Moments of Meeting in Psychoanalysis

Interaction and Change in the Therapeutic Encounter

Susan Lord

• Publisher: Routledge
• Year: 2017
• Print ISBN:
  9781138229228
• eBook ISBN:
  9781315389943
• Topic: Psychology
• Subtopic: Mental Health in Psychology
• Index: Psychology

There are moments of connection between analysts and patients during any therapeutic encounter upon which the therapy can turn. Moments of Meeting in Psychoanalysis explores how analysts and therapists can experience these moments of meeting, shows how this interaction can become an enlivening and creative process, and seeks to recognise how it can change both the analyst and patient in profound and fundamental ways.

The theory and practice of contemporary psychoanalysis and psychoanalytic psychotherapy has reached an exciting new moment of generous and generative interaction. As psychoanalysts become more intersubjective and relational in their work, it becomes increasingly critical that they develop approaches that have the capacity to harness and understand powerful moments of meeting, capable of propelling change through the therapeutic relationship. Often these are surprising human moments in which both client and clinician are moved and transformed. Moments of Meeting in Psychoanalysis offers a window into the ways in which some of today's practitioners think about, encourage, and work with these moments of meeting in their practices. Each chapter of the book offers theoretical material, case examples, and a discussion of various therapists' reflections on and experiences with these moments of meeting.

With contributions from relational psychoanalysts, psychotherapists and Jungian analysts, and covering essential topics such as shame, impasse, mindfulness, and group work, this book offers new theoretical thinking and practical clinical guidance on how best to work with moments of meeting in any relationally oriented therapeutic practice. Moments of Meeting in Psychoanalysis will be of great interest to psychoanalysts, psychoanalytic psychotherapists, psychologists, social workers, workers in other mental health fields, graduate students, and anyone interested in change processes.

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Part I
Background/context

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Chapter 1
My journey in infant research and psychoanalysis

Microanalysis, a social microscope

Beatrice Beebe

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Video microanalysis taught me to see how the intricate process of mother-infant moment-to-moment communication works. It is a powerful research, treatment, and training tool. I owe my love of video microanalysis to Dan Stern.

Video or film microanalysis operates like a social microscope into the underworld just below perceptible view in real time. Mother-infant communicative events occur in less than a second (Beebe, 1982). They are so rapid and subtle that they are not quite grasped in real time. By slowing down the movements, frame-by-frame microanalysis identifies remarkably beautiful moments, such as both partners rising up and up into glorious sunbursts of smiles. It also reveals very disturbing moments, such as maternal anger or disgust faces, or infants becoming frantically distressed or frozen in alarm. By videotaping mothers and infants split-screen, one camera on each partner, we can see the moment-by-moment dialogue between the two.

From birth, infants live in a two-person social world, and they are capable of coordinating their behaviors with those of the partner (Peery, 1980; Trevarthen, 1979).

Each partner coordinates with the other, a bidirectional mutual regulation. Later I will describe how bidirectional regulation became a key contribution of infant research to a psychoanalytic theory of development and treatment.

This rapid face-to-face communication system that we study between mothers and infants also operates between adults. Because verbal language is not available for infants, we must try to understand their nonverbal language. Adult face-to-face communication is very similar to mother-infant communication. The nonverbal aspects of behavior, such as gaze shifts, slight changes in facial expression or head orientation, and eyebrow raises, are almost imperceptible, but are extremely influential in communicating. This rapid, quasi-automatic social processing is largely nonconscious, out of awareness. It is an implicit, procedural, action-sequence form of processing. It is probably based on evolutionary adaptation to the need for rapid interpersonal processing and action in the service of survival. Frank Lachmann and I became fascinated with parallels between mother-infant communication and nonverbal communication in adult treatment. This fascination has fueled our collaboration for three decades.

The state of infant research as I entered graduate school in 1968

When I entered graduate school in 1968, at Teachers College, Columbia University, the empirical microanalysis of mother-infant face-to-face communication did not yet exist as a field. It was just beginning. Daniel Stern published his first paper in 1971; Colwyn Trevarthen in 1972; T. Berry Brazelton, Barbara Kozlowski, and Mary Main in 1974. Edward Tronick, Brazelton’s student, soon became a leading figure in the late 1970s. Lynne Murray, Trevarthen’s student, and Jeffrey Cohn, Ed Tronick’s student, as well as Alan Fogel, Tiffany Field, and Michael Lewis, among others, were active at that time. These researchers began with low-risk community samples to understand the course of normal development. Two decades later, risk factors, such as maternal depression, began to be included (Field, 1995).

The decade of the 1960s had generated a body of work that Stone, Smith, and Murphy (1973) summarized as “the competent infant.” This set the stage for the study of mother-infant communication, including the role of a competent, initiating, social infant. In 1968, Bell published a paper that helped shift the paradigm of child development research toward an interactive systems view. He argued that most of the research to date had emphasized parental influence upon children, a one-way influence model, to the relative exclusion of the child’s influence on the parent. Bell reinterpreted this research within a bidirectional model.

With increasing recognition of the infant’s social competence, researchers became interested in a bidirectional, or mutual, model of influence, within the dyad as a system. An important book entitled The Effect of the Infant on the Caregiver was written by Lewis and Rosenblum (1974) in an effort to highlight the neglected role of the infant in mutual regulation. However, in the 1970s and 1980s, infant researchers argued vehemently over whether the bidirectional, mutual regulation model was correct. This was the intellectual Zeitgeist that I entered as I began graduate school in 1968 and became interested in infant research.

Not until two decades later was this debate resolved, with Cohn and Tronick’s (1988) landmark paper that used time-series analysis to show that mother-infant interaction is indeed bidirectional. Until this time, everyone had used a different statistical method to try to assess bidirectional influence, and no one replicated his or her own work, or anyone else’s. The approach of time-series mathematics revolutionized the study of social interaction in the 1980s and was critical in resolving this debate. It assesses moment-to-moment adjustments (interactive predictability) that each individual makes to the partner’s prior behavior, while it controls for each partner’s self-predictability. Metaphorically, it measures expectancies of “how I affect you,” and “how you affect me.” This became our method as well. Cohn and Tronick’s (1988) resolution of this debate by documenting bidirectional mutual influence between mother and infant laid the empirical foundation for an interactive systems model of infant social development.

Graduate school at Teachers College

At Teachers College in 1968, I pursued a joint doctorate in developmental and clinical psychology. In my first year, George Rand, in developmental psychology, taught me about different theories of development and especially about Heinz Werner and Jean Piaget. George had studied with Heinz Werner. Both Werner and Piaget held an interactive model of development in which both organism and environment affect one another. This fit so well with the bidirectional model from infant research.

George was the first to encourage me to follow my interest in infants. I remember that I entered graduate school with the idea that I wanted to study “mother-infant reciprocity” and infant emotional development; however, initially I did not meet with a lot of encouragement to study infants. Even in a department of developmental psychology, infants were seen as rather undifferentiated. I was advised to study children whose emotional development would be really interesting.

Once I met Dan Stern, everything was different. There was no question that the study of mother-infant communication was hugely exciting and fascinating. I met Dan Stern at New York State Psychiatric Institute (NYSPI), Columbia University Medical School, in 1969, in my second year of graduate school. I was asking everyone for a lead to an infant researcher. I heard about him on Fire Island, where he often went for summer vacation. I remember the day I met Dan. I arrived at the open door of his office, while he was on the telephone. As he carried on his verbal conversation on the telephone, he also carried on another nonverbal conversation with me, through his face and eyes, which were welcoming and interested. Already we were into nonverbal communication.

I worked for Dan Stern as a volunteer research assistant at NYSPI from 1969 to 1973. I later learned that Dan had been a postdoctoral fellow of Joe Jaffe at NYSPI, and they were working together at this time. I had no idea then that eventually I would spend four decades working closely with Joe Jaffe.

Dan, accompanied by several graduate students, was videotaping twins in their homes with one camera. Dan encouraged the students to play with the infants on camera as well. I played with infants, which set the stage for the study of “stranger-infant” interaction. At that time, we had no idea that stranger-infant interaction would turn out to be a powerful predictor of development.

Being the stranger playing with the infants in those home visits with Dan Stern shaped my interest in infant research. One of these visits was particularly memorable. I played with an infant whose face was full of joy. As I watched her face respond to mine, tears came to my eyes. I was so astonished and moved by how closely she tracked my face, how exquisitely she seemed to respond to me, how her face burst into what I later came to call the “gape smile,” the hugely open-mouth smile, the apex of positive affect. That particular experience led me to do my dissertation with Stern. I wanted to study what I had observed in that infant, the process of positive affect, how it surges, ebbs, and crescendos. My dissertation was entitled, “Ontogeny of positive affect in the third and fourth months of life of one infant” (Beebe, 1973). The four frames below are taken from my dissertation and illustrate the process of positive affect crescendo. The fourth frame is the gape smile (Figure 1).

Dan was very playful. We, the other graduate students and I, loved going on these outings with Dan. In the lab, he always wanted to go get a cup of coffee and tell about his newest ideas. He had tremendous energy and enthusiasm and brilliance. Everything seemed possible with Dan.

Figure 1 Sequence of infant positive affect. Note: 16mm film, 24 frames per second. Numbers printed at the top of the frame indicate 24ths of a second: 10651, 10661, 10695, 10717. Frames 1 to 2 are about ½ second apart; frames 2 to 3 about 1.5 second apart, and frames 3 to 4 about 1 second apart. Affect intensity levels are coded by degree of mouth open (1 to 4), degree of mouth widen (1 to 3), and presence or absence of bowing at the mouth corners, which indicates zygomaticus retraction, producing a smile. Note that the infant’s head moving up is salient in the final frame.

Dan sponsored my PhD dissertation, along with Herbert Birch and Rosalie Schonbar at Teachers College. Herbert Birch was a brilliant developmental researcher. He backed my interest in doing a case study, a microanalysis of one mother-infant pair. Then, and even now, an empirical dissertation on a single case is rare. Sadly, Birch died just as I began the initial phases of analyzing my data. I wish he could have seen the work that he had so encouraged.

Microanalysis in 1969

In 1969, the use of video cameras was relatively new, and computers were still uncommon. Video was reel-to-reel and difficult to code. To perform a microanalysis, we converted video to 16 mm film, which had 24 frames per second. We used an editing viewer, a small metal box anchored to a board, through which one could view the film. The board had metal posts on either side of the box, onto which two film reels were securely attached. The film fit through the metal box, and a light projected the film onto the wall, but to see the film, one had to be in a darkroom. The setup was just like one for editing a film, except instead of cutting the film, we were analyzing it. Numbers were printed on the top of each film frame. With one’s own hands, one could slowly move the film forward and back to watch movement unfold in time. We identified the beginning and ending frame of each little movement of mother and infant. These movements, such as slight shifts of gaze, head-up, or mouth-opening, typically last about a quarter to a third of a second (Beebe, 1982).

Today, digitized video makes this entire process so much easier, but the hand method of frame-by-frame analysis of film had one interesting advantage. My own body movement was involved in detecting the onset and offset of each behavior. For example, in the chase and dodge interaction (described below), as I rocked the film back and forth between the two reels, my body moved with the mother’s movement as she loomed in close to the infant’s face, and my body moved with the infant’s head movement back and away from the mother, a split-second later. I believe my own visceral feedback helped me better comprehend how these movements might be experienced by the infant and by the mother. This is a form of embodied simulation. Performing the action of another person influences one’s perception of the person’s action and facilitates recognition of it (Oberman, Winkielman, & Ramachandran, 2007; Niedenthal, Mermillod, Maringer, & Hess, 2010; Beebe & Lachmann, 2013). In my case, I was participating in the action through my body movements as I coded.

Stern’s first paper

Dan Stern’s first paper was in progress as I joined his research team. It was a film microanalysis showing the difference in interactive regulation between a mother and her dyzygotic twins (Stern, 1971). Stern’s approach to microanalysis was influenced by ethology, which privileges the careful description of behavior in its natural habitat, detailing the form, sequence, and timing of behavior. Careful description is a prerequisite to understanding the social communication value of behavior. This ethological approach continues to influence the microanalysis of mother-infant communication.

When Dan had finished the coding of the mother and infant gaze and head orientation behaviors for his paper, we pasted the data all over the walls of Dan’s office. We were so excited. In this very first paper, Dan positioned the interaction and its bidirectional regulation as central to the understanding of a relationship. He was interested in how each partner affected the other. Dan showed fascinating ways in which this mother interacted so differently with her two twins, and each twin, Fred and Mark, interacted differently with her. Mother and Fred had an approach-avoid spatial pattern, with split-second bidirectional contingencies. Mother and Mark had an approach-approach pattern, also with split-second coordination.

Dan presented his findings in the infant research meetings, the International Conference of Infant Studies (ICIS). We all felt on the crest of something so new, so important. I met Ed Tronick at the ICIS meeting in the spring of 1974. He has remained an important friend and colleague for four decades.

Stern (1974) framed the study of mother-infant interaction in the larger context of its importance for interpersonal object relations and attachment, still a central research issue today: “By providing a more fine-grained view of the instant-by-instant interactive events which make up the mother-infant relationship, we may be in a better position to modify and expand current working theories on the nature of developing object relations or attachments” (Stern, 1974, p. 402). Stern (1985) later developed these ideas in his groundbreaking work, The Interpersonal World of the Infant, which had a transforming effect on psychoanalysis.

My clinical training

Meanwhile, I also pursued the clinical side of my training. In 1971 to 1972, I did my clinical internship at Yale at the Connecticut Mental Health Center. There I met Sid Blatt. We shared an interest in the developmental theories of Heinz Werner and Jean Piaget. Sid ...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Table of Contents
• List of contributors
• Acknowledgments
• Introduction
• Part I Background/context
• Part II Jungian approaches to relational work
• Part III Relational analysis and psychoanalytic psychotherapy
• Part IV Alternative relational modalities
• Afterword
• Index