email page print pageAll Topic Reviews
Maximizing Effectiveness in Dynamic Psychotherapy Self-Compassion in Psychotherapy101 Healing StoriesA Clinician's Guide to Legal Issues in PsychotherapyA Map of the MindA Primer for Beginning PsychotherapyACT With LoveActive Treatment of DepressionAffect Regulation, Mentalization, and the Development of SelfAlready FreeBad TherapyBecoming an Effective PsychotherapistBecoming MyselfBefore ForgivingBeing a Brain-Wise TherapistBetrayed as BoysBeyond Evidence-Based PsychotherapyBeyond MadnessBeyond PostmodernismBinge No MoreBiofeedback for the BrainBipolar DisorderBody PsychotherapyBoundaries and Boundary Violations in PsychoanalysisBrain Change TherapyBrain Science and Psychological DisordersBrain-Based Therapy with AdultsBrain-Based Therapy with Children and AdolescentsBrief Adolescent Therapy Homework PlannerBrief Child Therapy Homework PlannerBrief Therapy Homework PlannerBuffy the Vampire Slayer and PhilosophyBuilding on BionCare of the PsycheCase Studies in DepressionCaught in the NetChild and Adolescent Treatment for Social Work PracticeChoosing an Online TherapistChronic DepressionClinical Dilemmas in PsychotherapyClinical Handbook of Psychological DisordersClinical Intuition in PsychotherapyClinical Pearls of WisdomCo-Creating ChangeCognitive Therapy for Challenging ProblemsCompassionConfessions of a Former ChildConfidential RelationshipsConfidentiality and Mental HealthConfidingContemplative Psychotherapy EssentialsControlConversations About Psychology and Sexual OrientationCoping with BPDCouch FictionCounseling in GenderlandCounseling with Choice TheoryCouple SkillsCrazy for YouCreating a Life of Meaning and CompassionCreating HysteriaCritical Issues in PsychotherapyCrucial Choices, Crucial ChangesDeafness In MindDecoding the Ethics CodeDeconstructing PsychotherapyDeep Brain StimulationDemystifying TherapyDepression 101Depression in ContextDialogues on DifferenceDissociative ChildrenDo-It-Yourself Eye Movement Techniques for Emotional HealingDoing CBTE-TherapyEarly WarningEncountering the Sacred in PsychotherapyEnergy Psychology InteractiveErrant SelvesEssays on Philosophical CounselingEssentials of Wais-III AssessmentEthically Challenged ProfessionsEthics and Values in PsychotherapyEthics in Plain EnglishEthics in Psychotherapy and CounselingExercise-Based Interventions for Mental IllnessExistential PsychotherapyExpectationExploring the Self through PhotographyExpressing EmotionFacing Human SufferingFairbairn's Object Relations Theory in the Clinical SettingFamily TherapyFavorite Counseling and Therapy Homework AssignmentsFear of IntimacyFlourishingFolie a DeuxForms of Intersubjectivity in Infant Reasearch and Adult TreatmentFoundations of Ethical Practice, Research, and Teaching in PsychologyFreud and the Question of PseudoscienceFrom Morality to Mental HealthFundamentals of Psychoanalytic TechniqueGenes on the CouchGod & TherapyHalf Empty, Half FullHandbook of Clinical Psychopharmacology for TherapistsHandbook of Counseling and Psychotherapy with Lesbian, Gay, and Bisexual ClientsHandbook of Evidence-Based Therapies for Children and AdolescentsHealing the Heart and Mind with MindfulnessHeinz KohutHelping Children Cope With Disasters and TerrorismHigh RiskHistory of PsychotherapyHow and Why Are Some Therapists Better Than Others?How Clients Make Therapy WorkHow People ChangeHow Psychotherapists DevelopHow to Fail As a TherapistHow to Go to TherapyHypnosis for Inner Conflict ResolutionHypnosis for Smoking CessationI Never Promised You a Rose GardenIf Only I Had KnownIn Others' EyesIn SessionIn Therapy We TrustIn Treatment: Season 1Incorporating Spirituality in Counseling and PsychotherapyInside the SessionInside TherapyIs Long-Term Therapy Unethical?Issues in Philosophical CounselingIt's Not as Bad as It SeemsItís Your HourLearning ACTLearning from Our MistakesLearning Supportive PsychotherapyLetters to a Young TherapistLife CoachingLogotherapy and Existential AnalysisLove's ExecutionerMadness and DemocracyMaking the Big LeapMan's Search for MeaningMetaphoria: Metaphor and Guided Metaphor for Psychotherapy and HealingMind GamesMindfulnessMindfulness and AcceptanceMindfulness-Based Cognitive Therapy for DepressionMindworks: An Introduction to NLPMockingbird YearsMoments of EngagementMomma and the Meaning of LifeMotivational Interviewing: Preparing People For ChangeMulticulturalism and the Therapeutic ProcessMultifamily Groups in the Treatment of Severe Psychiatric DisordersNarrative PracticeOn the CouchOne Nation Under TherapyOur Inner WorldOur Last Great IllusionOutsider ArtOutsider Art and Art TherapyOvercoming Destructive Beliefs, Feelings, and BehaviorsOverexposedPathways to SpiritualityPersonality and PsychotherapyPhilosophical CounselingPhilosophical Counselling and the UnconsciousPhilosophical Issues in Counseling and PsychotherapyPhilosophical PracticePhilosophy and PsychotherapyPhilosophy for Counselling and PsychotherapyPhilosophy PracticePhilosophy's Role in Counseling and PsychotherapyPillar of SaltPlan BPlato, Not Prozac!Polarities of ExperiencesPower GamesPractical Psychoanalysis for Therapists and PatientsPrinciples and Practice of Sex TherapyProcess-Based CBTPsychologists Defying the CrowdPsychology, Psychotherapy, Psychoanalysis, and the Politics of Human RelationshipsPsychosis in the FamilyPsychotherapyPsychotherapyPsychotherapy and ConfidentialityPsychotherapy As PraxisPsychotherapy East and WestPsychotherapy for Children and AdolescentsPsychotherapy for Personality DisordersPsychotherapy Is Worth ItPsychotherapy Isn't What You ThinkPsychotherapy with Adolescent Girls and Young WomenPsychotherapy with Children and AdolescentsPsychotherapy without the SelfPsychotherapy, American Culture, and Social PolicyRapid Cognitive TherapyRational Emotive Behavior TherapyRational Emotive Behavior TherapyRationality and the Pursuit of HappinessRebuilding Shattered LivesReclaiming Our ChildrenRecovery OptionsRelationalityRent Two Films and Let's Talk in the MorningSaving the Modern SoulScience and Pseudoscience in Clinical PsychologySecond-order Change in PsychotherapySelf-Compassion in PsychotherapySelf-Determination Theory in the ClinicSelf-Disclosure in Psychotherapy and RecoverySerious ShoppingSex, Therapy, and KidsSexual Orientation and Psychodynamic PsychotherapySigns of SafetySoul Murder RevisitedStaring at the SunStraight to JesusStrangers to OurselvesSubjective Experience and the Logic of the OtherTaking America Off DrugsTales of PsychotherapyTales of UnknowingTalk is Not EnoughTalking Cures and Placebo EffectsTelling SecretsThe Behavioral Medicine Treatment PlannerThe Body in PsychotherapyThe Brief Couples Therapy Homework Planner with DiskThe Case Formulation Approach to Cognitive-Behavior TherapyThe Challenge for Psychoanalysis and PsychotherapyThe Child and Adolescent Psychotherapy Treatment PlannerThe Clinical Child Documentation SourcebookThe Clinical Documentation SourcebookThe Complete Adult Psychotherapy Treatment PlannerThe Couch and the TreeThe Couples Psychotherapy Treatment PlannerThe Crucible of ExperienceThe Cure of SoulsThe Death of PsychotherapyThe Education of Mrs. BemisThe Ethical Treatment of DepressionThe Ethics of PsychoanalysisThe Gay and Lesbian Psychotherapy Treatment PlannerThe Gift of TherapyThe Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The Healing JourneyThe Heart & Soul of ChangeThe Heroic ClientThe Husbands and Wives ClubThe Love CureThe Making of a TherapistThe Mindful TherapistThe Mirror Crack'dThe Mummy at the Dining Room TableThe Neuroscience of PsychotherapyThe Neuroscience of Psychotherapy: Healing the Social BrainThe New Rational TherapyThe Older Adult Psychotherapy Treatment PlannerThe Other Side of DesireThe Pastoral Counseling Treatment PlannerThe Philosopher's Autobiography The Pornographer's GriefThe Portable CoachThe Portable Ethicist for Mental Health Professionals The Present Moment in Psychotherapy and Everyday LifeThe Problem of EvilThe Problem with Cognitive Behavioural TherapyThe Psychodynamics of Gender and Gender RoleThe Psychotherapy Documentation PrimerThe Psychotherapy Documentation PrimerThe Psychotherapy of HopeThe Real World Guide to Psychotherapy PracticeThe Schopenhauer CureThe Sex Lives of TeenagersThe Talking CureThe Therapeutic "Aha!"The Therapist's Guide to PsychopharmacologyThe Therapist's Guide to Psychopharmacology, Revised EditionThe Therapist's Ultimate Solution BookThe Trauma of Everyday LifeThe Trouble with IllnessThe UnsayableThe Way of the JournalTheory and Practice of Brief TherapyTherapy with ChildrenTherapy's DelusionsTheraScribe 3.0 for WindowsTheraScribe 4.0Thinking about ThinkingThinking for CliniciansThinking for CliniciansThoughts Without a ThinkerThriveToward a Psychology of AwakeningTracking Mental Health OutcomesTrauma, Truth and ReconciliationTreating Attachment DisordersTreatment for Chronic DepressionTreatment Plans and Interventions for Depression and Anxiety DisordersUnderstanding Child MolestersUnspeakable Truths and Happy EndingsWhat the Buddha FeltWhat Works for Whom?What Works for Whom? Second EditionWhen the Body SpeaksWhispers from the EastWise TherapyWittgenstein and PsychotherapyWorking MindsWoulda, Coulda, ShouldaWriting About PatientsYoga Skills for Therapists:Yoga Therapy
In this book, Stephen Mitchell, the leading theorist of the relational
movement in psychoanalysis, explores connections between earlier
psychoanalytic perspectives (especially Loewald, Winnicott, Fairbairn,
and Bowlby, but also Sullivan and Fromm) and relational thinking
and introduces some of his own ideas about levels of mental functioning.
Mitchell uses clinical material to good effect: not only does
this illuminate the ideas under discussion, but it enables us
to witness a clinician at work who is deeply honest and fully
engaged in the therapeutic enterprise. Indeed, Mitchell's clinical
work stands out for its boldness and originality. Although some
of the book covers old ground in its criticism of the classical
model of psychoanalysis, Mitchell does branch out here in a new
direction by emphasizing connections between relational psychoanalysis
and recent versions of attachment theory (like Fonagy's work).
Mitchell's reading of figures like Loewald, Winnicott and Fairbairn
highlights the distinctiveness of their respective contributions.
The first two chapters are devoted to an assessment of Loewald
in which Mitchell demonstrates how Loewald uses traditional psychoanalytic
terms in novel ways-for example, in construing the unconscious
in terms of dedifferentiation, rather than in terms of explosive
energy or propulsive drives (p. 11), and in redefining the boundary
between fantasy and reality in a less rigid manner (p. 18). Mitchell
offers an interesting discussion of Loewald's notion of the "primal
density" of the mind, which is manifest in the infant's sense
of unity with the mother. In this context, Mitchell observes the
similarity to Mahler's commitment to a phase of symbiosis, but
Mitchell does not grapple with the extent to which such ideas
have come under attack by infant researchers (Gergely has reviewed
this literature in relation to psychoanalysis; for a current version,
see Fonagy, Gergely, Jurist, Target's Affect Regulation and Mentalization,
forthcoming in 2001 from the Other Press).
Mitchell's appreciative examination of Loewald emphasizes his
wish to affirm adult reality without minimizing the value of infantile
fantasy. The former without the latter would mean "a dessicated,
meaningless, passionless world," (p.24). According to Mitchell's
interpretation of Loewald, "only the enchanted life is worth
living" (p. 29).
In the third chapter, Mitchell moves on to present his own ideas.
Developing Loewald's notion of how different levels of functioning
coexist in the mind, Mitchell offers four different modes of organization.
It will be possible to do justice to this theoretical framework
here. Let me briefly characterize the range of distinct kinds
of human interaction which Mitchell specifies: 1) non-reflective
exchanges, which are revealed in actual behavior; 2) interactions
which are predicated upon affect permeability (or what is sometimes
referred to as "emotional contagion"); 3) interactions
which determine self-other configurations (including how others
can be part of oneself and how the self is multiplicitous); and
4) intersubjective interactions, which are mediated by the capacity
for self-reflexivity that allows us to have a richer sense of
both the self and others (pp. 58f). This framework is helpful
in establishing Mitchell's claim that secondary process does not
replace primary process and that we need to accept and promote
interaction between these two general realms.
Clinical illustrations are used throughout the book to capture
aspects of this theoretical framework. For anyone who would like
to get a real sense of how psychoanalysts are working these days--
and thus to escape the antiquated, tired images that popular culture
tends to favor-- I would highly recommend Mitchell's book. He
is candid about his own moments of confusion and frustration.
Mitchell has a subtle eye, noticing the value of opting not to
make an explicit interpretation in favor of allowing an emotional
moment to linger in the room. He also does not hesitate to examine
challenging topics such as excitement and erotic arousal between
patients and analysts.
Perhaps the most fascinating aspect of Mitchell's clinical work
has to do with his use of himself. With a patient who was chronically
hostile both within and outside of therapy, but also attuned to
how this drives others away from her, Mitchell responds to her
assertion that it was likely that at that moment he was hating
her by saying: "If this were not an analytic relationship,
if this were out on the street and you were talking to me this
way and I weren't your analyst, I probably would say 'FUCK YOU!'
But I am your analyst" (p. 142). This served to defuse
the hostility in the room and facilitated a new level of connection
in the treatment. The example represents a fine case of how acknowledging
countertransference, even negative countertransference (within
the bounds of what will be beneficial to the patient) can be helpful.
This book breaks new ground for the relational model in the way
it warms to attachment theory in the fourth chapter. Mitchell
offers a good discussion of how psychoanalysts failed to appreciate
Bowlby's work and also of how attachment theory has evolved in
a direction that is less behavioral and thus more readily compatible
with psychoanalytic ideas. Fonagy and Target's notion of "playing
with reality" and the process of mentalization through which
a child becomes interested in his/her own mind, fits well with
Loewald's redefinition of the boundary between fantasy and reality.
The warming to attachment theory is significant as well because
the relational movement has tended to identify itself with the
hermeneutic side of psychoanalysis and to bequeath the scientific
side to post-Freudians. One of the merits of attachment theory
is its solid basis in empirical research. Mitchell's openness
to science is also apparent in his passing comments on Edelman's
I would like to conclude this review by noting that Stephen Mitchell
died in December 2000 shortly after its publication. This is a
huge loss to the relational perspective, but also to the entire
field of psychoanalysis-all the more so since Mitchell was only
54 years old. On a personal note, I encountered Mitchell in a
number of times professionally (and once in a consultation). One
did not have to know him well to sense what a decent, humane and
astute man he was.
© Elliot Jurist, 2001
Ph.D. is a Professor of Philosophy at Hofstra University and is a Lecturer in the Department of Psychiatry
at Columbia University.
He is the author of Beyond Hegel and Nietzsche: Philosophy, Culture, and Agency (MIT