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Fosshage, J.L. (2011). How Do We “Know” What We “Know?” And Change What We “Know?”. Psychoanal. Dial., 21(1):55-74.

(2011). Psychoanalytic Dialogues, 21(1):55-74

How Do We “Know” What We “Know?” And Change What We “Know?”

James L. Fosshage, Ph.D.

How the implicit and explicit domains of affective/cognitive processing are similar, are different, and interconnect is pivotal for theories of therapeutic action. The specific focus here is on how these systems encode information for processing and memory and how the encoding formats and learning processes of the implicit system affect its accessibility to higher order reflective consciousness and change processes. In contrast to positing that the implicit processing system exclusively uses a nonsymbolic format of encoding, the evidence strongly indicates that the implicit system primarily uses, as the explicit system, imagistic and verbal symbolic formats for encoding and processing information. The use of the same symbolic formats, it is proposed, facilitates the fluid interplay between these two systems and their access to higher order reflective consciousness. In addition, a variety of factors contribute to the variability of procedural knowledge (as well as explicit attitudes) to reflective conscious access. For example, the formative process of implicit procedural memory that begins with an explicit focus is more available to consciousness than those implicit memories formed totally out of awareness. Other factors include the age of onset when the procedure was being learned, frequency of repetition, intensity of affects, degree of emotional trauma, dissociation, and the current analytic intersubjective context. These considerations play a major role in what this author has proposed as two fundamental, interrelated pathways of therapeutic action involving explicit reflective exploration and implicit learning that occur in the psychoanalytic encounter. Rather than change taking place primarily through reflective exploration, the traditional focus, or primarily through implicit relational learning, a more recent proposal, this author is emphasizing the interplay between the implicit and explicit systems for therapeutic change.

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