Clinical theory at the border(s): Emerging and unintended crossings in the development of clinical theory

Abstract

The author provides some scaffolding for thinking about emerging and unintended integrative developments in clinical theory. The emergent theory to which the author refers works at a different level of theoretical discourse than explicit attempts at comparative translation of psychoanalytic concepts or theories. In contrast, most of the theory that is explored in this paper involves clinical discourse aimed at solving important common clinical problems. The work of a group of authors (Jay Greenberg, John Steiner, Anton Kris, Michael Feldman and Charles Spezzano) is described as simultaneously embedded within a particular orientation while demonstrating a kind of unwitting reach to a broad swathe of analysts. Distinctions are made between this kind of linking of clinical theory versus self-consciously syncretic and integrative approaches to theory development. The author also discusses the educational implications of this emergent theory for teaching and learning during psychoanalytic training.

A common ground in clinical discussion groups: Intersubjective resonance and implicit operational theories

“…I would add that the difference between the two tends to blur when authors pose questions about or explore similarities among several approaches to a specific clinical situation (Cooper, ). Similarities will appear that may be more easily perceived in a ‘bottom‐up’ clinical reasoning than in an analysis that is paying attention to authors' theoretical background.…”

“…Contrariwise, as we can appreciate when reading a paper, writing about clinical theory responds "to the demands of formal intellectual discourse selecting out a single phenomenon and, often, considering that phenomenon through the lens of a single theoretical perspective and describing it with that perspective's particular vocabulary" (Zimmer, 2014, no pagination). I would add that the difference between the two tends to blur when authors pose questions about or explore similarities among several approaches to a specific clinical situation (Cooper, 2015). Similarities will appear that may be more easily perceived in a 'bottom-up' clinical reasoning than in an analysis that is paying attention to authors' theoretical background.…”

Introduction

“…Steven Cooper (2015) has noted that, as a generation of analysts mature who have been exposed to multiple theoretical systems in their training, and as efforts to formally integrate two or more of the theories into unified theoretical systems have found a place in our literature, we have entered a “post-pluralistic era” that has begun to shift the nature of our professional discourse. In seminars and panels we hear colleagues present clinical material, often compelling, apparently based on a hybridization of two or more theories.…”

From “Either/or” to “and”: The Analyst’s Use of Multiple Models in Clinical Work

“…Tracing the influence of theory on the analyst’s clinical work is notoriously difficult. The analyst’s relation to theory in the clinical moment reflects a complex mix of conscious thought and unconscious fantasy, identifications with teachers, analysts, and theorists, and complex transferences to these figures (Smith 2003; Cooper 2015). Theory is not in the foreground of the analyst’s mind when she is at work.…”

“…In our "post-pluralistic era" (Cooper 2015), analysts, perhaps particularly in North America, are exposed to a multiplicity of formal theories in their training and their reading; their clinical work often reflects ideas drawn from more than one of them. An aspect of this development is the analyst's mental process as she draws on heterogeneous models when with the patient and when processing the events of the session afterward.…”