Needed Relationships and Psychoanalytic Healing
A Holistic Relational Perspective on the Therapeutic Process
Needed Relationships and Psychoanalytic Healing is both a personal analytic credo and a multidimensional approach to thinking about clinical interaction. The book’s central theme is that of analytic needed relationships—the science and art of co-creating unique, evolving relational experiences fitted to each patient’s implicit therapeutic aims and needs.
Steven Stern argues that, while we need psychoanalytic theories to "grow the receptors and processors" necessary to sense, understand, and connect with our patients, these often tend to frame the therapist’s participation in terms of theoretical and technical categories rather than offering a more holistic view of the relationship in all of its human complexity. Stern believes that a new set of higher order constructs is needed to counteract this tendency. In addition to his own concept of needed relationships, he invokes principles from the work of renowned developmental researcher and theorist, Louis Sander: especially his concept of relational fittedness. Stern draws on the work of Freud, Bion, Winnicott, Kohut, and a broad spectrum of contemporary psychoanalytic authors, in fleshing out the therapeutic implications of Sander’s (and Stern’s own) vision. The result is a rich, humane, and accessible narrative.
Needed Relationships and Psychoanalytic Healing offers diverse clinical examples in which you will find Stern engaging with each of his patients in idiomatic, spontaneous ways as he attempts to contour interventions to the evolving analytic situation. This case material will inspire therapist-readers to feel freer to find their own creative voices and idioms of participation, as they seek to meet each patient within the psychoanalytic space. The book is intended for psychoanalysts and psychodynamic therapists at all levels of experience, including those in training.
Table of Contents
Preface by Donna M. Orange
Introduction: An Orienting Principle for Relational Psychoanalysis
1: Needed Relationships and Psychoanalytic Healing
2: Complexity Made Simple; Simplicity Made Complex
3: Fittedness and its Vicissitudes
4: The Tendency Toward Fittedness and the Forward Edge of the Relational Unconscious
5: Understanding and Engagement in the Analytic Process
6: The Dialectic of Empathy and Freedom
7: The Conundrum of Self-Care
8: Analytic Peace
Appendix A: The Forward Edge of the Relational Unconscious: A Theoretical Comparison
Steven Stern, PsyD, is Clinical Associate Professor of Psychiatry at Maine Medical Center and Tufts University School of Medicine, faculty member at the Massachusetts Institute for Psychoanalysis, and a member of the International Council of the International Association of Psychoanalytic Self Psychology. He practices in Portland, Maine with specializations in psychoanalysis, psychodynamic psychotherapy, couples therapy, and clinical supervision.
"Steven Stern’s Needed Relationship and Psychoanalytic Healing is an innovative and erudite work of scholarship and, perhaps more importantly, it is a leading-edged contribution to clinical psychoanalytic practice and education. Stern utilizes Louis Sander’s developmental concept of progressive "fittedness," as a central organizing principle, and he systematically examines and illustrates the complex clinical implications of this paradigm. Focusing especially on the dialectics of understanding and relational engagement, and of conscious and unconscious participation, Stern advocates a holistic relational approach that uses but transcends theory in co-creating forms of engagement contoured to the uniquely evolving aims and needs of each patient. Compelling and rich clinical examples allow the reader to not only follow how Stern himself utilizes his multi-modelled pluralistic approach but more importantly, they allow readers to imagine how they themselves can make use of these conceptualizations to find creative and unique solutions to improving the quality of their understanding and engagement with patients. This book will be essential reading for students and sophisticated mental-health practitioners."-Lewis Aron, Ph.D., Director, New York University Postdoctoral Program in Psychotherapy & Psychoanalysis.
"Culled from Stern’s decades of intensive immersion in both the theory and the practice of analytic therapy, Needed Relationship and Psychoanalytic Healing explores, in richly satisfying detail, the nuances and subleties of the moment-to-moment encounter between patient and therapist. It is a lovingly crafted, synergistic blend of elements that are at once self psychological, relational, existential, humanistic, empathic, present-focused, attachment-based, and systemic – a holistic view of the analytic relationship that appreciates both its simplicity and its complexity. Stern, clearly a brilliantly integrative scholar and an exquisitely gifted clinician, is able to hone in, with precision and finesse, on the very essence of the therapeutic process.
Ever mindful of avoiding dogma, Stern has masterfully found a way to tease out a number of "organizing principles" specifically designed to provide the therapist with a broad-based conceptual – and contextual – framework for understanding both the patient’s subjectivity and the ever-evolving intersubjective dynamic between patient and therapist – at the same time that this framework encourages the therapist not only to be mindful of all that is emerging at the "points of emotional urgency" and in the "moments of meeting" between patient and therapist but also to be attuned to the gradually unfolding and ever-evolving "relational fittedness" between them. Chapter after chapter, we are gently reminded that, although we need theory to help guide us, it is important that we never allow it to get in the way of our ability to be present with our patients – so that we will have the freedom to find both them and "us."
Stern’s book, a humane and accessible narrative that both inspires and is inspired, should be required reading for therapists of all levels."-Martha Stark, MD, Faculty, Harvard Medical School; Co-Director, Center for Psychoanalytic Studies; Faculty, Psychiatry Redefined.
"Steve Stern has given us a thorough interrogation of the central issues being debated in contemporary psychoanalysis today. His book demonstrates breadth and depth of scholarship at a level of detail that would take our collective breath away if it did not simultaneously breathe fresh new life into almost every psychoanalytic question ever asked. Stern lays out our current theoretical and technical conflicts using densely muscular prose that is at the same time finely chiseled in both style and content. And in his clinical vignettes, not only does each of his patients come achingly alive in her individuality and suffering, but so too does Steve Stern come alive as the struggling psychoanalyst. This book moves 21st century psychoanalytic discourse forward."-Judith Guss Teicholz, Ph.D., Massachusetts Institute for Psychoanalysis.
"A unique characteristic of Stern’s writing is that he absorbs, draws from, and integrates the best of so many analytic writers. I haven’t seen anyone else do this so well. He tries for an integration of what he sees as the best of psychoanalysis, and then uses this integrative vision as the basis for his own original and valuable perspective on the psychoanalytic process and therapeutic action."-James William Anderson, Ph.D., Northwestern University and the Chicago Institute for Psychoanalysis.
"Steven Stern has written an amazing book. Needed Relationships and Psychoanalytic Healing not only offers the sophisticated, psychoanalytically informed clinician a refreshing and integrating vision of the field, it provides at the same time a thorough-going education for the novice in the profession. If I had my way as an educator, I would insist that every psychoanalytic institute include in its training program for both the psychotherapist and the psychoanalyst-in-training an opportunity to study this book in full. I myself am teaching a course in psychoanalytic technique for the advanced candidates in psychoanalytic training at ICP, and Stern's book is the backbone of my syllabus."-Estelle Shane, Ph.D., Founding member and training analyst, Institute for Contemporary Psychoanalysis, Los Angeles, CA.