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Book Reviews |
Key Words: Books Reviewed
It was with considerable sadness that I took up this last book written by Stephen Mitchell. Reading it became a reminder of what he has offered us over the past 20 years and a sad awareness that we will no longer have his unique and very original voice available to us. It has made a critical reading of the book rather difficult. Who wishes to quarrel with his views when he is no longer available to continue the dialogue? Nonetheless, the review is well deserved, and despite his absence, it is important to explore this book as a rich addition to the expanding body of ideas emerging from contemporary psychoanalysis.
In the preface, Mitchell sets the stage for the exploration of the many ways in which psychoanalysis occurs. His idea is "[that] human minds interact with each other in many different ways, and that the variety of relational concepts pervading the recent analytic literature is best understood not as representing competing theories, but as addressing themselves to different interwoven dimensions of relationality."
In chapters 1 and 2, he begins by exploring the contributions of Hans Loewald, whom he describes as writing from within traditional drive theory language while subtly shifting the meaning of the terms. In his work, he recognized some of the underpinnings of current relational thinking in psychoanalysis. Loewald's emphasis on the significance of the external object spoke to an early awareness of the inevitability of intersubjectivity. The importance of the analytic relationship for the curative effect was a sophisticated shift away from drive theory in that it placed great importance on the relational experience. Mitchell captures Loewald's unique emphasis on language, in which "language transcends the distinction between preverbal and verbal; language begins to play an important role from the earliest days of life." He contrasts Loewald with Stern and Sullivan and their views on the impact of the movement from preverbal to verbal.
Mitchell's grasp of the subtleties of Loewald's contribution and his impact on current relational thinking is presented in clear and concise language. The clinical vignettes offered in each chapter are clarifying in that they capture Mitchell's relational style as well as explicate the theoretical contribution not only of Loewald but also of Fairbairn and others.
In chapter 3, "An Interactional Hierarchy," he offers a relational framework, a "heuristic device for locating, juxtaposing, and integrating different kinds of explorations of different dimensions of relationality," which reflects organizational patterns of increasing sophistication. He suggests four modes, ranging from nonreflective behavior (mode 1) to affective-permeability (mode 2) to self–other configuration (mode 3) and intersubjectivity (mode 4), that can be used to explore clinical choices the analyst makes. These four modes are then used throughout the book in each clinical example in a way that clarifies the work of particular clinicians.
In chapter 4, "Attachment Theory and Relationality," Mitchell weaves in the works of Bowlby, Stern, Main, Ainsworth, and others and then offers clinical examples of attachment and modes 2, 3, and 4. These examples help to solidify the idea of mode and offer a potential tool for fine tuning the clinical exchange. He reaches for a convergence of psychological ideas, attachment theory, and psychoanalytic theory. The prospect is stimulating.
Mitchell goes on to explore Fairbairn's work, seeing him as offering, for his time, a rather radical view of relationality that is now seen as quite significant. His explication of Fairbairn's work is both interesting and thought-provoking in that he goes beyond Fairbairn and explores what that author might have been implicitly suggesting. He offers some compelling clinical examples that expand Fairbairn's work.
The final chapter, on intersubjectivity, tackles the thorny issues of expressiveness and restraint in the analytic relationship. This chapter focuses on the analyst's "inevitable participation in the process" and is the most clinically practical in its straightforward look at the analyst's position vis-à-vis the patient. He concentrates on the strong emotions that inevitably emerge in the analytic relationship, exploring the complexity of love and hate in the analyst toward the patient. His clinical examples are both revealing and clarifying.
Although this brief review does not capture the rich complexity of the book, it offers a brief look at the far-ranging exploration that has been so characteristic of Mitchell's thinking. If there is a complaint to be made, it is simply that at least some of these chapters call for further expansion. This is particularly the case for the Loewald and Fairbairn chapters. The book is dense with interesting ideas and worth a read and a reread. The clinical examples are self-revealing and useful in their explanatory power. This effort to expand and clarify the relational field is very necessary, and I hope Mitchell's ideas will be expanded by others, just as he attempted to expand the ideas and influences of earlier theorists.
FOOTNOTES
Dr. Segalla is the Director of the Institute of Contemporary Psychotherapy and Psychoanalysis, Washington, DC, where she also serves on the faculty. She is on the faculty of the Group Training Program of the Washington School of Psychiatry. Her private practice is in Washington, DC.
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