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Psychoanalytic metapsychology has changed in the past decades from an emphasis on drives as the source of intrapsychic organization, energy, and movement. The nexus of psychoanalytic theory has evolved from the intrapsychic to an interpersonal, intersubjective, and relational focus. With the evolution of intersubjective psychoanalysis, the bi-personal field of the analytic pair is now seen as the vehicle of intrapsychic growth. The relational field further evolved as the locus for development of the ego. An appreciation of the social milieu and its effect on the individual led to an understanding of the long arm of trauma on development. Relational psychoanalysis holds that one sequela of trauma is dissociation, the inability to hold overwhelming pain that threatens the ego with fragmentation. The individual's internal states are cut off from one another, disabling the ego from cohering. Self-states are not perceived as belonging to the individual but are felt to be “not me” states. Internal conflict cannot be accessed because it did not fully develop or because it was sidelined by overwhelming trauma. Affect regulation and thought are not available to stem the flow of traumatic fight/flight/freeze enactment.
Philip Bromberg's “Credo” (2012) tells us that “the therapeutic action of psychoanalysis is a self-Other negotiation that takes place between and within analyst and patient at the interface of dissociation and the capacity to hold internal conflict” (p. 273). Bromberg counseled achieving a balance of “safety and risk” within the therapeutic alliance as the most effective analytic tool. Enactments are processed jointly with the goal of developing the capacity for thought and affect tolerance.
Complexity becomes available, and the world is no longer seen as monolithic and annihilating.
Kimberlé Crenshaw (2016, 1991) is the originator of the term “intersectionality,” which is a way to name and frame the complexity at the intersection of racism, sexism, classism,