1st Edition

Clinical Interaction and the Analysis of Meaning A New Psychoanalytic Theory

By Theo L. Dorpat, Michael L. Miller Copyright 1992
    336 Pages
    by Routledge

    336 Pages
    by Routledge

    Clinical Interaction and the Analysis of Meaning evinces a therapeutic vitality all too rare in works of theory.  Rather than fleeing from the insights of other disciplines, Dorpat and Miller discover in recent research confirmation of the possibilities of psychoanalytic treatment.  In Section I, "Critique of Classical Theory," Dorpat proposes a radical revision of the notion of primary process consonant with contemporary cognitive science.  Such a revised conception not only enlarges our understanding of the analytic process; it also provides analysis with a conceptual language that can articulate meaningful connections with a growing body of empirical research about the development and nature of human cognition.

    In Section II, "Interactional Theory," Miller reverses the direction of inquiry.  He begins with the literature on cognitive development and functioning, and proceeds to mine it for concepts relevant to the clinical process.  He shows how a revised understanding of the operation of cognition and affect can impart new meaning to basic clinical concepts such as resistance, transference, and level of psychopathology.  In Section III, "Applications and Exemplifications," Dorpat concludes this exemplary collaboration by exploring select topics from the standpoint of his and Miller's new psychoanalytic theory.

    At the heart of the authors' endeavor it "meaning analysis," a concept that integrates an up-to-date model of human information processing with the traditional goals of psychoanalysis.  The patient approaches the clinical encounter, they argue, with cognitive-affective schemas that are the accumulatice product of his life experience to date; the manifold meanings ascribed to the clinical interaction must be understood as the product of these schemas rather than as distortions deriving from unconscious, drive-related fantasies.  The therapist's goal is to make the patient's meaning-making conscious and thus available for introspection.  

    I. Critique of Classical Psychoanalytic Theory  1. Freud's Theory of Cognition  2. The Primary Process Revisited  3. On Unconscious Fantasy  4. Unconscious Pathogenic Beliefs or Unconscious Fantasy? Psychoanalytic Theories on Psychic Trauma  II. Interactional Theory  5. Basic Principles of Mental Organization  6. The Mind in Operation  7. Defense and Psychopathology  8. Process and Technique  9. A Clinical Study  III. Applications and Exemplifications  10. Social versus Asocial Perspectives on Transference  11. Self-fulfulling Prophecies and the Repetition Compulsion: An Interaction Perspective  12. Interactional Aspects of Defense  13. Unconscious Meaning Analysis, Unconscious Perception, the Day Residue, and Dreaming  


    Theo L. Dorpat, M.D., is Training and Supervising Analyst and former Director, Seattle Institute for Psychoanalysis, and Clinical Professor, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine.  The author of over 225 scientific publications, Dr. Dorpat has twice received the Seattle Psychoanalytic Society's Edward D. Hoedemaker Memorial Prize for best clinical case study.

    Michael L. Miller, Ph.D., is Clinical Associate Professor, Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, and Clinical Associate Professor, Department of Psychology, University of Washington.  He is currently completing psychoanalytic training at the Seattle Institute for Psychoanalysis.

    "Drs. Dorpat and Miller have given us a fascinating and fundamental revision of psychoanalytic theory that has profound implications for metapsychology and clinical practice.  Their work is the product of long and hard thought about critical issues in the field.  All psychoanalysts and clinical psychologists would benefit from a careful reading of their seminal work."

    - Joseph Weiss, M.D., Training Analyst, San Francisco Psychoanalytic Institute

    "A superb synthesis of principles of cognitive psychology and contemporary relational perspectives in psychoanalysis, Clinical Interaction and the Analysis of Meaning offers major revisions of aspects of psychoanalytic theory and practice.  Beginning with an incisive critique of the isolating assumptions of classical psychoanalysis and its 'blind spot for interactional dynamics,' Dorpat and Miller go on to demonstrate that clinical phenomena derive not from endogenously arising fantasies but from actual interactions between patient and therapist and the unconscious meanings these interactions acquire for the patient.  The book's central focus is on what the authors term 'unconscious meaning analysis,' the process by which a person unconsciously evaluates and represents his or her interactions with others.  Rich clinical illustrations convey the important implications of the authors' theoretical revisions for one's therapeutic approach to transference, resistance, dreams, and psychopathology in general.  This book is highly recommended for all who wish to keep up with the leading edge of current psychoanalytic thinking."

    - Robert D. Stolorow, Ph.D., Training and Supervising Analyst, Institute for Contemporary Psychoanalysis, Los Angeles

    "[A] valuable contribution to the ferment which currently seems to be roiling psychoanalysis most vigorously: the significance of interpersonal interaction in theory and practice. Applying a Piagetian framework to the contemporary interactional perspective, Dorpat and Miller present a structuralist developmental theory of psychopathology, and a model for the here-and-now dimension of analytic process. . . . There is a good deal of value in the theory, which assembles familiar elements of ego psychology and object-relations theory into a coherent whole."

    - Alan Pollack, M.D., International Journal of Psychoanalysis

    "[A[ sophisticated, well-documented attempt to bring psychoanalysis in tune with recent advances in cognitive science and interactional theory."

    - Joseph Reppen, Ph.D., Contemporary Psychology