‘We are all relational, but are some more relational than others?’ - completing the paradigm shift towards relationality

by Michael Soth

A Discussant Paper in response to: Ray Little: ‘The New Emerges out of the Old’

Building on Ray Little’s integration of humanistic TA with both traditional and relational psychoanalysis, this paper explores both shared ideas and assumptions as well as reflecting critically from the vantage point of a wider broad-spectrum integrative perspective, with an emphasis on TA’s sister tradition of Body Psychotherapy. The problems, inconsistencies and contradictions within the integrative project are discussed, with particular reference to our humanistic origins during the 1960’s and their – partially reactive - differentiation against psychoanalysis, which leaves us with unresolved legacies in the form of fixed assumptions regarding both theory and practice, and key concepts like ‘ego’ and ‘working alliance’. Taking the key notion of the therapist’s “equidistant position” between the “needed” and the “repeated” relationship as its starting point, this paper works towards ‘enactment’ as the central notion of relationality. In the process, a multiplicity of diverse therapeutic kinds of relatedness is affirmed as valid, and different notions of the ‘relational’ and inconsistencies and ambivalences in our integrative formulations are addressed. The aim is a more solid and robust integration which is grounded in a bodymind understanding of enactment as the paradoxical essence of therapeutic action.

Introduction It would also need to imply a significantly wider range of approaches from across the therapeutic Ray Little has been doing an urgent, significant and spectrum coming to the ‘integrated’ party. sterling job, bringing together TA and Considering that psychotherapy integration has psychoanalysis (especially its relational branch). now more than 20 years of history in this country His grasp of the two traditions, their historical as a distinct branch of the field, we can draw on its roots, their respective meta-psychologies and their findings in terms of different avenues towards – in some respects: contradictory - paradigms integration. Any model that calls itself ‘integrated’ allows him to fashion an attempt at integration that would need to build on a comprehensive combines the best of both worlds and that is larger foundation that includes not only all the than the sum of its parts. This work constitutes a approaches, but also all relational modalities quantum leap and is taking TA a long way from its (building on Clarkson 1994). origins in the 1960s towards the 21st century.

Integrated or integrative? As a discussant, I would like to take the opportunity to brainstorm and outline some of I think calling it an 'integrated' - rather than these challenges - which Little alludes to - for the 'integrative' - relational model is claiming too further development of relational TA towards a much. This is still a work in progress, reaching formulation that might eventually be called towards integration, rather than having arrived, as ‘integrated’. My understanding of Little’s Little himself indicates: integrative endeavours is supported by an “This article represents a stepping stone awareness that very similar developments have towards a further integration of a relational occurred in TA’s humanistic ‘sister traditions’, e.g. approach with TA and there remains a Body Psychotherapy and Gestalt. But my challenge for further development.” perspective is also informed by other approaches Apart from some distinct areas of dis-integration (e.g. existentialist or post-Jungian) which are more (or lack of integration) which I will try to discuss as outside our shared humanistic heritage and would issues for further exploration and discourse, to me be more critical of some of our taken-for-granted 'integrated' would require more than bridging the assumptions. humanistic-psychodynamic divide (which is indeed a crucial step in the integrative project).

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The legacies we inherit from the 1960’s We could think of Eric and Wilhelm as our fathers, Having been involved in similar struggles within whose unresolved struggles against grandfather the tradition of Body Psychotherapy – and yes: Sigmund leave us caught in a stance of protesting struggles they are - I recognise the growing pains and polarising against Freud, who is nevertheless and maturational challenges that need to be active as an introjected internal object in the psyche confronted by many of the humanistic approaches of the TA, Gestalt and Body Psychotherapy in 'coming of age' (see my 2005 paper in Therapy communities, and the humanistic movement in Today, or my chapter in Hartley 2008). general. We tend to underestimate the historical legacies we Their unresolved conflicts manifest as gaps, inherit as communities of practitioners - in terms of contradictions and lacunae in our theory, language, practice, theory and subcultural norms and meta-psychology as well as in our practice. Moving principles (not to say: ‘credos’) - from the towards an integrated position significantly originators of our approach and their times (Berne involves addressing those reactions, wounds and in the case of TA, Reich in Body Psychotherapy or conflicts, getting beyond defensive, dogmatic and Perls in Gestalt, etc). They each struggled and polarising stances, and establishing a third position defined themselves as distinct from their that both transcends and includes both polarities. psychoanalytic teachers, therapists, mentors and This is work which I have attempted to do within elders, and in the process established precious new the Body Psychotherapy tradition, by reflecting on insights and ways of working, which we are the developmental steps we went through over the benefiting from. Because these were not just last 30 years (Soth 2005, 2008), and which I see theoretical or philosophical divergences, but very being carried within TA by Cornell, Erskine (2007, deeply-felt and personal struggles, loaded with 2009) and clearly being spear-headed also by Little intergenerational transference and in this paper. countertransference entanglements, our humanistic traditions also inherit an atmosphere of reactive A growing consensus: the developmental protest, of anti-authoritarian rebellion which origins of relational patterns characterises our origins. Berne, Reich, Perls and The sections of Little’s paper on psychological others reacted against out-dated principles and development, psychopathology and wanted to liberate humanistic creativity and characterological structures represent, as far as I human potential, but in the process often jumped can see, a growing consensus across various from one extreme into the other. Their frequently developmental approaches, supported by dogmatic anti-positions are as absolutising and neuroscience and infant research. Although the categorical as the psychoanalytic orthodoxy they traditions use different terms and language, there were trying to overcome and get beyond. is a large overlap in theoretical understanding as to To this day, the humanistic field suffers from this how “intolerable experiences” in early reactive bias, and whilst in many ways some development are internalised and become the serious ‘growing up’ has taken place over the last internal blueprint through which later 30 years, we will not become fully mature unless relationships are perceived, interpreted and we become aware of and work through these shaped. wounds of our origins. “how the mind develops from various relational experiences and is constructed of We can draw instructive parallels here between our numerous relational schemata.” model of individual development, and the life story of our therapeutic traditions. As in the Implicitly integrating one of the core concepts of psychology of the individual, our early the Body Psychotherapy tradition, i.e. development has left both unhealed injuries and "characterological structures and defences" (as scars which are denied, dissociated and initially described by Reich and developed into an compensated for. These wounds at the root of our integrative theory by Stephen Johnson), Little traditions have generated defensive reaction brings together a range of humanistic and formations and compensations, manifesting as psychoanalytic ideas concerning the theoretical dogmatisms and fixed assumptions, developmental and etiological origins of what we lending each community of practitioners its are dealing with in therapy. His formulations are particular ‘character’ (and I mean character in the rooted in TA concepts, but draw in and Reichian sense, as a script-based protective circumscribe a depth-psychological consensus mechanism, rationalised and with fixed across a number of otherwise divergent traditions perceptions, beliefs and behaviours). as to how a person's 'primary scenario' (the In a nutshell, as therapists we inherit the wounds emotionally significant forces in the child's early of our family ancestors, the wounds of our cultural environment) continues to shape their identity and and sub-cultural forefathers and –mothers and also being-in-the world. the wounds of our therapeutic ancestors.

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 2 Object relations theory forms an important bridge perceptive capacity, which unites the disparate here between diverse traditions, that helps us factions of the relational movement. integrate TA, Reichian character structures, aspects I have suggested elsewhere (Soth in Totton 2005) of integrative Gestalt and various branches of that we might conceptualise this key psychoanalysis (British independent tradition, understanding in terms of parallel process, which Kernberg as well as relational psychoanalysis), as it can then tie together (see Fig. 1): informs our perception and conceptualisation of 1. the originally wounding relationship between the processes of introjection and internalisation parents and child which … which are essential ingredients in any relational 2. gets internalised as an object relationship in the model of developmental injury. All these clients inner world of character, with the … approaches recognise that what gets introjected by 3. re-externalisation of that internal(ised) dynamic the child are not just certain ‘traits’ or particular in adult relationships, including the transference. feelings, but a whole relational dynamic with all its This in turn engenders parallel processes in the significant relational poles, figures and attendant therapist’s countertransference (in the way that web of implicit and explicit messages. This focus Little describes transference and on systemic-relational dynamics (rather than countertransference as “two interlocking supposedly individual minds – see components”), which then become replicated in Atwood/Stolorow’s (1994) critique of the classical supervision as the kind of parallel process which is psychoanalytic position) is a key feature, and a a well-established concept (Hawkins/Shohet 2012).

Fig. 1: The Three Parallel Relationships: Past - Internal - Present

This graphic summarises some shared underlying assumptions of psychoanalytic traditions (especially object relations, eg Otto Kernberg), developmental and attachment theory, neo-Reichian Body Psychotherapy, Transactional Analysis and Character Styles (Stephen Johnson): - how the originally wounding relationship becomes internalised and re-externalised in the here & now of the transference - describing the client’s internal conflict as a relationship pattern - describing transference and countertransference as parallel process

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 3 This formulation covers the same ground and So we can say in summary that at least the describes the same phenomena as Little, and shows developmental origins of our clients’ suffering just how much overlap there is in our (and, of course, our own) - which is directly understanding: the same relational dynamic is relevant to how we perceive, understand and recognised as running throughout the whole engage the client's presenting problem - is an area sequence of relational dominoes (past wounding that many of us from different traditions can agree relationship –> internalisation -> internal on. relationships -> transference -> countertransference –> supervision) and shapes and constructs the Shared relational assumptions across themes and vicissitudes of these interconnected humanistic and psychoanalytic traditions systems of relationships. It is satisfying to recognise that our shared understanding – although largely developed in A couple of specific points may serve to illustrate parallel rather than through mutual influence and how far this consensus goes: direct cross-fertilisation - goes beyond this. “Although we internalise both the tolerable and Especially between those factions of the various intolerable experiences, it is the intolerable and approaches which call themselves ‘relational’ there unsatisfactory experiences that have been is a growing cross-modality consensus about the introjected and fixated in Child-Parent ego state philosophical underpinnings and the relational units (Little, 2006). Such structuring intersubjective complications of the therapeutic internalisations are un-integrated and result in a endeavour. closed script system, located in unconscious, The shift into a two-person meta-psychology, implicit memory, forming the foundation for although ambiguous and pervaded by confusions characterological structure and defences.” and misunderstandings, has brought humanistic Like Little, I usually insist to reserve the term and psychoanalytic traditions into closer contact ‘internalisation’ only for those wounding and dialogue, leading to all kinds of creative experiences which were intolerable (and which integrative initiatives and hybrid approaches. Still, therefore lead to what in Body Psychotherapy we what we actually mean by ‘relational’ and how the call ‘character formation’). I agree with Little that various traditions seem to appropriate the term, supposed internalisations of good objects become often without questioning their own inherited part of the child’s “functioning from an open assumptions and how these are challenged by system” and are not experienced as alien and quite different versions of the ‘relational’ in other dissociated in the same way that ‘bad objects’ are. modalities, means that the potential paradigm shift is far from complete. In this maelstrom of “What Moiso does not describe is the integrative confusion regarding the ‘relational’ possibility that C1 or C2 may be projected onto (‘tower of Babylon’ comes to mind), Little is the therapist. This occurs when the client is managing to put down some important markers. attempting to find identification with the Whilst I have some misgivings regarding the therapist.” language and terminology (which I will say more Like Little, along with most modern about later), the substance of these ideas is precious psychoanalysis, I consider the projection of C1 and to me. I am thinking here of the distinctions which C2 onto the therapist, and the therapist’s projective Little makes between the repeated, the needed and identification with these projections, a crucial the therapeutically required relationship, and feature of the countertransference (and one that especially the notion that therapeutic action relies many humanistic therapists overlook in working on the therapist’s capacity for what he calls – with the transference, with disturbing and following Davies and Frawley (1994) – “optimal destructive effects on the working alliance, neutrality”. something I come across frequently in “… Davies and Frawley (1994) includes “the supervision). Although I find Little’s clarification capacity to strike an optimal balance between “This occurs when the client is attempting to find reworking the old and co-creating the new.” identification with the therapist.” dubious and I prefer the other formulation of what I consider misleading (as it fails to differentiate which part of this paper’s key idea for therapeutic action which the client is making that attempt, and significantly describes the therapist’s position as “equidistant”: omits the equally strong impulse to evacuate “involves not being invested in one relationship unwanted and unbearable experience), this over the other. Instead, the therapist must be misgiving regarding the supposed aim and origin willing to remain equidistant from both.” of the projective process is minor. What matters in It is my perception that it is on this point that - over practice is that as therapists we can enquire into the last 30 years - humanistic attempts at our countertransference experience with this integrating psychoanalysis and work with the possibility in mind. transference have largely fallen down. Under the guise of being the client’s ally or being ‘alongside’ the client (see Gomez 2004) (which usually rests on

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 4 a semi-conscious identification with the client’s The ‘characterological’ wounds of TA wound), humanistic practitioners on the whole This is where the differences between our have had no trouble perceiving and identifying the traditions allow us a helpful outside perspective on transference process in the room, but have the ‘character’ and habitual stance of other implicitly championed the reparative modality, traditions, including their shadow aspects, taken- being unable to sustain the heat of the transference for-granted assumptions and wounds, and where arising from sticking with what Gomez calls the we might imagine a kind of mutual, dialogical ‘opposite’ position. In thus dodging the therapy between the approaches. In simple terms, uncomfortable experience of being perceived, we might imagine Berne and Reich being in related to and sometimes accused as the ‘bad’ or therapy with each other (and with Freud, etc), and ‘wounding’ object, the full experience of enactment what kind of profound encounters, unmanageable has been sidestepped, and the transformative impasses, creative confrontations, enlightening and potential of the constellated paradigm-shifting transformations they might be transference/countertransference process aborted. able to facilitate in and with each other. I agree with Little that in this case - by losing the So what kind of countertransferential perceptions equidistant position (or never taking it in the first might Reich, or a modern Body Psychotherapist, place, often because they themselves never had it have of TA and its ‘character’ as a community of modelled as a reference point) - therapists practitioners? inadvertently deprive the therapeutic space of the key ingredient that – according to Little – makes The language and style of mid-20th century therapy ‘work’. The client misses out on the depths America of therapeutic action, which - in the good case - leads to superficial, unsatisfying and unsustainable In the first instance, and on the most superficial therapeutic shortcuts, or - in the bad case - to a level, I find myself reacting against some of the disappointing breakdown or bland petering out of language: I stumble across certain terms and their the therapy. connotations. In most cases, these are probably As this sounds very categorical, we may want to linguistic relics which, on closer inspection, are soften this statement by specifying what we mean probably not understood the way they sound to by therapy ‘works’: the notion of therapy implicit me, as a cognitive and discursive style reminiscent in this statement is work in the realm of the of the 1950's and 1960's, i.e. when our humanistic characterological foundations of human suffering - forefathers, including Berne, were beginning to there are other realms in which other kinds of formulate their critique of psychoanalysis. therapy may be seen to work, through different For example, although I understand and agree with modes of therapeutic action. what the term is pointing to, I find it hard to use words like 'adaptive' without flinching. Whether But with this specification in mind, I can used in an evolutionary or social sense, it is used to wholeheartedly agree that in formulating the supposedly indicate psychological health. But what notion of the equidistant position, Little names a are we meant to be adapting to? Hasn't there been key feature of relational work: the transformative a comprehensive postmodern (feminist, existential, capacity of the therapeutic container or frame as an sociological) critique of the normative and ‘alchemical vessel’ depends on the therapist’s conformity-enforcing dangers of psychotherapy, capacity to ‘allow themselves to be constructed as i.e. as - in simple terms - oriented towards an object by the client’s unconscious’, and that adjusting healthy protest and supposedly needs to include all kinds of ‘objects’, including dysfunctional abnormalities to the moral majority ‘bad, ‘idealised’ and ‘transformative’ ones. of a sick society, by labelling them as ‘mal- The therapist’s capacity to do this is limited and adaptive’? hampered by what I am used to calling their ‘habitual position’ (Soth 2007a) which determines Even a term like ‘optimal neutrality’, in itself a and circumscribes the kind of relational and supposed improvement on ‘technical neutrality’, is therapeutic space which the therapist is capable of loaded with connotations of implicit medical offering. As the therapist’s implicit relational model thinking. This kind of language flies in the stance it is informed by an amalgamation, as I face of the sensibilities of a diverse range of other indicated earlier, of their inherited wounds psychological modalities and perspectives (e.g. through family and cultural ancestors, but existentialists, Gestalt, and elders like Laing and importantly also their therapeutic ancestors, Hillman). And the irony is, of course, that it even manifesting across all levels of their being, from the grates on some essential relational sensibilities, somatic and physiological through the emotional with its opposition to classical psychoanalytic and mental to the social as well as the theoretical neutrality, modernist 19th-century ‘medical model’ and meta-psychological implications of their assumptions and an emphasis on non-neutral chosen therapeutic tradition. subjectivity and intersubjectivity.

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 5 As I will address in more detail later, we could “One of the inherent contradictions of the argue that the essence of enactment is precisely humanistic revolution is its emphasis on groups that every semblance of therapeutic neutrality, and the collective, whilst also championing intentionality, ‘optimal anything’ gets lost, individual freedom over and against social subsumed and overwhelmed by apparently constraints. As necessary and liberating as both of counter-therapeutic unconscious processes, and those elements were, arguably the underlying that that loss is not only inevitable, but positively tensions were not fully resolved, and therefore necessary to therapeutic action. Little refers to this humanistic […] practice remains influenced by that quite clearly, in quoting Mann (2009): unresolved dichotomy, as well as pervaded by a “Neither is conscious of what is really going on reactive bias against authority and any kind of at the time. They are both caught in archaic hierarchy (see Bly, 1996). This – I suggest – is primitive unconscious processes that cannot be reflected in unworked-through attitudes towards known beforehand, they can only be known three key issues […]: (1) the conflict between after the event has occurred.” individual versus collective perspectives; (2) the So if any traditional semblance of therapeutic tension between power differential versus equality; position has to get lost in enactment, why re- and (3) the dialectic between structure versus institute a language that is steeped in traditions unstructured space. and meta-psychologies which were incapable of Any [integrative] formulation […] would therefore embracing, and - as we can see with hindsight: need to resolve, or at least address, these inherent actively defensive against - enactment? dichotomies to the point where both the productive Wouldn’t it be important and conducive to find a and the defensive aspects of each of the polarities language and terms that are experience-near and can be appreciated.” supportive of ‘intersubjective mess’ as the quintessential ingredient in depth therapy? The therapist as ‘doctor’ – disavowed and hidden Don’t get me wrong: although the language does ‘medical model’ assumptions superficially put me off, it does not by any means The birth of the humanistic movement was stop me from seeing through to the experiential focussed in the US and is, therefore, pervaded by substance, the intended meaning and the validity its zeitgeist and cultural environment at the time. of the ideas it is pointing to. But then, these Alongside an over-emphasis on individualist linguistic niggles draw my attention to deeper agency, autonomy, control and power-over and misgivings which arise in relation to some of the corresponding notions of the mind and psyche fundamental concepts and models, and especially (cognitive, rational, focussed, abstract), the cultural the meta-psychological paradigms which underpin bias also included a traditional tendency of both them. psychoanalysis and psychotherapy in the US to be less precious than its counterpart in the Old The ‘American Dream’ at the root of the Continent about the ‘medical model’. humanistic movement In a nutshell (these are, of course, huge over- Therapists in the US have been quite pragmatic generalisations of a much more complex and about therapy as ‘treatment’ (see the US version of varied picture, which I hope you will forgive me the Israeli TV series renamed “In Treatment”) and for the sake of clearly establishing some used to have less qualms than we Europeans did tendencies): although the humanistic movement about referring patients elsewhere without much had a strong emphasis on anti-establishment social concern about the attachment. This is precisely one and collective values, especially in the US it did not of the issues which the relational movement is entirely escape the American dream of the ‘self- having an impact on, but as a lingering historical made man’, with its inherent bias towards influence it can still be traced. individualist agency and fulfilment. Resting upon the foundations of underlying imperialism and There is no space here to discuss how I perceive conformism, and wider pre-feminist patriarchal humanistic practice as pervaded by hidden and assumptions still dominant in the mid-20th century disavowed ‘medical model’ assumptions which are (rationalism, mind-over-body dualism, profoundly at odds with our explicit humanistic technocratic pragmatism, progress through philosophy, values and principles. I have ‘growthism’) it took only two decades or so to lead addressed this issue repeatedly (Soth 2008a, 2008b), to the excesses of consumerist narcissism and have come to a paradoxical position which (‘Boomeritis’, see Wilber 2003), partly fuelled by neither excludes nor entirely subscribes to the the self-centred shadow aspects of humanistic ‘self- ‘medical model’ in therapy, but does validate it as actualization’. one of the relational modalities (in addition to I have summarised the shadow aspects of the early Clarkson’s (1994) five modalities of the therapeutic humanistic movement elsewhere (Soth 2007b): relationship).

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 6 The therapist as ‘educator? Over-emphasising the ego’s capacities and If we question the notion of the therapist as doctor, degree of agency? a similar discussion is necessary regarding therapy The bias towards independence and autonomy can as education, something which traditionally TA is be seen as only a special instance of a deeper quite keen on and which the zeitgeist of the early problem: our conception of the ego, its role and humanistic movement would have power within the psyche, its capacities and unquestioningly supported. But both functions and its relation to non-ego processes psychoanalytic and relational sensibilities alert us (unconscious, somatic, involuntary, spontaneous). to the profound dilemmas and double messages which the therapist as educator not only invites, As there is an ingrained habit in our culture (and but may actively and unwittingly set up. throughout the therapeutic field) of In the same way that Berne saw scripts as oversimplifying the mind-body relationship, by palimpsests - later layers upon earlier writing – in equating consciousness and voluntary agency with what follows I will try to trace some of these earlier the mind on the one hand and spontaneity and issues shining through Ray Little’s paper. involuntary feelings and behaviours with the body on the other, it is important to note that TA’s humanistic belief in autonomy spontaneous processes occur all over the In the 1960’s, the taken-for-granted aim of healthy bodymind spectrum, and not just in the somatic psychological development was autonomy (rather sphere. There are any number of involuntary than interdependence, as some of us relationalists mental spontaneous processes, like images, dreams might venture today), and approaches as diverse as and obsessive thoughts. ego psychology and TA over-emphasised that key characteristic of the American dream. Maybe I am Internal objects – and the relational units they mis-reading this, but some flavour that constitute – are whole bodymind processes, i.e. independence is considered the healthy norm, and flesh-and-blood realities, not merely mental everything else is inferior, if not pathological, representations or cognitive scripts. Internal objects comes across, for example, here: manifest across the whole bodymind spectrum, as “Psychopathology can be seen therefore as neuro-bio-psycho-social ‘holons’ (Wilber 2000) manifesting in the persistence of early modes of with gestures, feelings and corresponding thoughts relating, consisting of defensive relational schemas. and identities. This entails clinging to early self-other schemata What we have traditionally subsumed under the which may result in a conflict between a desire to notion of ‘ego’ is not a separate entity in a merge on the one hand and strivings for autonomy supposed meta-position to the supposed inner and separateness on the other.” world or ‘Id’, but a cognitive fantasy which This is conflating two separate issues: the a) the combines disparate conflicted fragments across the static inertia and imperviousness to change of characterological bodymind matrix. TA’s notion of relational schemas with b) developmental conflicts the integrated ‘Adult’ ego-state suffers from between merging and differentiation. Freud’s underlying reification of the ‘Ego’ in his Some developmentalists would prefer to see that structural theory, which obscures the view of ego as conflict between merger versus separateness as process (and significantly as a conflicted process of relevant across the lifespan at all developmental split, dissociated and opposing ‘sub-egos’). The stages and all levels of maturity. That conception equivalent is true for the Child ego-state, which then obviates the pejorative connotation of confusingly gets conflated with the body and ‘clinging’. spontaneity, as Cornell (2008) has pointed out. But more importantly we could ask: who - in this formulation - is doing the clinging (i.e. which ego Neuroscience has increasingly de-constructed the state, internal object or relational unit)? supposedly dominant position that the 20th The educated guess is that the formulation implies century still has attributed to cognitive processes, a ‘childish’ fixation, but in that case ‘clinging’ is the the mind, the ego. When we consequently follow self-schema, and does not inhere in any agency through neuroscientific ideas regarding implicit separate from the self-schema that might be able to relational knowing, right-brain-to-right-brain operate upon it. But the consequent application of attunement, non-verbal communication and the theory of relational units would not allow us to implicit memory, then some cherished locate the ‘clinging’ in the Child only, but as assumptions of traditional psychotherapy need to interactively co-created within the child-mother be questioned, and may not be saved into the 21st dyad. We might, therefore, include the ‘clinging’ as century. I am thinking here about traditional also belonging to the other pole of the relational notions and understandings, for example, of the unit, which may, for example, appear to manifest ‘working alliance’, ‘containment’, ‘working- in the Child only via the mother evacuating it into through’, which all were formulated originally and the Child. still retain their traditional bias towards the ‘ego’.

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 7 Traditionally, the working alliance was considered When we amalgamate ‘ego-states’ with Kernberg’s to be occurring between the two healthy parts of object relational units (as Little does), it becomes the two egos (or Adult ego-states) via an explicit more apparent that we have a term that includes contract, and suffused with implicit ‘medical both ego, pre-ego and non-ego aspects; more model’ attitudes regarding the therapist’s ego and importantly, in the light of the neuroscience that its stance and influence in therapeutic strategy, Little does draw on, we might even stretch beyond interventions and interpretations. These notions Kernberg’s notions to grasp relational units as inform our assumptions about the role of both the bodymind processes, that cut across and manifest client’s and the therapist’s reflective mind in across neurological, physiological, somatic, recovering from enactments (by naming, emotional and mental functions, all of which have negotiating and making meaning out of the conscious and unconscious aspects to them, and all unconscious entanglement). Whilst this recovery of which have ego, pre-ego and non-ego aspects. from enactments is understood as much more than a cognitive process, in practice there remains a It is one of the strengths of character theory as conceptual vacuum as to what therapeutic developed by Reich, that from the beginning it was responses might actually go beyond client and what we would call today a holistic-systemic (or therapist exchanging their respective narratives of maybe ‘integral’) approach to the bodymind, in the enactment by ‘talking about it’. which the ego and ego capacities were understood I’m also thinking about explanations and other as (merely) functions or consequences of the educational methods which are quite widely used underlying character, which allows or limits and and favoured throughout TA as a fairly habitual pre-structures all ego-activity. Inevitably, the more stance, apparently without much recognition as to we make ego our central explanatory focus, the why psychoanalysis usually takes a very dim view more we tend to get caught in a bias towards the of such interventions. mind and verbal-cognitive-reflective functioning. I But I have saved to the last the most controversial perceive an equivalent development in the question which arises out of these challenges to the psychoanalytic field: the more Fairbairn shifted his notion of ego and its postmodern de-throning and focus towards the split ego (libidinal versus anti- de-construction: libidinal), the more he actually lost connection with libido, instinct and the body. Time to question the concept of ‘ego-states’? “In more severe cases the ego state units will Integrating the recent insights of neuroscience, we constitute a part of the characterological find that the role and the significance of anything structure, as in borderline, narcissistic and we might call ‘ego’ shrinks, as the importance of schizoid personalities, where the individual is the body and non-ego processes is increasingly dominated by primitive ego state relational recognised, in the individual, in relationship and in units.” therapy. Why continue to use the term ‘ego’ for an experience which both subjectively and objectively It needs to be said that many writers throughout is far from a sense of ‘I’ or self? Why stretch the TA (Cornell, Erskine and others) have tried to term beyond all recognition, beyond its original extend the meaning of key TA concepts, trying to meaning, almost into its opposite meaning? Why make them more holistic, less cognitive-biased, not use new, more fitting terms, and leave the old more inclusive of early development and of pre- terms to accurately refer to their respective realm and non-verbal experience. I am not trying to of experience, which we have now grown beyond minimise their efforts, but I am posing the and therefore understand as partial? question: is it useful to continue stretching a Most ‘ego-states’ are not conscious, the person is framework – both conceptual and linguistic – that not (consciously) identified with the state or aware in many ways belongs to a different historical of it, nor has any sense of agency in relation to the period? Its fundamental assumptions and its state (it’s more like a being possessed). Significant terminology may now so be at odds with current aspects of ‘ego-states’ operate from and within relational theory and practice that it is increasingly implicit memory, and are communicated and becoming counterproductive. perceived subliminally, i.e. in any conventional understanding or definition, ego does not come I have picked out three examples – autonomy, ego into it. Thus it could be argued that the idea of and ego-states, but more would be possible to ‘ego-state’ poses a conceptual glass ceiling on make the general point that a new grasping the non-ego embodied nature of the state conceptualisation and language may become we are trying to describe – the more we follow the necessary. actual phenomenology of the ‘state’, within and beyond the internalised parent we find the grandparents and family ancestors, i.e. aspects of experience far beyond the ego.

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 8 The dangers of attempts at integration Thus, it is not uncommon for therapists who, for In the section above I have summarised what I example, appear to be working almost exclusively perceive to be some of the wounds, shadow aspects within a reparative mode to be claiming they are and relics from the origins of TA in the 1960s, ‘relational’ on the basis that their form of relating, which are liable to hamper the kind of integrative i.e. providing the ‘needed’ relationship in Little’s project Little is formulating. To some extent, these terms, is highly sensitive, attuned and therapeutic. issues come across to me as inherent This kind of claim, seen in the light of Clarkson’s inconsistencies between TA as it has been handed seminal insights from the early 1990’s, is of course down to us on the one hand and the principles of entirely valid. The only problem is that it is very traditional psychoanalysis plus the new partial and one-dimensional, and so inherently too perspectives emerging from neuroscience and dogmatic. relationality on the other. As a first step beyond such partial definitions of the ‘relational’, we therefore need to re-affirm I perceive inherent paradigm clashes and Clarkson’s insight: diverse - and therefore partly contradictions, which - if not explicitly contradictory – modalities of therapeutic relating acknowledged, addressed and resolved - typically co-exist within the field, and each and all have their lead therapists into oscillating between necessary place and situational validity. Rather contradictory principles, thus unwittingly giving than attempting to integrate different therapeutic double messages to their clients. As a consequence, theories and techniques, the focus shifts radically the client’s overall experience of integrative towards an integration of different kinds of therapy may become less rather than more therapeutic relatedness which need to be containing, as the therapist may be perceived as understood and used - on their own terms - as both fickle and vascillating rather than flexible, evoking antagonistic and complementary to others. parallels with insecure parenting. This is precisely But beyond this appreciation of the different the problem which Gomez (2004) warned about: relational modalities - in their overlaps with each that an attempt at integration might create other and the tensions between them – the relational disturbances and disadvantages which significance of Little’s contribution is that he limit the unquestionable benefits of the larger, establishes a second step which helps us define the more integrative frame. essence of the ‘relational’ in a way that I recognise and resonate with: by stipulating the optimal What is ‘relational’? therapeutic position as equidistant between the ‘needed’ and the ‘repeated relationship’, he affirms So the question is: is there a way in which a that the enactment of the ‘wounding relationship’ relational perspective can bring these contradictory in therapy is not only unavoidable, but necessary principles together, and do justice to the precious to therapeutic action. I take this to be a crucial gifts of each approach without minimising the insight which constitutes a paradigm shift in terms contradictions between them? of our understanding of relationality.

As I try to show later in my concluding remarks, I The three relational revolutions believe there is, but it depends upon whether we can transcend the current confusion between the I find it helpful to think about the last 100 years of multiple competing meanings which different psychoanalysis/psychotherapy in terms of three approaches claim for the term ‘relational’. In my relational revolutions (see Fig. 2): view Little is crystallizing the key features of the 1905: Freud reframes transference from an obstacle ‘relational’ as a qualitatively new set of ideas, to the treatment into the 'royal road' into the awareness, skills and attitudes, whereas many unconscious people seem to be appropriating the buzzword 1950's: the countertransference revolution ‘relational’ for what they have always been doing (Heimann, Racker, Searles) reframes within their established way of working, thus countertransference from the therapist’s reducing Clarkson’s (1994) multiple relational pathology into another 'royal road' modalities to their own taken-for-granted singular 1995 onwards: enactment revolution version.

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 9 Fig. 2: The Three Relational Revolutions

How the concepts of transference, countertransference and enactment have developed

Enactment as the central notion of So the paradox at the heart of therapeutic action, in relationality my view, hinges around the notion of enactment (Soth, 2008): “the therapeutic healing of the I have suggested elsewhere (Soth 2008) that the ‘wounding’ is inseparable from the enactment of notion of enactment offers an avenue into a the ‘wounding’ in and via therapy.” Therapy paradigm shift towards a paradoxical therapeutic works – i.e. transformation in therapy occurs – via position which can indeed embrace contradictory enactment and its containment. theories and models, precisely because it is no A similar recognition is implicit in Little’s longer theory-led, but relationally aware of the formulation of the therapist equidistant position defensive and counter-therapeutic dangers of between the needed and the repeated relationship, theory. From this position we understand that all to create the space for the ‘required’ relationship. therapeutic theories and techniques - however appropriately and sensitively the therapist may use The paradigm shift towards enactment them and however well-intentioned the therapist Whilst the likelihood – and historically later: the may be in using them - can become vehicles of inevitability - of ‘countertransference enactments’ enactment. (or what used to be called ‘acting-in’ on the part of Rather than imagining therapeutic action to inhere the therapist) has been recognised within in the supposed ‘correct’ use of theory or psychoanalysis for some decades, this was always technique, relationality attends to how the considered a danger to be avoided, precisely therapeutic space and the client-therapist because it was correctly intuited as counter- interaction within it replicate the client’s therapeutic. However, that enactment is necessary wounding. Both the therapist’s being and doing, for therapeutic action, i.e. essential to the way their therapeutic understanding and interventions, therapy does its work, and that therapeutic may be received by the client’s unconscious as an transformation paradoxically relies on the enactment (i.e. the “repeated” relationship). apparently counter-therapeutic nature of enactment, is a significant quantum leap beyond these long-standing psychoanalytic recognitions.

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 10 In my view, therefore, the success of the advocate profoundly diverse and contradictory integrative-relational project – whether in TA as positions on this question, and they are far from proposed by Little, or in other approaches - agreed on this delicate matter. depends decisively on our capacity to take the Ambivalence about the central notion of enactment notion of enactment far enough, towards that What we find throughout the relational movement paradoxical position which then becomes the are diverse and contradictory notions of enactment, relational knife edge that constitutes the secure surrounded by a variety of underlying base of the impossible profession. ambivalences when it comes to surrendering to The relational movement, as it has haphazardly enactment, embracing the inherent paradox as well coalesced over the last 20 years, does not approach as how to recover from enactment. We can refine this central paradox in any agreed or coherent this fundamental bone of contention in the fashion. In order to clarify this ambiguous territory, relational movement into more specific questions: we can ask the question: • To what degree can the therapist sustain loss of Is the notion of 'enactment' an extension of a their therapeutic position within the enactment transference-countertransference perspective, or dynamic? does it constitute a paradigm shift? • How does the therapist process, handle, reflect “Many contemporary theorists believe that the upon and engage with their countertransference outcome of therapy is related to the successful experience when caught in the enactment? elaboration and re-evaluation of patterns of • How does this translate into therapeutic relating that become accessible through the responses which enable recovery from enactment analysis of the transference-countertransference (or, in attachment language: repair of the matrix (Sandler & Sandler, 1997; Lemma, rupture)? 2003).” I have suggested elsewhere (Soth 2005) that the But one can subscribe to this statement, and traditional verbal-reflective bias of the ‘talking beyond it to the notion of enactment, both from a therapies’ imposes severe limitations on our one-and-a-half as well as from a two-person capacity for surviving and recovering from psychology, and Little acknowledges this fuzziness enactment. One of the perennial ambivalences (which Stark herself is confused about): around enactment manifests in the reliance on “Although at times some of what I describe traditional mind-over-body assumptions. If the sounds more like a one- or one-and-a-half relational transformation does occur, as Little person psychology, at other times a two-person declares, on the level of implicit unconscious psychology (Stark, 1999), I see the two-person processing, then how does one as a therapist position as a holding frame in which the work mindfully attend to one's own implicit unconscious occurs. In Stark’s conceptualisation Model 3 (2 processes? person psychology), which emphasises “This entails working mindfully with engagement and relationship, interpretations unconscious processes through the ‘direct the patient’s attention to her relational transference-countertransference matrix aiming dynamics-that is, those aspects of her internal to have ‘one foot in and one foot out’.” dynamics that she actually plays out (enacts) in I guess we all appreciate the old adage: the her relationships’ (p. 24), in particular within problem with the unconscious is that it is the therapeutic dyad.” unconscious. Now somehow, in practice, we do manage this conundrum as therapists all the time, From the client’s perspective, ‘enactment’ can because the unconscious is not like an on/off remain merely a further elaboration of traditional electrical switch. But appealing to the therapist's transference-countertransference notions within a mindful awareness of the unconscious still boils one-and-a-half person psychology. The question down to Freud's 'making the unconscious that delineates the paradigm shift focuses on the conscious' (or 'where Id was, there Ego shall be'). therapist within enactment: to what extent does the But this still leaves out what from a bodymind and therapist go unconscious, lose their therapeutic neuroscience perspective may be the most position, and what degree of that kind of 'failure' is important factors in therapeutic action, which Little acceptable, necessary, inevitable, conducive, also hints at: productive? “The emotional element and tone, in addition to the meaning making and understanding are The relational field, as homogenous and agreed as significant. Further, the mechanisms that it appears on some important issues (especially in support transformation are not limited to their opposition to classical analysis, drive theory interpretations and include other experiences and one-person psychology), falls into distinct that are transformative, and are not explicit, as camps around this question. When we look at the described by the Boston Change Process Study wide variety of psychoanalytic writers quoted in Group (BCPSG, 2010) as non-interpretive Little’s paper, (Kernberg, Maroda, Mann, Stolorow, mechanisms.” Davies, Aron, Bollas), they would inhabit and

© 2013 - Michael Soth: ‘We are all relational, but are some more relational than others?’ Page 11 Whilst there is increasing acknowledgement of But extending beyond these traditional pillars of implicit relational knowing (i.e. pre-reflexive and the ‘talking therapies’ requires profound changes body-to-body) throughout the therapeutic field - across the therapeutic field: in how we process our and although relational TA emphasises these non- bodymind experience and countertransference as conscious and unconscious processes - there is in therapists, how we support ourselves within the practice an experiential, conceptual and technical therapeutic position, what concepts and dearth when it comes to specifying these “other terminology we rely upon and ultimately how we experiences”, that are “not explicit” and “non- train future generations of therapists. As a first interpretive”. step, we need to catch up with the wounds of our diverse traditions and their historical origins, on all Conclusion levels from underlying paradigms to theory and Enactment represents a paradigm shift into a two- technique. In this process, we can use the person psychology framework to the extent that we contradictions between the various traditions to can get beyond the reflective bias of the ‘talking challenge each other in their dogmatisms – so an therapies’ and into these spontaneous bodymind integrative perspective becomes necessary as a processes. It is therefore my suggestion that an second step. The third step then is a thorough re- embodied understanding of enactment from within formulation of our traditional models from a the enactment - as systemic bodymind parallel relational two-and-many-people perspective, processes – profoundly enhances our chances for grounded in 21st-century embodied, integral, its transformative containment (Soth 2005, 2008). systemic, non-linear paradigms. It is my conviction This would imply that our therapeutic responses that the paradoxical nature of enactment will be would not need to remain limited to reflective, seen to constitute a central foundation of any such narrative and interpretive techniques. formulation.

References: Clarkson, P. & Wilson, S. (1994, 2nd Edition 2003) The Therapeutic Relationship. Wiley-Blackwell Cornell, W.F. (2008) Explorations in Transactional Analysis – The Meech Lake Papers. TA Press Davies, J.M. & Frawley, M.J. (1994). Treating the adult survivor of childhood sexual abuse. Basic Books, New York Erskine, R. G. (2007). Life scripts: Unconscious relational patterns and psychotherapeutic involvement. Retrieved 30 March 2013 from http://www.integrativetherapy.com Erskine, R. G. (2009). Life Scripts and Attachment Patterns: Theoretical Integration and Therapeutic Involvement. Retrieved 30 March 2013 from http://www.integrativetherapy.com Gomez, L. (2004) Humanistic or psychodynamic - what is the difference and do we have to make a choice ? Self & Society Vol. 31 No.6 Feb/Mar 2004 Hawkins, P & Shohet, R. (2012) Supervision in the Helping Professions (Supervision in Context). Open University Press. Soth, M. (2004) Integrating humanistic techniques into a transference-countertransference perspective - A Response to ‘Humanistic or psychodynamic - what is the difference and do we have to make a choice ?’ by Lavinia Gomez, Self & Society, 32(1), Apr./May 2004, p. 44 – 52 Soth, M. (2005) Body Psychotherapy today - an integral-relational approach, Therapy Today, November 2005, Vol 16 No 9 Soth, M. (2005) Embodied Countertransference. in: Totton, N. (2005) New Dimensions in Body Psychotherapy. Maidenhead: OUP Soth, M. (2007a) The implicit relational stance and habitual positions, CABP Journal No 35, July 2007 Soth, M. (2007b, in press) The Use of Body Psychotherapy in the Context of Group Therapy. Soth, M. (2008a) Embracing the paradigm clash between the 'medical model' and counselling. Therapy Today January 2008. A response to: 'Should counselling be considered a healthcare profession ?' by James T. Hansen (2007). Therapy Today October 2007 Soth, M. (2008b) From humanistic holism via the ‘integrative project’ towards integral-relational Body Psychotherapy. In Hartley, L. (2008) Contemporary Body Psychotherapy - The Chiron Approach. Routledge Stark, M. (1999) Modes of Therapeutic Action. Aronson Wilber, K. (New edition 2000) Sex, Ecology, Spirituality: The Spirit of Evolution. Shambhala Publications Inc Wilber, K. (2003) Boomeritis: A Novel That Will Set You Free! Shambhala Publications Inc

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