NEW EXPERIENCES AND MEANINGS

A Model of Change for Psychoanalysis

Rebecca Coleman Curtis, PhD
Derner Institute, Adelphi University, and the W. A. White Institute
A model of the self is presented emphasizing the experiential self, along with
self-with-other representations. This model focuses on primary consciousness in
distinction from consciousness of the theory of the self, or the sensory
perceptual self in addition to verbal/conceptual processes. The experiential self
is discussed in relation to contemporary neuroscience and nonlinear dynamic
systems theory. Acknowledgment of the experiential self leads to implications
for therapeutic action. Although psychoanalysis has focused on a change in the
meanings of experienceespecially unconscious meaningsas a route to
change, many recent theorists have commented on new experiences themselves
as leading to change. This idea is consistent with acknowledgment of the
experiential self. To the extent the idea of an experiential self is endorsed, there
are implications for interventions that can address it. These include attention to
sensory processes, the body, visual images, language in the present, and mind-
fulness techniques in addition to nonverbal aspects of the relationship. Instead
of simply relying on interpretation leading to insight, the model of change in
psychoanalysis can now be said to be one of new experiences and new meanings
of experiences. Such models of the self and change help to bridge the gap
between psychoanalysis and mainstream psychology.
Keywords: self, change, new experiences
Psychoanalysis, as well as psychology, is without a unied view of the self. As Summers
(2005) recently commented, although psychoanalysts have evolved from the language of
ego to the language of the self, the theory (including of technique) has not shifted
accordingly. Freuds model of the ego, id, and superego is still with us, but it has been
This article was published Online First August 29, 2011.
Portions of this article were presented in 2010 at the 26th annual conference of the Society for
the Exploration of Psychotherapy Integration, Florence, Italy; and at the 41st international meeting
of the Society for Psychotherapy Research, Asilomar, CA. Appreciation is expressed to Robert
Bornstein and an anonymous reviewer for comments on a previous version of this article.
Correspondence concerning this article should be addressed to Rebecca Coleman Curtis, 411
West End Avenue, 11-D, New York, NY 10024. E-mail: rcurtis.curtis@gmail.com
Psychoanalytic Psychology 2011 American Psychological Association
2012, Vol. 29, No. 1, 8198 0736-9735/11/$12.00 DOI: 10.1037/a0025086
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criticized from both within the Freudian orientation and without (Frank, 2007). The power
of the image of this world, what lies beneath, and what lies above goes back at least as far
as the Minoans 4,000 years ago, who constructed an image of a grifn with a lions body,
an eagles head, and a snake as a tail, representing the world around us, the world above,
and the underworld. Freud, however, never really separated the experiencing self from the
metaphysical ego. Part of the difculty may have come with the translation of Ich into
both ego and self in English where it seemed appropriate. Frank (2007) noted that
Freud (1926/1963) used the word Ich in two different waysone as synonymous with I
and the other to refer to a structure of the mind, only one time associating Ich with the
Latin term ego, which is more impersonal. However, the real neglect of the experiencing
self begins with the move from the topographical to the structural model (cf. Kernberg,
1982).
Hartmann commented on the use of the word ego as ambiguous, not synonymous
with person or individual or subject and by no means only the awareness of the
feeling of ones own self (Hartmann, 1950, p. 74). He emphasized the experiencing self
in the need to consider what he called the ego functions of perception, memory,
self-regulation, and so forth and considered the self to refer to self-representations.
Fairbairn (1952) rejected the Freudian model of ego and id because sexual and aggressive
wishes were partly conscious and it made no sense to consider them as unconscious its.
Both Fairbairn and Klein were focused on how the internalized representations of others
affected self-functioning. Fairbairns idea of a central ego and multiple ego states is still
seen in the idea of multiple selves of relational psychoanalysis.
In his development of self psychology, or what should perhaps be called selfobject
psychology or the psychology of selfobject experiences (Wolf, 1991), Kohut noted the
neglect of the subjective, experiencing self. Kohut emphasized subjective experiencing as
well as the self as a structure. The major problem with Kohuts conceptualization, as noted
by Stolorow and Brandchaft (1987), is that the two major components of the self are the
personal ambitions and societal ideals. It is not possible to differentiate this distinction in
many people. It also neglects the importance of reality as a factor, apart from the ideals.
Atwood and Stolorow (1984) found this aspect of Kohuts formulation problematic but
thought that psychoanalysis can only illuminate the experience of personal agency or its
absence in specic contexts of meaning (p. 34); they continue, [T]he person-as-agent,
in our view, lies squarely beyond the scope of psychoanalytic inquiry. Although the
experiencing subject may lie outside the realm of psychoanalytic investigation, this aspect
of self must at least be present in our view of the self. Brenner (1998), aligned more
strongly with the Freudian tradition, concluded that the idea of three agencies referred to
as id, ego, and superego is not supported by currently available data concerning mental
development and functioning (p. 179; cf. also 2002) while still seeing the mind as best
understood by compromises of the conicts over sexual and aggressive wishes in child-
hood.
Although Sullivans (1953) ideas about a good me, a bad me, and a not me are
widely accepted, his focus on interpersonal relations did not lead to much development of
ideas about the self. Winnicotts (1960, 1960/1965) differentiation of a true self from a
false self has been criticized by those who see various sorts of states with others
(Bromberg, 1996; Davies, 1996; Mitchell, 1991, 1993). For Winnicott,
[The] central or true self . . . could be said to be the inherited potential which is experiencing
a continuity of being, and acquiring its own way and at its own speed a personal psychic
reality and a personal bodily scheme. (Winnicott, 1960, p. 590)
82 CURTIS
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External impingements and compliance may lead to unconscious hiding of this true self
and to the development of a false self. Winnicott explained that people with intellectual
potential were particularly prone to the development of this sort of dissociation between
intellectual activity and psycho-somatic existence (1960/1965, p. 144), or false self.
Sullivan (1938) suggested that people operate in very different meyou patterns in
different circumstances. An individual might operate in a particular meyou pattern with
his or her mother and in another meyou pattern with a boss and thus have multiple ways
of being. Mitchell (1991), drawing on the interpersonal tradition of Sullivan, asked, Can
one experience oneself in a direct fashion, unmediated through relations with others? (p.
130) and advocated the concept of multiple self-states (Mitchell, 1993) while suggesting
that there was also a continuous sense of identity. The system of multiple self-states
suggested in interpersonalrelational psychoanalysis has not yet been fully spelled out,
however. In the conceptualization of multiple selves, there is no distinction between the
experiencing self and representations or theories of the self. Kernberg (1973), in fact, had
written of multiple self and other affectivecognitive representations but not of the
experiencing self. Stern (2002), in response to the idea of multiple selves, posited a
differentiation between primary subjective experience and intersubjectively organized
experiences. The primary subjective experience, he stated, corresponds to the true self of
Winnicott (1960) and Bollas (1989).
It is not necessary to endorse the idea of a true self, however, to support the idea that
human beings possess some sort of consciousness of experiences, just as other animals do.
Stern (1985), Damasio (1999), and Le Doux (2002) all describe this sort of core
consciousness. For Damasio, core consciousness is necessary to acquire a sense of an
autobiographical self over time. The distinction of consciousness in the present versus
consciousness over time (including a narrative sense of reference) has been made by Farb
et al. (2007), who describe consciousness in the present as evolutionarily older and
involving neural regions dealing with basic interoceptive and exteroceptive processes.
Although these two distinct forms of self-awareness are habitually integrated, research
shows that they can be dissociated again through training the self to attend to the present
moment.
Stern also differentiated the senses of self that exist before self-awareness and
language:
These [senses of self] include the sense of agency, of physical cohesion, of continuity of time,
and having intentions . . . . Self-reection and language come to work upon these preverbal
existential senses of the self and, in so doing, not only reveal their ongoing existence, but
transform them into new experiences (Stern, 1985, p. 6).
This sort of core consciousness does not necessarily include a sense of self, however, as
other animals must have this sense of agency and perhaps sameness. In fact, the word self
stems from the Latin word se meaning same. Damasio (1999) referred to core
consciousness (p. 82) and distinguished between the organism and the object of con-
sciousness. Edelman (1992), also a neuroscientist, distinguished primary consciousness
from higher order consciousness. According to Edelman:
Primary consciousness is the state of being mentally aware of things in the worldof having
mental images in the present. But it is not accompanied by any sense of a person with a past
and future. It is what one may presume to be possessed by some nonlinguistic and nonse-
mantic animals . . . . In contrast, higher-order consciousness involves the recognition by a
thinking subject of his or her own acts of affections. (Edelman, 1992, p. 112)
83 NEW EXPERIENCES MODEL OF CHANGE
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Both of these are distinguished from the even richer overlay present in humans with the
addition of language and symbol formation. In the philosophical literature, these con-
scious experiences are variously called phenomenal consciousness, raw feelings, or qualia
(qualia referring to the blueness of the sky or wetness of water). The idea of
consciousness does not prevent one from thinking of multiple streams of consciousness,
as Dennett (1991) and Mitchell (1993) have suggested, but all streams cannot act
simultaneously. The general properties of consciousness allowing for both the unity of
conscious experience and simultaneously rapid selection from a repertoire of possible
conscious states was recently articulated by Tononi and Edelman (1998).
The distinction between this experiencing self and the self as an object of thought is
also crucial in philosophy and needs to be given attention in psychoanalysis and psychol-
ogy. Recently, in cognitiveaffective neuroscience, Lieberman, Gaunt, Gilbert, and Trope
(2002) have reiterated the distinction between consciousness and consciousness of.
Cooper (1993) commented, after reviewing the literature in psychoanalysis on the self,
Most contemporary psychoanalytic theorists fail to take a systematic stand concerning
the self as distinguished from the self-representation (p. 41). In writing about the self as
an agent, Meissner (2000) and Fonagy, Gergely, Jurist, and Target (2002), in regard to the
development of the self, made this point. The failure to take into account the active I
aspects of the self in comparison with structural features of the self-concept has also been
noted in reviews in academic psychology (Harter, 1983; Markus & Wurf, 1987) and by
psychotherapists outside the analytic tradition (Wolfe, 1995). A self-concept or represen-
tation cannot act. Multiple self-states cannot act. As Meissner (2000) stated:
[S]elf representation is itself an action, a self-representing, of a subject-agent who does the
representing (i.e., the self-as-agent or subject). If we were to ask, who does the representing,
it cannot be the representing itself, but must be some other agency that performs the action of
representing. (p. 484)
Because Frie (2008) and Modell (2008), along with Meissner (2000) and Fonagy et al.
(2002), have made cogent arguments for the self as agent, I concentrate here on the
experiencing self.
The Experiencing Self
In psychology, James (1890), of course, distinguished the I or subjective self from the
me, or object of thought. Within psychology, Epstein (1973) was very inuential in his
articulation rst of the importance of the idea of the theory (or concept) of the self and
later (Epstein, 1991) in his distinction between the experiential self and the cognitive self
as two different ways of processing informationone emotional, the other rational. He
described the experiential self as a relatively crude system that automatically, rapidly,
effortlessly and efciently processes information, whereas the rational system is a
deliberative, effortful, abstract system that operates primarily in the medium of language
and that has a brief evolutionary history (1998, p. 105). Epstein (1994) then showed how
cognitiveexperiential self theory integrated psychodynamic and cognitive views of
unconscious processes, although his work does not appear to be cited frequently within
psychoanalytic literature. Similarly, Kahneman and Riis (2005) discussed both the expe-
riential self and the evaluative self in a chapter called Living, and Thinking About It:
Two Perspectives on Life.
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Rogers (1951) emphasized the experiencing self in his client-centered therapy, and
Gendlin (1981) continued this emphasis. The tradition was sustained in experiential
psychotherapy with Bohart (1993); Guidano (1991); Greenberg, Rice, and Elliot (1996);
and Fosha (2000). It has also been important in the Gestalt tradition (Perls, 1976). The
nonverbal way of processing has continued to be of importance to many of those working
in the interpersonal tradition, such as Schachtel (1959) and Singer (1974; Pope & Singer,
1978), and in the self psychology tradition within psychoanalysis (Beebe & Lachmann,
1994; Knoblauch, 2000; Lichtenberg, Lachmann, & Fosshage, 1992: Stern, 1985). Both of
these traditionsexperiential psychotherapies and self psychologyhave also empha-
sized the importance of conscious processing and empathy in the change process.
The relationship between mindfulness mediation and therapeutic processes has been
considered since the work of Suzuki, Fromm, and De Martino (1960) and dealt with
increasingly in recent years (Epstein, 1995; Langan, 2006; Safran, 2003). Mindfulness is
another concept related to experiencing in the present. In regard to psychological processes, the
literature on mindfulness differentiates two modes of mind: the sensoryperceptual and the
verbalconceptual, which is with labeling, elaborating, analyzing, judging, goal-setting plan-
ning, comparing, remembering and self-reecting aspects (Williams, 2010).
The effects of focusing attention on the experiencing process, as opposed to what is
thought about (noema or noemata in philosophical terms), is emphasized in Gendlins
(1981) focusing therapy, portions of Linehans dialectical behavior therapy Linehan,
(1993), and mindfulness training (e.g., Kabat-Zinn, Lipworth, & Burney, 1985), along
with what is called rst-person phenomenology training (Lutz & Thompson, 2003).
These practices cultivate the awareness of tacit, preverbal and prereective aspects of
subjective experiencewhich otherwise would remain simply lived through so that they
become subjectively accessible and describable, and thus available for intersubjective and
objective (biobehavioral) characterization (Lutz & Thompson, 2003, p. 37).
Farb et al. (2007) found that there are two networks of experience, rst a default
network, whereby memory is includeda narrative story line. For example, if you sit at
the edge of a dock, you might nd yourself thinking about what you would have for dinner
that night, the previous partner with whom you sat there, and so forth. There is another
way of experiencing called direct experience that refers to the information coming into
your senses in real timethe sun and breeze on your skin, the cool water on your toes,
and so forth. These circuits are independent. Damasio (1999) cited the character Winnie
in Samuel Becketts play Happy Days to describe this sort of direct experience. First,
Winnie wakes up.
Winnie opens her eyes to the audience and declares, Another heavenly day. On she goes,
like a morning sunrise, in a state that will permit her brain to form images of her surroundings:
her bag, her toothbrush, the rustlings of Willie, her body, which she tells us, does not have
much pain that day, hardly any. Wakefulness stops at the end of Winnies day . . . . When
wakefulness is removed, dream sleep aside, consciousness is removed. (p. 90)
The Experiencing Self and the Brain
A differentiation of an experiencing self from the concept of the self is consistent with
what we know about the brain. MacLean (1973) described the triune brain with three
relatively independent subsystems: the reptilian complex, the limbic system, and the
neocortex. Although his view may be too simplistic (Reiner, 1990), the reptilian and
limbic systems are more related to behavior and emotional processing, whereas the
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neocortex is related to meaningful thought. A number of cognitive scientists have
emphasized that this primitive self-consciousness is fundamentally linked to bodily
processes of life regulation, emotion, and affect (Damasio, 1999; Freeman, 2000; Pank-
sepp, 1998a, 1998b; Parvizi & Damasio, 2001; Watt, 1999). Neocortical processes
override, inhibit, and adjust more primitive reptilian ones.
Although I do not want to suggest that the experiencing self is limited to the right
hemisphere, Schore (2009a, 2009b, 2011) has argued at length that the right hemisphere
is more concerned with the analysis of direct information received from the body, and
Ramachandran and Rogers-Ramachandran (1996) has suggested that the cognitive style of
the right hemisphere shows a highly sensitive dependence to initial conditions and
perturbations, a fundamental property of chaotic systems. Increasingly, psychoanalysts
(cf. Davis, 2002; Ghent, 2002; Miller, 2004; Piers, 2000, 2005; Stolorow, 1997) have been
considering the sort of self-organizing processes suggested by nonlinear dynamic systems
theory. Pagels (1988) described self-organizing systems as systems that lower their degree
of disorganization by expelling disorganization into the environment (cf. Curtis, 1991).
These self-organizing processes, as Ramachandran and Rogers-Ramachandran have
stated, seem especially relevant to the experiencing self. There is not the space here to
expand on such processes in detail, but I shall try to explicate briey their relevance to the
experiencing self.
Prigogine (Prigogine & Strengers, 1984) won the Nobel Prize for his work showing
that living systems are open systems with a continuous exchange of energy with the
surrounds. Processes in the body, for example, are not simple and linear. A change in one
process creates changes in multiple systems. Under certain conditions, nonlinear systems
change in abrupt and sudden ways. A small perturbation can eventually lead to large
effects, sometimes referred to as the buttery principle. Also, systems can reach a
tipping point and then change drastically. Emotional states can change quickly like this
(Lewis & Granic, 2000). Damasio (1998) pointed out that spontaneous smiles or sobbing
are executed by brain structures located deep within the brain stem under the control of
the cingulate region where we have no means of exerting voluntary control.
The study of the relationship between subjective experience (phenomenal conscious-
ness) and neuroscience (Varela, 1996)now called neurophenomenologyis based on
the framework of complex dynamical systems theory (Freeman, 2001; Kelso, 1995;
Thompson & Varela, 2001; Varela, Lachaux, Rodriguez, & Martinerie, 2001). According
to this framework, the key variable for understanding the neural counterpart of subjective
experience is not at the level of specialized circuits but the emergence and change of
patterns of large-scale integration (Varela et al., 2001). A number of systems operate
separately and become synchronized at a moment of consciousness, or a unied cognitive
moment (p. 229). Thompson and Varela (2001), proposing that processes crucial for
consciousness cut across the brainbody world, attempted to map the neural substrates of
consciousness at the level of emergent and transient dynamical patterns of brain activity
rather than at the level of particular circuits or classes of neurons. They considered their
understanding of networks of nonlinear oscillators to be a paradigmatic example of
self-organization (p. 419).
Mindfulness meditation has been found to show changes in the brain by 8 weeks in
areas associated with attention and emotional integrationincreases in gray matter in the
hippocampus, the insula (a region related to perceiving bodily sensation), and the pre-
frontal cortext (Hlzel et al., 2011), and although there is greater reactivity in regions
associated with visceral and somatosensory processes, there is less depression in response
to sad lm clips (Farb et al., 2010). As Davidson (2010) has noted: The long-term
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consequences of most contemplative traditions include a transformation of trait affect.
After all, if change was not enduring and did not impact everyday life, it would be of little
utility (p. 10). Piers (2000) noted that the kinds of change we experience with individuals
in treatment more closely approximate those of nonlinear dynamic systems than models
of equilibrium-seeking dynamics (or of linear causeeffect models), and Harrison and
Tronick (2007) also recently described the interactions of analyst and patient in psycho-
analysis as resembling the changes described by nonlinear dynamic systems theory.
Two routes to the amygdala and emotional responses were differentiated by Le Doux
(1996)one fast, direct from sensory systems (sensory thalamus), and the other slower,
going through the sensory cortex. Fair (1992) also made a differentiation between cortical
and subcortical routes and stated that memories may be resistant to reactivation via the
usual cortical routes (p. 56). This differentiation helps us understand the experience of
traumatic responses. The work of Squire and Zola-Morgan (1991) showed that high-level
stimulation of the amygdala interfered with the functioning of the hippocampus and
inhibits cognitive evaluation and semantic representation. Processing by the hippocampus
is believed by most researchers to be necessary for conscious thought (Squire, 1987). In
posttraumatic stress disorders, memories are stored in somatic sensations and visual
images. Flashbacks and nightmares can be understood as eidetic memory disconnected
from context. Van der Kolk (1994) stated that when conscious control over limbic system
activity declines, as in sleep and under stress, sensorimotor, affective, and somatic
memories are activated without linguistic and symbolic organization. In ashbacks (Rauch
et al., 1996), activity decreases in Brocas area, which would be required to nd words
related to the experiences. These sorts of traumatic symptoms, along with many phobias,
are better explained by learning theory than by unconscious symbolic processes. It is
reasonable to assume that these reactions that do not involve symbolic processing benet
from therapeutic interventions other than free association and interpretation of uncon-
scious processes, including the sort of reconditioning that takes place with various forms
of relaxation training.
In summary, a focus on direct experiences, as opposed to only the meaning of
experiences, allows for many interventions beyond interpretation that approximate the sort
of psychoanalytic introspection Freud likely envisaged. This experiencing self has been
emphasized by those working in the experiential and mindfulness traditions, as well as
those working with patients suffering from trauma and phobias. Including a focus on the
experiencing self does not diminish the importance of the representations of self, others,
causality, and the meanings people make of their existence.
Elsewhere (Curtis, 2009) I have suggested that a metaphor for viewing the self
consistent with the notion of an experiencing, agental self in addition to the various
representations of the self is to think of a variation of Platos image of the charioteer and
horses. The charioteer might be thought of as the experiencing self and the horses as
various representations not always in syncactual, ideal, feared, and so forth To argue
fully for the utility of such a model would go beyond the scope of the present article,
however. Now I turn to the implications for therapeutic interaction of taking into account
the experiencing self, along with the representations of self with others.
The New Experiences and New Meanings of Experience Model of Change
Psychoanalysis has developed largely as a therapy to deal with the meaning system. For
example, George Klein described psychoanalysis as a psychology of meanings (1976,
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p. 54). Holt (1976) described Freuds work as dealing always and almost exclusively
with the pattern of meaning (p. 168). Gill (1976) thought of clinical psychoanalysis as a
pure psychology (p. 85) that deals with intentionality and meaning. Making meanings
was described by Fromm (1992) as the major activity of people. Therapeutic action was
described by Summers (2001) as the creation of meaning. Recently, Newirth (2004) noted
that there has been a change in focus in psychoanalysis from one of conict to the creation
of meaning. Friedman (2007), in commenting on a series of articles on therapeutic action,
described the manufacture of new meanings: one, a fostering of the patients raw
meanings into more thinkable form (p. 1646) and the other as sparking a kind of play
that automatically elaborates new meaning (p. 1646).
From the time Freud abandoned the seduction theory, psychoanalysis moved from a
theory based solidly in actual experiences to one that focused more exclusively on
fantasies and meanings of experiences. Freud, in a 1920 paper (not published until 1956),
asserted the view that traumatic symptoms from war stemmed from conict and repression
of the desire to ee the horrors of war. The German government relied on the theories of
Freud, prevalent in Germany, to claim that the posttraumatic symptoms of concentration
survivors were reactions related to child abuse and refused to pay reparations (Horowitz,
1999). Eitinger (1973) resolved the issue by nding that adult traumatization had caused
the reactions of 99% of Norwegian concentration camp survivors who suffered from
reactions after the war.
Ferenczi (1926, 1932/1985) treated patients who had experienced the reality of
seduction or abuse and wrote about such patients. One of these in his clinical diaries is
thought to be Clara Thompson, one of the founders of interpersonal psychoanalysis. The
tradition of regarding symptoms as often a consequence of real experiences has been
maintained in the interpersonalrelational traditions.
Sugarman (2006), on the other hand, stated [M]utative action occurs through helping
our patients attain or regain the symbolic level in regard to all mental functions (p. 965).
Friedman (2002) also questioned the reasons behind including experiences other than
interpretation. He stated that the purpose of our interactions should be to nd more
comprehensive ways of helping the patient nd a sense of himself and his world and trying
to focus the patients attention where it feels dangerous.
The positions of Atwood and Stolorow (1984), Friedman (2002), and Sugarman
(2006) may be the dominant position of many training psychoanalysts and analysts with
very well-functioning patients, but most psychoanalysts in the United States are seeing
many more patients in psychoanalytic psychotherapy than in psychoanalysis. Although
some psychoanalysts may want to conne their work to the psychology of meaning, our
models of the self and change need to acknowledge the experiencing self. Curtis (2009)
argued that our model of change in psychoanalytic psychotherapy has already evolved into
one that often focuses on new experiences and not simply new meanings of experience.
The interpretationinsight model of change, although possible in some circumstances, is
no longer the dominant one. Kohut (1971, 1977), perhaps more than anyone else in main-
stream psychoanalysis, moved the work to more of a focus on new experiences. This tendency
had long been occurring within interpersonal psychoanalysis. Interpersonalists have stated,
The patient needs an experience, not an explanation, a quotation usually attributed to Frieda
Fromm-Reichman (Kavanaugh, 1995). Ferenczi (1932/1985) thought that regression would
lead to benign, new experiences allowing for a new development of personality. Bion (1977),
Winnicott (1954/1978) and Guntrip (1969) continued in this tradition.
Stark (1999) categorized the theories of therapeutic action in psychoanalysis as models
of knowledge, relationship, and experience. A brief review of suggestions about what is
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therapeutic in psychoanalysis shows that most of these ideas fall under the rubric of new
experiences and do not require interpretation leading to insight. The relationship has been
suggested by many psychoanalysts such as Fairbairn (quoted in Guntrip, 1975), Ferenczi
(1926); Balint (1952), Thompson (1950), and Fonagy (1998). Although many theories
suggest insight into the relationship with the analyst, in his book, What Is Effective in
Psychoanalytic Therapy: The Move From Interpretation to Relation, Meissner (1991)
specically refers to the relationship with the analyst (p. 183). Freud, on one occasion
even commented, What turns the scale is not intellectual insight, but the relationship to
the doctor (1916/1963, p. 445). The following are other change mechanisms that have
been noted: new representations of self and others and reorganization of representational
schemas (Greenberg, 1995; Lichtenberg, Lachmann, & Fosshage, 1992; Loewald, 1960),
mourning lost objects (Fairbairn, 1952; Harris, 1996), increasing awareness of interper-
sonal relations (Sullivan, 1940: Thompson, 1953), identication with the analyst
(Menaker, 1991; Volkan, 1982), mutual recognition (Benjamin, 1990), the integration of
disconnected self-states (Bromberg, 1996), and, of course, empathy (Kohut, 1977; Lich-
tenberg et al., 1992).
Loewalds (1960) view of therapeutic action is one where The analytic process
consists . . . in certain integrative experiences between patient and analyst as the founda-
tion for the internalized version of such experiences (p. 25). Levenson (1972) believed
that, in contemporary theories, change occurs from new experience and the awareness of
interpersonal entanglements. Gill (1984) wrote, [I]n prevailing theory the role of new
experience in bringing about change is understated (p. 172). By 1994, he wrote,
[S]ometimes a directive, a piece of advice, a suggestion about how to behave in a difcult
situation may seem desirable to break an impasse or an obsessional vicious circle (p. 57).
Aron (1996) stated,
[W]hile insight and interpretation (verbal symbolization) continue to be valuable for relational
analyst, they do not retain the centrality they have for classical Freudian and Kleinian authors
. . . . Relational analysts generally believe that what is more important is that the patients have
a new experience rooted in a new relationship. (p. 214)
Aron continued further, saying that it is hoped that patient and analyst construct new
ways of being with each other. This is what is critical and ultimately leads to change (p.
214). This approach includes actual experiences as a precursor to difculties and expands
psychoanalysis from solely the interpretation of unconscious meanings and even the
creation of new meanings to the creation of new ways of being. Wallerstein (1995)
dedicated two chapters of his book to new experiences, mostly on new experiences in
relationships as conceived by Stone (1954), Loewald (1960), and later theorists.
Implications for Therapeutic Interventions
A model of self that takes into account the experiential self apart from the symbolic self
allows for consideration of change processes that are not symbolized. Psychoanalysts have
in recent years focused more on experiences that are never necessarily made conscious
(Lyons-Ruth, 1998; Tronick, 1998), the role of the body (Aron & Anderson, 1998;
McDougall, 1989) and somatosensory processes (Leuzinger-Bohleber & Pfeifer, 2002).
As subjective and intersubjective experiences are discussed more, the model of the self
and change should acknowledge explicitly the nonsymbolic aspects of self along with the
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symbolic. Whether psychoanalysts want to deal with these aspects of self in their
treatments is another matter.
Acknowledgement of the experiential self leads to some important but simple addi-
tions to technique for those conducting psychoanalytic psychotherapy. Psychoanalysts
have recognized the value of the here and now in the analysis of transference and
defense but the power of the here and now can be approached in other ways (e.g., in
working with dreams; and in encouraging greater attention to sensory information, to
some ignored aspects of language, and to the body).
One advantage of including new experiences as an important element in the thera-
peutic action is that analysts can get away from the intellectualization of free associations
in dream interpretations and ask patients to imagine being the various characters and
objects in dreams by actually saying, for example, I am the murderer. To do so creates
a new way of being and allows patients to connect disconnected self-states. It circumvents
the defense of the patient saying, I dont feel this way, because the patient is instructed
to imagine being someone else who feels this way. People then own disconnected
potential ways of being, an experience not required when someone says, it reminds me
of . . . . My experience with this technique is that it results in a much more powerful
change than does patients simply talking about dreams. For example, after feeling like
a murderer, one very sweet woman found a new voice in singing. Another patient was
abusing cocaine, exercising compulsively, underemployed, and engaging in various dan-
gerous actions. After mentioning the devil inside her, I asked her to be the devil. She
would not do so in the session, saying it was too scary, but went home and spent a great
deal of time being the devil, writing a long poem as the devil. Her behavior improved
abruptly after this experience, which she saw as a change point in her treatment.
Hopenwasser (1998) asked a patient to become the crack-using part of her personality. She
immediately went into a trance and swiftly developed rhinorrhea, lacrimation, pilomore
activity on her arms (gooseesh) and diaphoresis (Hopenwasser, 1998, p. 224). Within
minutes of switching back into other parts of herself, the physical symptoms stopped.
Experiential therapists (those in the person-centered and Gestalt traditions) have
emphasized the value of encouraging patients to speak in the present tense. When people
are connected to emotional experiences, they switch to the present tense: I was standing
in the deli and then this guy in a black jacket comes in. He points a gun at me and says,
Get out! Safran and Segal (1990) suggested to patients, Be there now. When people are
in the present moment, they are able to feel the sensations connected with the experi-
ences more easily. Inquiry about the sensory aspect of a situationwhat is seen, heard,
felt tactilely, smelled, and tastedoften leads to memories that had not been recalled with
fewer cues. Stanislavski (1989/2003) and Strasberg (1991) used this technique to help
actors have an affective experience on stage and communicate it to the audience. They
must feel the sunshine or the rain, the mud or the grass. Bucci (1997) described several
characteristics of speech that are high in connection between the sensory and symbolic
systemsconcreteness, specicity, clarity, and imagery. Therapists oriented specically
to affect (Fosha, 2000) often ask, Where in your body do you feel that? Ferenczi, calling
his technique analysis from below in 1919, tried to get at the bodily and muscular
expression of his patients (cited in Lowen, 1971).
Sensory experiences are connected directly to physiological responses (Foa & Kozak,
1986), but language that helps access such experiences, imagination, bodily postures, and
movements further improves patients recall of emotional memories and may affect
emotional regulation directly. One patient described her physical abuse of having to kneel
on a cheese grater with a straight back and balancing a book on her head with no emotion.
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She then spontaneously asked the therapist if she wanted to see how she kneeled. When
she did so, she showed emotion over the abuse for the rst time, exclaiming, I cant
believe I did that, but I had no choicemy body just took me there.
Focus on the experiencing self suggests more use of visual imagery. Lang (1985)
demonstrated that imagining material produces a strong physiological response, whereas
verbally articulating the same material produces little physiological response. Ferenczi
(1985) inquired what sort of image was occurring when various sorts of movements were
taking place, and Jung (1916) suggested concentrating on inner pictures. A number of
therapies in Europe, Africa, and Asia have even used the directed daydream (Desoille,
1945) and guided imagery (Edwards, 2001; Leuner, 1975). More active methods than free
association to access affect were also advocated by Fromm (1955):
Now concentrate on the picture of your father, and tell me what is the rst thing that comes
to your mind . . . or, Visualize your father now, and tell me what is on your mind. There
seems to be only a slight difference in wording. However, there is a very great difference in
the effect (p. 3).
Balint (cited in Ahsen, 1977) found Ahsens results on eidetic therapy so remarkable
that they are difcult to accept (p. 15) on the basis of one book. Ahsen (1973), Reyher
(1963), and Horowitz (1970) all thought that images evoked less defensiveness and
worked because people have not learned to censor them to the same degree. During
systematic desensitization, the critical factor turned out to be the imagery used, not the
hierarchy, as found by Singer (1974), an interpersonal psychoanalyst who has conducted
extensive work on the effect of visual images. Horowitz (1978) described interventions
involving images that can be used instead of interpretive interventions, which can often
make patients feel defensive. Bosnak (2003) presented the way he encourages patients to
discuss their images in dreams; for example, telling a woman who said that shaking in
front of a wave would end her consciousness to go inside the shaking. All of these
interventions are ways of accessing the experiencing self.
In summary, I have argued that our image of the self should include the experiencing,
sensing, agental self as well as the representations of the self and suggested that the
implication of this view of the self offers a model of therapeutic action that includes new
experiences as well as new meanings of experiences. This model suggests some additions
to technique that psychoanalysts might use. This model of the self and change presents a
view consistent with research in mainstream socialcognitive neuroscience and allows us
to connect with the broader eld of psychology.
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