She Wears Her Holding With a Difference: Joyce Slochower's Work on “Holding”

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Notes

Lester Lenoff practices in New York City. He is a Member of the Institute for Contemporary Psychoanalysis of Los Angeles and Internet Editor of the International Journal of Psychoanalytic Self Psychology.

¹I have chosen Karen because she is presented in the greatest detail, including clinical dialogue.

² Coburn (2002) adds, “Note the absence of specificity in the terms ‘useful’ and ‘positive.’ Therapeutic change is a phenomenon that can be particularized descriptively only a posteriori on an individual basis, not prescriptively beforehand. I believe this is the thrust and beauty of Bacal's concept of specificity theory (1994)” (p. 669).

³In service of the reader's continuity, I am presenting excerpts of dialogue and text without ellipses.

⁴The phrase defensive structures is used in a self psychological context. A patient requires an ambience in which she experiences as sufficiently safe to express selfobject needs. In some clinical situations, the provision of such an ambience is for, perhaps a long time, beyond the capacity of the therapist, or of any therapist. And the patient responds with a defense that has become a repetitive means of self protection from anticipated traumatic repetition. It has become a structure. But it remains a secondary phenomenon, still to be traced back to the underlying, primary functional disability. The structure does not represent, as in Fairbairn's internalized object relations, “dynamically active structures” (Stolorow, 1997, p. 522, Stolorow, Orange, and Atwood, 2001, p. 470) that spontaneously initiate interactions for its own satisfaction, like a drive. Instead, the repetitive need for defense derives from a chronic “dread to repeat” (A. Ornstein, 1974, 1991).

⁵The Kohutian description of the mind does not include a concept of internal representations (Mollon, 2001). Such representations are a necessary condition for a theory of compulsive repetition of past lived or phantasied object relations. This issue demands extensive inquiry but is not directly relevant to this inquiry.

⁶I am grateful to Shawn Lynn for adding to the concept of stabilization the component of experiencing the self as real.

⁷ Fosshage's (1994) view of transference, Bacal's (1994) Specificity Theory and Coburn's (2002) theory of complex organizations form a basis for a nonlinear, complex extension of Kohut's ideas that could be applied to clinical theory in general, but is well beyond the limits of a single article.