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Commentary by Stephen E. Levick (Philadelphia)

Stephen E. Levick

Philadelphia
Published online: 09 Jan 2014.

To cite this article: Stephen E. Levick (2002) Commentary by Stephen E. Levick (Philadelphia), Neuropsychoanalysis: An
Interdisciplinary Journal for Psychoanalysis and the Neurosciences, 4:1, 106-110, DOI: 10.1080/15294145.2002.10773384
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Stephen E. Levick
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Commentary by Stephen E. Levick (Philadelphia)

Introduction
Reading Jason Brown's reections on microgenetic theory reminded me of my rst indelible
encounter with Mind, Brain and Consciousness
(1977), over twenty years ago. Microgenetic
theory still strikes me as full of promise for
helping to understand psychological phenomena,
including what happens in psychotherapy, as
manifestation of brain process. As a paradigm
considered alien by the mainstream, it is not
surprising that its promise has not yet been
fullled, but does microgenetic theory bear some
responsibility for this state of aairs? As a clinical
psychiatrist, I nd microgenetic theory consistent
with clinical experience. As a psychoanalytically
oriented psychotherapist, I also conceive of myself
as a kind of microgenetic facilitator for the patient.
Furthermore, I think of psychiatric medications as
modulating the neural milieu from which the
microgenetic process unfolds. Microgenetic theory has become part of my personal clinical
philosophy, and not that this is unimportant,
but is there more to recommend it than this?
The Appeal of a Theory
A theory can hold appeal on several levels. On the

aesthetic level, I remain enamored. However, if

you ask me to be the art critic, I feel that my
words are inadequate to explain why the theory is
beautiful, and my conviction that it must, at a
minimum contain a deep core of truth. Whether a
theory is true ought to be a separate question
from whether it is beautiful. Beauty is in the eye
of the creator, and if the creator gets is ``right,'' in
the eyes of some but not all beholders. Truth, on
the other hand, should be discernable by unbiased
rationality, assisted by empirical investigation
suggested by the theory to test it. In the end,
theories are either disproved by results or the
results are found not to be inconsistent with the
theory. Theories cannot be proven to be true.
A theory can be useful experimentally if it
suggests lines of investigation, maintaining a
humility that it is not the nal word on how
things may work, only that they may work
something like it suggests.
A theory can be useful clinically if it suggests
ways of understanding signs and symptoms, and
the treatment process. Understanding as explanation encompasses everything from a coherent, not
necessarily theory-based narrative to a consistent
and comprehensive theoretical system. More stringent tests of how well we understand something is

Commentary on Jason Brown's Microgenetic Theory

whether that understanding can lead us to make
predictions, and whether it can guide, shape, or
enhance the eectiveness of clinically eective
interventions, and possibly suggest entirely new
ones. Whatever Dr. Brown may think of them,
the conceptions of inter- and intra-hemispheric
modularity have helped to suggest much research
yielding ndings not inconsistent with that conceptualization. This does not mean that that view
is more valid than the microgenetic one, but those
conceptions seem to be an easier place from which
to generate testable hypotheses.

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An Analogy to Physics
The rst physics we are taught is Newtonian
physics. Then we are told that it is wrong, well not
exactly. It's very useful in understanding and
predicting what happens in systems at relative
states of rest compared to those moving at very
high velocities or of very great mass. Relativistic
physics on the other hand, applies in these as well
as to velocities and masses outside the bounds of
our normal human experience. Critical is the
relativistic expression, where v is velocity with
respect to an observer, and c is the speed of light.
Used appropriately, as multiplier or divisor in
measurements of time, distance, mass, and related
phenomena, it adjusts our conventional Newtonian view to otherwise incomprehensible realms
(Carr and Weidner, 1971). Despite it limitations,
no one suggests that Newtonian physics be
discarded. It's easier to use, and within its
appropriate realm highly predictive and helpful.
Perhaps just as importantly, it's easier to get one's
mind around.
I would like to suggest an analogy between
the now conventional, functiono-anatomical cognitively modular approach and Newtonian physics, and between microgenetic theory and
relativistic physics. The challenge for microgenesis
is to show where and how the more conventional
approach breaks down, and also to account better
than it for certain phenomena outside the ones
the more conventional theory appears to be
reasonably adequate at explaining. These tend
to be experimental demonstrations of decits in
function that may co-occur with symptoms.
What psychological conditions and phenomena do I consider analogous to such ``relativistic''
conditions? Relativistic physics nds its greatest
application at and close to the birth of the
universe, and at places in the universe where
there are traumatic ruptures in its fabric. By
analogy, I believe microgenesis will come to be of
greatest value in understanding the birth of the

107
individual human mind, and the processing of
and response to overwhelming psychic trauma.
Microgenetic Theory ought to be able to
enrich Infant Psychology and an understanding
of disorders of the Self Microgenetic neuropsychological theory, while it draws on neurological
morphogenesis, phylogeny, and ontogenesis, requires a developmental perspective starting in
infancy. Nothing less than a microgenetic interpersonal psychology, derived from the earliest
interactions of mother and child is needed, when
the mother and child are as one, the child
experiencing the mother, and the mother making
herself available as a ``selfobject'' (Kohut, 1977).
Without this connection, which precedes a sense
of separateness, the person may develop what
Winnicott called a ``false self'' (Davis and Wallbridge, 1981) and be unable to connect vitally and
empathically to others, much less to themselves.
The child's caretakers continue to need to
empathically create space and safety for the
natural emergence of the child's self to occur,
and not overly impose their own selves.
Failures in the process of psychological birth
and early development are represented by the
classic disorders of self, pathological narcissism
and Borderline Personality Disorder. Microgenetic
theory ought to prove superior to the functionoanatomical cognitively modular approach in contributing to understanding the mind/brain process
in people with these disorders.
Moment-to-moment experiences in psychotherapy could be examined from this perspective,
incorporating Mardi Horwitz's (1987) ``states of
mind.'' Transference enactments and countertransference inclinations in psychotherapy could
become data. This added microgenetic perspective
should inform events in psychotherapy relatable
to Mahler's stages of human psychological birth
especially the critical separation-individuation
sub-phase (Mahler, 1975). Kohut's self-psychology (1977) and Kernberg's (1980) object relations
clinical theories and therapeutic approaches may
be looked at afresh from the kind of process
perspective microgenetic theory aords. It would
be a worthwhile challenge to apply EEG mapping
and functional neuroimaging techniques to such
an eort.
Microgenetic Theory and Severe Psychic Trauma
Metaphorically, psychic trauma is a ``black hole''
for the victim (Van der Kolk and McFarlane,
1996). Just as relativistic physics is indispensable
in describing the birth of the universe, it is
essential to accounting for traumatic ruptures in

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108
its fabric, such as black holes. I believe the
counterpart in the history of a person's psychological universe is the mind/brain response to
overwhelming traumatic events. What does it
mean microgenetically to be ``overwhelmed''?
Can microgenetic theory account for the consequences of psychic trauma as manifested in
trauma-related and dissociative disorders? I am
referring specically to Acute and Post-traumatic
Stress Disorders, and to the full range of
Dissociative Disorders, up to and including
Dissociative Identity Disorder (Multiple Personality Disorder in the older nomenclature). In these
disorders, there are striking discontinuities in the
experience and sense of time and self, the
dissociation of dierent aspects of experience
behavior, aect, sensation, and present and
memorial knowledge. Working with such patients,
one is forced to become a cognitivist, or at least
cognitive therapist some of time to help the
patient contain within partially disconnected
modules what would otherwise be overwhelming.
Generally in psychotherapy, empathic and accurate statements, clarications and interpretation
facilitate the emergence of insight. While I believe
the psychoanalytically oriented therapist serves as
microgenetic facilitator, with these patients, the
therapist often must also forestall or try to
prevent such emergences. Not everything is ready
to ``come out.'' It does no good for the patient to
be overwhelmed. It turns out to be safest to break
things down into small temporal chunks. In
addition, helping the patient to focus on only
one modular aspect of the experience at a time,
employing the ``BASK'' model of dissociation to
help the patient to focus on only the behavior,
aect, sensation, and knowledge of the traumatic
experience can be quite helpful (Braun, 1988).
Many clinicians nd it useful in treatment to
employ the eye movement desensitization response, pioneered by Francine Shapiro (1995). A
functiono-anatomic theoretical approach naturally
leads to the supposition that interhemispheric
connectivity is important to the mechanism of
action of the technique, given that directed rapid
back and forth lateral gaze shifts are a key feature
of it. More recently, drawing in part on my
research (Levick et al., 1993), Frederic Schier
has described a lateralization technique in psychotherapy (1998) with potential application to
dissociative disorders (2000). Can microgenesis
account better than a cognitivist/modular understanding for the ``relativistic'' conditions and
phenomena of the results of severe psychic
trauma? If microgenesis occurs on a neurologically distributed continuous wavefront, is the
microgenesis of dissociative experience dierent,

Stephen E. Levick
and in what way? How do multiple emergences
occur within the same mind, or rather, how does
one more than another ``self'' exist or coexist
within the same brain? Might the ``ego states''
that comprise dierent personalities in Dissociative Identity Disorder be akin to standing waves,
rapidly emerging and dissipating, only to reemerge in response to the right environmental
``trigger?''
Trauma and Empathy
A recent story in the New York Times gave follow
up regarding a woman who had been viciously
and intentionally disgured. More traumatic, she
writes, was the trauma of the trial of her
attackers, in which she was treated as if she were
the accused. This account pointed up to me again,
what I nd over and over with my traumatized
patients. The trauma was bad enough, but often
worse was empathic failure by those who should
have detected it and responded to it. As bad as
being disbelieved, is being believed, but without
compassion or understanding. Worse yet, is being
believed yet somehow blamed for having been a
victim. The ranges of these unempathic responses
compound the trauma many fold, and turn it into
evidence for the patient that they are without
value and meaning. The greatest trauma is
empathic failure. Empathy, important in any
psychotherapy is most critical in treating disorders resulting from overwhelming psychic
trauma. Empathy towards the patient and encouraging empathy of the patients towards herself
is essential. According to Richard Kluft (2002)
``Dissociation is a form of psychopathology that
dissolves in empathy.''
What Leonard Shengold calls ``soul murder''
(1989) captures the extremes of empathic failure
going beyond trauma to discounting the other
as a separate self. People, who have been treated
in this way, appear to have minds most like that
postulated by the adherents of cognitive modularity. Does that mean the mind naturally
functions as these theorists say? Or, is it evidence
of pathologyexceptions to normal brain/mind
function that become the norm in response to
severe psychic trauma? Does a murdered self take
refuge in cognitive modularity? Is it a natural
alternative to normal mind/brain function imposed as a survival mechanism when a person is
severely overwhelmed by severe trauma and
thoroughly discounted as a person? In any event,
we certainly know from our patients that the
extreme cognitive modularity we see in Posttraumatic Stress and Dissociative Disorders,

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Commentary on Jason Brown's Microgenetic Theory

though at rst adaptive, is not terribly ecient.
And, when it persists well beyond the trauma
eventually becomes quite maladaptive Is normal
neuropsychological modularity being pushed to
the limit for the purpose of psychic survival? Or,
are highly individual pseudoneuropsychological
systems, not unlike the more obviously neurologically incompatible symptoms of the hysterics
of Freud's and Breurer's time, giving an almost
caricatured appearance of cognitivist modules? I
believe that microgenesis could be compatible
with either view, though I suspect Dr. Brown
would see the latter as most consistent with
microgenesis.
The functiono-anatomical cognitively modular understanding of mind/brain function might
be subsumable within microgenesis, a supercial
reection of the continuous microgenetic ``wave''
that Dr. Brown describes. However, it would
reect an aspect of that wave process best for a
system at a state of relative ``rest,'' and might, in
an exaggerated way, appear to reect it in one
desperately seeking such a state in response to
overwhelming psychic trauma. If the mind at and
near its birth and in the processing of overwhelming psychic trauma is akin to the universe
at its birth and in other extraordinary states of
high velocity, then a less ``Newtonian'' approach
than the cognitively modular would be required
to understand them. In my view, a ``relativistic''
approach, may prove more suitablea better
specied microgenesis, or derivation.
Dr. Brown tells us he's venturing into the
moral consequences of thought, but in doing so I
hope he will linger on the implications inherent in
the fact that morality beyond rules, fear of
punishment, and guilta deep morality, must
be predicated on empathy. I hope that he and
others developing microgenetic theory will examine the role of empathy in the development of the
self and its disorders, and in the consequences of
serious empathic breaches and betrayals in the
context of psychic trauma and dissociation.
On aesthetic and philosophical grounds, I
expect that the functiono-anatomical cognitively
modular conceptualization, while clinically useful
in thinking about the consequences of psychic
trauma, will be demonstrated to provide, at best,
limited approximations of psychic-trauma related
mind/brain process.
In my clinical experience, it only seems ``as
if'' some things are modular, or at least,
modularity only goes so far. A deep connection
seems always to emerge. I hope microgenetic
theory can guide us to a better accounting of what
is happening as brain/mind process with these
traumatized patients.

109
Conclusions
Microgenetic theory needs to nd a language for
mind/brain process analogous to that of relativistic physics' language for the universe. The
equations of relativistic physics are not the
shorter, simpler, more easily grasped ones of
conventional Newtonian physics. Likewise, a
more specied language of microgenesis would
probably never be as easy to grasp as that of the
now conventional functiono-anatomical cognitively neuromodular approach. However, a
microgenetic language would apply to the entire
universe of mind/brain process, including conditions where the conventional approach is
inadequate.
I hope that microgenetic theory will incorporate and be incorporated by extant theories in
infant psychology, self-psychology and object
relations, and trauma and dissociation. I believe
microgenetic theory has the potential to enrich
and unify our understanding of the normal
phenomena of human psychological birth and
early psychological development and disorders of
self resulting from failures in empathic parenting.
It might also help to illuminate those disorders
resulting from the traumatic overwhelming of the
self. If microgenetic theory contributes to better
understanding these phenomena, it will also be
better understood. With this can come greater
clinically utility and scientic testability for the
theory.
Doubtless, Dr. Brown's creativity, vision and
courage will take him and many of us to
unexpected places in the future. While I am eager
to read his philosophical explorations, microgenetic theory should not be content to conne itself
to philosophy. It should also strive to make itself
a theory that can explain, and also predict clinical
phenomena, as well as suggest clinically eective
interventions. When its language is more fully
specied, microgenetic theory also ought to
suggest meaningful psychological and neuropsychological studies that could not have been
derived from the cognitively modular perspective.
Dr. Brown contends that the duration of the
subjective is important to his theory, and is an
obvious area for empirical investigation. We
might ask if there is a microgenetic analog to
the universal constant most relevant to timec,
the speed of light? Certainly, the subjective
experiences of greatly slowed time in crisis, slower
time in youth, and missing time in dissociative
disorders suggest that subjective temporality is an
essential area of research for microgenesis.
Moving beyond the phenomenological and
psychological account (van der Hart, 1997) to

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110
empirical psychological study of subjective temporality in relationship to trauma and empathy
might be promising in this regard.
If further theoretical specication enabling
scientic testing shows special value for microgenetic theory, it will come to coexist securely
with the functiono-anatomical cognitively modular conceptualization, but it will more than
coexist. Just as relativistic physics not only
coexists with, but also subsumes Newtonian
physics, microgenetic theory will be understood
to practically subsume, and theoretically supercede functiono-anatomical cognitively modular
conceptions. Only then, will those not intuitively
sensing the validity of microgenesis be convinced
that though it is harder to grasp, understanding
mind/brain process without it would be like trying
to do physics on the extraordinary without the
expression.
References
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dilation and space contraction; and Ch. 22,
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Davis, M., & Wallbridge, D. (1981), Boundary and
Space: An Introduction to the Work of D. W.

Maria Pachalska
Winnicott. New York: Brunner-Mazel.
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McFarlane. New York: Guilford, pp. 323.

The microgenetic revolution: reflections on a recent essay by Jason Brown

Commentary by Maria Pachalska (Poland)

The Crisis in the Neurosciences

It has become rather a commonplace to speak of
an ``explosion'' of knowledge about the human
brain over the last 2030 years, and in particular
over the last decade. This is a peculiar metaphor,
no less peculiar for being common. Explosions in
the literal, physical sense result from the sudden
and extremely rapid expansion of a gas, producing a burst of energy released in the form of both
heat and light. If uncontained and uncontrolled,
explosions are primarily a cause of destruction,

Maria Pachalska, Department of Medical Rehabilitation,

Cracow Rehabilitation Center, Cracow, Poland.

leaving the surroundings in ruins, while that

which explodes ipso facto ceases to exist. These
general observations hold true even for metaphorical explosions, which wreak havoc in our
mental world, though often we cannot see the
destruction and go on about our business as
though nothing had changed.
The explosion of new information about
certain aspects of brain functioning is no exception to this rule. It has indeed destroyed or
seriously undermined our condence in what we
thought we knew on that subject, for certain, not
so very long ago, though many of us give no
outward indication that we are aware of this
painful fact. Nor would it be reasonable to expect
that this metaphorical explosion will produce in