The Forward Edge, Connectedness, and the Therapeutic Process

Abstract

Marian Tolpin proposed an expanded theoretical framework for treating self-disorders—a framework than emphasized resuscitating thwarted normal development rather than healing pathology. This article suggests that the change in emphasis from pathology to health in the context of a connectedness sensibility encompasses important changes in how we listen and respond to our patients. Using a verbatim interview, the article discusses how a forward edge–connectedness listening perspective impacts empathic responsiveness, engaging the thread around which selfobject transferences evolve, and interpreting from within the patient's subjective world. The article illustrates how a connectedness listening perspective and responsiveness facilitates the emergence of tendrils of health, and it elucidates how, in most treatments, analyzing the forward edge of transference obviates the need to address the trailing edge.

Marian Tolpin propose un'espansione del sistema teorico per il trattamento dei disturbi del Sé, un sistema che enfatizzò per riportare l'attenzione sugli ostacoli al normale sviluppo piuttosto che concentrarsi sulla cura della patologia. Questo articolo suggerisce che nel contesto di una sensibilità relazionale lo spostamento dell'attenzione dalla patologia alla salute include importanti cambiamenti nel modo con cui ascoltiamo e rispondiamo ai nostri pazienti. Facendo ricorso a un'intervista estremamente fedele, il lavoro esamina come una prospettiva di ascolto relazionale che si sporge verso il limite abbia importanti conseguenze sulla responsività empatica, sull'ingaggiarsi con la direzione intorno a cui si sviluppano i transfert di oggetto-Sé e sul sostenere un'attività interpretativa dall'interno del mondo soggettivo del paziente. Il lavoro prima illustra come una prospettiva radicata in un ascolto relazionale faciliti l'emergere di filamenti di salute, per spiegare poi come, nella maggior parte dei trattamenti, l'analisi dei confini liminari del transfert prevenga il bisogno di orientarsi verso i bordi di fuga.

Marian Tolpin a proposé un cadre théorique élargi pour le traitement des désordres du soi, un cadre qui met l'accent sur la réactivation du développement normal plutôt que sur la guérison de la pathologie. Cet article suggère que le changement d'accent mis sur la pathologie vers la santé, dans le contexte d'une sensibilité à la connectivité, entraîne d'importants changements dans notre manière d'écouter et de répondre à nos patients. En utilisant le mot à mot d'une séance, cet article discute comment une perspective d'écoute de l'angle d'avancée (forward edge)/connectivité peut avoir un impact sur la réponse empathique, en dégageant le fil autour duquel le transfert objetsoi se développe, et en interprétant à partir de l'intérieur du monde subjectif du patient. Cet article illustre comment une perspective d'écoute et de réponse de connectivité facilite l'émergence des jeunes pousses de santé, et éclaircit comment, dans la plupart des traitements, l'analyse de l'angle d'avancée (forward edge) dans le transfert évite le besoin de mettre l'accent sur l'angle de fuite (trailing edge).

Marian Tolpin schlug einen erweiterten theoretischen Rahmen für die Behandlung von Persönlichkeitsstörungen vor. Ein Rahmen, der die Wiederbelebung behinderter normaler Entwicklung gegenüber der Heilung von Pathologie hervorhebt. Diese Arbeit weist darauf hin, dass der Wechsel in der Gewichtung von der Pathologie hin zur Gesundheit im Kontext einer Sensibilität der Verbundenheit wichtige Änderungen in der Art, wie wir unseren Patienten zuhören und wie wir ihnen antworten, einschließt. Anhand eines Verbatim-Interviews diskutiert die Arbeit, wie eine forward edge- Perpektive des Zuhörens in Verbundenheit die empathische Responsivität beeinflusst. Und zwar indem sie sich am Auftauchen der jeweiligen Selbstobjekt-übertragung orientiert und aus der subjektiven Welt des Patienten heraus interpretiert wird. Die Arbeit macht anschaulich, in welcher Weise Zuhören und Antworten in Verbundenheit das Auftauchen jener kleinen Ansätze (tendrils) von Gesundheit fördert und sie macht auch klar, wie in den meisten Behandlungen die Analyse der zur Gesundheit hin strebenden Tendenzen der Übertragung die Notwendigkeit, die trailing edge Tendenzen anzusprechen, überflüssig macht.

Marian Tolpin propuso y desarrolló un marco teórico para tratar los trastornos del self, un marco que enfatizaba el resucitar un desarrollo normal que había sido frustrado en lugar de la cura de la psicopatología. Este artículo sugiere que el cambio de énfasis desde la patología hacia la salud en el contexto de la sensibilidad para conectar implica un importante cambio en nuestra manera de escuchar o responder a nuestros pacientes. Utilizando el material transcrito textualmente, este artículo discute como el tipo de escucha centrada en la perspectiva del “movimiento hacia delante” impactará en el tipo de respuesta, entrando así en el campo en el que las transferencias de “selfobject” se desarrollan, e interpretando desde dentro del mundo subjetivo del paciente. Este artículo muestra como la escucha y las respuestas centradas en la conexión facilita la emergencia de brotes de salud, y elucida como, en la mayoría de tratamientos, analiza el “movimiento hacia delante” de la transferencia hace innecesario abordar el “movimiento hacia atrás”.

Keywords:

• connectedness
• empathy
• forward edge
• selfobject transference
• trailing edge

Notes

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¹Before her untimely death, Marian Tolpin (personal communication, November, 2007) told me she believed the idea of connectedness captured for her the clinical implications of her forward edge transference. She encouraged the further delineation of how connectedness facilitates the emergence of healthy transference, and this article is an initial attempt to pursue her suggestion.

² M. Tolpin (2002a) stated that “analysis of the forward edge of transference is as important, at the very least, as analyzing revived trailing edge pathology” (p. 171). The trailing edge transference is often confused with the repetitive dimension of the transference. Trailing edge refers to childhood pathology and genetic and dynamic underpinnings of neurotic constructions; repetitive dimension of the transference refers to the emotional convictions through which the patient interprets meaning in, or outside of, the analysis. Analyzing the repetitive dimension of the transference in its healthy sense is, in fact, part of analyzing the forward edge.

³Provocative is an experience-distant concept. From a therapeutic vantage point, whenever we experience the patient as being provocative, it should be a clue that we have been pulled out of an empathic stance and need to re-find our lost connectedness with the patient.

⁴Putting aside our penchant for training candidates to cure pathology, in my experience when the candidate (analyst) thinks of himself as more disturbed, he is more likely to focus on the patient's pathology. Thus, the importance of the candidate having an analysis that helps him/her understand healthy transferences.

⁵Offering interpretations from within the patient's subjective world is the primary reason why both the understanding and explaining phases of interpretation are empathic. There is, from a connectedness sensibility, no stepping back from the empathic mode when we explain dynamics and genetics. We continue to interpret from within the patient's world.

⁶Although beyond the scope of this article, my experience suggests that, from a self psychological perspective, the process of mourning can only commence after the patient is sure she will not experience disintegration anxiety if she talks about her loss. This assurance can only come from a felt connectedness with her therapist. Thus, our self psychological understanding of mourning is diametrically opposed to Freud's theory that mourning makes possible future relationships. Self psychology suggests that mourning is only possible in the context of a self-selfobject relationship that precedes mourning.