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Stern describes his adaptation of an interpersonal technique to the treatment of a particular subgroup of psychoanalytic patients—those who because of false self character defenses are highly resistant to the direct discussion of the transference or of the therapeutic relationship. These patients, e.g., the eating-disordered previously described by Hilde Bruch, are often hypervigilant about whose interests are being served in the treatment. Bruch emphasized mirroring the patient's own self-exploration and self-definition to counteract the suspicion of control by the therapist. Many of the patients described depend heavily on defenses of denial, disavowal, and dissociation to maintain a split between a traumatized self and the "false self" evolved for security relations with necessary others. A manifestation of this split in the transference is the patient's disavowal of affective wishes and needs with the therapist. This results in a restricted awareness of the transference process.
To counteract this restrictive influence, Stern advocates the use of a Sullivanian technique which clearly identifies the influences of "the other people in the room," and in a back-and-forth movement gradually differentiates the patient's actual experiences and wishes from the influence of those "other people." This has been referred to as a "widening and balancing" or "managing opposing currents" technique. The result is that disavowed affects, needs, and developmental goals previously unacceptable can, through this facilitating and "holding" method, be finally integrated. Stern refers here to character pathology subsumed under Winnicott's "false self" organization, Kohut's "vertical split," and Stolorow, Brandchaft, and Atwood's "fundamental psychic conflict." He emphasizes that the "opposing currents" method requires holding in mind simultaneously both of the patient's dominant motivations—the underlying repressed needs, and the "other-person" directed repudiation or disavowa