Poiesis in/between the Transferential Matrix: Insight, Imagination and the Relational Interpretation Emmanouil Manakas A dissertation submitted in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Psychotherapy, at the Goldsmiths College, University of London School of Social, Therapeutic and Community Studies JUNE 2017 1 Declaration of Authorship I confirm that this doctoral thesis consists of my own account of work which I have undertaken while registered for this programme. Any work included in the application which relies on the work of other authors and researchers is clearly indicated and referenced and abides by the University's rules and regulations regarding the submission of doctoral theses. Emmanouil Manakas 2 Acknowledgments Firstly, I would like to express my gratitude to my supervisor Dr. Anastasios Gaitanidis for his encouragement, the insightful comments and the long hours he has spent to read and comment on several drafts of this work. Moreover, I am indebted to colleagues at the North Hellenic Psychoanalytic Society for all those interesting discussions and comments that helped me focus several sections of this work. Finally, I extend my gratitude to all those close friends and my family that have shaped themselves into a great holding environment: thanks for listening carefully when I was quiet and thanks for being there when I didn’t know I need you, sometimes just for a walk or to turn the heat on. 3 Abstract The most important question for the Psychoanalytic Process Research is presumably what Mitchell calls the problem of “bootstrapping” the transferential matrix: how do the members of the dyad manage to disengage from being ‘heard’ according to old or unsuitable affective categories? On the grounds of a bi-phasic Conceptual and in-depth Analysis of the Psychoanalytic Complexity literature, I construct a minimal model of the psychoanalytic process as a theoretical context for conducting Process Research. According to the ‘story’ that I have read in the literature four main themes describe the process: a) the gradual emergence of a ‘phenomenological’ language that facilitates the flow of experience, b) the coupling, synchronicity and coordination of analyst and analysand, in ‘phase’ and ‘anti-phase’ at several levels, c) the shifting of the mental states and the thin and delicate slicing and sampling of experience that actualizes the emergence of mental objects and finally, d) Scaling that involves all those ‘mental’ processes that correct for the excesses or the deficiencies that are made evident during the shifting of mental states. Experience is generated as we ‘couple and shift’, and generative tensions appear as we ‘scale’ through this coupling and shifting process. Enactments, role-responsive transferences and countertransferences, testing of the transference and alliance or communication ruptures appear as coupled oscillating patterns that have both a repetitive and a developmental dynamic. Regarding the question of how we should study ‘Coupling, Shifting and Scaling’ I propose the adoption of an Enactivist epistemological framework which perceives the mind not as the workings of a representational machine but as a living process and the expression of an embodied living organism which in a “precarious” state of “needful freedom” (Jonas, in Thompson, 2007) strives to make sense of its environment. On the grounds of this framework I defend the view that we should study Scaling as an expression of the ‘radical dialogicality’ of the human mind that underlies the ‘structuring of experience’. I examine this ‘radical dialogicality’ at the level of inter-hemispheric differences, psychopathology and the enactive structuring of experience and the horizon of affective affordances in the clinical process. Finally, on the grounds of this conceptual analysis and its application to a case-study, I try to defend the view that, adopting relevant “dialogical” and micro-analytic methodological tools, we can achieve an appropriate level of ‘resolution’ so as to study “bootstrapping” at the moment-to- moment shifts in the experiential states or the shifts in attitudes that appear at bifurcation points in the system’s evolution. Through Scaling, the clinical dyad strives for a “maximum grip” of those experiential dimensions that carry the potential to expand the shared reality as a generative field and engage those surfaces of experience that bridge lost connections and separations, by 4 fractalizing the dimensionality of the generative space. A detailed examination of the Scaling processes may bring us closer to a better understanding of the problem of “bootstrapping”. Keywords: “Bootstrapping”, Psychoanalytic Process Research, Psychoanalytic Complexity, Dynamic Systems Theory, Enactivism, Dialogicality, Meaning-Making. Word count: Intro & Main Text: 107.543, References: 18.862, Appendices: 13.500 5 Contents Acknowledgments p. 3 Abstract p.4 Chapter 1 Introduction: The Research Question and the Methodological Considerations of the Present Study p.10 1.1 Methodological Considerations p.20 1.1 The Epistemological Framework and the Logic of Justification p.20 1.2 How did I Plan the Systematic Searches and the Literature Reviews p.23 1.2 Reflexively Positioning Myself as a Researcher p.28 1.3 Presentation of the Chapters p.33 Chapter 2: The Relational Context p.36 Chapter 3 Insight, Interpretation and the Therapeutic Relationship: Reviewing and Critically Discussing the Empirical and the Conceptual Literature p.51 3.1 Reviewing and Critically Discussing the Empirical Literature on Transference Interpretations, Insight and the Working or Therapeutic Alliance p.51 3.2 Reviewing and Critically Discussing the Conceptual Literature on Transference Interpretations, Insight and the Therapeutic Relationship p.71 6 Chapter 4: “Don’t push a car with its breaks on and don’t push one which is already rolling”: A Bi-Phasic Conceptual Analysis of How Chaos and Complexity Released the Psychoanalytic Imagination p.90 4.1 A The Evolution of the Epistemological Infrastructure and the Analytic Methodology Used for Making Sense of the Data p.91 4.2 From Structures to Processes: Discussing the Ideas that Framed the In-Depth Analysis p.102 4.2.1 How Complexity Thinking Integrates Theories of Therapeutic Action p.103 4.2.2 From Structural to Dynamic Theories of Brain/Mind p.109 4.2.3 Theory as a Live Object of the Clinical Situation p.116 4.2.4 Working at the Edge of Chaos: Self-organization, Emergence and Novelty p.122 4.3 Shifting Phases and Connecting: Themes Emerging in the In-Depth Analytic Phase p.131 4.3.1 The Language of Experience p.134 4.3.2 The Ubiquity of Coupling, Synchronicity and Coordination p.152 4.3.2.1 Talking to Carla and talking to Jean: Let the Matching Puzzle Flow p.164 4.3.2.2 Matching the Flowing Puzzle of Experience through p.174 Metaphor 4.3.3 Shifting States and, the Thin and Delicate Slicing and Sampling of Experience p.177 7 4.3.3.1 The void at the heart of empiricism p.189 4.3.4 Scaling for Meaning-Making p.197 Chapter 5: Scaling and the Structure of Experience p.206 5.1 Inter-hemispheric Differences and the Structure of Experience p.215 5.2 Psychopathology and the Structure of Experience p.248 5.3 The Enactive Structuring of Experience in the Psychoanalytic p.264 Process 5.4 “Being banal and inadequate? What should bother me about that?”: Enacting Curiosity in a Bootstrapping Matrix p.280 Chapter 6: Conclusions p.296 References p.310 Appendix I Table of Themes extracted from the in-depth analysis of the Psychoanalytic Complexity Literature p.361 Appendix II (Lists of Reviewed Documents) p.370 A. List of Documents included in the Conceptual Analysis of the Psychoanalytic Complexity Literature p.370 B. List of Documents included in the review of the Psychoanalytic Literature on Therapeutic Action p.377 8 Appendix III (Case Studies Material) p.382 A. Carla and Antonino Ferro p.382 B. Jean and Jeremy Nahum p.386 C. Nathan and Robert Carrere p.393 9 Chapter 1 Introduction: The Research Question and the Methodological Considerations of the present Study How do people change in psychoanalysis? What is it that actually changes? Is it something inside them? Is it the whole person or some kind of internal psychic structures? Is it the way they narrate themselves and their stories or it is the way they relate to people around themselves? These two seemingly simple questions, the how and what of change, suggest the core of the pressing matter of therapeutic change in psychoanalysis. Greenberg (2012) believes that we will never arrive at some convincing and universally accepted answers to these questions. Moreover, he notes that we should rather start exploring new ways of conceptualizing the therapeutic action of psychoanalysis, refraining from models of thinking where the analyst purposefully does something that has some curative effect. May be, “we don’t cure”, he writes, “we do our jobs and cure happens” (ibid, p.241). Despite the collective efforts of clinicians and empirical researchers, the question of how any psychotherapy cures and, why it does cure in the way it does, it has not been answered (Salvatore, 2011). It is almost impossible to understand what is happening in the consulting room (Canestri, 2007; Spezzano, 2007; Steiner, 1994). Process research promises to bring up interesting knowledge regarding the question of how people change in psychotherapy (Elliot, 2010; Salvatore & Valsiner, 2008; Salvatore, 2011). Much of the interest of the psychotherapeutic community has moved from questions of outcome to questions of process, of how change happens in psychotherapy. As already mentioned, many researchers now recognize that research “in” and “on” (Salvatore & Gennaro, 2015) the process has to follow the 10 route of theory-driven paradigms. As Salvatore, Tschacher, Gelo and Koch (2015) mention “[t]he key to open the black box is theory not data” (p.2).