Academic journal article International Journal of Psychoanalysis

Analytic Impasse and the Third: Clinical Implications of Intersubjectivity Theory

Academic journal article International Journal of Psychoanalysis

Analytic Impasse and the Third: Clinical Implications of Intersubjectivity Theory

Article excerpt

The author examines the notion of the third within contemporary intersubjectivity theory. He utilizes a variety of metaphors (the triangle, the seesaw, strange attractors, and the compass) in an effort to explain this often misunderstood concept in a clear and readily usable manner. An argument is made to the effect that intersubjectivity theory has direct implications for clinical practice, and that the notion of the third is particularly useful in understanding what happens in and in resolving clinical impasses and stalemates. Specifically, the author suggests that certain forms of self-disclosure are best understood as attempts to create a third point of reference, thus opening up psychic space for self-reflection and mentalization. He provides a clinical case as well as a number of briefer vignettes to illustrate the theoretical concepts and to suggest specific modifications of the psychoanalyst's stance that give the patient greater access to the inner workings of the analyst's mind. This introduces a third that facilitates the gradual transformation from relations of complementarity to relations of mutuality.

Keywords: impasse, third, Benjamin, intersubjectivity, self-disclosure, complementarity, relational, mutuality

A bright, talented, and experienced supervisee, whose office is in downtown Manhattan, presented a dilemma to me in consultation soon after 9/11. She was treating a man who, following the calamity, confided in her that he actually was not very upset about the event. As a matter of fact, he said, he found the whole thing exciting and energizing. During the morning of September 11th, he stood upon his Manhattan rooftop, like many New Yorkers, with binoculars and camera in hand, and in the aftermath of the attack he was glued to CNN enjoying the prospect of war. My supervisee told me that she was privately horrified by his callousness. She had long known of his narcissistic tendencies but was not sure how to approach this material. She, like so many of our colleagues in the psychoanalytic community, had been volunteering her time and was actively engaged in disaster-relief efforts. It disturbed my supervisee to think that such raw aggression and pitilessness could so dominate her patient's mind. She told me that in the midst of the session she became determined to make every effort to sustain 'an empathic stance.' She found this quite difficult and uncomfortable and doubted that she could maintain an empathic attitude in any way that felt genuine.

As a supervisor, I had the distinct advantage that I was not caught up in the immediacy of the transference-countertransference enactment. I was able to help my supervisee to see that there were many ways of understanding her patient's reactions on the basis of what we already knew about him. For one, her patient had a chaotic inner life, filled with images of violence, unconscious fantasies of bodily damage, and themes of sadomasochism. It seemed to me quite understandable that her patient felt relief in the midst of the city's catastrophe, simply because, at least momentarily, the violence and chaos, the destructiveness and the destruction, were externalized, concretely taking place, for once, not in his own mind but externally in the world of others.

I pointed out that, with the patient so directly barraging her with his aggression, it would be hard to know what it might mean to him if she responded with exaggerated or feigned empathy. Together we explored to what degree my supervisee had become fixed in her identification with the victims and the rescuers, thus locking her patient into his reciprocal identifications with the powerful and frightening terrorists. But, from the reverse perspective, how much was the patient's being locked into one set of identifications pushing the therapist into identifying with the complementary roles? As Davies has written,

Such cases of apparently inescapable therapeutic impasse always pose for me the dilemma that patient and analyst become prisoners of the coercive projective power of each other's vision; each becomes hopelessly defined by the other and incapable of escaping the force of the interactive pull to act in creative and fully agentic ways. …

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