Construtivismo Como Teoria Integracionista Por Mahoney M. J. Marquis a. 2002 . Integral...

Integral Constructivism andDynamic Systems in PsychotherapyProcesses

M I C H A E L J . M A H O N E Y , PH.D.A N D R E M A R Q U I S , PH.D.

This article presents a brief overview of the metatheory of integralconstructivism, highlighting important convergences among construc-tivist, dynamic systems, integral, object relations, self-psychology, andintersubjective approaches to the practice of psychotherapy. The roles ofrelationships, emotionality, and perturbations in the client–therapist bondare emphasized. Complex nonlinear dynamics are inherent to life organi-zation and to therapeutic process.

PROCESSES OF CHANGE HAVE BEEN A CENTRAL TOPIC OF HUMAN INQUIRY

for millennia. We have been particularly fascinated with under-standing our own change processes and the roles we may play in directingor facilitating change in ourselves and in others. Indeed, the practice ofpsychotherapy presumes that people can and do change, and that theycan be offered valuable counsel in the process. Studies of human changewithin and beyond psychotherapy have made it clear that complex

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Michael J. Mahoney, Ph.D. is Professor of Psychology, University of North Texasand Saybrook Graduate School and Research Center; author, Human Change Processesand Constructive Psychotherapy.

Andre Marquis, Ph.D. is Assistant Professor of Psychology, Northeastern StateUniversity, and serves as an officer of the University Student Outreach branch of theIntegral Institute.

Parts of this article were adapted from Mahoney (in press).

processes are involved (Mahoney, 1991). Our goal in this article is tosketch the metatheory of integral constructivsm and to outline the rele-vance of its dynamic systems approach for the practice of psychotherapy.We begin with a brief synopsis of dynamic systems theory, which wethen relate to constructivism and integral psychology. To illustrate theresonance of these perspectives with contemporary psychoanalytic the-ory and practice, we emphasize their parallels with object relations, selfpsychology, and intersubjective theory.

Dynamic Systems and Developmental Processes

Dynamic systems theory (DST) is actually a family of theories thataddresses the principled processes of emergent development in sponta-neously self-organizing complex systems (Prigogine, 1980; Prigogineand Stengers, 1984; Mahoney, 1991; Kauffman, 1993, 1995; Thelen andSmith, 1994; Kelso, 1995; Haken, 1996; Mahoney and Moes, 1997;Masterpasqua and Perna, 1997). Contemporary expressions of DST wereanticipated by a number of scientists and scholars interested in nonlinearphenomena. A critical mass of interest gravitated around the topic ofchaos when it was shown that small differences in initial conditions oftenled to substantially different trajectories of development in open systems.Chaos is emotionally synonymous with disorder, and it turns out to beone of the hottest topics in the emergence of new models and methodsin science. As Gleick (1987) put it, “Where chaos begins, classicalscience stops. For as long as the world has had physicists inquiring intothe laws of nature, it has suffered a special ignorance about disorder. . . .The irregular side of nature, the discontinuous and erratic side—thesehave been puzzles to science, or worse, monstrosities” (p. 3). Postclas-sical science, however—in its study of complexly dynamic self-organ-izing systems—has changed all of that. Across disciplines ranging fromastronomy, nuclear physics, and molecular biology to medicine, econom-ics, and political science, parallel themes of inquiry and discovery arebeing reported. These themes reflect the emergence of a new view ofourselves and our universe. Kauffman (1995), one of the leading propo-nents of this new view, says:

We are entering a new era in which life will be seen as a naturalexpression of tendencies toward order in a far from equilibriumuniverse . . . the fate of all complex adapting systems in the

INTEGRAL CONSTRUCTIVISM, DYNAMIC SYSTEMS 795

biosphere—from single cells to economies—is to evolve to anatural state between order and chaos, a grand compromise be-tween structure and surprise [p. 15].

According to Kauffman and other leading thinkers on dynamic systems,we are now in search of a theory of emergence that acknowledges thecomplex interplay between natural selection processes and the self-or-ganizing tendencies and capacities of evolving complex systems (Thelenand Smith, 1994; Kelso, 1995). As living systems, we literally exist onthe edge of chaos and it is our excursions into and through disorder thatserve as grist for the mills of our constructions of order. Palombo (1999),among others, has rendered a view of ego emergence as an expressionof coevolution in the psychoanalytic process (see also Chamberlain andButz, 1998).

This new view of the relationship between order and disorder isfundamentally relevant to our understanding of human adaptation andour services as therapists. Order requires ongoing energy exchangesacross boundaries that both separate and connect the orderly system fromand with its contexts. Such order involves a form of organizational(relational) integrity (wholeness) that exhibits continuity over space andtime. Among other things, this means that each person is always engagedin active gestures of seeking a dynamic balance in their life. From thisperspective, a “disordered person” is one whose life circumstancesexceed his or her developed integrative skills.

A fascinating and promising theme emerges from recent discoveriesabout the processes involved in spontaneous self-organization when acomplex self-organizing system is challenged beyond its current capaci-ties to adapt. Without belaboring the technicalities, it appears that personaltransformations—significant and enduring personal changes—are oftenpreceded by brief or prolonged episodes of whole system disorganization.Such disorganization may be an essential element in the emergence ofmore adaptive, adequate, and complex forms of life organization. Topreview a theme that will be elaborated shortly, disorder and disorgani-zation are not the enemies of developmental emergence (personal evolu-tion); they may, in fact, be necessary prerequisites for the holistic changenecessary for a new level of functioning to emerge.

Not surprisingly, it is difficult to speak simply of complexity. Severalyears ago one of the authors tried to describe the consensus about howorder emerges from chaos in systems like ourselves:

796 MICHAEL J. MAHONEY AND ANDRE MARQUIS

No matter how stable they are, dynamic systems are always under-going perturbations (literally, “agitations” or “deviations”) thatreflect the complex interplay of internal self-organizing activitiesand their ongoing exchanges with their local environments. So longas these perturbations do not exceed the “balancing” capacities ofthe system, it moves onward (through space and time) at the sameaverage level of organizational complexity that would have beenpredicted by the second law of thermodynamics. But the perturba-tions can get out of hand as a result of both inside and outsidedynamics. If the perturbations exceed a certain threshold (thebifurcation point), a whole new level of principles is required toaccount for the processes that emerge [Mahoney, 1991, p. 418].

Dewey (1934) made this point much more plainly and poetically morethan half a century earlier:

Life itself consists of phases in which the organism falls out of stepwith the march of surrounding things and then recovers unison withit—either through effort or by some happy chance. And, in agrowing life, the recovery is never mere return to a prior state, forit is enriched by the state of disparity and resistance through whichit has successfully passed. . . . Life grows when a temporary fallingout is a transition to a more extensive balance of the energies of theorganism with those of the conditions under which it lives. . . . [If]life continues and if in continuing it expands, there is a transforma-tion of them into differentiated aspects of a higher powered andmore significant life. The marvel of organic, of vital, adaptationthrough expansion (instead of by contraction and passive accom-modation) actually takes place. Here in germ are balance andharmony attained through rhythm. Equilibrium comes about notmechanically and inertly but out of, and because of, tension [1934,pp. 535–536].

Dewey was prescient in recognizing that development is never a simplereturn to a prior state. It is always a “moving on,” if only becausemovement (process) lies at the heart of both life and its changingexpressions. We survive the trials and tribulations of “falling out of step”and losing our balance again and again, and each time we reach a newcenter, the system incorporates and elaborates the previous centers. This


means that the “system as a whole thus shifts to a new, higher order, morecomplex structural form whose parts are governed by a new set offunctional properties and characterized by a new set of statistical parame-ters” (Brent, 1978, p. 380). What emerges, when circumstances permit,is a transformation in the identity and functioning of the system. Whenthe system manages to wrestle order out of the disorder into which it wasthrown, the emerging system tends to be both more complex and morecapable. This is not to say that its increasing complexity does not involvevulnerabilities, or that disorder is always followed by successful devel-opmental reorganization. But the picture is full of more hope and poten-tial than has been portrayed by pathology-based models of humandysfunction.

Integral constructivism offers a view of disorder that respects the roleof ever-present cascades of disorganization in the living system’s dy-namic and lifelong development. The resilience and resourcefulness ofthe human system is much greater than is generally appreciated. More-over, “growing pains”—ranging from mild discomfort to intense suffer-ing—are more central to our development than most like to admit. Fromthe perspective of integral constructivism, allegedly strategic interven-tions that seek to suppress quickly the pain of systemic disorganizationoften carry a significant risk.

Besides depathologizing disorder, an important contribution of com-plexity studies to the conceptualization and practice of psychotherapy isan appreciation for what are called “phase transitions” and the dynamicsof development. Phase transitions are those places in development wherea system suddenly changes course. Although therapists may not be ableto use the technical terminology of chaos and the sciences of complexityto help patients conceptualize what they are experiencing and how itreflects natural processes, we can use developmental metaphors thatconvey some of that same message. Physical metaphors that invokebodily experiences are often helpful in reassuring patients: “growingpains,” “molting,” and the like. Metaphors of journeying are also useful,and patients can be encouraged to construct a description of where theyhave been and where they now are. One of our patients, for example, wasvery experienced in white water canoeing. When an unexpected lifeevent destabilized her, she described her transition into chaos in termsof what she was familiar with: a slowly moving stream suddenlybecoming a torrent of unexpected rapids where she had little control andwas desperately struggling just to stay upright and off the rocks. This


metaphor helped her to regain some sense of familiarity with what shewas experiencing, and she felt reassured by realizing that—like riverrapids—the rapids in her psychological life were not likely to last forever,and that they were likely to be followed by calm waters and opportunitiesto rest.

Life challenges may lead to possibilities for learning and develop-ment, but possibilities necessarily involve risks, and some risks result indisaster or chronic dysfunction. People can easily become “stuck” indisorder. Ordering processes can vary from flexibly stable to rigidlyover- or understabilizing. Psychological disorders tend to fall at theextremes of this constructed dimension. Anxious hypervigilance andhopeless disengagement reflect the extremes of the tension between fearand hope, and impulse control disorders reflect the dynamics of oscillat-ing among such extremes. Disorder, in the sense of diminished psycho-logical functioning and well-being, becomes a lifestyle for these unfor-tunate people, and they struggle for years—and sometimes lifetimes—inthe same painful patterns. This is where the empathic attunement andflexible collaboration of the therapist is most important, and we shalladdress these therapeutic strategies after we present an overview ofconstructive metatheory.

Constructivism: An Outline

The verb “to construct” comes from the Latin construere, which meansto arrange or give structure. The ongoing nature of structuring (organiz-ing) processes is the developmental heart of constructivism. Although itcan trace a legacy far back into written and oral history, constructivismis a term that is just now making its way into the vocabulary of psychol-ogy. It does not appear, as yet, in most dictionaries of psychology. If onelooks at the psychological literature over the past quarter-century, how-ever, it is being used with increasing frequency. “Constructive” and“constructivist” are being used, for example, to describe developingperspectives in domains ranging from biology and brain science tocognitive-behavioral, humanistic, and psychoanalytic psychotherapies.

There is considerable diversity in expressions of constructivism,which is why we term it here a metatheory—a family of theories. Thefamily resemblance appears to be reflected, however, in a consensualemphasis on five principle assertions about human experience anddevelopment:


1. Human experiencing reflects continuous and primarily anticipatoryactivity.

2. The ongoing activity of humans is primarily devoted to orderingprocesses or the organizational patterning of experience; these orderingprocesses are fundamentally emotional and tacit, and they are the es-sence of meaning-making.

3. The organization of personal activity is fundamentally self-referent or recursive, making the body a fulcrum of experiencing andencouraging a deep phenomenological sense of selfhood or personalidentity.

4. Self-organizing capacities and creations of meaning are stronglyinfluenced by social-symbolic processes; persons exist in living webs ofrelationships, many of which are mediated by language and symbolsystems.

5. Each human life reflects principles of dynamic dialectical devel-opment; complex flows among essential tensions (contrasts) are reflectedin patterns and cycles of experiencing that can lead to episodes ofdisorder (disorganization) and, under some circumstances, the reorgani-zation (transformation) of core patterns of activity, including meaning-making and both self- and social relationships.

These themes suggest a view of the person that is “integral,” in the senseof embracing many of the apparent dualities that have traditionallydominated psychology and philosophy (Wilber, 2000a).

Among the earliest recorded proponents of some form of constructiv-ism are the Buddha, Lao Tzu, and Heraclitus. The Buddha emphasizedthe role of minds and thinking in the creation and maintenance of ourexperience of reality. Lao Tzu and Heraclitus believed that oppositescoexist and, in fact, lead to and mutually define one another. In theeighteenth and nineteenth centuries, the major western proponents ofconstructivism were Vico, Kant, and Vaihinger. Vico said that humanknowing involves an imaginative construction of order in experience,and that knowledge must be understood as a process of construction thattakes place in social contexts. He maintained that our thinking expressesmetaphors of the body, and he suggested that fantasy, imagination,mythology, and etymology are important resources for understandingourselves.

Kant emphasized the power of patterns in our thinking, and heregarded ideas as regulative principles. Although these patterns place


limits on our knowing, Kant did not view us as prisoners of our minds.He believed in both freedom and an autonomous will, and he related theseto an ethics of action. Kant believed that we participate in the constructionof a universal lawfulness, and that integrity and good will are essentialto that process.

In The Philosophy of “As If,” Vaihinger argued that the primarypurpose of mind and mental processes is not to portray or mirror reality,but to serve individuals in their navigations through life circumstances.Vaihinger’s principle of “functional fictions” would later form a corner-stone of Adler’s theory of individual psychology.

Later developments in constructivism included Bartlett’s (1932) clas-sic work on reconstructive processes in memory. At about the same time,Piaget began his series of influential studies on children’s cognitivedevelopment. Drawing on the dynamic view of learning described byHerbart (1776–1841), Piaget described knowing as a quest for a dynamicbalance between what is familiar and what is novel. This balancing actis accomplished by the coordination of processes of assimilation andaccommodation. Piaget emphasized that we organize our worlds byorganizing ourselves, and this theme of self-organization pervades con-structive views of human experience.

A powerful theoretical presentation of constructivism was offered byHayek (1952), who showed that “much that we believe to know aboutthe external world is, in fact, knowledge about ourselves” (pp. 6–7)—thatis, knowledge about our patterns of organizing ourselves and our worlds.Another major event in the emergence of constructivism was the publi-cation of Kelly’s (1955) theory of “constructive alternativism,” betterknown as “personal construct theory,” which emphasized both possibil-ity and pattern in the self-organization of personality. He went on toelaborate an original theory of personality built around the concept ofconstructs. For Kelly, constructs (organizing processes) were dichoto-mous (either/or) in structure and exhibited dynamic (ever-changing)aspects (e.g., in their permeability and relative tightness and looseness).Kelly translated his theory into a novel approach to psychotherapy inwhich the role of the therapist is to challenge skillfully the patient’s waysof construing self, others, the world, and their possible relationships.Kelly’s work has stimulated substantial research on personality andpsychotherapy.

Constructive influences continued to increase throughout the secondhalf of the twentieth century, and it is the focus of numerous books


(Watzlawick, 1984; Ford, 1987; Guidano, 1987, 1991; Anderson, 1990,1997; Mahoney, 1991; Neimeyer and Mahoney, 1995; Sexton and Grif-fin, 1997; Franklin and Nurius, 1998; Hoyt, 1998; Neimeyer and Raskin,2000). The increase in its recent visibility has sometimes made construc-tivism seem like a new development, when in fact it has been emergingfor centuries. There are now two international journals devoted to con-structivism, and in 1996, the Society for Constructivism in the HumanSciences was formed to encourage and communicate developments intheory, research, and practices that reflect an appreciation for “humanbeings as actively complex, socially embedded, and developmentallydynamic self-organizing systems.”1

There are diverse expressions of constructivism in contemporaryapproaches to development and mental health services. Some emphasizea cognitive-behavioral legacy, others the existential-humanism, psycho-analytic, or transpersonal. Our approach includes aspects of each of theselegacies. Within the transpersonal (spiritual) traditions, Wilber’s (1998,1999, 2000) “integral psychology” approach is particularly appealing.Working from a uniquely comprehensive view, integral psychologyembraces the categorical dualisms of internal versus external, individualversus collective, and scientific knowledge versus spiritual wisdom.Wilber also adopts a developmental approach to human experience andincorporates the insights of major contributions in developmental, thera-peutic, and higher potential psychologies. This approach is called integralbecause of its emphasis on a sufficiently comprehensive view to embracethe unity of principles and processes that are apparent in wide diversities.We see important convergences among constructivist, dynamic systems,integral, intersubjective, and self psychology approaches. These conver-gences are illustrated in the following discussions of relationships,emotionality, and the processes by which perturbations may be trans-formed into significant personal development.

Honoring Emotionality and Relationships

As noted in the second theme of constructivism, emotions are viewed aspowerful self-organizing processes in human adaptation. Emotions serve

1Journal of Constructivist Psychology and Constructivism in the Human Sciences

(Web site, http://orgs.unt.edu/constructivism/society.htm; e-mail, [email protected]).


critical roles in directing attention, shaping perceptions, organizing mem-ory, developing a healthy sense of selfhood, and motivating activeengagement with the learning that life relentlessly requires. The mostintense emotions are usually generated in (intersubjective) relationshipswith others, particularly with those others whom Kohut and the intersub-jective theorists might conceptualize as serving selfobjects functions(Kohut, 1971, 1977; Stolorow and Atwood, 1992; Schore, 1994). Thissuggests that how emotions are handled in psychotherapy is central tothe patient’s optimal reorganization of experience, and thus, to “success-ful outcome.” As psychoanalytic, constructive, and integral theoristshave increasingly attested, the experience and regulation of emotions islearned in human relationships and is central to the achievement ofcoherent and valued sense of self.

In contrast to many other perspectives on human experiencing, inte-gral constructivism and intersubjectivity do not view emotions as eitherenemies or epiphenomena. Emotional experiences are the foundations ofpersonal realities, and this fact warrants a respect for individual phe-nomenology in the process of life counseling that is reminiscent ofKohut’s emphasis on empathy, or “vicarious introspection,” as the foun-dation of therapeutic processes. It is neither the intensity of the emotions,the nature of the drives, nor the ensuing conflicts between a child and itscaregivers/selfobjects that influences whether or not the child will suc-cessfully navigate the phases of development. Rather, it is the manner inwhich a preemerging selfobject functions, attunes, attends, and relates toa child’s experience of emotions and the intersubjective bond—theself–selfobject bond—that best accounts for a child’s developmentaltrajectory (Kohut, 1984). And this applies just as readily to adult patientsand psychotherapists as to children and caregivers. As Basch (1984)wrote, people are crippled not by emotion in and of itself, but by “theanticipation of reexperiencing the devastating, potentially disintegratingdisappointment of early empathic failures if they dare once again reachfor emotional fulfillment” (p. 10).

The centrality and import we assign to the therapist’s attending topatients’ emotional blocks, difficulties in verbalizing their emotions, orboth, as well as to disruptions in the therapeutic relationship, stem fromour belief that the articulation and integration of affective experiences,especially those that are phenomenologically disruptive or discrepant, isa developmental imperative. Atwood and Stolorow (1984) state thisclearly:


A requirement for the child’s attainment of the capacity to synthe-size affectively contrasting experiences of self and others is thepresence of a holding, containing selfobject who, by virtue of firmlyintegrated perceptions, is able reliably to accept, tolerate, compre-hend, and eventually render intelligible the child’s intense, contra-dictory affective states as issuing from a unitary, continuous self.When a parent, in contrast, must perceive the child as “split” . . .then the development of the child’s integrative capacity will beseverely impeded as affectively discrepant experiences of self andothers become enduringly sequestered from one another in con-formity with the parents’ fragmentary perceptions [p. 76].

Thus, children whose caregivers fail to provide selfobject functions willnot integrate opposing affective experiences, and will experience them-selves as lacking a cohesive, unitary, continuous self. This readilyaccounts for Kohut’s (1984) choice of terminology—“disorders of theself.” Optimal self-development requires that children not only be al-lowed to express their affective experience, but that such expression notbe experienced by them as threatening to their caregivers. Children alsorequire the assistance of their caregivers in learning to make sense of, orassign meaning to, what they are experiencing affectively.

Affects are initially experienced simply as bodily sensations (Krystal,1988; Stolorow and Atwood, 1992; Fosha, 2000). In order for suchsensory feelings to develop into emotions, the child must learn toarticulate symbolically the direct bodily feeling. It appears that childrencannot do this on their own. They need their caregivers to help themidentify and then label their feelings. In the absence of this facilitatingintersubjective context, several different derailments of optimal affectintegration can occur. If children do not receive assistance in the domainof symbolic articulation/verbalization, they will continue to experienceaffects primarily as bodily sensations, with the mind/body split thus beingperpetuated and even intensified. In these instances, people are literallyalexithymic (Krystal, 1988). If caregivers try to help the child articulatefeelings but the “child regularly perceives that his affective experiencesare intolerable or injurious to a caregiver, then the symbolic articulationof affect may become blocked or ‘dispersed’ (McDougall, 1989) in orderto safeguard the needed tie” (Stolorow and Atwood, 1992, p. 43). Laterin life, when such people anticipate that their articulated feelings willeither be ignored, rejected, or harmful to an important relationship, they


revert to relatively archaic and primarily somatic experiences and ex-pressions of affect. Intersubjective systems perspective has corroboratedour experiences of working with such individuals. When the therapist isperceived as an accepting, attuned, and affect-articulating presence,patients’ emotional blocks diminish, and they allow the disavowed partsof themselves to reemerge for the renewed developmental opportunitiesthat may be available to them.

What some therapists fail to appreciate is that for many patients, therevival of a relatively archaic self–selfobject bond (with its accompany-ing idealizing and mirroring needs) with the therapist is an absolutelynecessary prerequisite to resumption of development. Patients whosecaregivers fail to provide selfobject functions will seek (transferential)relationships within which they feel held and contained, needing thetherapist to recognize, tolerate, and affirm the validity of their intenseand often contradictory feelings (Atwood and Stolorow, 1984). When atherapist interprets these needs as merely intrapsychic and pathologicallyresistant (failing to recognize that resistance is always a function of theintersubjective matrix), the therapist has effectively repeated the trau-matic psychological injuries of early life. The traditional analytic atti-tudes of neutrality and abstinence can be particularly dangerous for thosewhose early caregivers were perceived as emotionally malattuned andunresponsive.

An integral, constructive approach to psychotherapy involves aninvitation to use the therapeutic relationship as a safe and secure base inwhich and from which the patient, with the help of the therapist’ssustained empathic attunement and inquiry, can learn to explore andexperiment. Precious little strengthens the bond between patient andtherapist more effectively than the therapist’s extending his inquiry into(a) disruptions or perturbations of the self–selfobject bond or (b) realmsof experience that the patient perceives, even if tacitly, as threatening tothe therapist (Stolorow, Brandchaft, and Atwood, 1987; Orange, At-wood, and Stolorow, 1997). Attending to such perturbed ruptures in thetherapeutic bond, which patients experience as threatening to their senseof self-esteem, cohesion, and integrity, affords the patient the opportunityto integrate disruptive affective states, rather than rigidly sequesteringthose parts of themselves. These therapeutic efforts echo those of Kohut(1971, 1977, 1984) and Stolorow and colleagues (1987, 1992) in thatconsistently inquiring into the patients’ experience of ruptured self–selfobject bonds illuminates not only their unconscious organizing


principles and the past traumas they replicate, but also and more impor-tantly, their expectations as to how their therapists will react and respondin such situations. These endeavors simultaneously mend the cracks inthe bond. However, before a disrupted bond can be mended, it must firstbe established.

Intersubjective Consolidation

In order for therapy to be maximally effective, an affectional bondbetween the patient and therapist must be established, with the therapistserving selfobject functions for the patient. Despite the fact that apatient’s early self–selfobject bonds may have been experienced asaffective shackles (as occurs with a child’s selfobjects either reject orignore vital emotional states accompanying the child’s self-differentia-tion ), it is precisely such a bond in treatment that can liberate the patientfrom archaic patterns of self-organization. This is more likely to occurwhen the therapist provides an intersubjective milieu that prizes thepatient and all of the emotionality that inevitably accompanies theprocess of self-development (Stolorow et al., 1987). Such (transferential)relationships, in which patients’ developmentally thwarted needs arereactivated, simultaneously make patients vulnerable to old trauma:

The patient struggles to contact and express the selfobject needsand related negative affects that he disavowed or repressed in theface of the frustration of these needs by his caretakers in childhoodand that he now fears may be responded to in the same way by hisanalyst. The patient not only fears rejection and retaliation from theanalyst, and that he will experience the frightening affects withwhich these are associated, he also wants to preserve his sense ofthe analyst as a good or idealized figure, which he desperately needsto internalize in order to shore up a self that is weakened and injuredby selfobject failure [Bacal and Newman, 1990, p. 265].

This peculiar mixture of potentials either to shackle one to, or to freeone from, ossified patterns of self-experience recalls the delicate balanceof assimilation and accommodation that is so vital to all learning.Patients’ current patterns and configurations of experience—all the waysthey expect the therapist to be and to respond—represent the unconsciousstructures into which the therapist is assimilated. For many patients,


feedforward processes are so dominating that their anticipatory, trans-ferential expectations diminish the likelihood of experiencing novelty,even when, “objectively,” the experience is quite unfamiliar. Ideally, thetherapist’s consistency and devotion to the empathic stance will beperceived as sufficiently novel to demand that patients also accommo-date—that is, break up or disintegrate their older patterns of structurali-zation so that these patterns may be reorganized, synthesized, and inte-grated into “newly expanded and reflectively conscious structures” oftheir subjective worlds (Atwood and Stolorow, 1984, p. 60). We believethat such an “experience near” approach not only avoids the “experiencedistant” “empiricide” (Kohut, cited in Masek, 1989, p. 184) of the neutral,abstinent analyst, but also provides a secure crucible “in which one cansafely and easily be in bits and pieces without the feeling of falling apart”(Winnicott, cited in Epstein, 1995, p. 206).

Once the patient’s transference has “clicked into place,” the intersub-jective experience is explored, and the therapist offers interpretations, orconstructions of experience. More important than the “objective correct-ness” of interpretations is the manner in which they are communi-cated—expressions of optimal responsiveness that patients experienceas restoring self-cohesion and resilience. Broadly defined, interpretingtransference involves investigating, understanding, and communicatingto the patient her experience of her therapist—which is unconsciouslyand recurrently organized via preestablished patterns (Stolorow et al.,1987). The interpretation of transference follows two basic steps: under-standing and explaining (Kohut, 1984). “It bears stressing” wrote Kohut,“that the analyst’s essential activities in each of these positions—not onlythe first one—are based on empathy” (1984, p. 176).

Each time the patient receives an interpretation that does not “feelright,” he or she experiences anxiety regarding whether or not thetherapist (unlike the patient’s caregivers) will recognize his mistake andprocess it with the patient, thus transforming a potentially traumaticexperience into a “development-enhancing structure-building optimalfrustration” (Kohut, 1984, p. 207). No therapist can avoid offeringerroneous interpretations to patients. However, provided that the thera-pist recognizes the patient’s (sometimes subtle, sometimes severe) re-treats, and responds appropriately, such “errors” constitute “optimalfailures.” Kohut wrote that such failures occur hundreds of times in goodtherapy, with each “attended-to failure” resulting in the patient’s en-hanced resiliency and the firming of self structure and self-esteem.


Change occurs not through isolated rational interpretations, butthrough an intersubjective experience—with the therapist serving as thepatient’s selfobject: “Interpretations are not disembodied transmissionof insight about the analytic relationship. They are inherent, inseparablecomponents of that very bond, and their therapeutic action derives fromthe intersubjective matrix in which they crystallize” (Stolorow et al.,1987, p. 101). It was in this context that Kohut argued that “even thoughthe content of the interpretation was wrong, the interpretation itself wasstill right” (1984, p. 94). Although sounding paradoxical, Kohut’s pro-nouncement underscores the primacy of empathic attunement, not “ob-jective correctness.” He (1984) proceeded to clarify that what was“correct” about the interpretation was the

simple but, I believe, profoundly human message, expressed withhuman warmth, that the patient heard. . . . And I am convincedfurthermore—to make my point from the opposite direction—thatthe analyst could have spoken the same words without the patient’swholesome response to the interpretation if she had failed totransmit her correct empathic perception of the patient’s devastatedstate [p. 94].

Our perspective on “resistance” is quite similar. Like transference,“resistance” involves the patient’s self-protective organization, and fre-quently an experience that too much of their core is changing too quickly.They may fear that their needs and emotions will be met by the therapistin a manner similar to those experienced in the traumatic responses oftheir early selfobjects (Kohut, 1984; Stolorow et al., 1987; Bacal andNewman, 1990). Following this conceptualization, resistance can beviewed as the result of the patient’s not experiencing the therapist as aselfobject. Therefore, “resistance” is not merely an intrapsychic functionof the patient, but, rather, a product of the intersubjective field betweenthem—with the therapist’s actions always playing a role (Stolorow et al.,1987). It is here that the therapist’s “affective competence”—the capacityto handle, “deal with,” metabolize, and facilitate one’s own and others’affective (relational) experience—becomes paramount (Fosha, 2000).Unless the therapist is able to know empathically the patient’s experienceof impending fear or danger—which results in the patient’s felt need toenlist resistance—analysis of resistance will be therapeutically useless.Consequently, the patient’s feeling understood in a moment of great fear


(re)establishes the selfobject bond—creating the image of an object (thetherapist) that is not a repetition of the patient’s past parental imagoes.Important at such junctures is the therapist’s ability to shift perspectives,so that his “aspect blindness” (Wittgenstein, 1953) not ensnare him inthe traps of reductionism and objectivism.

Coemergence of New Order in Patient and Therapist

In dynamically developing systems, change is pervasive, multiply deter-mined, and distributed. This translates into an insight that is morecommonly recognized among analytic practitioners—namely, that thepatient is not the only person changed by the process of psychotherapy(Bugental, 1978; Mahoney, 1991; Kantrowitz, 1996; Palombo, 1999).Patient change is certainly and appropriately the primary focus, but itemerges out of a human relationship that changes both participantsdevelopmentally. Not all of these changes are positive or progressive, ofcourse. Our focus here is on the patient’s developmental process, butpsychotherapy practitioners are wise to appreciate the risks of their workand the priority of self-care in their lives (Radeke and Mahoney, 2000).

The trajectory of a patient’s development during and after successfulpsychotherapy cannot be captured by a simple linear model. Even withthe best available methods for modeling complex nonlinear systems, theparticulars cannot be predicted. Some patterns are more likely to emergethan others, of course, and these reflect the principles operative indynamic systems. Oscillations, for example, are common in the devel-opment of new skills and often apparent in the restructuring of coreordering processes. A patient who enters therapy in the throes of anintense contraction may require a longer interval of intersubjectiveholding before risking expansions into new patterns. Exploratory behav-ior is suppressed in the presence of strong negative affect, and such affectis frequently a motivation for entering therapy. The emergence of novelpatterns may be signaled by shifts in dream content and process(Palombo, 1999). Oscillations are often apparent in the therapeuticrelationship as well, and not simply on the patient’s “side” of thatdynamic. This is why we have emphasized the critical role of thetherapist’s consistent empathic presence and affective competence.

Perturbations in the therapeutic bond are rich sources of opportunityfor development, but only when these perturbations are negotiated inways that honor and encourage the patient’s emotional experience and


competence (Stolorow et al., 1987; Fosha, 2000; Safran and Muran,2000). We are here reminded of what Kegan (1982) termed “the danger-ous recruitability” that is inherent in optimal psychotherapy:

What the eye sees better the heart feels more deeply. We not onlyincrease the likelihood of our being moved; we also run the risksthat being moved entail. For we are moved somewhere, and thatsomewhere is further into life, closer to those we live with. Theycome to matter more. Seeing better increases our vulnerability tobeing recruited to the welfare of another. It is our recruitability, asmuch as our knowledge of what to do once drawn, that makes us ofvalue in our caring for another’s development. . . . And why is itso important to be recruitable? The answer is that a person’s lifedepends . . . on whether he or she moves someone in this way [pp.16–17, italics added].

To what degree are we, as professional helpers, willing to be vulnerableto the unforeseen consequences that such vulnerable recruitability en-tails? And to what degree are we practicing a life-wisdom, rather thanmerely accumulating information and mechanically repeating tech-niques? Pondering such questions is a vital component of professionalhelping.

An integral constructivist approach rests upon phronesis—the practi-cal wisdom of the therapist’s being—rather than techne—the type ofknowledge involved with production, crafts, and machinery. Extrapolat-ing from Aristotle’s Nicomachean Ethics and Gadamer’s Truth andMethod, Orange and colleagues (1997) posit that the notion of therapeu-tic practice based upon technique is misguided, erroneous, and “seriouslyharmful” (p. 19). Not only does the tyranny of technique do violence tothe individuality of the patient by encouraging in the therapist an attitudeof knowing what to expect in advance, it also is teleologically associatedwith the product, as opposed to a teleonomic, phenomenological trust inthe process. And here enter the particulars that obscure the simplepatterns, rendering more uncertainty to our endeavors than most wouldlike to acknowledge. As Hoffman noted, our work

requires an underlying tolerance of uncertainty and with it a radical,yet critical kind of openness that is conveyed over time in variousways including a readiness to soul-search, to negotiate, and to


change . . . some things are always left in the dark. One might saythat one of the contexts of our actions is always the context ofignorance of contexts. And yet, act we must [Hoffman, cited inMoore, 1999, p. 122].

Psychotherapy, like life, involves complex processes. We have attemptedto convey some of the broad strokes that we have repeatedly encounteredin our experiences with our patients’ life-murals. These patterns, or“orienting generalizations” (Wilber, 2000b, vol. 6), are never a simplefunction of the patient’s intrapsychic world, but are rather coarticulatedin the intersubjective field that emerges between patient and therapist.We are thus in favor of supplanting traditional conceptions of transfer-ence and countertransference with the more complex, reciprocal idea of“cotransference” which acknowledges that “the emotional history andpsychological organization of patient and analyst are equally importantto the understanding of any clinical exchange” (Orange et al., 1997, p. 9).

Conclusion

Our brief sketch of the psychotherapy process has emphasized thedynamic and fundamentally intersubjective nature of human develop-ment. We have incorporated an integral view of constructivism that canembrace theoretical and disciplinary diversity. As this special journalissue reflects, dynamic systems theories have substantial relevance forthe conceptualization and practice of psychotherapy. There is also adynamic complementarity to this assertion that has been touched uponby Palombo (1999) and others—namely, that intensive longitudinalstudies of psychological development (such as in psychoanalysis) offerinvaluable opportunities for refining theories of dynamic systems. Wetherefore look forward to the convolution of creative dialogue betweensuch theories and psychoanalytic inquiry.

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