The Need to Get In, Not Out, of Generative Enactments: A Relational Argument for Frequency

Abstract

Atlas and Aron (2017/2019) invite us to think about the utility of enactments– not only as something that the analytic pair must recognize and work their way out of– but as a form of engagement with the patient’s prospective potential that can only emerge in a rich dyadic field. But what of the problems generated by the analytic dyad’s conscious and/or unconscious avoidance of getting involved enough with one another that those enactments—those “dramatic dialogues” –necessary for transformation can, in fact, develop? Using a clinical illustration, I build on my relational argument for frequency as a necessary (if not sufficient) condition for a psychoanalysis that relies on enactment as the mainstay of therapeutic action. It is frequency that stands a chance of exposing both analyst and patient to enough data that they find their way into, not only out of, those enactments that require contact with otherwise disavowed, yet potentially generative, aspects of self.

Keywords:

• frequency
• enactment
• mutual avoidance
• exposure
• prospective potential.

Notes

¹ For a review of the burgeoning interest among relational theorists in the “proactive dimension” of psychoanalytic treatments and theorizing, see Davies (2018, p. 356).

² Some noteworthy exceptions to this generalization are Hirsch (2008), Kraemer (1996), Slochower (2006, 2017), Stack (1998), Tublin (2002).

³ Neil Skolnick’s (2015) relational argument against the use of the couch was based on how the absence of face-to-face contact limited access to salient enactments. While I agree wholeheartedly that the use of the couch affects the material that does, or does not, emerge, the wisdom of the relational turn that we recognize that lying down, or sitting up, like other salient features of the frame will, for different patients, in different dyads, at different times, facilitate and inhibit different material, and thus different enacted outcomes.

⁴ While frequency does not guarantee the intensity that generates needed and repeated enactments, our discourse has often neglected its explicit role because of political concerns about the misuse and reification of this criterion in the past, and practical concerns about access to treatment and appeal to consumers in the present. Yet, in underemphasizing the clinical meaning of frequency in contemporary analytic work, we have neglected a full exploration of its inextricable relationship to clinical process, and minimized the transformative power generated in an engaged analytic treatment.

⁵ While the current emphasis on “fit” or “match” has been an important corrective to the historical assumption of faux objectivity in assessing “analyzability” (e.g., Hirsch, 2008), it presents different problems, among them the ease with which we fail to consider intensive treatments with those patients with whom we do not make obvious “matches.”

⁶ Ghent (1995) notes that it falls to the analyst to want more for the patient than they are able to want for themselves. I believe that proposing psychoanalysis, and thus making the case for seeing a lot of one another, is potentially the most dramatic way the analyst enacts this desire (Schoen, 2015).

Additional information

Notes on contributors

Sarah Schoen

Sarah Schoen, PhD is faculty and supervising analyst at the William Alanson White institute; faculty and supervisor at the Eating Disorders, Compulsions and Addictions Program at the White Institute; adjunct clinical professor of psychology at the New York University Postdoctoral Program in Psychotherapy and Psychoanalysis; and editorial board member of Contemporary Psychoanalysis. She is in private practice in Manhattan’s Flatiron District in New York City.