Enactment and the emergence of new relational organization

J Am Psychoanal Assoc. 2013 Aug;61(4):727-49. doi: 10.1177/0003065113496636.

Abstract

Enactments are investigated from the process-oriented focus of our therapeutic approach. By embedding their occurrence within the on-going flow of nonlinear dyadic process, we focus on the subtle back-and-forth between patient and analyst, as well as the importance of what we call now moments. An alternative to the dissociative self-state model is offered that emphasizes implicit memory processes in bodily comportment and style of relating with others. We suggest that change occurs through the emergence of new relational (i.e., procedural) skills within a therapeutic relationship that is self-organizing at more inclusive levels. Treating enactment as an emergent property of the dyad means not concentrating on the level of the individual components of a system. Rather, it means regarding enactment as a property of the entire system, without which there would be no emergent property. Going forward, we suggest use of the term relational apprehension in referring to the complex process of grasping a gestalt of relational meaning as an integration of perceptions, feelings, images and imaginings, sensations, fantasies, thoughts, and intuitions. Two brief case vignettes from the literature are discussed in order to illustrate this view.

MeSH terms

  • Fantasy
  • Humans
  • Professional-Patient Relations*
  • Psychoanalytic Theory
  • Psychoanalytic Therapy*