Difference and Dependence: A dance with many bruised toes

James Donnelly, DSW, LCSW

Camouflage We abide dependence, in our society, as means to an end: the achievement of independence. One relies on others in order to be able to rely on oneself. We are taught that differences, although often viewed with suspicion and wariness, are to be respected, tolerated, and accepted in one way or another; and are counseled to transcend differences by seeing “beyond” or “beneath” them to a perception of a common humanity. However, except for profoundly common events such as birth and death, a “common humanity” seems much like an abstraction in comparison to the often difficult experiences of bumping into the reality of our neighbor (Arendt, 1958; Kristeva, 1991; Sjoholm, 2005). Within societal and personal arenas, dependence and difference are managed more often through denial, avoidance or aggression. It is the misuse and misunderstanding of these two aspects of our existence that brings clients into our care. Dependence and difference are at the core of the enigma of our existence as well as the paradox and dilemmas (Donnelly, 2005) of our relationships with each other.

Stemming from Freud’s initial insights into the nature of human consciousness and its implications for the development of the person, psychoanalytic theory has progressively delved into the paradox of meaningful relationships rooted in the dilemmas of dependence and difference.

In addition to his discovery of the unconscious, the insight into transference and counter-transference as the heart of the psychoanalytic method led to an understanding of dependence as an achievement that was essential for the healing effect of psychotherapeutic treatment. The progressive developments of the structural and drive theories that led eventually to ego psychology, I believe, were surpassed by the work of Ferenczi, Balint (1968) and the English object relations School (Bollas, 1987; Fairbairn, 1952; Guntrip, 1969; Khan, 1974; Winnicott, 1965) in grasping the implications of transference and counter-transference for understanding human development and relationships. Object relations theory, along with the work of Bowlby (1973) Mahler (2000) and Spitz (1966), imparted profound insights into the interplay of dependence and difference in the first two years of life. It became possible to see dependence in relationships in a radically different way; not as a transitional phase to overcome, but as the essence of our being. The acknowledgement of dependence was understood to be a profound achievement and foundation of a meaningful human life.

The process of defining our differences with each other is, in fact, the core of articulating of our being with each other throughout all phases of our life (Erickson, 1959). The insights of self psychology (Kohut, 1984) and the work of the French psychoanalytic theorists (Kristeva, 1991, 2000; Miller, 1997: Oliver, 2002; Sjoholm, 2005) focus on the intrinsic interrelations of drive, language and relationship, and highlight the profound and paradoxical relationship between dependence and the articulation of difference with meaning.

In the psychoanalytic literature cited above, we are often indirectly exposed to the notion of dependence as an achievement in the various discussions on regression in the transference. The articulation of difference as the essence of a meaningful life is clearly highlighted in the work of Kristeva (2000) and Winnicott (1965).

Through reflecting upon the richness of the literature cited above, we can bring to light some of the implications that will highlight the power and importance of the interaction between dependence and difference in our work and, indeed, our lives.

Relation – Relationship

In the hands of authors such as Balint (1968), Bollas (1987) and Winnicott (1965), Freud’s initial concept of primary narcissism was transformed and enhanced to affirm the inherent relatedness of being human. Primary narcissism evolves from a kind of solipsist bubble that is burst with the awareness of separation, to the beginnings of a continuous articulation and clarification of an inherent relatedness; i.e., a process of differentiation within a context of participation. Two crucial aspects of this development in the writings of these authors are:

the absolute inseparability and mutuality between the developing person and the environment of care, and

an understanding of development in terms of continuous transformation of an intrinsic and mutual capacity to imagine.

For example, Winnicott’s elaborations of the interrelatedness of the maturational process and the facilitating environment – through the concepts of holding, handling and object placing, – describe the means through which the capacity to imagine is transformed into self-other consciousness. Balint’s writings embody these two aspects in his redefining of primary narcissism as primary love. Bollas, building on these conceptualizations, presents the dynamics of development via the transformational object.

Out of the concepts of the object relations approach, an important distinction can be drawn: the distinction between relation, or the inherent relatedness of being, and relationship, that is, the particular articulations of relation.

Relation is not established, but is given. Nothing exists outside of relation – existence and relation are synonymous. Relationships, on the other hand, are established and varied. They are the mutual articulation of relation out of “the primary creative illusion” (Winnicott, 1965), or our inherent capacity to imagine.

Relation and relationship, of course, are intrinsic to each other. Relation is the inherent process of being human and relationship its expression.

Although intrinsic, they are not identical. Relation is the capacity to articulate relationships, but can never be totally defined by them. Between relation and relationship there is always, in the process and articulation of being-together, an area or space which is inherently undefined. These spatial metaphors are an attempt to describe an essential aspect of an indefinable state of being-between us. The acknowledgement and allowance of that ‘space’ is the hallmark of healthy environmental provision-development interaction. It is crucial to our understanding of the power of transference/counter-transference as well as therapeutic regression. Winnicott’s description of the “capacity to be alone” is a beautiful depiction of the undefined space between relation and relationship. The necessity and power of this “space” are illustrated in Balint’s requirement to reach the “area of the basic fault” and Bollas’ to attain the area of the “un-thought known”.

Dependence – Dependability

The undefined state of being or ‘space’ between relation and relationship is described in various ways in the literature.

For Winnicott (1965), it is that state of undifferentiated presence when one is alone with another. It is marked by a release from focused desire and consequent formulations of relationship. It is the touchstone of a sense of one’s “going on being”. It is at once the experience of the undefined reality of one’s being as well as the essence of relation. This state cannot be realized outside the contexts of relationships while, at the same time, it is a release from their definitions.

Kristeva (1991, 2000; Oliver, 2002; Sjoholm, 2005) captures the concept of this space by the Greek term chora or vessel. Taken from Plato’s Timaeus, it is the receptive, undefined source of being and intelligibility – “a space or room in which a thing is” (Sjoholm, 2005). Both Bollas’(1987) and Balint’s (1968) descriptions of the experience of therapeutic regression are in terms of this undefined state of relation, within which one re-experiences the creative core of one’s being – without which the “basic fault” cannot be overcome or “new beginnings” occur.

In this realization of relation lies the experience of dependence as intrinsic to our being human. All that is relational is intrinsically dependent. Dependence, as relation, is a given throughout all the phases of life. Access to the undefined state of being is via the allowance of the reality of dependence.

The capacity to be dependent is essential for a realization of one’s own reality – a reality that is always in relation.

Within the context of relationships, there must be the allowance of dependence. Winnicott speaks to the necessity of an “ebb and flow between the quiet and excited states” as crucial for the development of a child’s sense of his or her “continuity of being” or “going on of being”; i.e. a sense of their own unique reality within relationships.

Environmental provision that allows dependence as so defined is experienced as relationships that are dependable. Relationships that are dependable are those that allow for the undefined space between relation and relationship; that allow for the realization of mutual dependence as intrinsic and necessary. The consequences of failure of this allowance in environmental provision of care of the developing child are variously described as “impingement” (Winnicott, 1965), “the basic fault” (Balint, 1968), and the pre-verbal internalization of a faulty “logic of parental care” in the “un-thought known” that denies this access (Bollas, 1987). Parental denial of the realization of dependence is at the root of schizoid phenomena described by Fairbairn (1952), Guntrip (1969) and Winnicott (1965).

Environmental failure in the breakdown of dependability in relationships exposes one to the raw reality of being intrinsically dependent. Conditional upon the level of maturity when this exposure occurs, the consequences can be as extreme as unbearable anxiety, psychosis or even death; or a character formation designed to maintain the denial of dependence. Seen in this light, much of the behavior that is casually called “dependent” or “co-dependent” is actually an effort at control in service of the denial of dependence. Many of the symptoms bringing clients into treatment are expressions of the stress secondary to their efforts to “hold” themselves in the denial of dependence. Symptoms present both protest and longing.

Dependence, like relation, is the experience of the underlying process of our being-in-relation. Dependability is the structure, quality and definition of relationships that are rooted in that process, and maintain it as vital in the undefined space between relation and relationship.

Meaningfulness – Meaning

A person has meaning within the mutual images and definitions of one’s relational context; a person is meaningful in the realization of the active capacity to create, influence and be influenced by meanings within their relational context.

The previous concepts of relation and dependence describe the states and conditions within which differentiation and negotiating definitions of ourselves with each other take place. Meaningfulness and meaning are concepts that specifically address this process of differentiation; a process whereby we both define our uniqueness and maintain a realized sense of participation with each other. They relate to the function of our innate capacity to imagine and, eventually, conceptualize. Understood with relation and dependence in mind, meanings and the process of creating meanings is always mutually held and created. Meanings are always shared and mutually modified.

Object relations theory posits an innate capacity to imagine and create phantasy, out of which evolves our faculty for thought and language. Winnicott’s “primary creative illusion”, for example, is illustrative. His concept demonstrates how the formation and development of ego, and increased capacity to understand oneself and environment, is linked to the continuous projection and modification of phantasy and imagination.

Meanings evolve initially out of the pre-verbal images and sensorial rhythms evoked through the interaction between the child’s innate reality and the environment of care. Meanings, here, are felt before thought. Although not conceptual in language, they are meanings none the less.

Kristeva (1991, 2000; Oliver, 2002; Sjoholm, 2005), whose work addresses the psychodynamic development of language, calls this aspect of meaning the semiotic. The semiotic is that aspect of meaning reflected in the language and syntax of primary process. It is the language of the chora expressed in rhythms, images, bodily movements and sensations that become the relational aspect of ones physical and psychological reality. The semiotic is not simply considered to be prior to the language aspect of meaning. It is the ground of language. It is always present but never completely held or captured by it. It represents the presence of that “space” or undefined state of being between us that is the ground of conceptual language; indeed, it abides within every word and structure of meaning. It is what keeps meaningfulness alive within meanings.

Winnicott (1965), Balint (1968) and Bollas (1987) have descriptions of this aspect of meaning. For Balint, it is the area of the “basic fault” – a pre-linguistic area. Bollas describes this area of meaning as the “un-thought known”. The “un-thought known” is the pre-verbal aspect of the relationship dialogue between the child and parent. It is met and shaped by the interaction of the innate reality of the child and the “logic” of parental care. This “logic” is communicated in the parental activities of care so aptly described by Winnicott as the “holding”, “handling” and “object placement”. It is the total environment of care as well as the particular interactions that are given meanings that, for the most part, are not readily available to thought and language. It is important to keep in mind that this aspect of meaning abides within the whole context of our relationships as well as within each person.

All of the authors above acknowledge that a child’s developing sense of meaningfulness and meanings evolves in the medium of a pre-established and active context of relational discourse.

It is in the area of meaningfulness and meaning that the importance of difference is manifest.

The vitality of shared meanings is maintained in the manner in which differences are addressed, used and valued. The value and use of difference is the crucial element that maintains access to and the influence of the chora – that undefined “space” between relation and relationship. It is with access to that undefined state of being between us that the process of meaningfulness is maintained – and meanings are grounded in a sense of being real. As noted above, however, this “space” represents a state of being that allows for the relief from definition – a state of being that is comfortable with un-differentiation and semiotic processes. The paradox is: meanings are kept vital in a “state of being” that must maintain the challenge of the undefined

The manner of managing difference in relationship is the determining factor contributing to the balance between the “true” and “false” selves described by Winnicott. As so graphically expressed by Kristeva (1991), it is engaging the “stranger” within and between us that holds the best hope for meaningful community. Difference presents its own unique challenge to meaning; a challenge that abides in the fact that the appearance of the different, strange and uncanny, both within and between us, triggers an awareness of vulnerability and consequent anxiety. It presents a challenge to both dependability and relationship. Although relation and dependence are givens, dependability in relationships is not.

Dependability is a mutually sustained condition. Dependability in relationships is a communal achievement and, on an existential level, neither an entitlement nor a guarantee. Although life is intrinsically relational and the source of our nurturance, it can be experienced in the appearance of the strange, as indifferent to us. We depend on the kindness of intimates and strangers … neither of which are guaranteed. It is Bowlby (1973) that reminds us of the virtually biological fear of predators that is an important motivational aspect of attachment behavior.

The challenge of difference in the face of the stranger is met in that shared state of being undefined where meaningfulness can be found and new, inclusive, meanings created. To avoid this challenge, in the rejection of the stranger within and between us, is to deny the reality of our dependence and fail in the achievement of relationships and community. We cannot maintain sense without allowing its challenge (Kristeva, 1996). Our individual and shared destinies remain vital and viable only if the creation of meaning remains genuinely mutual; only with the incorporation of difference, within and between us, into the familial and communal imagination.

Inter-subjectivity – Identity

The conceptualization described above has looked at object relations theory within a frame that highlights the inherent interactive unity of process and structure. This is exemplified in the distinctions made above between relation-relationship, dependence-dependability and meaningfulness-meaning. The emphasis is on the intrinsic and ever active mutuality of influence between persons and their environments. In this frame, there is an intrinsic permeability of boundaries. The traditionally used concepts of self and identity have a somewhat reified connotation. They may mask the dynamism of the mutually interactive and dependent reality of the “going on being”; a reality always present in every person within their relationships. This is the undefined element active within any self or identity. The terms subject-in-process, subjectivity and inter-subjectivity seem to connote a more open ended and dynamic sense of the person in relation. They preserve a sense of the undefined core and fluidity of self and identity (Oliver, 2002; Sjoholm, 2005). Terms such as inter-subjectivity more clearly emphasize the underlying dependence implied in the inherently relational nature of human being. Kristeva’s (1991, 2000) “subject-in-process” particularly implies the importance of difference in maintaining the vitality of identity.

Object relations theory has attempted to capture these realities in the various formulations regarding “internalized objects relations”. Such concepts place at our disposal a clearer statement regarding the ever present mutual influence that constitutes the essence of our being and identities. Although the mutuality of interpersonal influence is conveyed in these formulations, the notion of the ongoing nature of our dependence upon each other throughout all of the stages of life is not as strong – except in descriptions of the therapeutic situation and particularly, that of regression in the therapeutic transference.

Winnicott (1965) and Balint (1968) both have moving and vivid descriptions of the therapeutic transference as a vehicle within which that “state of being” between relation and relationship can be realized … by both therapist and client. They and Bollas (1987) describe reaching a part of the client’s mind that has been both protecting the inner, dependent self and searching for a lost dependability in relationship. Bollas’ (1987) concept of the “transformational object” captures the need for an available, responsive and receptive other, in order for development to occur.

These descriptions, as powerful and moving as they are, don’t emphasize the on-going need for regression throughout all the phases of life. Often it is the impression that after this dramatic regression in the transference is successful, everything falls into place. The “real self” has been contacted and now can hold its own in the world. It is Kohut (1984) who addresses and questions this impression in his discussion of the validity of the “incomplete analysis”. Through his concept of the internalized self-object, the continuous validity of dependence on the other is stated clearly. In health, the self-object is open to modification and change in response to the ever different and changing realities that confront any relationship. The self-object concept highlights the validity and necessity of acknowledging dependence in relationships.

Discussion

Because of the nature of the psychoanalytic method, the dynamics of development and interpersonal relations are presented primarily in dyadic terms. This is associated with its address and repair of the residual pre-verbal impingements in adults. Balint (1968), for example, describes the level of the basic fault as the dyadic level. Winnicott (1965) and Bollas (1987), similarly, are addressing issues at this pre-verbal level. The implications of their work, however, go far beyond the particulars of this type and intensity of psychotherapeutic intervention.

Once the basic mutuality of relationships is so clearly identified, it applies to the entire network of relationships within which a person is a participant. In fact, it identifies on an almost philosophical level, the basic foundational dynamics of whole systems of relationships. Even Kristeva (2000 ), who more frankly sees psychoanalysis as a kind of leaven and antidote to the depersonalizing trends of our mass culture, still envisions interventions primarily on a one-on-one basis. She understands the broader impact of her work to be the influence of her writings – particularly in the arena of politics and literary criticism.

There are other approaches to treatment that are based on a process and systems orientation of the person in relationship. They focus on the whole family as the context of intervention.

Despite what may seem to be extreme differences in method and sensibility, the systemic family theory approach shares some features in common with object relations theory. Authors like Milton Erickson (Haley, 1985), Bateson (2002) and Watzlawick (1967, 1974, 1978), for example, have strikingly similar views regarding the central role of imagination and phantasy in human relationships. They illustrate as well as the power image and phantasy have to gain or block access to both a person’s and a relationship system’s underlying creative core. Family metaphor, for example, is a commonly used term. These approaches acknowledge the permeability of boundaries in a system. In fact, personal boundaries are not a central focus of the theory. Very striking, however, is the emphasis on the effect of introducing difference into the behavioral interaction to change the images and metaphors that have kept a family system less open.

Another salient similarity between object relations theory and family systems concepts is the understanding and use of the semiotic in communication. Many of the methods are meant to short circuit resistances inherent in a more interpretive approach and directly access the power of semiotic logic to effect a change; change that is often introduced as a small, seemingly nonsensical directive. In this view, any difference that is absorbed into a system begins a process of change in the whole system. They are assertive in the conscious use of difference to therapeutically unbalance a system of inter-relationships. They also value play and humor in the therapeutic situation and, perhaps, share that sensibility with Winnicott (1971).

What the systemic approach does not have in common with the object relations theory is the concept of transference and counter-transference. Consequently, there is less importance in the theory placed on the person of the client and the therapist, as well as the depth of demands on both in the method of treatment. With the absence of a transference and counter-transference underpinning the inherent dynamism of phantasy in the family system, the systemic approach seems limited to behavioral interactions with transactional meaning rather than inter-subjective or inter-personal exchanges that carry with them the weight of history. The systemic approach is based largely on a cybernetic feedback model rather than a more bio-organic systems model (Piaget, 1971).

Boszormenyi-Nagy (1973, 1986, and 1987) developed an approach to family treatment that seeks to integrate the strengths of both the systemic-process emphasis and the validity and depth of a person-in-relation perspective. Contextual therapy has deep philosophical roots in the writings of Martin Buber (1958, 1965). It has a very strong emphasis on the inherent reality of dependence in relationships (“ontic dependence”) from which Boszormenyi-Nagy derives his clinical and ethical premises regarding family intervention. The reality of transference and counter-transference is not only affirmed but expanded to address the impact of unresolved multi-generational issues within the family. Issues are addressed regarding concerns of loyalty and justice that must be engaged. There is a strong focus on commitment to the wellbeing of all family members, past, present and future. This includes a sense of mutual accountability and personal responsibility in rectifying the stultifying false loyalty conflicts and consequent possible exploitation within the family. Its intervention keystone is the demonstration and use of dialogue to honestly address painful issues, join in a communal sense of mourning over irreversible losses and explore new “relational resources” currently available within the family. Dealing with the present to undo the harmful influence of the past, in order to create a future with possibilities, is the primary goal of contextual therapy. Although the concept of self-object is not used, contextual therapy very clearly asserts the reality of an “ontological” dependence in all relations that, if ignored, will be to the detriment of all. There is between object relations theory and the contextual therapy approach a strong ethically based emphasis upon the method of treatment and the pursuit of a meaningful, not simply symptom free, life.

Conclusion

The concept of transference and counter-transference holds a profound depth of meaning for therapists and clients that transcends its understanding as a “treatment” methodology. It lifts “mental health” out of a medical-pathology frame and plunges us into the heart and paradox of what it means to be a human being. It requires both client and therapist to face together the Gordian knot: that our very being both nurtures us and appears at times to be remarkably indifferent to us. Dependability in all relationships is a human achievement – possible only with the acknowledgement of our intrinsic dependence upon each other. To the extent that the irresolvable paradox of nurturance and caprice at the very core of our being cannot be held in dialectic tension – and is split, our speaking can only be to and from each other; not of and with each other. The endurance of this paradox, the phantom of which is often in the face of the stranger, is the condition for dialogue. Dialogue is the only guarantor of Dependability.

We truly are, each and all, a work in progress.

REFERENCES

Arendt, Hannah (1958). The Human Condition. Chicago: University of Chicago Press.

Balint, M. (1968). The Basic Fault: Therapeutic aspects of regression. Evanston, Illinois:

Northwestern University Press.

Bateson, Gregory (2002). Mind and Nature: A Necessary Unity. Bresskill, New Jersey: Hampton Press, Inc.

Bollas, Christopher (1987). The Shadow of the Object. New York: Columbia University Press.

Boszormenyi-Nagy (1987). Foundations of Contextual Therapy: Collected Papers of Ivan Boszormenyi-Nagy. New York: Brunner-Routledge.

_______________ and Krasner, Barbara (1986). Between Give and Take: A Clinical Guide to Contextual Therapy. New York: Brunner/Mazel.

_______________ and Spark, Geraldine (1894). Invisible Loyalties. New York: Brunner/Mazel.

Bowlby, John (1980) Attachment and Loss, Volume II. Separation, Anxiety and Anger. London: The Hogarth Press.

Buber, M. (1958). I and Thou. Translated by Ronald Gregor Smith. New York: Charles

Scribner’s Sons.

__________. (1965). Between Man and Man. Translated by Ronald Gregor Smith. New

York: Macmillan.

Donnelly, J. (2005). Conditions of Hope: The Ethical Anchor for Psychotherapeutic Practice. New York: South Garden Press.

Erikson, E. (1959). Identity and the Life Cycle. New York: International Universities Press.

Fairbairn, W.R.D. (1994). Psychoanalytic Studies of the Personality. Hove and New York: Brunner-Routledge.

Grotstein, J. S. and Rinsley, D. B. ed. (2000). Fairbairn and the Origins of Object Relations. New York: Other Press.

Guntrip, H. (1969). Schizoid Phenomena, Object-Relations and the Self. New York: International Universities Press, INC.

Khan, M. Masud (1974). The Privacy of the Self: Papers on Psychoanalytic Theory and Technique. New York: International Universities Press, Inc.

Kohut, Heinz (1984). How Does Analysis Cure? Chicago: The University of Chicago Press.

Kristeva, J. (1991). Strangers to Ourselves. New York: Columbia University Press.

_________ (2002). The Sense and Non-Sense of Revolt. New York: Columbia University Press.

Haley, J. (1985). Conversations with Milton H. Erickson, MD.: Volume II Changing Couples. New York: Triangle Press.

Mahler, M. (1975). The Psychological Birth in the Human Infant: Symbiosis and Individuation. New York: Basic Books.

Miller, J. ed. (1997). The Ethics of Psychoanalysis. 1959-1960. The Seminar of Jacques Lacan, Book VII. New York: W.W.Norton & Company.

Oliver, K. ed. (2002). The Portable Kristeva. New York: Columbia University Press.

Piaget, J. (1971). Biology and Knowledge: An Essay on the Relations Between Organic Regulations and Cognitive Processes. New York: W.W.Norton & Co.

Spitz, R. (1966). The First Year of Life: A Psychoanalytic Study of Normal and Deviant Development of Object Relations. New York: International Universities Press.

Sjoholm, C. (2005) Kristeva & the Political. New York: Routledge.

Watzlawick, P. (1978). The Language of Change. New York: W.

W. Norton & Company, Inc.

___________ et al. (1967) Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies and Paradoxes. New York: W.W. Norton & Company, Inc.

____________ et al.(1974). Change: Principles of Problem Formation and Problem Resolution. New York: W.W. Norton & Company, Inc.

Winnicott, D. W. (1965). The Maturational Process and the Facilitating Environment. New York: International University Press.

________ . (1971). Playing and Reality. London: Tavistock Publications.

For thoughts and comments please send to: jdonnellydsw@gmail.com

South Garden Press, New York