship. While such moments may come as a surprise to the patient, they do not have the quality of coming from out of the blue or from out of some “left field” in the analyst's psyche, nor are they some whimsical bestowal or slip in analytic attitude. Rather, they have the quality of the analyst's yielding to some subtlety of being in the patient, some subtlety of their relatedness over time, which allows for a freshly discovered play in the analytic framework. These enactments by the analyst have been prepared for over time in the analytic partnership that has made them feasible, viable, and usable. Mitchell (1993) has made note of such analytic moments and attributed them to a negotiation between patient and analyst over the requisite countertransference response to the patient's relational needs, as differentiated from an enacted countertransference gratification of the patient's desires. As Mitchell observes,

What may be most crucial is neither gratification nor frustration, but the process of negotiation itself, in which the analyst finds his own particular way to confirm and participate in the patient's subjective experience yet slowly, over time, establishes his own presence and perspective in a way that the patient can find enriching rather than demolishing [p. 196].

I would add that, while the process of negotiation does unfold “slowly, over time” and while moments of sublime, spontaneous rapport may be rare (and perhaps need not be frequent), the give-and-take of subjectivity, desire, stricture, and demand between patient and analyst is continual, recurrent, and always somehow new and incomplete. Out of this two-person process of negotiation, one may find emerging a patient's growing capacity to encompass wider experiential possibilities within his or her range of negotiable options in living, a growing trust and hope for participation in an increasingly negotiable interpersonal world, and a growing synthetic facility for bridging the inescapable paradoxes of human separateness and connection—in short, ego development set in motion by the analytic process.

Winnicott, that artful dodger of a psychoanalytic author, comfortably nestled in a British literary tradition that conveyed sense through nonsense, was profoundly sensitive to the elemental paradoxes that shape our being and our development (Phillips, 1988). Paradox requires negotiation, and Winnicott's theory is built on paradox.

Perhaps the most widely recognized statement of paradox in Winnicott's writings is in his paper on “Transitional Objects and Transitional Phenomena.” As Winnicott (1951) wrote:

We cannot ignore . . . an intermediate area of experiencing, to which inner reality and external life both contribute. It is an area that is not challenged, because no claim is made on its behalf except that it shall exist as a resting-place for the individual engaged in the perpetual human task of keeping inner and outer reality separate yet interrelated [p. 2].

Thus, out of need, the infant creates the mother's breast, which is there to be found. Later, the child makes of the first not-me possession, such as his Teddy or Blankie, a personal object imbued with life from the subjective world along with sentient qualities from the objective world. According to Winnicott, “The transitional object and the transitional phenomena start each human being off with what will always be important for them, i.e. a neutral area of experience which will not be challenged” (p. 12). Within the paradox of transitional space lies the potential for creative play. Within the preservation of paradox lies the necessity for an ongoing process of negotiation.

Probably the most profound spiritual paradox elucidated by Winnicott is the essential human need to communicate juxtaposed with the essential human need to remain incommunicado. On one hand, we need to experience our connection with objects in the external world in order to feel real. Winnicott recognized the terror to which we are subject if we feel threatened by submergence in the boundless ocean of our own subjectivity. Our psychic life requires both the limits encountered through our abutment with externality and the nourishment provided by other-than-me substance. Even to enjoy our solitude, we need to achieve the state of “ego-relatedness” that Winnicott (1958a) described as the product of the paradoxical experience in infancy of being alone in the presence of another. On the other hand, Winnicott grasped that, as the infant becomes increasingly competent, the mother who anticipates her baby's needs before her baby signals is no longer “good enough.” What was once exquisitely empathic can become traumatically invasive, and the loss of inviolable privacy is an annihilation.

Winnicott (1958a) suggests that, when growth takes place under the best of circumstances, the child comes to possess “three lines of communication” (p. 188). The first is “for ever silent” and constitutes a nonnegotiable retreat to relaxation within the subjective world of the inviolable self. The second is “explicit, indirect and pleasurable” and consists of the capacity for language; and, as Stern (1985) has argued (following Vygotsky, 1962), the meaning of language is negotiated in each child-parent dyad. Thus, language equips the child, for life, with the competence to reveal while concealing, to portray an approximation of experience, to achieve consensual validation without utter exposure. Finally, Winnicott's third line of communication is that “intermediate form of communication that slides out of playing into cultural experience of every kind” (p. 188). This third area of communication, then, is the area of shared symbols, where the most intimate negotiations occur in the overlap between the subjective worlds of self and other, where two people may engage in the creative exchange of gestures, or squiggles,² and construct mutually useful metaphors. When Winnicott shifts the scene to the analytic process, he writes, “Here there is danger if the analyst interprets instead of waiting for the patient to creatively discover” (p. 189). Winnicott is referring to the crucial importance of the negotiation of meaning between analyst and patient, through linguistic approximations and with an attitude of joint creation and a sensitivity to mutual regulation.

As I see it, the process of psychoanalysis may be conceived as an exchange of “squiggles” between adults without pencil and paper. By such an exchange, mostly verbal, of marks and “remarks” offered in evocative and resonant sequence, analyst and patient become cocreators of a relational construction that represents and communicates a place of intersection of their separate experiences together over time. Neither the analyst's “squiggle”—be it interpretation, clarification, confrontation, empathic reflection, or self-disclosure—nor the patient's “squiggle”—be it historical narrative, transference impression, manifest dream, or other association—constitutes an X-ray rendering of “the self's core.” Rather, analyst and patient, in their use of what Winnicott terms “explicit, indirect” communication—that is, language—become an intersubjective partnership for the collaborative creation of a shared culture of usable, and reusable, reverberative images. As analyst and patient come into play in the area of illusion, they create metaphorical renderings of the approximate meaning of their shared trans-ference-countertransference experience (see Chapter 2 for further elaboration of the use of metaphor).

Human self-interest constitutes another basic paradox. We are not only consumers, but also providers. We realize our selves both through the care we receive and the care we give. This fundamental paradox of our nature is entailed in Winnicott's (1962a, 1963b) notion of the principal human drive: toward development. On one hand, it is easy for us to read Winnicott's theory of human development as a kind of infant advocacy theory. From this perspective, development seems to mean the development of a spontaneous self, the achievement of ego integration and psychosomatic unity, and the capacity to use environmental provision for internal robustness and a sense of subjective mastery over the external world. On the other hand, if we trace Winnicott's developmental schema from the phase of absolute dependence through relative dependence and toward independence, we may ask, What are the qualities of “independence”? In this manifestly baby-centered theory, which reminded the psychoanalytic field of the significance of the real facilitating environment in psychological development, we each grow to an adulthood in which we provide the facilitating environment for the next generation. Having once been babies, we now become mothers, fathers, or analysts. Our destiny, as we grow toward independence, is to develop the capacities whereby we may contribute back to the world, by our own adaptations, the holding environment for the nourishment of others. In a sense, reflecting the Kleinian roots in Winnicott's thinking, this generativity constitutes our reparation for our own earliest voracious feeding upon the world that held us in the bliss of our subjectivity. Although Winnicott describes the “primary maternal preoccupation” of the “good-enough” mother as a kind of temporary illness, this state is not based on maternal masochism or sentimentality. It is closer to primary creativity, the mother's illusion that she continues to create her baby while she is merged with it by “almost 100% adaptation” to its needs. The analyst, in moments of “primary analytic preoccupation,” is fortunate to experience a similar joy at being found and used. But what of the human abhorrence of being found? If, as Winnicott has argued, to be found is to be violated, how do we willingly allow ourselves to be found by the infant or the analysand who needs to conjure us for personal usage?

How has the mother actually managed to survive as a separately existing center of need, affect, intensity, and will while adapting to her infant's moment-by-moment imperatives? The answer is implied in Winnicott's (1968) observation that, whereas the baby has not been a mother before—or even a baby—the mother has both been a baby and played at being a mother. Hence, the mother survives in her position as mother by having recourse to her survival as a baby, past, present, and future. Within herself, the mother must find ways of retaining access to her own ruthlessness through her dependence on the actual sustaining support of others; through memory, fantasy, and projection—including her fantasies of utterly creating her baby and utterly destroying her baby; and through her anticipation of her baby's development toward independence, as she has developed in her own course of time. The mother also knows, from her own experience as infant and child, that she is contributing both to her own survival and to her child's growth by imposing a disillusioning process as she introduces frustration where her needs and her baby's emerging tolerance intersect. Similarly, in analysis, the analyst has already been both a baby and a patient and has previously played at being an analyst. The analyst's survival of a patient's ruthlessness reflects the analyst's continued connection with his own inner ruthlessness.³ The analyst, then, survives as an analyst by surviving as a patient, with his memories of patienthood; his projections of patienthood; his own fantasies of primary creativity and utter destructiveness toward his patient; and his anticipation of his patient's potential for development, including a firmer tolerance for the essential disillusioning process delivered through optimal frustrations (including interpretations). This very process within the analyst, surviving as a patient, constitutes the analyst's ongoing, self-analytic use of the countertransference and the opportunity to change and grow as a person while responsibly fulfilling his role to survive as analyst.

In the developmental process, as it approximately follows this course, the infant comes to recognize that its mother has endured its ruthless usage and has survived. The infant has been able to make of mother what it needed, and yet mother has been capable of remaining herself. This recognition allows for the emergence of love for the mother, a love that is not only libidinall...

Table of contents

• Front Cover
• Half Title
• RELATIONAL PERSPECTIVES BOOK SERIES
• Title Page
• Copyright
• Dedication
• Contents
• Dedication
• Preface
• Acknowledgments
• Part I: Paradox and Negotiation in Development and Analysis
• Part II: Paradox and Negotiation in Wider Contexts: Genders, Species, Nations
• Epilogue: “The Scent of a Spring Day”
• References
• Index