Reply to Carolyn Clement's Commentary

It is a challenge to respond to Carolyn Clement's extension of my work. Because we work with different sets of assumptions derived from different theoretical models, it at times seems as if we are applying the characteristics of appels to a discussion of oranges. Nevertheless, there are three areas of commonality to which I can respond: (1) her extension of the concept of agency, (2) her critique of the lack of bidirectionality in the clinical material; and (3) her concerns about the clinical material, which I believe is a misinterpretation. I will use the latter two points to raise some larger issues about the way we report clinical material.

Clement extends the concept of agency to self-experience at the motoric level through proprioceptive feedback. She further elaborates agency as the infant's experience of his own states and activities during the “disjoining” periods or periods of “open space.” These aspects of agency are important but significantly different from the aspect of agency that I have highlighted, that is, the contingent responsiveness of the human environment to the infant's regulation of his own state.

I chose to highlight the human environment's contingent responsiveness because (1) it seems to afford a better parallel to the analyst—patient dyad, and (2) I believe it is a foundation from which other capacities develop. For example, the capacity of the infant to experience itself in the alone state is partly a function of the effectiveness of the infant—caregiver system in helping the infant achieve state regulation. The case of Jack is illustrative. Jack's parents were both massively indifferent and psychotic. As an adult, Jack did not experience his own inner states with any specificity. He did not have access to the experience of hunger, fatigue, proprioceptive feedback, or, at another level, basic affect states. It took many years of treatment in a dyad with me, where there was some continuous recognition and contingent responsivenes