When the Music Changes, it is Possible to Come Out of the Box: A Relational Self Psychological Perspective of Lucyann Carlton's “Struggling Out of the Box”

This article offers, from a relational self psychological perspective, a discussion of the analytic treatment of a patient who had experienced repetitive emotional, physical, and sexual abuse and abandonment. It is suggested that therapeutic action in this analysis was anchored in the analyst's consistent empathically based “spirit of inquiry” that contributed to the cocreation of a profound experience of being seen, understood, and known by a deeply caring person. Importantly, the analyst's subjectivity was expressed interactively in a myriad of ways, including inquiry, validation, affirmation, deep caring, modulation of affect, interpretive reframing, and an educational vision of “how analysis cures.” These interactions contributed to the creation of a sense of safety and feeling understood that enabled Renee to recall, feel, and articulate traumatic memories. Explicit inquiry illuminated negative percepts of self and other and their relational origins and facilitated their suspension, so that new models based on current implicit and explicit relational experience were gradually integrated into long-term memory systems for lasting change. Indeed, when the music changes, it is possible to come out of the box.