Review - The Present Moment in Psychotherapy and Everyday Life
by Daniel N. Stern
W.W. Norton, 2004
Review by Marilyn Nissim-Sabat, Ph.D., M.S.W.
Feb 15th 2005 (Volume 9, Issue 7)

Daniel Stern's new book, The Present Moment, has already generated in depth analysis and has been seen as an intervention in the ongoing struggle in psychoanalysis regarding the effort to eliminate remnants of Freudian positivism. I refer to Heward Wilkinson's lengthy review essay in the Nov. 2003 issue of the International Journal of Psychotherapy (pp. 235-254). In his review, which is both highly favorable and highly critical, Wilkinson maintains that Stern's formulations incorporate elements of positivism and atomism that reflect the latter's commitment to the Freud legacy in psychoanalysis. In the present review, I describe what I take to be the most significant aspects of the contents of The Present Moment, and assess its general character and great merit. In addition, I explain the important role of Husserlian phenomenology in Stern's viewpoint, which Wilkinson alludes to twice but does not address at all, except to refer to Husserl disparagingly as one who "is also reductive in his way…" (Wilkinson 248).

While I share with Wilkinson the view that the future of psychoanalysis depends on fully transcending positivism, I reject his view on how to overcome those positivist elements (which as I show below he mistakenly attributes to Stern) while retaining Stern's "breakthrough" (Wilkinson). Unfortunately, however, Wilkinson slights the pervasive presence of elements of Husserlian phenomenology in Stern. Because Wilkinson does not see the value of specifically Husserlian phenomenology, he does not see that the antidote within Stern's thinking is an expanded role for phenomenology rather than, as he proposes, a move towards what I (and others) view as Heideggerean linguistic reductionism… (e.g., see Wilkinson 253).

What, then, is "the present moment", and what is its significance for psychoanalysis? How has Stern been influenced by Husserl?

 The present moment is understood by Stern to be a moment of intersubjective lived experience (Stern's overriding emphasis is on experience in the consulting room between analyst and patient). Present moments are lived nonconsciously on the level of implicit, rather than explicit, i.e., conscious, verbalized, or verbalizable, experience. Implicit experience is nonconscious rather than unconscious in that it is not repressed and is not subject to psychic resistance. (Stern's book is replete with extensive examples and descriptions of present moments derived from the method, fully conceptualized in the book's appendix, of "microanlysis" of analyst-patient dialogues and patient recording of daily experiences.)

 In focusing on nonconscious, implicit experience, Stern is not rejecting the Freudian unconscious. He does not deny either its existence or its significance for psychoanalytic psychotherapy. Nevertheless, in one of his most revealing metatheoretical statements, he maintains that,

The temporal aspect of the present moment…had to be addressed…After all, the presentness of lived experience is central. This question sent me on an extended learning journey into the realm of phenomenological philosophy…It was there that the hidden but obvious fact that we are psychologically and consciously alive only now became apparent…This is, of course, a radical departure from the path historically taken by most psychologies that put the central emphasis on the past and its influence. It also implies that consciousness, rather than the unconscious is the key mystery, another radical departure…xiv-xv

In thus pointing out in the Preface to The Present Moment that consciousness rather than the unconscious is "the key mystery," Stern might confuse readers subsequently when he focuses, as we have seen, on nonconscious, implicit experience rather than conscious, verbal, explicit experience. The point is, however, that nonconscious, implicit experience is not unconscious dynamically; it is unconscious topographically and, as such, is actually experienced; i.e., it is conscious as a form of experience, though unreflected and nonexplicit. This is consistent (although Stern does not at all discuss this point) with the phenomenological notion of consciousness which is far broader and deeper than the Freudian notion.

Most important for grasping the nature of the present moment is understanding, as Stern points out in the quote above, that present moments have a temporal structure. That structure is such that they bear within them the immediate past and the foreshadowed future. In developing his conception of the temporal structure of experience Stern was profoundly influenced, as he fully acknowledges, by the work of Edmund Husserl, the founder of phenomenology For Husserl, there is no "standing now". The present, the 'now' moment, is a process with retentive (immediate past) and protentive (anticipated future) horizons. The present moment is infused with and structured by these flowing temporal horizons, as well as with their experiential content. This flowing process is what Husserl referred to as "erlebnis", a word usually translated from the German as "lived experience." (In the phenomenological-existential perspective, "lived experience" is referred to as "existence"). (Also, although I cannot elaborate here, Stern fully appreciates and uses the Husserlian notion of the intentionality of consciousness.)

Equally important for understanding Stern's formulations is that for him the mutative effect of psychoanalysis occurs in the therapy session in and through present moments. Oddly, Wilkinson does not even mention, let alone discuss, the mutative effect of psychoanalysis. Yet, understanding the mutative effect has been, and is, the holy grail that analytic theoreticians and practitioners have sought for more and more intensively as psychoanalysis has undergone change since Freud and has abandoned Freud's simplistic "where id was there ego shall be"; and in particular, as theorists have gained deeper understanding of the depth dimension of the imbrication of positivism in psychoanalysis. For, if psychoanalysis is not a positivist, physicalist, reductive science, and if, therefore, the mutative effect does not have a causal structure as positivists maintain, how does analysis bring about change in patients? As mentioned above, Wilkinson in his review does not at all touch upon this all-important issue, even though accounting for it is the cornerstone of Stern's perspective.

For Stern, the mutative effect occurs through the attainment, in and through present moments, of what he calls "intersubjective knowing".

 Intersubjective knowing is implicit and nonconscious. It occurs in the here and now, but as Stern points out, the present moment of intersubjective knowing is quite different from "the here and now" as presently understood in psychoanalysis. The difference is that Stern considers the presentness of the present moment to be absolutely crucial in constituting the mutative effect of psychoanalysis. Thus, this effect does not come about through analytic considerations and interventions regarding the here and now of the patient's narrative or the here and now of the relationship between analyst and patient. Rather, the present moment occurs in the heat atnd intensity of the intersubjective field in the present of that heat and intensity. This is correlated with Stern's view that the present moments in analysis that bring about change are nonconscious (rather than unconscious) and are not matters that are subject to repression either before, after, or during their occurrence. In fact, for Stern, intersubjective, implicit knowing is subject, rather, to repression of any attempt to verbalize it; in this way, its authenticity is retained and protected from objectvation. Stern maintains that there is universally in human beings a motivational system the aim of which is intersubjective knowing, i.e., implicit knowing shared by two people; and, that motivational aim is achieved in present moments. In my view, this is the most important contribution in Stern's book in that it comes closer to an explication of the mutative effect of psychoanalysis than previous theories. 

At this point, we can consider the positivist elements in Stern and how they can be most constructively transcended. For, the elements of transcendence are already implicit in the book.

Wilkinson points to three positivist elements in Stern's formulations:   1. Stern maintains a "strong logical behaviorism." Wilkinson's basis for this claim: Stern states that "We are capable of 'reading' other people's intentions and feeling within our bodies what they are feeling [Stern's grammar MN-S]. Not in any mystical way [Wilkinson's italics], but from watching their face, movements, and posture, etc. etc."[I have truncated Wilkinson's quote from Stern on Wilkinson 246]. Wilkinson maintains that Stern partially recognizes "direct mimetic mutual resonance" and that Stern moves towards the recognition that the social basis of mind is prior to, and the logical presupposition of individual conscious awareness and mentality (246).

2. Wilkinson avers that Stern maintains a very simple experience/neuro-process dualism "so that neuro-processes are treated as functionally equivalent to personal phenomenological processes." For Wilkinson, this dualism should point instead "towards interactionism so thoroughgoing that it begins to relativize the position of neuroscience from a phenomenological position" (247).

3. Wilkinson states: "Third, and for my present purpose most important, (for this one is within the phenomenological field and is still atomistic) there is the central atomistic postulate of basic experiential units conceived of as constituted in 'the present moment' by way of a 'lived story'…." (247).

Contrary to Wilkinson, it seems to me that the second point, the claim of neuro-scientific dualism, is the most plausible claim of positivism against Stern.

Regarding Wilkinson's first point, that Stern fails to see that the social basis of mind is prior to individual consciousness, this is in the first place an assumption that needs a rationale that is not provided by Wilkinson. Secondly, many of the finest psychoanalytic theoreticians reject the view that the 'we' is ontologically prior to the 'I'; for example, Jessica Benjamin shows in her richly argued books that psychoanalysis, to remain psychoanalysis, must recognize both intra- and intersubjective phenomena, where neither precedes the other. Indeed, here psychoanalysis is homologous not with the Heideggerean insistence on the priority of the "we" and on language as the "house of being" and bearer of the "we'; rather, psychoanalysis is homologous with Husserlian phenomenology which is a philosophic stance recognizes the irreducible interplay of individual and socius where neither has priority over the other. As Daniel Stern wrote in his (1985) The Interpersonal World of the Infant (New York: Basic Books, 1985), "While intersubjective relatedness transforms the interpersonal world, however, core-relatedness continues. Intersubjective relatedness does not displace it; nothing ever will. It is the existential bedrock of interpersonal relations" (125). Moreover, core relatedness presupposes the "core self" (pp. 26-27).

Wilkinson's third point is that Stern's conception of basic experiential units constituted in present moments by way of lived stories is atomistic. Stern writes, however, that: "The problem with chronos [objective time, clock time] is that if there is no now long enough that something can unfold in it, there can be no direct experience…Also, life-as-lived is not experienced as a continuous flow. Rather, it is felt to be discontinuous, made up of incidents and events separated in time but also somehow connected" (6). Thus, while on one hand Stern maintains that "life as lived is not experienced as an inexorably continuous flow", on the other hand he urges this against a reductive, objectified time. Clock time flows inexorably continuously precisely because it is objectified and as such senseless and devoid of significance. Thus also, Wilkinson's use of objectified language, "basic experiential units" taken out of the rich context provided by Stern is tendentious--it is itself an objectification of Stern's view of the temporality of lived experience.

Finally, in his second point, Wilkinson alleges that Stern posits a simple experience/neuro-process dualism. It is indeed the case that throughout the book Stern cites and explicates neurological correlates of the processes in the phenomenal, i.e., experiential mind. Why does Stern do this? Certainly, that he does strongly suggests a form of mind-brain dualism. The problem of dualism (I add) is that it threatens to devolve, as it did in Cartesianism, into the physicalist reductionism of scientism. Wilkinson advocates "interactionism" as an antidote to dualism.

However, Stern's presentation of the relevant material indicates that he is not a mind-brain dualist. Stern's Husserlian orientation rules out dualism, for, Husserlian phenomenology is a monistic stance such that the person is a psychophysical unity. Stern's lengthiest excursus into neurobiological material is in Chapter Five, "The Intersubjective Matrix" in the sub-section, "Evidence for the Intersubjective Matrix." This sub-section is itself divided into two sections: "Neuroscientific Evidence" and "Support from Phenomenology." "Neuroscientific Evidence" is a lengthy discussion of mirror neurons and their role in intersubjective experience, as well as other recent neuroscientific findings. Stern's view of the relation between these findings and human phenomenal experience is expressed, for example, when, discussing his notion that there are mechanisms available for dyadic coordination between persons, he writes that "There is another finding that may serve as a neural correlate for intersubjectivty." The term "correlate" does not equate with cause in the positivist sense, nor does it necessarily imply dualism. Indeed, throughout the chapter, and the book as a whole, Stern's discussion of these factors is embedded in discussions of complex interactive feedback processes between neurological structures and processes and intersubjective, phenomenal, interactive processes.

In addition, in the section on "Support from Phenomenology," Stern discusses various aspects of Husserlian phenomenology and references writings by Husserl scholars who have themselves engaged the literature and findings of cognitive neuroscience, for example the well-known and much published Husserl scholar Dan Zahavi. These scholars and interpreters of the relation between Husserlian phenomenology and cognitive neurosciences are attempting to bridge the gap non-dualistically and non-reductively between the phenomenality of experience and the neurological structuration that correlates with that phenomenality. [i]

The point that I am progressing towards is as follows: All of these writings and discussions in the literature on neurobiological correlates of phenomenal experience are, from a phenomenological perspective, important and exciting, with one overriding caveat:

In the first chapter of The Present Moment, "The Problem of 'Now'", in presenting "a minimal list of the features of a clinically relevant present moment", Stern writes that the third feature is as follows: "The felt experience of the present moment is whatever is in awareness now, during the moment being lived [Stern's emphasis]. In discussing the problem of objectivating present moments subsequent to experiencing them, Stern writes: "This natural problem is why Husserl insisted that to capture phenomenal experience and examine it for itself, we have to put a bracket (Husserl's epoche) around it to protect it from being "explained away" at another level" (33). This is an accurate presentation of the meaning of the epoche or suspension of ontological commitments that is the inaugural act of phenomenological philosophizing--it prevents a metabasis eis allo genus, i.e., it prevents a positivist, or dualist, reduction of the phenomenal to the naturalistic.

Given this, to make his work internally consistent, Stern needs to make it clear that he as phenomenological philosopher-psychoanalyst stands always within the phenomenological attitude, the epoche. Otherwise, his excursions into neurobiology give the unfortunate impression of being both ad hoc and defensively motivated. For this, the antidote is not less Husserlian phenomenology, but more thoroughgoing and consistent work within the phenomenological epoche.

With this, I leave you to read this marvelous book 

© 2005 Marilyn Nissim-Sabat

Marilyn Nissim-Sabat, Ph.D., M.S.W., Professor Emeritus, Department of Philosophy, Lewis University, Romeoville, IL , Clinical Social Worker, private practice in psychodynamic psychotherapy, Chicago, IL, Member Executive Board, Assoc. for the Advancement of Philosophy and Psychiatry

Heward Wilkinson responds to the review above. Received October 11, 2006

I am very grateful to Dr Christian Perring for this unusual opportunity of a creative dialogue.

Dr Nissim-Sabat used my original review article (available on my website below) as her departure for her own review. I think she got me wrong in certain ways;  but even our disagreements are our ways of coming to grips with a great book, one of those rare philosophically sophisticated writings from a psychotherapist, which grips our philosophical curiosity in a first hand way. Thus I am grateful to Nissim-Sabat, whose review has sent me back again with renewed intensity, both to Stern's book, and to Husserl.

I make sense of Nissim-Sabat's response to my view of Stern in terms of her Husserlian perspective, embracing the full sense of Husserl's phenomenological 'epoché', his reduction of (or elucidation of) the world in terms of the transcendental ego. She believes full-bloodedly this is the way to resolve Stern's dilemmas over psycho-physical parallelism:

'Given this, to make his work internally consistent, Stern needs to make it clear that he as phenomenological philosopher-psychoanalyst stands always within the phenomenological attitude, the epoché. Otherwise, his excursions into neurobiology give the unfortunate impression of being both ad hoc and defensively motivated. For this, the antidote is not less Husserlian phenomenology, but more thoroughgoing and consistent work within the phenomenological epoché.'

In this light she accuses me:

'Unfortunately, however, Wilkinson slights the pervasive presence of elements of Husserlian phenomenology in Stern. Because Wilkinson does not see the value of specifically Husserlian phenomenology, he does not see that the antidote within Stern's thinking is an expanded role for phenomenology rather than, as he proposes, a move towards what I (and others) view as Heideggerean linguistic reductionism... (e.g., see Wilkinson 253).'

I think that, whilst Stern has drawn deeply from Husserl's intentionality and temporality analyses, he, like philosophers such as Heidegger, Sartre, Merleau-Ponty, Levinas, and Derrida, restores Husserl's transcendentalism to a moderate realistic basis (I think, in an interactionist form), and therefore, his version of the epoché is a descriptive suspension of belief, not a transcendental one. It is also closer to Freud's episodic-catastrophic concept of temporality than Husserl. At the level of the transcendental ego, I consider Husserl never resolves the tension between his transcendental ego-subjectivism and his transcendental inter-subjectivism, a fault line also at the heart of psychoanalysis, (a link Nissim-Sabat makes, though, from my perspective, uncritically).

I find Stern's descriptive realism particularly evident in his chapter on The Past and the Present Moment where it is clear that his intentionalism is that (familiar in Heidegger and Merleau-Ponty) of the total world whole as realized in the 'now':

'The present remembering context is not only just one of these ongoing experiences;  it is the totality of what is going on now.  It is the complete amalgam of perceptions, sensations, cognitions, affects, feelings, and actions that are currently acting upon us, consciously and unconsciously, implicitly and explicitly. In this sense, past traumas, conflicts, and other basic elements of traditional psychoanalysis that remain partially activated can be a foreground or background part of the present remembering context.' (p198)

I believe a fault-line runs through Stern's whole book between this comprehensive 'totality' vision, and elements of atomism, or foundationalism (the idea that we can identify basic building blocks of experience on which all others are founded), for instance:

'Yet, larger narratives are made of smaller ones that are embedded in them.  The size of the smaller nested life stories is not usually explored in detail.  This leads to the question:  Are there minimal lived stories from which all larger narrative structures are built?  I am going to answer yes, and propose that present moments are the basis building blocks. [my italics] ('Present Moment', p58)'

The aim of my paper was to explore the implications of that fault line, including questions like:

1. whether his conception of psychotherapy as being, in the light of the 'present moment' analysis, wider than the past-interpretative paradigm of psychoanalysis (including existential, and other related, approaches), which I encapsulated in my shorter title ('The Shadow of Freud: is Daniel Stern still a psychoanalyst'), nevertheless subscribes to an artificial antithesis between present and past, implicit and unconscious, which I called his 'apartheid solution', or whether it transcends it; 

2. whether his strong element of support for a thoroughgoing social theory of mind (I invoked the work of Julian Jaynes here) implicitly shifts the focus away from his 'present moment' foundationalism; 

3. whether his 'linguistic/non-linguistic', and 'implicit' versus 'unconscious', and other such antitheses, are artificial in relation to the bulk of experience, and whether he himself accepts this;  and so on. 

I was conjecturing that the deepest implication of his work and fine intelligence would pull him towards the wider-based position in each case.

Nissim-Sabat ignored much of these wider ranging questionings, in particular my basic focus on the issues Stern raises of 'psychotherapy beyond psychoanalysis' (potentially an integrated widening of our understanding of psychoanalysis itself), claiming I overlooked Stern's concern with present moments and moments of meeting as mutative factors in psychoanalysis, whereas I simply took that as not wholly new (I don't think we fundamentally disagree in our analysis of mutative factors!), and raised more embracing issues of the nature of change more than once. E.g: we can grasp that there is the most subtle play between forms of relationship in therapeutic work (Clarkson, 2002), the transferential, the therapeutic alliance, the I-Thou of dialogue, the developmentally corrective, the sacred or alchemical relationship in the context of religious rite or process, in some sense, (of which arguably the psychotherapy relationship is a low-key instance);  in the subtle interplay of all of these the depth of process emerges in the work, and the shifts are manifold and unfathomable.  It seems a gross narrowing of perspective to say this is either primarily conscious (non-conscious, implicit), or primarily unconscious;  both concepts have their place, but so does that of a total communication network, in frame, partly fictitious, partly actual or real -----, of which the overt 'present moment' relationship is but one manifestation, and which remains comprehensively the medium of psychodynamic effects.' (p.251)

We do disagree over Husserl, who I consider great, rightly influential, but also mistaken, in the creative way the greatest philosophers sometimes are, and who offers us a potently captivating transcendental will o' the wisp, on the 'hard problem' of the relation of consciousness to neural activity, a problem also unresolved by Stern, despite the fact that his great book provides us important further data and clarifications from which the solution of such problems will come.

http://hewardwilkinson.co.uk

© 2005 Heward Wilkinson

Marilyn Nissim-Sabbat replies. Received November 11, 2005.

I would like to express my appreciation to Professors Wilkinson and Perring for fostering this dialogue. I intend here to respond to Prof. Wilkinson's substantive critiques of the interpretation of Daniel Stern's perspective in my review of the latter's book, The Present Moment.

1. Prof. Wilkinson points out that I have suggested that Stern incorporate more elements of Husserlian phenomenology into his work, including Husserl's "transcendentalism." Wilkinson is correct--I do advocate this as an advance for Stern. However, Wilkinson goes on to say that, like post-Husserl phenomenologists, Stern "restores Husserl's transcendentalism to a moderate realistic basis..., and therefore, his version of the epoche is a descriptive suspension of belief, not a transcendental one. " Wilkinson then goes on to say that "Stern's descriptive realism" is evident in Chapter 12 of Stern's book, "where it is clear that his intentionalism is that (familiar in Heidegger and Merleau-Ponty) of the total world whole as realized in the 'now' ;..."(Wilkinson's italics). Wilkinson then quotes from Stern to the effect that "The present remembering context...is the complete amalgam of perceptions, sensations, cognitions, affects, feelings and actions that are currently acting upon us. ...etc." (my elisions, MN-S), 

Wilkinson's account here seemingly expresses the distinction he makes between transcendentalism (Husserl) and descriptive realism (Stern). That is, descriptive realism is the view that the present moment is the "totality of what is going on now", whereas transcendentalism is the view that the phenomenological suspension of ontological commitments, i.e., the transcendental phenomenological epoche, rules out an intentionality that is directed toward the "total world whole."

It seems to me that students of Husserlian phenomenology would find Wilkinson's version of it to be extremely baffling. Specifically, the quote that Wilkinson cites as evidence of Stern's non-Husserlian descriptive realism is entirely consistent with what Husserl elaborated in his Cartesian Meditations and The Crisis of European Sciences and Transcendental Phenomenology as genetic phenomenology. It is true that in his early work Husserl spoke of descriptive phenomenology, which, in contrast to genetic phenomenology, Husserl later spoke of as "static" phenomenology. But it was precisely in the period in which Husserl most fully elaborated transcendental phenomenology that he developed genetic phenomenology. For Husserl, all experience is both present experience (never construed by Husserl or Stern as a nunc stans or standing now) of the sedimented layers of encounter with inner and outer "objects", i.e., perceptions, sensations, affects, feelings, and so on. Moreover, "the total world whole" of which Wilkinson speaks can only come into view from a transcendental perspective--i.e., a perspective like that presented by Thomas Nagel  in his famous book The View from Nowhere, a book in which Nagel fails to acknowledge his debt to Husserl.

2.  Prof. Wilkinson then presents his critique of Stern, a critique that would show Stern to be far a field from any phenomenological perspective and at the same time far a field from any psychoanalytic perspective. Wilkinson, (and here I believe that Wilkinson's Heideggerean perspective shows through again) maintains that Stern "subscribes to an artificial antithesis between present and past, implicit and unconscious..."  Wilkinson says that Stern has a "fault line" between his "totality vision" and elements of atomism or foundationalism. He quotes Stern to the effect that present moments are "minimal lived stories from which all larger narrative structures and built" and that "present moments are the basic building blocks" (p. 58). For Wilkinson, this claim by Stern is atomistic and therefore foundationalist.

Pertinent to this aspect of Wilkinson's critique of Stern is the question of whether or not Wilkinson construes psychoanalysis as a theory and practice of developmental processes in human experience. When Heidegger elaborated his notion of ready-to-handedness (zuhandenheit), he provided no notion whatsoever as to the psychosocial process in and through which a tool, for example, becomes ready-to-hand, i.e., not an objectified object, but an extension of the carpenter's body. Indeed, Heidegger's perspective does not provide any ground whatsoever for a developmental psychology, or even one that would account in some way for the actuality of human psychic development. Thus, what Wilkinson refers to as "atomistic" and "foundationalist' in Stern's theory flows from Stern's concern, in all of his work, for providing a meaningful account of the phenomenon of human development. To suggest that Stern's views are "atomistic" because Stern sees that "present moments", which are experiential phenomena that occur from the inception of human existence, and are shot through with temporal flow, are the medium of all developmental processes--to refer to this view as "atomistic" is simply egregious. Atomism is relevant to scientistic empiricist perspectives--a far cry from Stern's phenomenology of human psychosocial, developmental processes. Moreover, the fact that Wilkinson links atomism and foundationalism is egregious as well. The term "foundationalism" is used in contemporary postmodern philosophy as a term of negative critique generally applied to philosophies that include an a priori dimension of subjectivity or existence, i.e., like Husserlian phenomenology. However, atomism is a term that is generally used in empiricist perspectives that deny any a priori dimension Thus, Wilkinson's linkage of the terms is again baffling. Does he mean to suggest that any view that includes differentiations amongst its components is "foundationalist" in the negative critical sense? Are we then, Heidegger like, to just await the advent of Being? Or, as in Stern's developmental psychoanalysis and Husserl's philosophy of development, can we gain insight and wisdom regarding human development that would enable us to facilitate our own growth and maturation? I think that Stern would opt for the latter.