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Narur, J.P. (2005). Tre '3orelr|rg Vore lrar lrlerprelal|or Rev|s|led:... J. Arer. Psycroara|. Assr., 53:93-Z29.


(2005). Jourra| ol lre Arer|car Psycroara|yl|c Assoc|al|or, 53:93-Z29
The "8ometh|ng Hore" than |nterpretat|on Rev|s|ted: 8|opp|ness and 6o-
6reat|v|ty |n the Psychoana|yt|c Encounter
1eremy P. Aahum
Features oI dynamical systems thinking can illuminate insuIIiciently recognized levels oI
psychoanalytic process. A central aspect oI dynamical models is that changes in complex systems are
unpredictable and arise out oI the interaction oI elements. Examination oI the moment-by-moment
micro-Ioreground, or local level, oI psychoanalytic sessions led to the conclusion that indeterminacy
and surprise are inherent properties oI intersubjective systems. This indeterminacy, or sloppiness,
comprises several interrelated Ieatures oI the dialogue: 'Iuzzy intentionalizing, unpredictability,
improvisation, variation, and redundancy. Audiotaped transcripts oI two analytic sessions illustrate
how these sloppy Ieatures generate unpredictable and potentially creative elements that contribute to
psychotherapeutic change.
In applying dynamical systems theory to psychoanalytic process, we have come to the view that
psychoanalytic therapeutic interaction is an inherently sloppy process (Boston Change Proces Study
Group

The Boston Change Process Study Group includes the Iollowing members, listed alphabetically: Nadia
Bruschweiler-Stern, Director, Brazelton Center oI Switzerland. Karlen Lyons-Ruth, Associate ProIessor oI
Psychiatry, Harvard Medical School; teaching and supervising psychologist, Cambridge Hospital; principal
investigator, Family Pathways Project; Iaculty, Massachusetts Institute oI Psychoanalysis; AIIiliate Scholar,
Boston Psychoanalytic Society and Institute. Alexander C. Morgan, Assistant Clinical ProIessor oI Psychiatry,
Harvard Medical School at Cambridge Hospital; Iaculty, Boston Psychoanalytic Society and Institute and the
Massachusetts Institute Ior Psychoanalysis. Jeremy P. Nahum, Iaculty, Boston Psychoanalytic Society and
Institute, the Massachusetts Institute oI Psychoanalysis, and the Psychiatry Department oI Harvard Medical School
at Cambridge Hospital. Louis W. Sander, ProIessor oI Psychiatry Emeritus, Boston University School oI
Medicine; ProIessor oI Psychiatry Emeritus and Senior Scholar, University oI Colorado Medical School. Daniel
Stern, ProIessor oI Psychology, University oI Geneva, Switzerland.
At the time the paper was coneived and written, Alexandra M. Harrison and Edward Z. Tronick were also
members, but they have since leIt the group. The authors acknowledge the generous support oI Kohler-StiItung Ior
convening meetings oI the group. Submitted Ior publication August 6, 2003.

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2002; hereaIter BCPSG). This sloppiness arises Irom the intrinsic indeterminacy oI the co-creative
process between two minds. $loppiness here reIers to the indeterminate, untidy, or approximate
qualities oI the exchange oI meaning between patient and analyst. This paper is an attempt to elaborate
2
and explore this idea oI indeterminacy, as well as its implications Ior the process oI psychoanalysis.
We will also ground this understanding oI the sloppiness oI moment-to-moment therapeutic process in
observed Ieatures oI a transcribed analytic session.
We will attempt to describe the process oI psychoanalysis at what we have called the local level
(BCPSG 2002). The local level is the second-by-second interchange between patient and therapist
consisting oI relational moves composed oI nonverbal and verbal happenings such as spoken phrases,
silences, gestures, and shiIts in posture or topic. Each relational move at the local level is seen as
revealing an intention to create, alter, or Iine-tune the immediate nature oI the therapeutic relationship.
Any exchange will have a local level.
This approach permits a Iocus on what we think has been insuIIiciently recognized as happening in
the therapeutic process. Many recent thinkers have been exploring interactive dimensions oI the
psychoanalytic process (see, e.g., Benjamin 1995; HoIIman 1998; Mitchell 1997; Ogden 1997).
However, most relational thinkers have been concerned with the larger sweep oI psychodynamic
meaning and have not Iocused systematically on the moment-to-moment level (but see Beebe and
Lachmann 2002). Examining process at the local level can be seen as a converging lens Ior viewing
psychoanalytic process, an additional level oI analysis that does not replace traditional psychodynamic
descriptions at the more macro level.
New conceptual and descriptive approaches oIten require new terminology to capture ideas
speciIic to them. As we began to develop our views oI the moment-to-moment dimension oI
psychoanalytic treatment, it became clear that most oI the established psychoanalytic vocabulary had
strong conceptual links to the dynamic unconscious and the tripartite theory oI mind. Using that
vocabulary to reIer to our somewhat diIIerent view oI the varieties oI unconscious processes oIten

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
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proved conIusing rather than clariIying. We thereIore Iound it necessary to introduce new terms into
our discussion.
While our Iindings may have implications Ior psychoanalytic issues such as the reach oI the
dynamic unconscious, the relation between the imprecision observed at the local level and its technical
handling, and the relation between what we regard as co-created spontaneous material and intrapsychic
dynamic material Irom the past, such implications are beyond our scope here. For the moment, our
approach and the descriptions that come Irom it will occupy our attention.
Despite the negative connotations oI the word sloppiness, we view sloppiness as pervasive,
inescapable, and inherent in the moment-to-moment level oI all dyadic interaction. Rather than seeing
this sloppiness as problematic, we view it as crucial to the generation oI new possibilities Ior
psychotherapeutic change. Although the sloppiness oI the exchange oI meaning introduces substantial
uncertainty into the interaction, creating what usually are viewed as errors or mishaps, it paradoxically
introduces new possibilities Ior increasing the coherence oI the interactive process between analyst and
patient. Sloppiness is potentially creative.
While dynamical systems models, which include the Ieature oI sloppiness in one Iorm or another,
have contributed striking new insights in many areas oI science (see Thelen and Smith 1994; Prigogine
1997; Edelman 1992; Freeman 1995, 1999), Iew theorists have considered how these models might be
applied to relational processes in psychotherapy (but see Beebe and Lachmann 2002; Stolorow 1997).
In exploring the implications oI developmental research Ior psychoanalytic therapies, we have taken
aspects oI the dyadic, relational, and intersubjective perspectives on analysis and integrated them into a
developmentally based dynamical systems view oI therapeutic process. Dynamical systems models are
especially well suited to dealing with complex systems with many interdependent variables. Such
systems have selI-organizing properties, resulting in discontinuous, nonlinear shiIts in organization that
are largely unpredictable. These shiIts lead to the unanticipated emergence oI properties that did not
exist beIore.
This dynamical systems Iramework has several characteristics. First, the dynamic engine oI the
therapy lies in the selI-organizing properties oI analyst and patient together as a dyad. Second, analyst
and patient contribute both individual tendencies and input shaped by others. These variables can at
times be in opposition, and can at other times be

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3
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congruent or complementary. Third, the trajectory that will emerge Irom the interaction oI the two
partners is unpredictable and includes emergent properties that pop up Irom the interaction oI the many
variables. Fourth, the emerging trajectory will be sensitive to and constrained by the initial conditions
oI the relationship, including the relational histories brought by both partners. Such a Iramework
includes a strong role Ior both organization and constraint operating within the system.
In addition to a dynamical systems Iramework, developmental research has pointed to the
importance oI nonconscious, implicit, procedural Iorms oI memory. We have recently called attention
to the importance oI such implicit Iorms oI representation in the relational arena and have termed these
implicit relational knowings. This term reIers to representations oI the ways individuals relate to one
another that are outside both Iocal attention and conscious verbal experience (Lyons-Ruth 1999; Stern
et al. 1998; Tronick et al. 1998).
We do not reject the concept oI the dynamic unconscious. Rather, we think in terms oI a range oI
unconscious phenomena. Traditionally, the dynamic unconscious, construed as verbal or symbolic, and
as unconscious only by reason oI repression, is in psychoanalysis the only unconscious phenomenon
considered 'psychodynamic, the locus oI all aIIectively important representations. However, there is
also implicit knowledge that is nonconscious, has no verbal or symbolic label, and does not require
repression to remain unconscious (Stern et al. 1998). Because the implicit level represents goal-
directed interpersonal action, with its strong aIIective valences and conIlictual elements, this level is
also rich in psychodynamic meaning, without necessarily being part oI the dynamic unconscious
(Lyons-Ruth 1999). However, Iurther teasing apart the contributions oI the implicit nonconscious and
the repressed unconscious is beyond the scope oI this paper. Here our task is to direct attention to the
existence oI the implicit level.
We Iind that Iraming the contribution oI the past to the present in terms oI implicit relational
knowing oIIers several advantages. It provides a description oI the past-present relationship consistent
with current developmental and neuroscientiIic knowledge (see Lyons-Ruth 1999; Schore 1994;
Westen and Gabbard 2002a, b). Cognitive neuroscience has repeatedly demonstrated the existence and
separable Iunctioning oI two Iorms oI memory, commonly labeled implicit and explicit, or procedural
and semantic, memory. Developmental research has described the preverbal inIant's capacity Ior
representing and anticipating

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patterns oI interaction with others beIore symbolic or explicit Iorms oI memory are Iunctioning and
long beIore any symbolic description oI the interaction structure could be Iormulated.
While previous psychoanalytic theory has tended to equate nonverbal Iorms oI representation with
the preverbal Iunctioning oI inIancy, current neuroscience makes clear that implicit Iorms oI
representation are Iundamental to complex adult Iunctioning as well as to inIant Iunctioning (see, e.g.,
Jacoby and Dallas l981; Schachter and Moscovitch l984). In addition, complex new learning occurs in
adulthood through implicit mechanisms. This new learning is not mediated by translation oI implicit
knowing into symbolic or conscious Iorm, even though words or images may be involved as part oI the
learning that is implicitly represented. Indeed, many Iorms oI implicit knowing are about how to do
things with words. Because implicit Iorms oI memory are not initially encoded in words, the verbal
Iorm is not how the mind usually Iunctions.
In addition, the concept oI implicit relational knowing maintains a view oI the dynamic
unconscious (repressed) and nonconscious processing as central to aIIective and relational liIe, while
Ireeing us Irom a model oI the dynamic unconscious as the necessary or only way to understand the
intrapsychic domain. It also Irees us Irom the expectation that change necessarily requires verbal
understanding in the sense oI making the unconscious conscious. While most relational theories
explain change as the result oI the shared verbal understanding oI patient-analyst transactions achieved
aIter the critical interactions have occurred, our model proposes that aIIectively rich implicit processes
can bring about change in interactive capacities in the moment (see Stern 2004). In some instances,
these changes may not require that the interactants explicitly reIlect on what has transpired.
We conceive oI implicit relational knowing as a domain oI relational memory that is constantly in
the dynamical process oI being reorganized with each new relational encounter. Though any two
therapeutic partners have many intersubjective capacities, including capacities Ior interpreting
4
relational intentions and the states oI mind oI the other, the capacity Ior creating shared implicit
knowledge does not reside solely in either oI them acting alone. Rather, as the therapeutic relationship
moves along, shared implicit knowing and shared intentions emerge bit by bit Irom the co-creative
relational overtures each provides the other. The dynamical dyadic system has emergent capacities

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 9Z -
Ior creating new and unpredictable Iorms oI shared implicit knowing in the interactants as new ways oI
being together are co-created in the treatment.
In summary, we make the Iollowing assumptions. Most oI the aIIectively meaningIul liIe
experiences that are relevant in psychotherapy are represented in the domain oI nonconscious implicit
knowledge. This also includes many maniIestations oI transIerence. ThereIore, much oI what happens
at the local level is psychodynamically meaningIul, though not necessarily repressed. The Iact that the
dynamically repressed unconscious can also be an active inI luence at the local level is not our Iocus.
We are simply calling attention to a diIIerent level oI process.
In elaborating this dynamical systems model oI the emergence oI new Iorms oI implicit relational
knowing, we have come to Iocus on the moment-to-moment activity oI patient and analyst. In previous
work, we began by grappling with memorable moments that were 'lit up Ior both participants (Stern
et al. 1998).
In subsequent work, we expanded our Iocus to include the quieter everyday moments oI
engagement between the two therapeutic partners at the local level oI moment-to-moment interactions
(BCPSG 2002). At this local level it became clear that change occurred in similar Iashion both in the
small, apparently unremarkable moments and in the 'lit-up moments oI more noticeable therapeutic
change. Because we believe that the local level is an important site oI therapeutic action, we think that
clariIying the processes and phenomena, including sloppiness, occurring at this level will illuminate
additional Iacets oI what actually happens in a psychoanalytic treatment.
Compared to the attention devoted to metatheory, that accorded the moment-to-moment level oI
therapeutic process has been scant. We believe this level oI therapeutic activity has its own complexity,
structure, and organization. It is at this moment-to-moment level that implicit relational procedures are
enacted and evolve. However, our Iocus on the local level is not intended to imply that the background
and metatheory oI the psychoanalytic Iramework are not relevant as well. In Iact, Iuture work will need
to Iocus on integrating the local level with the level oI larger psychodynamic meanings and narratives.

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8|opp|ness and 6o-6reat|v|ty: |ntr|ns|c to the Therapeut|c Process
A view oI the therapeutic process as sloppy at the local level is a central observation oI this paper.
It has Iar-reaching consequences. Sloppiness expands the possibilities and variability inherent in the
psychoanalytic dyad. And co-creation is the process by which sloppiness is capitalized on to generate
order or shared direction in the interaction.
The analyst typically enters the treatment process with only a general and Iairly abstract notion oI
where he or she might like to see the patient progress in relation to the resolution oI conIlict, the
enlarging oI areas oI eIIective Iunctioning, the reduction oI anxiety, or the Ilexible expression oI aIIect.
Similarly, the patient begins with only very general ideas oI where he or she might like to end up.
Neither analyst nor patient can know in any speciIic detail what the two oI them will need to do
together to reach their goals. Indeed, both analyst and patient can only grapple with the immediate
dilemma oI what to do to take the next step in the interactive process. This grappling is, oI course, the
point at which all oI the analyst's dynamic training and humanity come into play. It is here that the
analyst's grasp oI some healing direction, some selection oI what to 'recognize in the patient's words
and actions, will be operationalized. But this indeterminacy oI the 'how to oI therapy is inescapable,
regardless oI technical stance, and emerges necessarily Irom the irreducible Iact that both patient and
analyst are sources oI independent agency and subjectivity and at the same time are constantly
inIluencing each other.
The sloppiness oI a therapeutic dyadic system emerges in part Irom a core Ieature oI therapeutic
interaction that we will reIer to as 1: intentionaliing. When any two creative and independent
5
agencies interact, a central problem they encounter is that while actions are observable, their intentions
or meanings must be inIerred. We would claim, along with Freeman (l995, 1999) and in line with
current inIant studies (MeltzoII 1995; Carpenter, Nagell, and Tomasello 1998), that this process oI
inIerring intentions through parsing oI actions is central to how the brain works, and to how we
understand others. These inIerences regarding the other's intentions are the raw materials Irom which
one's own relational moves are partially craIted.
The inIerring oI intention, or motivational direction, is a critical issue Iacing any two people
interacting, but looms particularly large in

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a psychoanalytic treatment because oI the primary Iocus on motivational directions. When we use the
term intention here, we use it in both a narrow sense (What is the other trying to do now with that
comment?) and in a broader sense (What are the larger meanings or goals that contribute to the act or
comment?). However, the relation between the observed action, usually a verbal action in the analytic
setting, and the inIerred intention is necessarily loose. The parsing and translating oI action into
intention or meaning oIten requires reiteration and redundancy in interactive sequences so that potential
alternative 'readings can be evaluated and ruled out. This inIerence and evaluation process is
occurring all the time, primarily at an implicit level outside oI consciousness.
8|opp|ness and |ntent|ona||ty
The ongoing indeIiniteness in the process oI inIerring intention or goal-directedness in the other's
activity lends inevitable sloppiness to the interactive process. Each partner is not only putting Iorth
actions and inIerring intentions; these actions and inIerences oI intention themselves have an eIIect on
shaping the actions and intentions oI the other as they emerge.
This sloppiness in apprehending intentions is one source oI corresponding sloppiness in the
interactive process itselI. Sloppiness is inherent in the nature oI human subjectivity. Over time, out oI a
process oI negotiation, the intentions oI each may become 'recognized by the other at an implicit
level.
This ongoing process oI Iuzzy intentionalizing involves a great deal oI variability and redundancy
at the heart oI the therapeutic process. This is necessary to allow the two partners to Iind Iitted
responses to one another that lead to the emergence oI a joint direction in the treatment. The
recognition process at the core oI our view oI therapeutic change capitalizes on sloppiness, with its
variability, unpredictability, and redundancy, to achieve special moments oI meeting that contribute to
the emergence oI a new shared direction Ior the dyad. We have discussed this implicit recognition
process in previous work (Stern et al. 1998; Tronick et al. 1998; BCPSG 2002) and will return to it in
more detail in the Iinal sections oI the paper.

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8|opp|ness and 6o-creat|v|ty
Because we Iind that sloppiness is intrinsic to moment-to-moment relating, we needed to grapple
with how it might contribute to the generation oI change. It is here that the concept oI co-creativity
comes into play. We think oI co-creation as a selI-organizing process oI two minds acting together that
takes advantage oI the sloppiness inherent in the interaction to create something psychologically new.
What comes into being did not exist beIore and could not be Iully predicted by either partner. The
many sources oI conIusion and surprise in any interaction create the potential Ior unpredictable
elements to emerge and be elaborated in the dyad. Nonlinear dynamical systems as seen in dyadic
interaction by their nature reassemble interpersonal and mental events in ways that are not predictable
and that emerge spontaneously as a Iunction oI the interaction. ThereIore, interactive processes make
nonlinear leaps or qualitative shiIts. For this reason, new intentions, Ieelings, and meanings are some oI
the creative products oI interest in a nonlinear dyadic system. Although meanings, Ieelings, intentions
are not usually thought oI as created products that pop up unexpectedly Irom a dyadic process, they are
arguably the most important and complex products that emerge Irom human interaction.
We use the term co-creativit rather than co-construction Ior several reasons. The latter has
6
connotations inconsistent with a dynamical systems model. The word constr:ction implies a directed
process in which preIormed elements are brought together according to an a priori plan. In contrast,
with co-creativity there is no blueprint Ior assembly. Instead the elements assembled are themselves
Iormed during the process oI the interchange.
This creativity at the heart oI the microprocess oI therapeutic interaction is easy to overlook. At
times it may even appear that nothing much is happening. However, at the subjective level there is a
sustained experience oI uncertainty and unpredictability as therapist and patient attempt together to
apprehend and align their emerging intentions and initiatives in the service oI a sustained shared
direction in the interaction. Parenthetically, it must be mentioned that not every direction that could be
co-created would be healing or constructive Ior the patient. But this is a matter oI technique and oI how
therapeutic eIIicacy is conceived, topics beyond our scope here.

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6o-6reat|v|ty and 8|opp|ness |n an na|yt|c 8ess|on
We will illustrate these Ieatures oI relational systems and their essential role in generating
therapeutic change by looking very closely at the line-by-line process oI an analytic session, using
material excerpted Irom three successive portions oI the transcript oI an audiotaped session oI an
analysis conducted by one oI us. The Iull transcript appears below as an appendix. Because implicit
relational knowing has oIten been misunderstood as reIerring entirely to the nonverbal aspects oI the
interaction, we Ielt it important to illustrate that these sloppy Ieatures oI the communication are not
conIined to the nonverbal domain but are evident at the implicit procedural, or process, level oI the
verbal exchange itselI. What an exclusively verbal transcript cannot capture is that many levels oI
communication, both verbal and nonverbal, occur simultaneously in any two-person exchange. The
coherence oI these communications within and across levels is crucial to their impact on the therapeutic
partner.
Despite the psychodynamically rich nature oI the themes presented by the patient in these excerpts
and our belieI that the local level is connected to the level oI psychodynamic meanings, we will not
discuss these dynamics. While any therapeutic interaction could lend itselI to a discussion oI
psychodynamics, it also has an organization at the local level, regardless oI the particular analytic
technique adopted. The negotiation oI intention and direction will look quite diIIerent with diIIerent
techniques, but such negotiation will always be present. And the reality oI the Ieatures we are
describing is not apparent unless one looks very closely at this moment-to-moment level. In Iact it is
lost at the narrative level. We will thereIore demonstrate what we mean by sloppiness in the co-creative
process as it occurs at the local level, relational move by relational move. We will illustrate the process
oI Iuzzy intentionalizing, with its associated need Ior variability and redundancy. We will also
comment on how these Ieatures oI sloppiness are intrinsic to the creation oI shared meaning.
To summarize the case history, the patient had come Ior analysis Iour years earlier Ior recurrent
thoughts oI suicide as her only way to assert herselI in the aItermath oI a history oI Iamilial sexual
abuse. The Monday session to be described Iollowed an extra session the preceding Friday that the
analyst had proposed, having sensed increased distress

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- Z02 -
in the patient during their last scheduled meeting. In the extra session, the analyst suggested that the
patient might have Ielt coerced to come, but the patient had disagreed.
In the Monday session, the patient reported two dreams she'd had since the extra meeting.
Together, patient and analyst used these dreams to enter territory that was new Ior both oI them. In the
Iirst dream, which had occurred on Friday night, the patient was in a group therapy meeting that
reminded her oI a sexual abuse group she had actually attended. That group had disturbed her because,
by emphasizing her victimization, it made her Ieel worse, not better. The second dream had occurred
the night beIore, Sunday, and contained somewhat humorous material in which imperIections oI the
analyst made him seem more human and normally Iallible, not someone totally in control oI his liIe.
Here the patient Ielt that the analyst, contrary to her previous notions, was much more like she was.
The next day, the patient began the session sitting up rather than lying down and said that,
7
uncharacteristically, she Ielt she had an agenda oI her own. In Iact, later in the session they began Ior
the Iirst time to talk about termination in a way that Ielt realistic and reasonable to them both.
How did they arrive at this new territory Irom having begun at a point oI distress? Obviously the
answer lies in the Iull history oI both analyst and patient and their previous encounters, and is not
attributable solely to the current exchange. However, we will conIine ourselves to a line-by-line
examination oI the transcript rather than attempting to have the analyst explain and clariIy in retrospect
his internal process. Our concepts will be used to highlight aspects oI the change process that occur at
the local level oI the interaction and that give rise to the more visible, macro-level changes experienced
by this analytic dyad.
The 6o-6reat|on of |ntent|ons |n the Therapeut|c Process
In the Iirst excerpt we will Iocus on the co-creative process and Iuzzy intentionalizing in the
therapeutic interaction. We will use an example Irom early in the analytic session in which the pair had
been discussing the Iirst dream about the disturbing group therapy session. On Saturday morning the
patient thought oI phoning the analyst to say that she Ielt diI Ierently about him than she had Ielt about
the therapy group. However, she decided that she could wait until the next meeting to tell

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- Z03 -
him. Below, she describes the second dream (concerning the analyst's imperIections and her Ieeling
more like him) as a contrast to that Iirst dream. As can be seen, the analyst does not stay with her talk
about the Sunday night dream but directs her back to the idea oI calling him aIter the dream concerning
the group therapy.
|rst Excerpt: hat 0ream are we Co|ng to Ta|k -out and hy?
!atient. $o there are two completel di11erent . the dream that I had last night le1t me 1eeling
reall connected to o:, and o: know it made me 1eelI dont know, I g:ess closer to o:,
that o: wo:ld tell me o: were not per1ect.
($he has presented two dreams with some disc:ssion and analsis, b:t at this point she
proceeds with the second one. Wh While there ma have been man reasons 1or her
choicede1ensiveness, closeness in time, etc.this is an example o1 the indeterminac in
comm:nication regarding the direction the person intends to take, what we re1er to as 1:
intentionaliing. Was there more to learn 1rom the 1irst dream We dont know, beca:se what
she talks abo:t, the 1eeling o1 closeness in the second dream, is where she has taken :s. And
even within the choice she has made, she introd:ces some minor :ncertainties, saing things
like 'I dont know, I g:ess..` These declari1ications co:ld be resistances, show a rel:ctance
to engage the topic, or s:ggest a real q:estion abo:t what she was saing. In an case, the
add to the 1: intentionalit, or indeterminac, in in1erring where the patient wants to go.)
Analst. Uh-h:h.
(This ma 'mean` go ahead, b:t in a n:mber o1 di11erent possible was. Beca:se Im tring to
be with o:. Beca:se I have not et :nderstood eno:gh and need to hear more. Beca:se I
dont have anthing to sa et. Beca:se I dont even know where o:re headed. Beca:se I
need more time, mabe the other dream is more important. An and perhaps all o1 these
intentions co:ld be in operation, making 1or a 1: mix. $he gets the general idea beca:se o1
convention and their past histor o1 working together. F:iness is present b:t is not too
broad or important here, et.)
!atient. Um.
($he seems to be saing 'Im not s:re where Im going to go with this, either. Or i1 I do know
where, Im not s:re I will go there. Its starting

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z01 -
to 1eel like Ill need some help.` The analst provides that help in the next line.)
Analst. Yo: act:all tho:ght abo:t calling me on $at:rda abo:t this other dream.
8
(Here we have the 1irst s:rprise, an example o1 the :npredictabilit in the sloppiness. The
analst exercises his own initiative and shi1ts the disc:ssion to the other dream. In 1act, not
even to the dream b:t to what she tho:ght o1 doing a1ter the dream. Wh He seems to have
radicall altered the direction o1 things. Did he know wh at the moment o1 doing it The
word act:all stands o:t. It is either a req:est 1or clari1ication that she reall did think abo:t
calling him, or a statement o1 his own s:rprise that she did. Or it co:ld be related to his
concern that he had coerced her into accepting an extra ho:r. In an case, his intentions are
probabl m:ltiple, and not et well 1ormed. It t:rned o:t 1ine, b:t that does not mean he knew
what he was doing at the time. The analsts shi1t, his abandonment o1 the second dream, the
one 1rom $:nda night, is also s:rprising beca:se the second dream appears to contain hotter
trans1erence material.)
!atient. Yeah'
($he works thro:gh some o1 the 1:iness b 1oc:sing on onl one piece o1 :nclarit. Yes, she
reall did think o1 calling him :p.)
Analst. Which wo:ld have been, :h, and the reason o: were thinking o1 that, that kind o1
ver real connection, was what
(He is str:ggling here to 1ind his wa. He makes a n:mber o1 incomplete and rapidl
abandoned sorties to 1ind and express his intention, an example o1 red:ndanc within his
thinking. In so doing, he comes :p with the phrase real connection, echoing words the patient
had :sed in her 1irst statement abo:t the second dream. 'reall connected.` He has
recontex:alied the phrase. He co:ld be seen as starting to make a small and tentative bridge
between the two dreams, or he might be talking abo:t the realit o1 the connection between
the two o1 them. This intention still remains 1:. B:t the phrase real connection is starting to
become an enriched, co-created notion that will later help organie the session. The
enrichment o1 this notion is a foint prod:ct o1 the sloppiness and o1 the attempts to 1ind a foint
direction and point o1 meeting in shared :nderstanding.)
!atient. What are o: re1erring to, the calling
Analst. Yeah, the calling.
(The trade attempts to red:ce the :ncertaint and discover/create

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z05 -
less 1: intentions. Here we also see red:ndanc and variations :sed to lock home
clari1ications.)
!atient. Well, beca:se I had seen o: on Frida and 1elt there was like a thread o1
conscio:sness that had 1lowed into that dream.
($he also vag:el senses some relation between the two dreams. Their 1: intentions are
starting to converge. The sloppiness between them concerning which dream to disc:ss and the
switching between dreams has made the relation between the dreams emerge as a theme.
However, this was the original intention o1 neither patient nor analst. It emerged 1rom their
collaborative attempts to clear :p some o1 the indeterminac.)
Analst. Yeah.
!atient. It seemed kind o1 con1:sing to me thatI dont know how to sa this exactl. Its like
a throwback or something. To be dreaming abo:t [the gro:p therapist] and 1eeling that kind
o1 press:re .
(Unsteadil, she goes back to the other dream, the 1irst dream. There is a disf:nctive going
back and 1orth, another example o1 red:ndanc. In this context, the 1eeling o1 'press:re`
emerges. It rises :p as a new and interesting element, still 1: b:t well marked.)
Analst. Yeah.
!atient. . is what I dont q:ite getI mean I think .
($he is st:mbling 1orward.)
Analst. The press:re is there, isnt it Here we come into the iss:e o1 coercion, being made to
do something. And in this dream o: reall are being press:red to sa something more. And I
g:ess I wonder how did it, :h, connect to the 1act that we had that extra session on Frida.
9
(He interr:pts. Is he 1eeling a press:re, too, b:t with a di11erent and as et :nclear
intentionalit Improvisation enters here as he goes 1rom the idea o1 press:re to that o1
coercion. The now have to work thro:gh the 1: intentions that will compose and clari1
this notion. The coercion o1 the extra session has apparentl been on his mind, contrib:ting to
his, b:t not necessaril her, sense o1 press:re. He is testing to see i1 there is a 1it o1 intentions
here.)
!atient. What it seems like to me is thatthe dream was more connected to the idea o1 me
1eeling I have to meas:re :p, come :p with the right st:11 .
($he sas the 1it with his idea o1 coercion was not good. The analst was partl right and
partl wrong. For the patient, the connection to the extra session was less important and is
not picked :p. What is

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z0 -
more important at this moment is that she is clari1ing what press:re meansnamel, to
'come :p with the right st:1 1.` The emergence o1 this cr:cial precision on her part was
1acilitated b the analsts mis:nderstanding, another harvest 1rom sloppiness. Note again the
repeated variations necessar to move to greater m:t:al clarit.)
Analst. Uh-h:h.
(Having been p:t back on her path, he is watching and enco:raging this :nexpected
:n1olding.)
!atient. . than the 1eeling o1 [being] coerced into coming here. $omehow theres a di11erence
somehow in there 1rom sort o1 making a link with .
($he is re1ining the precision and st:mbling 1orward. The level o1 sloppiness seems to have
momentaril increased again. $he is alone, with another, and o:t o1 this sloppiness the are
co-creating something novel and something with greater clarit.)
Analst. Yeah, :h-h:h.
(He is :rging her to contin:e to 1ind her wa, their wa.)
!atient. . 1eeling coerced to coming here on Frida, which I didnt 1eel, at least conscio:sl.
Beca:se what I was 1eeling had more to do with [the gro:ps] asking meit was like I had to
be sicker than I 1elt. And I think thats 1req:entl a part o1 what m mind-set is when I come
here, that theres some sick part o1 m mind that I have to access .
Analst. Uh-h:h.
Progressively, out oI the sloppiness, patient and analyst have co-created islands oI intentional
Iittedness and shared direction. Through the same process, oI using the co-creativity oI sloppiness,
these islands then coalesced to make larger spaces oI shared implicit knowing. In this way the analytic
pair stumble Iorward Irom the patient's Ieeling that she had to be sicker than she was, the Ieeling that
emerged Irom the dream oI the group therapy. This is a way station toward her greater sense oI agency,
seen most clearly the Iollowing day, when she began the session sitting up.
To sum up our understanding oI this set oI transactions at the level oI implicit process, the patient
has recently articulated her recognition oI the need to claim her agency. She decides not to call her
analyst Saturday morning. Then she brings two dreams in which she is connected to another person: in
the Iirst through her sexually abused, sick selI, and in the other through her competent, equal-to-the-
analyst selI. In the ensuing dialogue patient and analyst discuss the dreams and the

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z0Z -
patient's associations to them Irom the point oI view oI symbolic meaning. In addition, however, they
are on the local level simultaneously working on the development oI the patient's agency through the
implicit, moment-to-moment interactions we call co-creativity. (The analyst's contribution to this task
is to give the patient the opportunity to clariIy what is her own experience, to not merely accept his
direction, an illustration oI technique in the scaIIolding oI the patient's agency.) In a sloppy process oI
trying to Iind a Iit with each other, they negotiate shared intentional directions and local-level
meanings. Although this might be viewed as merely Iacilitating the patient's developing agency, our
10
view is that such Iacilitation is part oI the co-creative process that led to changes in her sense oI
agency.
Out oI this activity, more complex symbolic meaning and intentionality emerge. These more
complex meanings include that oI the patient being connected to another person through a positive
sense oI selI, equal, while at the same time being aware oI angry, helpless selI-experience'the sick
part oI my mindthat she is still struggling to manage. The intentions that emerge include the
beginnings oI her own agenda and the conIidence to assert it.
How does the co-creative, sloppy nature oI the local-level process operate in this segment to
contribute to change? It is in the implicit jockeying back and Iorth, patient and analyst checking out at
each step how much each can contribute and respond to the emergence oI a new shared direction, that a
new shared meaning is co-created (this, rather than change in symbolic meaning leading the way
through shared understanding oI the patient's dreams and associations). As patient and analyst search
Ior a Iit with each other, while at the same time reIerencing their own agendas, they are co-creating a
shared intention. This new intention reorganizes and recontextualizes each oI the old agendas in the
process oI its emergence (Ior related data on the recontextualization oI previous perceptual experience
by new experience, see Freeman 1995).
It should be noted, however, that the problem oI arriving at a shared direction is more complex
than simply decoding the ambiguous communications oI the other. The deeply relational nature oI the
human mind (Bruner 1990; Dilthey 1976; Husserl 1930; LakoII and Johnson 1999; Modell 2003;
Feldman and Kalmar 1996; Stern 1985; Vygotsky 1934) means that an intention or motivational
direction is not simply a thing in one person's mind that is conveyed to the other. Instead, joint
intentions or directions Ior the next steps in the relationship are co-created, negotiated

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z08 -
between partners on a moment-to-moment basis. What we usually think oI as solely within the person
is not internal and Iixed but is continually co-created in interaction with another. Each partner is both
putting Iorth actions and inIerring intentions, which have an eIIect on shaping the actions and
intentions oI the other as they emerge. Not only is the communication oI intention by each partner
ambiguous, but those communications are constantly shiIting and adjusting based on the Ieedback oI
the partner and the possibilities sensed by each oI Iinding a shared direction Ior their exchanges. The
expression oI a relational intention, then, is not a simple one-person act but an emergent property oI the
interaction itselI. Finally, the mental complexity and agency oI each oI the participants inevitably
introduces unpredictable and improvisational elements into how any joint direction will be worked out.
The essence oI the therapeutic interaction can be seen to be this joint negotiation and co-creation oI
intent or direction.
8|oppy Processes, Unpred|cta-|||ty, and Var|a-|||ty
We have noted that co-creativity is the upshot oI an unpredictable, improvisational process and
that Iuzzy intentionalizing depends on variability and redundancy. We do not mean to imply that
everything that happens in a session is unpredictable. Rather, we emphasize that the interplay oI two
subjectivities inevitably throws up unpredictable and surprising phenomena at the local level.
Let us look again at the clinical material in light oI these multiple sources oI new elements in the
interaction. The patient has been talking about the second dream, in which the analyst seemed more
like her. In this segment there are two extended silences, one Ior eighty-three seconds and one Ior
sixty-eight. What is notable in relation to our Iocus here is that the outcome oI each is unpredictable,
variable. One cannot know how long each will last, who will end it, or what will happen aIterward.
8econd Excerpt: how do we Know here we are Co|ng?
!atient. In the dream, it made me 1eel stronger.
Analst. Yeah'

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z09 -
(He seconds her tho:ght.)
11
!atient. It made me 1eel more . eq:al to o: . [83-second pa:se]
Analst. Is that something thats happened nowadas
(Is there something abo:t the idea o1 her being eq:al that gives both o1 them pa:se Or is it
the analsts recognition that it is the patients moment to take the initiative that sets the stage
1or the pa:se)
!atient. Uhh . I think to some extent . m 1eeling is beginning to change abo:t . abo:t
that. I wo:ldnt sa that . I dont think its a done deal [ch:ckles] . Umm . One o1 the
things that I was thinking abo:t on $at:rda as I was thinking abo:t calling o: was that I, I
was convinced in m own mind that I co:ld call o: and that I co:ld tell o: abo:t that dream
and it wo:ld be oka. $o somehow that made me 1eel like I didnt have to do it.
($he is saing that she now recognies that she had the agenc and didnt have to prove it.)
Analst. Um-h:h.
($he shi1ts in a wa that the analst co:ldnt have predicted to 1oc:s on the tho:ght o1 a
$at:rda call.)
!atient. Yo: know I didnt have to prove anthing so . so I didnt do it.
Analst. Um-h:h.
!atient. Yo: know it was eno:gh, it was eno:gh to acknowledge to msel1 that I knew I co:ld
pick :p the phone and tell o: abo:t it and that co:ld be interesting, b:t I co:ld also [brie1
ch:ckle] tell o: abo:t it toda.
Analst. Um-h:h.
!atient. And I mean theres something in m viewing it that wa, m viewing that it was oka
to call o: that makes me 1eel were more eq:al .
Analst. Um-h:h.
!atient. . than :neq:al.
Analst. Uh-h:h . [68-second pa:se]
!atient. In the dream, :m, the dream last night, I was 1eeling like, :m . I dont know how to
sa it was exactl, the word acceptance keeps coming into m .
($he has broken the silence with the new idea o1 acceptance. While it relates to and expands
on the idea o1 connection, it introd:ces a variation.)
Analst. Um-h:h.

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z10 -
!atient. . head. It was like I was 1eeling accepted . the wa I am, and .
($he repeats the idea o1 acceptance, a1ter the analsts assenting :m-h:h, in a second
initiative that :nderscores her interest in moving in this direction.)
When the patient introduces the idea oI acceptance, a shiIt in the intersubjective Iield has occurred
that could not have been predicted as an outcome oI the silence. One can see that there is no consistent
narrative structure at the local level, and no way to tell what would Iollow any oI the relational moves.
Even the most insightIul analyst cannot know what the patient will say in the very next sentence. Even
iI the general topic is clear, the exact Iorm it will take is unpredictable. Yet the exact Iorm oI what the
analyst says will create the context and thus inIluence what happens next. This important Ieature oI
what actually happens in the therapeutic process is not revealed by a Iocus on dynamic unconscious
meanings.
To take this unpredictability into account, one need only attempt to consider that what did happen
is not what had to happen. Many things co:ld have happened. At any point, guided by the meaning the
moment had Ior either, either patient or analyst could have made a diIIerent relational move that would
have changed the path oI their interactional Ilow. The presence oI co-creativity and Iuzzy
intentionalizing in the therapeutic interaction means that any particular relational move could have
been diIIerent. There are many equally valid and eIIective pathways Ior the dyad, many oI which might
arrive at roughly the same destination. In biology and developmental psychology, this equivalence oI
diverse and idiosyncratic pathways is called the principle oI equiIinality.
12
The Redundancy of 8|oppy Processes
Despite this unpredictability in the precise path to be taken in the therapeutic interaction, analyst
and patient convey meanings, develop implicit knowledge oI how to be together, negotiate mutual
directions, and Ieel connected with each other. With the conveying and inIerring oI intentions being
such a Iuzzy, unpredictable, and variable process, how does any individual come to know what
meaning has been expressed? We Ielt the key to this puzzle lay in the recurrence and redundancy that
characterize interactions. To state the case more strongly, an

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z11 -
enormous amount oI time in treatment will necessarily be spent in repetitions, variations on a theme,
restatings, so that intentions will be optimally inIerred and collaborative directions can emerge.
We have noted that sloppiness, which is intrinsic to intentionalizing, is both variable and
redundant. This iterative process characterizes the bit-by-bit exchange and negotiation oI meaning. We
see this again near the end oI the Iirst excerpt, where patient and analyst discuss which dream they are
talking about. At this point the patient is talking about the 'sick part oI her mind that she had Ielt
pressured to discuss.
Th|rd Excerpt: e Need to do Th|s |n Hany 0|fferent ays
!atient. . 1eeling coerced to coming here on Frida, which I didnt 1eel, at least conscio:sl.
Beca:se what I was 1eeling had more to do with [the therap gro:ps] asking meit was like I
had to be sicker than I 1elt. And I think thats 1req:entl a part o1 what m mindset is when I
come here, that there is some sick part o1 m mind that I have to access .
Analst. Uh-h:h.
!atient. . in order to be talking abo:t the right thing. Yo: know, theres some pathological
thing in m head that I have to be able to .
($he reiterates the sense o1 having to talk abo:t the sick part o1 her mind.)
Analst. Yeah, and that is something that o: 1eel here sometimes.
(He emphaticall agrees with her abo:t the experience between them.)
!atient. Yeah.
($he sas, es, o:re getting it.)
Analst. $o the dream is also abo:t coming here, the press:re to get this sick part o1 o:r
brain o:t in the open.
(B strengthening and clari1ing in her own mind thro:gh the exchange what she had meant
b press:re, the patient has helped the analst get the idea that the press:re is abo:t
disc:ssing the sick part o1 her, not abo:t 1eeling coerced into the Frida appointment. His
getting it has strengthened her sense that her initiative can enable her to make hersel1
:nderstood.)
!atient. The thing that is reall con1:sing to me is that when I was in that gro:p with [the
therapist] the thing that was so impossible

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z12 -
1or me was to 1eel convinced that m experience was somehow . comparable to the other
people in the gro:p.
($hes repeating the sense o1 1eeling press:red abo:t the 'sick part o1 her mind,` this time b
saing she 1elt di11erent 1rom the other gro:p members, who were more inclined to 1oc:s on
their victimiation and who seemed to 1eel more damaged b their ab:se experiences.)
Analst. Yeah.
!atient. And I f:st co:ld not 1eel that . I 1irst o1 all didnt :nderstand wh anbod wo:ld
want me to think that. What good does it do me to think that
Analst. H:h.
13
!atient. I dont know. I get con1:sed. Yo: know, when I came to see o: what I wanted o: to
tell me was that I was sicker than I tho:ght I was and that it was oka 1or me to be here.
(Now she directs their attention to the wa she and the analst talked abo:t the 'sick part` o1
her in their 1irst meetings. to be connected, one m:st be sick. There1ore, she had to exaggerate
her 'sickness,` an earlier mani1estation o1 the sense o1 press:re. $he is indirectl re1erring to
her sense that in those earl meetings the analst had also helped her retain 1oc:s on the
positive parts o1 her sel1-experience.)
Analst. Uh-h:h.
!atient. And then, with that gro:p and with [the gro:p leader] it was like, oh es, o:re ver
sick. [ch:ckles] Yo:ve got this reall horrible thing wrong with o:. And Im thinking its not
reall that bad' It was like two ver opposite experiences.
(Now she shi1ts the 1oc:s back to her experience in the gro:p, in e11ect coming back to the
topic o1 the 1irst dream, 1eeling press:red.)
Analst. Uh-h:h.
!atient. [longish pa:se] And I think there is still some iss:e 1or me in m own perception o1
m sel1, abo:t whether I want to be sick or not. I mean I cant, I havent q:ite 1ig:red o:t how
to make that scar1 it in to m image o1 msel1. [another long pa:se] And beca:se o1 that, ever
time I come here I 1eel like I have to come with that wo:nd, that gaping wo:nd being the most
visible thing. I1 Im act:all 1eeling in to:ch with the wa m li1e is now [i.e., witho:t that a
sense o1 a gaping wo:nd], then I dont know what to sa to o:, theres nothing to talk abo:t.
Yo: know, o:ll ask me wh Im here.
($hes not s:re, b:t its becoming clearer that the are disc:ssing the extent to which her
'perception o1 hersel1` contains onl the 'sick` part o1 her. From the beginning o1 this
excerpt, the two o1 them have been looping aro:nd her 1eeling o1 press:re to 1oc:s on the
'sick`

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z13 -
part and have expanded the iss:e. $he wonders, can the be connected with her not being
sick Within a 1ew min:tes, the have moved to talking more abo:t the second dream and her
1eeling 'stronger` and 'more eq:al.`)
How in this brieI exchange did they come to 'agree to what their shared intention was? It was not
explicitly articulated. The key to this joint accomplishment lies in the recurrences in the patient's and
analyst's statements. These recurrences are not redundant in the sense oI being unnecessary or boring.
The cycling oI the pair's recurrent turn-taking is crucial to how they co-create a shared relational
intention. It is an exploratory process oI slow, incremental steps toward co-creation oI shared meaning
and shared direction.
There are several reasons why this redundancy oI relational moves is necessary. The objective
behaviors making up the relational moves during each turn-taking step can only partly convey each
partner's emerging apprehension oI the joint direction. The behaviors do not map the intention in a one-
to-one Iashion. The mapping is sloppy. We also see in this vignette how the same intention can be
conveyed in a great variety oI ways.
In addition to the inherent variability oI the expressive and receptive processes, here we can see
that intentions are most oIten not Iully Iormed and are thereIore oIten tentatively expressed. The
recipient's comprehension oI the emerging intention is similarly partial and hesitant. ThereIore, implicit
questions are communicated between the partners in Iorms like 'I want to talk about X, but do you?
And can we talk about it, given the way we are together? And what shape will the intention take as we
begin to jointly articulate it? This expression oI a relational intention is not simply a yes or no. Rather,
it demands a series oI responses Irom the other person as the two continue to negotiate and Iorm the
intention. In turn, each response is not simply a go-ahead yes or no, because it too demands a response
('Yes, I do, but do you, really? or 'I am not sure I get what you want or 'Is this the sort oI thing you
had in mind?). The Iirst person needs to respond again, and so on, recurrently. Out oI the recurrence in
their exchange, the shared intent emerges. This view oI a sloppy, redundant, co-creative process gives
us a way oI modeling more speciIically how relational intentions are created by dyadic systems. When
the analyst 'got what the patient meant by

14
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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z11 -
pressure, she also became clearer about it herselI and moved on to say how with the analyst she Ielt
diIIerently Irom how she had Ielt with the group. The change in the analyst catalyzed a change in the
patient. Her being able to Iacilitate the analyst's understanding heightened her own sense oI
communicative competence, an altered sense oI selI.
Redundancy overcomes the inherent variability oI the expression and reception oI a relational
intent. It is a bit-by-bit process that not only clariIies each individual's sense oI the emerging intention
oI the other person but also catalyzes the creation and consolidation oI each partner's own intention.
When recurrence is successIul, a co-created shared intention or direction oI interaction emerges.
Although we view the individual as a source oI primary activity, organization, and intentional
direction, the emergent directions oI the individual are continually selected, reassembled,
recontextualized, and redirected by the relational context. Functionally speaking, then, the relational
unit is the crucible in which 'individual intentions are Iorged as part oI participating in a joint
direction with another. Paradoxically, the only way to become oneselI is through participating in shared
intentional directions with others.
8|opp|ness, 6o-creat|v|ty, and the Past
Although we speak oI intentions as co-created, we do not mean to imply that they are created de
novo. De novo creation denies the past and the carrying Iorward oI the past to relational possibilities
available to each individual. The inIluence oI the past on the present has been Iramed in several ways.
For example, in earlier theory, the past was viewed through the lens oI representations or meanings
Iormed at the time oI the events themselves. In one set oI more contemporary views, the past is viewed
as a narrative construction oI the patient that is subject to change as a Iunction oI the therapy (Schafer
1992). In our view as well, the organization derived Irom the past, though inIluencing the present, is
also being continually updated. Our conceptualization departs Irom the narrative approach in most
other aspects, however. The narrative approach operates at the explicit level oI conscious, reIlective
dialogue and views change as occurring through the dialogue in the therapeutic session. In contrast, we
do not conceptualize the updating oI the past as operating primarily through explicit narrative
processes. Instead, in keeping with current models oI brain Iunction

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z15 -
(see, e.g., Freeman 1995; Edelman 1992), we view implicit relational knowing as being automatically
or implicitly updated in small ways with each relational encounter, rather than as operating primarily
through explicit narrative exchanges. Each time an aspect oI older internalized models is accessed in
the treatment, those past organizations are subtly reorganized by the present context oI interaction
between patient and therapist. In our view, the accumulation oI many small changes in implicit
relational knowing in this new context, these subtly shiIting organizations, inIluences behavior outside
the treatment situation. The recontextualization and reorganization process occurring at the local level
is subtle and occurs in tiny shiIts that would not be easily visible until they have accumulated in the
treatment.
The creative process we delineate at the level oI primary moment-by-moment interaction does not
vitiate the inI luence oI the past on the present interaction; instead the past conIigures the present
moment through the constraints contained in the implicit relational knowings that both partners bring to
the encounter (i.e., transIerence and countertransIerence). As noted earlier, these knowings include
expectancies derived Irom the individual pasts oI the two participants and expectancies derived Irom
their joint history oI encounters with each other. Thus, the co-created parsing oI a highly variable Ilow
oI behaviors into mutually shared relational intentions is contextualized, and in part made possible, by
the dyad's already created implicit relational knowings, knowings that in turn draw on each
participant's past outside the dyad.
This implicit relational knowing includes implicit knowing oI how analyst and patient have been
together in the past and their implicit and explicit goals, both short- and long-term. The Iollowing
illustrates how their history together can be seen in the material.
Analst. Is that something thats happened nowadas
!atient. Uhh . I think to some extent . m 1eeling is beginning to change abo:t . abo:t
15
that. I wo:ldnt sa that.. I dont think its a done deal. [ch:ckles] . Umm . one o1 the
things that I was thinking abo:t on $at:rda as I was thinking abo:t calling o: was that I, I
was convinced in m own mind that I co:ld call o: and that I co:ld tell o: abo:t that dream
[abo:t the dist:rbing gro:p session] and it wo:ld be oka. $o somehow that made me 1eel like
I didnt have to do it.
(Despite reass:rances, calling between sessions was something she 1elt she sho:ldnt do, and
had done on onl one occasion.)

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z1 -
Analst. Um-h:h .
!atient. Yo: know I didnt have to prove anthing so . so I didnt do it.
Analst. Um-h:h.
!atient. Yo: know it was eno:gh, it was eno:gh to acknowledge to msel1 that I knew I co:ld
pick :p the phone and tell o: abo:t it and that co:ld be interesting, b:t I co:ld also [brie1
ch:ckle] tell o: abo:t it toda.
Aside Irom the Iact that the telephoning between sessions had a mutual meaning Ior this patient
and analyst, the patient's chuckle also communicated shared knowledgeIor example, oI the way they
both Irequently used humor, oIten oI this mildly selI-deprecating kind, to ease tension. When she
chuckled, they both knew implicitly that he would understand that she was trying to ease tension. This
shared awareness aI Iects the analytic interventionswhether to interpret the turning away Irom
negative aIIect, or whether to appreciate the patient's selI-regulatory activity as having the goal oI
continuing to explore challenging issues in the hour. Another instance oI this kind oI shared implicit
knowing is the way the analyst's um-huhs were understood by both oI them as meaning 'Yeah, go on.
However, even though we view each individual as having a past and as bringing a set oI potential
ways oI relating into the new encounter, we see the dyadic situation as dominating the past events. In
our view the way the past oI the two participants inIluences their interactions is the way transIerence
and countertransIerence expressions present themselves in this model. It is the present interaction oI the
participants that recontextualizes the transIerential maniIestations oI the past. The current dyadic
direction will continually select Irom the past oI each person those elements that will be used to Iashion
a joint direction in the dyad. And those elements will be rapidly recombined into new, jointly created
elements oI process between the two parties. The creative elements oI the therapy will oIten
overshadow the static elements that depend on the past, to the extent that the two parties begin to
construct a joint direction. We believe that the center oI gravity lies in the interaction between two
parties, not in the individual past oI either person. In agreement with current views oI memory, we
believe the present moment contextualizes what will be remembered but also transIorms that memory
as it is recontextualized in light oI the present interaction (Freeman l995; Edelman l992).

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z1Z -
6o-6reat|v|ty and the Need for a Recogn|t|on Process
Some obvious questions arise about so sloppy and variable a dyadic system. How does it arrive at
adequate resolution to move on? What is the punctuation oI the relational exchange? How do patient
and therapist sense when they have successIully joined in an intentional direction? How is it that some
relational initiatives between patient and analyst are selected to be repeated, Iollowed up on, and
elaborated and others are not? Here Sander's work on recognition process (1980, 1997; see also Weiss
1947; Lyons-Ruth 2000) served as our guide. He has repeatedly examined the problem oI accounting
Ior directionality in human growth and development and sees both biological and psychological
organization as directed toward increased coherence oI adaptive organization.
By recognition process we mean the sensing by both parties that a speciIic Iitting together has
occurred in their responses to one another in the service oI moving toward shared goals. Sander has
pointed out that the essential characteristic oI these moments is that there is a speciIic recognition oI
the other's subjective reality, or intentional direction, at several levels simultaneously. Each partner
grasps and ratiIies a similar version oI 'what is happening now, between us, by providing a
16
speciIically Iitted response to the other's initiative (Stern et al. 1998).
Sander's view oI recognition process at the level oI selI-awareness can be extended to encompass
this kind oI speciIic Iittedness at an implicit, unarticulated level, with no implication oI awareness or
consciousness. For example, in Sander's classic Irame-by-Irame Iilm analysis oI a Iather and an inIant,
the inIant Ialls asleep in the Iather's arms at the moment oI a speciIic Iittedness between the Iather's
actions and the selI-organized sleep processes oI the inIant. The implicit recognition that comes with
speciIic Iittedness serves the same Iunction Ior patient and analyst. When Iittedness oI intention is
achieved, a coherent shared state oI intersubjectivity emerges, together with a sense oI shared direction.
Recognition process is the joint apprehension oI this dyadic state.
This recognition oI the Iittedness oI one person's initiative is most oIten conveyed by a responsive
move on the part oI the other, a move that when successIul builds on the previous move in a way that
deepens the dialogue in the service oI the collaborative goals. Both

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z18 -
partners sense the Iittedness oI their actions to the relational potential oI the other and hence to the
potential achievement oI more complex and more collaborative ways oI being together. Recognition
process is in this sense the directional element oI developmental and clinical process; it is how we Ieel
our way along in unscripted relational encounters.
SuIIicient Iittedness is most easily deIined in terms oI what happens next. Has it permitted a
change in direction, a shiIt in Ielt coherence, a vitalization? This Iunctional deIinition raises the
problem oI intrinsic and extrinsic criteria Ior knowing when Iittedness is achieved. The actual criteria
oI suIIicient Iittedness are so Iluctuant, so relative to such happenings in the past, that it is a constantly
moving set point.
Two illustrations oI how Iittedness and recognition are ratiI ied are seen in the transcript. The Iirst
comes toward the end oI the Iirst session oI the week, aIter the patient speaks oI the uneasiness she
Ieels with the Ieeling oI acceptance.
!atient. It was like I was 1eeling accepted . the wa I am and . theres something abo:t the
1eelings that go along with that, that make me a1raid, and I start to 1eel a1raid o1 being h:rt,
when I notice that Im letting m g:ard down, or somethingand, o: know, one o1 the things
that is dist:rbing to me is that Ill wake :p with that 1eeling o1 being accepted and then as
soon as Im conscio:s o1 the 1act that its a dream I start to 1eel a1raid o1 the 1eeling. Its like I
dont reall want to 1eel that with o:.
Analst. H:h' . $omethins scar.
!atient. Yeah.
Analst. Yeah.
When the two echo each other with 'Yeah` and 'Yeah,` we see the shared acknowledgment
o1 their shared state.
Another example o1 the recognition process can be seen at the beginning o1 the second session
o1 the week, a1ter the excerpted session. It began ver di11erentl, with the patient wanting to
sit rather than lie on the co:ch. For the 1irst time, she began talking while sitting :p on the
co:ch and looking at the analst.
!atient. Toda I somehow dont want to lie down right awa.
Analst. Well, thats a change'' Can o: sa whats happening
!atient. Im not exactl s:re, b:t somehow I 1eel like Im more aware o1 what I want 1or
msel1. Its like I have m own agenda.
$hortl a1ter that, she la down and contin:ed to talk abo:t this 1eeling o1 being in a new state
with her analst.

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z19 -
!atient. Toda it 1eels a lot more connected here . beca:se it 1eels like Im opening :p
something to o: . in a vol:ntar wa. Its like, o: know, Im in control o1 what were
17
talking abo:t, in a wa that I dont :s:all 1eel. Its like I have an agenda toda.
Analst. [wrl] Its hard to have agendas other das
!atient. Yeah'
The two then burst into laughter, enacting a sense oI shared Iitted-ness oI initiatives. This shared
recognition oI Iittedness is the period, or sometimes the exclamation point, that marks the creation oI a
new joint intention that contextualizes the interaction. When this recognition occurs, a new phase oI
exploration can begin. In Iact, it did later in the session when Ior the Iirst time the two began to
realistically discuss termination.
The 8|oppy Process of the Loca| Leve| and other V|ews of Psychoana|yt|c
Process
OI course, the clinical material presented can be considered Irom many perspectives. Our goal in
viewing the material here was to examine the local level oI interaction, where the process oI
negotiating a shared intention comes into Iocus. Other theories, where the Iocus is on the narrative
level, might Iind in it the unIolding oI an existing narrative, or unconscious Iantasy about ambition, or
conIlicts about aggression, or the exchange contributing to the emergence oI a sense oI selI. They
might Iocus on the transIerence meaning oI these developing themes in the therapeutic relationship.
They might understand the intensiIication oI aIIect in the analytic process in terms oI an underlying
Iear oI aggression that Iree association has revealed. Then they might identiIy insight as the mechanism
through which the conIlict is resolved and Iear is diminished. In addition, the analyst who has
integrated these many alternative readings oI possible intentional directions Ior the patient-analyst
interaction may have more possibilities Ior helping the patient. However, we Ieel that the analyst's
openness to the sloppiness oI the therapeutic process and the need to join directions with the patient
through a process oI dialogue and negotiation is necessary to the successIul emergence oI a shared
direction and thereIore to a successIul analysis. The local level oI the patient-analyst dialogue is the
crucial matrix Ior this process oI co-creation and recognition.

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z20 -
We could also consider alternative paths Irom the point oI view oI the analyst's activity. The
analyst might have chosen to give priority to Iree association and so not have interrupted the Iree-
associative process with his comment early on about the patient's thoughts oI telephoning him.
Similarly, he might have analyzed the patient's deIensive departure Irom Iree association in the two
quite long pauses, perhaps by inquiring about what happened at the point she Iell silent. Alternatively,
he might have chosen to return to the dream to analyze transIerence issues such as conIlicts about
dependent longings, sexuality, and aggression. Or he might have chosen to elaborate her Iantasy oI
being 'very sick as an avenue into intense aIIect in relation to a selI-representation as sexual and as
aggressive, bad, and damaged. Finally, but not exclusively, he might have worked in displacement to
explore transIerence reactions, as through a Iocus on the therapy group and its leader. All oI these
approaches may inIorm the analyst's work. Whatever approach is taken, however, it is inescapable that
every analyst is simultaneously interacting with the patient at the micro level. And any approach will
have implications at this level. It cannot be ignored in any view oI treatment, whatever the orientation.
It has changed our clinical sensibilities.
8ummary and 6onc|us|on
We have explored the sloppiness that is an inherent property oI the two-person intersubjective
dialogue at the local level. We Iind it to be an enormously interesting and productive aspect oI a
dynamical systems model oI psychoanalytic treatment. It is also an essential element oI the co-creative
process that leads to greater intersubjective coherence. We view sloppiness not as errors or mishaps in
the dialogue, but rather as a generator oI potentially creative elements that may alter the direction oI the
dyad's evolution in unexpected, even previously unimaginable, ways.
Where do the novel elements come Irom in the analytic process that make it such a surprisingly
speciIic journey? One could say that sloppiness is to a two-person psychology what Iree association is
to a one-person psychology. They each add the unexpected speciIic details. They create the surprise
discoveries that push the dyad to its uniqueness. However, there is also an important diIIerence. Free
associations are assumed to lead to and Irom pre-existing networks oI meanings.
18

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z21 -
Sloppiness, by contrast, is not part oI any established organization, even though it, too, is
inIluenced by the past.
Sloppiness, like Iree association or other unanticipated 'pop-up events, can be used creatively
only when Iramed within a well-established therapeutic system or within a well-Iunctioning dyad.
Without the direction and constraints oI those dyadic systems, the improvisational elements can veer
toward chaos.
We have demonstrated with audiotaped transcripts oI two analytic sessions several examples oI
sloppiness and its associated Ieatures, and have suggested how these Ieatures may advance the co-
creative process oI psychotherapy. This view contributes to the emergence oI a relational theory oI
psychoanalysis based on a dynamical systems model and provides descriptions oI how such sloppy
dyadic processes work to create psychoanalytic change.
ppend|x: 8ess|on Transcr|pts
0ay 1: Honday
!atient. $o there are two completel di11erent . the dream that I had last night le1t me 1eeling
reall connected to o:, and o: know it made me 1eelI dont know, I g:ess closer to o:,
that o: wo:ld tell me that o: were not per1ect.
Analst. Uh-h:h.
!atient. Um.
Analst. Yo: act:all tho:ght abo:t calling me on $at:rda abo:t this other dream.
!atient. Yeah'
Analst. Which wo:ld have been, :h, and the reason o: were thinking o1 that, that kind o1
ver real connection, was what
!atient. What are o: re1erring to, the calling
Analst. Yeah, the calling.
!atient. Well, beca:se I had seen o: on Frida and 1elt there was like a thread o1
conscio:sness that had 1lowed into that dream.
Analst. Yeah.
!atient. It seemed kind o1 con1:sing to me thatI dont know how to sa this exactl. Its like
a throwback or something. To be dreaming abo:t [the gro:p therapist] and 1eeling that kind
o1 press:re .
Analst. Yeah.
!atient. . is what I dont q:ite getI mean, I think .

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z22 -
Analst. The press:re is there, isnt it Here we come into the iss:e o1 coercion, being made to
do something. And in this dream o: reall are being press:red to sa something more. And I
g:ess I wonder how did it, :h, connect to the 1act that we had that extra session on Frida.
!atient. What it seems like to me is thatthe dream was more connected to the idea o1 me
1eeling I have to meas:re :p, come :p with the right st:11 .
Analst. Uh-h:h.
!atient. . than the 1eeling o1 [being] coerced into coming here. $omehow theres a di11erence
somehow in there 1rom sort o1 making a link with .
Analst. Yeah, :h-h:h.
!atient. . 1eeling coerced to coming here on Frida, which I didnt 1eel, at least conscio:sl.
Beca:se what I was 1eeling had more to do with [the therap gro:ps] asking meit was like I
had to be sicker than I 1elt. And I think thats 1req:entl a part o1 what m mind-set is when I
19
come here, that theres some sick part o1 m mind that I have to access .
Analst. Uh-h:h.
!atient. . in order to be talking abo:t the right thing. Yo: know, theres some pathological
thing in m head that I have to be able to .
Analst. Yeah, and that is something that o: 1eel here sometimes.
!atient. Yeah.
Analst. $o the dream is also abo:t coming here, the press:re to get this sick part o1 o:r
brain o:t in the open.
!atient. The thing that is reall con1:sing to me is that when I was in that gro:p with [the
therapist] the thing that was so impossible 1or me was to 1eel convinced that m experience
was somehow . comparable to the other people in the gro:p.
Analst. Yeah.
!atient. And I f:st co:ld not 1eel that, I 1irst o1 all didnt :nderstand wh anbod wo:ld want
me to think that. What good does it do me to think that
Analst. H:h.
!atient. I dont know. I get con1:sed. Yo: know, when I came to see o: what I wanted o: to
tell me [was] that I was sicker than I tho:ght I was and that it was oka 1or me to be here.
Analst. Uh-h:h.
!atient. And then, with that gro:p and with [the gro:p leader] it

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z23 -
was like, oh es, o:re ver sick. [ch:ckles] Yo:ve got this reall horrible thing wrong with
o:. And Im thinking its not reall that bad' It was like two ver opposite experiences.
Analst. Uh-h:h.
!atient. [longish pa:se] And I think there is still some iss:e 1or me in m own perception o1
m sel1, abo:t whether I want to be sick or not. I mean I cant, I havent q:ite 1ig:red o:t how
to make that scar 1it into m image o1 msel1. [another long pa:se] And beca:se o1 that, ever
time I come here I 1eel like I have to come with that wo:nd, that gaping wo:nd being the most
visible thing. I1 Im act:all 1eeling in to:ch with the wa m li1e is now, then I dont know
what to sa to o:, theres nothing to talk abo:t. Yo: know, o:ll ask me wh Im here.
Analst. H:h. I1 o: dont come with the gaping wo:nd
!atient. Uh-h:h. Yeah, i1 I dont present msel1 in the proper damaged state, then Im not
going to gettaken serio:sl, or something. Its like Im not in m proper role .
Analst. And that is in the dream Frida night, that o: 1eel that Im sort o1 tring to get o:
to be in this proper role o1 a damaged person. And it is like in the second dream too, that and
the iss:e is how damaged are o:. On the one hand o:re press:red into being more
damaged and on the other o:re being told o:re not so bad, so:nds like.
!atient. Yeah, I mean the iss:e.
Analst. Thats the iss:e, o:re not s:re how bad.
!atient. Well, m 1eeling in the dream last night was that the reason I was allowed to see o:r
children and o:r wi1e was that I was oka.
Analst. Uh-h:h.
!atient. That somehow that was oka, that o: were tring to con
vince me thatI g:ess that I was like everbod else [i.e., normal].
[$everal lines o1 transcript are deleted.]
!atient. One o1 the books that I picked :p while I was o:t at the Book1air wasI mean I went
o:t there 1or one speci1ic thing and I 1o:nd it immediatel and so then I made the mistake o1
starting to roam aro:nd. And I 1o:nd this book completel b accident, called, :m, How to Go
to !ieces Witho:t Falling Apart.
Analst. H:m.
!atient. H:m. Its written b a pschiatrist in New York who is also a B:ddhist. And I f:st was
20
1lipping thro:gh it while I was waiting 1or o:. He was q:oting Fre:ds disciple, $andor
Feren, or whatever his name is.
Analst. Uh-h:h.

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z21 -
!atient. And Feren said its not the 1ree assoc itsel1 that is the c:re. It is that i1 o: can 1ree
associate, o:re c:red. [ch:ckles]
Analst. Uh-h:h.
!atient. And I tho:ght, o: know, that reall str:ck me as relevant to what o: and I have
been talking abo:t.
Analst. Yeah, :h-h:h, how speci1icall abo:t o: and me
!atient. Well, that o: know m problem seems to be that Im still wa too m:ch in control o1
what Im aware o1 thinking.
Analst. Uh-h:h.
[$everal lines o1 transcript are deleted. $omewhat later in the session the iss:es abo:t the 1irst
dream come back into disc:ssion.]
!atient. [Talking with the gro:p therapist] makes me 1eel too v:lnerable, and it makes me 1eel
something I dont 1eel I can a11ord to 1eel. Yknow, I wo:ld rather . I wo:ld rather 1oc:s on
I dont know, the part o1 me that 1eels strongthan to be in to:ch with the part o1 me that 1elt
like I was going to be stabbed to death [a re1erence to some o1 the sex pla that occ:rred in
her 1amilial sex:al ab:se]. It f:st makes me think I co:ld never, I co:ldnt have tolerated
doing therap with her or something like her beca:se that reall wo:ld make me 1all apart,
and it 1eels like I wo:ld be disintegrating in s:ch a wa I co:ld never reconstr:ct msel1. I
wo:ld be too, like Id have no con1idence in msel1 at all, as opposed to the wa m
relationship with o: has alwas been. Yo: and I both know that there is a part o1 me that is
strong.. I dont know where an o1 this is going, b:t .
Analst. Well, where, I, I mean I g:ess I was thinking, do o: 1eel that in the second dream
this, are o:, how strong are o: vis-a-vis me
I . o: told me how strong I am raising these children and et .
I tell o: that, o: know.
!atient. In the dream, it made me 1eel stronger .
Analst. Yeah'
!atient. It made me 1eel more . eq:al to . [83-second pa:se]
Analst. Is that something thats happened nowadas
!atient. Uhh . I think to some extent . m 1eeling is beginning to change abo:t . abo:t
that. I wo:ldnt sa that.. I dont think its a done deal [ch:ckles] . One o1 the things that I
was thinking abo:t on $at:rda as I was thinking abo:t calling o: was that I, I was
convinced in m own mind that I co:ld call o: and that I co:ld tell o: abo:t that dream and
it wo:ld be oka. $o somehow that made me 1eel like I didnt have to do it.

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Analst. Um-h:h .!atient. Yo: know I didnt have to prove anthing so . so I didnt do it.
Analst. Um-h:h. !atient. Yo: know it was eno:gh, it was eno:gh to acknowledge to msel1
that I knew I co:ld pick :p the phone and tell o: abo:t it and that co:ld be interesting, b:t I
co:ld also [brie1 ch:ckle] tell o: abo:t it toda.
Analst. Um-h:h.
!atient. And I mean theres something in m viewing it that wa, m viewing that it was oka
to call o: that makes me 1eel were more eq:al .
Analst. Um-h:h.
!atient. . than :neq:al.
21
Analst. Uh-h:h . [68-second pa:se]
!atient. In the dream, :m, the dream last night, I was 1eeling like, :m . I dont know how to
sa it was exactl, the word acceptance, keeps coming into m .
Analst. Um-h:h.
!atient. . head. It was like I was 1eeling accepted . the wa I am and . theres something
abo:t the 1eelings that go along with that, that make me a1raid, and I start to 1eel a1raid o1
being h:rt, when I notice that Im letting m g:ard down, or somethingand, o: know, one
o1 the things that is dist:rbing to me is that Ill wake :p with that 1eeling o1 being accepted and
then as soon as Im conscio:s o1 the 1act that its a dream I start to 1eel a1raid o1 the 1eeling.
Its like I dont reall want to 1eel that with o:.
Analst. H:h' . $omethins scar.
!atient. Yeah.
Analst. Yeah.
!atient. And I dont know whether its beca:se I know I have to tell o: abo:t the dream
[ch:ckles] and Im, o: know, a1raid o1 o:r reaction when I tell o: that, or i1 Im a1raid o1
the realit o1 tring to have the relationship 1eel that wa, or mabe thats the same thing. I
dont know.
[The session ended with patient and analst exploring more o1 what was scar to the patient
abo:t 1eeling 'accepted.`]

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0ay 2: Tuesday
The Iollowing day began extraordinarily diIIerently, in that the patient wanted to sit rather than lie
on the couch. On this day, and Ior the Iirst time, she began talking while sitting up on the couch and
looking at the analyst.|
!atient. Toda I somehow dont want to lie down right awa. Analst. Well, thats a change''
Can o: sa whats happening !atient. Im not exactl s:re, b:t somehow I 1eel like Im more
aware o1 what I want 1or msel1. Its like I have m own agenda.
[$hortl a1ter that she la down and contin:ed to talk abo:t this 1eeling o1 being in a new state
with her analst.]
!atient. Toda it 1eels a lot more connected here . beca:se it 1eels like Im opening :p
something to o: . in a vol:ntar wa. Its like, o: know, Im in control o1 what were
talking abo:t, in a wa that I dont :s:all 1eel. Its like I have an agenda toda.
Analst. [wrl] Its hard to have agendas other das
!atient. Yeah'
[The two then b:rst into lo:d m:t:al la:ghter.]
References
Beebe, B., & Lachmann, F. (2002). InIant Research and Adult Treatment: Co-constructing Interactions.
Hillsdale, NJ: Analytic Press.
Benjamin, J. (1995). Like Subjects, Love Objects. New Haven: Yale University Press.
Boston Change Process Study Group (2002). Report III: Explicating the implicit: The local level and
the microprocess oI change in the analytic situation. Int. J. !scho-Anal. 83: 1051-1062. (
Bruner, J. (1990). Acts oI Meaning. New York: Basic Books.
Carpenter, M., Nagell, K., & Tomasello, M. (1998). Social Cognition, Joint Attention, and
Communicative Competence Irom 9 to 18 Months oI Age. Monographs oI the Society Ior
Research in Child Development, Vol. 63.
Dilthey, W. (1976). Selected Writings, ed. H.P. Riokmen. London: Cambridge University Press.
Edelman, G.M. (1992). Bright Air, Brilliant Fire: On the Matter oI the Mind. New York: Basic Books.
Feldman, C.F., & Kalmar, D. (1996). Autobiography and Iiction as modes oI thought. In: Modes oI
Thought: Explorations in Culture and Cognition, ed. D. Olson & N. Torrence. Cambridge:
Cambridge University Press, pp. 106-122.
Freeman, W. (1995). Societies oI Brains. Hillsdale, NJ: Erlbaum.
22
Freeman, W. (1999). How Brains Make up Their Minds. London: WeidenIeld & Johnson.

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z2Z -
HoIIman, I.Z. (1998). Ritual and Spontaneity in the Psychoanalytic Process: A Dialectical
Constructivist View. Hillsdale, NJ: Analytic Press.
Husserl, E. (1930). Ideas Pertaining to a Pure Phenomenology and to a Phenomenological Philosophy.
Second Book: Studies in the Phenomenology oI Constitution, transl. R. Rojcewicz & A. Schuwer.
Dordrecht, Netherlands: Kluwer Academic Publishers, 1989.
Jacoby, L.L., & Dallas, M. (1981). On the relationship between autobiographical memory and
perceptual learning. Jo:rnal o1 Experimental !scholog. General 110: 300-324.
LakoII, G., & Johnson, M. (1999). Philosophy in the Flesh. New York: Basic Books.
Lyons-Ruth, K. (1999). The two-person unconscious: Intersubjective dialogue, enactive relational
representation, and the emergence oI new Iorms oI relational organization. !schoanal. Inq. 19:
576-617. (
Lyons-Ruth, K. (2000). 'I sense that you sense that I sense .: Sander's recognition process and the
speciIicity oI relational moves in the psychotherapeutic setting. In1ant Mental Health Jo:rnal 21:
85-98.
MeltzoII, A. (1995). Understanding the intentions oI others: Re-enactment oI intended acts by 18-
month-old children. Devel. !schol. 31: 838-850.
Mitchell, S. (1997). InIluence and Autonomy in Psychoanalysis. Hillsdale, NJ: Analytic Press.
Modell, A. (2003). Imagination and the MeaningIul Brain. Cambridge: MIT Press.
Ogden, T. (1997). Reverie and Interpretation. Northvale, NJ: Aronson.
Prigogine, I. (1997). The End oI Certainty: Time, Chaos, and the New Laws oI Nature. New York: Free
Press.
Sander, L. (1980). Investigation oI the inIant and its caregiving environment as a biological system. In
The Course oI LiIe: Vol. 1. InIancy and Early Childhood, ed. S. Greenspan & G. Pollock.
Washington, DC: NIMH, pp. 177-201.
Sander, L. (1997). Paradox and resolution: From the beginning. In Handbook oI Child and Adolescent
Psychiatry: Vol. 1. InIants and Preschoolers: Development and Syndromes, ed. S. Greenspan, S.
Wieder, & J. OsoIsky. New York: Wiley, pp. 153-160.
Schachter, D.L., & Moscovitch, M. (1984). InIants, amnesia and dissociable memory systems. In InIant
Memory, ed. M. Moscovitch. New York: Plenum, pp. 173-216.
SchaIer, R. (1992). Retelling a LiIe. New York: Basic Books.
Schore, A. (1994). AIIect Regulation and the Origins oI the SelI: The Neurobiology oI Emotional
Development. Hillsdale, NJ: Erlbaum.
Stern, D. N. (1985). The Interpersonal World oI the InIant. New York: Basic Books. (

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z28 -
Stern, D.N. (2004). The Present Moment in Psychotherapy and Everyday LiIe. New York: Norton.
Stern, D.N. Sander, L.W., Nahum, J.P., Harrison, A.M., Lyons-Ruth, K., Morgan, A.C., Bruschweiler-
Stern, N., & Tronick, E.Z. (1998). Non-interpretive mechanisms in psychoanalytic therapy: the
something more than interpretation. Int. J. !scho-Anal. 79: 908-921. (
Stolorow, R. (1997). Dynamic, dyadic, intersubjective systems: An evolving paradigm Ior
psychoanalysis. !schoanal. !schol. 14: 337-346. (
Thelen, E., & Smith, L. (1994). A Dynamic Systems Approach to the Development oI Cognition and
Action. Cambridge: MIT Press.
Tronick, E. (1998). Interventions that eIIect change in psychotherapy: A model based on inIant
research. In1ant Mental Health Jo:rnal 19: 277-353.
Bruschweiler-Stern, N., Harrison, A.M., Lyons-Ruth, K., Morgan, A.C., Nahum, J.P., Sander, L.W., &
Stern, D. (1998). Dyadically expanded states oI consciousness and the process oI therapeutic
change. In1ant Mental Health Jo:rnal 19: 290-299.
Vygotsky, L.S. (1934). Thought and Language, transl. E. HanImann & G. Vakar. Cambridge: MIT
Press, 1962.
Weiss, P. (1947). The problem oI speciIicity in growth and development. Yale Jo:rnal o1 Biolog &
Medicine 19: 234-278.
23
Westen, D., & Gabbard, G. (2002a). Developments in cognitive neuroscience: I. ConIlict, compromise,
and connectionism. J. Amer. !schoanal. Assn. 50: 53-98. (
Westen, D., & Gabbard, G. (2002b). Developments in cognitive neuroscience: II. Implications Ior
theories oI transIerence. J. Amer. !schoanal. Assn. 50: 99-134. (

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- Z29 -
rt|c|e 6|tat|on [ho 6|ted Th|s?j
ahum, 1.P. (2005). The 'Something More than Interpretation Revisited: Sloppiness and Co-
Creativity in the Psychoanalytic Encounter. J. Amer. !schoanal. Assn., 53:693-729
opyr|grl @ 2010, Psycroara|yl|c E|eclror|c Puo||sr|rg. le|p j Aooul j Reporl a Proo|er
# This text is printed for the personal use of the subscriber to PEP Web and is copyright to the Journal in
which it originally appeared. t is illegal to copy, distribute or circulate it in any form whatsoever.
ogoul
lore
orlerls
0ocument
3lerr, 0.N., 3arder, .w., Narur, J.P., larr|sor, A.V., yors-Rulr, K., Vorgar, A.., 8ruscrWe||erslerr, N., Tror|c|,
E.Z. (1998). Nor-lrlerprel|ve Vecrar|srs |r Psycroara|yl|c Trerapy: Tre '3orelr|rg Vore' Trar lrlerprelal|or. lrl. J.
Psycro-Ara|., Z9:903-921.


(1998). lrlerral|ora| Jourra| ol Psycro-Ara|ys|s, 79:903-921
Non-|nterpret|ve Hechan|sms |n Psychoana|yt|c Therapy: The '8ometh|ng
Hore' Than |nterpretat|on
aniel A. Stern , Louis W. Sander , 1eremy P. Aahum , Alexandra M. Harrison ,
Karlen Lyons-Ruth , Alec C. Morgan , Aadia Bruschweilerstern and Edward Z.
1ronick
It is by now generally accepted that something more than interpretation is necessary to bring about
therapeutic change. Using an approach based on recent studies oI mother-inIant interaction and non-
linear dynamic systems and their relation to theories oI mind, the authors propose that the something
more resides in interactional intersubjective process that give rise to what they will call implicit
relational knowing`. This relational procedural domain is intrapsychically distinct Irom the symbolic
domain. In the analytic relationship it comprises intersubjective moments occurring between patient
and analyst that can create new organisations in, or reorganise not only the relationship between the
interactants, but more importantly the patient's implicit procedural knowledge, his ways oI being with
others. The distinct qualities and consequences oI these moments (now moments, moments oI
meeting`) are modelled and discussed in terms oI a sequencing process that they call moving along.
Conceptions oI the shared implicit relationship, transIerence and countertransIerence are discussed
within the parameters oI this perspective, which is distinguished Irom other relational theories and selI-
psychology. In sum, powerIul therapeutic action occurs within implicit relational knowledge. They
propose that much oI what is observed to be lasting therapeutic eIIect results Irom such changes in this
24
intersubjective relational domain.
|ntroduct|on
How do psychoanalytic therapies bring about change? There has long been a consensus that
something more than interpretation, in the sense oI making the unconscious conscious, is needed. The
discussion oI what is the something more comes Irom many perspectives, involving diIIerent polarities,
where the something more has taken the Iorm oI psychological acts versus psychological words; oI
change in psychological structures versus undoing repression and rendering conscious; oI a mutative
relationship with the therapist versus mutative inIormation Ior the patient. Many psychoanalytic
writers, beginning early in the psychoanalytic movement and accelerating up to the present, have
directly or indirectly addressed these issues (erenczi & Rank, 1924; enichel et al., 1941;
Greenson, 1967; Loewald, 1971; Sterba, 1940; Strachey, 1934; Winnicott, 1957; Zetzel, 1956).
More recently, the same issues are being reconsidered by Ehrenberg (1992), Gill (1994), Greenberg
(1996), Lachmann & Beebe (1996),

This article represents work in progress. Requests Ior pre- or reprints should be addressed to: the Process oI
Change Study Group, c/o E. Z. Tronick, Children's Hospital, 300 Longwood Ave., Boston, MA 02115. This article
has been selected to appear Ior discussion on the IJ!A's World Wide Web pages and bulletin board. For details
see: http://www.ijpa.org.
Copyright Institute oI Psycho-Analysis, London, 1998

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Mitchell (1995), Sandler (1987), Schwaber (1996) and Stolorow et al. (1994).
This paper will present a new understanding oI the something more, and attempt to show where in
the therapeutic relationship it acts, and how. We will do this by applying a developmental perspective
to clinical material.
Anecdotal evidence suggests that aIter most patients have completed a successIul treatment, they
tend to remember two kinds oI nodal events that they believe changed them. One concerns the key
interpretation(s) that rearranged their intrapsychic landscape. The other concerns special moments` oI
authentic person-to-person connection (deIined below) with the therapist that altered the relationship
with him or her and thereby the patient's sense oI himselI. These reports suggest that many therapies
Iail or are terminated, not because oI incorrect or unaccepted interpretations, but because oI missed
opportunities Ior a meaningIul connection between two people. Although we cannot claim that there is
a one-to-one correlation between the quality oI what one remembers and the nature oI the therapeutic
outcome, we also cannot dismiss the Iact that both the moments oI authentic meeting, and the Iailures
oI such meetings, are oIten recalled with great clarity as pivotal events in the treatment.
The present article will diIIerentiate these two mutative phenomena: the interpretation and the
moment oI meeting`. It will also ask in what domain oI the therapeutic relationship these two mutative
events occur. While interpretations and moments oI meeting` may act together to make possible the
emergence or reinIorcement oI each other, one is not explicable in terms oI the other. Nor does one
occupy a privileged place as an explanation oI change. They remain separable phenomena.
Even those analysts who believe in the mutative primacy oI interpretation will readily agree that as
a rule, good interpretations require preparation and carry along with them something more. A problem
with this inclusive view oI interpretation is that it leaves unexplored what part oI the enlarged
interpretive activity is actually the something more, and what part is purely insight via interpretation.
Without a clear distinction it becomes impossible to explore whether the two are conceptually related
or quite diIIerent.
Nonetheless, we do not wish to set up a Ialse competition between these two mutative events. They
are complementary. Rather, we wish to explore the something more, as it is less well understood.
We will present a conceptual Iramework Ior understanding the something more and will describe
where and how it works (see also, %ronick, 1998). First, we make a distinction between therapeutic
changes in two domains: the declarative, or conscious verbal, domain; and the implicit procedural or
relational domain (see Clyman, 1991; Lyons-Ruth, in press). Then we will apply a theoretical
perspective derived Irom a dynamic systems model oI developmental change to the process oI
25
therapeutic change. This model is well suited to an exploration oI the implicit, procedural processes
occurring between partners in a relationship.
n pproach to the Pro-|em
Our approach is based on recent ideas Irom developmental studies oI mother-inIant interaction and
Irom studies oI non-linear dynamic systems, and their relation to mental events. These perspectives
will be brought to bear as we elaborate our view on the something more oI psychoanalytic therapy,
which involves grappling with notions such as moments oI meeting`, the real` relationship, and
authenticity. We present here a conceptual overview Ior the sections on developmental and therapeutic
processes.
The something more must be diIIerentiated Irom other processes in psychoanalysis. At least two
kinds oI knowledge, two kinds oI representations, and two kinds oI memory are constructed and
reorganised in dynamic psychotherapies. One is explicit (declarative) and the other is implicit
(procedural). Whether they

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are in Iact two distinct mental phenomena remains to be determined. At this stage, however, we believe
that Iurther enquiry demands that they be considered separately.
Declarative knowledge is explicit and conscious or readily made conscious. It is represented
symbolically in imagistic or verbal Iorm. It is the content matter oI interpretations that alter the
conscious understanding oI the patient's intrapsychic organisation. Historically, interpretation has been
tied to intrapsychic dynamics rather than to the implicit rules governing one's transactions with others.
This emphasis is currently shiIting.
Procedural knowledge oI relationships, on the other hand, is implicit, operating outside both Iocal
attention and conscious verbal experience. This knowledge is represented non-symbolically in the Iorm
oI what we will call implicit relational knowing. Most oI the literature on procedural knowledge
concerns knowing about interactions between our own body and the inanimate world (e.g. riding a
bicycle). There is another kind that concerns knowing about interpersonal and intersubjective relations,
i.e. how to be with` someone (Stern, 1985, 1995). For instance, the inIant comes to know early in liIe
what Iorms oI aIIectionate approaches the parent will welcome or turn away, as described in the
attachment literature (Lyons-Ruth, 1991). It is this second kind that we are calling implicit relational
knowing. Such knowings integrate aIIect, cognition, and behavioural/interactive dimensions. They can
remain out oI awareness as Bollas's unthought known` (1987), or Sandler's past unconscious`
(Sandler & onagy, 1997) but can also Iorm a basis Ior much oI what may later become symbolically
represented.
In summary, declarative knowledge is gained or acquired through verbal interpretations that alter
the patient's intrapsychic understanding within the context oI the psychoanalytic`, and usually
transIerential, relationship. Implicit relational knowing, on the other hand, occurs through
interactional, intersubjective processes` that alter the relational Iield within the context oI what we will
call the shared implicit relationship`.
The Nature of '|mp||c|t Re|at|ona| Know|ng'
Implicit relational knowing has been an essential concept in the developmental psychology oI pre-
verbal inIants. Observations and experiments strongly suggest that inIants interact with caregivers on
the basis oI a great deal oI relational knowledge. They show anticipations and expectations and
maniIest surprise or upset at violations oI the expected (Sander, 1988; %revarthen, 1979; %ronick et
al., 1978). Furthermore, this implicit knowing is registered in representations oI interpersonal events in
a non-symbolic Iorm, beginning in the Iirst year oI liIe. This is evident not only in their expectations
but also in the generalisation oI certain interactive patterns (Stern, 1985; Beebe & Lachmann, 1988;
Lyons-Ruth, 1991).
Studies oI development by several oI the authors (Stern, 1985, 1995; Sander, 1962, 1988;
%ronick & Cohn, 1989; Lyons-Ruth & 1acobvitz, in press) have emphasised an ongoing process oI
negotiation over the early years oI liIe involving a sequence oI adaptive tasks between inIant and
caregiving environment. The unique conIiguration oI adaptive strategies that emerges Irom this
sequence in each individual constitutes the initial organisation oI his/her domain oI implicit relational
knowing. Several diIIerent terms and conceptual variations have been proposed, each accounting Ior
26
somewhat diIIerent relational phenomena. These include Bowlby's internal working models` oI
attachment (1973), Stern's proto-narrative envelopes` and schemas oI being-with` (1995), Sander's
themes oI organisation` (1997), and Trevarthen's relational scripts` (1993), among others. A Iormal
description oI how these strategies are represented remains an active Iield oI enquiry.
Implicit relational knowing is hardly unique to the pre-symbolic inIant. A vast array oI implicit
knowings concerning the many ways oI being with others continue throughout liIe, including many oI
the ways oI being with the

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therapist that we call transIerence. These knowings are oIten not symbolically represented but are not
necessarily dynamically unconscious in the sense oI being deIensively excluded Irom awareness. We
believe much oI transIerence interpretation may avail itselI oI data gathered by the analyst about the
patient's relational knowings. A prototypical example is that reported by Guntrip (1975) Irom the end oI
his Iirst session with Winnicott. Winnicott said, I don't have anything to say, but I'm aIraid iI I don't
say something, you will think I am not here`.
how 6hanges |n '|mp||c|t Re|at|ona| Know|ng' are Exper|enced
A Ieature oI dynamic systems theory relevant to our study is the selI-organising principle.
Applying the selI-organising principle to human mental organisation, we would claim that, in the
absence oI an opposing dynamic, the mind will tend to use all the shiIts and changes in the
intersubjective environment to create progressively more coherent implicit relational knowledge. In
treatment, this will include what each member understands to be their own and the other's experience oI
the relationship, even iI the intersubjective relationship itselI does not come under therapeutic scrutiny,
i.e. it remains implicit. Just as an interpretation is the therapeutic event that rearranges the patient's
conscious declarative knowledge, we propose that what we will call a moment oI meeting` is the event
that rearranges implicit relational knowing Ior patient and analyst alike. It is in this sense that the
moment` takes on cardinal importance as the basic unit oI subjective change in the domain oI implicit
relational knowing`. When a change occurs in the intersubjective environment, a moment oI meeting`
will have precipitated it. The change will be sensed and the newly altered environment then acts as the
new eIIective context in which subsequent mental actions occur and are shaped and past events are
reorganised. The relationship as implicitly known has been altered, thus changing mental actions and
behaviours that assemble in this diIIerent context.
The concept that new contexts lead to new assemblies oI a system's constitutive elements is a tenet
oI general systems theory. An illustration oI the same principle Irom the neurosciences is that oI
Freeman (1994). He describes the way that in the rabbit brain the neural Iirings activated by diIIerent
odours create a diIIerent spatial pattern. When a new odour is encountered, not only does it establish its
own unique pattern, but the patterns Ior all oI the previously established odours become altered. There
is a new olIactory context, and each pre-existing element undergoes a change.
The idea oI a moment oI meeting` grew out oI the study oI the adaptive process in development
(Sander, 1962, 1967, 1987; ahum, 1994). Such moments were seen to be key to state shiIts and
organismic reorganisation. We believe the idea oI the well-timed interpretation` is also an attempt to
grasp aspects oI this idea.
A major subjective Ieature oI a shiIt in implicit relational knowing is that it will Ieel like a sudden
qualitative change. This is why the moment` is so important in our thinking. The moment` as a
notion, captures the subjective experience oI a sudden shiIt in implicit relational knowing Ior both
analyst and patient. We will discuss this in greater detail below.
Clinically, the most interesting aspect oI the intersubjective environment between patient and
analyst is the mutual knowing oI what is in the other's mind, as it concerns the current nature and state
oI their relationship. It may include states oI activation, aIIect, Ieeling, arousal, desire, belieI, motive or
content oI thought, in any combination. These states can be transient or enduring, as mutual context. A
prevailing intersubjective environment is shared. The sharing can Iurther be mutually validated and
ratiIied. However, the shared knowing about the relationship may remain implicit.

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 90 -
27
0eve|opmenta| Perspect|ves on the Process of 6hange
Since inIants are the most rapidly changing human beings, it is natural to wish to understand
change processes in development Ior their relevance to therapeutic change. OI particular relevance is
the widely accepted view that despite neurological maturation, new capacities require an interactive
intersubjective environment to be optimally realised. In this environment most oI the inIant and
parent's time together is spent in active mutual regulation oI their own and the other's states, in the
service oI some aim or goal. For Iurther explication oI the mutual regulation model and the concepts
that underpin it, see Tronick (1989) and Gianino & Tronick (1988). The key notions that elaborate this
general view Iollow.
Hutua| Regu|at|on of 8tate |s the 6entra| Jo|nt ct|v|ty
State` is a concept that captures the semistable organisation oI the organism as a whole at a given
moment. As Tronick (1989) has argued, dyadic state regulation between two people is based on the
micro-exchange oI inIormation through perceptual systems and aIIective displays as they are
appreciated and responded to by mother and inIant over time. The states that need to be regulated
initially are hunger, sleep, activity cycling, arousal, and social contact; soon thereaIter (the level oI) joy
or other aIIect states, (the level oI) activation or excitation, exploration, attachment and attribution oI
meanings; and eventually almost any Iorm oI state organisation, including mental, physiological and
motivational. Regulation includes ampliIying, down-regulating, elaborating, repairing, scaIIolding, as
well as returning to some pre-set equilibrium. How well the caretaker apprehends the state oI the
inIant, the speci1icit oI his/her recognition will, among other Iactors, determine the nature and degree
oI coherence oI the inIant's experience. Fittedness gives shared direction and helps determine the nature
and qualities oI the properties that emerge. Mutual regulation implies no symmetry between the
interactants, only that inIluence is bi-directional. Each oI the actors brings his or her history to the
interaction, thus shaping what adaptive manoeuvres are possible Ior each. Current concepts Irom
development studies suggest that what the inIant internalises is the process oI mutual regulation, not
the object itselI or part-objects (Beebe & Lachmann, 1988, 1994; Stern, 1985, 1995; %ronick &
Weinberg, 1997). Ongoing regulation involves the repetition oI sequenced experiences giving rise to
expectancies and thus, becomes the basis oI implicit relational knowing (Lyons-Ruth, 1991; ahum,
1994; Sander, 1962, 1983; Stern, 1985, 1995; %ronick, 1989).
Regu|at|on |s Coa|-0|rected
The processes oI mutual regulation moving towards a goal are neither simple nor straight-Iorward
most oI the time and do not run smoothly (%ronick, 1989). Nor would we expect or want them to,
ideally. Rather they demand a constant struggling, negotiating, missing and repairing, mid-course
correcting, scaIIolding, to remain within or return to a range oI equilibrium. This requires both
persistence and tolerance oI Iailures on both partners' part. (OI course the work is asymmetrical, with
the caregiver, in most situations doing the lion's share.) This trial-by-error temporal process oI moving
in the general direction oI goals, and also identiIying and agreeing on these goals, we will call moving
along`, to capture the ongoing ordinariness oI the process as well as its divergence Irom a narrow and
direct path to the goal. Sometimes the goal is clear and the dyad can move along briskly, as when
hunger requires Ieeding. Sometimes an unclear goal must be discovered or uncovered in the moving
along process, as in Iree play or most play with objects.

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 90Z -
Hutua| Regu|at|on |so |nvo|ves an |ntersu-ect|ve Coa|
The moving along process is oriented towards two goals simultaneously. The Iirst is physical
and/or physiological, and is achieved through actions that bring about a behavioural Iittedness between
the two partners, such as positioning and holding oI the baby Ior a Ieeding by the caregiver, coupled
with sucking and drinking by the baby; or, high-level Iacial and vocal stimulation during Iace-to-Iace
play by the caregiver, coupled with a high level oI pleasurable activation and Iacial expressivity in the
baby. The second, parallel goal is the experience oI a mutual recognition oI each other's motives,
desires and implicit aims that direct actions, and the Ieelings that accompany this process (%ronick et
al., 1979). This is the intersubjective goal. In addition to a mutual sensing oI each others' motives or
desires, the intersubjective goal also implies a signalling or ratiIying to one another oI this sharing.
There must be some act assuring consensuality. AIIect attunement provides an example (Stern, 1985).
28
It is not possible to determine which goal is primary, the physical or intersubjective. At times one
oI them seems to take precedence, and a shiIting back and Iorth occurs between what is Ioreground or
background. In any event both are always present. Our central interest here, however, remains the
intersubjective goal.
The Regu|atory Process C|ves R|se to 'Emergent Propert|es'
In moving along much oI the time, one does not know exactly what will happen, or when, even iI
general estimates can be made. This indeterminacy is due not only to the nature oI dynamic systems,
but to the shiIting oI local and even intermediate goals, as well as the Iact that so much oI moving
along is ad-libbed. Even Irequently repeated interactions are almost never repeated in exactly the same
way. Themes oI interaction are always in the process oI evolving variations, quite evident in certain
activities such as Iree play`, where part oI the nature oI the activity is to constantly introduce
variations so as to avoid habituation (Stern, 1977). But, even a more tightly structured activity, such as
Ieeding or changing, is never repeated exactly.
The improvisational nature oI these interactions has led us to Iind guidance in the recent
theoretical work on non-linear, dynamic systems which produce emergent properties (ivaz-
Depeursinge & Corboz-Warnery, 1995; Maturana & Varela, 1980; Prigogine & Stengers, 1984
and as applied to early development, %helen & Smith, 1994). These concepts seem to provide the best
models to capture the process oI moving along and the nature oI speci1ic moments o1 meeting (see
below), which are emergent properties oI moving along. In the course oI moving along, the dual goals
oI complementary Iitted actions and intersubjective meeting about that Iittedness can be suddenly
realised in a moment oI meeting`, one which has inevitably been well prepared Ior, but not
determined, over a longer period oI time. Such moments are jointly constructed, requiring the provision
oI something unique Irom each party. It is in this sense that meeting hinges on a speci1icit o1
recognition as conceptualised by Sander (1991).
Examples oI moments oI meeting` are such events as: the moment when the parent's behavioural
input Iits with the baby's movement towards sleep so as to trigger a shiIt in the inIant Irom awake to
asleep; or, the moment when a bout oI Iree play evolves into an explosion oI mutual laughter; or, the
moment that the baby learns, with much teaching and scaIIolding by the parent, that the word that they
will use Ior that barking thing is dog`. In the latter two examples, the meeting is also intersubjective in
the sense that each partner recognises that there has been a mutual Iittedness. Each has captured an
essential Ieature oI the other's goal-oriented motive structure. To state it colloquially, each grasps a
similar version oI what is happening, now, here, between us`.

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 908 -
We assume that intersubjective meetings have goal status in humans. They are the mental version
oI the aim oI object-relatedness. In systems terms, such meetings involve linking between organism
and context, inside and outside, giving rise to a state that is more inclusive than what either system
alone can create. Tronick has termed this more inclusive state the dyadic expansion oI consciousness.
'moment of meet|ng' can create a new |ntersu-ect|ve env|ronment and an a|tered
doma|n of '|mp||c|t re|at|ona| know|ng'
An example provides the best illustration. II in the course oI playing, a mother and inIant
unexpectedly achieve a new and higher level oI activation and intensity oI joy, the inIant's capacity to
tolerate higher levels oI mutually created positive excitement has been expanded Ior Iuture interactions.
Once an expansion oI the range has occurred, and there is the mutual recognition that the two partners
have successIully interacted together in a higher orbit oI joy, their subsequent interactions will be
conducted within this altered intersubjective environment. It is not the simple Iact oI each having done
it beIore, but the sense that the two have been here beIore. The domain oI implicit relational knowing
has been altered.
As another example, imagine a young child visiting a new playground with his Iather. The child
rushes over to the slide and climbs the ladder. As he gets near the top, he Ieels a little anxious about the
height and the limits oI his newly emerging skill. In a smoothly Iunctioning dyadic system, he will look
to his Iather as a guide to help him regulate his aIIective state. His Iather responds with a warm smile
and a nod, perhaps moving a little closer to the child. The child goes up and over the top, gaining a new
sense oI mastery and Iun. They have shared, intersubjectively, the aIIective sequence tied to the act.
29
Such moments will occur again in support oI the child's conIident engagement with the world.
|mmed|ate consequences of 'moments of meet|ng' that a|ter the |ntersu-ect|ve
env|ronment
When a moment oI meeting` occurs in a sequence oI mutual regulation, an equilibrium occurs that
allows Ior a disjoin` between the interactants and a detente in the dyadic agenda (ahum, 1994).
Sander (1983) has called this disjoin an open space` in which the inIant can be alone, brieIly, in the
presence oI the other, as they share the new context (Winnicott, 1957). Here an opening exists in
which a new initiative is possible, one Ireed Irom the imperative oI regulation to restore equilibrium.
The constraint oI the usual implicit relational knowledge is loosened and creativity becomes possible.
The inIant will re-contextualise his new experience.
During the open space, mutual regulation is momentarily suspended. Then the dyad reinitiates the
process oI moving along. However, the moving along will now be diIIerent because it starts Irom the
terrain oI the newly established intersubjective environment, Irom an altered implicit relational
knowing`.
pp||cat|on to Therapeut|c 6hange
We shall now provide a descriptive terminology and conceptual base Ior the something more,
showing how it operates as a vehicle Ior change in psychoanalytic therapies.
The key concept, the moment oI meeting`, is the emergent property oI the moving along` process
that alters the intersubjective environment, and thus the implicit relational knowing. In brieI, moving
along is comprised oI a string oI present moments`, which are the subjective units marking the slight
shiIts in direction while proceeding Iorward. At times, a present moment becomes hot` aIIectively, and
Iull oI portent Ior the therapeutic process. These moments are called now moments`. When a now
moment is seized, i.e. responded to with an authentic, speciIic, personal response Irom each partner, it
becomes a moment oI meeting`. This

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 909 -
is the emergent property that alters the subjective context. We will now discuss each element in this
process.
The preparatory process: 'mov|ng a|ong' and 'present moments'
In many ways, the therapeutic process oI moving along is similar to the moving along process in
the parent-inIant dyad. The Iorm is diIIerent. One is mainly verbal while the other non-verbal, but the
underlying Iunctions oI the moving along process share much in common. Moving along involves the
movement in the direction oI the goals oI the therapy, however they may be explicitly or implicitly
deIined by the participants. It subsumes all oI the usual components oI a psychoanalytic therapy, such
as interpretation, clariIication, etc. In any therapeutic session, as in any parent-inIant interaction, the
dyad moves towards an intermediate goal. One intermediate goal in a session is deIining the topics they
will take up together, such as lateness to a session, was the patient properly heard` yesterday, the up-
coming vacation, is therapy helping the Ieeling oI emptiness, does the therapist like the patient, etc.
The participants do not have to agree. They must only negotiate the interactive Ilow so as to move it
Iorward to grasp what is happening between them, and what each member perceives, believes and says
in the particular context, and what each member believes the other member perceives, Ieels and
believes. They are working on deIining the intersubjective environment, moving along. The events in
the conscious Ioreground that propel the movement are Iree associations, clariIications, questions,
silences, interpretations, etc. Unlike the largely non-verbal behaviours that make up the background oI
the parent-inIant environment, the verbal content usually occupies the Ioreground in the consciousness
oI both partners. In the background, however, the movement is towards intersubjective sharing and
understanding. The verbal content should not blind us to the parallel process oI moving along towards
an implicit intersubjective goal.
Analogous to the physical Iittedness goal in the non-verbal parent-inIant interactions, we see the
moving along process in an adult therapy session as consisting oI two parallel goals. One is a
reordering oI conscious verbal knowledge. This would include discovering topics to work on, clariIy,
elaborate, interpret and understand. The second goal is the mutual deIinition and understanding oI the
intersubjective environment that captures the implicit relational knowing and deIines the shared
30
implicit relationship`. A set oI smaller local goals are needed to micro-regulate the moving along
process. Local goals perIorm almost constant course corrections that act to redirect, repair, test, probe
or veriIy the direction oI the interactive Ilow towards the intermediate goal.
As will be seen, the intersubjective environment is part oI what we shall call the shared implicit
relationship`. The negotiating and deIining oI the intersubjective environment occurs in parallel with
the explicit examination oI the patient's liIe and the examination oI the transIerence. It is a process that
is conducted out oI awareness most oI the time. Yet, it is going on with every therapeutic manoeuvre.
Moving along carries the interactants towards a clearer sense oI where they are in their shared implicit
relationship`.
We conceive oI moving along as a process that subjectively is divided into moments oI diIIerent
quality and Iunction that we call present moments`. Among clinicians the notion oI a present moment
is intuitively evident and has proved invaluable in our discussions. The duration oI a present moment is
usually short, because as a subjective unit it is the duration oI time needed to grasp the sense oI what is
happening now, here, between us`. Accordingly, it lasts Irom micro-seconds to many seconds. It is
constructed around intentions or wishes and their enactment which trace a dramatic line oI tension as it
moves towards its goal (see Stern, 1995). A present moment is a unit oI dialogic exchange that is
relatively coherent in content, homogeneous in Ieeling and oriented in the same direction towards a
goal. A shiIt in any oI the above ushers

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 910 -
in a new, the next, present moment. For example iI the therapist says, Do you realise that you have
been late to the last three sessions? That's unusual Ior you`, the patient responds, Yes, I do`, and the
analyst adds, What are your thoughts about that?`, this exchange constitutes a present moment.
The patient replies, I think I've been angry at you`. Silence. Yes I have been.` Silence. This is a
second present moment.
The patient then says, Last week you said something that really got me ticked oII.` This is the
third present moment.
These present moments are the steps oI the moving along process. Between each there is a
discontinuity oI a kind, but strung together they progress, though not evenly, towards a goal. They
proceed in a Iashion that is rarely linear.
In brieI, we are speaking oI a bounded envelope oI subjective time in which a motive is enacted to
micro-regulate the content oI what is being talked about and to adjust the intersubjective environment.
The Iairly tight cyclicity oI inIant activities (sleep, activity, hunger, play etc.) assures a high level
oI repetition, creating a repertoire oI present moments. In therapy too, present moments repeat
variations on the theme oI habitual moves that constitute the unique way any therapeutic dyad will
move along`. Present moments will oI course be constrained by the nature oI the therapeutic
technique, the personalities oI the interactants and the pathology at issue.
Because present moments are so oIten repeated with only minor variations, they become extremely
Iamiliar, canons oI what moments oI liIe with that other person are expected to be like. Present
moments become represented as schemas oI ways oI being with another` (Stern, 1995) in the domain
oI implicit relational knowing`. The pair evolves a set oI micro-interactive patterns in which steps
include errors, disruptions and repairs (Lachmann & Beebe, 1996; %ronick, 1989). These recurrent
sequences tell us about the patient's unthought known` (Bollas, 1987) or the prereIlective
unconscious` oI Stolorow & Atwood (1992). They are the building blocks oI Bowlby's working models
and oI most internalisation. They are not in awareness but are intrapsychically distinct Irom that which
is repressed.
In sum, present moments strung together make up the moving along process. But both the units,
present moments, and direction oI this moving along occur within a Iramework that is Iamiliar to and
characteristic oI each dyad.
'Now moments'
In our conceptualisation, now moments` are a special kind oI present moment`, one that gets lit
up subjectively and aIIectively, pulling one more Iully into the present.1 They take on this subjective
quality because the habitual Irameworkthe known, Iamiliar intersubjective environment oI the
therapist-patient relationshiphas all oI a sudden been altered or risks alteration. The current state oI
31
the shared implicit relationship` is called into the open. This potential breach in the established
proceedings happens at various moments. It does not have to threaten the therapeutic Iramework, but
requires a response that is too speciIic and personal to be a known technical manoeuvre.
Now moments are not part oI the set oI characteristic present moments that make up the usual way
oI being together and moving along. They demand an intensiIied attention and some kind oI choice oI
whether or not to remain in the established habitual Iramework. And iI not, what to do? They Iorce the
therapist into some kind oI action`, be it an interpretation or a response that is novel relative to the
habitual Iramework, or a silence. In this sense, now moments are like the ancient Greek concept oI
kairos, a unique moment oI opportunity

1 We borrow the term now moment` Irom Walter Freeman.

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 911 -
that must be seized, because your Iate will turn on whether you seize it and how.
Clinically and subjectively, the way the therapist and patient know that they have entered a now
moment` and that it is distinct Irom the usual present moments, is that these moments are unIamiliar,
unexpected in their exact Iorm and timing, unsettling or weird. They are oIten conIusing as to what is
happening or what to do. These moments are pregnant with an unknown Iuture that can Ieel like an
impasse or an opportunity. The present becomes very dense subjectively as in a moment oI truth`.
These now moments` are oIten accompanied by expectancy or anxiety because the necessity oI choice
is pressing, yet there is no immediately available prior plan oI action or explanation. The application oI
habitual technical moves will not suIIice. The analyst intuitively recognises that a window oI
opportunity Ior some kind oI therapeutic reorganisation or derailment is present, and the patient may
recognise that he has arrived at a watershed in the therapeutic relationship.
Now moments can be described as evolving subjectively in three phases. There is a pregnancy
phase` that is Iilled with the Ieeling oI imminence. There is the weird phase` when it is realised that
one has entered an unknown and unexpected intersubjective space. And there is the decision phase`
when the now moment is to be seized or not. II it is seized, it will lead to a moment oI meeting`, iI all
goes well, or to a Iailed now moment iI it does not.
A now moment` is an announcement oI a potential emergent property oI a complex dynamic
system. Although the history oI its emergence may be untraceable, it is prepared Ior with Ileeting or
pale prior apparitions, something like a motiI in music that quietly and progressively prepares Ior its
transIormation into the major theme. Still the exact instant and Iorm oI its appearance remain
unpredictable.
The paths towards the now moment are many. The patient may identiIy an event during a session
and immediately realise that the intersubjective environment has just shiIted, but not share and ratiIy
this shiIt during the session. Or, the patient might have let the event pass without much notice and later
re-work it to discover its importance in signalling a possible shiIt in the intersubjective environment.
These events are Iorms oI hidden or potential now moments that are part oI the preparatory process.
They will perhaps, one day, reach a state oI readiness to enter into the mutual dialogue and become
now moments as we have described.
Now moments may occur when the traditional therapeutic Irame risks being, or is, or should be,
broken.
For example:
- II an analytic patient stops the exchange and asks, Do you love me?`
- When the patient has succeeded in getting the therapist to do something out oI the
(therapeutic) ordinary, as when the patient says something very Iunny and both break into
a sustained belly laugh.
- When by chance patient and therapist meet unexpectedly in a diIIerent context, such as
in a queue at the theatre, and a novel interactive and intersubjective move is Iashioned, or
Iails to be.
- When something momentous, good or bad, has happened in the real liIe oI the patient
that common decency demands it to be acknowledged and responded to somehow.
32
Recall that we are dealing with a complex dynamic process where only one oI several components
may be changing in a slow and progressive Iashion during the preparatory phase and may be hardly
perceptible, until reaching a certain threshold when it suddenly threatens to change the context Ior the
Iunctioning oI other components. Conceptually, now moments are the threshold to an emergent
property oI the interaction, namely, the moment oI meeting`.
The most intriguing now moments arise when the patient does something that is diIIicult to
categorise, something that demands a diIIerent and new kind oI response with a personal signature that
shares the analyst's subjective state (aIIect, phantasy, real experience etc.) with the patient. II this
happens, they will enter

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 912 -
an authentic moment oI meeting`. During the moment oI meeting` a novel intersubjective contact
between them will become established, new in the sense that an alteration in the shared implicit
relationship` is created.
The 'moment of meet|ng'
A now moment that is therapeutically seized and mutually realised is a moment oI meeting`. As in
the parent-inIant situation, a moment oI meeting` is highly speciIic; each partner has actively
contributed something unique and authentic oI his or herselI as an individual (not unique to their theory
or technique oI therapeutics) in the construction oI the moment oI meeting`. When the therapist
(especially), but also the patient, grapples with the now moment, explores and experiences it, it can
become a moment oI meeting`. There are essential elements that go into creating a moment oI
meeting`. The therapist must use a speciIic aspect oI his or her individuality that carries a personal
signature. The two are meeting as persons relatively unhidden by their usual therapeutic roles, Ior that
moment. Also, the actions that make up the moment oI meeting` cannot be routine, habitual or
technical; they must be novel and Iashioned to meet the singularity oI the moment. OI course this
implies a measure oI empathy, an openness to aIIective and cognitive reappraisal, a signalled aIIect
attunement, a viewpoint that reIlects and ratiIies that what is happening is occurring in the domain oI
the shared implicit relationship`, i.e. a newly created dyadic state speciIic to the participants.
The moment oI meeting` is the nodal event in this process because it is the point at which the
intersubjective context gets altered, thus changing the implicit relational knowing about the patient-
therapist relationship.
That the moment` plays such a key mutative role has been recognised by others as well.
Lachmann & Beebe (1996) have emphasised it, and Ehrenberg has described her mutative therapeutic
work as taking place precisely during intimate subjective moments (1992).
An example is instructive at this point. Molly, a married woman in her mid-thirties, entered
analysis because oI poor selI-esteem that was Iocused on her body, her inability to lose weight, and her
severe anxiety about losing the people most dear to her. She was a second daughter. Because her older
sister had been crippled by polio as an inIant, Molly's parents cherished her healthy body. When she
was a child, they would ask her to dance Ior them while they watched admiringly.
She began the session talking about body things` and associated having Ieelings oI sexual
excitement and a Ilash oI anger at the analyst on her way to the session. I have the image oI your
sitting back . and watching me Irom some superior position.` Later in the session she recalled her
parents watching her dance and wondered iI there were some sexual excitement in it Ior them, too, iI
they wanted it, too`. There Iollowed a long discussion oI her body experience, including physical
examinations, Iears there was something wrong with her body and body sensations. Then, aIter a
prolonged silence, Molly said, Now I wonder iI you're looking at me`. (The now moment began here.)
The analyst Ielt taken aback, put on the spot. Her Iirst thought was whether to remain silent or say
something. II she were silent, would Molly Ieel abandoned? Repeating Molly's statementyou
wonder iI I'm looking at you`seemed awkward and distancing. The analyst's responding with a
remark oI her own, however, Ielt risky. The sexual implications were so intense that to speak them
seemed to bring them too close to action. Noting her own discomIort and trying to understand its
source, the analyst identiIied the related issue oI dominance and realised that she Ielt as iI she were
being invited either to take the superior position` or to submit to Molly. At this point in her
considerations, she suddenly Ielt Iree to be spontaneous and communicate to Molly her actual
experience.
33
It kind oI Ieels as iI you're trying to pull my eyes to you`, she said. Yes`, Molly agreed, with
avidity. (These two sentences made :p the moment o1 meeting.) It's a mixed thing` said

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appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 913 -
the analyst. There's nothing wrong with the longings`, Molly replied. Right`, the analyst agreed. The
thing is, it takes two to manage`, Molly said. Certainly at Iirst`, the analyst replied. That's what I was
thinking . It's nice thinking about this now . and I actually am able to Ieel some compassion.` For
yourselI?` the analyst asked. Yes`, Molly answered. I'm glad`, the analyst responded.
In this vignette, an intersubjective meeting took place because the analyst used her own inner
struggle to apprehend the patient and seize the now moment by responding speciIically and honestly,
It kind oI Ieels (to me as a speciIic individual, is implied) as iI you are trying to pull my eyes to you`.
This turned the now moment into a moment oI meeting`. This is quite diIIerent Irom the various
possible, technically adequate, responses that leave the speciIicity oI the analyst as person, at that
moment, out oI the picture, such as: is this the way it was with your parents?` or tell me what you
imagined` etc.
|nterpretat|ons |n Re|at|on to 'Homents of Heet|ng'
Now moments can also lead directly to an interpretation. And interpretations can lead to moments
oI meeting` or the other way around. A successIul traditional interpretation allows the patient to see
himselI, his liIe and his past diIIerently. This realisation will invariably be accompanied by aIIect. II
the interpretation is made in a way that conveys the aIIective participation oI the analyst, a moment oI
meeting` may also have occurred. Matched speciIicities between two systems in resonance, attuned to
each other` (Sander, 1997) will have happened. This is akin to the aIIect attunement seen in parent-
inIant interactions (Stern, 1985).
Suppose that the analyst makes an excellent interpretation with exquisite timing. It will have an
eIIect on the patient, which may be a silence, or an aha`, or most oIten something like, yes, it really is
like that`. II the analyst Iails to convey his or her aIIective participation (even with a response as simple
as, Yes, it has been, Ior you`, but said with a signature born oI his own liIe experience) the patient
could assume or imagine that the analyst was only applying technique, and there will have been a
Iailure to permit an important new experience to alter the known intersubjective environment. In
consequence, the interpretation will be much less potent.
Strictly speaking, an interpretation can close out a now moment by explaining` it Iurther or
elaborating or generalising it. However, unless the therapist does something more than the strict
interpretation, something to make clear his or her response and recognition oI the patient's experience
oI a shiIt in the relationship, then there will be no new intersubjective context created. A sterile
interpretation may have been correctly or well Iormulated but it will most likely not have landed and
taken root. Most giIted psychoanalysts know this and do the something more`, even considering it part
oI the interpretation. But it is not. And that is exactly the theoretical problem we are grappling with. II
the scope oI what is considered an interpretation becomes too large and ill-deIined, the theoretical
problems become impossibly conIused.
A distinction must be made here. A now moment can, and oIten does, arise around charged
transIerential material, and gets resolved with a traditional interpretation. II this interpretation is given
in an authentic` manner, how is that diIIerent Irom a moment oI meeting`? It is diIIerent Ior this
reason. During a traditional interpretation involving transIerential material, the therapist as a person, as
he exists in his own mind, is not called into the open and put into play. Nor is the shared implicit
relationship called into the open Ior review. Rather, the therapeutic understanding and response
occurring within the analytic role is called into play. What authentic` means in this context is diIIicult
to deIine. During an authentic` transIerence interpretation, there should not be a moment oI meeting`
oI two people more or less denuded oI their therapeutic roles. II there were, the act oI the therapist, in
response to the transIerence act oI the

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patient, would have the character oI countertransIerence. In contradistinction, the transIerence and
countertransIerence aspects are at a minimum in a moment oI meeting` and the personhood oI the
34
interactants, relatively denuded oI role trappings, is put into play. Assessing the relative lack oI
transIerence-countertransIerence, and the relative presence oI two people experiencing one another
outside oI their proIessionally prescribed roles, is, oI course, not easy, but we are all aware oI such
moments, provided that the very concept is accepted. We will return to this point below.
The 'open space'
As in the developmental sequence, we assume that in the therapeutic situation moments oI
meeting` leave in their wake an open space` in which a shiIt in the intersubjective environment creates
a new equilibrium, a disjoin` with an alteration in or rearrangement oI deIensive processes. Individual
creativity, agency emerging within the individual's conIiguration oI open space, becomes possible, as
the patient's implicit relational knowing` has been Ireed oI constraints imposed by the habitual
(Winnicott, 1957).
ther fates of the now moment
The other various Iates oI the now moment, iI it is not seized to become a moment oI meeting` or
an interpretation are:
1. A missed now moment`
A missed now moment is a lost opportunity. Gill provides a graphic example. In one
oI my own analyses . I was once bold enough to say, 'I'll bet I will make more oI a
contribution to analysis than you have. I almost rolled oII the couch when the analyst
replied, 'I wouldn't be a bit surprised. I must also regretIully report that the exchange
was not Iurther analysed, not in that analysis at any rate' (1994, pp. 105-6). We taken him
to mean there was no Iurther discussion oI this exchange. Here a moment had been
allowed to pass by, never to be returned to.
2. A Iailed now moment`
In a Iailed now moment, something potentially destructive happens to the treatment.
When a now moment has been recognised but there is a Iailure to meet intersubjectively,
the course oI therapy can be put in jeopardy. II the Iailure is leIt unrepaired, the two
gravest consequences are that either a part oI the intersubjective terrain gets closed oII to
the therapy, as iI one had said we cannot go there`, or even worse, a basic sense oI the
Iundamental nature oI the therapeutic relationship is put into such serious question that
therapy can no longer continue (whether or not they actually stop).
David, a young man had begun an analysis. In a session aIter several months had
elapsed, he was talking about a severe burn covering much oI his chest that he had
sustained as a toddler and musing about its inIluence on his subsequent development. It
had leIt him with a disIiguring scar, easily seen when in a bathing suit or shorts, which
had caused him much selI-consciousness and acted as the Iocus Ior various issues
concerning his body. Without thinking, David reached down and started to pull back his
shirt, saying, here, let me show you. You will understand better`. Abruptly, beIore he had
uncovered the scar, his analyst broke in, No! Stop, you needn't do that!` Both were leIt
surprised by the analyst's response.
Both David and his analyst later agreed that what had transpired had not been
helpIul. David Ielt, however, and told his analyst, that the analyst's subsequent response
had compounded the Iailure because, instead oI saying that he Ielt badly Ior having
reacted as he had to David, he said only that he had not perIormed to his own standards.
3. A repaired now moment`
Failed now moments can be repaired, by staying with them or by returning to them.
Reparation, in itselI, can be positive. Almost by deIinition the repair oI a Iailed now
moment will lead the dyad into one or more new now moments.
4. A Ilagged now moment`
A now moment can be labelled. These labels are not easy to come by because the
dyadic

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states concerned do not, in Iact, have names and are extremely subtle and complex
35
entities. They usually acquire names like, the time when you . and I .` Flagging them
with a label is extremely important, not only because it Iacilitates their recall and use, but
it also adds another layer to the jointness oI this interpersonal creation. Flagging may also
serve the purpose oI dealing with a now moment only partially at the time oI its Iirst
emergence without running the risk oI missing or Iailing the moment. In this way it can
buy the therapy needed time.
5. An enduring now moment`
Sometimes a now moment emerges that can not be immediately
resolved/disclosed/shared, but does not go away. It remains and hangs in the air Ior many
sessions, even weeks. Nothing else can happen until its Iate is determined. These
enduring now moments are not necessarily Iailures. They may result Irom conditions that
do not permit the usual solutions because the timing or readiness is not ripe or because the
intersubjective meeting required is too complex to be contained in a single transaction. In
this sense they also may buy needed time. Usually they are resolved with a diIIerent now
moment that encompasses the enduring now moment. We will discuss this Iurther below.
The '8hared |mp||c|t Re|at|onsh|p' as the Locus of Hutat|ve ct|on |n
Therapy
We return now to the question posed at the beginning oI this paper, namely, in what domain oI the
relationship between therapist and patient does the moment oI meeting` occur and implicit knowledge
get altered? We suggest that it takes place in the shared implicit relationship`.
The notion oI any relationship in analysis that is not predominantly transIerential-
countertransIerential has always been troublesome. Many analysts claim that all relatedness in this
clinical situation is permeated with transIerence and countertransIerence Ieelings and interpretations,
including those intermediary phenomena such as the therapeutic alliance and its related concepts. Yet
others insist that a more authentic sense oI relatedness is the necessary experiential background without
which transIerence is not perceivable, let alone alterable (%hom & Kachele, 1987).
The shared implicit relationship` consists oI shared implicit knowledge about a relationship that
exists apart Irom, but parallel to both the transIerence-countertransIerence relationship and the assigned
psychoanalytic roles. While each partner's implicit knowledge about the relationship is unique to him,
the area oI overlap between them is what we mean by the shared implicit relationship. (This shared
implicit relationship is never symmetrical.)
The emphasis on the importance oI the shared implicit relationship` was Ior us unexpected, a
conclusion that we came to aIter realising the nature oI a moment oI meeting`. Since a moment oI
meeting` could only occur when something happened that was personal, shared, outside or in addition
to technique`, and subjectively novel to habitual Iunctioning, we were Iorced to reconsider the entire
domain oI the shared implicit relationship.
In our view, inIant research has simpliIied consideration oI the shared implicit relationship by
highlighting the Iact oI aIIective communication and intersubjectivity virtually Irom the outset oI
postnatal liIe (%ronick, 1989; Lachmann & Beebe, 1996). InIant and caretaker are both seen to be
capable oI expressing aIIect and comprehending the aIIective expressions oI the other. This Iirst
communication system continues to operate throughout liIe and has attracted ever more interest in our
Iield under the rubric oI the non-verbal`. We agree with Stechler (1996) that although our proIessional
responsibility enjoins us Irom sharing the same liIe space as the patient, it is misguided to assume that
the complex emotional being oI the analyst can be (or should be) kept Irom the sensings oI the patient,
sensings` based on the operation oI a highly complex system that is always Iunctioning. Our position
is that the operation oI this system constructs the shared implicit relationship`, which consists oI

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a personal engagement between the two, constructed progressively in the domain oI intersubjectivity
and implicit knowledge. This personal engagement is constructed over time and acquires its own
history. It involves basic issues that exist beyond and endure longer than the more therapeutically labile
distortions oI the transIerence-countertransIerence prism, because it includes more or less accurate
sensings oI the therapist's and patient's person.
When we speak oI an authentic` meeting, we mean communications that reveal a personal aspect
36
oI the selI that has been evoked in an aIIective response to another. In turn, it reveals to the other a
personal signature, so as to create a new dyadic state speciIic to the two participants.
It is these stable, implicit knowings between analyst and analysand, their mutual sensings and
apprehendings oI one another, that we are calling their shared implicit relationship`. Such knowings
endure over the Iluctuations in the transIerence relationship and could even be detected with a micro-
analysis, much oI the time, by a third party observing them, in which case it could be an objective`
event.
We have been Iorced by our reIlections upon the moment oI meeting` and its role in altering
implicit knowledge, to Iocus on and examine this shared implicit relationship. This is so because oI
several characteristics oI a moment oI meeting`.
1. It is marked by a sense oI departure Irom the habitual way oI proceeding in the therapy. It
is a novel happening that the ongoing Iramework can neither account Ior nor encompass.
It is the opposite oI business as usual.
2. It cannot be sustained or IulIilled iI the analyst resorts to a response that Ieels merely
technical to the patient. The analyst must respond with something that is experienced as
speciIic to the relationship with the patient and that is expressive oI her own experience
and personhood, and carries her signature.
3. A moment oI meeting` cannot be realised with a transIerence interpretation. Other aspects
oI the relationship must be accessed.
4. It is a dealing with what is happening here and now between us?` The strongest emphasis
is on the now`, because oI the aIIective immediacy. It requires spontaneous responses
and is actualised in the sense that analyst and patient become contemporaneous objects
Ior one another.
5. The moment oI meeting`, with its engagement oI what is happening here and now
between us` need never be verbally explicated, but can be, aIter the Iact.
All these considerations push the moment oI meeting` into a domain that transcends but does not
abrogate the proIessional` relationship and becomes partially Ireed oI transIerential-
countertransIerential overtones.
Although it is beyond the scope oI this paper, we believe that a Iurther exploration oI this shared
implicit relationship` is badly needed.
8ummary and 0|scuss|on
Whereas interpretation is traditionally viewed as the nodal event acting within and upon the
transIerential relationship, and changing it by altering the intrapsychic environment, we view moments
oI meeting` as the nodal event acting within and upon the shared implicit relationship` and changing it
by altering implicit knowledge that is both intrapsychic and interpersonal. Both oI these
complementary processes are mutative. However, they use diIIerent change mechanisms in diIIerent
domains oI experience.
With the aim oI Iurthering clinical enquiry and research, we have attempted to provide a
descriptive terminology Ior the phenomenology oI these moments that create the shared implicit
relationship`.
It should be noted that change in implicit relational knowledge and change in conscious verbal
knowledge through interpretation are sometimes hard to distinguish Irom each other in the actual
interactive process oI the therapeutic situation. The shared implicit relationship` and the transIerential
relationship Ilow in parallel, intertwined, one or the other taking its

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turn in the Ioreground. However, it is a necessary condition Ior relatedness that processing oI implicit
knowing be ongoing. Interpretation, on the other hand, is a punctate event.
We locate the Ioundations oI the shared implicit relationship` in the primordial process oI
aIIective communication, with its roots in the earliest relationships. We suggest it consists largely oI
implicit knowledge and that changes in this relationship may result in long-lasting therapeutic eIIects.
In the course oI an analysis some oI the implicit relational knowledge will get slowly and painstakingly
transcribed into conscious explicit knowledge. How much is an open question. This, however, is not
37
the same as making the unconscious conscious, as psychoanalysis has always asserted. The diIIerence
is that implicit knowing is not rendered unconscious by repression and is not made available to
consciousness by liIting repression. The process oI rendering repressed knowledge conscious is quite
diIIerent Irom that oI rendering implicit knowing conscious. They require diIIerent conceptualisations.
They may also require diIIerent clinical procedures, which has important technical implications.
The proposed model is centred on processes rather than structure and is derived Irom observing
inIant-caretaker interaction and Irom dynamic systems theory. In this model, there is a reciprocal
process in which change takes place in the implicit relationship at moments oI meeting` through
alterations in ways oI being with`. It does not correct past empathic Iailures through the analytic
empathic activity. It does not replace a past deIicit. Rather something new is created in the relationship
which alters the intersubjective environment. Past experience is recontextualised in the present such
that a person operates Irom within a diIIerent mental landscape, resulting in new behaviours and
experiences in the present and Iuture.
Our position on mutual regulation in the therapy situation is akin to one described by Lachmann &
Beebe (1996). Our idea oI a now moment` potentially becoming a moment oI meeting` diIIers Irom
their idea oI heightened aIIective moments` in that we have tried to provide a terminology and a
detailed sequential description oI the process that leads up to and Iollows these privileged moments.
We agree with many contemporary thinkers that a dyadic state shiIt is Iundamental, but we locate
its emergence in the moment oI meeting` oI the interactants. Our position is similar to those taken by
Mitchell and Stolorow & Atwood. We add to these authors, however, in considering most oI the
intersubjective environment as belonging to implicit relational knowing, which gets built into the
shared implicit relationship in the course oI therapy. The process oI change, thus, takes place in the
shared implicit relationship. Finally, we anticipate that this view oI altering implicit relational knowing
during moments oI meeting` will open up new and useIul perspectives that consider therapeutic
change.
Trans|at|ons of 8ummary
De nos jours, tous s'entendent generalement a reconnatre que pour que le changement
therapeutique prenne place l'interpretation n'est pas suIIisante. A l'aide d'une approche recente qui se
base sur des etudes de l'interaction mere-nourrisson et des systemes dynamiques non-lineaires et leurs
rapports aux theories de l'esprit, les auteurs de cet article proposent que le quelque chose en plus de
l'interpretation reside dans des processus intersubjectiIs interactiIs qui donnent lieu a ce qu'ils appellent
un savoir relationnel implicite. Ce champ de la procedure relationnelle est de Iaon intrapsychique
distinct du champ symbolique. Dans la relation analytique cela comprend des moments intersubjectiIs
apparaissant entre le patient et l'analyste, moments qui peuvent creer de nouvelles organisations ou
reorganiser non seulement le rapport entre les interactiIs, mais aussi le savoir de procedure implicite du
patient, sa maniere d'tre avec les autres. Les qualites et consequences distinctes de ces moments
(moments de maintenant, de rencontre) sont organisees et discutees en terme de processus sequentiel
que les auteurs appellent circulatoire moving along|. Les auteurs traitent des conceptions de la relation
implicite partagee, du transIert et du contre-transIert au sein des parametres de leur perspective qu'ils
distinguent des autres theories relationnelles et de la psychologie du selI. En somme, une action
therapeutique puissante survient au sein du savoir relationnel implicite. Les auteurs pensent qu'une
grande partie des eIIets therapeutiques

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qui semblent durer proviennent de tels changements apparaissant dans le champ relationnel
intersubjectiI.
Es ist heute allgemein anerkannt, da etwas mehr als Deutung ntig ist, um zu therapeutischer
Vernderung zu Ihren. Die Autoren benutzen eine Zugangsweise, die auI neueren Studien zur Mutter-
Kind-Interaktion sowie non-linearen Systemen und deren Beziehung zu Theorien der Seele beruhen.
Nach Meinung der Autoren liegt das etwas mehr in den interaktionellen intersubjektiven Prozessen, die
zu etwas Ihren, was sie impliites Beieh:ngswissen nennen. Dieser Beziehungsbereich ist
intrapsychisch von dem symbolischen Bereich unterschieden. In der analytischen Beziehung beinhaltet
dieser Bereich intersubjektive Augenblicke zwischen Patient und Analytiker, die neue Organisationen
in den interagierenden Personen schaIIen oder die Beziehung zwischen ihnen neuorganisieren knnen,
die aber auch, und noch wichtiger, das implizite Wissen des Patienten und seine Art, mit anderen zu
38
sein, verndern knnen. Die besonderen EigenschaIten und Auswirkungen dieser Augenblicke, bei
denen es sich um Augenblicke der Begegnung handelt, werden im Sinne eines auIeinanderIolgenden
Prozesses, der Weiterrcken moving along| genannt wird, dargestellt und diskutiert. Vorstellungen
ber die gemeinsame implizite Beziehung, bertragung und Gegenbertragung werden innerhalb der
Parameter dieser Sichtweise der Autoren diskutiert, die sich von anderen Beziehungstheorien und der
Selbstpsychologie unterscheidet. ZusammengeIat kann man sagen, da wirkungsvolle therapeutische
Handlung innerhalb impliziten Beziehungswissens stattIindet. Nach Meinung der Autoren ist viel von
dem, was sich als bleibende therapeutische Wirkung erweist, das Ergebnis von Vernderungen in
diesem intersubjektiven Bereich der Beziehung.
En la actualidad, esta bastante aceptado que hace Ialta algo mas que la interpretacion para que
tenga lugar un cambio terapeutico. Partiendo de una postura que se basa en trabajos recientes sobre la
interaccion madre-bebe y en sistemas dinamicos no lineales y su relacion con teorias de la mente, los
autores sostienen que ese algo mas` esta en los procesos inter-subjetivos e inter-activos que dan lugar
a lo que podemos llamar conocimiento relacional implicito. Este campo, relativo al procedimiento
relacional es, intra-psiquicamente, diIerente del campo simbolico. En la relacion analitica, incluye
momentos inter-subjetivos que tienen lugar entre paciente y analista y que pueden crear organizaciones
nuevas en tal relacion o re-organizar no solo la relacion entre las dos partes sino tambien lo que es mas
importante: el conocimiento implicito relativo al procedimiento del paciente y a su manera de
relacionarse con los demas. Las diIerentes cualidades y consecuencias de esos momentos (momento del
ahora, de encuentro) toman Iorma y se estudian en terminos de un proceso secuencial que podemos
llamar de ir hacia adelante. Se estudian tambien conceptos tales como la relacion implicita compartida,
la transIerencia y la contra-transIerencia, dentro de parametros de la perspectiva de los autores, que se
diIerencia de otras teorias relacionales y de la Psicologia del SelI. Resumiendo, la Iuerte actividad
terapeutica tiene lugar dentro del conocimiento relacional implicito. Los autores hacen la hipotesis de
que gran parte de lo que consideramos eIectos terapeuticos duraderos proviene de tales cambios en este
campo relacional inter-subjetivo.
References
Atwood, G. & Stolorow, R. (1984). Structures oI Subjectivity. Hillsdale, NJ: Analytic Press.
Beebe, B. & Lachmann, F. (1988). The contribution oI mother-inIant mutual inIluence to the origins oI
selI and object representations. !schoanal. !schol., 5: 305-337. (
Beebe, B. & 1994). Representation and internalization in inIancy: three principles oI salience.
!schoanal. !schol., 11: 127-165. (
Bollas, C. (1987). The Shadow oI the Object: Psychoanalysis oI the Unthought Known. New York:
Columbia Univ. Press.
Bowlby, J. (1973). Attachment and Loss. Vol. II Separation. New York: Basic Books. (
Clyman, R. (1991). The procedural organisation oI emotions: a contribution Irom cognitive science to
the psychoanalytic theory oI therapeutic action. J. Amer. !schoanal. Assn., 39: 349-381. (
Ehrenberg, D. B. (1992). The Intimate Edge. New York: Norton.
Fenichel, O. (1941). Problems oI Psychoanalytic Technique. New York: Psychoanalytic Quarterly Inc.
Ferenczi, S. & Rank, O. (1924). The Development oI Psychoanalysis. Madison, CT: Int. Univ. Press,
1986.
Fivaz-Depeursinge, E. & Corboz-Warnery, A. (1995). Triangulation in relationships. The $ignal, 3 ( 2):
1-6.
Freeman, W. (1994). Societies oI Brains. Hillsdale, NJ: Erlbaum.
Gianino, A. & Tronick, E. (1988). The mutual regulation model: the inIant's selI and interactive
regulation. Coping and deIense capacities. In $tress and Coping, ed. T. Field et al. Hillsdale, NJ:
Erlbaum, pp. 47-68.

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 919 -
Gill, M. (1994). Psychoanalysis in Transition. Hillsdale, NJ: Analytic Press.
Greenberg, J. (1996). Psychoanalytic words and psychoanalytic acts. Contemp. !schoanal., 32: 195-
203. (
Greenson, R. R. (1967). The Technique and Practice oI Psychoanalysis, Vol I. New York: Int. Univ.
Press.
Guntrip, H. (1975). My experience oI analysis with Fairbairn and Winnicott. Int. R. !scho-Anal., 2:
145-156. (
39
Lachmann, F. & Beebe, B. (1996). Three principles oI salience in the patient-analyst interaction.
!schoanal. !schol., 13: 1-22. (
Loewald, H. W. (1971). The transIerence neurosis: comments on the concept and the phenomenon. J.
Amer. !schoanal. Assn., 19: 54-66. (
Lyons-Ruth, K. (1991). Rapprochement or approchement: Mahler's theory reconsidered Irom the
vantage point oI recent research on early attachment relationships. !schoanal. !schol., 8: 1-23.
(
Lyons-Ruth, K. (in press). The two-person unconscious: Intersubjective dialogue, enactive relational
representation, and the emergence oI new Iorms oI relational organisation. !schoanal. Inq. (
Lyons-Ruth, K. & Jacobvitz, D. (in press). Attachment disorganization: unresolved loss, relational
violence, and lapses in behavioural and attentional strategies. In Handbook o1 Attachment Theor
and Research, ed. J. Cassidy & P. Shaver. New York: GuilIord.
Maturana, H. & Varela, F. (1980). The Tree oI Knowledge. Boston: Shambhala.
Mitchell, S. (1993). Hope and Dread in Psychoanalysis. New York: Basic Books.
Nahum, J. (1994). New theoretical vistas in psychoanalysis: Louis Sander's theory oI early
development. !schoanal. !schol., 11: 1-19. (
Prigogine, I. & Stengers, I. (1984). Order Out oI Chaos: Man's New Dialogue with Nature. New York:
Basic Books.
Sander, L. (1962). Issues in early mother-child interaction. J. Amer. Acad. Child !schiat., 1: 144-166.
Sander, L. (1983). Polarity, paradox, and the organisational process in development. In Frontiers o1
in1ant !schiatr, ed. J. Call et al. New York: Basic Books, pp. 333-346.
Sander, L. (1987). Awareness oI inner experience. Child Ab:se and Neglect, 2: 339-346.
Sander, L. (1988). The event-structure oI regulation in the neonate-caregiver system as a biological
background Ior early organisation oI psychic structure. In Frontiers in $el1 !scholog, ed. A.
Goldberg. Hillsdale, NJ: Analytic Press, pp. 64-77.
Sander, L. (1991). Recognition process: SpeciIicity and organisation in early human development.
Unpublished manuscript.
Sander, L. (1997). Paradox and resolution. In Handbook o1 Child and Adolescent !schiatr, ed. J.
OsoIsky. New York: John Wiley, pp. 153-160.
Sandler, J. (1987). Projection, IdentiIication, Projective IdentiIication. New York: Int. Univ. Press.
Sandler, J. & Fonagy, P. (eds.) ( 1997). Recovered Memories oI Abuse: True or False. London: Karnac
Books and Int. Univ. Press (in press).
Schwaber, E. (1998). The non-verbal dimension in psychoanalysis: state` and its clinical vicissitudes.
Int. J. !scho-Anal., 79: 667-680. (
Stechler, G. (1996). SelI disclosure and aIIect. Presented at the American Psychological Association,
Division 39 April meeting.
Sterba, R. F. (1940). The dynamics oI the dissolution oI the transIerence resistance. !schoanal Q., 9:
363-379. (
Stern, D. N. (1977). The First Relationship. Cambridge, MA: Harvard Univ. Press.
Stern, D. N. (1985). The Interpersonal World oI the InIant. New York: Basic Books. (
Stern, D. N. (1994). One way to build a clinically relevant baby. In1ant Ment. Health J., 15: 9-25.
Stern, D. N. (1995). The Motherhood Constellation. New York: Basic Books.
Stolorow, R. D. & Atwood, G. (1992). Contexts oI Being. Hillsdale, NJ: Analytic Press.
Stolorow, R. D. et al. (eds.) ( 1994). The Intersubjective Perspective. Northvale, NJ: Jason Aronson.
Strachey, J. (1934). The nature oI the therapeutic action oI psychoanalysis. In The Evol:tion o1
!schoanaltic Techniq:e, ed. M. Bergmann & F. Hartman. New York: Basic Books, pp. 331-360.
Thelen, E. & Smith, L B. (1994). A Dynamic Systems Approach to the Development oI Cognition and
Action. Cambridge, MA: MIT Press.
Thoma, H. & Kachele, H. (1987). Psychoanalytic Practice. 1 Principles. Berlin: Springer-Verlag.

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 920 -
Trevarthen, C. (1979). Communication and cooperation in early inIancy: a description oI primary
intersubjectivity. In Be1ore $peech. The Beginning o1 Interpersonal Comm:nication, ed. M. M.
Bullowa. Cambridge: Cambridge Univ. Press, pp. 321-349.
Trevarthen, C. (1993). Brain, science and the human spirit. In Brain, C:lt:re and the H:man $pirit, ed.
J. B. Ashbrook et al. Lanham, MD: Univ. Press America, pp. 129-181.
Tronick, E. Z. (1989). Emotions and emotional communication in inIants. Amer. !schologist, 44: 112-
119.
40
Tronick, E. Z. (ed.) ( 1998). Interactions that eIIect change in psychotherapy: a model based on inIant
research. In1ant Ment. Health J. special issue| 19 ( 3), Fall.
Tronick, E. Z. & Cohn, J. (1989). InIant-mother Iace-to-Iace interaction: age and gender diIIerences in
coordination and the occurrence oI miscoordination. Child Devel., 60: 85-92.
Tronick, E. Z. Als, H. & Adamson, L. (1979). Mother-inIant Iace-to-Iace communicative interaction.
In Be1ore $peech. The Beginnings o1 H:man Comm:nication, ed. M. Bullowa. Cambridge:
Cambridge Univ. Press, pp. 349-373.
Tronick, E. Z. & Weinberg, K. (1997). Depressed mothers and inIants: the Iailure to Iorm dyadic states
oI consciousness. In !ostpart:m Depression and Child Development, ed. L. Murray & P. Cooper.
Hillsdale, NJ: GuilIord Press, pp. 54-85.
Tronick, E. Z. et al. ( 1978). The inIant's response to entrapment between contradictory messages in
Iace-to-Iace interaction. J. Amer. Acad. Child !schiat., 17: 1-13.
Tronick, E. Z. et al. ( 1998). Dyadically expanded states oI consciousness and the process oI
therapeutic change. In1ant Mental Health Jo:rnal, Special issue| in press.
Winnicott, D. W. (1957). The Child and the Family. London: Tavistock.
Zetzel, E. R. (1956). Current concepts oI transIerence. Int. J. !scho-Anal., 37: 369-376. (

RN|NC! Tr|s lexl |s pr|rled lor lre persora| use ol lre suoscr|oer lo PEP weo ard |s copyr|grl lo lre Jourra| |r Wr|cr |l or|g|ra||y
appeared. ll |s |||ega| lo copy, d|slr|oule or c|rcu|ale |l |r ary lorr Wralsoever.
- 921 -
rt|c|e 6|tat|on [ho 6|ted Th|s?j
Stern, D.., Sander, L.W., ahum, 1.P., Harrison, A.M., Lyons-Ruth, K., Morgan, A.C.,
Bruschweilerstern, . and %ronick, E.Z. (1998). Non-Interpretive Mechanisms in
Psychoanalytic Therapy: The Something More` Than Interpretation. Int. J. !scho-Anal., 79:903-
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