In this book, Stephen Mitchell, the leading theorist of the relational
movement in psychoanalysis, explores connections between earlier
psychoanalytic perspectives (especially Loewald, Winnicott, Fairbairn,
and Bowlby, but also Sullivan and Fromm) and relational thinking
and introduces some of his own ideas about levels of mental functioning.
Mitchell uses clinical material to good effect: not only does
this illuminate the ideas under discussion, but it enables us
to witness a clinician at work who is deeply honest and fully
engaged in the therapeutic enterprise. Indeed, Mitchell’s clinical
work stands out for its boldness and originality. Although some
of the book covers old ground in its criticism of the classical
model of psychoanalysis, Mitchell does branch out here in a new
direction by emphasizing connections between relational psychoanalysis
and recent versions of attachment theory (like Fonagy’s work).

Mitchell’s reading of figures like Loewald, Winnicott and Fairbairn
highlights the distinctiveness of their respective contributions.
The first two chapters are devoted to an assessment of Loewald
in which Mitchell demonstrates how Loewald uses traditional psychoanalytic
terms in novel ways-for example, in construing the unconscious
in terms of dedifferentiation, rather than in terms of explosive
energy or propulsive drives (p. 11), and in redefining the boundary
between fantasy and reality in a less rigid manner (p. 18). Mitchell
offers an interesting discussion of Loewald’s notion of the “primal
density” of the mind, which is manifest in the infant’s sense
of unity with the mother. In this context, Mitchell observes the
similarity to Mahler’s commitment to a phase of symbiosis, but
Mitchell does not grapple with the extent to which such ideas
have come under attack by infant researchers (Gergely has reviewed
this literature in relation to psychoanalysis; for a current version,
see Fonagy, Gergely, Jurist, Target’s Affect Regulation and Mentalization,
forthcoming in 2001 from the Other Press).
Mitchell’s appreciative examination of Loewald emphasizes his
wish to affirm adult reality without minimizing the value of infantile
fantasy. The former without the latter would mean “a dessicated,
meaningless, passionless world,” (p.24). According to Mitchell’s
interpretation of Loewald, “only the enchanted life is worth
living” (p. 29).

In the third chapter, Mitchell moves on to present his own ideas.
Developing Loewald’s notion of how different levels of functioning
coexist in the mind, Mitchell offers four different modes of organization.
It will be possible to do justice to this theoretical framework
here. Let me briefly characterize the range of distinct kinds
of human interaction which Mitchell specifies: 1) non-reflective
exchanges, which are revealed in actual behavior; 2) interactions
which are predicated upon affect permeability (or what is sometimes
referred to as “emotional contagion”); 3) interactions
which determine self-other configurations (including how others
can be part of oneself and how the self is multiplicitous); and
4) intersubjective interactions, which are mediated by the capacity
for self-reflexivity that allows us to have a richer sense of
both the self and others (pp. 58f). This framework is helpful
in establishing Mitchell’s claim that secondary process does not
replace primary process and that we need to accept and promote
interaction between these two general realms.

Clinical illustrations are used throughout the book to capture
aspects of this theoretical framework. For anyone who would like
to get a real sense of how psychoanalysts are working these days–
and thus to escape the antiquated, tired images that popular culture
tends to favor– I would highly recommend Mitchell’s book. He
is candid about his own moments of confusion and frustration.
Mitchell has a subtle eye, noticing the value of opting not to
make an explicit interpretation in favor of allowing an emotional
moment to linger in the room. He also does not hesitate to examine
challenging topics such as excitement and erotic arousal between
patients and analysts.

Perhaps the most fascinating aspect of Mitchell’s clinical work
has to do with his use of himself. With a patient who was chronically
hostile both within and outside of therapy, but also attuned to
how this drives others away from her, Mitchell responds to her
assertion that it was likely that at that moment he was hating
her by saying: “If this were not an analytic relationship,
if this were out on the street and you were talking to me this
way and I weren’t your analyst, I probably would say ‘FUCK YOU!’
But I am your analyst” (p. 142). This served to defuse
the hostility in the room and facilitated a new level of connection
in the treatment. The example represents a fine case of how acknowledging
countertransference, even negative countertransference (within
the bounds of what will be beneficial to the patient) can be helpful.

This book breaks new ground for the relational model in the way
it warms to attachment theory in the fourth chapter. Mitchell
offers a good discussion of how psychoanalysts failed to appreciate
Bowlby’s work and also of how attachment theory has evolved in
a direction that is less behavioral and thus more readily compatible
with psychoanalytic ideas. Fonagy and Target’s notion of “playing
with reality” and the process of mentalization through which
a child becomes interested in his/her own mind, fits well with
Loewald’s redefinition of the boundary between fantasy and reality.
The warming to attachment theory is significant as well because
the relational movement has tended to identify itself with the
hermeneutic side of psychoanalysis and to bequeath the scientific
side to post-Freudians. One of the merits of attachment theory
is its solid basis in empirical research. Mitchell’s openness
to science is also apparent in his passing comments on Edelman’s
neuroscientific work.

I would like to conclude this review by noting that Stephen Mitchell
died in December 2000 shortly after its publication. This is a
huge loss to the relational perspective, but also to the entire
field of psychoanalysis-all the more so since Mitchell was only
54 years old. On a personal note, I encountered Mitchell in a
number of times professionally (and once in a consultation). One
did not have to know him well to sense what a decent, humane and
astute man he was.

© Elliot Jurist, 2001

Elliot Jurist,
Ph.D. is a Professor of Philosophy at Hofstra University and is a Lecturer in the Department of Psychiatry
at Columbia University.
He is the author of Beyond Hegel and Nietzsche: Philosophy, Culture, and Agency (MIT
Press, 2000).

Categories: Psychoanalysis, Psychotherapy

Tags: Psychoanalysis, Psychology