ABSTRACT
In this chapter I question the primary emphasis on repetitive enactments in mainstream relational theory and practice. I argue that this emphasis has given relational psychoanalysis a pathology-oriented cast, and encouraged an over-focus on the “trailing edge” as opposed to the “forward edge” (Tolpin, 2002) of the patient’s motivations and communications. I also argue that the theoretical “superstructure” underpinning the focus on enactments—including (1) the positioning of dissociation as the fundamental organizing principle of the psyche, and (2) a view of the psyche as constituted by multiple self-states—provides an insufficient conceptual foundation for understanding the minds, struggles, and therapeutic needs of our patients. While it may provide a powerful model of the “cracks and warps” in the psyche, it does not offer a sufficient account of “the bedrock of the psyche” and how it is formed. To address these imbalances, I propose an expanded conceptual framework based on the concept of “needed relationships” (Stern, 2017). Patients are always seeking the relational experiences they need, even as they recreate (co-create) versions of their early debilitating relationships. In support of this expanded model, I review the extensive literature (from Sullivan, 1954, to the present) describing various aspects of patients’ forward edge motivations. I then suggest that there is convergence among many theorists from diverse theoretical traditions implicating a fundamental principle of both healthy development and analytic transformation and growth—namely a principle of recurrent matching or meeting patients in state-specific ways that support the patient’s self-consolidation, self-articulation, and forward movement toward their own developmental aims. It is these experiences that form “the bedrock of the psyche.” Finally, I illustrate the clinical implications of this expanded relational framework in a case vignette.
