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Psychoanalytic Psychology 2012, Vol. 29, No.

1, 8198

2011 American Psychological Association 0736-9735/11/$12.00 DOI: 10.1037/a0025086


A Model of Change for Psychoanalysis
Rebecca Coleman Curtis, PhD
Derner Institute, Adelphi University, and the W. A. White Institute

A model of the self is presented emphasizing the experiential self, along with self-with-other representations. This model focuses on primary consciousness in distinction from consciousness of the theory of the self, or the sensory perceptual self in addition to verbal/conceptual processes. The experiential self is discussed in relation to contemporary neuroscience and nonlinear dynamic systems theory. Acknowledgment of the experiential self leads to implications for therapeutic action. Although psychoanalysis has focused on a change in the meanings of experience especially unconscious meaningsas a route to change, many recent theorists have commented on new experiences themselves as leading to change. This idea is consistent with acknowledgment of the experiential self. To the extent the idea of an experiential self is endorsed, there are implications for interventions that can address it. These include attention to sensory processes, the body, visual images, language in the present, and mindfulness techniques in addition to nonverbal aspects of the relationship. Instead of simply relying on interpretation leading to insight, the model of change in psychoanalysis can now be said to be one of new experiences and new meanings of experiences. Such models of the self and change help to bridge the gap between psychoanalysis and mainstream psychology. Keywords: self, change, new experiences
Psychoanalysis, as well as psychology, is without a unied view of the self. As Summers (2005) recently commented, although psychoanalysts have evolved from the language of ego to the language of the self, the theory (including of technique) has not shifted accordingly. Freuds model of the ego, id, and superego is still with us, but it has been

This article was published Online First August 29, 2011. Portions of this article were presented in 2010 at the 26th annual conference of the Society for the Exploration of Psychotherapy Integration, Florence, Italy; and at the 41st international meeting of the Society for Psychotherapy Research, Asilomar, CA. Appreciation is expressed to Robert Bornstein and an anonymous reviewer for comments on a previous version of this article. Correspondence concerning this article should be addressed to Rebecca Coleman Curtis, 411 West End Avenue, 11-D, New York, NY 10024. E-mail: rcurtis.curtis@gmail.com




criticized from both within the Freudian orientation and without (Frank, 2007). The power of the image of this world, what lies beneath, and what lies above goes back at least as far as the Minoans 4,000 years ago, who constructed an image of a grifn with a lions body, an eagles head, and a snake as a tail, representing the world around us, the world above, and the underworld. Freud, however, never really separated the experiencing self from the metaphysical ego. Part of the difculty may have come with the translation of Ich into both ego and self in English where it seemed appropriate. Frank (2007) noted that Freud (1926/1963) used the word Ich in two different ways one as synonymous with I and the other to refer to a structure of the mind, only one time associating Ich with the Latin term ego, which is more impersonal. However, the real neglect of the experiencing self begins with the move from the topographical to the structural model (cf. Kernberg, 1982). Hartmann commented on the use of the word ego as ambiguous, not synonymous with person or individual or subject and by no means only the awareness of the feeling of ones own self (Hartmann, 1950, p. 74). He emphasized the experiencing self in the need to consider what he called the ego functions of perception, memory, self-regulation, and so forth and considered the self to refer to self-representations. Fairbairn (1952) rejected the Freudian model of ego and id because sexual and aggressive wishes were partly conscious and it made no sense to consider them as unconscious its. Both Fairbairn and Klein were focused on how the internalized representations of others affected self-functioning. Fairbairns idea of a central ego and multiple ego states is still seen in the idea of multiple selves of relational psychoanalysis. In his development of self psychology, or what should perhaps be called self object psychology or the psychology of self object experiences (Wolf, 1991), Kohut noted the neglect of the subjective, experiencing self. Kohut emphasized subjective experiencing as well as the self as a structure. The major problem with Kohuts conceptualization, as noted by Stolorow and Brandchaft (1987), is that the two major components of the self are the personal ambitions and societal ideals. It is not possible to differentiate this distinction in many people. It also neglects the importance of reality as a factor, apart from the ideals. Atwood and Stolorow (1984) found this aspect of Kohuts formulation problematic but thought that psychoanalysis can only illuminate the experience of personal agency or its absence in specic contexts of meaning (p. 34); they continue, [T]he person-as-agent, in our view, lies squarely beyond the scope of psychoanalytic inquiry. Although the experiencing subject may lie outside the realm of psychoanalytic investigation, this aspect of self must at least be present in our view of the self. Brenner (1998), aligned more strongly with the Freudian tradition, concluded that the idea of three agencies referred to as id, ego, and superego is not supported by currently available data concerning mental development and functioning (p. 179; cf. also 2002) while still seeing the mind as best understood by compromises of the conicts over sexual and aggressive wishes in childhood. Although Sullivans (1953) ideas about a good me, a bad me, and a not me are widely accepted, his focus on interpersonal relations did not lead to much development of ideas about the self. Winnicotts (1960, 1960/1965) differentiation of a true self from a false self has been criticized by those who see various sorts of states with others (Bromberg, 1996; Davies, 1996; Mitchell, 1991, 1993). For Winnicott,
[The] central or true self . . . could be said to be the inherited potential which is experiencing a continuity of being, and acquiring its own way and at its own speed a personal psychic reality and a personal bodily scheme. (Winnicott, 1960, p. 590)



External impingements and compliance may lead to unconscious hiding of this true self and to the development of a false self. Winnicott explained that people with intellectual potential were particularly prone to the development of this sort of dissociation between intellectual activity and psycho-somatic existence (1960/1965, p. 144), or false self. Sullivan (1938) suggested that people operate in very different meyou patterns in different circumstances. An individual might operate in a particular meyou pattern with his or her mother and in another meyou pattern with a boss and thus have multiple ways of being. Mitchell (1991), drawing on the interpersonal tradition of Sullivan, asked, Can one experience oneself in a direct fashion, unmediated through relations with others? (p. 130) and advocated the concept of multiple self-states (Mitchell, 1993) while suggesting that there was also a continuous sense of identity. The system of multiple self-states suggested in interpersonalrelational psychoanalysis has not yet been fully spelled out, however. In the conceptualization of multiple selves, there is no distinction between the experiencing self and representations or theories of the self. Kernberg (1973), in fact, had written of multiple self and other affective cognitive representations but not of the experiencing self. Stern (2002), in response to the idea of multiple selves, posited a differentiation between primary subjective experience and intersubjectively organized experiences. The primary subjective experience, he stated, corresponds to the true self of Winnicott (1960) and Bollas (1989). It is not necessary to endorse the idea of a true self, however, to support the idea that human beings possess some sort of consciousness of experiences, just as other animals do. Stern (1985), Damasio (1999), and Le Doux (2002) all describe this sort of core consciousness. For Damasio, core consciousness is necessary to acquire a sense of an autobiographical self over time. The distinction of consciousness in the present versus consciousness over time (including a narrative sense of reference) has been made by Farb et al. (2007), who describe consciousness in the present as evolutionarily older and involving neural regions dealing with basic interoceptive and exteroceptive processes. Although these two distinct forms of self-awareness are habitually integrated, research shows that they can be dissociated again through training the self to attend to the present moment. Stern also differentiated the senses of self that exist before self-awareness and language:
These [senses of self] include the sense of agency, of physical cohesion, of continuity of time, and having intentions . . . . Self-reection and language come to work upon these preverbal existential senses of the self and, in so doing, not only reveal their ongoing existence, but transform them into new experiences (Stern, 1985, p. 6).

This sort of core consciousness does not necessarily include a sense of self, however, as other animals must have this sense of agency and perhaps sameness. In fact, the word self stems from the Latin word se meaning same. Damasio (1999) referred to core consciousness (p. 82) and distinguished between the organism and the object of consciousness. Edelman (1992), also a neuroscientist, distinguished primary consciousness from higher order consciousness. According to Edelman:
Primary consciousness is the state of being mentally aware of things in the world of having mental images in the present. But it is not accompanied by any sense of a person with a past and future. It is what one may presume to be possessed by some nonlinguistic and nonsemantic animals . . . . In contrast, higher-order consciousness involves the recognition by a thinking subject of his or her own acts of affections. (Edelman, 1992, p. 112)



Both of these are distinguished from the even richer overlay present in humans with the addition of language and symbol formation. In the philosophical literature, these conscious experiences are variously called phenomenal consciousness, raw feelings, or qualia (qualia referring to the blueness of the sky or wetness of water). The idea of consciousness does not prevent one from thinking of multiple streams of consciousness, as Dennett (1991) and Mitchell (1993) have suggested, but all streams cannot act simultaneously. The general properties of consciousness allowing for both the unity of conscious experience and simultaneously rapid selection from a repertoire of possible conscious states was recently articulated by Tononi and Edelman (1998). The distinction between this experiencing self and the self as an object of thought is also crucial in philosophy and needs to be given attention in psychoanalysis and psychology. Recently, in cognitiveaffective neuroscience, Lieberman, Gaunt, Gilbert, and Trope (2002) have reiterated the distinction between consciousness and consciousness of. Cooper (1993) commented, after reviewing the literature in psychoanalysis on the self, Most contemporary psychoanalytic theorists fail to take a systematic stand concerning the self as distinguished from the self-representation (p. 41). In writing about the self as an agent, Meissner (2000) and Fonagy, Gergely, Jurist, and Target (2002), in regard to the development of the self, made this point. The failure to take into account the active I aspects of the self in comparison with structural features of the self-concept has also been noted in reviews in academic psychology (Harter, 1983; Markus & Wurf, 1987) and by psychotherapists outside the analytic tradition (Wolfe, 1995). A self-concept or representation cannot act. Multiple self-states cannot act. As Meissner (2000) stated:
[S]elf representation is itself an action, a self-representing, of a subject-agent who does the representing (i.e., the self-as-agent or subject). If we were to ask, who does the representing, it cannot be the representing itself, but must be some other agency that performs the action of representing. (p. 484)

Because Frie (2008) and Modell (2008), along with Meissner (2000) and Fonagy et al. (2002), have made cogent arguments for the self as agent, I concentrate here on the experiencing self.

The Experiencing Self

In psychology, James (1890), of course, distinguished the I or subjective self from the me, or object of thought. Within psychology, Epstein (1973) was very inuential in his articulation rst of the importance of the idea of the theory (or concept) of the self and later (Epstein, 1991) in his distinction between the experiential self and the cognitive self as two different ways of processing information one emotional, the other rational. He described the experiential self as a relatively crude system that automatically, rapidly, effortlessly and efciently processes information, whereas the rational system is a deliberative, effortful, abstract system that operates primarily in the medium of language and that has a brief evolutionary history (1998, p. 105). Epstein (1994) then showed how cognitive experiential self theory integrated psychodynamic and cognitive views of unconscious processes, although his work does not appear to be cited frequently within psychoanalytic literature. Similarly, Kahneman and Riis (2005) discussed both the experiential self and the evaluative self in a chapter called Living, and Thinking About It: Two Perspectives on Life.



Rogers (1951) emphasized the experiencing self in his client-centered therapy, and Gendlin (1981) continued this emphasis. The tradition was sustained in experiential psychotherapy with Bohart (1993); Guidano (1991); Greenberg, Rice, and Elliot (1996); and Fosha (2000). It has also been important in the Gestalt tradition (Perls, 1976). The nonverbal way of processing has continued to be of importance to many of those working in the interpersonal tradition, such as Schachtel (1959) and Singer (1974; Pope & Singer, 1978), and in the self psychology tradition within psychoanalysis (Beebe & Lachmann, 1994; Knoblauch, 2000; Lichtenberg, Lachmann, & Fosshage, 1992: Stern, 1985). Both of these traditions experiential psychotherapies and self psychology have also emphasized the importance of conscious processing and empathy in the change process. The relationship between mindfulness mediation and therapeutic processes has been considered since the work of Suzuki, Fromm, and De Martino (1960) and dealt with increasingly in recent years (Epstein, 1995; Langan, 2006; Safran, 2003). Mindfulness is another concept related to experiencing in the present. In regard to psychological processes, the literature on mindfulness differentiates two modes of mind: the sensoryperceptual and the verbal conceptual, which is with labeling, elaborating, analyzing, judging, goal-setting planning, comparing, remembering and self-reecting aspects (Williams, 2010). The effects of focusing attention on the experiencing process, as opposed to what is thought about (noema or noemata in philosophical terms), is emphasized in Gendlins (1981) focusing therapy, portions of Linehans dialectical behavior therapy Linehan, (1993), and mindfulness training (e.g., Kabat-Zinn, Lipworth, & Burney, 1985), along with what is called rst-person phenomenology training (Lutz & Thompson, 2003). These practices cultivate the awareness of tacit, preverbal and prereective aspects of subjective experiencewhich otherwise would remain simply lived through so that they become subjectively accessible and describable, and thus available for intersubjective and objective (biobehavioral) characterization (Lutz & Thompson, 2003, p. 37). Farb et al. (2007) found that there are two networks of experience, rst a default network, whereby memory is includeda narrative story line. For example, if you sit at the edge of a dock, you might nd yourself thinking about what you would have for dinner that night, the previous partner with whom you sat there, and so forth. There is another way of experiencing called direct experience that refers to the information coming into your senses in real timethe sun and breeze on your skin, the cool water on your toes, and so forth. These circuits are independent. Damasio (1999) cited the character Winnie in Samuel Becketts play Happy Days to describe this sort of direct experience. First, Winnie wakes up.
Winnie opens her eyes to the audience and declares, Another heavenly day. On she goes, like a morning sunrise, in a state that will permit her brain to form images of her surroundings: her bag, her toothbrush, the rustlings of Willie, her body, which she tells us, does not have much pain that day, hardly any. Wakefulness stops at the end of Winnies day . . . . When wakefulness is removed, dream sleep aside, consciousness is removed. (p. 90)

The Experiencing Self and the Brain

A differentiation of an experiencing self from the concept of the self is consistent with what we know about the brain. MacLean (1973) described the triune brain with three relatively independent subsystems: the reptilian complex, the limbic system, and the neocortex. Although his view may be too simplistic (Reiner, 1990), the reptilian and limbic systems are more related to behavior and emotional processing, whereas the



neocortex is related to meaningful thought. A number of cognitive scientists have emphasized that this primitive self-consciousness is fundamentally linked to bodily processes of life regulation, emotion, and affect (Damasio, 1999; Freeman, 2000; Panksepp, 1998a, 1998b; Parvizi & Damasio, 2001; Watt, 1999). Neocortical processes override, inhibit, and adjust more primitive reptilian ones. Although I do not want to suggest that the experiencing self is limited to the right hemisphere, Schore (2009a, 2009b, 2011) has argued at length that the right hemisphere is more concerned with the analysis of direct information received from the body, and Ramachandran and Rogers-Ramachandran (1996) has suggested that the cognitive style of the right hemisphere shows a highly sensitive dependence to initial conditions and perturbations, a fundamental property of chaotic systems. Increasingly, psychoanalysts (cf. Davis, 2002; Ghent, 2002; Miller, 2004; Piers, 2000, 2005; Stolorow, 1997) have been considering the sort of self-organizing processes suggested by nonlinear dynamic systems theory. Pagels (1988) described self-organizing systems as systems that lower their degree of disorganization by expelling disorganization into the environment (cf. Curtis, 1991). These self-organizing processes, as Ramachandran and Rogers-Ramachandran have stated, seem especially relevant to the experiencing self. There is not the space here to expand on such processes in detail, but I shall try to explicate briey their relevance to the experiencing self. Prigogine (Prigogine & Strengers, 1984) won the Nobel Prize for his work showing that living systems are open systems with a continuous exchange of energy with the surrounds. Processes in the body, for example, are not simple and linear. A change in one process creates changes in multiple systems. Under certain conditions, nonlinear systems change in abrupt and sudden ways. A small perturbation can eventually lead to large effects, sometimes referred to as the buttery principle. Also, systems can reach a tipping point and then change drastically. Emotional states can change quickly like this (Lewis & Granic, 2000). Damasio (1998) pointed out that spontaneous smiles or sobbing are executed by brain structures located deep within the brain stem under the control of the cingulate region where we have no means of exerting voluntary control. The study of the relationship between subjective experience (phenomenal consciousness) and neuroscience (Varela, 1996)now called neurophenomenologyis based on the framework of complex dynamical systems theory (Freeman, 2001; Kelso, 1995; Thompson & Varela, 2001; Varela, Lachaux, Rodriguez, & Martinerie, 2001). According to this framework, the key variable for understanding the neural counterpart of subjective experience is not at the level of specialized circuits but the emergence and change of patterns of large-scale integration (Varela et al., 2001). A number of systems operate separately and become synchronized at a moment of consciousness, or a unied cognitive moment (p. 229). Thompson and Varela (2001), proposing that processes crucial for consciousness cut across the brain body world, attempted to map the neural substrates of consciousness at the level of emergent and transient dynamical patterns of brain activity rather than at the level of particular circuits or classes of neurons. They considered their understanding of networks of nonlinear oscillators to be a paradigmatic example of self-organization (p. 419). Mindfulness meditation has been found to show changes in the brain by 8 weeks in areas associated with attention and emotional integrationincreases in gray matter in the hippocampus, the insula (a region related to perceiving bodily sensation), and the prefrontal cortext (Hlzel et al., 2011), and although there is greater reactivity in regions associated with visceral and somatosensory processes, there is less depression in response to sad lm clips (Farb et al., 2010). As Davidson (2010) has noted: The long-term



consequences of most contemplative traditions include a transformation of trait affect. After all, if change was not enduring and did not impact everyday life, it would be of little utility (p. 10). Piers (2000) noted that the kinds of change we experience with individuals in treatment more closely approximate those of nonlinear dynamic systems than models of equilibrium-seeking dynamics (or of linear cause effect models), and Harrison and Tronick (2007) also recently described the interactions of analyst and patient in psychoanalysis as resembling the changes described by nonlinear dynamic systems theory. Two routes to the amygdala and emotional responses were differentiated by Le Doux (1996) one fast, direct from sensory systems (sensory thalamus), and the other slower, going through the sensory cortex. Fair (1992) also made a differentiation between cortical and subcortical routes and stated that memories may be resistant to reactivation via the usual cortical routes (p. 56). This differentiation helps us understand the experience of traumatic responses. The work of Squire and Zola-Morgan (1991) showed that high-level stimulation of the amygdala interfered with the functioning of the hippocampus and inhibits cognitive evaluation and semantic representation. Processing by the hippocampus is believed by most researchers to be necessary for conscious thought (Squire, 1987). In posttraumatic stress disorders, memories are stored in somatic sensations and visual images. Flashbacks and nightmares can be understood as eidetic memory disconnected from context. Van der Kolk (1994) stated that when conscious control over limbic system activity declines, as in sleep and under stress, sensorimotor, affective, and somatic memories are activated without linguistic and symbolic organization. In ashbacks (Rauch et al., 1996), activity decreases in Brocas area, which would be required to nd words related to the experiences. These sorts of traumatic symptoms, along with many phobias, are better explained by learning theory than by unconscious symbolic processes. It is reasonable to assume that these reactions that do not involve symbolic processing benet from therapeutic interventions other than free association and interpretation of unconscious processes, including the sort of reconditioning that takes place with various forms of relaxation training. In summary, a focus on direct experiences, as opposed to only the meaning of experiences, allows for many interventions beyond interpretation that approximate the sort of psychoanalytic introspection Freud likely envisaged. This experiencing self has been emphasized by those working in the experiential and mindfulness traditions, as well as those working with patients suffering from trauma and phobias. Including a focus on the experiencing self does not diminish the importance of the representations of self, others, causality, and the meanings people make of their existence. Elsewhere (Curtis, 2009) I have suggested that a metaphor for viewing the self consistent with the notion of an experiencing, agental self in addition to the various representations of the self is to think of a variation of Platos image of the charioteer and horses. The charioteer might be thought of as the experiencing self and the horses as various representations not always in syncactual, ideal, feared, and so forth To argue fully for the utility of such a model would go beyond the scope of the present article, however. Now I turn to the implications for therapeutic interaction of taking into account the experiencing self, along with the representations of self with others.

The New Experiences and New Meanings of Experience Model of Change

Psychoanalysis has developed largely as a therapy to deal with the meaning system. For example, George Klein described psychoanalysis as a psychology of meanings (1976,



p. 54). Holt (1976) described Freuds work as dealing always and almost exclusively with the pattern of meaning (p. 168). Gill (1976) thought of clinical psychoanalysis as a pure psychology (p. 85) that deals with intentionality and meaning. Making meanings was described by Fromm (1992) as the major activity of people. Therapeutic action was described by Summers (2001) as the creation of meaning. Recently, Newirth (2004) noted that there has been a change in focus in psychoanalysis from one of conict to the creation of meaning. Friedman (2007), in commenting on a series of articles on therapeutic action, described the manufacture of new meanings: one, a fostering of the patients raw meanings into more thinkable form (p. 1646) and the other as sparking a kind of play that automatically elaborates new meaning (p. 1646). From the time Freud abandoned the seduction theory, psychoanalysis moved from a theory based solidly in actual experiences to one that focused more exclusively on fantasies and meanings of experiences. Freud, in a 1920 paper (not published until 1956), asserted the view that traumatic symptoms from war stemmed from conict and repression of the desire to ee the horrors of war. The German government relied on the theories of Freud, prevalent in Germany, to claim that the posttraumatic symptoms of concentration survivors were reactions related to child abuse and refused to pay reparations (Horowitz, 1999). Eitinger (1973) resolved the issue by nding that adult traumatization had caused the reactions of 99% of Norwegian concentration camp survivors who suffered from reactions after the war. Ferenczi (1926, 1932/1985) treated patients who had experienced the reality of seduction or abuse and wrote about such patients. One of these in his clinical diaries is thought to be Clara Thompson, one of the founders of interpersonal psychoanalysis. The tradition of regarding symptoms as often a consequence of real experiences has been maintained in the interpersonalrelational traditions. Sugarman (2006), on the other hand, stated [M]utative action occurs through helping our patients attain or regain the symbolic level in regard to all mental functions (p. 965). Friedman (2002) also questioned the reasons behind including experiences other than interpretation. He stated that the purpose of our interactions should be to nd more comprehensive ways of helping the patient nd a sense of himself and his world and trying to focus the patients attention where it feels dangerous. The positions of Atwood and Stolorow (1984), Friedman (2002), and Sugarman (2006) may be the dominant position of many training psychoanalysts and analysts with very well-functioning patients, but most psychoanalysts in the United States are seeing many more patients in psychoanalytic psychotherapy than in psychoanalysis. Although some psychoanalysts may want to conne their work to the psychology of meaning, our models of the self and change need to acknowledge the experiencing self. Curtis (2009) argued that our model of change in psychoanalytic psychotherapy has already evolved into one that often focuses on new experiences and not simply new meanings of experience. The interpretationinsight model of change, although possible in some circumstances, is no longer the dominant one. Kohut (1971, 1977), perhaps more than anyone else in mainstream psychoanalysis, moved the work to more of a focus on new experiences. This tendency had long been occurring within interpersonal psychoanalysis. Interpersonalists have stated, The patient needs an experience, not an explanation, a quotation usually attributed to Frieda Fromm-Reichman (Kavanaugh, 1995). Ferenczi (1932/1985) thought that regression would lead to benign, new experiences allowing for a new development of personality. Bion (1977), Winnicott (1954/1978) and Guntrip (1969) continued in this tradition. Stark (1999) categorized the theories of therapeutic action in psychoanalysis as models of knowledge, relationship, and experience. A brief review of suggestions about what is



therapeutic in psychoanalysis shows that most of these ideas fall under the rubric of new experiences and do not require interpretation leading to insight. The relationship has been suggested by many psychoanalysts such as Fairbairn (quoted in Guntrip, 1975), Ferenczi (1926); Balint (1952), Thompson (1950), and Fonagy (1998). Although many theories suggest insight into the relationship with the analyst, in his book, What Is Effective in Psychoanalytic Therapy: The Move From Interpretation to Relation, Meissner (1991) specically refers to the relationship with the analyst (p. 183). Freud, on one occasion even commented, What turns the scale is not intellectual insight, but the relationship to the doctor (1916/1963, p. 445). The following are other change mechanisms that have been noted: new representations of self and others and reorganization of representational schemas (Greenberg, 1995; Lichtenberg, Lachmann, & Fosshage, 1992; Loewald, 1960), mourning lost objects (Fairbairn, 1952; Harris, 1996), increasing awareness of interpersonal relations (Sullivan, 1940: Thompson, 1953), identication with the analyst (Menaker, 1991; Volkan, 1982), mutual recognition (Benjamin, 1990), the integration of disconnected self-states (Bromberg, 1996), and, of course, empathy (Kohut, 1977; Lichtenberg et al., 1992). Loewalds (1960) view of therapeutic action is one where The analytic process consists . . . in certain integrative experiences between patient and analyst as the foundation for the internalized version of such experiences (p. 25). Levenson (1972) believed that, in contemporary theories, change occurs from new experience and the awareness of interpersonal entanglements. Gill (1984) wrote, [I]n prevailing theory the role of new experience in bringing about change is understated (p. 172). By 1994, he wrote, [S]ometimes a directive, a piece of advice, a suggestion about how to behave in a difcult situation may seem desirable to break an impasse or an obsessional vicious circle (p. 57). Aron (1996) stated,
[W]hile insight and interpretation (verbal symbolization) continue to be valuable for relational analyst, they do not retain the centrality they have for classical Freudian and Kleinian authors . . . . Relational analysts generally believe that what is more important is that the patients have a new experience rooted in a new relationship. (p. 214)

Aron continued further, saying that it is hoped that patient and analyst construct new ways of being with each other. This is what is critical and ultimately leads to change (p. 214). This approach includes actual experiences as a precursor to difculties and expands psychoanalysis from solely the interpretation of unconscious meanings and even the creation of new meanings to the creation of new ways of being. Wallerstein (1995) dedicated two chapters of his book to new experiences, mostly on new experiences in relationships as conceived by Stone (1954), Loewald (1960), and later theorists.

Implications for Therapeutic Interventions

A model of self that takes into account the experiential self apart from the symbolic self allows for consideration of change processes that are not symbolized. Psychoanalysts have in recent years focused more on experiences that are never necessarily made conscious (Lyons-Ruth, 1998; Tronick, 1998), the role of the body (Aron & Anderson, 1998; McDougall, 1989) and somatosensory processes (Leuzinger-Bohleber & Pfeifer, 2002). As subjective and intersubjective experiences are discussed more, the model of the self and change should acknowledge explicitly the nonsymbolic aspects of self along with the



symbolic. Whether psychoanalysts want to deal with these aspects of self in their treatments is another matter. Acknowledgement of the experiential self leads to some important but simple additions to technique for those conducting psychoanalytic psychotherapy. Psychoanalysts have recognized the value of the here and now in the analysis of transference and defense but the power of the here and now can be approached in other ways (e.g., in working with dreams; and in encouraging greater attention to sensory information, to some ignored aspects of language, and to the body). One advantage of including new experiences as an important element in the therapeutic action is that analysts can get away from the intellectualization of free associations in dream interpretations and ask patients to imagine being the various characters and objects in dreams by actually saying, for example, I am the murderer. To do so creates a new way of being and allows patients to connect disconnected self-states. It circumvents the defense of the patient saying, I dont feel this way, because the patient is instructed to imagine being someone else who feels this way. People then own disconnected potential ways of being, an experience not required when someone says, it reminds me of . . . . My experience with this technique is that it results in a much more powerful change than does patients simply talking about dreams. For example, after feeling like a murderer, one very sweet woman found a new voice in singing. Another patient was abusing cocaine, exercising compulsively, underemployed, and engaging in various dangerous actions. After mentioning the devil inside her, I asked her to be the devil. She would not do so in the session, saying it was too scary, but went home and spent a great deal of time being the devil, writing a long poem as the devil. Her behavior improved abruptly after this experience, which she saw as a change point in her treatment. Hopenwasser (1998) asked a patient to become the crack-using part of her personality. She immediately went into a trance and swiftly developed rhinorrhea, lacrimation, pilomore activity on her arms (gooseesh) and diaphoresis (Hopenwasser, 1998, p. 224). Within minutes of switching back into other parts of herself, the physical symptoms stopped. Experiential therapists (those in the person-centered and Gestalt traditions) have emphasized the value of encouraging patients to speak in the present tense. When people are connected to emotional experiences, they switch to the present tense: I was standing in the deli and then this guy in a black jacket comes in. He points a gun at me and says, Get out! Safran and Segal (1990) suggested to patients, Be there now. When people are in the present moment, they are able to feel the sensations connected with the experiences more easily. Inquiry about the sensory aspect of a situationwhat is seen, heard, felt tactilely, smelled, and tasted often leads to memories that had not been recalled with fewer cues. Stanislavski (1989/2003) and Strasberg (1991) used this technique to help actors have an affective experience on stage and communicate it to the audience. They must feel the sunshine or the rain, the mud or the grass. Bucci (1997) described several characteristics of speech that are high in connection between the sensory and symbolic systems concreteness, specicity, clarity, and imagery. Therapists oriented specically to affect (Fosha, 2000) often ask, Where in your body do you feel that? Ferenczi, calling his technique analysis from below in 1919, tried to get at the bodily and muscular expression of his patients (cited in Lowen, 1971). Sensory experiences are connected directly to physiological responses (Foa & Kozak, 1986), but language that helps access such experiences, imagination, bodily postures, and movements further improves patients recall of emotional memories and may affect emotional regulation directly. One patient described her physical abuse of having to kneel on a cheese grater with a straight back and balancing a book on her head with no emotion.



She then spontaneously asked the therapist if she wanted to see how she kneeled. When she did so, she showed emotion over the abuse for the rst time, exclaiming, I cant believe I did that, but I had no choicemy body just took me there. Focus on the experiencing self suggests more use of visual imagery. Lang (1985) demonstrated that imagining material produces a strong physiological response, whereas verbally articulating the same material produces little physiological response. Ferenczi (1985) inquired what sort of image was occurring when various sorts of movements were taking place, and Jung (1916) suggested concentrating on inner pictures. A number of therapies in Europe, Africa, and Asia have even used the directed daydream (Desoille, 1945) and guided imagery (Edwards, 2001; Leuner, 1975). More active methods than free association to access affect were also advocated by Fromm (1955):
Now concentrate on the picture of your father, and tell me what is the rst thing that comes to your mind . . . or, Visualize your father now, and tell me what is on your mind. There seems to be only a slight difference in wording. However, there is a very great difference in the effect (p. 3).

Balint (cited in Ahsen, 1977) found Ahsens results on eidetic therapy so remarkable that they are difcult to accept (p. 15) on the basis of one book. Ahsen (1973), Reyher (1963), and Horowitz (1970) all thought that images evoked less defensiveness and worked because people have not learned to censor them to the same degree. During systematic desensitization, the critical factor turned out to be the imagery used, not the hierarchy, as found by Singer (1974), an interpersonal psychoanalyst who has conducted extensive work on the effect of visual images. Horowitz (1978) described interventions involving images that can be used instead of interpretive interventions, which can often make patients feel defensive. Bosnak (2003) presented the way he encourages patients to discuss their images in dreams; for example, telling a woman who said that shaking in front of a wave would end her consciousness to go inside the shaking. All of these interventions are ways of accessing the experiencing self. In summary, I have argued that our image of the self should include the experiencing, sensing, agental self as well as the representations of the self and suggested that the implication of this view of the self offers a model of therapeutic action that includes new experiences as well as new meanings of experiences. This model suggests some additions to technique that psychoanalysts might use. This model of the self and change presents a view consistent with research in mainstream social cognitive neuroscience and allows us to connect with the broader eld of psychology.

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