Toward an Emancipatory Psychoanalysis

Brandchaft's Intersubjective Vision

Bernard Brandchaft, Shelley Doctors, Dorienne Sorter

• Publisher: Routledge
• Year: 2011
• ISBN:
  9781135840433
• Edition: 1
• Topic: Psychologie
• Subtopic: Psychanalyse

Best known for his contributions to the development of contemporary intersubjectivity theory, Bernard Brandchaft has dedicated a career to the advancement of psychoanalytic theory and practice. Continually searching for a theoretical viewpoint that would satisfactorily explain the clinical phenomena he was encountering, his curiosity eventually led him to the work of Heinz Kohut and the then-emerging school of self psychology. However, seemingly always one step ahead of the crowd, Brandchaft constantly reformulated his ideas about and investigations into the intersubjective nature of human experiences.

Many of the chapters in this volume have never before been published. Together, they articulate the evolution of Brandchaft's thinking along the road toward an emancipatory psychoanalysis. Moreover, commentary fromShelley Doctors and Dorienne Sorter – in addition to Bernard Brandchaft himself – examines the clinical implications of the theoretical shifts that he advocated and provides a contemporary context for the case material and conclusions each paper presents. These theoretical shifts, both clear and subtle, are thereby elucidated to formthe grand narrative of a truly visionary psychoanalytic thinker.

Chapter 1
Encountering Brandchaft

The volume the reader holds in his or her hands is devoted to an explication of Bernard Brandchaft’s distinctive contributions over many decades to psychoanalysis. In this chapter, two of us, Shelley Doctors and Dorienne Sorter, describe how our collaboration with Bernard Brandchaft first came about and how it ultimately resulted in this volume. In addition, we will briefly preview the book’s main developmental and clinical concepts and its organization.

When we first heard Brandchaft present “A Case of Intractable Depression” (reprised herein as Chapter 5) at the annual Self Psychology Conference in 1986, intersubjectivity theory was still in its infancy. The treatment he described was remarkable in several ways. The patient suffered from a recurrent severe depression that had robbed his life of joy and interfered profoundly with his use of his prodigious creative talents. Previous attempts at therapy had been unsuccessful. The analysis with Brandchaft extended over many years, as analyst and patient struggled to understand the tenacious psychological obstacles that vitiated each small sign of progress. The audience was gripped. One could almost sense a collective groan rise up in the auditorium as Brandchaft reported that just as hard-won progress eventually came, the patient developed two very serious illnesses, one after the other, that further imperiled his life and challenged the nascent hope he was just beginning to consolidate. The description of the patient’s long, arduous journey to a full recovery, both physical and psychological, provided an awesome introduction to Brandchaft’s deep faith in the potential of psychoanalysis to free people from self-defeating patterns established in childhood. His capacities to recognize his own theoretical and clinical missteps, to bear his own frustration and self-doubt, and to avoid using psychological coercion in an effort to “cure” his patient seemed to us unrivaled.

Though we had each carefully studied Atwood and Stolorow’s (1984) Structures of Subjectivity and were excited about the then-new intersubjec-tive perspective on development, pathogenesis, and the clinical situation, we weren’t yet completely cognizant of the extent to which Brandchaft had been a significant contributor to that volume.¹ And, despite our admiration for Brandchaft’s clinical fortitude, we didn’t yet fully understand how the clinical work described in the paper we heard reflected a thoroughgoing intersubjective understanding of psychological life and its vicissitudes. The patterns of thought and feeling that characterized the patient’s adult personality bore a clear isomorphic relationship to the intersubjective interactions that pertained in his childhood. And the outlines of Brandchaft’s clinical approach (including his handling of transference wishes and fears) were already on display. As the reader will discover, Brandchaft believes that reliable, comfortable access to one’s own point of view is the irreplaceable foundation for a life that reflects one’s own spirit, values, and proclivities. Yet years would pass and many books and papers would be written before Bob Stolorow would name Brandchaft’s intersubjective approach an “eman-cipatory psychoanalysis,” emphasizing its most central, defining feature.

One of us, Shelley Doctors, had already profited from many years of close supervision with Robert Stolorow and George Atwood, and the other, Dorienne Sorter, was a veteran of a decade of wonderful supervision with another collaborator of theirs, Frank Lachmann, when the opportunity arose in the course of psychoanalytic training to have supervision with “Bernie” Brandchaft himself. First, one of us jumped at the chance, and soon thereafter the other followed suit. Both of us are grateful for the privilege, though we each initially found the experience puzzling and at times almost disorganizing.

Brandchaft seemed to listen in a way that was initially hard to fathom. We read our process notes to him over the phone. Each of us clearly recalls moments when he would intervene to point to a shift in the patient’s affective tone that hadn’t been noticed. Or else he would ask, simply, “Why did you say that?” With the luxury of repetition over time, we both came more easily to recognize the imprint of the patient’s formative intersubjective milieu on his or her narrative. And, as a consequence, we both found ourselves becoming more sensitive to whether we were facilitating or obstructing the empathic investigation of the patient’s psychological world—and to how we were doing so. These understandings are a central ingredient in Brandchaft’s distinctive therapeutic approach, and they inform his intersub-jective understanding of how the person fares in development and in the analytic process. We were privileged to learn firsthand how these skills might be utilized to inform our own perceptions of and responses to our patients. Yet our acquaintance with him, and his work, was still just beginning.

We also learned about Brandchaft’s best-known theoretical concept, “systems of pathological accommodation” (see Chapter 12), through our supervision with him, before the concept had acquired a name and before the first paper on it had been written (Brandchaft, 1994). When applied to the patient’s psychopathology, it refers to ways of being that first appear early in development in relation to caretakers whose capacity to adjust themselves to their children’s psychological worlds is limited (usually by the conditions they experienced in their own childhood). The term accommodation refers to the child’s response to this relational trauma, for children adjust to threats to their attachment relationships by attempting to fit in with their caretaker’s world when their caretaker cannot recognize and respond to theirs. The needs and feelings of the parent are then privileged by the child at the expense of the child’s authentic self experience. The tendency to recreate this kind of relational system causes profound strife in all who are so entrapped, partly because the sufferer is usually as unaware of his role in perpetuating this way of being as he is blind to its origins. Of course, this circumstance will also characterize aspects of the analyst’s development and its vicissitudes.

Patients and analysts alike will have acquired automatic relational tendencies in the domain of pathological accommodation. And these tendencies will affect the co-constructed interaction in the therapeutic dyad, often in ways that can be difficult to recognize. To be sure, attending to the patient’s need to “accommodate” to the analyst to avoid upsetting him or her and disrupting the connection is far easier than coming to notice such tendencies of one’s own in the interaction with the patient. Yet, as Brandchaft insists, the emancipatory goal must be pursued by analyst and patient alike for the communicative link to remain truly open. For the two of us, nothing in the acquisition of psychotherapeutic skills has been as elusive or as rewarding as learning to recognize and to monitor more closely the choices made in balancing what one assumes is clinical tact with one’s continuing efforts to illuminate the patient’s psychological world. To discover one’s own prereflectively unconscious need to manage a patient’s affect, as one has learned to do in an early attachment relationship, is personally astonishing but bears fruit therapeutically. Furthermore, it sensitizes the analyst to the automaticity of such tendencies and their deep roots, which helps him or her to empathize with his or her patient’s struggles.

As one conference followed another and more papers and cases were presented, we often reflected on our good fortune in learning from Brandchaft himself aspects of his approach not easily grasped, even by many of his admirers and close colleagues. It was our habit to travel back and forth to the annual meetings together. We began to notice that each year, as we reviewed the conference proceedings, we found ourselves observing and commenting to each other about how one or another of our colleagues’ contributions might have benefitted from a greater appreciation of Bernie’s ideas. Thus was the inspiration for this book born—but also resisted, as each of us deferred tackling what loomed as an imposing endeavor in favor of keeping up with our already demanding schedules and overflowing commitments, personal and professional. Though as members of an enthusiastic informal cadre of professional colleagues, former students, and supervisees we continued to propagate Brandchaft’s views through teaching, supervision, and professional writing, it wasn’t until 20 years after meeting him that we undertook to approach him about preparing this book.

In a series of discussions, which came to include Kristopher Spring of Routledge, we agreed on a plan to approach an ambitious project. Brandchaft, Doctors, and Sorter would review all Brandchaft’s existing papers, including some important unpublished manuscripts and presentations that had sometimes been circulated privately. Together, we would choose published and previously unpublished papers for the volume and make such revisions as the book required. Brandchaft committed himself to writing two new chapters, one (Chapter 2) that would survey his work as a whole and another (Chapter 13) that would offer his summary thoughts about how his work furthers the distinctive psychoanalytic understanding of unconscious determination while describing further features of his own intersubjective approach and how it has been informed by systems theory and new developmental understandings. We two would write three chapters of our own: this one as an introduction to the volume, another one reviewing some of Brandchaft’s reconsiderations of psychoanalytic theory not included in the volume (Chapter 4), and the last (Chapter 14) considering the volume as a whole and highlighting some of its interconnections with current psychoanalytic theory and practice. In addition, we two would write brief commentaries, either at the beginning or at the end of the chapters (the commentary for Chapter 11, however, was written by Brandchaft himself); these commentaries were to provide historical context and/or to emphasize nuances that our own experiences had led us to be believe might be especially appreciated by new readers and by teachers of psychotherapy and psychoanalysis. Our collaboration has involved two years of countless animated discussions, two-way and three-way, by phone, e-mail, and post; a more engrossing and rewarding odyssey can hardly be imagined. All the pages of this volume have been carefully reviewed by all three of us.

Not everything is possible. The need to restrict the length of this volume has forced us to exclude some contributions we believe should be saved for analytic posterity, a problem that still occupies us and that may eventually be solved by posting the papers on a Web site. Nonetheless, we hope that the works we were able to include, whether published, published and revised, previously unpublished, or newly written for this volume, succeed in capturing the trajectory of Brandchaft’s thinking and, more important, in detailing the building blocks of an emancipatory psychoanalytic approach.

In the main, following Chapters 1 and 2, the chapters proceed chronologically. Reading them in sequence, one can trace the evolution of Brandchaft’s passionate commitment to psychoanalysis and his continuous search for theories and methods capable of illuminating and transforming symptoms and problems that had been impervious to previous theoretical and clinical efforts. It is an inspiring chronicle. Again and again, without losing his respect for either psychoanalysis or its dedicated practitioners (sometimes valued friends and colleagues), Brandchaft trenchantly eschewed approaches he found inadequate to the treatment of the psychopathological configurations he was encountering. Learning from his clinical encounters, he developed a subtle appreciation, informed by current research but uniquely his own, for the vulnerability of the child’s developing psychological organization to the intersubjective impact of his or her surround. This understanding enabled him to create a set of ideas that carry powerful therapeutic implications for the conduct of treatment. Reexamined retrospectively, each shift in Brandchaft’s thinking over a 60-year period occurred somewhat ahead of the eventual acceptance of his or similar ideas in the wider analytic community, as the pace of his progress accelerated toward a fully contextual mode of understanding. He has been, throughout his career, a truly original thinker.

The intersubjective point of view is currently prominent. By following the arc of Brandchaft’s development, one can view the conceptual groundwork he helped lay for it at the outset and, as it evolved, in a new light. Contemporary psychoanalytic developmental theory and clinical formulations are replete with references to intersubjective ideas, though sometimes the term intersubjectivity refers to the psychological field created by the interaction of two different worlds of experience (Atwood & Stolorow, 1984; Orange, 1995; Orange, Atwood, & Stolorow, 1997; Stolorow, Atwood, & Brandchaft, 1994; Stolorow, Brandchaft, & Atwood, 1987) and sometimes to a mode of relationship (Beebe, Knoblauch, Rustin, & Sorter, 2005; Benjamin, 1988, 1992; Meltzoff & Moore, 1998; Ogden, 1986; Stern, 1985; Trevarthen, 1980). Both usages are also prominent in the burgeoning relational approach to psychoanalysis (Greenberg & Mitchell, 1983; Mitchell, 1988). For many years now Brandchaft (1983, 1987, 1994) has been making seminal contributions to intersubjectivity considered both as the psychological context within which all development, and indeed all psychological life, takes place and as the necessary context for observation and therapeutic intervention in the intersubjective field of the psychoanalytic situation.

To see these dimensions intertwine again and again, to see the patient’s subjectivity, which has developed intersubjectively, unfold and interact intersubjectively in life and psychoanalysis is, we think, one of the rewards of this volume. To understand how this intertwining yields new leverage in the treatment of conditions hitherto considered unanalyzable is powerful and, we think, revelatory. The patient’s struggle to recognize and free himself from ways of being that were established to survive in underfacilitating, even noxious, contexts comes alive in Brandchaft’s empathic recounting.

We believe these chapters will also be of interest to anyone seeking a better general understanding of the evolution of psychoanalytic theory and practice in the past 60 years, for this period of dramatic change corresponds precisely with the span of Brandchaft’s psychoanalytic career. His training began when drives were considered paramount and ego psychology ruled the day. He soon became one of the first American analysts to study extensively with the British object relations group, even taking a sabbatical year in London for that purpose. His continuous scholarly search for models that better captured the clinical phenomena he was observing next brought him into Heinz Kohut’s circle early during the development of self psychology. From there, via his collaboration with Atwood and Stolorow, he went on to become a pivotal figure in advancing the intersubjective viewpoint. One can learn about these developments in other ways, to be sure, but here it is possible, through the refracted lens of Brandchaft’s experiences in psychoanalytic practice, to see clearly how the shifts from one point of view to the next were clinically necessary and therapeutically consequential.

Most important, these chapters provide a guide to the evolution of Brandchaft’s thinking about daunting clinical phenomena. His understanding of resistance and defense, for example, topics of continuous interest to psychoanalysts from Freud onward, can be seen to develop ever more precisely and emphatically as his understanding of the radically intersub-jective nature of human experience deepened. Yet, as conceptually astute as it is, Brandchaft’s intersubjective clinical approach cannot be reduced to a series of technical precepts. Rather, the reader will repeatedly encounter an emphasis on processes that potentially contribute to the illumination of the patient’s psychological universe—processes such as sustained empathic inquiry, self-reflection for patient and analyst, and attention to (and investigation of) minute shifts in affect together with the patterns that characterize repetitive affective sequences.

The sensitive and disciplined utilization of these processes informs Brandchaft’s emancipatory approach. Though Brandchaft has remained committed to the empathic-introspective stance pioneered by Kohut (1959) and advocated encouraging the patient’s (and analyst’s) self-reflection long before this idea gained popularity through Peter Fonagy, Mary Target, and their coworkers’ work on “mentalization,” his clinical approach remains distinctive. As the reader will see, it is informed by (a) his intersubjective understanding of the development of mind in both facilitating and traumatic circumstances, (b) his appreciation of the complications introduced by the bedrock nature of the human need for attachment relationships, and (c) his understanding of the reverberating, reciprocal interactive regulation that characterizes the developmental and therapeutic contexts. Taken together, these elements constitute a framework for appreciating human nature, relationships, and psychological life from which important clinical understandings flow.

It is the patient who matters most. Whether, on the one hand, one thinks in terms of the principles that once organized the patient’s intersubjective milieu in childhood and how these prereflectively unconscious organizing principles present in the patient’s narrative or, on the other hand, one attends to the minute affect shifts that signal the accommodations patients and analysts make to one another in the present, the understanding of such clinical phenomena merges in these pages with Brandchaft’s overall perspective in a way that facilitates a deeply human conception of human nature in all its particularity. Rather than technical precepts, one finds rich case descriptions replete with convincing human detail, providing a series of illustrations of real personalities and of what can be done to alleviate their suffering and self-alienation.

Ultimately Brandchaft seeks to empower patients to privilege their own thoughts and feelings while learning to recognize the psychological conditions that lead them to cling to received wisdom and to old patterns that once provided a modicum of security. There is great profundity to this contribution, and there is exquisite subtlety as well. Learning to attend closely to small shifts in the patient’s affect yields important dividends, though sensitively opening such shifts to clinical investigation requires a disciplined, careful approach. Learning to become aware of what one listens for and what informs one’s responses and developing a keener appreciation of how the analyst’s presence affects the patient (as the patient’s presence affects the analyst) emerge from studying Brandchaft’s example and can transform one’s understanding of the analytic process.

Although constructed to be read from start to finish, this volume is structured so that those seeking to sample some of Brandchaft’s work, as well as those seeking to add some of Brandchaft’s contributions to their psychoanalytic or psychotherapeutic syllabus, will, we hope, find it easy to utilize individual chapters to learn or to teach.

1 Bernard Brandchaft was acknowledged as a collaborator on Chapters 2 and 3 of Structures of Subjectivity (1984).

Chapter 2
Toward an emancipatory psychoanalysis

It is with some surprise that I find myself, at the end of my career, involved in the writing of a book. It is not that writing has been foreign to me or that the business of assembling chapters and polishing arguments is unknown in my professional experience. But I had not envisioned undertaking a project of this scope at this late date or that with the encouragement of valued colleagues and former students, I would be joining with Dorienne Sorter and Shelley Doctors in an effort to publish a...