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Summary

There were many problematic consequences to the early analytic framework and institutional stance, even though it was born accompanied by an understandable "euphoria of discovery" (Greenberg, 1999a) Amongst these were/are: the privileging of intrapsychic and archaeological materials; the implied hierarchical relationship between the uncovering analyst and patient; the implied epistemological objectivism of the analytic stance, both with respect to the patient's experience and in relation to other therapies; the creation of prototypical case-histories as instruments of dissemination, knowledge, or insight (perhaps seen in male mode as a stance of "mastery"); images of bold analyst as heroic outsider; and foundational myths about the nature of psychoanalytic knowledge. All have contributed to a significant degree of intolerance and isolating within psychoanalytic groups. The idea of the behind-the-couch, out-of-sight analyst in psychoanalysis had metaphorical dimensions, linked to the idea of the uncontaminated analyst, always, ultimately, one step ahead paradoxically by virtue of having a view from behind; the idea of the "behind" also fits in with the early psychoanalytic preoccupation of "latent" and "manifest" and the analyst as occupying a superior perspectival position.

In an interesting comparison to medieval morality plays, Greenberg (1999b) touches upon the inescapable moral dimension of the analytic situation, and whilst the patient is telling her story, the analyst is also telling his own, using his own narrative conventions and figures of discourse. Greenberg rightly notes that "relational psychoanalysis" likewise carries a different set of moral values. And yet, the "writing analyst" is always different from the practicing analyst. The risk is that different psychoanalytic models will structure the patient's "free associations" differently, with all schools tending to create prototypical case histories. Wittgenstein (in McGuiness, 1982) suggested that there were both helpful and harmful aspects to Freud's mythology and claims, that something is gained, but also lost, in any act of interpretation, according to the classical regime.

Therapy implications

The philosophical and theoretical influences upon, and implications of, intersubjectivity theory are manifold and can be linked to many developments in late nineteenth and twentieth-century philosophy: the ideas of Nietzsche, Husserl, Heidegger (Group Analysis, 1998; Orange, Atwood & Stolorow, 1997) to name a few. Some of these links are explored in this book. The following discussion, relevant to group analysis as much as to individual psychotherapy (Nitsun, 1989; Stacey, 2001), describes how intersubjectivity theory contrasts with the classical paradigm. Rather than being a new "technique", the intersubjective— contextual paradigm cultivates a particular sensitivity to the work of therapy and understanding and is one that is more diverse and pragmatic in aim.

A changing view of interpretation

Foulkes' (1975a) encouragement of psychotherapy "by the group, for the group, including the conductor" (p. 3), rather than merely between analyst and group, was an important divergence from the classical psychoanalytic stance. Foulkes' "conductor" had many capacities besides making interpretations, such as confrontations, clarifications, acknowledging and receiving contributions, and so on. Furthermore, by getting away from the idea that group analysis was more than "a hunt for unconscious meaning" (1971), he opened up the transforming power of communication, theorised as the opening up, the ever-widening and deepening of a group "matrix", a horizontal perspective conjoined with the more traditional vertical perspective of individual psychoanalysis.

In spite of these advances, when it came to an understanding of the patient's individual pathology, Foulkes was a committed Freudian, retaining a rather insular view of human development and accepting the pre-eminence of the psychosexual stages as universal psychic contents. Dalal (1998) refers to this as the "orthodox Foulkes", contrasted with the "radical Foulkes". It is curious, perhaps, that Foulkes the analyst (he was a training analyst within Anna Freud's "B" school in Britain) was not more explicitly influenced by the emergent Independent School of psychoanalysis, which, amongst many things, theorised the role of other agents of psychic change, besides interpretation (Stewart, 1990).

Stern (Stern et al., 1998), working from a contemporary interpersonal and intersubjective perspective, has researched "non-interpretive mechanisms" in therapy. He talks about the notion of a "something more" than interpretation, noting that patients frequently recall, after treatment, not only "key interpretations" that might have affected psychic change, but also special "moments" of "authentic person-to-person connection". Hence, he suggests two mutative phenomena, interpretation and "moments of meeting", the latter involving what his research group term "implicit relational knowing" and complex "affect attunement", ideas based upon investigations of infants. Yet, even interpretations, good or bad, are a relational process and not disembodied observations about the patient, as in a vertical perspective. In the traditional epistemology of psychoanalysis, the "word" (the voice, the interpretation) was seen as different from the "act" and was conceived as informative rather than performative (Aron, 1996). Pines (1996a) offers a Bahktian view of interpretation as an act of revelation, of the therapist and patient, the momentary instance of an unfolding dialogue.

 
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