It seems to me, too, that we tend to use this forum to explain why we individually prefer one or another way of understanding our patients and what happens between them and us. We also tend to fill in with guesses that suit our preconceptions wherever it seems there are spaces in the accounts as given. Two things contribute to this, I think. First, this is not designed as a problem seminar in which we raise questions for each other. It is more--to my mind--an ecumenical conference. The second problem arises from the first. Feeling that we present work that makes sense to us within an already tested framework, we try to clarify further what we do when others seem to understand things differently. We may stimulate each other with various unanticipated ideas and yet end up feeling more than ever as we did to start with. Thinking things through again is valuable. Obviously, it is a fine gain if we end up with new ideas we keep. More than semantics is involved. In the case of Laura, which I knew first hand, I did feel that some contributions from others in the forum got away from the data because of preferring another way of understanding what I reported. With other contributions, it interested me to learn how the same data made sense from a different perspective than mine. I still feel that the special quality of this forum is the opportunity for us all to find out more about what subsumes effective work, regardless of the framework a particular one of us applies to our work with patients. Some of us are also intrigued by questions of "Why," answers to which may seem quite relevant to matters that come up in the work. To give a quick example of how that involves me, I have noticed over the years that just when I believe there has been a session of special importance to a person (particularly with people who are characterized as borderline perosnalities--much as I find I do not routinely think in diagnostic categories), immediately afterwards the person acts disruptively and counter to any expectation of mine. Recent fine research with infants shows that even at four months of age, infants protect a sense of personal integrity by a maneuver called "rupture and repair." When the mother is in too close attunement with the infant, or seems to swoop in too demandingly, the infant withdraws. Then it returns its attention to the mother. Beatrice Beebe and Tronick are two people who are at the forefront of this research. Beebe, particularly writes of how this pattern reveals itself in work with adult patients. What their discernment of this pattern offers to me is understanding that the borderline person, who is floundering with issues concerning self-recognition, must defend against feeling too close to another--and then try (often charmingly) to control the repair process. Can one skate along with just a here-and-now focus? Obviously, many of our colleagues do. I tried to say by way of the desk analogy that some therapists and some patients prefer to stay at that level. Others prefer an approach that integrates as much as possible of the person's experience, including as deep as possible a cognitive sense of origins of problems and options. Another question can be, "Why not 'why'?" To a certain degree, we are able to separate theory from technique. Yet there is implicit theory in any technique. And, I suppose, theory always
technique implied in theory. Nonetheless, we all have much to puzzle about, even if we may feel a need to operate on the basis of some interim knowledge. That's my "Why" in joining BOL
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