‘Non-Interpretive Mechanisms in Psychoanalytic Therapy’ By Daniel Stern Et

Al. And ‘What Is “Applied” in “Applied” Psychoanalysis?’ By Aaron H.

Esman
Paul Williams
The paper by Stern et al. was placed on the IJP Web Site on 13 October 1998: Esman's
paper appeared on 20 July and remained on the Web Site until the beginning of October.
Both papers and discussions are summarised in this review, beginning with Stern. His paper
argues that something more than interpretation is necessary to bring about therapeutic
change. It introduces the concept of ‘implicit relational knowledge’, a phenomenon that is
distinct from the symbolic domain. This form of knowledge acts upon relationships,
creating change, and alters an individual's ways of being with others, notably in the analytic
relationship. Its potential for therapeutic action is considerable and is advocated. Stern's
paper should be read in full if its argument is to be appreciated.
Stern begins by asking how psychoanalytic therapies create change: the idea of
‘something more’ than interpretation acting to create change has a long history. Through
the application of a developmental perspective Stern believes this ‘something more’ can be
identified. In analytic treatment there are two mutative agents, Stern suggests:
interpretations and ‘moments of meeting’. The former rearrange the intrapsychic landscape
via insight; the latter generate changes in the quality of relating through authentic person-
to-person encounters and experiences. Linked to these are two further domains: the
declarative, conscious, verbal domain and the implicit procedural or relational domain.
Stern is concerned with elaborating the implicit procedural domain. This domain is founded
upon ‘implicit relational knowing’, a term derived from the developmental psychology of
pre-verbal infants that denotes a set of representations of interpersonal events born of
adaptive strategies. These comprise in-built anticipations and expectations. Stern discusses
‘implicit relational knowing’ and its origins, which lie in the self-organising principle of
mental functioning—the mind's tendency to construct ever more coherent, implicit
relational knowledge out of intersubjective communications. Just
asinterpretation rearranges conscious, declarative knowledge, so ‘moments of meeting’
rearrange implicit relational knowing. These moments evoke new relational contexts and,
following systems theory, can lead to new assemblies of a system's constitutive elements.
Experientially, ‘moments of meeting’ are felt to be qualitative shifts based on a sense of
mutual understanding or shared knowledge that may be explicitly acknowledged or remain
implicit.
Developmentally, the mutual regulation of states is the central activity of relating
(‘state’ being the semi-stable organisation of the organism at a given moment). Initially,
hunger, sleep, arousal etc. are paramount states and these are followed by affect states,
excitement, attachment
—————————————

Esman's paper (IJP, 79: 741-756) was discussed between late July and early October and
Stern et al.'s paper (IJP, 79: 903-921) was discussed between mid-October and the end of
November. Full details of the discussion can be downloaded at the heading
‘Discussion Group Archives’ at the IJP Home Page: http://www.ijpa.org.
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etc. This complex, trial-by-error negotiation is oriented towards two goals: the first
physiological (e.g. the comprehensive provision of care to an infant) and the second
intersubjective: mutual recognition of motives, desires and aims, including the feelings that
accompany these (affect attunement is a good example). These goals are pursued in
parallel. Achieving them involves non-linear, dynamic variation and improvisation around
given activities and themes as the relationship ‘moves along’ by generating ‘moments of
meeting’. Examples of ‘moments of meeting’ are when a parent's behaviour fits with a
baby's desire for sleep, triggering the shift from awake to asleep, explosions of mutual
laughter etc. These moments alter the domain of ‘implicit relational knowing’ through their
capacity to transport both participants to a new, higher orbit of interaction. This has the
effect of creating an opening for further creativity and initiative in the subject as a
consequence of confidence endowed by the qualitative change in the
intersubjective environment.
Stern provides a descriptive terminology and conceptual base for the phenomena
outlined above. The therapeutic process ‘moves along’ with aims similar to those of the
parent-infant dyad, although the means differ. The reordering
of conscious verbal knowledge involves negotiating themes to work on, interpretation and
understanding. At the same time mutual definition and understanding of the
intersubjective environment facilitates implicit relational knowing and defines the shared
implicit relationship. As the therapy ‘moves along’ so ‘present moments’ of dialogic
exchange occur. These are mutually experienced, goal-oriented points of shared
understanding embodying wishes and intentions. Stern gives an example of an analyst who
points out to the patient that he has, unusually, arrived late for last three sessions. The
patient acknowledge this. The analyst asks him for his thoughts—first present moment. The
patient thinks and replies that he has been angry with the analyst—second present moment.
The patient then says that the analyst said something the previous week that had annoyed
him —third present moment. These ‘present moments’ are shared steps in the ‘moving
along’ of the therapeutic process. ‘Now moments’ are special kinds of ‘present moments’ in
that they carry a particular affective charge as a result of their capacity suddenly to disturb
the intersubjective environment —like ‘moments of truth’. Examples are when the patient
succeeds in getting the analyst to do something out of the ordinary and both may break into
a belly laugh. Or when a momentous life event such as a bereavementintrudes into the
therapy demanding acknowledgement, out of decency. Or, say, when analyst and patient
meet in a theatre queue. ‘Now moments’ seized therapeutically can create ‘moments of
meeting’. Stern provides a further clinical example of a female patient who, in the midst of
recounting sexualised material, suddenly felt that the (female) analyst was looking at her
sexually. How analyst and patient dealt with this in an open, freeing way is described.
Interpretations can also create ‘moments of meeting’ if timed well and conveyed with
meaning. Sterile interpretations destroy such moments. The theoretical problem in all this,
for Stern, is that transference interpretations do not call into play the analyst as a person—it
is the analytic role that is evoked. True ‘moments of meeting’ contain
minimaltransference and countertransference aspects.
Stern lists examples of ways in which ‘now moments’ can be missed, failed, repaired,
flagged or how they can endure for long periods, demanding to be addressed. He turns to
the question of how ‘moments of meeting’ occur and how implicit knowledge is altered
within a ‘shared implicit relationship’ in order to create therapeutic change. Stern

2
acknowledges the controversial nature of attributing the locus of therapeutic change to
anything other than transference-countertransferenceinteractions. The ‘shared implicit
relationship’ exists apart from and in parallel to
the transference/countertransference relationship and other psychoanalytic roles. Its
therapeutic potential is advocated as it utilises personal aspects
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pects of the self that are evoked in affective response to the other. These sensings of
the other's personality are different from the distortions
of transference andcountertransference. ‘Moments of meeting’ are novel, personal, ‘more’
than transference interpretations, spontaneous, transcend but do not abrogate the
professional relationship and are somewhat ‘freed’
from transference and countertransference overtones. Stern views ‘moments of meeting’ as
the nodal events of treatment.
The discussion was opened by Eric Gillett, who welcomed this controversial paper but
felt that there was a muddle in the use of the procedural/declarative distinction between
types of memory. He added that modern theory views all expectancy learning as Pavlovian
conditioning. Throughout Stern's paper any reference to expectations and their alteration
involves a link to the modern theory of Pavlovian conditioning.
Howard Covitz appreciated Stern's model. Stern notes that: ‘In the course of
an analysis some of the implicit relational knowledge will get slowly and painstakingly
transcribed into conscious explicit knowledge … This, however, is not the same as
making the unconscious conscious, as psychoanalysis has always asserted’. Stern suggests
that the difference is that implicit knowing is not rendered unconscious by repression and is
not made available to consciousness by liftingrepression. Different conceptualisations and
clinical procedures may be required. Covitz was not convinced that such a clear distinction
existed. In projectiveidentification as part of transference activity, for example, both the
(genetic) meaning and the modus operandi are equally inaccessible to the person carrying it
out. This applies even to behaviour that is ego dystonic. He personally used the term
intersubjectivity in an idiosyncratic way that exceeded Stern's concepts of ‘matching’,
‘alignment’, ‘attunement’ etc. The paranoid individual is quite capable of reading other’
intetions but in a self-referential manner. As-if personalities and narcissists may be
exquisitely attuned to their environment but never achieve the richness of other's inner
worlds. Intersubjectivity refers to how the subject is, intends, acts, animates and executes
the predicate to the object—as in grammar, by analogy.
Per Roar Anthi felt that Stern et al.'s thought-provoking paper contained some
confusions in its conceptualisations. Stern's main point (‘the moment of meeting’) is
illustrated by a central piece of analytic dialogue: just two sentences that make up
‘the moment of meeting’ and thus a mutative interaction. Stern then emphasises that
a moment of meeting cannot be realised with a transference interpretation. Anthi was
confounded by this. Stern's vignette amounts to an intervention that aims to make the
patient aware of the transference implications of behaviour ‘here and now’. Anthi felt that it
wasn't possible to draw a sharp distinction betweeninterpretation and personal engagement
in the way Stern et al. had. Aspects of the personal relationship between patient and analyst
are always invested withtransference or countertransference responses. An alternative to

3
Stern's approach might be to investigate why some transference interpretations are effective
and why others are not.
Gillett contributed again suggesting that Stern's mistake is his emphasis on
‘procedural’ memory. The philosopher Jerry Fodor (1998) criticises the
procedural/declarative distinction on the grounds that most ‘knowing how’ requires a lot of
‘knowing that’. The ‘something more’ that Stern et al. emphasise does in fact
involve transference, and psychoanalysis has always recognised a distinction
between transference and the need to avoid repeating pathogenic interaction patterns from
the patient's childhood. The notion of a ‘moment of meeting’ sounded to Gillett like an
‘empathic response’ on the part of the analyst.
Matias Fernandez Depetris admired the paper but felt uncomfortable about an
artificial separation of what seemed to be one thing. Non-interpretive work involves
the personality of the therapist: this is part of the art of therapy and is something that cannot
be taught. It is one reason why personal analysis is so necessary
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for becoming a therapist. Depetris saw the work of Stern as being rather close to Winnicott,
who communicates very similar ideas in a form that is nearer to poeticlanguage than to
technical/scientific concepts.
Howard B. Levine congratulated Stern et al. but was also troubled by their attempts to
distinguish between the analyst's ‘technical’ and ‘personal’ attitudes. The authors have
located themselves in a theoretically conservative position. They do not appreciate the
irreducibly intersubjective nature of the analytic relationship. Their implied assumption that
the analyst's ‘technical’ attitude is not also deeply ‘personal’ comes from a theoretical
orientation in which the analyst's subjectivity(read ‘countertransference’ in the broadest
sense) can be eliminated. Levine thought it more useful to recognise that the speech of both
parties is ‘action’ as well ascommunication. Even a ‘technically
correct’ interpretation involves the analyst in many simultaneous unconscious actions that
go far beyond ‘interpretation’ as onlycommunication of insight. Levine argued for not
separating conceptually ‘good interpretation’ from ‘countertransference enactment’, but
instead argued that everyintervention may be both. Levine felt that the authors did not give
enough recognition to contemporary Kleinian and object-relations theory, which
acknowledges how the patient is always unconsciously trying to manoeuvre the relationship
into or away from certain forms of relating. Finally, is not the nature of
every momentbetween analyst and patient intersubjective, i.e. co-constructed?
Adrian Stanica thought that a problem is that ‘implicit relational knowing’ cannot be
defined. Rules and methods for its application don't exist. He reviewed theevolution of
analytic method over the decades and concluded that there has been and always will be
something ‘implicit’ between patient and analyst—good clinicians know this. There is also
a grey area beyond which lies the risk of over-involvement by the clinician and this is
something of which analysts are acutelyconscious. There will always be misunderstandings
and polemical positions taken in this kind of debate because individuals look at the same
problems with different eyes and different minds.
Olli-Pekka Santala felt that Stern et al.'s thinking resembled Joseph and Anne-Marie
Sandler's work on object-relations theory. Stern et al. say that ‘current concepts

4
from development studies suggest that what the infant internalises is the process of mutual
regulation, not the object itself or part-objects’. The Sandlers view is similar: ‘object
relations’ means internalised interactions between self and important others, not
internalised others. These interactions regulate inner feeling states. The patient attempts to
actualise his past object relations in reality or in fantasy. Actualisation in reality means the
manipulating of others to behave according to past object relations, and so the attempt to
use others in the regulation of one's own inner states. Santala suggested that interpreting
Stern's clinical case in the paper using the Sandlers’ theory would be very similar to Stern
et al.'s interpretation. A ‘moment of meeting’ in the terminology of the Sandlers’ theory
corresponds to the analyst's move outside the role or way of interacting that the patient
attempts to actualise, together with the communication of the
corresponding countertransferenceto the patient.
Meir Perlow found Stern's paper fascinating. Stern’ language of intersubjective theory
is an ideological choice: nevertheless, Stern's understanding of ‘moments of meeting’ was
convincing. He could not accept however the (almost complete?) emphasis on such
moments as agents of change. There are many everyday processestaking place in the
intersubjective environment that lead to a considerable degree of change. Perlow felt that
Stern needed to address these processes, which although of a less intersubjective nature
than ‘moments of meeting’, are nonetheless a crucial and pervasive part of clinical work.
Perlow contributed again to say that he found Levine's point regarding the intersubjectivity
of every moment in analysis to be logical but impractical. At a theoretical level every
technical intervention has personal undercurrents. We react
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to patients from different areas within our own personalities. Perlow invited Levine to
explain why ‘it is practically impossible and theoretically misleading to separate
interpretations from relational manoeuvres’. Is the distinction between technical and
personal, between interpretation and interaction, in analytic practice disappearing? If so, it
is a development worth discussion.
Gillett contributed again to say that drawing a distinction is not the same thing as
‘separating’ two things, as Levine would have it. He could not see anything in Stern's paper
claiming, as Levine said, that ‘the analysts subjectivity (read “countertransference” in the
broadest sense) can be totally eliminated’.
Emanuel Berman found the notion of ‘now moments’ useful. He felt Levine raised an
important point in deconstructing some of the distinctions made by Stern and shared
Levine's view that technical and personal are never really distinct. He felt Perlow
minimised the issue in suggesting that the distinction disappears only within a certain
(relational, informal) analytic style. The distinction was illusory in any analytic style.
Generalisations about ‘what's analytic’ (e.g. ‘interpretations are more analytic than personal
expressions’) are less helpful than a truly analytic sensitivity to the significance
any intervention acquires within the analytic process, a sensitivity that Stern et al. often
demonstrate. Rather than try and reach a consensus about the preferred way of analysing,
we could improve our work by closely monitoring and discussing the impact of our style on
our patients.
Tullio Carere-Comes felt that the use of the words ‘transference’ and
‘countertransference’ should be forbidden unless their meanings were defined. Even then

5
the use of the same words to describe different phenomena (as with Stern et al. and Levine)
creates confusion. Carere-Comes has organised the distinction between
information/insight provision and personal/affective engagement by mapping the
therapeutic field along two axes: the remaking axis and the uncovering axis. The horizontal,
remaking axis connects the maternal and the paternal poles. The vertical, uncovering axis
connects two other vertices: Knowledge (K) and the Unknown (O). The K vertex is where
the therapist investigates the meaning of whatever is said or done explicitly or implicitly.
The therapist shifts to the O vertex when there is an absence of knowledge to be tolerated
and trusted in (it is the position Bion referred to with his formula ‘Faith in O’). There are in
Stern's paper many references to this position.
Levine asked Stern and his colleagues to join the discussion. When Levine drew the
distinction between ‘personal’ and ‘technical’ aspects of the relationship he had in mind the
view that every correct interpretation or intervention also reflected and enacted a (personal)
piece of the analyst's countertransference or subjectivity. However, not every relational
experience is an interpretation. When Stern et al. say ‘unless the therapist does something
more than the strict interpretation …’ they imply that analysts conceptualise ‘strict
interpretations’ as something less than personal, for example impersonal, objective, neutral.
This implication tends to create a false dichotomy. Levine felt that Stern et al. believed that
sometimes the analyst can be outside a personal relationship and at other times not. He
believed that the analyst is always inside the relationship. Stern et al. used the word
‘intersubjectivity’ to indicate the (acquired) capacity to know the subjectivity of the other.
This is a different sense and spirit from the way it has been used in
psychoanalytic discourse by Stolorow and his colleagues, Natterson and Friedman and by
Levine himself. They have used it to indicate that all experience within the analytic dyad is
co-constructed.
Gillett stated that using the term ‘constructed’ should make clear whether they are
endorsing what might be called ‘commonsense constructivism’ (which everyone accepts)
from ‘radical constructivism’ (which is untenable). Common-sense constructivism holds
that the mind constructs beliefs about and experience ofreality but not reality itself. Radical
constructivism, by contrast, claims that my belief that something is so determines (i.e.
‘constructs’)
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that is so. Radical constructivism implies backward causation.

There then followed a response from the authors of the paper—The Change Process
Study Group—Daniel Stern, Louis Sander, Jeremy Nahum, Alexandra Harrison, Karen
Lyons-Ruth, Alexander Morgan, Nadia Bruschweiler-Stern and Edward Tronick. They
stated that there is now much research on automatic or implicit processing that elaborates
the declarative-procedural distinction. They agreed with Levine that they had taken a
traditional line on interpretation and that it is difficult to separate interpretive, enactive and
relational activities. They did this to highlight the excessive dependency of
analytic language about interpretation on declarative memory. They wanted to hear more
about people's responses to the application of the developmental model to the process of
change in treatment. Mother-infant and child development work vividly illustrates the
patterns and processes of change that they think may apply in these other interactional
domains, such as psychoanalytic therapy. Pre-verbal communication offers a window of

6
understanding on to implicit processes. Regarding Perlow's comment about finding it ‘hard
to accept their (almost complete?) emphasis on these moments as agents of change…I
would like to ask Dr Stern et al. to address these (more everyday) processes that are no less
in need of conceptualisation and explication than the “moments of meeting” which he
describes’. Stern et al. completely agreed. There is a need to explicate the minutiae of
therapeutic interaction. Stern et al. were struggling to develop a classification
and language of ‘relational moves’ that constitute therapy, and this work would be
discussed further at their forthcoming Boston symposium.
Six contributions were subsequently posted, which were received before the response
from the authors. Maria Ponsi echoed previous criticisms of too sharp a distinction between
the ‘personal’ and the ‘technical’. Any effective interpretation needs proper tact and timing.
Stern et al. implicitly refuse to consider interpretationas a process moving along through
different stages and moments, where the relational factor is alternately in the background
and then in the foreground. They assume a concept of interpretation as a type of
proposition linking conscious verbal content with an unconscious representation. In this
way they ascribe the interactivecomponent to the different domain of implicit
relational knowledge. A privileged position is accorded to changes taking place in the
shared implicit relationship to the detriment of interpretation. They are depriving
the transference-countertransference experience (and interpretation) of any lively quality.
Covitz felt mesmerised by the correspondences in response to Stern et al. It had made
him reflect on three analytic ‘roles’. The ‘objective observer’ who has sufficient self-
other boundaries to have some sense of where one party to the analytic contract ends and
the other begins. The ‘neutral one’ who permits sufficientfrustration in the relationship to
induce cravings for deeper or more encompassing attachments to the analyst. And the
‘genuine co-relating analyst’ who, in a substantive way, feels deeply concerned for the
welfare of the patient to which he responds. He expanded on each of these.
Arnold Richard sent the following (in this reviewer's opinion, lucid) contribution to the
discussion of intersubjectivity and relativism and the recognition of the inevitable effect of
the knower on the known. The discussion reminded him of the Chinese aphorism ‘You
can't step into the same river twice’. However, you come out wet both times.
Peter Owen stated that for neurotics, language does not inform, it evokes; and what is
evoked is what is understood—‘understood’ in the sense of ‘supporting thefantasy around
which our subjectivity is spun’. Left to our own devices we understand nothing but
our fantasy. Freud's discovery is, as he understood it, that ‘reality’ is determined upon
connections, and that these connections are false connections. ‘Connections’ evokes
‘evocation’. The essence of Freudian thinking is the instability of the
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‘objective’. This is why Freud stopped suggesting objective notions of the world to patients
in search of a cure. This is the point where psychology ends and psychoanalysis begins.
Tullio Carere-Comes asked whether the interaction between therapist and patient was
just something unavoidable to be monitored and interpreted like anyunconscious material,
or something to pursue for its intrinsic therapeutic value, independent of whether or not it
was explicitly interpreted? Also, it does not matter what we call our treatments (‘analysis’

7
or ‘therapy’)—we all follow both the ‘supportive -stabilising’ and the ‘expressive-
interpretive’ paths. Interactions of both types are usually inextricably intermingled.
Anthi contributed again noting that the extreme consequence of the co-constructed
view affects how we understand negative transference. Is the patient's
destructive aggression towards the analyst merely a result of the interaction with the
analyst, that is, mobilised and provoked by the analyst's lack of empathy and
understanding? Or is it impulsively brought into the analytic interaction as it is stems from
aspects of the patient's specific psychopathology? An extreme co-
construction position would destroy the value of a dynamic transference concept, while the
analyst qua participant observer would lose his capacity. Anthi also registered a certain
disappointment with the response from the authors.
Gillett was also disappointed by the response of the authors and provided an extended
elaboration of his previous contributions in order to clarify Stern et al.'s conceptual failings,
as he saw them.
Meir Perlow did not believe that research on infant development really contributed to
our understanding of processes of change in therapy in a positivist way. It is not as if there
are any new ‘facts’ about infancy that are being brought into our discussions: the domain
of infancy seems to be useful for researchers to create conceptualisations (metaphors?). He
didn't see how ‘implicit relational knowing’, ‘intersubjective environment’, ‘now
moments’, ‘moments of meeting’ have any special connection with infant development,
although they could certainly help in thinking more clearly about the processes occurring in
therapy. He didn't expect these conceptualisations to tell us what is or isn't therapeutic
about therpay.
Stanica was surprised by the development of the discussion. He defended Stern et al.,
who he felt were trying to point out not only that there is something more between the
psychoanalyst and the patient, but also that this belongs to something that is in our inner
soul. Stanica elaborated his view of why ‘moments of meeting’ offer a uniquely personal
experience to the patient of the analyst as a human being, which deepens the analytic
relationship.
Two further contributions were received but it was not possible to distribute these to the
discussion group, so they are included here. Rainer Krause expressed his interest in
participating in this discussion group and in conveying something of the recent work in the
same area by his research group-details from web sitehttp://www.uni-
sb.de/philfak/fb6/krause.
Depetris asked Stern et al. what they thought about their ideas about the child-
mother developmental relationship as a model for the therapeutic relationship, when
considered against the ideas of Ferenczi, Bion, Winncott, to mention but a few. His query
was not about who was first or who ‘owns’ these ideas but rather a wish to try to link up
different ideas about motherhood as a feature of a model of therapeutic work. He also
wondered whether, if we conceptualise the interpersonal process in therapy using a
descriptive relational model of therapy that does not need a metapsychology or
any other meta-concept, would this still be psychoanalytic? He felt it would. There the
Stern discussion closed.
Esman Paper and Discussion

8
 Esman argues that psychoanalysis is an evolving system of propositions and hypotheses
that are capable of ‘application’ and study in clinical and extra-clinical settings. Also, he
believes that the development and even survival
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of psychoanalysis requires the integration of its institutions and training facilities into the
university system.
Esman begins by citing Donald Kaplan (1993) who advocated the application of
psychoanalysis to the products of culture. Kaplan was of the view that psychoanalysis in its
pure form finds its place in the clinical psychoanalytic situation. The analytic situation—the
recumbent adult neurotic patient seen four or five times a week—is the crucible in which
the ‘pure gold’ of psychoanalysis is forged. Psychoanalytically informed activities that do
not conform to this model fall under the rubric of ‘applied’ psychoanalysis. In the
‘application’ of psychoanalysis to the arts and other cultural phenomena, the patient is
absent, so the potentiality for reductionism and ‘wild’ analysis is considered to be ever
present. Also the humanist scholar will lack the full grasp of psychoanalytic principles that
can come only from ‘clinical immersion’.
Esman challenges this conventional wisdom and reviews the history of the distinction
to question the primacy of the clinical situation as the source of certain essential
propositions. In the Schreber case Freud developed ideas about the unconscious roots
of paranoia that then found clinical application, and in his ‘Leonardo’ paper (1910) he
cultivated the seeds of his thinking about narcissism. Which came first, ‘clinical data’ or
‘applied’ concepts? Freud's self-analysis led him to the story of Oedipus Tyrannus which he
extended to the case of Hamlet. He published essentially the same accounts, founded on the
same non-clinical data, in The Interpretation of Dreams (1900) and again in a paper written
around 1905/6 but published only posthumously in 1942, ‘Psychopathic characters on
the stage’. All this before his first formal venture into ‘applied’ analysis, the ‘Gradiva’
paper of 1906, and its successor, ‘Creative writers and daydreaming’ in 1908. What, again,
was being applied to what? From ‘Gradiva’ through Totem and Taboo (1913) cultural
phenomena served to illustrate or reinforce Freud's ideas about individual and social
psychology. Even the published clinical cases were intended to serve this end. Many of
Freud's followers have worked in a similar way. Stephen Cooper has recently written
‘rarely does a fact emerge in psychoanlaytic thinking that does not already come with a
point of view’ (1996, p. 256). (From this Esman infers that Bion's plea for the analyst to
listen ‘without memory or desire’ is a pious but unrealistic and unrealisable hope.) A
current example of the admixture is the revolution in psychoanalytic thinking about the
psychology of women, determined not by newly discovered clinical ‘data’ but by changes
in socio-cultural views. The heuristic power of psychoanalytic concepts has also engaged
academic thinkers across a range of disciplines. Despite this heritage there has been a
consistent current of scepticism about ‘applied’ psychoanalysis, from Lionel Trilling
through to recent advocates of ‘applied’ analysis who set forth guidelines for its proper,
respectable pursuit. Clinical psychoanalysis is a private affair whereas ‘applied’
psychoanalysis is a public performance; its interpretations/constructions are subject to
review, reconsideration, correction or rejection by the community of scholars. The best
example of the evaluative process in ‘applied’ psychoanalysis is Freud's ‘Leonardo’ essay
(1910), where his ‘nibbio/vulture’, based on a mistranslation by his secondary source, was

9
corrected by Wohl & Trosman (1955), Schapiro (1956), and others into ‘nibbio/kite’, with
significant consequences for his argument.
What of ‘data’ in clinical psychoanalysis? Recent consideration of this question has
exposed an epistemological jungle, a total lack of consensus as to what constitutes a
‘clinical fact’. Is there a place elsewhere for such bedrock elements of the clinical situation
as transference and countertransference? Peter Brooks discerned an analogy between the
roles of analyst and analysand on the one hand and reader and text on the other; ‘just as the
patient's communications are designed to influence the analyst, so the text is intended to
influence the reader. Efforts to rewrite and retransmit the text may closely resemble the
psychoanalyst's,
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with the attendant perils of transference and countertransference’ (1987, p. 12).

Esman then offers an illustration of how a psychoanalytic perspective may illuminate a
particular work of art and certain of its motives. He cites man Ray who painted ‘L'heure de
l'observatoire—les amoureux’, generally referred to as ‘The lips’, in 1931. A pair of lips
float over an urban landscape. ‘The lips, because of their scale, no doubt, suggest two
closely joined bodies. Quite Freudian’, said Ray (1963, p. 255). In fact, the painting was a
response to his abandonment by his student, protégéé and lover, Lee Miller, Ray had been
determined to remake her in his own image—she was a narcissistic object. His response to
Miller's departure was one ofnarcissistic rage. He proceeded to recreate an object he had
first made in 1923, a metronome with the picture of an eye attached to the pendulum,
originally entitled ‘Object to be destroyed’. This time, however, the eye was cut from a
photograph of Lee Miller, and he wrote, ‘Cut the eye from a photograph of one who has
been loved but is seen no more. Attach the eye to the pendulum of a metronome…with a
hammer, well-aimed, try to destroy the whole at a blow’ (Baldwin, 1988, p. 168). In short,
what cannot be possessed and controlled must be demolished. ‘Les amoureux’ was a later
reference to the affair, an acknowledgement of loss, an effort to retain the lost object, a
means of resolving the ensuing conflict and of curing a depressive response and an
illustration of the Kleinian concept of creativity as an effort at restitution of the
lost/destroyed object, in the depressive position. With this work Man Ray achieved a level
of artistic performance that, as a painter, he never equalled again. In his autobiography
three decades later Man Ray makes no reference to the connection between ‘Les amoureux’
and Lee Miller. The same is true in his friend Roland Penrose's monograph on the artist
(1975), although Penrose had subsequently married Miller. This silence was, perhaps, Man
Ray's final revenge and gesture of detachment. Why the eradication of history? Man Ray
had long been involved in manipulating history. He had alienated himself from his past
(Esman describes how), suggesting intense hostility, conscious or unconscious, towards
major figures in his life. Man Ray's rejection of his origins, his dominating attachments to
women and his violent reactions to what he experienced as abandonment by them bespeak a
deep sense of disappointment or deprivation at the hands of those who were his earliest
caretakers. Man Ray's conception of the ‘Object-to-be-destroyed’ has the quality of a
retaliatory fantasy, an active, aggressive response to a passively experienced trauma. Ray's
family changed residences regularly and frequently, disrupting his attachments to place,
peers, schools, and school fellows, aggravating what Bowlby and associates (Ainsworth et
al., 1978; Bowlby, 1969, 1973) refer to as ‘insecure attachment’. Unconscious gestures of

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revenge and statements of omnipotent autonomy characterise Ray's life as though he were
saying, ‘I reject the world in which I grew up; I will create my own world and seek to fill it
with people who will fulfil my needs as I perceive them’.
Esman, echoing Kuspit, takes the position that ‘the term applied psychoanalysis no
longer makes sense. It is no longer the case that psychoanalysis is applied to some artistic
phenomenon, but that the phenomenon, but that the phenomenon swims (sinks?) in it and is
in a sense reconstructed as a psychoanalytic phenomenon by its immersion in the
psychoanalytic force field’ (Kuspit, 1996, pp. 267-8). It has been a part of the received
wisdom that psychoanalysis is at once a body of ideas (or a theoretical system), a mode of
research, and a clinical, therapeutic instrument. Esman is not sure that we have done
ourselves a service through this terminological and functional conflation. We need to
recognise that there are no principled distinctions between the application of
psychoanalysis to the products ofculture and its application to the treatment of patients.
Esman favours the integration of psychoanalysis and psychoanalytic institutes
and training centres into the wider world of the academy to promote the effective teaching
of psychoanalysis as a basic conceptual discipline for students in many disciplines.
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It would, at the same time, serve to promote and protect its status as a field for specialised
postgraduate study and training in research and clinical practice. Anxietyregarding the
future of psychoanalysis is party the result of our tendency to define it solely or primarily as
a clinical instrument rather than as a basic discipline for the human sciences, an
essential component of the study of mankind.
The discussion was opened by Howard Covitz, who strongly supported Esman's paper
as proof of the robustness of the psychoanalytic enterprise. He felt that we should no longer
be surprised in our work that no distinction can ever be finely drawn between theoretical
clinical, and applied analytic work. He believed that if applied analysis can bring us and our
candidates to a sceptical position (via Freud's nibbio-vulture mistranslation or
through female psychology, for example), then it may serve a pedagogical function in
inoculating us against the imperious, authoritarian diseases of our profession. Covitz took
issue with the notion that symbol formation is the outcome of a loss (cf. Hanna Segal).
Both symbol formation and loss are ubiquitous processes, representing major constituents
of ego, ego ideal, self and superego development. The two all-encompassing categories
cannot be so easily correlated.
Emanual Berman appreciated the paper but felt that Esman did not take seriously
enough Chipset's objection to the term ‘applied analysis’, which does not imply
interdisciplinary work, and the two terms cannot be equated. ‘Applied analysis’ implies a
one-sided encounter, in which a body of authoritative knowledge is used to decipher a text
or a work of art that would otherwise remain misunderstood. Therefore, this very concept
carries with it imperialistic connotations that have aroused so much protest from artists and
art scholars. Berman agreed with Esman regarding the similarity of issues in clinical and
‘applied’ analysis. Greater attention to the unavoidable impact of countertransference and
of the analyst's subjectivity requires humility and caution in both clinical work and
encounters with art. When—as analysts—we encounter art we badly need specific expertise
which cannot derive entirely from our consulting room or we easily confuse personal

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sources with conventional influences and make naïve interpretations. Interdisciplinary work
is crucial for serious results.
Donald Marcus wished to comment only on Esman's reference to the work of Bion,
which he felt he misunderstands and so dismisses the work of one of our most creative
thinkers. Bion was neither pious nor naïve: he believed that the ‘observations’ we need to
make are of emotional experience such as anxiety, love and hate. which cannot be observed
directly with our sense organs but have to be intuited. Memory and desire interfere with our
intuiting the emotional experience of themoment. The greater the impulse to remember
what has been done or said, the more the need to resist. Bion did not plead
with other analysts to eschew memory anddesire. He recommended it as a way of working
that is very powerful. Marcus hoped that readers would not be put off by Esman's dismissal
of Bion's method.
Kay Torney Souter was another contributor who agreed that it is a mistake to imagine
that psychoanalysis grows naturally in the clinical setting, and is ‘applied’, in a slightly
debased way, as a sort of master key to prise open recalcitrant works of
art. Countertransference style responses are not any more limpid in a reader than in a
clinician. Boredom, despair or sexual arousal, for example, can mean a number of things,
from recognition of boringness, awfulness or seductiveness, to a response to something
disavowed in the text. Texts have their own ‘counter/transferences’: traces of Words-worth
in Coleridge or Shakespeare in Jane Austen etc. Clinical expertise can be immensely
helpful when one is trying to untangle this sort of thing. Having a mind is an experience
within history, and thinking about the mind (and art) is a historically situated act. Seeing,
for example, Freud as a specifically modernist thinker and writer does illuminate the
question of representing the self in modernist and subsequent writing. The
unconscious, internal objects, intersubjectivity are not concepts that outdate
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and invalidate each other; they are concepts that arise out of different ways
of thinking about self and other, and out of different historical circumstances.
Adrian Stanica found it a pleasure to read Esman's paper. Does applied
psychoanalysis make us agree with one interpretation of a painting, or look for more?
Picasso wanted everybody to see in his paintings what he saw by himself. But we want
more, and it is generally not difficult to find a link between the personal life of an author
and his work, even though the author might try to hide his feelings like Man Ray. Applied
psychoanalysis tries to create a better understanding of things/events and/or their effects on
us. We do this for ourselves, not for patients, and the event itself doesn't gain anything. The
only thing we change are influences for the future. Psychoanalysis is a ‘tool’ to help a real
patient. In applied psychoanalysis it is only one of the tools that help to integrate the
object/event among otherobjects/events. In clinical practice we listen to the patient, see
changes and note how far the patient is conscious of these. Applied psychoanalysis has only
its opinions within a bounded culture/society about an object/event. Feedback is
missing. Culture has an enormously complex influence on psychoanalysis and applied
psychoanalysis. More and different cultures mean more and different ways of facing
the truth about oneself and one's environment. We can write about Faust not using only
Goethe, but also Delacroix or Paul Valery and many, many others. Or we can use him to
write/talk about the German people, perhaps using Thomas Mann's Doctor Faustus. We try

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to understand these chefs d’oeuvre not only through our knowledge of psychoanalysis, but
also through history, literature and otherdisciplines.
Felix Mendelssohn took up the matter of symbol formation being the outcome of an
experience of loss. Covitz had stated that ‘both symbol formation and lossare
ubiquitous processes, representing major constituents of ego, ego ideal, self
and superego development … and are even apparent in other mammals’. Would Dr Covitz
not hold that symbol formation is a function intimately connected to an elaboration
of language? Stern has written about the acquisition of verbal language, which brings a
sense of loss in the mode of direct affective communication with the primary caretaker. On
another plane Lacan posits the symbolic realm as not only linked with language but
involving a loss of the ‘real’. For Klein, symbol formation arises only with the onset of
the depressive position (the term itself denotes loss), when subject and object are
sufficiently separated so that projective identification need no longer be the sole mode
of communication. Segal discriminates between ‘symbolic equation’ (where the symbol is
taken to be materially identical with what it symbolises) as a primitive function, and
true symbol formation, which results from the ability to mourn the loss of an object. This is
important when we discuss the psychoanalysis not only of artistic productions, but also of
the nature of the creative process, not least in the case of Man Ray's losses.
Erick A. Median disagreed with Esman in his assessment that the ‘crisis of American
psychoanalysis’ is due to over-reliance on the clinical situation as a barometer of
psychoanalysis’ worth. What he thought underlay both this crisis and the estrangement
between the institute and the academy is the cultural over-reliance on an
outdated conception of the relation of theory to practice in psychoanalysis: namely that
both are exterior to and separate from one another. The antidote to such an antiquated
notion seems to be a periodic reminder that all theorising is doing and that when
psychoanalysis is thoughtfully and skilfully done, it is hard to extricate the theory from the
practice much in the same way a dancer and ‘the dance’ become one and the same in a
good performance.
Per Roar Anthi agreed with Adrian Stanica about the necessity of making proper
differentiations. In clinical analysis the method of free association is our fundamental
instrument. In applied analysis there is no patient, no therapeutic alliance or attachment,
no dream, memory
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or fantasy that may follow an intervention and no motivation for being analysed or under-
going psychic change. There is no mutual enactment or interplay
oftransference and countertransference leading to further insight and integration. Esman
seems to imply that the patient's material in the clinical setting can be treated as if it were a
text that can be interpreted like a product of literature or art. This would reduce
clinical analysis to an intellectual enterprise. Non-verbal behaviour, motor
movement, body attitudes, respiration as well as acoustic impressions such as intonation
and other qualities of speech are constantly qualifying the patient's text and are derivations
of affects. It is affects that enable the analyst to know what is going on in the analytic
situation. Changes in respiration and voice quality, the appearance of tears and crying and
so on function as convincing standards of measurement. The material to be investigated in

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applied analysis lacks the dimension of a living person responding to the analytic observer
and inter-preter.
Norman Rosenblood took up the problem of applying theory to an object that isn't
‘alive’ and therefore is not capable of responding to interpretation. He had re-read Ernest
Jones's paper on Paul Morphy and marvelled at its illumination of the forces affecting his
career. That Morphy was not alive did not hamper Jones's sensitive exploration. What
Matthew Arnold called the ‘buried life’ is imagined in literature in full and powerful ways
that approximate to real life. To mirror life and copy nature have been the literary and
critical goals of artists and theoretical critics for generations. The poet can create
a reality that surpasses reality as we know it. The depiction of psychological reality is one
of the writer's greatest contributions to culture; why should one ignore the capabilities of
psychoanalysis to formulate responses to these dramatisations of psychic ‘reality’?
Rosenblood supported Esman in his call for the inclusion of psychoanalytic studies in the
university (as did most other contributors).
Matias Fernandez Depetris supported Stanica's statements about the need for proper
differentiation of the analytic situation. The specific and particular analytic setting does not
allow us to move from there to explain culture in a ‘psychoanalytic’ way. We do not have
the setting or fixed variables to assist us. Psychoanalytic reductionism can also easily arise
if we try.
Myriam B. Arditi agreed with the stress that psychoanalysis can place on
the active nature of the relation with text and reader, and between the observer and a piece
of art, to permit enquiry into the laws of human mental life. But is this ‘applied
psychoanalysis?’ Take Freud's paper on the Moses of Michelangelo. Not only did he use a
pseudonym but he didn't dare publish it until ten years later. Freud drafted ‘The Moses of
Michelangelo’ in late 1913, just before he began to give shape to ‘The history of the
psycho-analytic movement’. ‘In my mood, I compare myself with the historical rather than
with the Moses of Michelangelo I have interpreted’, Freud said at that time. In a reference
to the interplay between Freud and the text, Peter Gay later remarked, ‘This sounds very
much as though Freud's reading of Michelangelo was a reading of himself’. Freud's article
on Leonardo was a contribution to theory. Leonardo on the couch would have produced
something quite different. The ethic of the analyst during a patient's session differs from
when the analyst writes. Writing expresses the urge of desire. Is an analyst who reinterprets
a piece of art practising applied psychoanalysis? In Arditi's view, no. Ethics makes different
demands than aesthetics.
Olli-Pekka Santala stated that there is the epistemic process of building new
psychoanalytic knowledge, and there is the process of applying these models. Many regard
the ‘pure’ clinical situation as the ideal for building new models. Esman describes Freud's
frequent construction of theory with non-clinical material as an example of applied
psychoanalysis. This is not applying psychoanalysis at all, but theory construction with
non-clinical examples. ‘Clinical’ and ‘applied’ here just describe different
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kinds of raw material, not something to do with models. If ‘applied’ meant just the
application of a psychoanalytic model, we could speak of application with regard both to
clinical and non-clinical material. But Esman wants to use ‘applied psychoanalysis’ by
defining it as an application only to non-clinical material! Santala thought that Esman's way

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of using concepts can confuse the distinction between epistemic and application processes,
as in: ‘Because applications were integral to the early development of psychoanalysis, it
would be dubious to condemn applications’. This means that because Freud used non-
clinical material in his theoryconstruction, it is all right to apply psychoanalytic models to
non-clinical settings. This is not valid; it represents a confusion between the multiple
readings of ‘applied psychoanalysis’.
Imre Szecsody supported Arditi: it is not only for ethical but also for scientific and
decency reasons important not to call impressions, interpretations tracts or essays written
about art by psychoanalysts ‘applied psychoanalysis’. Any person confronted with a piece
of art relates to it according to his/her past and presenthistory,
experience, personality, knowledge, education, training, etc. We also use our experiences as
psychoanalysts—but this does not make our exchange with the piece of art psychoanalysis.
It is unscientific to pretend otherwise.
Per Roar Anthi, following Imre Szecsody's reasoning, wondered whether Esman's study
is therefore unethical and unscientific. Szecsody's absolute standpoint implies that
thousands of studies in the field of so-called applied psychoanalysis including Freud's many
works including central aspects of The Interpretation of Dreams, are unscientific and
ethically reprehensible. He strongly disagreed. Clinical analysis, empirical analytic research
and applied psychoanalysis raise important ethical questions linked to the search for
the truth. Although the ethics are extremely important for all branches of psychoanalysis,
Esman's paper is primarily a contribution to elucidate the similarities between clinical and
applied analysis. Anthi felt that Olli-Pekka Santala grasped the point in saying that
“‘clinical” and “applied” just describe different kinds of raw material’. Anthi drew a
sharper distinction between ‘clinical’ and ‘applied’ than Esman. He has made three
biographical studies of public persons (Wilhelm Reich, Knut Hamsun and Axel
Sandemose): all three had been in psychoanalytic treatment. In some respects he was in a
betterposition to obtain a more precise picture of aspects of their psychology than their
actual analysts. He had a broader overview of their life and much supplementary data.
His countertransference was tempered by there being no concrete presence of the
subjects’ personality. In the same way, more advanced theoretical conceptualisations and
detailed biographical and historical data have led to the ‘re-analysis’ of aspects of
Freud's thinking, behaviour, dreams, unconscious and creative processes.
Ken Robinson pursued Esman's idea that up to the ‘Gradiva’ paper of 1906 Freud ‘was
exploiting literary classics universally familiar and hallowed by traditionto support and
validate his inchoate psychoanalytic ideas, rather than using psychoanalysis to explicate the
texts’. Esman offers two alternatives: either psychoanalysis is applied to texts or texts serve
as a source of illustration, analogy and evidence. There is another possibility. Perhaps we
might think of works of the artistic imagination as playing a part in unconscious thinking in
the process of a theory being formed. The analogy or illustration would then be the end
product of that process. We do not just read books; books read us. They give shape to the
depths of our inner worlds. We remember one quotation rather than another because it has
taken root in our unconscious. It may be years before we begin to understand its meaning
for us. To understand more fully the use Freud made of ‘Oedipus Rex’ in his famous letter
to Fliess we would have to know about the inner history of Freud's creative dialogue with
the play. The performance Freud saw ‘made a deep impression on him’ (Jones, 1953, p.
177) in the context of oedipal excitement and anxiety

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 - 209 -

stirred up by his stay in Paris. In such a case it is not a matter of anything being ‘applied’.
Augusto Escribens endorsed Olli-Pekka Santala's comments. The distinction between
epistemic and application processes is very important and frequently overlooked. If ‘pure’
practice is set against ‘applied’ practice this is rather like the classical grammarians who
considered Latin and Greek to be superior to otherlanguages. This was an ideological rather
than a scientific stance. Psychoanalysis, psychoanalytic psychotherapy and
psychoanalytically oriented literary criticism are ultimately all forms of applied
psychoanalysis. The conceptual confusions pinpointed by Santala have their roots in hidden
value judgements.
Prado de Oliveira could not recognise Medina's ‘crisis of American psychoanalysis’ or
the ‘crisis of psychoanalysis everywhere’. The notion of a ‘crisis of psychoanalysis’ seems
to be a weapon psychoanalysts use to regulate their institutional rivalry and is an expression
of their inability to inscribe their science in a normal educational curriculum. If there is a
‘crisis of psychoanalysis’ it is linked to a general crisis of medical services and liberal
professions. Median suggests rightly that any theory is already some kind of practice. But
every practice implies some kind of theory. Theory and practice walk hand in hand in a
dialectical relationship. Theories and practices from other fields of thought and experience
often shed light on areas that previously seemed alien to them. Years ago the
psychoanalytical approach to psychotic patients (de Oliveira's field) was considered to be
‘applied psychoanalysis’. not ‘true psychoanalysis’. In a letter to Abraham
about melancholyand Amenhotep IV. Freud stated that the only particularity of the
psychoanalytical approach is that it is meta-psychological. He does not define the object of
the approach. De Oliveira discussed this further in relation to psychosis. He also made a
plea to the discussion group, saying that contributions seemed to take too little account
of history—the history of psychoanalysis and the history of human thought.
Also, transference is rarely discussed. Why? There, the Esman discussion closed.
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Article Citation [Who Cited This?]

Williams, P. (1999). ‘Non-Interpretive Mechanisms in Psychoanalytic Therapy’ By Daniel
Stern Et Al. And ‘What Is “Applied” in “Applied” Psychoanalysis?’ By Aaron H.
Esman. Int. J. Psycho-Anal., 80:197-210

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