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AGENCY AS
A PSYCHOANALYTIC IDEA

Competent agency is a basic assumption of psychoanalytic change. Yet as


an aspect of health, personal agency has in the main been only intuitively
addressed and remains clinically unsystematized. Here experience-near
and observer-centered criteria are developed that assess a person-
as-agents competence in particular domains. These ideas, clinically illus-
trated, stand as an operational framework that helps thinking and talking
about agency in everyday clinical events and psychoanalytic outcomes.
Three specific criteria are proposed: reversibility, self-observation, and
appropriateness. The first is descriptively polar; together the three apply
to each given context of action. They can also serve to ground future
research. In this regard, several empirical psychoanalytic studies of adults
and children that exemplify measurable aspects of agency are reviewed.
Once clinical markers of personal agency are articulated, it will not be
necessary to resolve the free will debate: pragmatically, we need only put
such distinctions to work.

Whenever we examine clinical evidence in contemporary psychoanalysis,


we have very few theories of pathology . . . that distinguish normal from
pathological on a qualitative basis. . . . With no objective way to determine
what is pathological and what is not, the analyst is encouraged to continue
deep analyzing . . . and to let the analysis take its course.
Henry Smith (2003, pp. 63, 65)

Inviting analysts to have a dialogue about the background assumptions


that inform their theory-driven clinical inferences is tantamount to asking
them to go back to basics, but I think the field has reached a critical junc-
ture from which common ground can only be established from the ground
up, not from theory-driven argument down. . . . And, as Longino reminds
us, implicit background assumptions can be rendered explicit, they can
always be articulated.
Paul Stepansky (2009, p. 243)

T he point of the present project is to work out and illustrate observable


criteria for competent agency, both clinically and empirically, as a basic

DOI: 10.1177/0003065111422541 907


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Joseph Caston

assumption of psychoanalytic change. Three clinical markers of personal


agency are proposed: reversibility, self-observation, and appropriateness.
These are not research tools in themselves. Rather, they will serve as an
operational framework for daily work with patients and for the gradual devel-
opment of empirical instruments. They will, moreover, apply acrossbut not
supplantall psychoanalytic paradigms, and be agnostic about predictions.
Although all analysts share the notions of a dynamic unconscious,
defensive functioning, and the play of transferences and countertransfer-
ences, the common ground these offer has failed to overcome the existing
pluralism, much less promise a unified clinical theory (Wallerstein 1992;
Stepansky 2009). These concepts remain too variably defined among the
different analytic paradigms and are excessively broad to begin with. Back-
ground assumptions, as we identify or discover them, need be finer-grained
to usefully span the schools of the discipline, and we should best anchor
them in what can be reliably observed. In this regard, attending to how a
clinical thing is happening likely offers as much, or more, than what-and-
why. Such matters unfortunately tend to be taken for granted; as they do
not readily stand as the pillars of any paradigm, they are in danger of being
dismissed as mundane. The salient signs of these basic matters, and the
processes they tap, deserve to be further unpacked and described, unencum-
bered by paradigmatic branding.
One such elementary matter is that through treatment we can become
freer, in particular and important ways, showing changes toward greater
agency. But here the clinical-theoretical sorting-out is difficult, because
on the one hand the large matters of freedom and the will are philo-
sophically complex, and on the other we know that while people may claim
a sense or experience of greater freedom and at times be quite right about
that, at other times their distortions and denial muddle the matter.1 That is
to say, a reported sense of agency is not a rigorous clinical marker.

1
The word will in this paper, or rather, to will (better represented by the verb than
by the noun), refers to the process of self-direction, in particular, to choose, to delib-
erate, to initiate options.

Training and Supervising Analyst, San Francisco Center for Psychoanalysis;


Personal and Supervising Analyst, Psychoanalytic Institute of Northern California.
The author is indebted to Neal Brast, Lisa Buchberg, Victor Caston, Marcia Cavell,
Nancy Chodorow, Diane Elise, Charles Fisher, Daniel Goldberg, Alan Skolnikoff, and
the members of Robert and Judith Wallersteins Semi-baked Writing Group for their
valuable commentary. Submitted for publication October 13, 2010.

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AGENCY AS A PSYCHOANALYTIC IDEA

Freud specifies personal agency by referring to that capacity as the


will or willing both in early and late works, as when he summarily states
that mental life encompasses what a person thinks, feels, and wills (19161917,
p. 22; 1938, p. 157). But then he ingeniously develops how personal agency
may be encumbered or may fail: in the early papers through the operations
of a counter-will, or in the later works by unconscious subpersonal agen-
cies. The position of the person as agent becomes dimmed within Freuds
theory, even though it holds a necessary presence in the lively drama of his
clinical narratives. Clinicians and theorists have nevertheless struggled over
the years with the theoretical aspects of these questionsamong more clas-
sical analysts, Waelder (1936, 1963), Knight (1946), Wheelis (1956),
Aarons (1965), Rangell (1969, 1971, 1986, 1989), Beres (1971), Schafer
(1976), Hanly (1979), Shapiro (1965, 1981, 1999, 2000), Schwartz (1984),
Lear (1990, 2009), Cavell (1993, 2003), and Meissner (1993, 1999a,b,
2009)or assumed and invoked it, as have the relationalists Mitchell (1984,
1997), Greenberg (2008), Knox (2010), Symington (1990), Slavin (1997,
2010; Slavin and Pollock 1997), and Weisel-Barth (2009), or even accorded
it a prominent place, even embracing it, as did Otto Rank (1929, 1930) and
the existential psychiatrists (Farber 1966; May 1969). What discussions
of this topic have generally lacked is a coherent set of markers for the cli-
nician. The literature is best reviewed once criteria are in place, and that
is the point of the present project.

T H E C L I N I C A L M AT T E R O F P E R S O N A L A G E N C Y

I will distinguish three features herereversibility, self-observation, and


appropriatenessthat count to say a person is able to direct himselfor
notin a context, or becomes more enabled after therapeutic intervention.
It is an important consideration that how ably a person directs himself in
some real or prospective sceneor notspeaks to his health in those
moments: a kind of local competence, as an agent. I propose that this gen-
eral feature is deeply, implicitly, and centrally embedded in our notions of
good and not-so-good functioning, and underlies our clinical judgment of
how someone is doing. It is at once both person-centered and causal.
Although it lies near our experience and is intuitively addressed, it rarely
finds an explicit place in our understanding. Clinical approaches to per-
sonal agency are usually unsystematized and casual, virtually absent in the
DSM, and only embryonic in the Psychodynamic Diagnostic Manual.

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Once we articulate experience-near clinical markers of the capacity


to choose, it will not be necessary to resolve the free will debate, since for
work with patients we only need apply such pragmatic distinctions. Tack-
ling observable features in this area can relieve clinical theory of that recur-
ring philosophical problem. Although Beres (1971), for instance, clearly
asserted the clinical relevance of choice and responsibility, he could not
coherently conjoin them with accounts of the egos autonomous function-
ing: in his view, matters of indeterminacy or freedom do not mix with
causal determinism. Here I will clinically illustrate the three criteria, show
how they apply in three empirical psychoanalytic research studies of adults
and children, and how they pertinently relate to the Scales of Psycholog-
ical Capacities (an important investigative tool developed by Wallerstein
et al. [2000]).

A Case Instance

As ordinary observers we can usually sense what freedom or flexibil-


ity a person shows as he glidesor sputtersinto a moment or an act, or
how he tells its story. Sometimes we address a patient in just such terms,
as in the following.

The patient, an engineer, began the session with a long prelude praising the value
of teamwork in general, and of his own team players. He spoke appreciatively of
their collective talents and collaborative strengths. They had arrived at a break-
through solution to a long-standing problem in a new product line. It was of
complex magnitude, requiring in the end both a systems approach and discern-
ing glimpses into its microworks, in order to locate the offending technical
flaws. As the story gradually developed, it became evident that his discoveries
had been central. He was going to great lengths to downplay the credit due him.
There had also been other times when the patients modesty seemed over the top.
The situation called for directness: You dont feel free to boastto me, or to
anyone else.
The patient took this in. At first he seemed to be bracing awkwardly or
squirming a little, and was silent. When he spoke, he said that he had first felt
giddy and weird about that comment, then uncomfortable and confused.
Whats that mean, anyway? That its good to boast? Thats a horrible idea! Any
mother would tell you thats not nice! It made him think of how when he was
nine or ten hed tell fish stories.
Well, not fish stories really, they were things I did do, but Id make out that
they were better than they were. So it was true he used to bragit makes him
wince now. But then he recalled that when he entered his teens, maybe a year or
so after his bar mitzvah, he had made a noble commitment, essentially to

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eschew all affectation. He hadnt thought about this for a long time. It was like
making an oath to no longer go after the limelight or be superficial or phony.
Late in the session he realized that while he said that any mother would scold
you for puffery, his own mother never did. In fact, she did plenty of her own
bragging, much of it about him.

Some failure is visibly operating in the patient: its hard for him to
keep from being overmodest. As observers, we dont have to go very far
to make this judgment, and the patient may eventually observe this in
himself. At this point, however, he is unreflective, claiming that modesty
is his preferred choice, so that, although the analytic setting permits the
possibility of his bragging to the analyst, he will not. And it is fair to sug-
gest that not only will he not, given his frame of mind, but he cannot brag.
He might, if he believes the analyst to be hinting that he ought to brag,
react counterphobically. If he then forces or fakes a boast, that will look
very different clinically. In fact it will shortly become clear that he can
barely tolerate it in the privacy of his mind. Thus, he seems unable to fit
boasting to contexts that feature no reasonable emotional cost. We note
he has no trouble feeling free not bragging. We can even imagine another
person, perhaps like his mother, who can hardly keep herself from being
boastful, given the opportunity. So she is free to do the opposite of our
patient, and both seem free enough to do what they do in one corner of
their own domain, but not what the other does. We might consider it opti-
mal for a person in this context to be able to do eitherbe modest or
brag, given the circumstances.

DOMAINS

Such a domain, running from over- to undermodesty, hardly figures in


diagnostic manuals. Boasting, moreover, is not particularly adaptive. So
what do these matters have to do with health? It is the formthe compe-
tence of ones agencyand not the content of the behaviorthat is the
target of this understanding: being (judgeably) free to do or to not do what-
ever it is, which may or may not be socially adaptive. Optimally a man can
be free to act adaptively and socially within a context, but also be free
not to. In adding this dimension, we have departed from Hartmann and
the ego psychology that constrained clinical theory within an adapta-
tion framework. Hartmann did in fact call for a theory of action and of

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will-processes (1947, p. 37; 1958, pp. 7475), but neither he nor Rapaport
could go farther with it.2
We can describe hundreds of domains in everyday lifelittle realms
or contexts of behaviorthat it benefits us to be competent within: to be
able to be close or to distance oneself; to be able to be silent or to speak
up; to be able to make love or to abstain; and so on. These are familiar and
yet moderately complex directions of potential action, and are descrip-
tively polar. The ranges of competent agency cannot fulfill all aspects of
health, but only those relating to domains where choice is possible. More-
over, this larger universe of domains encompasses the ability to work and
love, as Freud defined health, because there are many other species of
action about which we make choices, and because clinical situations demand
a greater specificity of context than these rubrics offer (e.g., working alone,
rather than in collaboration, or by improvisation, or as a leader, a soldier,
etc., within which one may be conflicted or free in one kind of work, but
not another).
To center on the competence of personal agency in given domains suits
the wider range of neurotic problems that defy the current DSM catego-
ries, which fail to recognize them as significant targets of therapy. Westen
(1997) and Gabbard (1997) have succinctly criticized this state of affairs.
The target here is how-the-patient-is-doing rather than the what or why
of interpretive depth. Our patient in being unable to boast does not have a
freedom that might realistically be available to him. The analysts com-
ment has brought to light his incapacity to choose against modesty, which
on his own he might not have come to see and experience as a limitation.
In a case reported by Greenson (1967, pp. 9596), by contrast, a circum-
stance rather than an interpretation exposes the patient to a failure in his
own agency. Greensons patient would never come late to sessions, but
always a few minutes early, a feature he saw no point in exploring. He
merely preferred punctuality. One day Greenson forewarned the patient
that he would be arriving ten minutes late, which the patient received

2
Hartmanns and Rapaports concept of ego autonomy, moreover, represents nei-
ther the subjective experience of feeling free nor the individuals capacity to act freely
(Hartmann 1958; Rapaport 1953). Rather, it is a metapsychological account of the egos
relative independence (as an apparatus) from impingement by either the world or the
drives. Whites work (1963) does elaborate an ego psychological / adaptational frame-
work to arrive at concepts of competence and effectance. These concern effective
interaction with the environment in pursuit of goals, however, and are not about an
agents competent freedom to do otherwise (as an aspect of health).

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without comment. But when it came down to it, the patient still had to
arrive early, and was furious with Greenson for this torture. He acknowl-
edged that in fact hed wanted to come late himself, but felt driven by an
irresistible force to come his usual three minutes early (p. 95).
Some might fuss as to whether overcoming punctuality merits assign-
ment as a therapeutic task. But analytic goals generally include beneficial
changes in activities that one is failing at as an agent, and are worth becom-
ing a competent agent for. In working through the constellation around
boasting, our patient became able to be comfortably proud of himself, and
openly enjoy others admiration. Thus, one small but real element in the
quality of his life improved. When he began treatment, he did not know
that this would be a relevant path.
Aarons (1965), writing on the criteria for healthy change and termina-
tion, proposed that the replacement of conflict by choice marks a suc-
cessful analysis, thus tying failures of agency to neurosis and implying that
unfettered choosing is somehow different from behavior that is conflicted.
But he offers no descriptive criteria to help us. Aaronss position antedates
Brenners very different assertion that all is conflict (1982). The latter
position signals that if we seriously take up the matter of freedom within
clinical analysis, we may be in for trouble. We can expect challenges from
analytic theory, regarding not only determinism or the interminability of
compromise formations, but also the problem of conscious as against uncon-
scious control, the matter of illusion in the sense of ones agency, the con-
troversy over intersubjectivity, and finally the question of the will itself.
Any of these questions may overwhelm the capacity of a psychoanalytic
theory that aspires to an explicit concept of personal agency.

DESCRIBING FREEDOM AND UNFREEDOM


P S YC H O A N A LY T I C A L LY

Matters of personal agency are woven into the fabric of everyday life. We
cannot understand, blame, or remember one another without implying
that we hold ourselves and others accountable for things said, promised,
hinted at, or done. Even when we consciously or unconsciously deny or
project any of the foregoing, our denials ground themselves in the assump-
tions underlying such accountability. It is experience-near and begins
early in childhood. We use a rough measure of this dimension, as when
we downgrade our expectations to find the otheror ourselvesless
blameworthy: the younger a person, or the more sleep-deprived, the

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gentler our demands. These matters are about degrees of answering for
that we ordinarily label as responsibility, for which there are two gen-
eral senses: for what one owns, as in my breathing, my bad cold, my
dream of incest, or for actions that are owned, as in what one does, omits,
or could do. What you own resides in yourself and no one else, although
we may cloud this notion through considerations of origin or intersubjec-
tive contribution.3 In 1925 Freud sharply enunciated this ownership in the
case of evil dream impulses: it is a part of my own being . . . [and I stand]
to learn what I am disavowing not only is in me, but acts from out of
me as well (p. 132). Note that Freud paradoxically frames this matter in
terms of the personal responsibility for those contents, even though the
origin of these acts and wishes falls under the determining unconscious
governance of topographic and, later, structural agencies that specify
no personal agent.
Add to these considerations our ample acquaintance with patients whose
capacity to choose is vastly inhibited or undermined by disclaimers, and we
see we have arrived at an area of convergence. Personal choice, action, and
responsibility, a familiar province of philosophy, may as behaviors fall casu-
alty to infelicitous development or experience, or be the beneficiary of good
therapy. Philosophers accounts of moral and prudent action rest on the
notion that while a man could choose to do this or that thing, and does, he
could have chosen to do otherwise. We do read each others agency in this
everyday way. A persons competence to act is therefore framed as a dual
power in a domainto be both able to do something (e.g., be boastful) and
be able not to do it (e.g., be modest). It is local and very much a matter of
degree. Some contemporary philosophers characterize this dimension as
the ability to will, a conception that in their view does not settle the free
will debate, but also need not (Gert and Duggan 1979).
Two general features guide reading people in this way. One is to view
the patient as the protagonist of his own moments, in which his goals
play out through actions and inaction. This is a narrative understanding,
rather than a diagnosing of states or traits (as in this woman is very

3
Schwartz (1984) distinguishes between the personal ownership of ones motives,
unconscious or not, and ones owning the deliberated choices one makes. In his view,
we accomplish the latter on a platform of conscious self-observation, and self-knowledge
of unconscious self-deceptions furthers ones capacity for choosing consciously (a
point close to that of Aarons [1965]; see also Lear [1990]).

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anxious or a little confused). Narratives conventionally lay out


sequences of events that are smaller subsets of stories: each portrays an
agent who acts or is in play with respect to other objects or persons or
oneself, or else expresses and enters some attitude about them.4 Second,
the compass of action that psychoanalytic clinicians judge is rather broad.
Philosophers, by contrast, address simple, single instances to work their
arguments (as about choosing to raise ones arm, or going through with
an assassination). For instance, a successful playwright entered analytic
treatment because he repeatedly found himself preparing or writing his
very next play, as he was finishing the present one. He could not quite
free himself from this pursuit, which, despite its gratifications, preoccu-
pied him and undermined other parts of his psychic and social life. In
general, we need to know not only whether a person can pull off an enter-
prise once (e.g., leave off beginning the next play), but how he fares over
time within that domain.

THE CRITERIA OF PERSONAL AGENCY

The conceptual registers of the three criteria differ. So long as the features
of each criterion are reliably observable, clinical and empirical matters can
be addressed for causal relation, linkage, or correlation, whether social or
psychological. The three criteria converge and overlap in pertaining to the
assessment of competent agency, but reversibility is the most central and
important.
Reversibility describes the range and character of power over actions
within a domain. It is not an action in itself. Where there are two direc-
tions of choice in a domain, moving toward one pole does not necessarily
serve as a defense against the other. A person may freely clean or freely
soil himself, in contrast to defensively or rigidly cleaning so as not to soil.
Thus, polarity is merely descriptive here, and does not imply dialectical
force, weight, or evolution (after Hegel, or Ogden [1977, 1986], or Hoffman

4
The simplest narratives involve an agent who enters an action or attitude with
respect to something, someone, or oneself, and offer the framework to judge whether
the person is competent or failing in that regard. State and trait diagnoses, by contrast,
do not specify domains. Anxiety, depression, externalization, narcissistic vulnerabil-
ity, and the like do not clarify how much power remains for the person to overcome
such burdens in given contexts; they disclose little of that range, even if they predis-
pose to degrees of agentic failure.

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[1998]); nor does it represent reaction-formation pairs or a complemen-


tary series, as in Freud.5
Self-observation relates to the degree of conscious focus available to
and/or attendant to target actions. But it is itself an action or set of actions,
valuably applied in the service of competently reversible powers, yet, like
all actions, potentially vulnerable.
Appropriateness relates to the coherent fit of an intended action to the
circumstance or context in which it plays out, and may include a social or
interpersonal dimension.

REVERSIBILITY

The central point is whether personal action is smoothly reversible rather


than conflicted (that is to say, inhibited, driven, or contradictory)and put
colloquially, whether it is flexible rather than rigid.
Just how free is a man to get messy and clean, or speak up and shut
up, or enter into as well as withdraw from intimacy with a lover or friends?
Can he both free associate and directedly focus? Splurge and be frugal?
Judging freedom in terms of polarities and contexts captures richness and
complexity.6 With enough of an account, we may be able to judge that a
person can begin acting within a realm or leave off, and also whether he
has the capacity to maintain action at either pole. In short, is he able to
start and stop and continue?
Conflictednessthe inability to be competently flexible in given
actionsand its markers are observable. Examples of inhibition include
the child who cannot go to school, the lecturer who finds she cannot speak,
the executive who cannot ask for a raise or a luncheon date. Examples of
drivenness include the man who must bed a new woman every night, the
teen who proves her courage through repeated recklessness, the woman
who cannot resist any sale. Examples of contradictoriness include the

5
Anton Kriss concept of divergent (vs. classical, or convergent) conflicts (1982),
however, is germane. It invokes polar interest pairs. Kris characterizes a patients posi-
tion toward these aims by its dilemma, and its possibility of being bridged by his tech-
nique. The present project maintains neutral descriptions so that its criteria assess a
full range of agentic competence within a domain, regardless of practice or theory.
6
Context generates this complexity, as when raising ones arm takes place in a
classroom to challenge or to ask a question, and endows arm-raisings with different
meanings. We might then recharacterize the given domain by just such labels (i.e., is
the person free to challenge or hold back, or to raise a question or wait?).

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bridegroom who speeds to his wedding and yet stops at every green light,
and the woman who, though assured of her lovers devotion, brings a mis-
erable balance to this good fortune by dwelling on romantic rivals out
of the past, or the possibility of tragic fates.
These concepts overlap and include each other. Inhibition can be viewed
as drivenness not to enter a particular act or engage particular objects;
drivenness to pursue an activity may represent an inhibiting avoidance of a
counterpart object-choice or action; and contradictoriness points up inhibi-
tion to continue on a path, or drivenness to switch. One way or another, these
are instances of people who cant start, or cant stop, or cant continue, or
must start, or must stop, or must continuedisrupting what otherwise might
have been a more competent or optimally flexible unfolding of life circum-
stances. Instead, the resulting narrative pattern shows that an intended flow
of action is impeded.
In the domain of play, Erikson regularly discovered such phenomena in
childrens therapy, calling them play disruptions (1940, 1950). Whenever
a child abruptly shifts the course of smoothly flowing play, or flat-out stops,
or resumes the play halfheartedly, such scenes tell much: something about
the childs intended direction of play has gone wrong, and she is not free
to enter playing that way, given its meaning. Bernfeld (1941) character-
ized similar disruptions in the flow of talk in analytic sessions. Usually the
patient associates or talks on about matters of interest. At some point, how-
ever, she switches subjects, or becomes hesitant, less coherent, grows silent,
slows down, or speeds up. Seasoned clinicians label these changes points of
urgency. Bernfeld saw them as shifts to states analogous to secret-keeping,
or resistance. In agency terms, wed say the patient is now not as free as
he was to say, do, or imagine something. Many analysts intervene at such
a pointif this is effective, the patient opens up (or confesses), returning
to unimpeded conversational flow.

Triggersand the Limits of Reversible Action

I dont suggest that we can elect to enter any action or state what-
ever. Most certainly, we cannot. We cannot will away the seizure of a
sneeze, a startle, a blink. We may find ourselveswithout plan or
reflectionabout to weep, retch, laugh, or climax. Once triggered, these
actions run their course and emerge not by directed choice; rather, they
are evoked and released by what is meaningfully going on around and
inside of us. These triggerable (or obligatory) actions typify our emotions,

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our visceral responses, and various reactions fixed early in our lives.7
They evade our conscious selection, except in a secondary but impor-
tant way: one may pursue or avoid the trigger by choice. We can choose
to re-enter the places that we know make us drowsy, inspired, or
excited. We can revisit the memory or grave or melody that brings us to
tears. Nonetheless, we can be neurotically conflicted to pursue these
secondary ends, or not.

A woman early in her second year of analysis revealed for the first time how
she would for years, to her huge embarrassment, become powerfully and inex-
plicably overcome by tears as a spectator at parades and other performances.
The period between Halloween and Christmas ushered in a rash of pageants in
her family life, pushing the tears anew and commanding a strong focus in the
analytic lens for both of us. It did so again the following year. The crudity of
this experience was singular. It overtook hershe had not initiated it; it made
no sense, and so she felt childish and inappropriate; she could self-observe the
event but not its meaning; it felt peremptory, even though she opposed the
emotion.
Our analysis of many associational fragments during the next two years
contributed to our understanding this repeated experience. Central were screen
memories in which the patient, as a little girl, stands very close to her mother at
military parades. Her baby sister is there with an aunt, and not her big brother.
The mother meanwhile enthuses at the grand spectacle. Inasmuch as the patient
would find herself in the present breaking into tears to explain a pageant to her
own child, we infer a probable tie to her experiences with her own mother.
But the patients passionate contempt for and disidentification with her
mother in the present had nevertheless impeded a full understanding. Early in the
work, she readily voiced rage and disappointment at the mother for having given
birth to her baby sister, and for having glorified the older brother.
Yet late in the analysis, dreams and other material began to illuminate early
experiences of her mother as young and beautiful. It became clear that she had
then been in love with her mother and felt her to be central to her life. She began
to realize that weeping at pageants represented not sadness alone: it was tapping
a yearned-for and relived joy from her childhood romance with her mother.
These insights brought her to a turning point. I felt surprise when, after all this
time, the patient began to permit herself to positively identify with her mother
in attitudes, and in cooking and clothing styles.

7
We note here that the clinically colloquial terms flexibility and rigidity charac-
terize the bandwidth of less-to-more-neurotic actionwhich is the proper realm of
therapeutic intervention. Yet they do not encompass the fullest range of failed agency,
that is, when we would like to choose and actually cannot. Accordingly, reversibility
serves here as the general covering term, for its greater compass.

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Moreover, the weeping had now become precious. She announced she had
a desire to go to parades and pageants, welcoming them as opportunities for
triggering the eruption of tears. She now knew what they were all about. It was
as if weeping re-created her as a little girl engaged with her Mom. She no longer
disparaged the child she still was, but she was also the adult who could choose.

We again note that, once begun, triggered tears still run their course,
beyond the reach of choice except in a secondary way. How the patient
came to bring these strands together inside herself demonstrates the harmo-
nious mesh that is possible between the creature of will and the machine
that she is and that we arewhen we have come to act more freely.

S E L F - O B S E R VAT I O N

Second is the question whether personal action falls or can fall within the
range of self-observation, rather than out of reach.
Self-observation of the ownership of ones personal attributes, prod-
ucts, and actions serves to maintain competent agency. Treatment moves
to uncover the irrational dangers that hinder this competence. When I rec-
ognize that I have been obstructed or defensive out of unconscious defer-
ence, guilt, vengefulness, or greed, I may be enabled to act more freely
and competently in a relevant domain.
Looking at oneself involves more directed attentiveness than does raw
and passive everyday experience. Beyond sensing or feeling things, we
can think about the noticing itself. This focus often attends decision-making,
in whichusuallywe deliberate with our eyes open, until and unless the
chosen action enters an automatic repertoire. Deliberating calls past choices
into the theater of awareness so that we may consider an imagined future.
Failure there, otherwise, renders the governance of new action unreliable.
And when it happens that we choose well but yet are not able to act, that
predicament evokes a singular self-scrutiny.
Analytic self-observation is heir and cousin to looking inward in its
three generic aspects. Looking inward involves reading the contents that
are thought or experienced; reporting what is read, whether to oneself or
others; and the possibility of a practice, privately developed or recom-
mended by others, as to how, when, and what one should target within the
introspectable world. Self-observation is more regularly and vigorously
pursued in psychoanalysis than in any other discipline, including Eastern
meditative ones.8 Analytic technique adds free association and its contents

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as regular targets to the practice of the introspective task (Grossman 1967).


In earlier investigations, self-observers held greater sway, as with Freuds
self-analysis of dreams (1900) and in patients self-explorations (Breuer
and Freud 1895). But technique soon evolved to emphasize the patients
collaboration with or submission to what the listening analyst interprets
(Spacal 1990; Gray 1994, p. xix), with the patients self-observed offer-
ings serving as raw material (although postinterpretive understandings
depend on the analysands further self-review).9 Interpretation thus won
star billing as source of insight and discovery in that trend, with self-
observation playing a supporting role.10 The patient nonetheless optimally
becomes his own self-observing, self-interpreting analyst.

The Limits of Self-Observation

Self-observing actions create unique occasions with consciousness at


their core, yet suffer the same vulnerability as all actions: neurotic distor-
tion or immobility. Driven self-monitoring undermines pleasure and apt
fruition in the flow of work or passion. Inhibition of self-observation is
often carried out through active avoidance, floods of distraction, absent-
mindedness, or repression.11 Self-observation can either serve healthy self-
review or be a conflicted muddle. Classical theorists divide on this point,
and situate it either as an overseer function on behalf of the superego
(Waelder 1936; Horowitz, in Orgel and Gombert 1994) or as a conflict-free
function that perceives and attends the self (Miller, Isaacs, and Haggard
1965). It remains an open question, however, whether a persons competent

8
Insight, in contrast to self-observing actions, is an end-result rubric, a frame of
mind devolving from multiple channels, such as self-discovery, received interpretation
in words, or significant unworded communications from others or social context.
9
In Sterbas view (1934), interpretations beget the patients self-reflectiveness
(p. 123)as though it had not already been operative, causing the latter to split off
from an originally nonreflective, experiencing ego.
10
Gray (1994) noted this deemphasis and sought to redress it, elevating self-observation
as an instrument that serves autonomy, rationality, and potential for unneurotic functioning.
In Grays approach, one does not interpret an unconscious derivative directly, but first leads
the patient to review what has just unfolded in live experience.
11
Fonagy et al. (2002) apply the term mentalization to the imaginative capacity to
interpret and understand others mental states (intentions) and ones own. They have
extensively studied its development in relation to the individuals early secure or inse-
cure attachment to primary caregivers. In brief, optimal mentalizing correlates with
secure attachment history, while insecure attachment contributes to its defensive inhi-
bition and crippling. Conscious self-observing (as in the interpreting of implied desires
and beliefs in oneself) clearly falls within the broader scope of Fonagys term.

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agency within domains can be improved through unconsciously acquired


internalizations (see, e.g., Strachey 1934), conscious understandings built
out of self-observed evidence of unconscious derivatives (see, e.g., Gray
1994), or both. That inquiry may be conceptually and, eventually, empir-
ically evaluated and tested using the agency criteria set forth here.12

A P P R O P R I AT E N E S S

The third question is whether personal action in a domain is contextually


appropriate rather than unmerited or out of place.
Common sense leads us to anticipate that what we and others do will
be intelligible and coherent. Generally, flexible freedoms require a sen-
sible fit of the intended action to the circumstance in which it is to play out:
otherwise we would have reason to doubt an agents competence to do
otherwise in that domain. Clinical judgments about this dimension are
conceptually different from those about reversibility or self-observation,
despite their close relation. Here matters relate to reality testing about the
world, and with greater complexity, to the interpersonal sphere and the
consequences of ones actions. Socially constructed in the larger sense,
they also apply within small groups and dyads, and vary as to time, place,
and context. We do not necessarily accord more competence to moves that
are adaptive or moral, because what is maladaptive or immoral can also
be intelligible and coherent. When we see action deviating from the expec-
tation of appropriateness, something has gone, or is going, wrong. Wrong
may mean that the person is mistaken, misguided, misattuned, or misin-
terpreting, and that disrupted action or interaction may result.
Typically, any of these circumstances may rest on ones being inhib-
ited, driven, contradictory, or self-deceiving, that is to say, neuroticbut
they may not be. Accordingly, though analysts usually read the failure to

12
For instance, analytic process that arrives at and shows a conflicted domain free-
ing up toward greater flexibility (e.g., increased tolerance/expression of previously
unconscious/inhibited hostility toward x), can be retrospectively evaluated for the con-
ditions under which such change occurscomparatively, in clinical passages with dis-
tinct styles (e.g., minimal interventions; close process monitoring after Gray; active
interpretation of unconscious/transferential hostility). Ultimately, however, creative
research methodologies (following Waldron et al. [2004] or Joness psychoanalytic
Q-sort [2000; Jones and Windholz 1990; Caston 2004]) applied to taped transcripts
can offer clearer tests of this question, provided they also employ domain-specific
agency criteria (or can be shown to be agency-relevant).

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be appropriate as a tip-off that a person is conflicted or acting unwittingly,


clinical judgments about troubled reversibility and self-observation do not
exhaust the sources of inappropriateness.
We must consider that rules of thumb for conduct also inform the given
action. At our healthiest we read others, as well as the nonpersonal world.
Out of this learned attunement about how people usually behave and how
they ought to, we notice and choose our way, or fail to. Ought to does
not mean one has to, but knowing the expectable ought-tos serves our
strategies in making a choice. The sources are several, including not only
broadly publicized rule sets, such as the law, the Ten Commandments, the
rules of a game, but what has been called the morality of everyday life,
practices that are more socially modeled than taught (Garfinkel 1967).13
Most familiar is saying hello to friends or coworkers each day, with clear
accountability for not doing so. Breaches of such everyday practices lead
to interactional breakdowns that are rapid and complete (Heritage 1984,
p. 81). When things go wrong, people will demonstrate great concern, going
to great lengths to clarify, straighten out, demystify, rationalize, or revise
whats been going on, rather than allow the engagement to fall apart.
Relevantly, Almond (1999) describes the give-and-take by which both
parties operate within prescribed ranges of behavior in the particular social
context of psychoanalysis. Out of professional attitudes, the analyst actively
sets up expectations in the patientrolesas to how to listen and act.
Almond delineates five polar continua14 of the patients expected roles within
which the analytic dyad is constantly moving. He emphasizes that transfer-
ences and countertransferences, although psychodynamically expressed, are
also formed by social expectancies that can be examined separately.
To this picture we add that even tinier, idiosyncratic boundaries of
conduct implicitly arise out of the routines of therapeutic dyads (just as
between romantic or work partners). For example, some patients have

13
The work of sociologists for whom actors agency is a central theoretical inter-
est (Garfinkel 1963, 1967; Goffman 1974; Heritage 1984) informs this account. They
focus on the observable, necessarily consciousness-centered regularities of peoples
outward social behavior and talk. Adding the dimension of unconscious dynamics sig-
nificantly extends this picture. I am indebted to Nancy Chodorow for indicating the
relevance of such studies to my own thinking.
14
Almond describes reporting and editing; transferring and containing; thinking
about oneself and about the analyst; regressing and listening/self-observing; initiating
trial action and mediating inner states.

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inferred that, because the treatment arrangement is not face-to-face, they


must not look at the analyst on their way to the couch (the same expecta-
tion may be induced in the analyst as well). Close readings of actual situ-
ations like this can help dissect what relative failures of reversibility or
self-observation have contributedor not: the little guideline that informs
the behavior may emerge as the only constraint against the freedom to do
otherwise. That is, the patient isnt looking at you, not because he is con-
flicted about it, or has no conscious access to that choice, but simply because
he thought it was a rule of the game.

The Limits of Appropriateness

Ambiguity often saturates our clinical reading of the interpersonal


environment, whether we participate or stand in it as observers. Limita-
tions in being appropriate as well as of evaluating appropriateness lie in
how hard it can sometimes be to grasp whats called for. Worse, one may
misperceive things on his own, or be deceived by the other.15
Each instance of relative appropriateness from the observers viewpoint
must be clinically judged on a case-by-case basis, and empirical approaches
to this criterion will have to depend on considerable sweeps of sequential
process data. These difficulties pertain more to the assessment of appropri-
ateness in high-functioning individuals for given domains. The clinical fac-
tors that more clearly undermine coherence and intelligibility, and therefore
competent agency, include thought disorder, poor socialization, underdevel-
oped mentalizing capacities, altered states, and senescence.

C L I N I C A L LY T R A C K I N G A G E N C Y I N
A DOMAIN: A BIRDS-EYE VIEW

Moments of health often appear embedded in a mass of narratives and


emotion, co-occurring in the midst of analytic patients ongoing troubles.
In my own work, and especially in supervising analyses, I find experience-
near progress sensible to follow as the patient becomes freer, as well as
self-observing and appropriate, within domains previously driven, inhib-
ited, or contradictory.

15
Or, as Goffman puts it, misframe. See Goffman on ambiguity in frames of
experience (1974).

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Blackers longitudinal case example (1975) succinctly captures such


shifts. I present it here in simple agency terms to illustrate agentic compe-
tence as a background assumption of clinical change. Thus reframed, Blackers
clinical material concerns the patients freedom to be better than others,
that is, to enter into actions or frames of mind in which she could present
as superior, favored, victorious, or admired: she could not do so at the begin-
ning of treatment, and yet by the end of the analysis she could consciously
take responsibility for choosing and seeking this option in all its variants.
Blackers design zeroed in on and limited itself to what the patient has
said just before and after a specific, spontaneously recurring memory
told some fourteen times over the six hundred hours of her analysis. In the
memory, to her dismay, she bests her older and less favored sister at Chinese
checkers. This memory emerges five times within the first thirty sessions,
three times in the last hundred, and six times through mid-analysis.16 These
fragments, amounting to only a sliver of this patients history and analy-
sis, cannot alone represent all that was neurotic in her. Blacker wanted to
know: can the associations organized around such a recurrent focus and
the retellings of the memoryas targeted nuclei of clinical information
provide a window of analytic progress? Excerpts retrieved from process
notes taken during and after the sessions (written or dictated and tran-
scribed) were limited to ten typewritten lines of what the patient said just
before and after the reported memory.
By this natural experiment, Blacker created an exquisite test of his
question as follows: he shuffled the order of the targeted analytic frag-
ments, having removed any references to temporal locus or the termina-
tion, and asked both clinical and nonclinical judges (analysts, psychiatrists,
social workers, medical students, and housewives) to now arrange the
randomized excerpts in a sequence that could fit a narrative of therapeu-
tic and analytic progress, leaving the judges to their own guidelines.
Spectacularly, everyone was able to recognize progress to a statisti-
cally significant degree, without necessarily saying what constituted

16
This patient entered treatment because of uncontrollable episodes of crying and
anguish, evoked as she would begin to rock her healthy six-month-old. She herself was
the second of four children. When she was two and a half, a baby brother had fallen ill
and died. Within the first two years of her adolescence, a seven-year-old brother had died
in an accident; her depressed older sister had become pregnant (and married) though still
in high school; her mother was hospitalized for psychosis; and the parents divorced. The
patient, the more intelligent and favored of the surviving children, remained with her
father, but was no longer as bubbly and extroverted as she had once been.

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AGENCY AS A PSYCHOANALYTIC IDEA

such change.17 Most important, Blacker concluded that the differences that
represent this therapeutic movement appear to be noticeable at manifest
levels without much deeper interpretation of meaning.
The clinical beauty of these systematically collected sequential excerpts
is that they allow one to illustrate progress over time in this one domain.
At first the patient could not fully own her own desire, instead prefer-
ring that she not be the active, originating source of wanting to be su-
perior, favored, victorious, or admired. She preferred to think she was
influenced by others or by circumstance. Inappropriateness was evident in
early past rejections of friends so as not to hurt them. By the end of ther-
apy she was able to pursue the goals of being superior, winning, or achiev-
ing, and even bragging about it in an unconflicted way. Her ability to
self-observe within this domain also evolved: from a vague, hard-to-articulate
awareness of discomfiture early on, to the later conscious recognition of
herself-as-source, though this came with guilt and pain. She later became
able to see and accept this pattern in other sectors of her life. As Blacker
notes, this shift did not necessarily reflect positive changes in other, con-
temporaneous neurotic sectors. At the beginning of treatment the clinical
account shows how, at the other pole of this domain, she would enter into
options to be lesser than others without hesitation, and usually did so in
a driven way. The memorys drama itself permits us to conjecture that the
same failure to be free, within this domain, marked her past.
Blackers own formulation, essentially an ego psychological one,
viewed this patient as neurotically burdened by different aspects of her
aggression, in which he considered Rapaports treatment of the problem
of activity and passivity particularly pertinent. Rapaport (1953) had strug-
gled to clarify activity and passivity within a metapsychological rather than
clinical framework, but with no criteria to clinically distinguish and estab-
lish his claims. To my mind, he never resolved it. Quite remarkably, Margaret
Brenman advised Rapaport that the real issue he was dealing with was the
metapsychological considerations of the freedom of the will, and he
acknowledged he could not take that further (pp. 534, 535n, 557). Indeed,
Rapaports discussion implies that the general nature of passivity is path-
ological, in that it in one way or another represents a dynamic failure or

17
A simple correlation meets this test in that the true sequential order of the excerpts
can be statistically compared with the judges rank ordering. Blacker reports that an
experienced analysts judgments correlated at .80, a housewifes at .65. A prcis of
each excerpt can be reviewed in Blacker (1975).

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weakness of ego structure vis-vis the drives. In contrast, the project pre-
sented here argues that the polar freedoms of being either passive or
active together carry the possibility of health, and also that these freedoms,
or their lack, observably reside in the person rather than in an ego
apparatus.

AGENCY AND THE DIAGNOSTIC MANUALS

If our competence or failure as agents indicates a dimension of health,


shouldnt it find a place in the contemporary canons of psychopathology?
Several features of agency complicate such inclusion, and three issues
make for the difference.

The DSM

First, diagnostic systems call for general classes of disorder: the ancient
Greeks located four dark temperaments for us, while the Diagnostic and
Statistical Manual designates a few hundred assembled as state and trait
rubrics. Because an agency perspective more specifically encompasses
health problems domain by domain, it can easily posit several thousand
trouble spots in intentional human activity. This may not be the best thing
for nosology, but it certainly suits the clinical practice of tracking the
patients points of difficulty and progress. Second, an agency approach
lays out capacities as action narratives, while the DSM focuses on states.
Third, the latter attributes wellness by default, losing agency-informed
richness. We need to know: in what context, for what ends, and for whom,
does a persons flexibility bring off optimal performance?

The PDM

In contrast, the Psychodynamic Diagnostic Manual18 begins to move


toward a more direct presentation of elements relevant to agency. Its authors

18
The PDM, a collaborative effort undertaken by organized psychoanalysis, com-
plements the DSM in that it reaches beyond the latters shortcomings, in multifaceted
psychodynamic directions. Based on scholarly contributions from neuroscientific and
empirical outcome studies, the PDM expands the diagnostic spectrum to include health,
restores psychoanalytic categories of psychopathology, and develops observable criteria
in three converging dimensions. These include the P Axis, which describes personality
patterns and disorders; the S Axis, which addresses the subjective range of symptom
experience; and the M axis, which systematizes such capacities as emotional functioning,
information processing, maintenance of relationships, self-regulation, and so on.

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AGENCY AS A PSYCHOANALYTIC IDEA

conceive of mental health and disorder as a continuum and cite flexibility


and rigidity as descriptive features (pp.18, 2224). Also, the PDMs inno-
vative Profile of Mental Functioning (the M Axis) features some aspects
pertinent to agency (unlike the static descriptors of its P and S Axes). The
M Axis includes nine categories of experience, action, or mental organi-
zation (capacities) and evaluates levels of functioning in each. Flexibil-
ity stands as an explicit mark of overall, as well as specific, high functioning
(p. 88). The PDM takes note that a neurotic pattern is not pervasive, but
rather is more likely to concern one area (e.g., trouble with authority fig-
ures, but not in all interpersonal relations). This is a fertile direction. If our
clinical gaze is brought into narrow enough domains, we can better spell
out each persons specific competence as an agent.

T H E E M P I R I C A L S T U DY O F A G E N C Y

If the background assumptions of psychoanalysis can always be articu-


lated (Stepansky 2009), we should also expect that clinicians can agree
on their manifestations. Are the agency criteria offered here operational
and reliable enough for both clinical judgment calls and empirical research?
In the following, three studies using recorded clinical sessions, and a fourth
based on semistructured interviews, are reviewed through the lens of
domains and agentic competence.19

The Freedom to Play


The first study assesses childrens capacity to be free within a single
domain: to play in the presence of an adult (i.e., the therapist). Play pro-
ceeds smoothly or it doesnt, and as it unfolds narratively, it lends itself to
the study of personal agency. Paulina Kernberg and her coworkers, follow-
ing Eriksons psychoanalytic observational approach (1972), developed
the Childrens Play Therapy Instrument (CPTI) to systematically capture
features of play (p. 6). Basing ratings on video-recorded therapy, the man-
ual distinguishes nearly fifty aspects of play-relevant activity, thirty of
which pertain directly to agency in the childs play behavior, including the
quality, style, and focus of the childs initiation, absorption, conclusion,
role-playing, self-awareness, defense strategies, and play disruptions (Kernberg

19
These studies, though intended to apply across wider targets, yield findings per-
tinent to personal agency.

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2001; Kernberg, Chazan, and Normandin 1997, 1998; Chazan 2000, 2002).
Good to very good reliability of all these variables was established (Kernberg,
Chazan, and Normandin 1998). I summarize aspects pertinent to agency
criteria as follows:
Reversibility. A childs capacity to begin, end, become engrossed, or
move smoothly into new play demonstrates her power to start, stop, or
continueor not, when she cant get into or deserts itsatisfying the
criterion of reversibility in this play domain. Kernbergs team distin-
guishes these variations with 100 percent agreement. Normal and neu-
rotic children often drive the scripts of their play, spontaneously directing
or narrating the action, and bring their tales to an end or into smooth
transitionsuntil something conflicted intervenes. Then we may see reluc-
tance, withdrawal, outbursts, or shifts away from topic. Borderline and
traumatized children tend to be seized by sudden break-offs, or distrac-
tions, and depressed children often get stuck, never quite entering actual
play (Kernberg 2001; Chazan 2002).
Self-observation. How can we notice that a child is knowingly in a state
of play? Pretending requires that one is able to attribute intentions (to self,
others, objects) in the playat willthat would be very hard to do without
knowing it. Clues include a childs opening with lets play/pretend, alerting
the therapist to notice or explain something in the play narrative, or correct-
ing the therapist who slips out of an assigned role. Play tied to concrete vs.
imagined depictions suggests less self-awareness.
Appropriateness. Play that diverges from expected age, gender, or
cultural standards, or that is idiosyncratic, bizarre, or cryptic (rather than
merely magical) raises the question of pathology and inappropriateness.
Other distinctions relate to how stable the child remains in character.
To undertake a role other than oneself without threat to identity (using
oneself, an object, or the therapist as a vehicle) requires that attributions
of intentions to these others be stable. One switch of roles may be
expected to occur under voluntary control, while fluid role-changes
are viewed as involuntary. Sometimes a child, having begun in one
role, becomes surprised or frightened by these switched roles erupting
within him, and cannot end the story comfortably. Not only does such a
child choose inappropriately, but we are led to infer that he is not choosing
with awareness: when a child can flexibly initiate, sparingly reshuffle,
and not foreclose pretended roles, she performs optimally as a playing
agent.

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I Must, I Cant, Etc. as Clinical Markers

The second study tracks the frequency of verbal markers of inhibition


and drivenness as it changes over time in a progressing analysis. Criterially,
these mark conflictednessthe inability to be competently flexible in given
actions. Horowitz et al. (1978) looked at just such phrasings identified in
the first one hundred hours of the case of Mrs. C.,20 in which, in their view,
the patient verbalized her experience of being inhibited or compelled (as
in I cant praise my assistant; or I have to fight with my husband). The
domains of this inflexibility varied in each instance; the authors looked for
its common themes, however broad. Data were drawn from synoptic pro-
cess notes the analyst transcribed during sessions.21 The frequency of these
locutions in the process notes, compared with that in the taped verbatim
text, correlates highly and significantly.22
Thirty dozen markers of drivenness or inhibition were found in the
hundred sessions, with a pattern of steady decline. With Mrs. C., such
phrases occur about four or five times a session as the treatment begins,
gradually slowing to two or three by the end of the first hundred hours (sta-
tistically significant at -.28, p < .01). Taped verbatim transcripts used to
replicate these findings with a different sample (twenty random sessions,
first one hundred hours) show a more striking decline at -.63, p < .001.
When samplings are taken up through the mid-four-hundred-hour range,
the frequency slips further to one or two a session (Weiss et al. 1986,
pp. 343344). If we trust that I must, I have to, I cant, I mustnt, etc.
tend to mark conflicted states in Mrs. C., thenfrom an agency viewpoint
what she said over time in the analysis signaled less and less constriction
and inflexibility. But what domains involved conflictedness? Of the more
than three hundred instances Horowitzs team identified, they could fit only
a third to themes of either opposition (broadly, aggressive) or intimate
engagement (broadly, sexual).
Thus, sexual and aggressive are hardly monolithic rubrics. The remain-
ing two hundred instances of inhibition and drivenness significantly rep-
resent an extensive range of other neurotic concerns and domains. As this
decline in inflexibility markers lies across domains, paralleling Mrs. C.s
general improvement in the analysis, we may view it as a correlative

20
See fn. 23 below.
21
Two judges independently located and tabulated such instances. The analyst
wrote notes without adding clinical commentary.
22
+.73, p < .001 (Weiss et al. 1986, p. 203).

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reflection of that trend. (Horowitz et al. 1978, p. 558 n.2; Weiss et al.
1986, p. 338).

Recognizing and Agreeing on Failed Agency

The third study tests whether clinicians can agree on degrees of


conflictedness, and whether that agreement depends on clinicians stereo-
typical expectations in a single tape-recorded analysis (Caston 1993, 1995;
Caston and Martin 1993). 23 Judges used 9-point scales in assessing
features of paradoxical intention, drivenness, inhibition, constriction of
expression or affect, and contextual inappropriatenessas opposed to the
features of relative unconflictedness: ease, flexibility of choice and control,
and contextual appropriateness, in twenty-five action narratives randomly
drawn from the first one hundred sessions.24 But they also rated each action
narrative twice: (1) Was the patient conflicted about that action at the time
it happened? (2) How conflicted is she now to talk about this action with
the analyst? The latter question essentially addresses a transference dimen-
sion. Thus, domains varied for each of the rated actions as analyst-judges
understood them in context.
Excellent levels of agreement obtain for degrees of conflictedness, in
both (1) the historical moment and (2) talking about it with the analyst.25
Moreover, the study demonstrated that the judges agreement was not a

23
Conflictedness was one target of an analytic formulation reliability study (other
targets were defense-impulse configurations, transferences, wish structures, and his-
torical antecedents). Judges, grounded in the first five verbatim sessions from the Mrs.
C. case and biography, assessed randomized excerpts from the first hundred hours in
the given tasks. Mrs. C. had sought treatment for difficulties with pleasure, sexual
responsiveness, esteem, timidity, and emotional constriction (the treating analyst was
outside the research). This case has been diversely investigated (see, e.g., Weiss et al.
1986; Jones and Windholz 1990; Bucci 1988).
24
For example, the action the patients leading a man on at a party occurs in
session 3: And this is sometimes, I mean no situation has really occurred when weve
been anywhere like cocktail parties, but just with morality being what it is today, or
things happening as they are today, Ive sometimes been kind of worried again that I
might, in a situation, where people have had too much to drink, lead some somebody
on beyond where hell stop, and thenand I wont realize Ive been doing it con-
sciously, although maybe unconsciously I do and, and, I might be in a real situation
(Caston and Martin 1993, p. 519).
25
Spearman rho correlations p < .001 for Conflictedness in the historical moment
.61 (with Q-sort method, .74), and Conflictedness in telling it to the analyst .64 (with
Q-sort method, .72). Agreements on magnitude also obtained chi-squares for both,
p < .01. These two variables correlate at zero with each other, thus demonstrating diver-
gent validity with no halo effect.

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consequence of stereotypical expectationsa high standard for clinical


judgments (Caston 1993, 1995; Caston and Martin 1993).

The SPC

The Scales of Psychological Capacities, developed by psychoana-


lytic workers to evaluate treatment outcomes, is based on semistructured
interviews rather than clinical process (Wallerstein et al. 2000; DeWitt,
2007).26 Nonetheless, its evaluating schema applies to clinical contexts
and further develops observable markers of personal agency. The SPC
uses experience-near, atheoretic constructs to capture a range of behav-
iors in seventeen categories related to adaptive-interpersonal functioning,
for example, Empathy, Attribution of responsibility, Affect-regulation,
and Trust. The full universe of clinical domains encompasses more than
the SPC rubrics do, but the latter do have the merit of approaching the
narrowness of domains of action. The SPCs polar scales range between
exaggerated and inhibited expressiveness in these areas of functioning
(and have demonstrated excellent reliability across neurotic and border-
line cases). Each capacity branches in two directions (amounting to
thirty-seven subscales in all).
Strikingly, none of the SPC categories or subscales designate agency
as a rubric. This proves conceptually sound: agency has no single measure
as a stand-alone aspect of a persons behavior, but must be taken up domain
by domain. A close look at the SPCs schema for evaluating levels of func-
tioning reveals another facet of agentic competence, through markers that
focus on how much a person is able to self-correct or needs outside help.27
Each capacity is scaled by four levels, from high to suboptimal function-
ing, to assess degrees of change after treatment. When functioning in a
given area is optimal, for instance, a person on his own needs no correc-
tion, and we may say he acts freely in that domain. For example, he can
be free to be skeptical, or free to worry, or to assert, or to be dependent.
At a mild degree of difficulty, a person needs correction, but is able to self-
correctpointing up the persons self-awareness and reversibility. But
a person who can correct himself only with outside help functions at a
moderate level of difficulty, requiring assisted awareness and assisted

26
The SPC served as one background source for the PDMs Profile of Mental
Functioning, or M Axis.
27
Agency, in my view, forms its very backbone. Robert Wallerstein concurs on
this point (personal communication).

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Joseph Caston

reversibility. Fixity marks the fourth and most troubled level of function-
ing, labeled severe, in which subscale descriptions often refer to rigidity,
drivenness, inhibition, inappropriateness, and imperviousness. At this level,
assistance does not help a person attempt a less disabling path: she is unable
to reverse or self-correct, and is deeply unaware.

CONCLUDING COMMENTS

Psychoanalytic theories construe mental states as assemblages of deeper


mental conflict or disordered object-worlds, but that level of complexity
fails our technique if it cannot also offer us a way to objectively recognize
pathology and healthy change in clinical situations. People come to treat-
ment because they desire to do things and to enter frames of mind and
emotions they ought to be able to but cannot because of what goes on inside
them. That a person becomes more enabled toward those ends and actions
through therapeutic influence and access to otherwise inaccessible self-
understandingsrepresents health, and establishes personal agency as a
basic assumption of psychoanalysis.
I have put forth three experience-near markersreversibility, self-
observation, and appropriatenessthat firm up the evidential nature of a
persons agentic competence, and are operationally useful in following
changes toward health. I have clinically illustrated these criteria and located
partial versions of them in three empirical studies that support their util-
ity and testability.
To have done so, however, has called for conceptual tools for which
clinicians often have little taste. What we most savor and are excited by as
analytic intellectuals is that which is symbolic, deep, unconscious, and com-
plexly meaningfuland retrievable through live interactions in the cup of
the couch. But assessing healthy change must objectively look toward a dif-
ferent facet, however mundane. Evaluating agency depends on observing
from a distancewhat the philosopher Thomas Nagel (1986) metaphori-
cally calls the view from nowhere. That is because a persons belief or
experience that she is acting freely cannot be fully relied on as an adequate
clinical marker. The sense of ones agency in the immediate moment is a
fragile judgment that can be mistaken or defensively false. For instance, the
adolescent who opposes each and every authoritys edict will assert a pow-
erful sense of agency. You cant make me do what you wantasserting that
not only can he not do A, but that he can also choose to do A. He

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AGENCY AS A PSYCHOANALYTIC IDEA

demonstrates this power by switching tracks under your very eyes, and that
much is within his compass. But he must do the opposite, compelled to react
rather than be free to agree or resist, as a dual capacity. It takes us as observ-
ers (and perhaps the boy himself later in life) to recognize that significant
fact. In contrast, note how much more reliable is the experience of ones
own failed agency, as seen in Greensons patient (1967) who wanted to
come late to his session and could not, or Freuds patient (1893) who was
unable to breastfeed, furious at her inability, against which she had strug-
gled with all her strength and could only do so following hypnosis.
These comments hardly complete the discussion. The criteria I pro-
pose can be usefully applied in reviewing the agency literature in psycho-
analysis, evaluating clinical conundrums, and reviewing developmental
research of the infant as an emerging personal agent. It can help us con-
sider, from a clinicians vantage, what cognitive and philosophical studies
have regarded as illusional in choice-making.
This way of presenting things brings to light that once we become
optimally unconflicted in a given areareaching freer range of choice
there, stably or temporarilywhat is achieved is a power. But however
psychoanalyzed we become, that transformation still does not tell us what
to do: whether to move to the Oregon mountains or the Bronx, whether
to become pregnant now or after training, or whether to exclude some-
one from our club or from the life raft at sea. The what remains as much
an existential problem for practical and moral choices after we have grown
in our capacity to choose, consequent to therapy or other endeavors, as
before. We seek to enlarge this power, and find it a goal in treatment and
daily living: that a person become as optimally passionate, dispassionate,
and compassionate as one can, in appropriate contexts and the circum-
stances of life.

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