Contact & inter-subjectivity: the definition of the self in the therapeutic relationship

“The patient’s unconscious and repressed desires and fears are constantly seeking release or, more precisely, contact with real persons and situations.” (Reich, 1945/1984, p. 5) This relational contact between individuals, as well as the therapist and client, is a common reciprocating mutual co-influence on each other. Whereby one person’s existence is realized only in the presence and perception of each other and the self in the interaction. This togetherness contributes to a co-creation of common meaning-making; a product which is more than the sum of two individuals put together. This personal contact between persons is an inter-subjective event. To further displace Descartes’ dictum, “cogito ergo sum,” the concept of inter-subjectivity maintains instead the notion of “I am seen, therefore I am”. Buber (1936, p. 261) puts it shortly in quote, “Der Mensch wird am Du zum Ich”, which implies the other is a part of the self.

I am seen, therefore I am.

Martin Buber, 1936, p. 261

Self-identity is determined by the internalized relationship of the self with others, which in turn is the relationship between different (sometimes split) aspects of the self. As Kierkegaard (1941/1849) explains, “The self is a relation which relates itself to its own self, or it is that in the relation [which accounts for it] that the relation relates itself to its own self; the self is not the relation but [consists in the fact] that the relation relates itself to its own self.” To further reiterate that this process of self-relating is a continuous dynamic process and not a static one, “Man is a synthesis of the infinite and the finite, of the temporal and the eternal, of freedom and necessity, in short it is a synthesis. A synthesis is a relation between two factors. So regarded, man is not yet a self” (p. 9). Self identity is thus a continual self relation in relation to others. This process, however, involves a mutual recognition of the other, distinguishing oneself from the other, to acknowledge the other as an other self. Self identity, in other words, is implicit in relating of the self to the socio-cultural environment. This dimension of inter-subjectivity in contact is experiential, and considered in psychotherapeutic schools an essential part of the therapeutic hour (Staemmler, 2013).

The origins of an individual’s self-concept and its relation to Inter-subjectivity is elaborated by development psychologists. Trevarthen (1993) writes, “The core of every human consciousness appears to be an immediate, unrational, unverbalized, conceptless, totally atheoretical potential for rapport of the self with another’s mind (p. 121).” The infant’s “primitive state of mind” is inherently aware of human presence and ready to follow and communicate with human mental states. This pre-learning stage is prelinguistic— non-intellectual and primarily emotional— and is a “delicate and immediate with-the-other awareness.” From birth there exists this human self-awareness which is a “manifestation of mind in a person who is capable of being a companion and confidant to the responses of the other, at an emotional level.” This sets the stage for—and precedes— an eagerness and motivation for learning shared meanings with the community in his/her cultural setting (p. 122). Cultural learning (at about 9 months of age) involves the development of self-perception: the child learns to make meaning out of objects, and see themself in the eyes of another person – usually the adult (Tomasello, 1993). Through the child’s interaction with their caregivers, they develop a sense of self-identity which is dependent on how the other perceives them and relates to the meaning of worldly objects according to the other’s perception of these objects. Kernberg (1976) and Kohut (1984) have hypothesized the development of infants’ sense of self is important clinically because it determines certain forms of adult psychopathology (Pipp, 1993).

In adults, the preverbal self is independent of cultural influences, and hence symbolic mediation. It is this aspect of the self that when reached for in the psychotherapeutic alliance, gets through to the transpersonal relationship. This dyadic system within the alliance holds more information and is far more complex than what exists in the consciousness of each individual (i.e. therapist and client) in the alliance (Tronick, 1998).

Vygotsky is noted by Staemmler (2013) to have been one of the first psychologists to develop the idea of the intersubjective relationship as a groundwork for the development and change process, as opposed to the assumption of change as an individual process alone. The intersubjective relationship, that which exists “in-between” during the meeting of persons, is the process to the change. The client benefits from the essence of the contact in the relationship; even more so than the content of the narratives during therapy itself.

Watzlawick et al. (2011) point out the impossibility of not communicating. As human beings, we cannot not communicate; even when we try to defer speaking or reacting to another person. It is also hypothesized that, in the case of psychopathological conditions like schizophrenia, where the client’s strategy is not to say anything, perhaps to avoid communication, in doing so, however, he/she unwittingly communicate. Interaction between individuals ultimately exists in communication. “Communication implies a commitment and thereby defines a relationship(…) Communication not only conveys information but at the same time it imposes behavior” (p. 51).

Bearing this connection between relationships and behavior, we can fathom how an alliance, like a psychotherapeutic alliance can support change in behavior in an individual. According to Vygotsky, the individual carries around with him/her his sociocultural interactions regardless of whether he/she is with others or alone. “It is necessary that everything internal in higher forms was external, (…). Any higher mental function necessarily goes through an external stage in its development because it is initially a social function. (…) Any higher mental function was external because it was social at some point before becoming an internal, truly mental function … the composition, genetic structure, and means of action [of higher mental functions]—in a word, their whole nature—is social. Even when we turn to mental processes, their nature remains quasi-social. In their own private sphere, human beings retain the functions of social interaction” (Vygotsky, 1981, p. 162-164). In other words, our social interactions, which are linked to our self-perception, are internalized.

Family therapy in many ways, can be seen as bringing to the external what is already internalized. The focus is on generating dialogues in the social system and also internalized voices. These voices are also known as Bakhtin’s (1984) polyphonic voices. Virginia Satir calls the dialogue of these internalized voices, “the theatre of the inside”, which is unconscious until we realize and accept their existence, and become aware of the conflict that exists between these voices (Satir, 1978/2009). Generating dialogues in therapy means shifting the focus from the content of what is being said in the client’s narrative to the unfolding of emotions that arises as the narratives are told. In therapy, the therapist gets to witness the client’s unfolding and an intersubjective consciousness emerges (Seikkula, 2011). What therefore is mostly needed in the realm of psychological help is not the change of an individual as a person in isolation, but the change in the individual within his/her internalized societal interactions. In a therapeutic setting, the change process occurs in the person-person contact between the client and therapist, to which both parties contribute to. The quality of the contact provides the client with new internalized experiences with another human being, eliciting a shift in prior internalized mental states. The newly internalized experience gained during the therapy hour through transpersonal contact lays the ground for growth and healing long after therapy ends (Staemmler, 2013).

Reference

Chew-Helbig, N. (2017). The Psychotherapeutic Alliance and Change: A discussion on the healing aspects in a psychotherapeutic relationship. Bachelor Thesis.