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Leblanc, J.A. (1994). Contemporary Psychoanalysis. XXVIII, 1992: The Opposing Currents Technique for Eating Disorders and Other False Self Problems. Steven Stern. Pp. 594-615.. Psychoanal Q., 63:823-824.
Psychoanalytic Electronic Publishing: Contemporary Psychoanalysis. XXVIII, 1992: The Opposing Currents Technique for Eating Disorders and Other False Self Problems. Steven Stern. Pp. 594-615.
Stern describes his adaptation of an interpersonal technique to the treatment of a particular subgroup of psychoanalytic patients—those who because of false selfcharacter defenses are highly resistant to the direct discussion of the transference or of the therapeutic relationship. These patients, e.g., the eating-disordered previously described by Hilde Bruch, are often hypervigilant about whose interests are being served in the treatment. Bruch emphasized mirroring the patient's own self-exploration and self-definition to counteract the suspicion of control by the therapist. Many of the patients described depend heavily on defenses of denial, disavowal, and dissociation to maintain a split between a traumatized self and the "false self" evolved for security relations with necessary others. A manifestation of this split in the transference is the patient's disavowal of affective wishes and needs with the therapist. This results in a restricted awareness of the transference process.
To counteract this restrictive influence, Stern advocates the use of a Sullivanian technique which clearly identifies the influences of "the other people in the room," and in a back-and-forth movement gradually differentiates the patient's actual experiences and wishes from the influence of those "other people." This has been referred to as a "widening and balancing" or "managing opposing currents" technique. The result is that disavowed affects, needs, and developmental goals previously unacceptable can, through this facilitating and "holding" method, be finally integrated. Stern refers here to character pathology subsumed under Winnicott's "false self" organization, Kohut's "vertical split," and Stolorow, Brandchaft, and Atwood's "fundamental psychic conflict." He emphasizes that the "opposing currents" method requires holding in mind simultaneously both of the patient's dominant motivations—the underlying repressed needs, and the "other-person" directed repudiation or disavowal of those needs—which structure the false self. Stern, in a discussion of a twenty-six-year-old woman's anorexic and character pathology and treatment, underscores his opposing currents technique as crucial to her emergence and recovery. His empathic recognition of the patient's defensive need for control and for primary nurturance and connectedness is emphasized, as are safety needs and the search for mastery. Following Weiss and Sampson, Stern views reenactments primarily as problem-solving attempts, not as compulsive acts under the aegis of the pleasureprinciple, nor as efforts to re-create the interpersonally familiar, as in Mitchell's view. Stern omits reference to the reality principle and to prior contributions on mastery, including Freud's. Nor does he address himself to qualities of pleasure that may fuel the satisfaction achieved through mastery, except to emphasize the sense of safety the patient achieves in the analysis.
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From this perspective of safety, or of control-mastery theory, Stern indicates that interpretations are to be utilized only when facilitating, or deepening, the analytic process. He stresses that not all interpretation is useful, and one wonders if he is referring to "wild analysis," in which issues of resistance, defense analysis, and timing of interpretation are eschewed. But his digression from Gill's recommendation—to aggressively interpret the transference where there is clear resistance to awareness of the transference and to utilize instead this opposing currents technique—appears constructive. Moving away from generalization to specific application, Stern offers a clearer understanding of the quality and character of the underlying resistances and transference experiences of this group of patients.
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Leblanc, J.A. (1994). Contemporary Psychoanalysis. XXVIII, 1992. Psychoanal. Q., 63:823-824