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Stern, S. (2017). Holistic Thinking and Therapeutic Action: Building on Louis Sander’s Contribution. Psychoanal. Dial., 27(1):89-103.

(2017). Psychoanalytic Dialogues, 27(1):89-103

Holistic Thinking and Therapeutic Action: Building on Louis Sander’s Contribution

Steven Stern, Psy.D.

This paper makes the case for a holistic approach to conceptualizing what we actually do with our patients. Psychoanalytic theories, whether comprehensive or circumscribed, conceptualize the nature of analytic interaction and the principles of therapeutic action into distinct theoretical categories. These categories then shape our thinking, causing us to lose sight of our fundamental purpose: to provide each patient with the specific and unique forms of help they need to move toward and achieve their therapeutic aims, both implicit and explicit. To counteract this long-standing trend, we need more holistic constructs oriented toward each patient’s unique, and uniquely complex, aims and process. Louis Sander’s principles of specificity of recognition, specificity of connection, moments of meeting, and progressive fittedness are identified as powerful examples of such higher order constructs. Sander’s language is unique in that it bridges the objective-descriptive perspective of nonlinear dynamic systems theory and the phenomenological perspective of the analytic therapist-at-work. The author adds three of his own concepts to Sander’s, then presents an extended clinical example illustrating the more personal, intuitive, improvisational quality of an analytic process grounded in these principles. The case and discussion follow the evolution of the treatment over time, focusing especially on an extended “moment of meeting” at the conclusion of which the analytic system had reorganized at a dramatically more complex and alive level of relational fittedness.

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