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Pizer's views challenge the traditional classical assumption that insight is the main curative factor in psychoanalysis. Instead, he sees therapeutic change following upon a process of relationally determined interactions (the negotiation of paradox). Thus, his theory of therapeutic action privileges experience and a particular form of interaction over insight and the acquisition of knowledge about the self.
In this commentary, I examine Pizer's views of therapeutic action and the dialectic of insight versus experience by locating them in relation to the work and views of Elvin Semrad, a dominant figure in Boston psychoanalysis from the early 1950s until his death in 1976. Semrad played a central role in the training of Paul Russell, who, in turn, had an important influence on Pizer.
Following Semrad, I suggest that self-knowledge obtained through self-reflection, whether assisted, observed, or self-mediated, serves as an important scaffold on which experience and sense of self are integrated or constructed and gives continuity, coherence, and meaning to life. I believe that this dimension of human growth and development has been underemphasized in Pizer's work and needs to be better integrated into his and other relational, two-person models of therapeutic action.