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You're gonna need somebody on your bond [Blind Willie Johnson, 1929].
Caveat: I am aware that taking a stance of sustained “provision” in terms of “doing for” or “giving to” a patient (in this case, taking Julie at her word, rather than following the interpretive line insisted on by my instructors) challenges the consensus of contemporary practice. However, I am not seeking, by argument or example, to refute or supplant that consensus.
Instead, I invite the reader to judge my comments, not against metapsychological concerns, but with her or his own experience in mind:
Do I recognize myself in the clinical vignette or the discussion in a way that clarifies my own practice?
Do my comments provide a workable explanation for clinical interchanges I have experienced but have struggled to understand?
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If what is described diverges from my own practice, does it suggest ways to respond to clinical interchanges in which my typical practice has not worked?
“The Perversion of Attunement: Fundamentals Gone Awry in the Service of an Ideal” (Steinberg, 2011)is a highly charged, colorfully written brief communication. As an analyst who might be included among the “undeclared revisionists” singled out for criticism, I seek to offer my own reflections on the two issues I intuit the article raises.
“The Perversion of Attunement” opens with an endorsement of Kohut's “rupture and repair” model of therapeutic action (Friedman, 1986,p. 326). This would appear to be addressed toward self psychologists who privilege sustained attunement as the crucial therapeutic variable. Some of us view rupture as highly likely and demanding of repair, but not as inevitable, nor as a source of therapeutic action. The author then presents a rendition of the dynamics allegedly underlying what she characterizes as an over-concern with attunement.