Beatrice Beebe

CO-CONSTRUCTING INNER AND RELATIONAL PROCESSES : SELF- AND MUTUAL REGULATION IN INFANT RESEARCH AND ADULT TREATMENT

In the current climate of theoretical change, psychoanalysis is seeking a theory of interaction. We propose that principles of interactive organization documented in infant research have analogues in adult treatment. A systems model of the integration of self and mutual regulation is used to draw analogies, but not one-to-one correspondences, between infant research and adult psychoanalysis. We specifically address how self and mutual regulation impact on each other, arguing that internal and relational processes are simultaneously organized, in relation to each other, at all developmental levels. Co-constructing inner and relational processes: Self and mutual regulation in infant research and adult treatment Psychoanalysis has tended to privilege inner state as the focus of inquiry. Freud (l923) argued that perceptions of what goes on in the environment are never as important as those arising from within; that internal perceptions are more primordial, more elementary than perceptions arising externally, and that they have greater economic significance. Perceptions of the outer world are often seen as distorted through projections of the inner state. Instead, we suggest that the inner and the outer worlds are co-constructed, and thus are not separate domains. We distinguish between the two domains, but see them as fundamentally coordinated. By not privileging inner or outer, and by emphasizing their reciprocal coconstruction, we examine how dyadic process may (re-) organize both inner and relational processes, and reciprocally, how changes in self-regulation in either partner may alter the interactive process. In the past decade, efforts at conceptualizing systems views have been evident in both infant research and psychoanalysis. Each field, however, has come from the opposite bias. Heavily preoccupied with interactive regulation in the dyad, infant research on social development is only now seriously examining self regulation (see Tronick, 1989; Fox, 1994; Thompson, 1994). Similarly, psychoanalysis originally explicated the organization of inner states, and has only more recently seriously examined interaction in the dyad. Current versions of systems thinking conceptualizing interaction in psychoanalysis can be found, for example, in Stolorow, Atwood, and Brandschafts (1987) intersubjectivity, Mitchells (1988) relational psychoanalysis, Hoffman’s (1983) and Gills (1994) constructivist views, Arons (1996) mutuality, Lichtenbergs (1989; Lichtenberg, Lachmann, & Fosshage, 1992) placement of five motivational systems within a mutual regulation model, Benjamins (1988;1990) intersubjectivity, Ehrenbergs (1994) intimate edge, and Beebe, Jaffe, and Lachmanns (1992) dyadic systems model. These theorists all have in common the attempt to refine conceptualizations of psychoanalytic interaction. Systems thinking has also been implicit in much twentieth century psychoanalysis. For example, Ferenczi (1928), Balint (1968),

The reconstruction of early nonverbal relatedness in the treatment of difficult patients a special form of empathy

An interpretive strategy, based on current infant research, is described that facilitates engagement with emotionally constricted patients who appear to form little attachment to their analysts. Relevant research is reviewed and clinical material is presented to illustrate the presence of highly restrictive early modes of self‐ and mutual regulation organized in childhood and minimally transformed through later experience. These nonverbal presymbolic forms of relating constitute adult versions of the early interaction structures that protected the infant from trauma and continue to be used by patients to avoid retraumatization. How these configurations appear in the transference and can be reorganized in the analytic relationship is also detailed.

Self psychology: Today

Self psychology is maintaining continuity with Kohuts last work, How Does Analysis Cure? and his vision of human nature, as well as exploring a multiplicity of new directions. This paper discusses the expansion of Kohuts contributions in terms of the “figure‐ground”; dimensions of transference: a selfobject dimension and representational configurations. On the basis of empirical studies of infancy, the paper proposes that both self‐ and mutual regulation organize the treatment relationship. It illustrates the clinical applicability of the expansion of Kohuts contributions by discussing a case in which countertransference, aggression, and resistance could place an analyst in danger of contributing to a therapeutic stalemate were it not for the contributions of Kohut.

Human Development in the Twenty-First Century: Dyadic microanalysis of mother–infant communication informs clinical practice

Our research began in the 1960s with the study of adult dialogue by Joseph Jaffe and Stanley Feldstein. Our interest was in features of speech rhythms relevant to the communication of mood, the phenomenon of empathy, and the breakdown of effective dialogue. Speech rhythms include turn-taking, pausing and interrupting. By the late 1960s, when Daniel Stern and Beatrice Beebe joined the team, our interests widened to the study of mother–infant dialogues. Since then, the analysis of speech rhythms has been expanded to analogous rhythms of many modalities (gaze, vocal quality, facial expression, touching, head movement, and posture). This dyadic “microanalysis” research looks at the joint behaviors of two people. It operates like a microscope, identifying in detail the instant-by-instant interactive events which are so fast and subtle that they are usually lost to the naked eye (ear), and operate largely out of awareness. The analysis of different modalities of communication operates like the stains lighting up different coexisting structures under the microscope. Using this approach we discovered that maternal depression affected facial expression and gaze direction in opposite ways: mothers and infants were vigilant to each other’s facial shifts, but withdrawn from monitoring each other’s visual availability, as we describe in detail below. The discoveries made with this research have tremendous implications for early intervention in mother–infant communication disturbances. Both embodying the unusual combination of researcher and psychoanalyst, Beebe and Jaffe are intensely concerned with translating research findings into clinical interventions. Beebe offers a videoassisted therapeutic consultation to mother–infant pairs presenting for treatment, observing them in the same split-screen, videotaping format used for research pairs, and using research findings to guide treatment interventions. A therapeutic viewing of the videotape with the parent is the springboard for the treatment. We will illustrate this approach with