Nurturing the Leading Edge Through Life and Dementia

This is a case report that explores the intact selfobject tie and how it supports and promotes the leading edge of self-development in Intersubjective Self Psychology. This discussion is divided into three sections: the first four years of therapy, the middle years, and the final two plus years of a thirteen-year treatment. In the initial years of the treatment, the sustained intact selfobject tie unfolds in the therapeutic relationship, allowing for the expression of the leading edge strivings of both participants, which dominates the intersubjective field. This segment of the treatment has multiple focal points: how to promote and sustain the intact selfobject tie, the leading edge and curative agent of an ISP-informed treatment and how and why transference-based interpretations of the selfobject relationship actively contribute to a successful treatment by broadening and deepening the therapeutic collaboration. The “we” of the relationship is examined, including how an active discussion of the “we” strengthened the bond between them and how this shorthand, which felt generative to the patient and therapist, resulted in the solidification of the leading edge. The middle years of the treatment documents some examples of how the leading edge is manifested in the patient developing a sense of agency and a growing sense of self. In the last year and a half of the therapy, the depth of the leading edge is explored as both the patient and analyst encounter an unexpected turn in the patient’s physical health. This complicated the nature of how the leading edge was expressed. Over a long history of exploring and knowing each other, the “we” between them made possible an extraordinary leading edge experience for both.