ABSTRACT

In this chapter, the author raises the qualities of therapeutic meeting that emerge differently in the self-psychological and interpersonal traditions of psychoanalysis. He notes their convergence in contemporary theories about neuroscience, mentalization, and dynamic systems. The author uses the challenge of working with chronic shame as clinical context for his core theoretical point: The empathic-developmental and the interactive-interpersonal modes of psychoanalytic practice are powerful and complementary—because both move toward moments of meeting that are simultaneously attuned and interactive. He argues that as therapists, psychoanalysts do not have to choose between "empathic immersion in the client's experience" and "active interpersonal engagement with the client". This double kind of meeting is exactly what shame needs for healing; understanding this quintessentially relational malady clarifies for the nature of relational cure. As interpersonal theory developed, changing the doing of relationship remained the reason for interpretation, but with a growing awareness of how unconscious interaction constructs patterns of relationship.