Commentary on Markman's Vignette

The mere fact that JAPA has presented Henry Markman's vignette for discussion represents for me a bit of encouragement about the future of our field. I am encouraged not simply because I applaud what Markman did (although I do feel that way about it, under the circumstances in which it came about). No, what I appreciate is Markman's cautious openness to following his patient's emphatic lead, without feeling that he was disastrously violating his professional ideals. Markman trusted the patient to know something about what he needed. He listened, and he considered the alternatives available to him, and he chose selfdisclosure, or what I would prefer to call expressive participation.

Markman doesn't tell us the theoretical position from which he is working, although we are clear that he does not agree with the most traditional views, at least in this instance. We are safe in assuming, I think, that Markman is working from some kind of field theory, in which the events of the treatment are mutually constructed by the participants. The processes by which the field is constructed, and often enough the resulting outcomes, too, are liable to occur outside awareness, and do not necessarily lend themselves to representation in any kind of symbolic terms-that is, neither in imagery of some kind nor in words. Instead, at least in North American field theory,1 moments of clinical process such as the one we are discussing between Matt and Markman-and human relatedness of all kinds, for that matter-may not be represented in the mind by symbols