The Interpersonal Field
The Interpersonal Field: Its place in American psychoanalysis
This paper is about the conception of the construct of the interpersonal or relational field and its reception within the political landscape of American psychoanalysis. The interpersonal field refers to the continuous and reciprocal interaction between analyst and patient, where both parties influence each other, consciously and unconsciously, throughout the therapeutic process. This concept became central to interpersonal and relational psychoanalysis, which contrasts with the drive theory approach of ego psychology that was dominant in the early days of American psychoanalysis in the post-WWI period.
Interpersonal psychoanalysis is focused on the developmental history of the personality, just like classical analysis. However, what differs is its frame of reference in its radical inclusion of social relations in its understanding of the development of the mind, rather than the drive theory concept of classical Freudian analysis that focused on the energetic impulses of the libidinal or aggressive drives. Some interpersonalists rejected the centrality of drive and the Oedipus conflict and instead elaborated on interpersonal understandings of unconscious processes, the unconscious aspects of the analytic relationship, and the internal world. It’s unquestionably a two-person model.
The analytic situation is defined in terms of its relatedness. Donnel Stern posits that the concept of the interpersonal field played a crucial yet historically underrecognized role in shaping contemporary psychoanalytic theory and practice. He makes the case that its earlier adoption could have prevented American psychoanalysis from its poor public view as being out of touch and antiquated. He asks, “What if, instead, there had been an effort, in presenting psychoanalysis to the world, to combine intrapsychic views with a recognition of the clinical significance of the present context, in interaction with the past—that is, the field?”
History in American Psychoanalysis
Harry Stack Sullivan first wrote about the interpersonal field in the 1920s, and he had a major influence on the treatment of psychotic disorders. His study of interpersonal relationships between a person and the environment opened the door to a deeper understanding of conditions like schizophrenia as more than a “spontaneous, completely autonomous, deteriorative internal process.” Sullivan practiced at the Shepard Pratt Hospital in Baltimore and later played a part in founding the Chestnut Lodge in Rockville, MD, and The William Alanson White Institute in NYC, which is the main hub of what is now known as the interpersonal school. Sullivan was a pioneer in what he called “interpersonal psychiatry”, though he never really identified as a psychoanalyst. His ideas also predated and influenced a lot of the anti-psychiatry and deinstitutionalization movements that came later in the 1950s and 60s. This was a period when many state psychiatric hospitals were closed, and individuals with severe mental illness were moved to more community-based care settings, where they emphasized group and milieu therapy.
Erich Fromm’s influence was huge on the interpersonalists, but he did not write clinical books, so his influence is relatively ignored. Fromm emphasized the vitality of the analyst, whom he said should exhibit and encourage directness, spontaneity, affective vitality, and personal authenticity.
Key Concepts: meanings and applications to practice
The Interpersonal field “…is, on one hand, the sum total of all influences, conscious and unconscious, that each of the analytic participants exerts on the other. On the other hand, the field is the outcome of all those influences, the relatedness, and experience that is created between the two people as a result of the way they deal with one another.” Meaning is an interpersonal event. The meanings that we are free to articulate and to reflect upon are the ones that are allowed by the interpersonal field. The field is a social configuration, largely unconscious, in which both participants are unconsciously embedded, despite being its creators. The field is only partially our own creation; it is, to an important degree, imposed on us. We live in worlds that are continuously created with the other, so that we are never our own authors in any simple or straightforward way.
The Analyst’s Subjectivity: Stern comments that his intentions as an analyst and a person, like anyone’s, are not simply rational. He says, “They are affect-laden expressions of the themes in my life that have had the most to do with defining me and my mind—desire, disappointments, hopes, and fears. One cannot divide such intentions into neat categories. While I can identify my intentions to capture clinical and intellectual phenomena in language and thought, my intentions go far beyond anything as rational as that. My intentions and my theoretical commitments are personal, historical, somatic, moral-political, and aesthetic. Above all, and whatever else they are, they are passionate.” (Stern, 2015, p. 394)
Unconscious enactments: In interpersonal psychoanalysis, the analyst hopes to create thoughtful and emotionally responsive understandings of the patient and the ongoing clinical process; but the analyst also hopes to maintain a radical uncertainty that, when necessary, will allow them to reimagine these understandings as unconscious participations with the patient.
Treatment is always as much about the subjectivity of the analyst as it is about the subjectivity of the patient. The patient cannot change unless the field shifts in certain crucial ways, ways that are unconsciously maintained in the form of enactment. So the patient cannot change unless the analyst does. And the analyst, for their own part, cannot change in these key respects without the patient’s collaboration. Each participant in treatment has no choice but to depend on the other in the process of therapeutic change. And since it is the field that controls the expression of possibility as explicit meaning allowing unformulated experience its imaginative freedom requires that we first free the frozen or constricted parts of the field.
The interpersonal field sets the limits of the contents of consciousness for each of the participants. When the limits can be unfrozen or loosened then things previously unthinkable can be thought about. The key element of the interpersonal field is the idea of intersubjectivity. This is where unformulated experience is brought into consciousness through interaction with another person. Having the other person is very important because the self cannot be formed alone. This raises questions about self-analysis, where Freud was supposed to have analyzed himself, though the question could be asked whether his early analytic correspondences with his colleagues by letter amounted to something resembling an analysis.
The analyst is a participant in a jointly established interpersonal field. At one point in the article, Stern speaks of his own experience. Here, he brings in his own subjectivity, perhaps modeling interpersonal psychoanalytic thinking for us in his writing. Stern says, “The capable clinician is not necessarily one who knows the truth of what is in the patient’s mind, or even what is in the analyst’s mind. But given what she believes is the reality of her unconscious involvement and the ambiguity of the unconscious, she cannot be sure that she knows, and even if she thinks she does know something, she cannot be sure why she knows. The analyst continuously tries to imagine and reimagine the ways in which the contents of her own mind and the meanings of her own conduct may play a role in the unconscious aspects of relatedness with the patient.”
Stern argues that aspects of contemporary Freudian theory and practice remain inscrutable and historically incoherent if one does not relate them to the interpersonal theory that preceded them. Mainstream psychoanalytic writers were at least unconsciously influenced by interpersonal theories, e.g., when they talk about the therapeutic relationship. My clinical view is that the unconscious itself can only be observed in the relational here-and-now between at least two people.
Questions for clinical reflection:
1. When do you (if you do) bring up the therapeutic relationship itself as something to talk about in session?
2. How do you view enactments in your work with clients?
3. To what extent do you think self-analysis is possible?
4. What do you feel in response to the sentence, “The analyst’s job is to tell the patient the truth and let the chips fall where they may”?
References
Stern, D. B. (2015). The interpersonal field: Its place in American psychoanalysis. Psychoanalytic Dialogues, 25(6), 694–708.