Coparticipant Psychoanalysis

Toward a New Theory of Clinical Inquiry

John Fiscalini

• Publisher: Columbia University Press
• Year: 2007
• eBook ISBN: 9780231507264
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Traditionally, two clinical models have been dominant in psychoanalysis: the classical paradigm, which views the analyst as an objective mirror, and the participant-observation paradigm, which views the analyst as an intersubjective participant-observer. According to John Fiscalini, an evolutionary shift in psychoanalytic consciousness has been taking place, giving rise to coparticipant inquiry, a third paradigm that represents a dramatic shift in analytic clinical theory and that has profound clinical implications.

Coparticipant inquiry integrates the individualistic focus of the classical tradition and the social focus of the participant-observer perspective. It is marked by a radical emphasis on analysts' and patients' analytic equality, emotional reciprocity, psychic symmetry, and relational mutuality. Unlike the previous two paradigms, coparticipant inquiry suggests that we are all inherently communal beings and, yet, are simultaneously innately self-fulfilling, unique individuals. The book looks closely at the therapeutic dialectics of the personal and interpersonal selves and discusses narcissism—the perversion of the self—within its clinical role as the neurosis that contextualizes all other neuroses. Thus the goal of this book is to define coparticipant inquiry; articulate its major principles; analyze its implications for a theory of the self and the treatment of narcissism; and discuss the therapeutic potential of the coparticipant field and the coparticipant nature of transference, resistance, therapeutic action, and analytic vitality. Fiscalini explores "analytic space," which marks the psychic limit of coparticipant activity; the "living through process," which, he suggests, subtends all analytic change; and "openness to singularity," which is essential to analytic vitality.

Coparticipant Psychoanalysis brings crucial insights to clinical theory and practice and is an invaluable resource for psychoanalysts and therapists, as well as students and practitioners of psychology, psychiatry, and social work.

PART ONE

COPARTICIPATION

CHAPTER 1

Coparticipation and Coparticipant Inquiry

COPARTICIPATION

All psychoanalyses, however symbolized or structured, are coparticipatory integrations. The psychoanalytic situation always involves two unique personalities, entwined in double-helix fashion, continuously transferring experience, resisting influence, suffering anxiety, and analyzing themselves and each other. As the prefix co, meaning “with,” “joint,” “mutual,” “in conjunction,” suggests, analyst and patient are inevitably coparticipants—interrelated within an interpersonal field of their making, inextricably involved in a continuous series of reciprocal interactions.

Both analyst and patient bring their conscious and unconscious motives, wishes, and ideals—their personal strivings and stirrings, interpersonal insecurities, defensive striving, and relational yearnings—to their shared relationship. Consequently, they will interact around these psychic realities for as long as they remain in relationship with one another.

Fundamentally, psychoanalysis is a human encounter—a meeting of two beings or two minds (Aron 1996) in all their unique individuality. The coparticipants each bring to their shared relationship their unique expectations, desires, and abilities as well as their imagination, curiosity, and courage.

Coparticipation is a psychoanalytic given, whether one grasps this clinical fact and builds one’s inquiry upon it, or repudiates it and limits its vital potential for analytic inquiry. From the beginning, analysts have recognized the clinical reality that they and their patients actively participate with one another throughout an analysis. This simple fact, however, has been understood and treated in widely different ways, and in some instances its central role in coparticipant experience has even been denied. These differences reflect how analysts of different schools have variously conceptualized—decided how to think “correctly”—the coparticipant nature of the psychoanalytic situation and the two-person psychology of its dyadic integration. Historically, within classical psychoanalysis conceptions of the analytic process, from those of Freud (1912, 1913, 1915) through those of Menninger (1958), Greenson (1967), and Brenner (1976), have tended to limit the role of patients as true copartners, assigning them a more restricted psychoanalytic role. Nevertheless, many theorists, including Freud, practiced more liberally, freely, and personally than what they put forth in their theories of treatment; in some instances, they disregarded in practice the technique they formally prescribed for others. However, some analysts searched openly for their own answers. Psychoanalytic pioneers of an independent spirit, such as Franz Alexander, Otto Rank, and most notably Sandor Ferenczi tried to treat patients in more fully coparticipant terms. Nevertheless, most classical analysts hewed to the restrictive limits of acceptable Freudian orthodoxy, some more rigidly so than others.

One can certainly see the merits of such technical aims as analytic objectivity, impartiality, tact, judicious reserve, and authoritative knowledge. It was, in part, to facilitate the use of such clinical techniques or attitudes that Freud and his successors developed the impersonal technique of orthodox psychoanalysis. Freud had another reason for a canon of impersonal techniques and limited coparticipation. He feared that psychoanalysis, with its deeply personal and subjective nature, was subject to the criticism of achieving therapeutic results by virtue of suggestion (i.e., relational influence), that in essence psychoanalysis was simply a form of interpersonal hypnosis. Freud feared that psychoanalysis would be considered unscientific, and he understandably wished to develop it in terms of the science of his day. So he called for purity in the analytic situation.

This meant an emphasis on the analyst’s neutrality, anonymity, and interpretive authority and called for the patient’s abstinence, literal or metaphoric. In short, Freud argued for a highly circumscribed form of the coparticipant psychoanalytic relationship. The analytic doctor, as interpretive surgeon, knowing what was best, would operate upon the resistant patient. So the patient got the silent treatment, in more ways than one.

This restrictive technique, however, also represented what Freud himself needed or thought he needed in order to work with patients, and his followers adopted the same method. However, as noted earlier, those who were free to recognize the clinical implications of analytic coparticipation and who possessed the personal freedom and desire to work with their patients in a more coparticipant manner did so. In the process they found ways to resolve their dilemmas of personal versus institutional or theoretical loyalty, the question of whether to be true to their own natural way of working or to adhere to the teachings of the analytic canon, the prescribed path.

The British school of object relations opened the door to a more coparticipatory view of the analytic hour, attending, for example, to the clinical study of the mutual influences and complex intersubjective transactions that inevitably occur between patient and analyst, each contributing to the shaping of the other’s clinical experience. However, analytic participation still remained relatively circumscribed. The authoritarian mirror analyst had become the authoritarian mirroring analyst, the analytic good parent who knew best what the patient needed. The analyst, though no longer silent, detached, or rigid, was still the authority who had the final word. Thus, object relations theory began to focus on the critical interplay of transference and countertransference experience, the vast, complex, and constantly changing coparticipatory processes that characterize all analytic situations. However, there was no corresponding shift toward a comprehensive, bidirectional, and radical coparticipatory way of working. Nevertheless, this analytic approach, though often practiced in orthodox, authoritarian ways, represents a move toward a more coparticipatory inquiry.

The work of Kohut and post-Kohutian analysts, too, has recognized the interactive or transactive—i.e., intersubjective—nature of each person’s relatedness and found that psychoanalytic relatedness in the clinical situation was profound and pervasive, that patient and analyst essentially were each a coparticipant. But again, technique and inquiry remained circumscribed and fairly traditional. Kohut proposed a metapsychology that was vastly different from Freud’s and replaced or supplemented Freud’s libido theory with a theory of an interpersonal self that emphasized the primacy of reflected interpersonal appraisals and influences in psychic development and functioning. Nevertheless, Kohut (1971, 1977, 1984) failed to extend or alter or even enlarge neoclassical clinical thinking. His technique, as he asserted, was the same as Freud’s. Though Kohut emphasized the clinical primacy of a radically empathic listening stance and though he strove, in Rogerian (cf. Rogers 1951) spirit, to follow the patient’s needs for interpersonal security or self-other (what Kohut termed “self-object”) experience, this same patient was not admitted to the analytic hour as a full copartner or coparticipant inquirer, at least not in terms of his or her analytic capacities. Rather, the patient was defined implicitly as the analytic child, forlorn and forsaken, or starry-eyed and symbiotic, but not a copartner. In this sense, Kohut (whom I will return to in my discussion of the self in chapters 4 and 5), vitiates the promise, based upon the study of the intersubjective nature of the psychoanalytic field of experience and its natural influences, of conceptualizing analytic work as a coparticipatory process.

The clinical approaches of Kohut and the English object relationists strongly resemble the analytic perspective of the seminal American interpersonalist Harry Stack Sullivan for whom the analyst is, or should be, an expert in interpersonal relations. His expert was not of a family parent sort, but rather the expert interlocutor, the researcher who conducts a detailed inquiry into the patient’s difficulties. It was Sullivan (1940, 1953) who first mapped the psychic dimension of interpersonal security or social adaptation that the object-relational analysts also emphasized in their clinical approaches. However, as already noted, this dimension comprised the study of the patient by the expert analyst, not a true study of both the patient and analyst by both the patient and analyst. Nevertheless, Sullivan saw clearly that the analyst is always involved in an interpersonal field—a dynamic system of reciprocal transactions that includes all who are part of it. The analyst, in Sullivan’s (1953) view, was inevitably a participant-observer, a participant in and thus a part of what he or she studied. Sullivan’s conceptions of the analyst as a participant-observer summarized and gave theoretical voice to the ideas and sensibilities of those analysts who could be said to have advocated or practiced some form of participant analytic inquiry.

Sullivan’s participatory conceptions, radical for their time, were seminal and far-reaching. Nevertheless, they, too, had limitations and imposed restrictions on the living out of a full coparticipatory analysis. The analyst was the analyst and the patient was the patient and nothing more. The theory did not view analytic work as a coanalysis of both patient and analyst. Patient and analyst were simply not viewed as equals in analysis. Yet Sullivan’s interpersonal contributions have played a major role in the development of coparticipant analytic inquiry. Today, many modern analysts, from a variety of theoretical perspectives and schools of thought, practice some form of coparticipant inquiry. In particular, contemporary interpersonal analysts developed more comprehensive versions of Sullivan’s approach to the psychoanalytic situation. Recognition and appreciation of the coparticipatory nature of the analytic relationship has also marked recent clinical theorizing of some modern Freudians (see, for example, Jacobs 1991, 1998; Renik 1993, 2000). There also has been a burgeoning interest in coparticipatory concepts and practices, although often framed in other terms, among analysts who label themselves as “intersubjectivists,” “relationists,” or modern “object relationists” (see, for example, the work of Aron 1991, 2000; Bass 2001a,b, 2003; Stolorow, Atwood, and Brandchaft 1994).

This, in turn, has led to the formulation of various versions of coparticipant inquiry (though not put in this language), ranging from the relatively narrow to the comprehensive.¹ As will be discussed more fully in chapter 3, beyond a common repudiation of orthodox impersonal techniques, there is considerable diversity in the form of coparticipant inquiry practiced in these various relational clinical approaches.

The concept of coparticipation carries a dual meaning. It refers first of all to a universal characteristic of all analytic integrations (and all human relationships). Most simply stated, coparticipation refers to the inherently interactive and intersubjective, as well as intrasubjective, nature of the analytic relationship. Second, coparticipation refers to a particular form of clinical inquiry, which may be defined as one that takes into account the unique interpsychic and interactional nature of the analyst-patient relationship and addresses its implications for therapeutic procedure and process.

In modern psychoanalysis this form of inquiry is most closely approximated in the work of some contemporary analysts with an interpersonal and intersubjective orientation. Coparticipant inquiry is not associated with any one school of psychoanalysis, but it is most fully developed in the interpersonal school and, more recently, in post-Kohutian intersubjective psychoanalysis and other relational offshoots. Various forms of coparticipant inquiry characterize the psychoanalytic metaschool called relational theory. This metaschool includes social constructivist theory, intersubjectivity theory, self-psychology, various forms of object-relations psychology, some aspects of contemporary Freudian theory, and interpersonal psychoanalysis. Analysts of these various relational schools practice some form of coparticipant inquiry. Most of these contemporary analysts are relatively limited in their coparticipatory approach despite their relational metapsychologies and post-Cartesian epistemologies. The most comprehensive expression of coparticipant inquiry is the form practiced by those analysts who make up the “radical empiricist” wing of contemporary interpersonal psychoanalysis (see chapter 3 for a definition of radical empiricism).

Coparticipation as a quality of relatedness defines the interactive features of the interpersonal field that constitutes psychoanalysis (i.e., two unique selves in therapeutic interaction). Coparticipation as a concept of inquiry, derived from the coparticipatory nature of the analytic situation and process, represents a therapeutic sensibility and clinical philosophy, a way of living psychoanalysis, rather than a defined set of techniques, clinical strategies, or rules of praxis.

Coparticipation, as a description of the fundamental intersubjective nature of all psychoanalytic relationships, is not a new phenomenon—interaction is a fundamental fact and facet of all psychoanalyses. What is new is the growing recognition of the clinical promise of coparticipant inquiry as a new clinical paradigm. While coparticipant inquiry, recognizing the coparticipant nature of the psychoanalytic situation, is predominantly a modern movement in psychoanalytic practice, its roots reach back to the early history of psychoanalysis and the radical clinical experiments of Sandor Ferenczi.

One may ask: why use the term “coparticipation” instead of simply using the better known term “participation.” I use the word coparticipation to emphasize the intrinsic mutuality, motivational reciprocity, psychic symmetry, coequality of analytic authority, and participatory bidirectionality of the analytic relationship, whether or not one or both coparticipants choose to deny or ignore these clinical possibilities and proceed to work on some basis that fails to attend to this clinical reality.

In the psychoanalytic situation, coparticipant processes flow continuously, even if denied or restricted by the analyst’s metapsychological, clinical, or personal prejudices and preferences. Any psychoanalytic dyad or member of that dyad, out of personal reserve, personal inclination, obsessional need for control, or other pertinent reasons, may proscribe inquiry into particular aspects of their coparticipant functioning and experience. There is in such instances an ongoing coparticipant process but not a full coparticipant inquiry into that process. Nevertheless, in the coparticipant experience formed by the two copartners, as noted earlier, each inevitably brings all of himself or herself into the analytic situation, whether or not this is recognized and worked with. In other words, all analyses are coparticipant processes, but not all are coparticipant inquiries.

Coparticipant inquiry, the therapeutic use of coparticipant principles, does not require any particular metapsychology, nor does it represent a particular school of psychoanalysis. However, it usually finds a warmer welcome among modern interpersonalists or those contemporary analysts who are working relationally or intersubjectively. In its salient features coparticipant inquiry does not, as many historical new forms of psychoanalytic treatment do, represent the creation or discovery of a new metapsychology from which a new technique or psychoanalytic method is then derived. Coparticipation does not derive from a metapsychology. Born in clinical practice and therapeutically primary, coparticipant inquiry evolves instead from an awareness of the specific limitations of other, prior, forms of clinical inquiry.

How, then, do we define this new psychoanalytic approach? What features define this way of working and thinking? How does coparticipant inquiry differ from, for example, orthodox Freudian treatment conceptions or those of relational analysis? Let’s turn to a consideration of such questions.

COPARTICIPANT INQUIRY

Coparticipant inquiry is premised on the awareness of the intersubjective nature of the clinical situation and the commitment to working with its therapeutic potentialities. What distinguishes coparticipant inquiry is not a specific set of prescribed techniques nor a specific technical canon. Coparticipatory practice represents, instead, a clinical attitude or approach, a way of working and of being with the patient, that leads spontaneously to clinical actions consistent with the core principles of coparticipant inquiry (reviewed in chapter 2). Coparticipant inquiry does not call for the one right way to do analytic work; there is only the question of whether one’s work is true to the clinical reality of his or her coparticipant experience.

Whether they are aware of it or not, even the most conservative analysts, in varying degrees and in various ways, practice some principles of coparticipant inquiry (that is, an inquiry that takes cognizance of the complex two-way coparticipant nature of the psychoanalytic situation). However, few practice it fully or consistently.

Analysts of the different psychoanalytic schools view the coparticipatory nature of the analytic si...

Table of contents

• Cover 
• Half title
• Title
• Copyright
• Dedication
• Contents 
• Preface
• Acknowledgments
• Epigraph
• Introduction: Psychoanalytic Paradigms, Clinical Controversy, and Coparticipant Inquiry
• Part I: Coparticipation
• Part II: The Self
• Part III: Narcissism
• Part IV: Explorations in Therapy
• Notes
• References
• Index