A Spirit of Inquiry

Communication in Psychoanalysis

Joseph D. Lichtenberg, Frank M. Lachmann, James L. Fosshage

• Publisher: Routledge
• Year: 2013
• eBook ISBN: 9781134908257
• Topic: Psychology
• Subtopic: Applied Psychology
• Index: Psychology

Thoroughly grounded in contemporary developmental research, A Spirit of Inquiry: Communication in Psychoanalysis explores the ecological niche of the infant-caregiver dyad and examines the evolutionary leap that permits communication to take place concurrently in verbal an nonverbal modes. Via the uniquely human capacity for speech, the authors hold, intercommunication deepens into a continuous process of listening to, sensing into, and deciphering motivation-driven messages. The analytic exchange is unique owing to a broad communicative repertoire that encompasses all the permutations of day-to-day exchanges. It is the spirit of inquiry that endows such communicative moments with an overarching sense of purpose and thereby permits analysis to become an intimate relationship decisively unlike any other.

In elucidating the special character of this relationship, the authors refine their understanding of motivational systems theory by showing how exploration, previously conceptualized as a discrete motivational system, simultaneously infuses all the motivational systems with an integrative dynamic that tends to a cohesive sense of self. Of equal note is their discerning use of contemporary attachment reseach, which provides convincing evidence of the link between crucial relationships and communication.

Replete with detailed case studies that illustrate both the context and nature of specific analytic inquiries, A Spirit of Inquiry presents a novel perspective, sustained by empirical research, for integrating the various communicative modalities that arise in any psychoanalytic treatment. The result is a deepened understanding of subjectivity and intersubjectivity in analytic relationships. Indeed, the book is a compelling brief for the claim that subjectivity and intersubjectivity, in their full complexity, can only be understood through clinically relevant and scientifically credible theories of motivation and communication.

CHAPTER ONE

HOW DO WE EXPLAIN THE DEVELOPMENT OF COMMUNICATION WITH SELF AND OTHER IN INFANCY? PART 1

Our purpose is to offer clinicians a way to reconceptualize both the significance hitherto given to verbal associations and insight, and the importance now given to empathy and relational interaction. Communication is in our view the overarching phenomenon that integrates the verbal and nonverbal features of analytic therapy. By communication we mean exchanges of explicit and implicit information interpersonally and to one’s self. The main body of the book details our view of communication during treatment. But first we will take up communication during infancy. Communication is an integral part of the developing child’s intersubjective world long before the symbolic meaning of words are the shared currency of caregiver-infant informational exchanges. In the first two chapters we describe the origin of the development of communication before and after symbol sharing. We will emphasize a two-way stream of communication balanced between attentiveness to inner self and attentiveness to others.

We will draw on our prior writings (Lichtenberg, 1989; Lichtenberg, Lachmann, and Fosshage, 1992, 1996) in which we proposed five motivational systems. Each motivational system develops in response to an innate need and each involves caregiver’s responses. The five motivational systems self-organize and self-stabilize in response to the need for (1) regulation of physiological requirements; (2) attachment to individuals and affiliation to groups; (3) exploration and the assertion of preferences; (4) aversive reactions of antagonism and withdrawal; and (5) sensual enjoyment and sexual excitement. Between each system and within each system dialectic tensions exist so that the dominance of experience by a particular system is in constant flux in response to changes in context and intersubjective pressures. Hierarchical rearrangement within developing systems is a constant feature. This feature of motivational systems, their potential for hierarchial alteration, is particularly important to our presentation in chapters 1 and 2 of the development of communication and in subsequent chapters in the portrayal of change during psychoanalytic therapies conducted in a spirit of inquiry.

Throughout the book we make frequent references to attachment research and theory. We refer to the categories established through the Strange Situation Test. Based on the SST, researchers have identified specific strategies infants utilize to ensure a stable base of safety. One strategy played out between child and caregiver ensures a secure attachment. Other strategies of anxious-resisting and avoidance serve to maintain an insecure attachment. In some instances, any of these strategies prove unworkable and for periods of time infants will lapse into stages of disorganization, disorientation, and even dissociation. Adults have also been tested by an attachment interview, the AAI, as to their state of mind with respect to their attachment experiences. The groupings are those whose state of mind with respect to attachment are autonomous and secure, those that are preoccupied and those that are dismissive. In addition there are those who by virtue of being unresolved to loss and trauma suffer lapses in coherence, disorientation, and dissociation (see Psychoanalytic Inquiry, 1989, Vol. 19, No. 4: Attachment Research and Psychoanalysis: Theoretical Considerations, and No. 5: Clinical Implications).

We hold to a bidirectional, interactional systems view of communication. At times we may emphasize: (1) the child’s (or patient’s) communicative contribution as a self-regulating system; and (2) the caregiver’s (or therapist’s) communications as a self-regulating system ideally guided by empathic responsiveness and a spirit of provision (or inquiry). But neither system can be described without reference to (3) the parent-child (therapist-patient) dyad as an interactive communicative field—a uniquely organized system of its own (see Beebe and Lachmann, 2002).

After the developmental chapters, we will reframe familiar and current concepts of therapy by considering psychoanalysis as a process of communication conducted in a spirit of inquiry.

Part 1: The Emergence of a Communicative Self (0 to 18 Months)

As living organisms, we are dependent on nutritional-expulsion exchanges. As primates we are dependent on relational exchanges. As humans we are dependent on informational exchanges that facilitate communication with others and especially with ourselves. Why especially with ourselves? Probably alone of primates, humans have a stream of consciousness that, after the development of symbolization, allows us to converse with ourselves. From an early age, our experience involves a continuous interplay between discourse with others and discourse with ourselves. Communication is enlivened by affects triggered by perception of the external and inner world. The interplay of our experience affects what we can know about ourselves and how we feel about it. To be intimate with others is a widely recognized goal of human development. Less well recognized as a primary goal is to be intimate with oneself. What can we sense about ourselves, our feelings, sensations, thoughts, intentions, our view of others and our view of the view others have of us? Does our sense of self allow us to live within our skin more or less contentedly and productively? Along with empathic sensitivity, a cohesive sense of self, intersubjectivity, and systems of motivation, communication offers a perspective that is necessary to feel our way into how intimacy with others and with one’s self develops.

Affects and sensations are basic to a sense of familiarity with oneself and to the mode of consciousness of infancy. The uniquely human level of post-infancy consciousness depends on a symbolic realm mediated through words, images, and metaphor integrated with affect and sensation. The symbolic processing of information is fundamental to the stream of internal monologue-dialogue that characterizes communication with oneself and accompanies speech to others. Communication, however, including parent’s speech from birth (and before), is interwoven in all caregiver-infant exchanges long before symbolic processing by the baby is possible. Talking with and to a baby not only consolidates attachment but also builds intuitive communicative capacities prior to words themselves becoming the medium for the exchange of meaning. Growing infants are held in their caregivers’ symbolic world before they form one of their own. Caregivers ease their infants into a symbolic world of inner and outer communication by conveying their recognition of their particular baby through the flow of their “chatter” to and with the baby. Failure to communicate the recognition of a baby’s humanness (subjectivity) and essential uniqueness will impair the development of that baby’s attachment and other motivational systems and its sense of self.

Various essential provisions need to evolve from the explicit and implicit regulation of caregiver and infant. Attachment research has documented a sense of safety as the caregiver provides a secure base at times of danger and loss (Bowlby, 1969, 1973, 1980; Main, 2000). Self psychology and motivational systems theory have described the sensitive balancing of needs of each partner across a spectrum of motivational systems (Lichtenberg, 1989).

Concomitant with a view of a sense of self evolving out of the dynamics of infant-caregiver interactions, modern neurophysiology envisions the brain’s evolving out of the constant mutual influence of an innate adaptive potential and the environment. Edelman (1987, 1992) posits the brain developing before birth as a process of neuronal selection guided by genetic instructions. During fetal development, neurons and neuronal groups migrate in unpredictable ways to form unique patterns of cortical circuitry. After birth a second selection begins, guided by basic biases (values) that are experienced as feelings. After birth very little is preprogrammed; mostly the brain creates itself through a dynamic interaction with the environment. Gone are static views of structures formed fixedly, functions tightly localized, and simple restraints like feedback homeostatic control. Theorists such as Edelman and Damasio (1999) describe a brain that has both stability and extraordinary plasticity enabling it to undergo self-organization and emergent order with every lived experience. Memory is no longer encoded or deposited in the brain and reactivated in photographic fixity, but is initially selected by bias and is context-dependent in its recall. Perception and sensation are not simply recordings of the external and internal worlds but are acts of creation made through categorization and mapping. Maps are not merely laid down as functional tracks but are constantly reformed and recategorized. A continuous communication, characterized by Edelman as reentrant signaling, connects the active maps. As individuals organize their own categories, maps, and reentrant signals, a world of personal meaning and reference is constructed.

Consciousness is created in two momentous steps. The linking of very early memory maps with a current perception creates primary (Edelman) or core (Damasio) consciousness—a state of being mentally aware of things in the world in the form of here-and-now lived experience. The second step, a linking of symbolic memory, linguistically organized concepts, and a representation of self, creates higher-order consciousness. In higher-order (Edelman) or extended (Damasio) consciousness, concepts of self, past, and future can be connected to here and now awareness. Consciousness of consciousness, and reflective recognition of cognitive affective intentional states becomes possible. The complex picture of a brain creating an ever-changing individualistic picture of a world full of personal meaning coincides with our sense of a self experiencing an integrated and orchestrated stream of consciousness. Overall these theories postulate continuous communication within the brain in linkage with internal and external perception.

An Emergent Sense of Self (0–2 Months)

Neonates can be viewed as setting up an ecological niche in which they recreate conditions that enable them to experience familiar states by which they recognize themselves (Sander, 1983). How can we envision the emergent sense of neonates becoming familiar with themselves? The caregiver’s contribution to the ecological niche lies in empathic recognition of and response to the infant’s internally derived needs. The infant’s contribution lies in being able to offer recognizable signals of need and to activate specific innate and learned response patterns that permit the caregiver’s responses to be effective. An example is an infant’s cry that her mother correctly reads as hunger and institutes holding and feeding. The infant’s experience would combine an internal sensation of discomfort with a generalized feeling of distress, the activation of sucking with rhythmical rate changes, followed by the relief of distress and sensations leading to an internal sensation of fullness. The internal sensation of fullness may become distress from abdominal distention requiring relief by burping. The release of air may be followed by more intake to a point of satiety, disinterest in sucking, and conclude with rejection of the nipple. The mother’s experience is one of efficacy in her ministrations and the recognition of the particularities of her baby at that time. She is apt to express this as: “Oh, you were really hungry. OK I’m here. Oh, you need to be burped. OK now. Well you really have slowed down. I guess you’ve had enough.” The inevitable repetitions of this shared response pattern creates for the baby an experience of changing affect states. The changing affect states combine bodily sensations of internal and generalized distress, supportive holding and positioning, internal fullness and generalized relief, perceptions of mother’s face, eye contact, and her spoken voice. We are aware that our description implies more linearity than is appropriate for the complex interactive system of mutual influence in continuous operation between infant and caregiver.

A “package” of changing internal affect-laden state changes and external tactile, visual, olfactory, and auditory perceptions repeated with the same person or similarly enough with more than one caregiver becomes for the neonate a familiar re-creation, a memory map, a presymbolic nonverbal story (Damasio, 1999) or “scene” (Edelman, 1992) that we believe is experienced as an emergent sense of self. Bucci offers a similar accounting: “The chunking of continuous representations into prototypic images based on equivalence of structure, or function, or association in time and place may occur across as well as within modalities … (forming) … prototypic episodes.… Repeated episodes provide the basis for the construction of … emotion schemas, from the beginning of life, well prior to the acquisition of language, and also determine the process by which emotional experience may be symbolized and communicated to other” (1997, p. 183). Of course, feeding is but one of many repeated interactions that have a feeling story to be remembered and re-created—eliminating and being diapered, being put to sleep, being conversed with and stimulated pleasurably during alert periods of comfort, being soothed at times of nonspecific fussiness, being held, fondled, kissed, tussled about, being left without direct intrusion to explore crib, toy, or a button on mother’s blouse.

The terms “emergent” and “re-create” require further elaboration. To conceive of an infant as capable of the experience of re-creating implies several innate abilities. In experiments, infants have been found to change their sucking rhythm or turn their heads a set number of times to one side (Papousek and Papousek, 1975) in order to turn on a light display they are preprogrammed to enjoy (“value,” Edelman). The infants will continue to do this much longer if they are the agent than if the light is turned on for them or randomly activated. In conversational runs with their mother, infants will activate responses when their mother pauses or is distracted. We assume the infants have a primitive form of agency—I do it, I start it, I create it, and, now that it is repeated, I re-create it. Only what marks the re-creation for the infant? We believe the “actions” become meaningful as affect-sensory experiences—interest, a sense of efficacy, and competence in the exploratory activities, and joy of intimacy eventuating in the enlivening smile and body jiggling. In Damasio’s view, these actions produce such changes that the organism has a “feeling” of knowing about, that is, the infant has a feeling that he can sense that he is feeling.

Emergent has a double meaning: awareness begins and I become aware. We can draw an analogy to awakening in a strange room. First, light enters your eyes and next you are aware of the change from sleep state, more what has happened than what you have done. Then you feel the stuffed sensation in your nose and remember you have a cold, so it is you who is awakening. But, with some anxiety, where? You scan your surroundings, place yourself in your friend’s house, and take mental charge of your emergence into the day ahead. Using a similar construct, Damasio (1999) states that “stepping into the light is also a powerful metaphor for consciousness, for the birth of the knowing mind, for the simple and yet momentous coming of the sense of self into the world of the mental” (p. 3). Thus we can say we re-create our self each day that we metaphorically step into awakeness or after any major affective state change, as from a fright to a state of calm. This is not in accord with the Cartesian formula “I know therefore I am,” but is rather a matter of I feel and I sense I feel right now, therefore I am I. This here-and-now-I-am emerges into being with core consciousness. The core consciousness of self precedes higher consciousness and language organized thought when the child can reflectively recognize and monitor thoughts, feelings, plans, and prior actions.

For this explanation of an emergent sense of self to be credible, the central nervous system must have a number of complex capacities present at or very shortly after birth. Lived experience in the form of core consciousness involves perception, categorization, and mapping. Similar repeated sequences must be generalized and recategorized, and simple contingent or causal links established. Moreover, recognition of changes of affect states must be appreciated as a process that is occurring for a sense of creating and re-creating to evolve. The repeated experience and the sense of re-creating activates an elemental consciousness that is both flowing and differentiated in the here and now. Categorization, generalization, and recategorization are responsible for the organization of discrete states into feeling stories or affect schemas. However, much lived experience and communication occurs as a continuous flow (Fogel, 1993; Knoblauch, 1996, 2000) of nonverbal contours of vocal and breathing volume, rhythm, tempo, and tone, and of gestural patterning, proprioceptive shifts of face and body, body gurgles, smells, and expulsions. In caregiver-infant exchanges these continuous processes have a background influence on the essential affect tonality mapped into the more discrete feeling stories. Their ephemeral micromoments and bidirectional flow give to both early and later communication a basic pattern of being shaped by loosely formulated nonverbal cues that flow along with later exchanges of verbalized symbolic meanings.

Damasio (1999) proposes a theory of the development of elemental consciousness that coincides to a degree with the view we espouse:

As the brain forms images of an object—such as a face, a melody, a toothache, the memory of an event—and as the images of the object affect the state of the organism, yet another level of brain structure creates a swift nonverbal account of the events that are taking place in the varied brain regions activated as a consequence of the object-organism interaction. The mapping of the object-related consequences occurs in first-order neural maps representing proto-self and object; the account of the causal relationship between object and organism can only be captured in second-order neural maps..… [W]ith the license of metaphor, one might say that the swift second-order nonverbal account narrates a story: that of the organism caught in the act of representing its own changing state as it goes about representing something else. But the astonishing fact is that the knowable entity of the catcher has been created in the narrative of the creative process [p. 110].

Damasio equates core consciousness with the narrative account formed in a near-infinite series of pulses as we navigate the world. He cites the hippocampus, brain stem, and insula as the brain structures most involved in the detailed making and unmaking of neural maps or representations of the total physical state. The non-conscious foundation of self that Damasio calls “protoself” arises from the collective maps forming and altering a response to encounters requiring homeostatic adjustment. The essence of the core self is the representation in a second order map of the protoself being modified. “Because of the permanent availability of provoking objects, it [core consciousness] is continuously generated and thus appears continuous in time” (p. 175). The well-spring of consciousness is not language but the feeling of knowing that we have feelings.

Returning to psychological observation, affects prime the neonate to activate innate and learned responses to anything that alleviates an aversive state or augments a positive state. The infant is thus motivated to connect antecedents and consequences, that is, to learn incrementally (Tomkins, 1962, 1963). The intrapsychic development of a sense of self is inextricably context related or, in Kohut’s terms, the baby’s self is strong because it is embedded in a self-selfobject matrix. I would add that the self can only be construed as “strong” if (1) the sense of self develops as an affective being who has been responded to by an animated empathically sensitive caregiver ready to initiate needed provision and, (2) the sense of self includes a conviction of being able to initiate affective, need-fulfilling responses from the caregiver. The baby’s growing sense of an elementary I-ness through the re-creation of affective experience combined with a recognition of being able to trigger affective need-fulfilling responses from the caregiver (a we-ness) fills out Kohut’s definition of self as a center of initiative.

The sensitivity of the communication of affective state between caregiver and neonate can be appreciated through the study of both pairs who are successfully able to bring about secure attachment (Katie, our second example) and pairs in which insecure attachment (Main, 2000) occurs even in this early period, as in the case of Kierra.

Kierra

One of us (JL) was asked by a research group to evaluate the videotapes of a bottle feeding of 18-day-old Kierra by her 16-year-old mother in a facility for single first-time mothers who had no other support. I evaluated the feeding as effective in nutrient transmission and ordinary in maternal attentiveness although the mother was essentially silent throughout. I next viewed a feeding at one month 22 days in which Kierra was fully head and eye averted from her silent mother, who appeared both unaware and unconcerned. The researchers told me they had reviewed the tapes repeatedly before discovering a clue to how in the 18-day feeding the mother was communicating to Kierra that while she was conscientiously performing the task of feeding, she was not enacting or creating an intersubjective experience with the baby. While sh...

Table of contents

• Cover
• Halftitle
• Title
• Copyright
• Contents
• Introduction
• Chapter One: How do we Explain the Development of Communication with Self and Other in Infancy? Part 1
• Chapter Two: How do we Explain the Development of Communication with Self and Other in Infancy? Part 2
• Chapter Three: Open Flexible Communication in Moment-to-Moment Exchanges
• Chapter Four: Effective Communicative Exchanges
• Chapter Five: Transference as Communication: The Language of the Body
• Chapter Six: Words, Gestures, Metaphors, and Model Scenes
• Chapter Seven: Verbal and Nonverbal Communication During Analysis
• Chapter Eight: Controversies and Answers: Communication and a Spirit of Inquiry Reconsidered
• References
• Index