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Diane Shainberg offers an original and ambitious theory of the nature of the curative process. Arising particularly out of her work with borderline patients, she demonstrates in incisive and often poignant vignettes her techniques for establishing and working through positive therapeutic alliances with patients seemingly determined to provoke, belittle or ignore the therapist.
Her technique stresses learning to recognize and then actively inquiring into areas of nascent growth in the midst of the borderline patients' pathology. Working with this “growing edge” rather than prematurely addressing areas of greatest conflict, she suggests is the key to establishing a working alliance. Thus she writes “The therapist works outside the circle of greatest compulsivity, at the growing edge of something new … anything outside of conditioned, destructive, repetitive ways of behaving.” The following vignette illustrates her style:
“A flat, nontalkative detached man was sent by his parents to session…. He had little idea what he wanted to do. He was dull, listless and responded only when spoken to.
“One day he mentioned degrading himself—that he was a jantor in his family, cleaned the basement.” I asked what there was to clean. He tossed it off, said he was only ‘kidding.’ … Again I asked exactly what he did there and he said, ‘I muse at my desk.’
“I asked specific questions about where he got the desk, what it was made of, what led him to get it, what was in the drawers, what he did at the desk. As he told me of his purchase, his caring for the desk, his refinishing it, his whole manner changed to active participation. I asked what he did at the desk and he laughed, saying, I mostly daydream, but I also write poems. I found this out for the first time. My participation in this moment of healing was to feel his enthusiasm, to explore the particularities of his basement, his creativity, his work, his dreams, his desk, his actual efforts in life where he was in fact alive and natural.