Core Competencies of Relational Psychoanalysis

 

Excerpted from Barsness, R.E. (Ed.) (2017). Core Competencies of Relational Psychoanalysis: A Guide to Practice, Study and Research (Relational Perspectives Book Series). New York: Routledge.

 

  1. Therapeutic Intent

 

1.1. An analytic treatment is first established by a clear understanding of the intent or purpose of the analytic endeavor.

1.1.1. Increased capacity to experience and manage multiple affective states and to enjoy the full range of emotion

1.1.2. Increased access to multiple aspects of the self without shame

1.1.3. Ability to comfort and soothe oneself and to be self-reflective

1.1.4. Ability to accept responsibility

1.1.5. Ability to tolerate ambiguity and uncertainty

1.1.6. Ability to be more truthful with oneself

1.1.7. Ability to think more creatively and openly about one’s past rather than to continue to repeat it

1.1.8. Relief from internal constraints and rigidities that have become problematic

1.1.9. A more imaginative and creative mind

1.1.10. Increased capacity to love and to work; self-efficacy

1.1.11. To engage in more meaningful and redemptive relationships

1.112. Hope

 

  1. Therapeutic Stance/Attitude

 

2.1. Relational psychoanalysis was born out of radical critique of the authoritarian stance.

2.1.1. Radical open-mindedness

2.1.2. Collaborative authority

2.1.3. Relentless curiosity of patient/self/interplay of the two

2.1.4. Emotional risk-taking

2.1.5. Exploration

2.1.6. What happened and what is happening

2.1.7. Follow the patient’s lead by attending to the patient’s affects and thoughts

 

  1. Deep Listening/Attunement

 

3.1. The relational analyst seeks to be highly attuned and self-reflective.

3.1.1. Deep attention to affect states

3.1.2. Looks within him/herself to discover what is happening within the patient

3.1.3. Attends to the effect of his/her own personality

3.1.4. Attends to countertransference experiences as a means for understanding the patient

 

3.2. The relational analyst follows affective experiences both within him/herself, his/her patient, and in the relationship between the patient and him/herself.

3.2.1. What is the patient triggering in the analyst–who, how, what, and why?

3.2.2. Where is the affect?

3.2.3. What is the patient trying to protect or avoid?

 

3.3. Intuition

3.3.1. Attends to “inklings” or having a “sense” of something

3.3.2. Encourages his/her own mind to free-associate, wondering what his/her thoughts and affects have to do with the patient

3.3.3. Attends to the uncanny with a curiosity as to what this may be saying about the unconscious

 

3.4. The analyst listens beyond content and pays close attention to the words, the affects, and the bodies of his/her patients.

3.4.1. Where is this happening in their/my body?

3.4.2. What is happening in the “us”?

 

3.5. The analyst is interested in all emotion, with particular attention to those emotions the patient and the therapist seek to avoid.

3.5.1. Cannot ignore hate

3.5.2. Cannot ignore love

 

  1. Relational Dynamic: The There and Then and the Here and Now

 

4.1. Attend to past experiences, the “there and then,” played out in the present.

4.1.1. Early attachment

4.1.2. Developmental history

4.1.3. Defensive structures in both patient and analyst

4.1.4. Projection in both patient and therapist

4.1.5. Replication

4.1.6. Relational style

4.1.7. Transference/Countertransference

4.1.8. Culture

4.1.9. Trauma

 

4.2. Attend to the relational dynamic in the “here and now.”

4.2.1. Engage the patient in direct relationship with the analyst, believing that the most powerful work is what emerges between the analytic dyad.

4.2.2. Attend to what happened in the past is happening in the therapeutic dyad

4.2.3. Pursues the question of what is going on in the in-between

4.2.4. Attends to how the analytic dyad is impacting and influencing one another

4.2.5. Encourages the patient to be curious about the analyst

4.2.6. Attempts to avoid the temptation to “solve”

 

  1. Patterning and Linking

 

5.1. Listen for recurring themes and patterns and within the analytic dyad.

5.1.1. Shifts and patterns

5.1.2. Roles that are being assigned and played out

5.1.3. Matches and mismatches

5.1.4. Thoughts and affects

5.1.5. Bodily experiences

 

  1. Repetition and Working Through

 

6.1. As deep change occurs at the emotional level, the analyst attends to the inevitable conflicts that emerge in the relational dyad.

6.1.1. Works through enactments

6.1.2. Holds to the view of the necessity of destruction, survival and recognition

6.1.3. Rupture and repair is inherent in any authentic relationship, and leads to change

 

  1. Courageous Speech/Disciplined Spontaneity

 

7.1. The analyst holds to the notion that the patient needs to hear what is on the therapist’s mind and how the therapist experiences the patient.

7.1.1. Says out loud what he/she is thinking about and experiencing

7.1.2. Adheres to the ethic of honesty, both within the patient and within him/herself

7.1.3. Resists the urge for self-protection

7.1.4. The patient “knows” at some level the mind of the therapist, and thus it needs to be spoken

7.1.5. Clarity emerges from honest speech

7.1.6. Timing of speaking is adhered to by attending to what is happening in the moment

7.1.7. The general principle is to disclose, and then follow the patient’s response

7.1.8. Must regulate his/her own shame, as it limits full involvement

7.1.9. Offers his/her ideas from a non-authoritarian stance, with tentativeness, curiosity and humility

7.1.10. Attends to how his/her interventions/words expand, clarify, and deepen the patient’s experience

7.1.11. Needs to achieve an odd combination of restraint with being courageous

7.1.12. Shows emotions without being self-referential, and maintains the focus on the patient

7.1.13. Considers his/her own motivations for action and how this is relevant to the patient

7.1.14. Formulates thought and affect dialogically, and is open to the negotiation of ideas and affects

7.1.15. The goal in speaking boldly is to provide an authentic interaction

7.1.16. Is careful not to fill up space with his/her own needs or cleverness, but to keep the space open toward an understanding of the patient through the analyst’s experience of the patient

7.1.17. Interpretation is only helpful to understand and consolidate what has happened experientially

7.1.18. Works the transference, rather than interpreting it

 

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