Response to JAP's Questionnaire

I would like to answer some of these questions not individually, but simultaneously, because my way of thinking about therapeutic change is inextricable from the way I conceive of the role of the analyst in the treatment experience, and both are reflected in the way I work with dreams and think about self.

I would start with the notion that human experience takes place in two locations, through two kinds of organizations, in two registers, so to speak: the interpersonal and the intrapsychic. The term ‘relational’ was developed to encompass both. The interpersonal refers to the patterning that transpires between the individual and others in the public, transactional world; the intra-psychic refers to the ways in which patterns of experience become privately structuralized and internally transformed. The interpersonal and the intra-psychic are like two ends of a continuous loop: experience in each location is continually reorganized and transformed in ways that have an ongoing impact on forms of experience at the other end of the loop. New interpersonal experiences transform intrapsychic structures; changes in intrapsychic structures transform interpersonal patterns.

Therapeutic change entails changes in both these locations. I was trained in Interpersonal Psychoanalysis, so it was natural for me to see the importance of alterations in the interpersonal field. From my early graduate school experience, I was powerfully drawn to the work of W. R. D. Fairbairn and the British school of object relations theory, so that alterations in intrapsychic structuring also seemed very important. The analyst plays a key role in both types of changes. The analytic situation, in the way I think about it, is both radically intrapsychic and radically interpersonal. Both registers are fully there, not in an inverse relationship with each other where more of one might mean less of the other. The experience is both totally intrapsychic and totally interpersonal. Everything that happens has s