CONFER Enactments: are these to be welcomed or avoided?

Transcription

1 CONFER Enactments: are these to be welcomed or avoided? CONFER, 24 Sept 2016 Michael Soth 2016

2 Embodied pathways towards engaging and surviving enactments Most enactments build up implicitly long before they manifest externally, and when they do manifest, much of the emotional intensity is carried by unthought and often unspoken bodymind processes. Our capacity for transforming enactments remains limited as long as we remain focused on the reflective mind, mentalisation, and the techniques of the talking therapies. Whilst implicit relational knowing is increasingly being recognised as a rich area of further development for therapists, its practical application has remained vague and undeveloped. This presentation focuses on this important growing edge of our work.

3 Enactment at the heart of the impossible profession The enactment of the client s wounding between client and therapist - in and through therapy - is the paradoxical conundrum at the heart of our work. Facing this impossibility as therapist, to participate co-creatively in the therapeutic relationship as a self-organising system, we transcend traditional dogmatisms, pervasive medical model assumptions, eclectic and integrative pick n mix attitudes and relational fashions.

4 Martha Stark: one-person & two-person psychology one-person psychology one-and-a-halfperson psychology two-person psychology Medical Model enhancement of (self-)knowledge = formulating interpretations Reparative Model (absence of good) provision of corrective experience Intersubjectiveauthentic Model (presence of bad) engagement in relationship = work at the intimate edge - engaging authentically PS: this is just a summary of Martha Stark s definitions and correlations - I do not entirely agree with all the terms and categories. Martha Stark (1999) Modes of Therapeutic Action Commentary and critique of introductory chapter of Martha Stark s 1999 Modes of Therapeutic Action

5 the three relational revolutions (re-framing the supposedly counter-therapeutic) How 1. transference, then 2. countertransference and now 3. enactment can be re-framed from a countertherapeutic obstacle into royal roads into the depth of the work, and increasingly be embraced as valid and necessary. 5

6 history of enactment as a concept relational intuitions have been with us since Freud, even within therapy as treatment enactment has been intuited from beginning of psychotherapy, but also been defended against: all our inherited therapeutic theories and traditions tend to be partially revealing of enactment and partially defensive against it (and against the non-linear paradox inherent in it); whilst recognising the likelihood of enactment and its very real dangers, there are perennial attempts to anticipate, avoid, counter-act and overcome it (e.g. traditionally psychoanalysts see it as their tasks to avoid countertransference enactments, acting-out and acting-in) it is only the relational movement over the last 20 years which has embraced and validated enactment as a two-person intersubjective mess (in varying degrees) necessary to therapy, i.e. as a theory of therapeutic action Joseph Sandler: role-responsiveness Casement: countertransference enactment transference = pressure = hot potato projective identification (draws therapist in) allowing myself to be constructed as an object Mindell: being dreamed up

7 pervasive ambivalence around enactment What do we mean by relational? avoidance of enactment/lack of full embrace of enactment our valid fear of enactment manifests as internal conflict in us, pervades us as conflicted thinking - muddled, conflicted theorising ambivalence about enactment: non-abusive enactments (Alistair) why do we mistrust our theoretical grasp of enactment? - too complex to theoretise precisely (Paul s taxonomy of enactments) - historically all theory can be used as defence against enactment quality of relationship?? being relational = being empathic - reduce relational to reparative? unless we define relational around the central notion of enactment, those kinds of reductions occur once I fully embrace it, I can afford to be theoretically precise

8 psychoanalytic ambivalence about action traditional psychoanalytic bias towards reflection over action; legacies of one-person psychology pejorative: acting out; acting-in; somatisation; mentalisation mind-over-body bias inherent in talking therapies (e.g. Safran: lack of awareness of felt sense or implicit relational knowing) unfortunately that bias plugs us into and exacerbates Cartesianism = mind-over-body dualism: fantasy that enactment can be avoided or contained by reflective thought (however: most enactments are manifestations precisely of unconscious processes NOT available for reflection; there are enactments of action and enactments of non-action = withholding spontaneity) = there is no way OUT of enactment, only a way INTO it Can we be in a rupture without one or both people being aware of it? Alistair: incomplete enactment - Freud: analysis terminable & interminable

9 variety of attitudes regarding enactment enactment = the therapist s mistake professional responsibility to avoid it at all costs enactment = unfortunate but inevitable = it s the therapist s task/responsibility to avoid it enactment = therapist s unfortunate lack of attunement (which cannot be helped amongst humans, can't be attuned all the time) enactment = unfortunate and inevitable, but something that can be learned from it enactment as the theory of therapeutic action: unfortunate, inevitable and necessary for transformation (e.g. Bromberg 2001, Soth 1996) Bromberg, P. M. (2001) Standing in the Spaces: Essays on Clinical Process, Trauma and Dissociation. Routledge

10 variety of attitudes on how to recover (typology of rupture repair) apologise because it is a professional mistake, and the therapist's fault (apology may be valid and necessary, but also communicates superficial avoidance) acknowledge failure/rupture, own up to misattunement, reattune acknowledge realistic kernel of transference projection (e.g. Merton Gill/Robert Langs) Geneva talks: step back into observer, shared perception, reflect however: we fancy and over-estimate the mind s agency - fantasy of insight/reflection/mind over unconscious/embodied dynamic; when in fact multiple enactments catch 22 - impossible profession - frying pan into fire; digging my hole deeper; surrender to becoming the wounding or the wounded object helplessness (we don t have enactment - enactment has us) vortex acting into the wounding bring the moment to its crisis unify the fragments paradoxical intervention

11 the paradox of enactment at the heart of psychotherapy The healing of the client's wounding in and via therapy is inseparable from the enactment of that wounding in and via therapy, in relation to and by the therapist.

12 going down the vortex / plug-hole

13 the paradoxical nature of the working alliance when we embrace enactment, we need to re-vision our notion of the working alliance: working alliance needs to break-down in order to exist; it deepens by being ruptured/challenged/broken/ destroyed deepening spirals of rupture and repair failure - losing the therapeutic position break-down - break-through no theory or technique is immune against enactment every theory or technique can become vehicle of enactment

14 the paradoxical nature of containment the robustness of the wounded healer when we embrace enactment, we need to re-vision our notion of the working alliance: containment is paradoxical: it requires loss of boundaries and breaking of containment in order for containment to become possible (and for it to develop and deepen) the client's unconscious scans my reaction in moments of enactment, to test for the solidity of my own transformed wounding - any shrinking from the enactment is interpreted as my own anxiety and avoidance (i.e. that I cannot stand the intensity and heat of the transference - countertransference - enactment process)

15 in practice: charged moments: the wounding enters and manifests on multiple layers of parallel process multiple layers of enactment (dominoes): client s internal (character) conflict interpersonal therapist s internal process paralleled in supervision no need for detailed content/story/narrative enactment becomes noticeable in therapist s stream-ofconsciousness = bodymind process that s a sufficient starting point for supervision

16 How the wound enters How the wound[ing] enters the consulting room and the relationship, Therapy Today, December Michael Soth

17 in practice: charged moments: 3 kinds of contact phenomenology of enactment (intersubjective mess): therapist s shifting subjective sense of working alliance we can distinguish in principle 3 kinds of contact (see hand-out)

18 Three kinds of contact in the therapeutic relationship: 1. resonance 18

19 Three kinds of contact in the therapeutic relationship: 2. ambivalence/conflict 19

20 Three kinds of contact in the therapeutic relationship: 3. enactment 20

21 in practice: the client s conflict becomes the therapist s conflict therapist s availability to be constructed (allow transference) layers of therapist s conflict feelings of confusion = failure (yes!) - rupture (yes!) - damage (yes!) therapeutic position is paradoxical: it consists of process of losing and re-gaining it = rupture & repair non-linear emergence

22 in practice: the 4 main objects in the enactment? client elusive 'transformative' object projected idealised object = 'fairy godparent' promising 'cure', eradication, conquering and/or denial of the wounding healing the wounding by embracing it = 'good-enough' projected 'bad' object re-enacting the wounding th. = parent cl. = child evacuated wounded child re-enacting the wounding th. = child cl. = parent

23 integrative-embodied-relationalintersubjective-systemic holistic intersubjective phenomenology of enactment: The enactment of the wounding dynamic manifests as parallel process across multiple bodymind dimensions throughout the intersubjective system of the therapeutic relationship.

24 The wounding enters the therapeutic space (here-and-now) Three parallel relationships: past dynamic (primary scenario) internalised dynamic (object relations) external dynamic here & now (current relationships incl. transference)

25 three parallel relationships 25

26 extended model of parallel process Supervision Matrix Therapy Matrix Internal Relations BodyMindMatrix Primary Scenario Supervisor Therapist Client (outer) Client (inner) embodied character developmentally wounding r`ships supervisor - therapist dynamic parallels therapist's countertransference parallels client's interpersonal (transference) parallels client's internal dynamic parallels client's body-mind dynamic parallels client's formative family dynamic

27 the transformative containment of enactment The key parallel process principle of transformation: The more levels of parallel process can be held in awareness in the relationship in the 'here and now', the more like that transformation of the enactment will occur.

28 gather the bodymind-relational (parallel process) fragments of enactment both client and therapist only have partial/ fragmented awareness of the enactment what is the full un-fragmented experience of the enactment? what is the full bodymind matrix both spontaneous and reflective processes i.e. feelings as important as dissociation multiple enactments

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