Non-Interpretive Mechanisms in Psychoanalytic Therapy: The 'Something More' Than Interpretation

TLDR

It is widely accepted that something beyond interpretation is required for therapeutic change, and that the relational procedural domain is distinct from the symbolic domain. The study proposes that therapeutic change is driven by interactional intersubjective processes that generate implicit relational knowing. The authors model these intersubjective moments as a sequencing process called moving along, framing shared implicit relationships, transference, and countertransference within a distinct relational perspective. Therapeutic change arises from intersubjective moments that reorganize the patient’s implicit procedural knowledge and relational organization, producing lasting effects through changes in the intersubjective relational domain.

Abstract

It is by now generally accepted that something more than interpretation is necessary to bring about therapeutic change. Using an approach based on recent studies of mother-infant interaction and non-linear dynamic systems and their relation to theories of mind, the authors propose that the something more resides in interactional intersubjective process that give rise to what they will call ‘implicit relational knowing’. This relational procedural domain is intrapsychically distinct from the symbolic domain. In the analytic relationship it comprises intersubjective moments occurring between patient and analyst that can create new organisations in, or reorganise not only the relationship between the interactants, but more importantly the patient's implicit procedural knowledge, his ways of being with others. The distinct qualities and consequences of these moments (now moments, ‘moments of meeting’) are modelled and discussed in terms of a sequencing process that they call moving along. Conceptions of the shared implicit relationship, transference and countertransference are discussed within the parameters of this perspective, which is distinguished from other relational theories and self-psychology. In sum, powerful therapeutic action occurs within implicit relational knowledge. They propose that much of what is observed to be lasting therapeutic effect results from such changes in this intersubjective relational domain.