Commentaries

The concept of working through has been enhanced, first, by developments and innovative theories coming from neuroscience, and second by the relevance of the object-relations frame of reference and, within it, the role and therapeutic effects of intersubjective components in the analytic process.

Bridging from the intrapsychic to its correlates in brain function, Gedo states that for adaptational change to take place, it is necessary to establish new automatic response patterns. The reorganization of “neural networks” that this entails is the working through process. This follows Edelman's theory (1987, 1992) of “neural Darwinism” and his schema of brain functioning in terms of neural nuclei, neural mapping, neural group selection, etc., and their mutability for adaptation under the impact of development and experience (see also Sachs, 1989). From our vantage point this would include the intensive and extensive experience of psychoanalysis and its potential for change.

A relatively simple case pertains: About three years ago I became the involuntary participant in what might be called an experiment of nature which required a significant degree of neural network remapping. I had been myopic since childhood. It was fully correctable, but from the start the myopia of the left eye was much greater than that of the right, necessitating about twice the correction. With eyeglasses I had 20/20 vision in both eyes, except that the acuity of the right eye was slightly sharper, thereby favoring right eye dominance. So it was for about sixty years, until a beginning cataract of my right eye significantly reduced its sharpness of vision, while the acuity of the left eye remained as it had been. With this reversal, it might have been expected that dominance would have shifted then and there, but it did not. Apparently a functional inertia over which I had no voluntary control was a compelling factor. Even though I was suffering considerable eye strain, with much squinting and disco