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I resonate with Joe’s (Lichtenberg, 1983 , 1989 , 2005 ; Lichtenberg, Lachmann, & Fosshage, 1992 , 1996 , 2002 , 2011 ) interests in attach- ment research, infant studies, neuroscience, and, most particularly, with his signature contribution to the fi eld, Motivation Systems Theory. In this ground-breaking theory, Joe integrates fi ndings from developmental psych- ology with his rich experience as a psychoanalyst to reshape psychoana- lytic theory regarding motivation and human development. I fi nd that Joe’s expansion of motivation to seven systems (the regulation of physiologic pro- cesses, attachment, affi liation, caregiving, exploration and assertion, sensu- ality and sexuality, and the aversive system) helps me in my ongoing efforts to try to deeply understand a patient’s particular experience in moment-to- moment encounters. The theory also lays out contemporary clinical strat- egies that promote the full emotional engagement of the analyst in the dyadic treatment process. Further, the theory beautifully describes the implicit and explicit therapeutic processes that promote healing and growth. I fi nd the depth and breadth of Joe’s theory extremely helpful in my everyday work as an analyst.
Supervision during Psychoanalytic Training
My fi rst control case, a man I will call Aaron, provided me with a won- derful training experience. Prior to working with me, Aaron had been in a psychoanalytic treatment that he found unsatisfactory and sought a consult- ation with Joe. Although Joe offered guidance to the treating analyst, Aaron remained dissatisfi ed and left that treatment. Upon Joe’s recommendation, Aaron came to work with me in late 1994 for psychotherapy and Joe served as my supervisor. By the time my psychoanalytic training began in 1998, Aaron was engaged in four-sessions-per-week treatment and I continued my supervision with Joe for this case.
Aaron had a very traumatic childhood, as he suffered at the hands of his volatile, physically abusive father and his neglectful, manipulative mother.
Of particular note, Aaron experienced his mother as promising to be there for him but repeatedly failing him and then blaming him for her failure (Carr, 1997 , 1999 , 2006a , 2006b , 2008 ).
In my supervision, I read through notes of sessions with Aaron focusing on the clinical interaction including my affective responses. This allowed us to track closely what happened in the sessions. Joe did not take notes during my presentation but at the end of a session, in a clear and concise manner, conveyed his thoughts about Aaron and our work together. He spoke in everyday language and rarely used theoretical jargon to express his ideas. At the time, it was remarkable to me the way Joe could track the clinical process within a session as well as over a series of sessions with- out taking a single note and he demonstrated an ability to recall exact
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sequences of clinical interactions as well as to identify themes and pull many diverse aspects of the analytic conversation into a coherent whole.
In my own development as an analyst, supervisor, and teacher, I, too, have become able to track sequences, identify themes, and create a coherent narrative regarding my own and others’ clinical interactions. I relate these developments to learning processes at both the explicit/declarative level and the implicit/procedural level in which, I believe, my supervision with Joe played a central role.
The Interpretive Sequence
Joe taught me to listen carefully to how Aaron responded to my interven- tions and he stressed the importance of closely tracking a patient’s reac- tion to whatever I do or say. He said that I must try to determine whether the patient feels understood and if my interpretations seem to open up the exploratory process or shut it down. For example, in a session in the fourth year of analysis, Aaron refl ected on a sense of profound loneliness he felt upon being alone at home earlier in the day and became in touch with a memory around age 4.
A. Something was not right when I was home alone with my mother.
I remember feeling a loneliness that was debilitating. What I remember is her ironing and it was like she was at the end of a deep hall. I see her at a long distance. She ignored me.
E. Sounds like she was very shut down. (Thinking of his mother’s depression.)
A. It was like she was a zombie and I was all alone … I can remember going to the bathroom and telling her. She told me that I don’t need to tell her. For me, I felt without telling her I would be lost and she would never know.
E. You were telling her that you wanted to be connected to her and she was telling you that she did not want to be connected to you. That must have been very confusing and hurtful. (Empathically fi lling out my understanding of his experience.)
A. Yes, I felt all alone with no one to connect to. I think the anxiety I felt earlier today is connected to these experiences with my mother. To real- ize that is really something!
In these interactions, something new emerged in Aaron’s understand- ing of his current experience of anxiety and loneliness and he could place these feelings in relation to a pivotal childhood memory. Although Aaron and I realized that his mother was depressed, the extent and impact of her emotional absence had not been fully appreciated. I felt good about this
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sequence, as Joe told me that when something new emerges or the clinical process deepens, I will know I am on the right track.
On the other hand, Joe also taught me that when something I do or say activates a disruption in Aaron’s state, my participation needs to be acknowledged. An example of this occurred at moments when I found some of Aaron’s expressions of vengeance-seeking toward hurtful others threaten- ing (Carr, 2006 a) and I would subtly withdraw from full emotional engage- ment with Aaron’s feelings. He would feel my absence quite painfully. From my supervision, I knew the importance of fully exploring Aaron’s affective responses to such moments in order to provide understanding in depth. My willingness to shoulder my responsibility for the part I played in Aaron’s experience of disappointment and hurt and then to respond empathically to his feelings proved to be an important aspect of our analytic engagement.
Thus, Aaron was no longer left with the terrible feeling that he must take all the blame for what he senses is wrong between him and a needed other.
Identifying Emerging Themes
Joe taught me how to listen in order to be able to identify and engage emer- ging themes to help bring them alive in an analysis. In the supervision ses- sions, Joe had a gift for describing Aaron’s experience in emotionally rich, evocative language that expanded my understanding of my patient. Further, Joe framed Aaron’s experience from within a developmental context that deepened my appreciation of my patient while simultaneously deepening my understanding of human development. I found Joe’s formulations enlight- ening, as he put Aaron’s experience into words that captured their richness and complexity. An example of this relates to the prior vignette of Aaron’s experience with his mother while she was ironing and ignoring him and he was trying to connect with her. In subsequent discussion with Joe, he pointed out how the mother’s paralysis and abandonment during this cru- cial developmental period created a breakdown in Aaron’s expectations of mutuality and responsiveness from others as well as in his capacity to be responsive to the needs of others.
Joe would also offer suggestions about what he might say in a particular clinical moment, which provided me a way to think about communicating what I might want to say, including the words, tone, and affective quality.
The idea was not to mimic Joe but to fi nd my own communicative style. In a way, my supervision provided me with a deep immersion in an emotion- ally rich language that I could learn and use with my patients. An example of this involves Aaron telling me a dream that he found deeply disturbing.
In the dream, he is taking his dog to a training session. He was told by a bitchy woman (he associated to his mother) to put his beloved dog to sleep.
Aaron was too afraid to challenge the woman even as he knew his wife and
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nephews would be devastated, as they loved the dog. In the dream, Aaron felt he had no choice, injects the dog, and kills him. Then the head trainer returns, is horrifi ed, and is able to bring the dog back to life. In the dream, Aaron said that he felt such guilt, shame, and worried the dog would be permanently damaged. It was the end of the session and I felt strongly that I needed to respond and said,
This reminds me of what you felt growing up – that you had to fol- low your mother’s orders even if they were to your detriment. In the dream, your wife and nephews love your dog. I believe that you are the beloved dog that is saved but that you are also worried that following your mother’s orders as a child has permanently damaged you, even as our work together is bringing you back to life.
Aaron replies: “It’s what we’ve spoken about so many times. Can I for- give myself for following my mother’s orders? I know I can’t forget about it.” When Joe and I discussed the dream, we both agreed with the themes I mentioned – Aaron’s wish to be saved by a powerful, idealized self-object and his fears that his mistreatment has left him damaged. We also recog- nized that the dream image of the dog beloved by the wife and nephews demonstrated an important expansion of Aaron’s relational experience.
Disorganized Attachment and Fear in the Transference
A central theme that emerged in the treatment related to Aaron’s attachment experience. As Aaron was the victim of severe childhood abuse, Joe and I came to think of him, at least in part, as fi tting the disorganized attach- ment category – the category that is described as fear without solution. Joe cautioned me to be mindful of Aaron’s propensity for becoming frightened and to accept Aaron’s way of being attached to me. I have described this as
“attachment at a distance” (Carr, 2008 ) as Aaron was very cautious about acknowledging any attachment needs directed toward me. At times, he could tell me that I seemed to understand him and “get” what he was feeling, but going further was diffi cult.
Aaron told me, for example, that he could not get close to me or to any other human but could only safely get close to his beloved dog. Joe felt this was an important communication about Aaron’s extreme vulnerability that I should both recognize and acknowledge. As Joe explained it, Aaron’s fear- ful expectation of me grew out of his abusive, neglectful childhood experi- ences. Over time, Joe believed that Aaron would become more open and trusting through his alternative sense of me as a reliable, empathic collab- orator. Also, Joe thought that Aaron’s love for his dog was an important signifi er of his capacity to love and to be loved. As such, Joe felt this was a
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positive prognostic indicator. When Aaron’s dog died sometime later, he was able to express genuine grief to me. According to Joe, Aaron’s greater cap- acity to experience grief and to share it with me was a signifi cant step for- ward. I found Joe’s way of identifying these moments and framing them as indications of a positive therapeutic trajectory helped to sustain me during many diffi cult and discouraging moments in Aaron’s analysis.
As our analytic interaction evolved, in one aspect of our shared experi- ence, I remained a dangerous-other who could hurt Aaron. Simultaneously, in another aspect of our experience, I was the empathic-other who could appreciate the full force of his fears and his vulnerability. As mentioned, Aaron would tell me that it was impossible to ever trust me because if you can’t trust your own mother, one needs to remain forever vigilant to guard against getting hurt. I have indicated times when my emotional with- drawal adversely affected him. Over time, I became able to deeply appreci- ate Aaron’s sense of danger regarding my potential to hurt him (despite my good intentions) while simultaneously empathizing with both his longings and his fears. Joe thought that the discrepancy between Aaron’s percep- tions of me-as-dangerous versus his sense of me-as-reliable, empathic col- laborator would provide the essential building blocks for a change process.
Indeed, Aaron and I were eventually able to construct a safe way of being together and he began to express a growing sense of trust in me as well as a new view of himself as a strong and capable man.
Developmental Perspective on the Vitalizing Aspects of Aversive Experience
Another important theme that emerged in the analysis relates to the way Aaron sought out aversive experiences as a way to vitalize himself. For example, Aaron would tell me about numerous instances in which he would pick a fi ght in order to feel alive. Aaron had become hooked on a version of the affective intensity that he related to his “crazy family.” Joe viewed Aaron’s addiction to intensely negative affect states as a desperate attempt to overcome his deep sense of emptiness.
Aaron both enjoyed and was troubled by his outbursts. Interestingly, in our interactions, he was very rarely provocative and never nasty. However, with strangers who have irked or injured him and at times with his wife, he would really let loose. In exploring numerous interactions in which Aaron became enraged, I found Joe’s perspective very helpful in expanding my empathic understanding of Aaron and his experience. Essentially, Aaron grew up in a family devoid of attuned responsiveness to his feelings and needs. Further, Aaron’s father erupted in frightening rages and physically attacked him. His interactions with his mother were frequently negative and highly affectively charged. Aaron became hooked on replicating the intense,
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dysphoric affects of his family. In the analysis, Aaron and I came to appreci- ate how rage served to protect him against helplessness in the face of injury and also served as a source of needed exhilaration. Over time, this helped Aaron become able to deeply grieve his painful childhood and helped to free him from the tyranny of trying to fi ll the empty spaces through destructive outbursts.
Generosity and Generativity
Joe has given me a coherent, “user-friendly” frame for engaging analytically while simultaneously supporting me to develop my own unique ideas and my own analytic identity. Over the many years of supervision, our process of working together changed. Initially, he was the teacher and I was the learner, soaking up all he had to offer. As I developed, I was able to articulate my understanding of the analytic process as well as to formulate and discuss my own ideas. I found that I wanted a different, more collaborative relationship with Joe in supervision. Joe responded to my evolving learning needs and in the fi nal phase of our supervision, we spent many satisfying hours sharing ideas and reactions. Throughout my supervisory experience, I found our collaborative engagement captured the excitement and fun of learning at its very best.
Joe has encouraged my scholarship and my writing by inviting me to present my work at conferences and in Psychoanalytic Inquiry . As I have taken this up, Joe has consistently been in the background cheering me on. I remember a conversation we once had when I spoke to him about how much he means to me personally. Essentially, I told him that he was a father fi gure to me. This is especially important to me, as I had lost my father during childhood, as Joe knew. I remember him welcoming my heartfelt feelings and movingly responding, “Of course. After all, what could be more fatherly than providing guidance and supporting you?”
I am extremely grateful to Joe for all he has taught me, for his generos- ity to me and for our relationship which has evolved into an enriching friendship.
Bibliography
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Carr , E. ( 1999 ), Wounded but still walking: One man’s effort to move out of shame . Psychoanalytic Inquiry , pp. 289 – 308 .
Carr , E. ( 2006a ), On knowing and using myself: Developing a psychoanalytic state of mind . Psychoanalytic Inquiry , pp. 738 – 750 .
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Carr , E. ( 2006b ), Shame and abuse: A contemporary self psychological relational perspective. Presented at Symposium ’06: Committee of Psychoanalytic and Psychotherapeutic Publications and Organizations, New York, NY.
Carr , E. ( 2008 ), Leaping to safety: A psychoanalytic journey. Presented at the 31st Annual International Conference on the Psychology of the Self, Baltimore, MD.
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Lichtenberg , J. , Lachmann , F. , & Fosshage , J. ( 2011 ), Psychoanalysis and Motivational Systems: A New Look . New York : Routledge .