But What do You Want? the Problem of an Absence of Desire Presenter: Joyce A. Slochower, Ph.D. Discussant: Giselle Galdi, Ph.D. Date: November 16, 2000

Dr. Slochower's presentation centered around the question of how to treat patients who cannot access their feelings and desires and who are therefore unable to express them to others. She began with the case presentation of M, a man who reported that his girlfriend had nearly broken off their relationship because of his inability to express his desires, which resulted in her feeling suffocated by his tendency to go along with her. According to his girlfriend, he did not seem like a whole person because he had no access to his feelings. M was surprised by her reactions to him, but nevertheless, he was still unable to please her by identifying and expressing what he truly wanted. Dr. Slochower sought out ways of identifying, understanding, and facilitating the communication of M's inner thoughts, feelings, and experiences.

Central to Dr. Slochower's paper was the concept of interiority. This refers to the sense of the self as a subject and was described as “a basic ability to turn inward and contact affective states that can then be symbolized and articulated.” M clearly lacked this sense of interiority. Dr. Slochower proceeded to describe the development of the sense of interiority and the complex processes by which we locate our inner experience. Drawing on infant research by Beebe, Lachman, and Jaffe, she reminded the audience that internal experience always arises out of the subtle interplay between self and others and that, even when alone, we always define ourselves in the context of interactions with others. Dr. Slochower then related the concept of interiority to what Winnicott described as the capacity to be alone, the infant's experience of aloneness in the presence of the mother. For individuals who have not developed a capacity to be alone, the step of looking inward and getting in touch with one's inner experience is especially anxiety arousing because it implicitly requires a person to experience “aloneness” and detach from the other's experience. This ca