Dr. Martha Stark has developed a comprehensive theory of therapeutic action that integrates the interpretive perspective of classical psychoanalysis (which speaks to the power of insight); the corrective-provision perspective of self psychology and other deficit theories (which speaks to the importance of corrective experience as compensation for early-on deficiencies); and the contemporary relational perspective (which speaks to mutual enactment and negotiation by both patient and therapist of the entanglements that will inevitably emerge at the intimate edge of their authentic engagement). Her focus throughout the seminar will be on the interface between theory and practice; and Dr. Stark will demonstrate, by way of numerous clinical vignettes and prototypical interventions, the ways in which the three modes of therapeutic action (knowledge, experience, and relationship) can be used to accelerate the healing process. review of basic constructs: knowledge, experience, relationship as curative factors; “supporting” by being with the patient where she is vs. “challenging” by directing her attention to elsewhere; the therapeutic process as involving recursive cycles of defensive collapse and adaptive reconstitution at ever higher levels of integration and balance. the process of transforming defense into adaptation; the importance of awareness (wisdom), acceptance, and accountability; therapist as neutral object, empathic selfobject, authentic subject; prototypical interventions specifically designed to facilitate the grieving process and to accelerate the healing. working through the negative transference and disruptions to the positive transference; transforming infantile need into mature adult capacity; focusing on the contributions of both patient and therapist to the relational dynamics at their intimate edge; use of instructor’s process recordings to demonstrate the role of knowledge, experience, and relationship in strengthening the ego, consolidating the self, and resolving relational difficulties.

1. BY WAY OF REVIEW
MODEL 1
THE INTERPRETIVE PERSPECTIVE
OF CLASSICAL PSYCHOANALYSIS
A 1 – PERSON PSYCHOLOGY
THAT FOCUSES ON THE PATIENT’S INTERNAL DYNAMICS
AND POSITS INSIGHT, WISDOM, AWARENESS,
EMPOWERMENT, AND ACTUALIZATION OF INHERITED
POTENTIAL AS THE ULTIMATE THERAPEUTIC GOAL
MODEL 2
THE CORRECTIVE – PROVISION PERSPECTIVE
OF SELF PSYCHOLOGY AND OTHER DEFICIT THEORIES
A 1½ – PERSON PSYCHOLOGY
THAT FOCUSES ON THE PATIENT’S AFFECTIVE EXPERIENCE
AND POSITS ACCEPTANCE OF THE OBJECT’S
LIMITATIONS, SEPARATENESS, AND IMMUTABILITY
AS THE ULTIMATE THERAPEUTIC GOAL
1

2. BY WAY OF REVIEW
MODEL 3
THE CONTEMPORARY RELATIONAL
(OR INTERSUBJECTIVE) PERSPECTIVE
A 2 – PERSON PSYCHOLOGY
THAT FOCUSES ON THE PATIENT’S
RELATIONAL DYNAMICS
AND POSITS ACCOUNTABILITY
AS THE ULTIMATE THERAPEUTIC GOAL
MODEL 4
THE EXISTENTIAL PERSPECTIVE
A ½ – PERSON PSYCHOLOGY
THAT EMPHASIZES AN INDIVIDUAL’S STRUGGLE
TO FIND MEANING, PURPOSE, AND DIRECTION IN LIFE
AND POSITS ACCESSIBILITY AND THE FORGING OF
MEANINGFUL ATTACHMENTS TO THE WORLD OF ANIMATE
OBJECTS AS THE ULTIMATE THERAPEUTIC GOAL
2

3. AN OVERVIEW
PROTOTYPICAL “OPTIMALLY STRESSFUL”
ANXIETY – PROVOKING
BUT ULTIMATELY GROWTH – PROMOTING
INTERVENTIONS
MODEL 1 CONFLICT STATEMENTS ARE DESIGNED TO
ENCOURAGE THE “RESISTANT” PATIENT TO STEP BACK FROM
THE IMMEDIACY OF THE MOMENT IN ORDER TO TAKE STOCK
OF BOTH HER INVESTMENT IN MAINTAINING THINGS
AS THEY ARE AND THE PRICE SHE PAYS FOR DOING SO
MODEL 2 DISILLUSIONMENT STATEMENTS ARE DESIGNED TO
FACILITATE THE NECESSARY GRIEVING THAT THE “RELENTLESS”
PATIENT MUST DO AS SHE BEGINS TO CONFRONT
PAINFUL REALITIES ABOUT THE OBJECTS OF HER DESIRE
3

4. PROTOTYPICAL “OPTIMALLY STRESSFUL”
ANXIETY – PROVOKING
BUT ULTIMATELY GROWTH – PROMOTING
INTERVENTIONS
MODEL 3 ACCOUNTABILITY STATEMENTS ARE DESIGNED TO
ENCOURAGE THE “RE – ENACTING” PATIENT TO TAKE
RESPONSIBILITY FOR THE DYSFUNCTIONAL RELATIONAL
DYNAMICS (THE RESIDUA OF UNMASTERED CHILDHOOD
DRAMAS) THAT SHE IS COMPULSIVELY AND UNWITTINGLY
REPLAYING ON THE STAGE OF HER LIFE
MODEL 4 FACILITATION STATEMENTS ARE DESIGNED TO
HIGHLIGHT THE “RETREATING” PATIENT’S INTENSE
AMBIVALENCE ABOUT EVEN BEING IN RELATIONSHIP –
THE FACT THAT SHE LONGS TO BE SEEN AND
UNDERSTOOD BUT IS TERRIFIED OF BEING FOUND
4

5. MORE GENERALLY
MODEL 1 USES CONFLICT STATEMENTS
TO INCREASE THE PATIENT’S AWARENESS
OF HER INTERNAL CONFLICTEDNESS
AND THEREBY TO PROMPT
EVENTUAL TRANSFORMATION OF
THE DEFENSIVE NEED TO RESIST KNOWING
PAINFUL TRUTHS ABOUT THE SELF
INTO THE ADAPTIVE CAPACITY TO BE AWARE
OF THOSE ANXIETY – PROVOKING TRUTHS
MODEL 2 USES DISILLUSIONMENT STATEMENTS
TO FACILITATE THE PATIENT’S GRIEVING
OF INTOLERABLY PAINFUL DISAPPOINTMENTS
AND THEREBY TO PROMPT
EVENTUAL TRANSFORMATION OF
THE DEFENSIVE NEED TO RESIST KNOWING
PAINFUL TRUTHS ABOUT THE OBJECT
INTO THE ADAPTIVE CAPACITY TO ACCEPT
THOSE DISILLUSIONING TRUTHS
5

6. MORE GENERALLY
MODEL 3 USES ACCOUNTABILITY STATEMENTS
TO INCREASE THE PATIENT’S AWARENESS
OF HER TENDENCY TO RE – PLAY UNMASTERED
CHILDHOOD DRAMAS ON THE STAGE OF HER LIFE
AND THEREBY TO PROMPT
EVENTUAL TRANSFORMATION OF
THE DEFENSIVE NEED TO RE – ENACT
UNMASTERED CHILDHOOD DRAMAS
INTO THE ADAPTIVE CAPACITY
TO BE ACCOUNTABLE FOR HER
ACTIONS, REACTIONS, AND INTERACTIONS
AND MODEL 4 USES FACILITATION STATEMENTS
TO HIGHLIGHT NOT ONLY THE PATIENT’S TERROR OF BEING
ONCE AGAIN DESTROYED BY AN ANNIHILATING OBJECT BUT ALSO
HER DESPERATE LONGING TO RE – ENGAGE WITH THE WORLD
AND THEREBY TO PROMPT
EVENTUAL TRANSFORMATION OF
THE DEFENSIVE NEED TO RETREAT
INTO THE ADAPTIVE CAPACITY TO BE ACCESSED AND, AS A RESULT,
TO BE ABLE TO TOLERATE MOMENTS OF MEANINGFUL MEETING 6

7. PREVIEW
FOUR MODES OF THERAPEUTIC ACTION
FOUR APPROACHES TO TRANSFORMING DEFENSE INTO ADAPTATION
FOUR OPTIMAL STRESSORS THAT FACILITATE THIS ACTION
TRANSFORMATION OF RESISTANCE INTO AWARENESS
AND ACTUALIZATION OF POTENTIAL
BY WORKING THROUGH THE STRESS OF COGNITIVE DISSONANCE
(THE EXPERIENCE OF GAIN – BECOME – PAIN)
TRANSFORMATION OF RELENTLESSNESS INTO ACCEPTANCE
BY WORKING THROUGH THE STRESS OF AFFECTIVE DISILLUSIONMENT
(THE EXPERIENCE OF GOOD – BECOME – BAD)
TRANSFORMATION OF RE – ENACTMENT INTO ACCOUNTABILITY
BY WORKING THROUGH THE STRESS OF RELATIONAL DETOXIFICATION
(THE EXPERIENCE OF BAD – BECOME – GOOD)
TRANSFORMATION OF RETREAT INTO ACCESSIBILITY
BY WORKING THROUGH THE STRESS OF ABSOLUTE DEPENDENCE
(THE EXPERIENCE OF HIDDEN – BECOME – FOUND) 7

8. STRUCTURAL CONFLICT
RESISTANCE BECOMES TRANSFORMED INTO AWARENESS
AND ACTUALIZATION OF POTENTIAL
STRUCTURAL DEFICIT
RELENTLESSNESS BECOMES TRANSFORMED INTO ACCEPTANCE
RELATIONAL CONFLICT
RE – ENACTMENT BECOMES TRANSFORMED INTO ACCOUNTABILITY
RELATIONAL DEFICIT
RETREAT BECOMES TRANSFORMED INTO ACCESSIBILITY
NEUROTIC ~ NARCISSISTIC ~ CHARACTER DISORDERED ~ SCHIZOID
8

9. TRANSFORMATION OF LESS HEALTHY
DEFENSE INTO HEALTHIER ADAPTATION
MODEL 1
DEFENSIVE REACTION –
RESISTANCE TO AWARENESS OF
ONE’S DYSFUNCTIONAL INTERNAL DYNAMICS
ADAPTIVE RESPONSE –
AWARENESS AND ACTUALIZATION OF POTENTIAL
MODEL 2
DEFENSIVE REACTION –
RELENTLESSNESS (RELENTLESS HOPE) AND
REFUSAL TO CONFRONT – AND GRIEVE – CERTAIN
INTOLERABLY PAINFUL REALITIES ABOUT THE OBJECT’S
LIMITATIONS, SEPARATENESS, AND IMMUTABILITY
ADAPTIVE RESPONSE –
ACCEPTANCE OF ONE’S ULTIMATE POWERLESSNESS
TO MAKE THE OBJECT CHANGE 9

10. TRANSFORMATION OF LESS HEALTHY
DEFENSE INTO HEALTHIER ADAPTATION
MODEL 3
DEFENSIVE REACTION –
COMPULSIVE AND UNWITTING RE – ENACTMENT
OF DYSFUNCTIONAL RELATIONAL DYNAMICS
RESULTING FROM UNMASTERED EARLY – ON TRAUMAS
ADAPTIVE RESPONSE –
ACCOUNTABILITY FOR ONE’S ACTIONS,
REACTIONS, AND INTERACTIONS
MODEL 4
DEFENSIVE REACTION –
PSYCHIC RETREAT AND SCHIZOID WITHDRAWAL
ADAPTIVE RESPONSE –
ACCESSIBILITY AND ATTACHMENT
10

11. PSYCHODYNAMIC PSYCHOTHERAPY
AFFORDS THE PATIENT AN OPPORTUNITY
ALBEIT A BELATED ONE
TO MASTER EXPERIENCES
THAT HAD ONCE BEEN OVERWHELMING
AND THEREFORE DEFENDED AGAINST
BUT THAT CAN NOW
WITH ENOUGH SUPPORT FROM THE THERAPIST AND
BY TAPPING INTO THE PATIENT’S UNDERLYING RESILIENCE
AND CAPACITY TO COPE WITH STRESS
BE PROCESSED AND INTEGRATED
AND ULTIMATELY ADAPTED TO
11

12. WITH THE THERAPIST’S FINGER EVER ON THE
PULSE OF THE PATIENT’S ANXIETY AND
CAPACITY TO TOLERATE FURTHER CHALLENGE
THE THERAPIST WILL THEREFORE
CHALLENGE WHENEVER POSSIBLE
BY DIRECTING THE PATIENT’S
ATTENTION TO WHERE THE PATIENT IS NOT
“DISRUPTIVE ATTUNEMENT”
AND
SUPPORT WHENEVER NECESSARY
BY RESONATING WITH WHERE THE PATIENT IS
“HOMEOSTATIC ATTUNEMENT”
12

13. CHALLENGE
BY WAY OF ANXIETY – PROVOKING
INTERPRETIVE STATEMENTS
THAT CALL INTO QUESTION DEFENSES
TO WHICH THE PATIENT HAS LONG CLUNG
IN ORDER TO PRESERVE HER PSYCHOLOGICAL EQUILIBRIUM
THEREBY INCREASING HER ANXIETY
SUPPORT
BY WAY OF ANXIETY – ASSUAGING
EMPATHIC STATEMENTS
THAT HONOR THOSE SELF – PROTECTIVE DEFENSES
THEREBY DECREASING HER ANXIETY
13

14. MODEL 1 – STRUCTURAL CONFLICT
THE INTERPRETIVE PERSPECTIVE
OF CLASSICAL PSYCHOANALYSIS
SIGMUND FREUD, ANNA FREUD, HEINZ HARTMANN,
DAVID RAPAPORT, ERNST KRIS, AND RUDOLPH LOEWENSTEIN
MODEL 2 – STRUCTURAL DEFICIT
THE CORRECTIVE – PROVISION PERSPECTIVE
OF SELF PSYCHOLOGY AND THOSE OBJECT
RELATIONS THEORIES EMPHASIZING
INTERNAL ABSENCE OF GOOD
HEINZ KOHUT, ERNEST WOLF, ARNOLD GOLDBERG,
MICHAEL BALINT, AND PAUL / ANNA ORNSTEIN
14

15. MODEL 3 – RELATIONAL CONFLICT
THE INTERSUBJECTIVE PERSPECTIVE
OF CONTEMPORARY RELATIONAL THEORY AND
THOSE OBJECT RELATIONS THEORIES
EMPHASIZING INTERNAL PRESENCE OF BAD
W R D FAIRBAIRN, STEPHEN MITCHELL, JESSICA BENJAMIN,
DARLENE EHRENBERG, AND JAY GREENBERG
MODEL 4 – RELATIONAL DEFICIT
THE EXISTENTIAL PERSPECTIVE WITH ITS EMPHASIS
ON DREAD, ANGST, DESPAIR, SUFFERING, AND
SEARCH FOR MEANINGFUL CONNECTION
HARRY GUNTRIP, ARNOLD MODELL, MASUD KHAN, JOHN BOWLBY,
THOMAS OGDEN, ROLLO MAY, AND VIKTOR FRANKL
15

16. MODEL 1 – STRUCTURAL CONFLICT
ACCELERATOR / BRAKE ~ START / STOP
FORCES PRESSING “YES”
AND RESISTIVE COUNTERFORCES INSISTING “NO”
MODEL 2 – STRUCTURAL DEFICIT
INTERNAL ABSENCE OF GOOD ~ DEPRIVATION AND NEGLECT
IMPAIRED CAPACITY TO BE A GOOD PARENT UNTO ONESELF
MODEL 3 – RELATIONAL CONFLICT
INTERNAL PRESENCE OF BAD ~ TRAUMA AND ABUSE
COMPULSIVE RE – ENACTMENT OF UNRESOLVED
CHILDHOOD DRAMAS ON THE STAGE OF ONE’S LIFE
MODEL 4 – RELATIONAL DEFICIT
A HEART SHATTERED
PSYCHIC RETREAT, SCHIZOID WITHDRAWAL, AND SOLITARY
SUFFERING RESULTING FROM THE EXPERIENCE OF ANNIHILATING,
HEART – SHATTERING RESPONSES FROM THE OBJECT
16

17. THERAPEUTIC ACTION
MODEL 1 – COGNITIVE
ENHANCEMENT OF
KNOWLEDGE “WITHIN”
MODEL 2 – AFFECTIVE
PROVISION OF
CORRECTIVE EXPERIENCE “FOR”
MODEL 3 – RELATIONAL
ENGAGEMENT IN
AUTHENTIC RELATIONSHIP “WITH”
MODEL 4 – EXISTENTIAL
EMERGENCE OF MEANINGFUL
MOMENTS OF MEETING “BETWEEN”
AND CREATION OF TRANSITIONAL SPACE “BETWEEN”
17

18. MODEL 1 – NEUROTIC
WOODY ALLEN, JERRY SEINFELD’S AND JASON
ALEXANDER’S CHARACTERS ON SEINFELD, AND MONK
MODEL 2 – NARCISSISTIC
MADONNA, KIM KARDASHIAN, KANYE WEST,
AND DONALD TRUMP
MODEL 3 – CHARACTER DISORDERED
GEORGE AND MARTHA IN WHO’S AFRAID OF VIRGINIA WOOLF?
MODEL 4 – SCHIZOID
PRIVATE (TRUE) SELF / ADDICTIONS / SOCIAL (FALSE) SELF
GRETA GARBO, KATHARINE HEPBURN, JOHNNY CARSON,
AND GREGORY HOUSE, MD (FROM THE TV SHOW HOUSE)
18

19. MODEL 1 – NEUROTIC
THE NEUROTIC DEFENSE OF RELENTLESS CONFLICTEDNESS,
AVOIDANCE, AND PARALYSIS, LEADING TO UNACTUALIZED POTENTIAL
MODEL 2 – NARCISSISTIC
THE MASOCHISTIC DEFENSE OF RELENTLESS HOPE, LEADING
TO UNREQUITED LOVE AND CONSTANT HEARTBREAK
MODEL 3 – CHARACTER DISORDERED
THE SADISTIC DEFENSE OF RELENTLESS OUTRAGE
AND BITTERNESS, LEADING TO
UNACKNOWLEDGED ANGER AND AGGRESSION
AND A SENSE OF ONESELF AS EVER THE VICTIM
MODEL 4 – SCHIZOID
THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR
AND PROFOUND HOPELESSNESS, LEADING TO UNMITIGATED
LONELINESS, SILENT SUFFERING, SOLIPSISTIC WITHDRAWAL,
SCHIZOID DETACHMENT, PSYCHIC DEADNESS, AND INNER EMPTINESS
19

20. COMPARE AND CONTRAST
THE FOUR MODES
OF THERAPEUTIC ACTION
KAREN HORNEY’S INTERPERSONAL TRENDS
MOVEMENT INWARD ~ TOWARDS ~ AGAINST ~ AWAY
SYMPATHETIC ACTIVATION
FREEZE ~ FEED / FUCK ~ FIGHT ~ FLIGHT
MODES OF RELATEDNESS
NEUROTIC ~ NARCISSISTIC ~ NOXIOUS ~ NONRELATEDNESS
NUMBERS OF PEOPLE INVOLVED
1 – PERSON ~ 1½ – PERSON ~ 2 – PERSON ~ ½ – PERSON
THERAPEUTIC STANCE
NEUTRALITY ~ EMPATHY ~ AUTHENTICITY ~ DEPENDABILITY / DEVOTION
A PSYCHOLOGY OF THE …
EGO ~ SELF ~ SELF – IN – RELATION ~ PRIVATE SELF
20

21. KAREN HORNEY DESCRIBES
THREE “INTERPERSONAL TRENDS”
MOVEMENT INWARD
MODEL 1
MOVEMENT TOWARDS
MODEL 2
MOVEMENT AGAINST
MODEL 3
MOVEMENT AWAY
MODEL 4
21

22. FOUR Fs OF “SYMPATHETIC ACTIVATION”
FOUR BASIC DRIVES RELATED TO SURVIVAL
FIGHT OR FLIGHT OR FREEZE
AND, OF COURSE, FEED / REPRODUCE
FREEZE
MODEL 1 (MOVEMENT INWARD)
FEED / FUCK
MODEL 2 (MOVEMENT TOWARDS)
FIGHT
MODEL 3 (MOVEMENT AGAINST)
FLEE
MODEL 4 (MOVEMENT AWAY)
22

23. MODES OF RELATEDNESS
MODEL 1 – NEUROTIC RELATEDNESS
THE CONFLICT – RIDDEN NEUROTIC PATIENT STRUGGLES TO MOVE
FORWARD IN HER LIFE BUT IS JAMMED UP AND UNABLE TO EMPOWER
HERSELF BY MOBILIZING HER ID ENERGIES IN THE SERVICE OF HER EGO
MODEL 2 – NARCISSISTIC RELATEDNESS
THE DEFICIT – RIDDEN NARCISSISTIC PATIENT NEEDS HER OBJECTS
TO “COMPLETE” HER BY PROVIDING MIRRORING CONFIRMATION
OF HER PERFECTION AND / OR BY ALLOWING HER TO FUSE WITH THEM
IN FANTASY SUCH THAT SHE CAN THEN PARTAKE OF THEIR PERFECTION
MODEL 3 – NOXIOUS RELATEDNESS
UNDER THE SWAY OF HER REPETITION COMPULSION, THE CHARACTER
DISORDERED PATIENT DELIVERS HER UNMASTERED CHILDHOOD
DRAMAS (THAT IS, HER DYSFUNCTIONAL RELATIONAL DYNAMICS) INTO
HER RELATIONSHIPS AND THEN COMPULSIVELY AND UNWITTINGLY
RE – ENACTS THEM ON THE STAGE OF HER LIFE
MODEL 4 – NONRELATEDNESS
FOR FEAR OF BEING SHATTERED BY YET ANOTHER CATASTROPHICALLY
ANNIHILATING RESPONSE FROM THE OBJECT, THE SCHIZOID PATIENT
WITHDRAWS FROM ALL RELATIONSHIPS AND IS RELUCTANT TO BE FOUND23

24. MODEL 1 – 1 – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S INTERNAL DYNAMICS
THERAPIST AS A NEUTRAL OBJECT / OBJECTIVE OBSERVER
OBJECTIVITY OF A SURGEON / BLANK SCREEN
MODEL 2 – 1½ – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S AFFECTIVE EXPERIENCE
(ESPECIALLY THE PAIN OF HER GRIEF)
THERAPIST AS AN EMPATHIC SELFOBJECT OR GOOD OBJECT
MODEL 3 – 2 – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S RELATIONAL DYNAMICS
THERAPIST AS AN AUTHENTIC SUBJECT OR A RELATIONAL OBJECT
(AND, AT THE END OF THE DAY, INEVITABLY A BAD OBJECT)
MODEL 4 – ½ – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S AFFECTIVE NONRELATEDNESS
THERAPIST AS A RELIABLE, NONDEMANDING, STEADY, DEPENDABLE,
CONSISTENT, TRUSTWORTHY, LOVING, AND DEVOTED PRESENCE
24

25. THERAPEUTIC STANCE
MODEL 1 –
NEUTRALITY
MODEL 2 –
EMPATHY
MODEL 3 –
AUTHENTICITY
MODEL 4 –
RELIABILITY ~ DEPENDABILITY ~ DEVOTION
25

26. EMPATHY VS. AUTHENTICITY
THERE IS A CRITICAL DISTINCTION BETWEEN
THE EMPATHIC STANCE OF THE THERAPIST
WHEN SHE IS WEARING HER MODEL 2 HAT
AND THE AUTHENTIC STANCE OF THE THERAPIST
WHEN SHE IS WEARING HER MODEL 3 HAT
MODEL 2 IS ABOUT THE THERAPIST’S
EMPATHIC IMMERSION IN THE PATIENT’S INTERNAL WORLD
THE EMPATHIC THERAPIST “DECENTERS”
(ATWOOD AND STOLOROW 1984)
FROM HER OWN EXPERIENCE, JOINS ALONGSIDE THE PATIENT,
AND ENTERS INTO THE PATIENT’S INTERNAL EXPERIENCE –
BUT TAKES IT ON ONLY “AS IF” IT WERE HER OWN
BECAUSE IT NEVER ACTUALLY BECOMES HER OWN
EMPATHY IS NOT ABOUT THE THERAPIST
WHO HAS DECENTERED FROM HER OWN EXPERIENCE
IT IS ABOUT THE PATIENT
26

27. EMPATHY VS. AUTHENTICITY
MODEL 3 IS ABOUT THE THERAPIST’S
AUTHENTIC PARTICIPATION IN A REAL RELATIONSHIP
WITH THE PATIENT
UNLIKE THE EMPATHIC THERAPIST,
WHO DECENTERS FROM HER OWN EXPERIENCE,
THE AUTHENTIC THERAPIST
REMAINS VERY MUCH CENTERED
IN HER OWN EXPERIENCE
AND ALLOWS THE PATIENT’S EXPERIENCE
TO ENTER INTO HER,
WHICH SHE THEN TAKES ON “AS” HER OWN
THIS DYNAMIC IS AT THE HEART OF
PROJECTIVE IDENTIFICATION
THE MEAT AND POTATOES OF CONTEMPORARY RELATIONAL THEORY
AND, AS WE SHALL LATER SEE, AT THE HEART OF
INTROJECTIVE IDENTIFICATION AS WELL
27

28. A PSYCHOLOGY OF THE …
MODEL 1
EGO
GOAL ~ A STRONGER, WISER,
AND MORE EMPOWERED EGO
MODEL 2
SELF
GOAL ~ A MORE CONSOLIDATED, ACCEPTING,
AND COMPASSIONATE SELF
MODEL 3
SELF – IN – RELATION
GOAL ~ A MORE PRESENT
AND ACCOUNTABLE SELF – IN – RELATION
MODEL 4
PRIVATE SELF / ADDICTED SELF / FALSE SELF
GOAL ~ A LESS PROTECTED
AND MORE ACCESSIBLE TRUE SELF
28

29. RECURRING THEMES
MODEL 1
AVOIDANCE ~ PARALYSIS
MODEL 2
SHAME ~ CONTEMPT
EMPTY, SHAME – FILLED DEPRESSION
PATIENT NEEDS TO BE ABLE TO “GRIEVE”
MODEL 3
ANGER ~ AGGRESSION ~ GUILT
ANGRY, GUILT – RIDDEN DEPRESSION
PATIENT NEEDS TO BE ABLE TO “RAGE”
MODEL 4
SECRETS ~ LIES
PRETENSIONS ~ CONCEALMENTS
PROFOUND DESPAIR ~ SOLITARY SUFFERING
29

30. ALTHOUGH THE FOCUS IN EACH IS DIFFERENT
ALL FOUR OF MY MODELS INVOLVE
AS THEIR STARTING POINT
THE INTERNAL PRICE PAID BY THE CHILD
BECAUSE OF TRAUMATIC FRUSTRATION BY THE PARENT
MODEL 1
REINFORCEMENT OF INFANTILE NEED
IN THE FACE OF ITS TRAUMATIC FRUSTRATION
MODEL 2
FAILURE TO INTERNALIZE GOOD
IN THE FACE OF TRAUMATIC “ABSENCE OF GOOD”
MODEL 3
INTROJECTION OF BAD
IN THE FACE OF TRAUMATIC “PRESENCE OF BAD”
MODEL 4
SHATTERING OF THE HEART
IN THE FACE OF CATACLYSMIC HEARTBREAK AND LOSS 30

31. THE STARTING POINT IN MODEL 1
DEFENSIVELY REINFORCED INFANTILE (LIBIDINAL AND AGGRESSIVE) DRIVES
RESULTING FROM THE DRIVE OBJECT PARENT’S EARLY – ON TRAUMATIC
FRUSTRATION OF THE CHILD’S AGE – APPROPRIATE DRIVES
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH OPTIMAL FRUSTRATION OF THE
PATIENT’S INTENSIFIED (AND DEFENDED AGAINST) DRIVES
AS THEY ARISE IN THE CONTEXT OF THE TREATMENT
WHICH WILL ULTIMATELY RESULT IN
ADAPTIVE INTEGRATION OF THOSE (ID) DRIVES
NOW TAMED AND MODIFIED
INTO HEALTHY PSYCHIC (EGO) STRUCTURE
WHICH WILL THEN ALLOW FOR THE REDIRECTING
OF THEIR NOW BETTER REGULATED ENERGY
INTO MORE CONSTRUCTIVE PURSUITS
AND ACTUALIZATION OF POTENTIAL
BY A NOW MORE SKILLED EGO
DRIVE (HORSE) AND DEFENSE (RIDER)
NO LONGER WORKING IN CONFLICT BUT IN COLLABORATION 31

32. THE STARTING POINT IN MODEL 2
STRUCTURAL DEFICIT AND IMPAIRED CAPACITY RESULTING FROM THE
SELFOBJECT PARENT’S EARLY – ON TRAUMATIC FRUSTRATION OF THE CHILD’S
AGE – APPROPRIATE NEED TO HAVE A PERFECT PARENT
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH OPTIMAL FRUSTRATION OF THE PATIENT’S
INTENSIFIED (AND DEFENDED AGAINST) NARCISSISTIC NEED
TO FIND THE PERFECT PARENT AS IT ARISES IN THE CONTEXT
OF THE RELATIONSHIP WITH THE SELFOBJECT THERAPIST
WHICH WILL ULTIMATELY RESULT IN ADAPTIVE TRANSMUTING
(STRUCTURE – BUILDING) INTERNALIZATIONS
WHICH WILL THEN ALLOW FOR THE FILLING IN OF
STRUCTURAL DEFICIT, DEVELOPMENT OF A MORE ROBUST
CAPACITY TO BE A GOOD PARENT UNTO HERSELF,
ACCRETION OF HEALTHY PSYCHIC STRUCTURE,
AND CONSOLIDATION OF A MORE COHESIVE SELF
GRIEVING OPTIMAL DISILLUSIONMENT WILL TRANSFORM
THE DEFENSIVE NEED FOR EXTERNAL REGULATION OF THE SELF
INTO THE ADAPTIVE CAPACITY TO BE INTERNALLY SELF – REGULATING 32

33. THE STARTING POINT IN MODEL 3
INTERNAL DEMONS AND A SENSE OF INNER BADNESS RESULTING
FROM INTROJECTION OF THE DYSFUNCTIONAL RELATIONAL DYNAMIC
CHARACTERIZING THE CHILD’S EARLY – ON RELATIONSHIP
WITH THE TRAUMATICALLY ABUSIVE PARENT
INTERNAL BAD OBJECTS / PATHOGENIC INTROJECTS
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH THE TURBULENCE
THAT WILL INEVITABLY ARISE AT THE
“INTIMATE EDGE” (EHRENBERG 1992) OF AUTHENTIC
RELATEDNESS ONCE THE PATIENT DELIVERS HER
PATHOGENIC INTROJECTS
INTO THE RELATIONSHIP WITH HER THERAPIST
WHICH WILL ULTIMATELY RESULT IN GRADUAL MODIFICATION
OF THEIR TOXICITY BY WAY OF SERIAL DILUTIONS
WHICH WILL THEN ALLOW FOR TRANSFORMATION OF THE DEFENSIVE
NEED TO RE – ENACT UNMASTERED EARLY – ON RELATIONAL TRAUMAS
INTO THE ADAPTIVE CAPACITY TO HOLD HERSELF ACCOUNTABLE
AND TO ENGAGE IN HEALTHY, AUTHENTIC RELATEDNESS 33

34. THE STARTING POINT IN MODEL 4
A HEART SHATTERED, SCHIZOID WITHDRAWAL, AND PSYCHIC RETREAT
RESULTING FROM OVERWHELMINGLY DEVASTATING HEARTBREAK
EXPERIENCED AT THE HANDS OF A DEVASTATINGLY ANNIHILATING PARENT
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH THE PATIENT’S FEAR OF BEING
FOUND BY, BECOMING ABSOLUTELY DEPENDENT UPON, AND
EXPERIENCING MOMENTS OF MEETING WITH THE THERAPIST
THE THERAPIST’S PROVISION OF RELIABLE,
NONDEMANDING, STEADY, CONSISTENT, TRUSTWORTHY,
AND DEVOTED PRESENCE FOR A PATIENT
WHO IS INTENSELY AMBIVALENT ABOUT ENGAGEMENT ~
ON THE ONE HAND, DESPERATELY LONGING TO BE KNOWN
BUT, ON THE OTHER HAND, TERRIFIED OF BEING FOUND
WILL ULTIMATELY RESULT IN REDUCED TERROR, DREAD,
DESPAIR, RESIGNATION, ISOLATION, AND ALIENATION
TOLERATING ABSOLUTE DEPENDENCE WILL TRANSFORM
THE DEFENSIVE NEED TO STAY HIDDEN
INTO THE ADAPTIVE CAPACITY TO BE FOUND 34

35. WHEN, IN THE MOMENT, THE SPOTLIGHT IS ON THE PATIENT AS …
NEUROTICALLY CONFLICTED / JAMMED UP / STUCK
PARALYZED BY DYSFUNCTIONAL INTERNAL DYNAMICS
THINK MODEL 1
NARCISSISTICALLY VULNERABLE / NEEDY
EVER BUSY LOOKING TO THE OUTSIDE FOR EXTERNAL
PROVISION, VALIDATION, AND REINFORCEMENT
THINK MODEL 2
NOXIOUSLY ENGAGED / SELF – SABOTAGING
SELF – DEFEATING / SELF – INDULGENT / SELF – DESTRUCTIVE
RE – ENACTING DYSFUNCTIONAL RELATIONAL DYNAMICS
THINK MODEL 3
NONRELATED AFFECTIVELY / INACCESSIBLE / HIDDEN
DISCONNECTED / DETACHED / ENCAPSULATED IN A COCOON
IMPENETRABLE / SELF – PROTECTIVE ISOLATION
THINK MODEL 4 35

36. COMPARE AND CONTRAST
THE FOUR MODES
OF THERAPEUTIC ACTION
ROLE OF THE TRANSFERENCE
NOT PARTICULARLY RELEVANT ~ POSITIVE ~ NEGATIVE ~ COCOON
1 – PERSON vs. 2 – PERSON DEFENSES
PROTECT THE EGO FROM THE ID ~ PROTECT THE SELF FROM THE OBJECT
OPTIMAL STRESSORS
DISSONANCE ~ DISILLUSIONMENT ~ DETOXIFICATION ~ DEPENDENCE
OPTIMALLY STRESSFUL STATEMENTS
CONFLICT ~ DISILLUSIONMENT ~ ACCOUNTABILITY ~ FACILITATION
SPOTLIGHT IN THE MOMENT
RESISTANT ~ RELENTLESS ~ RE – ENACTING ~ RETREATING
NOT AWARE ~ NOT ACCEPTING ~ NOT ACCOUNTABLE ~ NOT ACCESSIBLE
36

37. ROLE OF THE TRANSFERENCE
MODEL 1
MORE RELEVANT THAN THE TRANSFERENCE
IS THE FACT OF THE INTERNAL CONFLICTEDNESS
BETWEEN ANXIETY – PROVOKING BUT ULTIMATELY
GROWTH – PROMOTING FORCES AND ANXIETY – ASSUAGING
BUT GROWTH – DISRUPTING RESISTIVE COUNTERFORCES
MODEL 2
POSITIVE TRANSFERENCE (DISPLACEMENT ~ ILLUSION)
POSITIVE TRANSFERENCE DISRUPTED (DISILLUSIONMENT)
MODEL 2½
POSITIVE TRANSFERENCE ACTUALIZED (DISPLACIVE IDENTIFICATION)
MODEL 3
NEGATIVE TRANSFERENCE (PROJECTION ~ DISTORTION)
NEGATIVE TRANSFERENCE ACTUALIZED (PROJECTIVE IDENTIFICATION)
MODEL 4
COCOON TRANSFERENCE (DENIAL OF OBJECT NEED)
37

38. 1 – PERSON vs. 2 – PERSON DEFENSES
MODEL 1
1 – PERSON DEFENSES
MOBILIZED TO PROTECT
THE EGO FROM THE ID
(REPRESSION ~ INTELLECTUALIZATION ~ REACTION FORMATION)
MODELS 2, 3, AND 4
2 – PERSON DEFENSES
MOBILIZED TO PROTECT
THE SELF FROM THE OBJECT
(RELENTLESS HOPE AND ENTITLEMENT ~ RELENTLESS OUTRAGE
THE DEFENSE OF AFFECTIVE NONRELATEDNESS ~ ILLUSIONS OF
GRANDIOSE SELF – SUFFICIENCY ~ DENIAL OF OBJECT NEED)
38

39. 1 – PERSON vs. 2 – PERSON DEFENSES
MODEL 1
FOCUSES ON INTRAPSYCHIC (1 – PERSON) DEFENSES
MOBILIZED BY THE EGO IN AN EFFORT TO PROTECT ITSELF
AGAINST THREATENED BREAKTHROUGH OF
DYSREGULATED AND ANXIETY – PROVOKING ID FORCES
THE IMPORTANT RELATIONSHIP IS THE ONE
BETWEEN THE EGO AND THE ID
MODEL 2
FOCUSES ON INTERPERSONAL (2 – PERSON) DEFENSES
MOBILIZED BY THE SELF IN AN EFFORT TO PROTECT ITSELF
AGAINST BEING DISAPPOINTED BY ITS SELFOBJECTS
THE IMPORTANT RELATIONSHIP IS THE ONE
BETWEEN THE SELF AND THE SELFOBJECT
39

40. 1 – PERSON vs. 2 – PERSON DEFENSES
MODEL 3
FOCUSES ON INTERPERSONAL (2 – PERSON) DEFENSES
MOBILIZED BY THE SELF – IN – RELATION IN AN EFFORT
TO PROTECT ITSELF AGAINST
BEING ABUSED BY ITS OBJECTS
THE IMPORTANT RELATIONSHIP IS THE ONE
BETWEEN THE SELF – IN – RELATION AND THE RELATIONAL OBJECT
MODEL 4
FOCUSES ON INTERPERSONAL (2 – PERSON) DEFENSES
MOBILIZED BY THE PRIVATE SELF IN AN EFFORT
TO PROTECT ITSELF AGAINST BEING SHATTERED BY
A CATASTROPHICALLY DEVASTATING OBJECT
THE IMPORTANT RELATIONSHIP IS THE ONE
BETWEEN THE PRIVATE SELF AND THE WORLD OF ANIMATE OBJECTS
40

41. THERAPEUTIC ACTION
MODEL 1
WORKING THROUGH THE RESISTANCE TO
AWARENESS OF INTERNAL CONFLICTEDNESS
MODEL 2
FACILITATING THE GRIEVING OF INTOLERABLY
PAINFUL REALITIES ABOUT THE OBJECT
MODEL 3
NEGOTIATING AT THE INTIMATE EDGE
OF AUTHENTIC ENGAGEMENT
MODEL 4
OVERCOMING THE DREAD OF SURRENDER
TO RESOURCELESS DEPENDENCE
41

42. ACHIEVED BY WAY OF WORKING THROUGH
THE OPTIMAL STRESS OF …
MODEL 1
COGNITIVE DISSONANCE
THE EXPERIENCE OF “GAIN – BECOME – PAIN”
“EGO – SYNTONIC – BECOME – EGO – DYSTONIC”
MODEL 2
AFFECTIVE (OPTIMAL) DISILLUSIONMENT
THE EXPERIENCE OF “GOOD – BECOME – BAD”
“ILLUSION – BECOME – DISILLUSIONMENT”
MODEL 3
RELATIONAL DETOXIFICATION
THE EXPERIENCE OF “BAD – BECOME – GOOD”
MODEL 4
ABSOLUTE DEPENDENCE
THE EXPERIENCE OF “HIDDEN – BECOME – FOUND”
42

43. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 1
CONFLICT STATEMENTS
TO FACILITATE RESOLUTION OF THE PATIENT’S INTERNAL
CONFLICT BETWEEN ANXIETY – PROVOKING BUT ULTIMATELY
GROWTH – PROMOTING FORCES AND ANXIETY – ASSUAGING
BUT GROWTH – DISRUPTING DEFENSIVE COUNTERFORCES
BY HIGHLIGHTING THE DISSONANCE BETWEEN
FIRST WHAT (WITH HER HEAD) THE PATIENT KNOWS …
AND THEN WHAT (WITH HER HEART) SHE FINDS HERSELF
THINKING, FEELING, OR DOING IN ORDER NOT TO HAVE TO KNOW …
“YOU KNOW THAT YOU COULD ALWAYS ASK FOR HELP; BUT,
IN THE MOMENT, MAKING YOURSELF THAT VULNERABLE –
BY ADMITTING THAT YOU MIGHT NEED SOMEONE – IS SIMPLY OUT
OF THE QUESTION. YOU’VE BEEN DISAPPOINTED TOO MANY TIMES
IN THE PAST TO BE WILLING TO TAKE SUCH A RISK NOW. ”
(WHICH ADDRESSES CONVERGENT CONFLICT) 43

44. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 2
DISILLUSIONMENT STATEMENTS
TO FACILITATE GRIEVING LOSSES AND DISAPPOINTMENTS
“OPTIMAL DISILLUSIONMENT”
BY FIRST HIGHLIGHTING THE ILLUSION (THE RELENTLESS HOPE),
THEN ADDRESSING THE REALITY OF THE DISILLUSIONMENT, AND
FINALLY RESONATING WITH THE PAIN OF THE PATIENT’S GRIEF
“YOU WOULD HAVE WANTED JOSE TO BE ABLE TO LOVE YOU
IN THE WAY THAT YOUR DAD NEVER DID; BUT YOU ARE COMING
TO REALIZE THAT HE JUST CAN’T BECAUSE HE IS SO TERRIFIED
OF COMMITMENT; AND KNOWING THIS BREAKS YOUR HEART.”
(FIRST THE ILLUSION, BUT THEN THE DISILLUSIONING REALITY,
AND FINALLY HER DEVASTATING GRIEF ABOUT IT)
THE RESULT OF WHICH WILL BE
TRANSMUTING (STRUCTURE – BUILDING) INTERNALIZATIONS
AND THE FILLING IN OF DEFICIT 44

45. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 3
ACCOUNTABILITY STATEMENTS
TO FOSTER “TAKING OWNERSHIP” AND TO FACILITATE
“NEGOTIATING AT THE INTIMATE EDGE” (EHRENBERG 1992)
BY HIGHLIGHTING THE CONTRIBUTIONS
OF BOTH PATIENT AND THERAPIST
TO THE CO – CREATED DYSFUNCTIONAL RELATIONAL
DYNAMIC THAT IS BEING PLAYED OUT BETWEEN THEM
“I WONDER IF MY DIFFICULTY APPRECIATING JUST HOW
DESPERATE YOU WERE MADE YOU FEEL THAT YOU HAD TO DO
SOMETHING DRAMATIC IN ORDER TO GET MY ATTENTION.”
IN THE AFTERMATH OF A PROVOCATIVE ENACTMENT
ON THE PART OF THE PATIENT
“HOW WERE YOU HOPING I WOULD RESPOND?” (ID)
“HOW WERE YOU AFRAID I MIGHT RESPOND?” (SUPEREGO)
“HOW WERE YOU IMAGINING THAT I WOULD RESPOND?” (EGO) 45

46. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 4
FACILITATION STATEMENTS
TO ADDRESS THE PATIENT’S CONFLICT BETWEEN
HER LONGING TO BE KNOWN AND UNDERSTOOD
AND HER TERROR OF BEING FOUND
AS WELL AS HER AMBIVALENCE ABOUT EVEN LIVING
IN A WORLD THAT SHE EXPERIENCES AS EMPTY
AND DEVOID OF MEANING OR PURPOSE
“A PART OF YOU WOULD WANT DESPERATELY TO
BE SEEN AND UNDERSTOOD; BUT ANOTHER
PART OF YOU IS TERRIFIED OF BEING FOUND.”
“A PART OF YOU WOULD WANT TO BE ABLE TO FIND A
REASON TO GO ON LIVING; BUT ANOTHER PART OF YOU IS
QUITE SURE THAT THERE IS NO MEANING TO BE FOUND.”
(BOTH OF WHICH ADDRESS DIVERGENT CONFLICT)
46

47. WHEN THE FOCUS IS ON THE PATIENT AS
“RESISTANT” AND / OR “NOT AWARE,”
THINK MODEL 1 AND CONFLICT STATEMENTS
TO MAKE THE PATIENT “MORE AWARE”
WHEN THE FOCUS IS ON THE PATIENT AS
“RELENTLESS” AND / OR “NOT ACCEPTING,”
THINK MODEL 2 AND DISILLUSIONMENT STATEMENTS
TO MAKE THE PATIENT “MORE ACCEPTING”
WHEN THE FOCUS IS ON THE PATIENT AS
“RE – ENACTING” AND / OR “NOT ACCOUNTABLE,”
THINK MODEL 3 AND ACCOUNTABILITY STATEMENTS
TO MAKE THE PATIENT “MORE ACCOUNTABLE”
WHEN THE FOCUS IS ON THE PATIENT AS
“RETREATING” AND / OR “NOT ACCESSIBLE,”
THINK MODEL 4 AND FACILITATION STATEMENTS
TO MAKE THE PATIENT “MORE ACCESSIBLE”
47

48. MODEL 1
RESOLUTION OF STRUCTURAL CONFLICT
INVOLVING DYSFUNCTIONAL INTERNAL DYNAMICS
TAMING THE ID AND STRENGTHENING THE EGO
SUCH THAT STRUCTURAL CONFLICT BECOMES STRUCTURAL COLLABORATION
MODEL 2
STRUCTURAL GROWTH / ADDING NEW GOOD
MAKING GOOD A DEFICIENCY / FILLING IN DEFICIT
SUCH THAT STRUCTURAL DEFICIT BECOMES STRUCTURAL CONSOLIDATION
MODEL 3
RESOLUTION OF RELATIONAL CONFLICT
INVOLVING DYSFUNCTIONAL RELATIONAL DYNAMICS
STRUCTURAL MODIFICATION / CHANGING OLD BAD
DETOXIFYING INTERNAL TOXICITY
SUCH THAT RELATIONAL CONFLICT BECOMES RELATIONAL COLLABORATION
MODEL 4
EMERGENCE OF MOMENTS OF MEETING
SUCH THAT RELATIONAL DEFICIT BECOMES MEANINGFUL
ENGAGEMENT WITH THE WORLD OF PEOPLE
48

49. THE THERAPEUTIC ACTION IN ALL FOUR MODES
WILL INVOLVE WORKING THROUGH
THE OPTIMAL STRESS CREATED BY INTERVENTIONS
THAT ALTERNATELY CHALLENGE AND THEN SUPPORT
INTERVENTIONS STRATEGICALLY DESIGNED
TO TARGET / HIGHLIGHT / GENERATE
MODEL 1 – COGNITIVE DISSONANCE
MODEL 2 – AFFECTIVE DISILLUSIONMENT
MODEL 3 – RELATIONAL DETOXIFICATION
MODEL 4 – ABSOLUTE DEPENDENCE
THE WORKING THROUGH OF WHICH
WILL RESULT ULTIMATELY IN RECONSTITUTION
AT EVER – HIGHER LEVELS OF
AWARENESS / ACTUALIZATION OF POTENTIAL,
ACCEPTANCE, ACCOUNTABILITY, AND ACCESSIBILITY
49

50. MATURITY INVOLVES DEVELOPING THE CAPACITY …
MODEL 1
TO KNOW AND ACCEPT THE SELF,
INCLUDING ITS PSYCHIC SCARS
MODEL 2
TO KNOW AND ACCEPT THE OBJECT,
INCLUDING ITS PSYCHIC SCARS
MODEL 3
TO TAKE RESPONSIBILITY FOR THE DYSFUNCTION
DELIVERED INTO ONE’S RELATIONSHIPS
AND, MORE GENERALLY, INTO ONE’S LIFE
MODEL 4
TO OVERCOME ONE’S TERROR OF BEING FOUND
SO THAT MOMENTS OF MEETING CAN BE TOLERATED
AND, EVEN, FOUND TO GIVE MEANING AND PURPOSE TO LIFE
50

51. PSYCHODYNAMIC SYNERGY ~
A SYNERGY OF FOUR MODALITIES
MODEL 1 ~ STRUCTURAL CONFLICT ~ 1 – PERSON PSYCHOLOGY
THE INTERPRETIVE PERSPECTIVE OF CLASSICAL PSYCHOANALYSIS
MODEL 2 ~ STRUCTURAL DEFICIT ~ 1½ – PERSON PSYCHOLOGY
THE CORRECTIVE – PROVISION PERSPECTIVE OF
SELF PSYCHOLOGY AND THOSE OBJECT RELATIONS
THEORIES THAT EMPHASIZE INTERNAL ABSENCE OF GOOD
MODEL 3 ~ RELATIONAL CONFLICT ~ 2 – PERSON PSYCHOLOGY
THE INTERSUBJECTIVE PERSPECTIVE OF CONTEMPORARY
RELATIONAL THEORY AND THOSE OBJECT RELATIONS
THEORIES THAT EMPHASIZE INTERNAL PRESENCE OF BAD
MODEL 4 ~ RELATIONAL DEFICIT ~ ½ – PERSON PSYCHOLOGY
THE EXISTENTIAL – HUMANISTIC APROACH
TO THE THERAPEUTIC ACTION
51

52. PSYCHODYNAMIC SYNERGY ~ A SYNERGY OF FOUR MODALITIES
MODEL 1 ~ STRUCTURAL CONFLICT ~ 1 – PERSON PSYCHOLOGY
THE INTERPRETIVE PERSPECTIVE OF CLASSICAL PSYCHOANALYSIS
DYSFUNCTIONAL INTERNAL DYNAMICS
NEUROTIC CONFLICTEDNESS
MODEL 2 ~ STRUCTURAL DEFICIT ~ 1½ – PERSON PSYCHOLOGY
THE CORRECTIVE – PROVISION PERSPECTIVE OF
SELF PSYCHOLOGY AND THOSE OBJECT RELATIONS
THEORIES THAT EMPHASIZE INTERNAL ABSENCE OF GOOD
RELENTLESS PURSUIT OF THE UNATTAINABLE
NARCISSISTIC VULNERABILITY
MODEL 3 ~ RELATIONAL CONFLICT ~ 2 – PERSON PSYCHOLOGY
THE INTERSUBJECTIVE PERSPECTIVE OF CONTEMPORARY
RELATIONAL THEORY AND THOSE OBJECT RELATIONS
THEORIES THAT EMPHASIZE INTERNAL PRESENCE OF BAD
DYSFUNCTIONAL RELATIONAL DYNAMICS
NOXIOUS RELATEDNESS
MODEL 4 ~ RELATIONAL DEFICIT ~ ½ – PERSON PSYCHOLOGY
THE EXISTENTIAL – HUMANISTIC APROACH TO THE THERAPEUTIC ACTION
RELENTLESS DESPAIR ABOUT AUTHENTIC BEING – IN – THE – WORLD
NONRELATEDNESS 52

53. MODEL 1 ~ STRUCTURAL CONFLICT
THE NEUROTIC DEFENSE OF RELENTLESS CONFLICTEDNESS
AVOIDANCE, PARALYSIS, AND UNACTUALIZED POTENTIAL
MODEL 2 ~ STRUCTURAL DEFICIT
THE NARCISSISTIC DEFENSE OF RELENTLESS NEED
FOR VALIDATION AND EXTERNAL PROVISION
INSATIABLE HUNGER
MODEL 3 ~ RELATIONAL CONFLICT
THE CHARACTER DISORDERED DEFENSE OF RELENTLESS
EXTERNALIZATION AND DENIAL OF RESPONSIBILITY
DYSFUNCTIONAL RELATEDNESS, A SENSE OF ONESELF AS EVER
THE VICTIM, AND A DECREASED SENSE OF PERSONAL AGENCY
MODEL 4 ~ RELATIONAL DEFICIT
THE SCHIZOID / NIHILISTIC DEFENSE OF RELENTLESS DESPAIR
UNRELENTING LONELINESS, SCHIZOID WITHDRAWAL, EXISTENTIAL ANGST, RETREAT
AND RESIGNATION, EMOTIONAL DETACHMENT, INNER EMPTINESS, PSYCHIC DEADNESS,
SOLITARY SUFFERING, ANNIHILATION TERROR, DENIAL OF OBJECT NEED,
ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY, AFFECTIVE NONRELATEDNESS,
IMPENETRABILITY, OVERWHELMING FEELINGS OF ALIENATION AND ESTRANGEMENT,
AND THE ONGOING STRUGGLE TO RECONCILE THE DIALECTICAL TENSION
BETWEEN THE NEED TO BE MET AND THE FEAR OF BEING FOUND
AND BETWEEN LIFE AS MEANINGFUL AND LIFE AS ABSURD AND POINTLESS
53

54. PSYCHODYNAMIC SYNERGY ~
A SYNERGY OF FOUR MODALITIES
MODEL 1 ~ STRUCTURAL CONFLICT
FROM RESISTANCE TO AWARENESS
MODEL 2 ~ STRUCTURAL DEFICIT
FROM RELENTLESS HOPE TO ACCEPTANCE
MODEL 3 ~ RELATIONAL CONFLICT
FROM RE – ENACTMENT TO ACCOUNTABILITY
MODEL 4 ~ RELATIONAL DEFICIT
FROM RETREAT TO ACCESSIBILITY
FROM RELENTLESS DESPAIR TO AWAKENED HOPE
FROM RELATIONAL ABSENCE TO AUTHENTIC PRESENCE
FROM NIHILISTIC REJECTION OF EXISTENCE
TO EXISTENTIAL ACCEPTANCE OF ITS DUALITIES
54

55. HOW THE THERAPIST POSITIONS HERSELF
MOMENT BY MOMENT
THE OPTIMAL THERAPEUTIC STANCE WILL
BE ONE THAT IS CONTINUOUSLY SHIFTING
SOMETIMES SPONTANEOUS
AND UNPLANNED
SOMETIMES MORE CONSIDERED
AND DELIBERATE
SOMETIMES THE THERAPIST WILL FIND
HERSELF UNWITTINGLY DRAWN IN
TO PARTICIPATING IN A CERTAIN WAY
BUT AT OTHER TIMES THE THERAPIST WILL
MAKE A MORE CONSCIOUS CHOICE BASED
ON WHAT SHE SENSES THE PATIENT MOST
NEEDS IN THE MOMENT IN ORDER TO HEAL
55

56. IF, IN THE MOMENT, THE PATIENT IS PRIMARILY
“NOT AWARE”
THEN MODEL 1 CONFLICT STATEMENTS
“NOT ACCEPTING”
THEN MODEL 2 DISILLUSIONMENT STATEMENTS
“NOT ACCOUNTABLE”
THEN MODEL 3 ACCOUNTABILITY STATEMENTS
“NOT ACCESSIBLE AND / OR NOT AUTHENTIC”
THEN MODEL 4 FACILITATION STATEMENTS
56

57. MODEL 1 ~ STRUCTURAL CONFLICT
OBJECTIVE NEUTRALITY
CONFLICT STATEMENTS ~ FROM RESISTANCE TO AWARENESS
WORKING THROUGH THE RESISTANCE
COGNITIVE DISSONANCE ~ THE STRESS OF GAIN – BECOME – PAIN
MODEL 2 ~ STRUCTURAL DEFICIT
EMPATHIC ATTUNEMENT
DISILLUSIONMENT STATEMENTS ~ FROM RELENTLESS HOPE TO ACCEPTANCE
GRIEVING
OPTIMAL DISILLUSIONMENT ~ THE STRESS OF GOOD – BECOME – BAD
MODEL 3 ~ RELATIONAL CONFLICT
AUTHENTIC ENGAGEMENT ~ SHARED MIND AND SHARED HEART
ACCOUNTABILITY STATEMENTS ~ FROM RE – ENACTMENT TO ACCOUNTABILITY
NEGOTIATING AT THE INTIMATE EDGE OF AUTHENTIC RELATEDNESS
RELATIONAL DETOXIFICATION ~ THE STRESS OF BAD – BECOME – GOOD
MODEL 4 ~ RELATIONAL DEFICIT
SOULFUL PRESENCE ~ ROCK – SOLID RELIABILITY AND STALWART DEPENDABILITY
FACILITATION STATEMENTS ~ FROM RETREAT TO ACCESSIBILITY
FROM RELATIONAL ABSENCE TO AUTHENTIC PRESENCE
OVERCOMING THE DREAD OF SURRENDER TO RESOURCELESS DEPENDENCE
IN ORDER TO FACILITATE THE EMERGENCE OF MOMENTS OF MEETING
ABSOLUTE DEPENDENCE ~ THE STRESS OF HIDDEN – BECOME – FOUND
DIALECTICAL TENSION ~ THE STRESS OF
DENIAL – OF – EXISTENCE – BECOME – ACCEPTANCE – OF – ITS – DUALITIES 57

58. FOUR MODES OF THERAPEUTIC ACTION
MODEL 1 ~ STRUCTURAL CONFLICT
MODEL 2 ~ STRUCTURAL DEFICIT
MODEL 3 ~ RELATIONAL CONFLICT
MODEL 4 ~ RELATIONAL DEFICIT
58

59. MODEL 1 – ENHANCEMENT OF KNOWLEDGE
“WITHIN”
THE INTERPRETIVE PERSPECTIVE
OF CLASSICAL PSYCHOANALYSIS
A DRIVE – DEFENSE MODEL
THAT PRIVILEGES
THE CURATIVE POWER OF INSIGHT
IT IS A 1 – PERSON PSYCHOLOGY
BECAUSE ITS FOCUS
IS ON THE PATIENT AND THE
INTERNAL WORKINGS OF HER MIND
THE THERAPIST IS NOT SUPPOSED TO
BRING “WHO SHE IS” INTO THE ROOM –
AND, IF SHE DOES,
IT IS CALLED COUNTERTRANSFERENCE
59

60. MODEL 2 – PROVISION OF CORRECTIVE EXPERIENCE
“FOR”
THE DEFICIENCY – COMPENSATION PERSPECTIVE
OF SELF PSYCHOLOGY AND THOSE OBJECT
RELATIONS THEORIES THAT EMPHASIZE
INTERNAL ABSENCE OF GOOD (DEFICIENCY)
AND THEREFORE POSITS
CORRECTIVE – PROVISION AS THE CURATIVE AGENT
IT IS A 1½ – PERSON PSYCHOLOGY
BECAUSE ITS FOCUS IS ON THE PATIENT AND HER
RELATIONSHIP WITH A THERAPIST WHOM SHE EXPERIENCES
AS EITHER AN EMPATHIC SELFOBJECT
WHEN THE FRAME OF REFERENCE IS SELF PSYCHOLOGY
OR A GOOD OBJECT / GOOD MOTHER
WHEN THE FRAME OF REFERENCE IS OBJECT RELATIONS THEORY
BUT WHETHER DESCRIBED AS AN EMPATHIC SELFOBJECT
OR A GOOD OBJECT, IN MODEL 2 THE THERAPIST IS
CONSIDERED A HALF PERSON BECAUSE IT IS NOT WHO
SHE IS THAT MATTERS BUT WHAT SHE CAN PROVIDE 60

61. MODEL 3 – ENGAGEMENT IN AUTHENTIC RELATIONSHIP
“WITH”
THE INTERSUBJECTIVE PERSPECTIVE OF
CONTEMPORARY RELATIONAL THEORY AND THOSE
OBJECT RELATIONS THEORIES THAT EMPHASIZE
INTERNAL PRESENCE OF BAD (TOXICITY)
AND POSITS COLLABORATIVE NEGOTIATION
OF THE TURBULENCE THAT WILL
INEVITABLY EMERGE AT THE INTIMATE EDGE
OF AUTHENTIC ENGAGEMENT
BETWEEN PATIENT AND THERAPIST
AS THE TRANSFORMATIVE AGENT
IT IS A 2 – PERSON PSYCHOLOGY
BECAUSE ITS FOCUS IS ON PATIENTS
AND THERAPISTS WHO RELATE
TO EACH OTHER AS “REAL” PEOPLE
IN MODEL 3 THE THERAPIST
IS CONSIDERED A WHOLE PERSON
61

62. MODEL 4 – CREATION OF TRANSITIONAL SPACE
“BETWEEN”
AN EXISTENTIAL – HUMANISTIC PERSPECTIVE THAT EMPHASIZES EITHER
(1) CATASTROPHICALLY ANNIHILATING EARLY – ON
DISAPPOINTMENTS AND LOSSES THAT SHATTER THE HEART OR
(2) FUNDAMENTAL INSECURITY ABOUT EXISTENCE
THE NET RESULT OF WHICH WILL BE SCHIZOID WITHDRAWAL,
PSYCHIC RETREAT, RELENTLESS DESPAIR, EXISTENTIAL ANGST,
AND FEELINGS OF ALIENATION AND ESTRANGEMENT
AND POSITS “MOMENTS OF MEETING”
AS NECESSARY TO RESTORE PURPOSE AND DIRECTION
TO AN OTHERWISE EMPTY AND MEANINGLESS EXISTENCE
IT IS A ½ – PERSON PSYCHOLOGY
BECAUSE ITS FOCUS IS ON PATIENTS WHO DENY THEIR
NEED FOR OBJECTS AND CLING INSTEAD TO
THEIR ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY
IN MODEL 4 THE THERAPIST IS THOUGHT TO FUNCTION AS
A FACILITATING ENVIRONMENT ~ A SOULFUL PRESENCE
62

63. HOW DOES THE THERAPIST ARRIVE AT UNDERSTANDING
AND HOW DOES SHE THEN INTERVENE?
AS A NEUTRAL OBJECT
THE MODEL 1 THERAPIST POSITIONS HERSELF
OUTSIDE THE THERAPEUTIC FIELD
THE BETTER TO OBSERVE THE PATIENT
HER FOCUS IS ON THE PATIENT’S INTERNAL DYNAMICS
SHE COMES TO KNOW BY OBSERVING
AND REFLECTING UPON WHAT SHE SEES
SHE THEN FORMULATES OPTIMALLY STRESSFUL INTERVENTIONS
CONFLICT STATEMENTS
WITH AN EYE TO ADVANCING THE PATIENT’S
KNOWLEDGE OF HER INTERNAL DYNAMICS
“THE PATIENT GETS BETTER ONCE THE PATIENT HAS COME TO
KNOW ALL THAT THE ANALYST KNOWS WHICH IS WHAT
THE PATIENT HAD UNCONSCIOUSLY KNOWN ALL ALONG” (LACAN)
THE ULTIMATE GOAL IS RESOLUTION OF THE
PATIENT’S STRUCTURAL CONFLICTS AND
ACTUALIZATION OF INHERITED POTENTIAL 63

64. AS AN EMPATHIC SELFOBJECT
THE MODEL 2 THERAPIST JOINS ALONGSIDE
THE PATIENT IN ORDER TO IMMERSE HERSELF
IN THE PATIENT’S SUBJECTIVE REALITY
HER FOCUS IS ON THE PATIENT’S AFFECTIVE EXPERIENCE
SHE COMES TO KNOW BY DECENTERING FROM HER OWN
EXPERIENCE, ENTERING INTO THE PATIENT’S EXPERIENCE,
AND THEN TAKING IT ON – BUT ONLY “AS IF” IT WERE HER
OWN BECAUSE IT NEVER ACTUALLY BECOMES HER OWN
SHE THEN FORMULATES OPTIMALLY STRESSFUL INTERVENTIONS
DISILLUSIONMENT STATEMENTS
WITH AN EYE TO VALIDATING THE PATIENT’S EXPERIENCE
AND, MORE SPECIFICALLY, TO PROVIDING THE PATIENT WITH AN
OPPORTUNITY TO CONFRONT THE PAIN OF HER GRIEF ABOUT THE
DISILLUSIONING REALITY THAT THE OBJECTS IN HER WORLD WERE NOT,
AND WILL NEVER BE, ALL THAT SHE WOULD HAVE WANTED THEM TO BE
THE ULTIMATE GOAL IS THE FILLING IN OF THE
PATIENT’S STRUCTURAL DEFICITS BY WAY OF ADAPTIVE
TRANSMUTING (STRUCTURE – BUILDING) INTERNALIZATIONS 64

65. AS AN AUTHENTIC SUBJECT (OR RELATIONAL OBJECT)
THE MODEL 3 THERAPIST
REMAINS VERY MUCH CENTERED WITHIN HER OWN
EXPERIENCE AND USES THAT EXPERIENCE
THAT IS, HER COUNTERTRANSFERENCE
TO DEEPEN HER UNDERSTANDING OF THE PATIENT
HER FOCUS IS ON THE PATIENT’S RELATIONAL DYNAMICS
AND THE HERE – AND – NOW ENGAGEMENT BETWEEN THEM
SHE NOT ONLY ALLOWS THE PATIENT’S
EXPERIENCE TO ENTER INTO HER
WHICH SHE THEN (REACTIVELY) TAKES ON “AS” HER OWN
THAT IS, PROJECTIVE IDENTIFICATION
BUT ALSO IS ABLE TO ENTER INTO
THE PATIENT’S EXPERIENCE
WHICH SHE THEN (PROACTIVELY) TAKES ON “AS” HER OWN
THAT IS, INTROJECTIVE IDENTIFICATION
SHE THEN FORMULATES OPTIMALLY STRESSFUL INTERVENTIONS
ACCOUNTABILITY STATEMENTS AND RELATIONAL INTERVENTIONS
WITH AN EYE TO ADVANCING THE PATIENT’S KNOWLEDGE
OF HER RELATIONAL DYNAMICS AND / OR TO DEEPENING
THE CONNECTION BETWEEN THE TWO OF THEM 65

66. AS A RELIABLE / NON – DEMANDING / SOULFUL PRESENCE AND
FACILITATING / HOLDING ENVIRONMENT UPON WHOM THE PATIENT
CAN BECOME “ABSOLUTELY DEPENDENT”
SUCH THAT EVENTUALLY THE PATIENT
HAVING OVERCOME HER DREAD OF SURRENDER TO RESOURCELESS DEPENDENCE
AND HER DENIAL OF OBJECT NEED
AND HAVING WORKED THROUGH HER INTENSE AMBIVALENCE ABOUT BEING FOUND
WILL BENIGNLY REGRESS TO HARMONIOUS
INTERPENETRATING MIX – UP WITH HER THERAPIST
– “REVISITING TO REDO” –
THE MODEL 4 THERAPIST
“MEETS THE OMNIPOTENCE” OF HER PATIENT BY
“RECOGNIZING AND RESPONDING” TO HER EVERY GESTURE
EVEN HAVING ANTICIPATED IT
THEREBY ENABLING THE PATIENT TO FEEL MORE
SECURE, MORE SAFE, AND MORE IN CONTROL
SHE THEN FORMULATES OPTIMALLY STRESSFUL INTERVENTIONS
FACILITATION STATEMENTS
WITH AN EYE TO CREATING OPPORTUNITIES FOR
“MOMENTS OF MEETING” THAT WILL GIVE MEANING TO A
LIFE THAT MIGHT OTHERWISE HAVE REMAINED
DESOLATE, BARREN, IMPOVERISHED, AND DESPERATELY LONELY 66

67. PSYCHODYNAMIC SYNERGY ~ A SYNERGY OF FOUR MODALITIES
MODEL 1 ~ STRUCTURAL CONFLICT ~ 1 – PERSON PSYCHOLOGY
THE INTERPRETIVE PERSPECTIVE OF CLASSICAL PSYCHOANALYSIS
DYSFUNCTIONAL INTERNAL DYNAMICS
NEUROTIC CONFLICTEDNESS
MODEL 2 ~ STRUCTURAL DEFICIT ~ 1½ – PERSON PSYCHOLOGY
THE CORRECTIVE – PROVISION PERSPECTIVE OF
SELF PSYCHOLOGY AND THOSE OBJECT RELATIONS
THEORIES THAT EMPHASIZE INTERNAL ABSENCE OF GOOD
RELENTLESS PURSUIT OF THE UNATTAINABLE
NARCISSISTIC VULNERABILITY
MODEL 3 ~ RELATIONAL CONFLICT ~ 2 – PERSON PSYCHOLOGY
THE INTERSUBJECTIVE PERSPECTIVE OF CONTEMPORARY
RELATIONAL THEORY AND THOSE OBJECT RELATIONS
THEORIES THAT EMPHASIZE INTERNAL PRESENCE OF BAD
DYSFUNCTIONAL RELATIONAL DYNAMICS
NOXIOUS RELATEDNESS
MODEL 4 ~ RELATIONAL DEFICIT ~ ½ – PERSON PSYCHOLOGY
THE EXISTENTIAL – HUMANISTIC APROACH TO THE THERAPEUTIC ACTION
RELENTLESS DESPAIR ABOUT AUTHENTIC BEING – IN – THE – WORLD
NONRELATEDNESS 67

68. MODEL 1 ~ STRUCTURAL CONFLICT
THE NEUROTIC DEFENSE OF RELENTLESS CONFLICTEDNESS
AVOIDANCE, PARALYSIS, AND UNACTUALIZED POTENTIAL
MODEL 2 ~ STRUCTURAL DEFICIT
THE NARCISSISTIC DEFENSE OF RELENTLESS NEED
FOR VALIDATION AND EXTERNAL PROVISION
INSATIABLE HUNGER
MODEL 3 ~ RELATIONAL CONFLICT
THE CHARACTER DISORDERED DEFENSE OF RELENTLESS
EXTERNALIZATION AND DENIAL OF RESPONSIBILITY
DYSFUNCTIONAL RELATEDNESS, A SENSE OF ONESELF AS EVER
THE VICTIM, AND A DECREASED SENSE OF PERSONAL AGENCY
MODEL 4 ~ RELATIONAL DEFICIT
THE SCHIZOID / NIHILISTIC DEFENSE OF RELENTLESS DESPAIR
UNRELENTING LONELINESS, SCHIZOID WITHDRAWAL, EXISTENTIAL ANGST, RETREAT
AND RESIGNATION, EMOTIONAL DETACHMENT, INNER EMPTINESS, PSYCHIC DEADNESS,
SOLITARY SUFFERING, ANNIHILATION TERROR, DENIAL OF OBJECT NEED,
ILLUSIONS OF GRANDIOSE SELF – SUFFICIENCY, AFFECTIVE NONRELATEDNESS,
IMPENETRABILITY, OVERWHELMING FEELINGS OF ALIENATION AND ESTRANGEMENT,
AND THE ONGOING STRUGGLE TO RECONCILE THE DIALECTICAL TENSION
BETWEEN THE NEED TO BE MET AND THE FEAR OF BEING FOUND
AND BETWEEN LIFE AS MEANINGFUL AND LIFE AS ABSURD AND POINTLESS
68

69. PSYCHODYNAMIC SYNERGY ~
A SYNERGY OF FOUR MODALITIES
MODEL 1 ~ STRUCTURAL CONFLICT
FROM RESISTANCE TO AWARENESS
MODEL 2 ~ STRUCTURAL DEFICIT
FROM RELENTLESS HOPE TO ACCEPTANCE
MODEL 3 ~ RELATIONAL CONFLICT
FROM RE – ENACTMENT TO ACCOUNTABILITY
MODEL 4 ~ RELATIONAL DEFICIT
FROM RETREAT TO ACCESSIBILITY
FROM RELENTLESS DESPAIR TO AWAKENED HOPE
FROM RELATIONAL ABSENCE TO AUTHENTIC PRESENCE
FROM NIHILISTIC REJECTION OF EXISTENCE
TO EXISTENTIAL ACCEPTANCE OF ITS DUALITIES
69

70. IF, IN THE MOMENT, THE PATIENT IS PRIMARILY
“NOT AWARE”
THEN MODEL 1 CONFLICT STATEMENTS
“NOT ACCEPTING”
THEN MODEL 2 DISILLUSIONMENT STATEMENTS
“NOT ACCOUNTABLE”
THEN MODEL 3 ACCOUNTABILITY STATEMENTS
“NOT ACCESSIBLE AND / OR NOT AUTHENTIC”
THEN MODEL 4 FACILITATION STATEMENTS
70

71. MODEL 1 ~ STRUCTURAL CONFLICT
OBJECTIVE NEUTRALITY
CONFLICT STATEMENTS ~ FROM RESISTANCE TO AWARENESS
WORKING THROUGH THE RESISTANCE
COGNITIVE DISSONANCE ~ THE STRESS OF GAIN – BECOME – PAIN
MODEL 2 ~ STRUCTURAL DEFICIT
EMPATHIC ATTUNEMENT
DISILLUSIONMENT STATEMENTS ~ FROM RELENTLESS HOPE TO ACCEPTANCE
GRIEVING
OPTIMAL DISILLUSIONMENT ~ THE STRESS OF GOOD – BECOME – BAD
MODEL 3 ~ RELATIONAL CONFLICT
AUTHENTIC ENGAGEMENT ~ SHARED MIND AND SHARED HEART
ACCOUNTABILITY STATEMENTS ~ FROM RE – ENACTMENT TO ACCOUNTABILITY
NEGOTIATING AT THE INTIMATE EDGE OF AUTHENTIC RELATEDNESS
RELATIONAL DETOXIFICATION ~ THE STRESS OF BAD – BECOME – GOOD
MODEL 4 ~ RELATIONAL DEFICIT
SOULFUL PRESENCE ~ ROCK – SOLID RELIABILITY AND STALWART DEPENDABILITY
FACILITATION STATEMENTS ~ FROM RETREAT TO ACCESSIBILITY
FROM RELATIONAL ABSENCE TO AUTHENTIC PRESENCE
OVERCOMING THE DREAD OF SURRENDER TO RESOURCELESS DEPENDENCE
IN ORDER TO FACILITATE THE EMERGENCE OF MOMENTS OF MEETING
ABSOLUTE DEPENDENCE ~ THE STRESS OF HIDDEN – BECOME – FOUND
DIALECTICAL TENSION ~ THE STRESS OF
DENIAL – OF – EXISTENCE – BECOME – ACCEPTANCE – OF – ITS – DUALITIES 71

72. MODEL 4 ~ RELATIONAL DEFICIT
THE EXISTENTIAL – HUMANISTIC APROACH TO THE THERAPEUTIC ACTION
ATTACHMENT INSECURITY ~ INAUTHENTIC BEING – IN – RELATIONSHIP
ONTOLOGICAL INSECURITY ~ INAUTHENTIC BEING – IN – THE – WORLD
FROM SCHIZOID RETREAT TO ACCESSIBILITY / EMOTIONAL AVAILABILITY
FROM RELENTLESS DESPAIR TO AUTHENTIC BEING – IN – THE – WORLD
AND AWAKENED HOPE
(HOPE THAT WAS THERE ALL ALONG, WAITING TO BE FOUND)
FROM RESIGNATION TO A LIFE LIVED
FROM RELATIONAL ABSENCE TO AUTHENTIC PRESENCE
FACILITATION STATEMENTS ~
RESONATE EMPATHICALLY WITH THE DUALITIES OF EXISTENCE, RECONCILE
THE DIALECTICAL TENSION BETWEEN POLARITIES, AND EVOLVE TO A HIGHER
LEVEL OF INTEGRATION, COMPLEX UNDERSTANDING, AND DYNAMIC BALANCE
FROM OPPOSITION TO COMPLEMENTARITY
EVOLVE FROM THE DICHOTOMIZATION OF “EITHER / OR”
“A PART OF YOU NEEDS … , BUT ANOTHER PART OF YOU FEARS …”
TO THE COMPLEMENTARITY OF “BOTH / AND”
“YOU HAVE THE FEAR AND THE DESPAIR … ,
BUT, AS YOU KNOW, YOU DO HAVE A CHOICE …”
JUST AS IN QUANTUM MECHANICS, WHERE PARTICLES AND WAVES
ARE THOUGHT TO BE DIFFERENT MANIFESTATIONS OF A SINGLE REALITY
DEPENDING UPON THE OBSERVER’S PERSPECTIVE
FROM LAING’S “DIVIDED SELF” TO BROMBERG’S “MULTIPLICITY OF SELF” 72

73. PSYCHODYNAMIC PSYCHOTHERAPY
AFFORDS THE PATIENT AN OPPORTUNITY
ALBEIT A BELATED ONE
TO MASTER EXPERIENCES THAT
HAD ONCE BEEN OVERWHELMING
AND THEREFORE DEFENDED AGAINST
BUT THAT CAN NOW
WITH ENOUGH SUPPORT FROM THE THERAPIST AND
BY TAPPING INTO THE PATIENT’S UNDERLYING
RESILIENCE AND CAPACITY TO COPE WITH STRESS
BE PROCESSED AND INTEGRATED
AND ULTIMATELY ADAPTED TO

74. WITH THE THERAPIST’S FINGER EVER ON THE
PULSE OF THE PATIENT’S LEVEL OF ANXIETY AND
CAPACITY TO TOLERATE FURTHER CHALLENGE
THE THERAPIST WILL THEREFORE
CHALLENGE WHENEVER POSSIBLE
BY DIRECTING THE PATIENT’S
ATTENTION TO WHERE THE PATIENT IS NOT
“DISRUPTIVE ATTUNEMENT”
AND
SUPPORT WHENEVER NECESSARY
BY RESONATING WITH WHERE THE PATIENT IS
“HOMEOSTATIC ATTUNEMENT”

75. CHALLENGE
BY WAY OF ANXIETY – PROVOKING
INTERPRETIVE STATEMENTS THAT
CALL INTO QUESTION DEFENSES TO WHICH
THE PATIENT HAS LONG CLUNG IN ORDER TO
PRESERVE HER PSYCHOLOGICAL EQUILIBRIUM
THEREBY INCREASING HER ANXIETY
SUPPORT
BY WAY OF ANXIETY – ASSUAGING
EMPATHIC STATEMENTS THAT HONOR
THOSE SELF – PROTECTIVE DEFENSES
THEREBY DECREASING HER ANXIETY

76. FOUR SCHOOLS OF
PSYCHOANALYTIC THOUGHT
STRUCTURAL CONFLICT
RESISTANCE BECOMES TRANSFORMED INTO AWARENESS
STRUCTURAL DEFICIT
RELENTLESSNESS BECOMES TRANSFORMED INTO ACCEPTANCE
RELATIONAL CONFLICT
RE – ENACTMENT BECOMES TRANSFORMED INTO ACCOUNTABILITY
RELATIONAL DEFICIT
RETREAT BECOMES TRANSFORMED INTO ACCESSIBILITY
NEUROTIC ~ NARCISSISTIC ~ CHARACTER DISORDERED ~ SCHIZOID

77. PREVIEW
FOUR MODES OF THERAPEUTIC ACTION
FOUR APPROACHES TO TRANSFORMING DEFENSE INTO ADAPTATION
FOUR OPTIMAL STRESSORS THAT FACILITATE THIS ACTION
TRANSFORMATION OF RESISTANCE INTO
AWARENESS AND ACTUALIZATION OF POTENTIAL
BY WORKING THROUGH THE STRESS OF COGNITIVE DISSONANCE
(THE EXPERIENCE OF GAIN – BECOME – PAIN)
TRANSFORMATION OF RELENTLESSNESS INTO ACCEPTANCE
BY WORKING THROUGH THE STRESS OF AFFECTIVE DISILLUSIONMENT
(THE EXPERIENCE OF GOOD – BECOME – BAD)
TRANSFORMATION OF RE – ENACTMENT INTO ACCOUNTABILITY
BY WORKING THROUGH THE STRESS OF RELATIONAL DETOXIFICATION
(THE EXPERIENCE OF BAD – BECOME – GOOD)
TRANSFORMATION OF RETREAT INTO ACCESSIBILITY
BY WORKING THROUGH THE STRESS OF ABSOLUTE DEPENDENCE
(THE EXPERIENCE OF HIDDEN – BECOME – FOUND)

78. TRANSFORMATION OF LESS HEALTHY
DEFENSE INTO HEALTHIER ADAPTATION
MODEL 1
DEFENSIVE REACTION –
RESISTANCE TO AWARENESS OF
ONE’S DYSFUNCTIONAL INTERNAL DYNAMICS
ADAPTIVE RESPONSE –
AWARENESS AND ACTUALIZATION OF POTENTIAL
MODEL 2
DEFENSIVE REACTION –
RELENTLESS PURSUIT OF THE UNATTAINABLE AND
REFUSAL TO CONFRONT – AND GRIEVE – CERTAIN
INTOLERABLY PAINFUL REALITIES ABOUT THE OBJECT’S
LIMITATIONS, SEPARATENESS, AND IMMUTABILITY
ADAPTIVE RESPONSE –
ACCEPTANCE OF ONE’S ULTIMATE POWERLESSNESS
TO MAKE THE OBJECT CHANGE

79. TRANSFORMATION OF LESS HEALTHY
DEFENSE INTO HEALTHIER ADAPTATION
MODEL 3
DEFENSIVE REACTION –
COMPULSIVE AND UNWITTING RE – ENACTMENT
OF DYSFUNCTIONAL RELATIONAL DYNAMICS
RESULTING FROM UNMASTERED EARLY – ON TRAUMAS
ADAPTIVE RESPONSE –
ACCOUNTABILITY FOR ONE’S ACTIONS,
REACTIONS, AND INTERACTIONS
MODEL 4
DEFENSIVE REACTION –
PSYCHIC RETREAT, SCHIZOID WITHDRAWAL, AND DETACHMENT
ADAPTIVE RESPONSE –
ACCESSIBILITY AND ATTACHMENT

80. MODEL 1 – STRUCTURAL CONFLICT
THE INTERPRETIVE PERSPECTIVE
OF CLASSICAL PSYCHOANALYSIS
SIGMUND FREUD, ANNA FREUD, HEINZ HARTMANN,
DAVID RAPAPORT, ERNST KRIS, AND RUDOLPH LOEWENSTEIN
MODEL 2 – STRUCTURAL DEFICIT
THE CORRECTIVE – PROVISION PERSPECTIVE
OF SELF PSYCHOLOGY AND THOSE OBJECT
RELATIONS THEORIES EMPHASIZING
INTERNAL ABSENCE OF GOOD
HEINZ KOHUT, ERNEST WOLF, ARNOLD GOLDBERG,
MICHAEL BALINT, AND PAUL / ANNA ORNSTEIN

81. MODEL 3 – RELATIONAL CONFLICT
THE INTERSUBJECTIVE PERSPECTIVE
OF CONTEMPORARY RELATIONAL THEORY AND
THOSE OBJECT RELATIONS THEORIES
EMPHASIZING INTERNAL PRESENCE OF BAD
W R D FAIRBAIRN, STEPHEN MITCHELL, JESSICA BENJAMIN,
DARLENE EHRENBERG, AND JAY GREENBERG
MODEL 4 – RELATIONAL DEFICIT
THE EXISTENTIAL PERSPECTIVE WITH ITS EMPHASIS
ON DREAD, ANGST, DESPAIR, SUFFERING, AND
SEARCH FOR MEANINGFUL CONNECTION
HARRY GUNTRIP, ARNOLD MODELL, MASUD KHAN, JOHN BOWLBY,
THOMAS OGDEN, ROLLO MAY, AND VIKTOR FRANKL

82. MODEL 1 – STRUCTURAL CONFLICT
ACCELERATOR / BRAKE ~ START / STOP
FORCES PRESSING “YES” AND
RESISTIVE COUNTERFORCES INSISTING “NO”
MODEL 2 – STRUCTURAL DEFICIT
INTERNAL ABSENCE OF GOOD ~ DEPRIVATION AND NEGLECT
IMPAIRED CAPACITY TO BE A GOOD PARENT UNTO ONESELF
MODEL 3 – RELATIONAL CONFLICT
INTERNAL PRESENCE OF BAD ~ TRAUMA AND ABUSE
COMPULSIVE RE – ENACTMENT OF UNRESOLVED
CHILDHOOD DRAMAS ON THE STAGE OF ONE’S LIFE
MODEL 4 – RELATIONAL DEFICIT
A HEART SHATTERED
PSYCHIC RETREAT, SCHIZOID WITHDRAWAL, AND SOLITARY
SUFFERING RESULTING FROM THE EXPERIENCE OF
CATACLYSMICALLY ANNIHILATING RESPONSES FROM THE OBJECT

83. THERAPEUTIC ACTION
MODEL 1 – COGNITIVE
ENHANCEMENT OF
KNOWLEDGE “WITHIN”
MODEL 2 – AFFECTIVE
PROVISION OF
CORRECTIVE EXPERIENCE “FOR”
MODEL 3 – RELATIONAL
ENGAGEMENT IN
AUTHENTIC RELATIONSHIP “WITH”
MODEL 4 – EXISTENTIAL
EMERGENCE OF MEANINGFUL
MOMENTS OF MEETING “BETWEEN”
AND CREATION OF TRANSITIONAL SPACE “BETWEEN”

84. MODEL 1 – NEUROTIC
DYSFUNCTIONAL INTERNAL DYNAMICS
MODEL 2 – NARCISSISTIC
RELENTLESS PURSUIT OF THE UNATTAINABLE
MODEL 3 – CHARACTER DISORDERED
DYSFUNCTIONAL RELATIONAL DYNAMICS
MODEL 4 – SCHIZOID
IMPENETRABILITY

85. MODEL 1 – NEUROTIC
WOODY ALLEN, JERRY SEINFELD’S AND JASON
ALEXANDER’S CHARACTERS ON SEINFELD, AND MONK
MODEL 2 – NARCISSISTIC
MADONNA, KIM KARDASHIAN, KANYE WEST,
AND DONALD TRUMP
MODEL 3 – CHARACTER DISORDERED
GEORGE AND MARTHA IN WHO’S AFRAID OF VIRGINIA WOOLF?
MODEL 4 – SCHIZOID
TRUE (PRIVATE) SELF / FALSE (PUBLIC) SELF
GRETA GARBO, KATHARINE HEPBURN, JOHNNY CARSON,
AND GREGORY HOUSE, MD (FROM THE TV SHOW HOUSE)

86. MODEL 1 – NEUROTIC
THE NEUROTIC DEFENSE OF
RELENTLESS CONFLICTEDNESS,
LEADING TO AVOIDANCE, PARALYSIS,
AND UNACTUALIZED POTENTIAL
MODEL 2 – NARCISSISTIC
THE NARCISSISTIC DEFENSE OF
RELENTLESS NEED FOR VALIDATION
AND EXTERNAL PROVISION,
LEADING TO INSATIABLE HUNGER
THE MASOCHISTIC DEFENSE OF RELENTLESS
HOPE, LEADING TO UNREQUITED
LOVE AND CONSTANT HEARTBREAK

87. MODEL 3 – CHARACTER DISORDERED
THE CHARACTER DISORDERED DEFENSE
OF RELENTLESS EXTERNALIZATION
AND DENIAL OF RESPONSIBILITY, LEADING
TO DYSFUNCTIONAL RELATIONSHIPS AND
A SENSE OF ONESELF AS EVER THE VICTIM
THE SADISTIC DEFENSE OF RELENTLESS OUTRAGE,
LEADING TO UNCOMPROMISING ANGER, SELF – RIGHTEOUS
INDIGNATION, RESENTMENT, AND BITTERNESS
MODEL 4 – SCHIZOID
THE SCHIZOID DEFENSE OF RELENTLESS DESPAIR
AND PROFOUND HOPELESSNESS, LEADING TO
UNMITIGATED LONELINESS, WITHDRAWAL,
DETACHMENT, SUFFERING, PSYCHIC DEADNESS,
INNER EMPTINESS, AND OVERWHELMING FEELINGS
OF ALIENATION AND ESTRANGEMENT

88. COMPARE AND CONTRAST
THE FOUR MODES
OF THERAPEUTIC ACTION
MODE OF RELATEDNESS
NEUROTIC ~ NARCISSISTIC ~ NOXIOUS ~ NONRELATEDNESS
NUMBER OF PEOPLE
1 – PERSON ~ 1½ – PERSON ~ 2 – PERSON ~ ½ – PERSON
THERAPIST’S STANCE
NEUTRALITY ~ EMPATHY ~ AUTHENTICITY ~ DEPENDABILITY / DEVOTION
A PSYCHOLOGY OF THE …
EGO ~ SELF ~ SELF – IN – RELATION ~ PRIVATE SELF

89. KAREN HORNEY DESCRIBES
THREE “INTERPERSONAL TRENDS”
MOVEMENT INWARDS
MODEL 1
MOVEMENT TOWARDS
MODEL 2
MOVEMENT AGAINST
MODEL 3
MOVEMENT AWAY
MODEL 4

90. FOUR BASIC DRIVES RELATED TO SURVIVAL
“SYMPATHETIC ACTIVATION”
FREEZE
MODEL 1 (MOVEMENT INWARDS)
FUCK
MODEL 2 (MOVEMENT TOWARDS)
FIGHT
MODEL 3 (MOVEMENT AGAINST)
FLEE
MODEL 4 (MOVEMENT AWAY)

91. CLINGING, AVERSION, AND IGNORING
ZEN MASTER JAN CHOZEN BAYS, MD
AS A PEDIATRICIAN HE HAS EXAMINED
HUNDREDS OF NEWBORN BABIES
SOME “ARE BORN WANTING SENSORY
EXPERIENCES” AND “ARE
UPSET IF THEY DON’T GET THEM”
(MODEL 2)
OTHERS “ARE BORN ANGRY
AND UPSET AT THE WORLD”
(MODEL 3)
STILL OTHERS “JUST LIKE TO
GO UNCONSCIOUS AND, IF
DISTRESSED, GO TO SLEEP”
(MODEL 4)

92. MODES OF RELATEDNESS
MODEL 1 – NEUROTIC RELATEDNESS
THE CONFLICT – RIDDEN NEUROTIC PATIENT STRUGGLES TO MOVE
FORWARD IN HER LIFE BUT IS JAMMED UP AND UNABLE TO EMPOWER
HERSELF BY HARNESSING HER ID ENERGIES IN THE SERVICE OF HER EGO
MODEL 2 – NARCISSISTIC RELATEDNESS
THE DEFICIT – RIDDEN NARCISSISTIC PATIENT NEEDS HER OBJECTS
TO “COMPLETE” HER BY PROVIDING MIRRORING CONFIRMATION
OF HER PERFECTION AND / OR BY ALLOWING HER TO FUSE WITH THEM
IN FANTASY SUCH THAT SHE CAN THEN PARTAKE OF THEIR PERFECTION
MODEL 3 – NOXIOUS RELATEDNESS
UNDER THE SWAY OF HER REPETITION COMPULSION, THE CHARACTER
DISORDERED PATIENT DELIVERS HER UNMASTERED CHILDHOOD
DRAMAS (THAT IS, HER DYSFUNCTIONAL RELATIONAL DYNAMICS) INTO
HER RELATIONSHIPS AND THEN COMPULSIVELY AND UNWITTINGLY
RE – ENACTS THEM ON THE STAGE OF HER LIFE
MODEL 4 – NONRELATEDNESS
FOR FEAR OF BEING SHATTERED BY YET ANOTHER CATACLYSMICALLY
ANNIHILATING RESPONSE FROM THE OBJECT, THE SCHIZOID PATIENT
WITHDRAWS FROM ALL RELATIONSHIPS, DESPERATE TO REMAIN HIDDEN

93. MODEL 1 – 1 – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S INTERNAL DYNAMICS
THERAPIST AS A NEUTRAL OBJECT / AN OBJECTIVE OBSERVER
A BLANK SCREEN WITH THE OBJECTIVITY OF A SURGEON
MODEL 2 – 1½ – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S AFFECTIVE EXPERIENCE
(ESPECIALLY THE PAIN OF HER GRIEF)
THERAPIST AS AN EMPATHIC SELFOBJECT / A GOOD OBJECT
MODEL 3 – 2 – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S RELATIONAL DYNAMICS
THERAPIST AS AN AUTHENTIC SUBJECT / A RELATIONAL OBJECT
(AND, AT THE END OF THE DAY, INEVITABLY A BAD OBJECT)
MODEL 4 – ½ – PERSON PSYCHOLOGY
FOCUS ON PATIENT’S AFFECTIVE NONRELATEDNESS
THERAPIST AS A RELIABLE, NONDEMANDING, STEADY, DEPENDABLE,
CONSISTENT, TRUSTWORTHY, LOVING, AND DEVOTED PRESENCE

94. THERAPIST’S STANCE
MODEL 1 –
NEUTRALITY
MODEL 2 –
EMPATHY
MODEL 3 –
AUTHENTICITY
MODEL 4 –
RELIABILITY ~ DEPENDABILITY ~ DEVOTION

95. EMPATHY VS. AUTHENTICITY
THERE IS A CRITICAL DISTINCTION BETWEEN
THE EMPATHIC STANCE OF THE THERAPIST
WHEN SHE IS WEARING HER MODEL 2 HAT
AND THE AUTHENTIC STANCE OF THE THERAPIST
WHEN SHE IS WEARING HER MODEL 3 HAT
MODEL 2 IS ABOUT THE THERAPIST’S
EMPATHIC IMMERSION IN THE PATIENT’S INTERNAL WORLD
THE EMPATHIC THERAPIST “DECENTERS”
(ATWOOD AND STOLOROW 1984)
FROM HER OWN EXPERIENCE, JOINS ALONGSIDE THE PATIENT,
AND ENTERS INTO THE PATIENT’S INTERNAL EXPERIENCE –
BUT TAKES IT ON ONLY “AS IF” IT WERE HER OWN
BECAUSE IT NEVER ACTUALLY BECOMES HER OWN
EMPATHY IS NOT ABOUT THE THERAPIST
WHO HAS DECENTERED FROM HER OWN EXPERIENCE
IT IS ABOUT THE PATIENT

96. EMPATHY VS. AUTHENTICITY
MODEL 3 IS ABOUT THE THERAPIST’S
AUTHENTIC PARTICIPATION IN A REAL RELATIONSHIP
WITH THE PATIENT
UNLIKE THE EMPATHIC THERAPIST,
WHO DECENTERS FROM HER OWN EXPERIENCE,
THE AUTHENTIC THERAPIST
REMAINS VERY MUCH CENTERED
IN HER OWN EXPERIENCE
AND ALLOWS THE PATIENT’S EXPERIENCE
TO ENTER INTO HER,
WHICH SHE THEN TAKES ON “AS” HER OWN
THIS DYNAMIC IS AT THE HEART OF
PROJECTIVE IDENTIFICATION
THE MEAT AND POTATOES OF CONTEMPORARY RELATIONAL THEORY
AND, AS WE SHALL LATER SEE, AT THE HEART OF
INTROJECTIVE IDENTIFICATION AS WELL

97. A PSYCHOLOGY OF THE …
MODEL 1
EGO
GOAL ~ A STRONGER, WISER,
AND MORE EMPOWERED EGO
MODEL 2
SELF
GOAL ~ A MORE CONSOLIDATED, ACCEPTING,
AND COMPASSIONATE SELF
MODEL 3
SELF – IN – RELATION
GOAL ~ A MORE PRESENT
AND ACCOUNTABLE SELF – IN – RELATION
MODEL 4
PRIVATE SELF / ADDICTED SELF / PUBLIC SELF
GOAL ~ A LESS PROTECTED
AND MORE ACCESSIBLE TRUE SELF

98. RECURRING THEMES
MODEL 1
AVOIDANCE ~ PARALYSIS
MODEL 2
SHAME ~ CONTEMPT
EMPTY, SHAME – FILLED DEPRESSION
PATIENT NEEDS TO “GRIEVE”
MODEL 3
ANGER ~ AGGRESSION ~ GUILT
ANGRY, GUILT – RIDDEN DEPRESSION
PATIENT NEEDS TO “RAGE”
MODEL 4
SECRETS ~ LIES
PRETENSIONS ~ CONCEALMENTS
PROFOUND DESPAIR ~ SOLITARY SUFFERING

99. ALTHOUGH THE FOCUS IN EACH IS DIFFERENT
ALL FOUR OF MY MODELS INVOLVE
AS THEIR STARTING POINT
THE INTERNAL PRICE PAID BY THE CHILD
BECAUSE OF TRAUMATIC FRUSTRATION BY THE PARENT
MODEL 1
REINFORCEMENT OF INFANTILE NEED
IN THE FACE OF ITS TRAUMATIC FRUSTRATION
MODEL 2
FAILURE TO INTERNALIZE GOOD
IN THE FACE OF TRAUMATIC “ABSENCE OF GOOD”
MODEL 3
INTROJECTION OF BAD
IN THE FACE OF TRAUMATIC “PRESENCE OF BAD”
MODEL 4
SHATTERING OF THE HEART
IN THE FACE OF CATACLYSMIC HEARTBREAK AND LOSS

100. THE STARTING POINT IN MODEL 1
DEFENSIVELY REINFORCED INFANTILE (LIBIDINAL AND AGGRESSIVE) DRIVES
RESULTING FROM THE DRIVE OBJECT PARENT’S EARLY – ON TRAUMATIC
FRUSTRATION OF THE CHILD’S AGE – APPROPRIATE DRIVES
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH OPTIMAL FRUSTRATION OF THE
PATIENT’S INTENSIFIED (AND DEFENDED AGAINST) DRIVES
AS THEY ARISE IN THE CONTEXT OF THE TREATMENT
WHICH WILL ULTIMATELY RESULT IN
ADAPTIVE INTEGRATION OF THOSE (ID) DRIVES
NOW TAMED AND MODIFIED
INTO HEALTHY PSYCHIC (EGO) STRUCTURE
WHICH WILL THEN ALLOW FOR THE REDIRECTING
OF THEIR NOW BETTER REGULATED ENERGY INTO
MORE CONSTRUCTIVE PURSUITS AND ACTUALIZATION
OF POTENTIAL BY A NOW MORE SKILLED EGO
DRIVE (HORSE) AND DEFENSE (RIDER)
NO LONGER WORKING IN CONFLICT BUT IN COLLABORATION

101. THE STARTING POINT IN MODEL 2
STRUCTURAL DEFICIT AND IMPAIRED CAPACITY RESULTING FROM THE
SELFOBJECT PARENT’S EARLY – ON TRAUMATIC FRUSTRATION OF THE CHILD’S
AGE – APPROPRIATE NEED TO HAVE A PERFECT PARENT
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH OPTIMAL FRUSTRATION OF THE PATIENT’S
INTENSIFIED (AND DEFENDED AGAINST) NARCISSISTIC NEED
TO FIND THE PERFECT PARENT AS IT ARISES IN THE CONTEXT
OF THE RELATIONSHIP WITH THE SELFOBJECT THERAPIST
WHICH WILL ULTIMATELY RESULT IN ADAPTIVE TRANSMUTING
(STRUCTURE – BUILDING) INTERNALIZATIONS
WHICH WILL THEN ALLOW FOR THE FILLING IN OF
STRUCTURAL DEFICIT, DEVELOPMENT OF A MORE ROBUST
CAPACITY TO BE A GOOD PARENT UNTO HERSELF,
ACCRETION OF HEALTHY PSYCHIC STRUCTURE,
AND CONSOLIDATION OF A MORE COHESIVE SELF
GRIEVING OPTIMAL DISILLUSIONMENT WILL TRANSFORM
THE DEFENSIVE NEED FOR EXTERNAL REGULATION OF THE SELF
INTO THE ADAPTIVE CAPACITY TO BE INTERNALLY SELF – REGULATING

102. THE STARTING POINT IN MODEL 3
INTERNAL DEMONS AND A SENSE OF INNER BADNESS RESULTING
FROM INTROJECTION OF THE DYSFUNCTIONAL RELATIONAL DYNAMIC
CHARACTERIZING THE CHILD’S EARLY – ON RELATIONSHIP
WITH THE TRAUMATICALLY ABUSIVE PARENT
INTERNAL BAD OBJECTS / PATHOGENIC INTROJECTS
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH THE TURBULENCE
THAT WILL INEVITABLY ARISE AT THE
“INTIMATE EDGE” (EHRENBERG 1992) OF AUTHENTIC
RELATEDNESS ONCE THE PATIENT DELIVERS HER
PATHOGENIC INTROJECTS
INTO THE RELATIONSHIP WITH HER THERAPIST
WHICH WILL ULTIMATELY RESULT IN GRADUAL MODIFICATION
OF THEIR TOXICITY BY WAY OF SERIAL DILUTIONS
WHICH WILL THEN ALLOW FOR TRANSFORMATION OF THE DEFENSIVE
NEED TO RE – ENACT UNMASTERED EARLY – ON RELATIONAL TRAUMAS
INTO THE ADAPTIVE CAPACITY TO HOLD HERSELF ACCOUNTABLE
AND TO ENGAGE IN HEALTHY, AUTHENTIC RELATEDNESS

103. THE STARTING POINT IN MODEL 4
A HEART SHATTERED, SCHIZOID WITHDRAWAL, AND PSYCHIC RETREAT
RESULTING FROM OVERWHELMINGLY DEVASTATING HEARTBREAK
EXPERIENCED AT THE HANDS OF A DEVASTATINGLY ANNIHILATING PARENT
THE THERAPEUTIC ACTION WILL INVOLVE
WORKING THROUGH THE PATIENT’S FEAR OF BEING
FOUND BY, OF BECOMING ABSOLUTELY DEPENDENT UPON, AND
OF EXPERIENCING MOMENTS OF MEETING WITH THE THERAPIST
THE THERAPIST’S PROVISION OF RELIABLE, DEPENDABLE,
NONDEMANDING, STEADY, CONSISTENT, TRUSTWORTHY,
AND DEVOTED PRESENCE FOR A PATIENT
WHO IS INTENSELY AMBIVALENT ABOUT ENGAGEMENT
ON THE ONE HAND, DESPERATELY LONGING TO BE KNOWN
BUT, ON THE OTHER HAND, TERRIFIED OF BEING FOUND
WILL ULTIMATELY RESULT IN REDUCED TERROR, DREAD,
DESPAIR, RESIGNATION, ISOLATION, AND ALIENATION
TOLERATING ABSOLUTE DEPENDENCE WILL TRANSFORM
THE DEFENSIVE NEED TO STAY HIDDEN
INTO THE ADAPTIVE CAPACITY TO BE FOUND

104. WHEN, IN THE MOMENT, THE SPOTLIGHT IS ON THE PATIENT AS …
NEUROTICALLY CONFLICTED / JAMMED UP / STUCK
PARALYZED BY DYSFUNCTIONAL INTERNAL DYNAMICS
THINK MODEL 1
NARCISSISTICALLY VULNERABLE / NEEDY
EVER BUSY LOOKING TO THE OUTSIDE FOR EXTERNAL
PROVISION, VALIDATION, AND REINFORCEMENT
THINK MODEL 2
NOXIOUSLY ENGAGED / SELF – SABOTAGING
SELF – DEFEATING / SELF – INDULGENT / SELF – DESTRUCTIVE
RE – ENACTING DYSFUNCTIONAL RELATIONAL DYNAMICS
THINK MODEL 3
NONRELATED AFFECTIVELY / INACCESSIBLE / HIDDEN
DISCONNECTED / DETACHED / ENCAPSULATED IN A COCOON
IMPENETRABLE / SELF – PROTECTIVELY ISOLATED
THINK MODEL 4

105. COMPARE AND CONTRAST
THE FOUR MODES
OF THERAPEUTIC ACTION
ROLE OF THE TRANSFERENCE
NOT PARTICULARLY RELEVANT ~ POSITIVE ~ NEGATIVE ~ COCOON
1 – PERSON vs. 2 – PERSON DEFENSES
PROTECT THE EGO FROM THE ID vs. PROTECT THE SELF FROM THE OBJECT
OPTIMAL STRESSORS
DISSONANCE ~ DISILLUSIONMENT ~ DETOXIFICATION ~ DEPENDENCE
OPTIMALLY STRESSFUL STATEMENTS
CONFLICT ~ DISILLUSIONMENT ~ ACCOUNTABILITY ~ FACILITATION
SPOTLIGHT IN THE MOMENT
RESISTANT ~ RELENTLESS ~ RE – ENACTING ~ RETREATING
NOT AWARE ~ NOT ACCEPTING ~ NOT ACCOUNTABLE ~ NOT ACCESSIBLE

106. ROLE OF THE TRANSFERENCE
MODEL 1
MORE RELEVANT THAN THE TRANSFERENCE
IS THE FACT OF THE INTERNAL CONFLICTEDNESS
BETWEEN ANXIETY – PROVOKING BUT ULTIMATELY
GROWTH – PROMOTING FORCES AND ANXIETY – ASSUAGING
BUT GROWTH – DISRUPTING RESISTIVE COUNTERFORCES
MODEL 2
POSITIVE TRANSFERENCE (DISPLACEMENT ~ ILLUSION)
POSITIVE TRANSFERENCE DISRUPTED (DISILLUSIONMENT)
MODEL 2½
POSITIVE TRANSFERENCE ACTUALIZED (DISPLACIVE IDENTIFICATION)
MODEL 3
NEGATIVE TRANSFERENCE (PROJECTION ~ DISTORTION)
NEGATIVE TRANSFERENCE ACTUALIZED (PROJECTIVE IDENTIFICATION)
MODEL 4
COCOON TRANSFERENCE (DENIAL OF OBJECT NEED)

107. 1 – PERSON vs. 2 – PERSON DEFENSES
MODEL 1
1 – PERSON DEFENSES
MOBILIZED TO PROTECT
THE EGO FROM THE ID
(REPRESSION ~ INTELLECTUALIZATION ~ REACTION FORMATION)
MODELS 2, 3, AND 4
2 – PERSON DEFENSES
MOBILIZED TO PROTECT
THE SELF FROM THE OBJECT
(RELENTLESS HOPE AND ENTITLEMENT ~ RELENTLESS OUTRAGE
THE DEFENSE OF AFFECTIVE NONRELATEDNESS ~ ILLUSIONS OF
GRANDIOSE SELF – SUFFICIENCY ~ DENIAL OF OBJECT NEED)

108. 1 – PERSON vs. 2 – PERSON DEFENSES
MODEL 1
FOCUSES ON INTRAPSYCHIC (1 – PERSON) DEFENSES
MOBILIZED BY THE EGO IN AN EFFORT TO PROTECT
ITSELF AGAINST THREATENED BREAKTHROUGH OF
DYSREGULATED AND ANXIETY – PROVOKING ID FORCES
THE IMPORTANT RELATIONSHIP BEING THE ONE
THAT EXISTS BETWEEN THE ID AND THE “ANXIOUS” EGO
MODEL 2
FOCUSES ON INTERPERSONAL (2 – PERSON) DEFENSES
MOBILIZED BY THE SELF IN AN EFFORT TO PROTECT ITSELF
AGAINST BEING DISAPPOINTED BY ITS SELFOBJECTS
THE IMPORTANT RELATIONSHIP BEING THE ONE
THAT EXISTS BETWEEN THE SELF AND THE “GOOD” OBJECT

109. 1 – PERSON vs. 2 – PERSON DEFENSES
MODEL 3
FOCUSES ON INTERPERSONAL (2 – PERSON) DEFENSES
MOBILIZED BY THE SELF – IN – RELATION IN AN
EFFORT TO PROTECT ITSELF AGAINST
BEING ABUSED BY ITS OBJECTS
THE IMPORTANT RELATIONSHIP BEING THE ONE THAT EXISTS
BETWEEN THE SELF – IN – RELATION AND THE “BAD” OBJECT
MODEL 4
FOCUSES ON INTERPERSONAL (2 – PERSON) DEFENSES
MOBILIZED BY THE PRIVATE SELF IN AN EFFORT TO
PROTECT ITSELF AGAINST BEING SHATTERED BY
A CATACLYSMICALLY DEVASTATING OBJECT
THE IMPORTANT RELATIONSHIP BEING THE ONE THAT EXISTS
BETWEEN THE PRIVATE SELF AND THE “ANNIHILATING” OBJECT

110. THERAPEUTIC ACTION
MODEL 1
WORKING THROUGH THE RESISTANCE TO AWARENESS
OF INTERNAL FORCES / COUNTERFORCES
GIVING RISE TO NEUROTIC CONFLICTEDNESS
MODEL 2
FACILITATING THE GRIEVING OF INTOLERABLY PAINFUL
REALITIES ABOUT THE OBJECT OF ONE’S DESIRE
MODEL 3
NEGOTIATING AT THE INTIMATE EDGE
OF AUTHENTIC ENGAGEMENT
MODEL 4
OVERCOMING THE DREAD OF SURRENDER
TO RESOURCELESS DEPENDENCE

111. ACHIEVED BY WAY OF WORKING THROUGH
THE OPTIMAL STRESS OF …
MODEL 1
COGNITIVE DISSONANCE
THE EXPERIENCE OF “GAIN – BECOME – PAIN”
“EGO – SYNTONIC – BECOME – EGO – DYSTONIC”
MODEL 2
AFFECTIVE (OPTIMAL) DISILLUSIONMENT
THE EXPERIENCE OF “GOOD – BECOME – BAD”
“ILLUSION – BECOME – DISILLUSIONMENT”
MODEL 3
RELATIONAL DETOXIFICATION
THE EXPERIENCE OF “BAD – BECOME – GOOD”
MODEL 4
ABSOLUTE DEPENDENCE
THE EXPERIENCE OF “HIDDEN – BECOME – FOUND”

112. ANXIETY – PROVOKING
BUT
ULTIMATELY
GROWTH – PROMOTING
STATEMENTS
CONFLICT STATEMENTS
DISILLUSIONMENT STATEMENTS
ACCOUNTABILITY STATEMENTS
FACILITATION STATEMENTS

113. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 1
CONFLICT STATEMENTS
TO FACILITATE RESOLUTION OF THE PATIENT’S INTERNAL
CONFLICT BETWEEN ANXIETY – PROVOKING BUT ULTIMATELY
GROWTH – PROMOTING FORCES AND ANXIETY – ASSUAGING
BUT GROWTH – DISRUPTING DEFENSIVE COUNTERFORCES
BY HIGHLIGHTING THE DISSONANCE BETWEEN
FIRST WHAT (WITH HER HEAD) THE PATIENT KNOWS …
AND THEN WHAT (WITH HER HEART) SHE FINDS HERSELF THINKING,
FEELING, OR DOING IN ORDER NOT TO HAVE TO KNOW …
“YOU KNOW THAT YOU COULD ALWAYS ASK FOR HELP; BUT,
IN THE MOMENT, MAKING YOURSELF THAT VULNERABLE –
BY ADMITTING THAT YOU MIGHT NEED SOMEONE – IS SIMPLY OUT
OF THE QUESTION. YOU’VE BEEN DISAPPOINTED TOO MANY TIMES
IN THE PAST TO BE WILLING TO TAKE SUCH A RISK NOW. ”
(WHICH ADDRESSES CONVERGENT CONFLICT)

114. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 2
DISILLUSIONMENT STATEMENTS
TO FACILITATE GRIEVING LOSSES AND DISAPPOINTMENTS
“OPTIMAL DISILLUSIONMENT”
BY FIRST HIGHLIGHTING THE ILLUSION (THE RELENTLESS HOPE),
THEN ADDRESSING THE REALITY OF THE DISILLUSIONMENT, AND
FINALLY RESONATING WITH THE PAIN OF THE PATIENT’S GRIEF
“YOU WOULD HAVE WANTED JOSE TO BE ABLE TO LOVE YOU
IN THE WAY THAT YOUR DAD NEVER DID; BUT YOU ARE COMING
TO REALIZE THAT HE JUST CAN’T BECAUSE HE IS SO TERRIFIED
OF COMMITMENT; AND KNOWING THIS BREAKS YOUR HEART.”
(FIRST THE ILLUSION, BUT THEN THE DISILLUSIONING REALITY,
AND FINALLY HER DEVASTATING GRIEF ABOUT IT)
THE RESULT OF WHICH WILL BE
TRANSMUTING (STRUCTURE – BUILDING) INTERNALIZATIONS
AND THE FILLING IN OF DEFICIT

115. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 3
ACCOUNTABILITY STATEMENTS
TO FOSTER “TAKING OWNERSHIP” AND TO FACILITATE
“NEGOTIATING AT THE INTIMATE EDGE” (EHRENBERG 1992)
BY HIGHLIGHTING THE CONTRIBUTIONS
OF BOTH PATIENT AND THERAPIST
TO THE CO – CREATED DYSFUNCTIONAL RELATIONAL
DYNAMIC THAT IS BEING PLAYED OUT BETWEEN THEM
“I WONDER IF MY DIFFICULTY APPRECIATING JUST HOW
DESPERATE YOU WERE MADE YOU FEEL THAT YOU HAD TO DO
SOMETHING DRAMATIC IN ORDER TO GET MY ATTENTION.”
IN THE AFTERMATH OF A PATIENT’S PROVOCATIVE ENACTMENT
“HOW WERE YOU HOPING I WOULD RESPOND?” (ID)
“HOW WERE YOU AFRAID I MIGHT RESPOND?” (SUPEREGO)
“HOW WERE YOU IMAGINING THAT I WOULD RESPOND?” (EGO)

116. MODEL 3
ALTHOUGH INITIALLY THE THERAPIST MAY
INDEED FAIL THE PATIENT IN MUCH THE SAME
WAY THAT THE PATIENT’S PARENT HAD FAILED HER,
ULTIMATELY THE THERAPIST WILL CHALLENGE
THE PATIENT’S PROJECTIONS BY LENDING
ASPECTS OF HER “OTHERNESS,”
OR, AS WINNICOTT WOULD HAVE SAID,
HER “EXTERNALITY” TO THE INTERACTION,
SUCH THAT THE PATIENT WILL HAVE
THE EXPERIENCE OF SOMETHING THAT IS
“OTHER – THAN – ME” AND CAN TAKE THAT IN

117. MODEL 3
THE THERAPIST WILL CHALLENGE THE
PATIENT’S PROJECTIONS BY LENDING ASPECTS
OF HER OWN GREATER CAPACITY
TO PROCESS AND INTEGRATE,
SUCH THAT THE PATIENT WILL HAVE THE
EXPERIENCE OF BEING ABLE TO TAKE IN
SOMETHING THAT IS NOW MORE PROCESSED,
LESS TOXIC, AND MORE MANAGEABLE

118. MODEL 3
IN OTHER WORDS, BECAUSE THE THERAPIST IS
NOT, IN FACT, AS BAD AS THE PARENT HAD BEEN
AND IS ABLE TO BRING TO BEAR HER OWN, MORE
EVOLVED CAPACITY TO PROCESS AND INTEGRATE
ON BEHALF OF A PATIENT WHO TRULY DOES NOT
KNOW HOW, THERE CAN BE A BETTER OUTCOME –
A REPETITION OF THE ORIGINAL TRAUMA BUT
WITH A MUCH HEALTHIER RESOLUTION THIS TIME,
THE REPETITION LEADING TO MODIFICATION
OF THE PATIENT’S INTERNAL WORLD
AND INTEGRATION ON A HIGHER LEVEL OF
ADAPTIVE CAPACITY AND RELATIONAL MATURITY

119. PROTOTYPICAL “OPTIMALLY STRESSFUL”
THERAPEUTIC INTERVENTIONS
MODEL 4
FACILITATION STATEMENTS
TO ADDRESS THE PATIENT’S CONFLICT BETWEEN
HER LONGING TO BE KNOWN AND UNDERSTOOD
AND HER TERROR OF BEING FOUND
AS WELL AS HER AMBIVALENCE ABOUT LIVING
IN A WORLD THAT SHE EXPERIENCES AS EMPTY
AND DEVOID OF MEANING AND PURPOSE
“A PART OF YOU WOULD WANT DESPERATELY TO
BE SEEN AND UNDERSTOOD; BUT ANOTHER
PART OF YOU IS TERRIFIED OF BEING FOUND.”
“A PART OF YOU WOULD WANT TO BE ABLE TO FIND A
REASON TO GO ON LIVING; BUT ANOTHER PART OF YOU IS
QUITE SURE THAT THERE IS NO MEANING TO BE FOUND.”
(BOTH OF WHICH ADDRESS DIVERGENT CONFLICT)

120. WHEN THE FOCUS IS ON THE PATIENT AS
“RESISTANT” AND / OR “NOT AWARE,”
THINK MODEL 1 AND CONFLICT STATEMENTS
TO MAKE THE PATIENT “MORE AWARE”
WHEN THE FOCUS IS ON THE PATIENT AS
“RELENTLESS” AND / OR “NOT ACCEPTING,”
THINK MODEL 2 AND DISILLUSIONMENT STATEMENTS
TO MAKE THE PATIENT “MORE ACCEPTING”
WHEN THE FOCUS IS ON THE PATIENT AS
“RE – ENACTING” AND / OR “NOT ACCOUNTABLE,”
THINK MODEL 3 AND ACCOUNTABILITY STATEMENTS
TO MAKE THE PATIENT “MORE ACCOUNTABLE”
WHEN THE FOCUS IS ON THE PATIENT AS
“RETREATING” AND / OR “NOT ACCESSIBLE,”
THINK MODEL 4 AND FACILITATION STATEMENTS
TO MAKE THE PATIENT “MORE ACCESSIBLE”

121. MODEL 1
RESOLUTION OF STRUCTURAL CONFLICT
INVOLVING DYSFUNCTIONAL INTERNAL DYNAMICS
TAMING THE ID AND STRENGTHENING THE EGO
SUCH THAT STRUCTURAL CONFLICT BECOMES STRUCTURAL COLLABORATION
MODEL 2
STRUCTURAL GROWTH / ADDING NEW GOOD
MAKING GOOD A DEFICIENCY / FILLING IN DEFICIT
SUCH THAT STRUCTURAL DEFICIT BECOMES STRUCTURAL CONSOLIDATION
MODEL 3
RESOLUTION OF RELATIONAL CONFLICT
INVOLVING DYSFUNCTIONAL RELATIONAL DYNAMICS
STRUCTURAL MODIFICATION / CHANGING OLD BAD
DETOXIFYING INTERNAL TOXICITY
SUCH THAT RELATIONAL CONFLICT BECOMES RELATIONAL COLLABORATION
MODEL 4
EMERGENCE OF MOMENTS OF MEETING
SUCH THAT RELATIONAL DEFICIT BECOMES MEANINGFUL
ENGAGEMENT WITH THE WORLD OF ANIMATE OBJECTS

122. THE THERAPEUTIC ACTION IN ALL FOUR MODELS
WILL INVOLVE WORKING THROUGH THE
OPTIMAL STRESS CREATED BY INTERVENTIONS
THAT ALTERNATELY CHALLENGE AND THEN SUPPORT
INTERVENTIONS STRATEGICALLY DESIGNED
TO TARGET / HIGHLIGHT / GENERATE
MODEL 1 – COGNITIVE DISSONANCE
MODEL 2 – AFFECTIVE DISILLUSIONMENT
MODEL 3 – RELATIONAL DETOXIFICATION
MODEL 4 – ABSOLUTE DEPENDENCE
THE WORKING THROUGH OF WHICH
WILL RESULT ULTIMATELY IN RECONSTITUTION
AT EVER – HIGHER LEVELS OF
AWARENESS / ACTUALIZATION OF POTENTIAL,
ACCEPTANCE, ACCOUNTABILITY, AND ACCESSIBILITY

123. MATURITY INVOLVES DEVELOPING THE CAPACITY …
MODEL 1
TO KNOW AND ACCEPT THE SELF,
INCLUDING ITS PSYCHIC SCARS
MODEL 2
TO KNOW AND ACCEPT THE OBJECT,
INCLUDING ITS PSYCHIC SCARS
MODEL 3
TO TAKE RESPONSIBILITY FOR THE DYSFUNCTION
DELIVERED INTO ONE’S RELATIONSHIPS
AND, MORE GENERALLY, INTO ONE’S LIFE
MODEL 4
TO OVERCOME ONE’S TERROR OF BEING FOUND SO
THAT MOMENTS OF MEETING CAN BE TOLERATED AND,
EVEN, FOUND TO GIVE MEANING AND PURPOSE TO LIFE

124. BY WAY OF REVIEW
MODEL 1
THE INTERPRETIVE PERSPECTIVE
OF CLASSICAL PSYCHOANALYSIS
A 1 – PERSON PSYCHOLOGY
THAT FOCUSES ON THE PATIENT’S INTERNAL DYNAMICS
AND POSITS INSIGHT, WISDOM, AWARENESS,
EMPOWERMENT, AND ACTUALIZATION OF INHERITED
POTENTIAL AS THE ULTIMATE THERAPEUTIC GOALS
MODEL 2
THE CORRECTIVE – PROVISION PERSPECTIVE
OF SELF PSYCHOLOGY AND OTHER DEFICIT THEORIES
A 1½ – PERSON PSYCHOLOGY
THAT FOCUSES ON THE PATIENT’S AFFECTIVE EXPERIENCE
AND POSITS ACCEPTANCE OF THE OBJECT’S
LIMITATIONS, SEPARATENESS, AND IMMUTABILITY
AS THE ULTIMATE THERAPEUTIC GOAL

125. BY WAY OF REVIEW
MODEL 3
THE CONTEMPORARY RELATIONAL
(OR INTERSUBJECTIVE) PERSPECTIVE
A 2 – PERSON PSYCHOLOGY
THAT FOCUSES ON THE PATIENT’S
RELATIONAL DYNAMICS
AND POSITS ACCOUNTABILITY
AS THE ULTIMATE THERAPEUTIC GOAL
MODEL 4
THE EXISTENTIAL PERSPECTIVE
A ½ – PERSON PSYCHOLOGY
THAT EMPHASIZES AN INDIVIDUAL’S STRUGGLE TO FIND
MEANING, PURPOSE, AND DIRECTION FOR A LIFE THAT
WOULD OTHERWISE BE DESOLATE, BARREN, AND EMPTY
AND POSITS ACCESSIBILITY AND THE FORGING OF
MEANINGFUL ATTACHMENTS TO THE WORLD OF ANIMATE
OBJECTS AS THE ULTIMATE THERAPEUTIC GOALS

126. AN OVERVIEW
PROTOTYPICAL “OPTIMALLY STRESSFUL”
ANXIETY – PROVOKING
BUT ULTIMATELY GROWTH – PROMOTING
INTERVENTIONS
MODEL 1 CONFLICT STATEMENTS ARE DESIGNED TO
ENCOURAGE THE “RESISTANT” PATIENT TO STEP BACK FROM
THE IMMEDIACY OF THE MOMENT IN ORDER TO TAKE STOCK
OF BOTH HER INVESTMENT IN MAINTAINING THINGS
AS THEY ARE AND THE PRICE SHE PAYS FOR DOING SO
MODEL 2 DISILLUSIONMENT STATEMENTS ARE DESIGNED TO
FACILITATE THE NECESSARY GRIEVING THAT THE “RELENTLESS”
PATIENT MUST DO AS SHE BEGINS TO CONFRONT
PAINFUL REALITIES ABOUT THE OBJECTS OF HER DESIRE

127. PROTOTYPICAL “OPTIMALLY STRESSFUL”
ANXIETY – PROVOKING
BUT ULTIMATELY GROWTH – PROMOTING
INTERVENTIONS
MODEL 3 ACCOUNTABILITY STATEMENTS ARE DESIGNED TO
ENCOURAGE THE “RE – ENACTING” PATIENT TO TAKE
RESPONSIBILITY FOR THE DYSFUNCTIONAL RELATIONAL
DYNAMICS (THE RESIDUA OF UNMASTERED CHILDHOOD
DRAMAS) THAT SHE IS COMPULSIVELY AND UNWITTINGLY
REPLAYING ON THE STAGE OF HER LIFE
MODEL 4 FACILITATION STATEMENTS ARE DESIGNED TO
HIGHLIGHT THE “RETREATING” PATIENT’S INTENSE
AMBIVALENCE ABOUT EVEN BEING IN RELATIONSHIP –
THE FACT THAT SHE LONGS TO BE SEEN AND
UNDERSTOOD BUT IS TERRIFIED OF BEING FOUND

128. MORE GENERALLY
MODEL 1 USES CONFLICT STATEMENTS
TO INCREASE THE PATIENT’S AWARENESS
OF HER INTERNAL CONFLICTEDNESS
AND THEREBY TO PROMPT
EVENTUAL TRANSFORMATION OF
THE DEFENSIVE NEED TO RESIST KNOWING
PAINFUL TRUTHS ABOUT THE SELF
INTO THE ADAPTIVE CAPACITY TO BE AWARE
OF THOSE ANXIETY – PROVOKING TRUTHS
MODEL 2 USES DISILLUSIONMENT STATEMENTS
TO FACILITATE THE PATIENT’S GRIEVING
OF INTOLERABLY PAINFUL DISAPPOINTMENTS
AND THEREBY TO PROMPT
EVENTUAL TRANSFORMATION OF
THE DEFENSIVE NEED TO RESIST KNOWING
PAINFUL TRUTHS ABOUT THE OBJECT
INTO THE ADAPTIVE CAPACITY TO ACCEPT
THOSE DISILLUSIONING TRUTHS

129. MORE GENERALLY
MODEL 3 USES ACCOUNTABILITY STATEMENTS
TO INCREASE THE PATIENT’S AWARENESS
OF HER TENDENCY TO RE – PLAY UNMASTERED
CHILDHOOD DRAMAS ON THE STAGE OF HER LIFE
AND THEREBY TO PROMPT
EVENTUAL TRANSFORMATION OF
THE DEFENSIVE NEED TO RE – ENACT
UNMASTERED CHILDHOOD DRAMAS
INTO THE ADAPTIVE CAPACITY
TO BE ACCOUNTABLE FOR HER
ACTIONS, REACTIONS, AND INTERACTIONS
AND MODEL 4 USES FACILITATION STATEMENTS
TO HIGHLIGHT NOT ONLY THE PATIENT’S TERROR OF BEING
ONCE AGAIN DESTROYED BY AN ANNIHILATING OBJECT BUT ALSO
HER DESPERATE LONGING TO RE – ENGAGE WITH THE WORLD
AND THEREBY TO PROMPT EVENTUAL TRANSFORMATION
OF THE DEFENSIVE NEED TO RETREAT INTO THE
ADAPTIVE CAPACITY TO BE ACCESSED AND, AS A RESULT,
TO BE ABLE TO TOLERATE MOMENTS OF MEANINGFUL MEETING

130. THE HEALING PROCESS IN ALL FOUR MODELS
PSYCHODYNAMIC PSYCHOTHERAPY AFFORDS
THE PATIENT AN OPPORTUNITY
ALBEIT A BELATED ONE
TO MASTER STRESSFUL EXPERIENCES
THAT HAD ONCE BEEN OVERWHELMING
AND THEREFORE DEFENDED AGAINST
BUT THAT CAN NOW
WITH ENOUGH SUPPORT FROM THE THERAPIST
AND BY TAPPING INTO THE PATIENT’S UNDERLYING RESILIENCE
AND CAPACITY TO SELF – CORRECT
IN THE FACE OF ENVIRONMENTAL CHALLENGE
BE PROCESSED, INTEGRATED, AND ULTIMATELY ADAPTED TO
AT THE END OF THE DAY
THE HEALING PROCESS WILL INVOLVE
TRANSFORMATION OF DEFENSE INTO ADAPTATION
BY WAY OF WORKING THROUGH THE IMPACT OF
OPTIMALLY STRESSFUL PSYCHOTHERAPEUTIC INTERVENTIONS
CONFLICT STATEMENTS (MODEL 1) ~ DISILLUSIONMENT STATEMENTS (MODEL 2)
ACCOUNTABILITY STATEMENTS (MODEL 3) ~ FACILITATION STATEMENTS (MODEL 4)
130