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Finally relegating simple cause-and-effect thinking to a long overdue
resting place, William J. Coburn, Ph.D. headlined Panel II of the 2007
conference with his paper, "Complexity Theory Made Easy." Case
presentations by Drs. Amy Eldridge and Joye Weisel-Barth offered
differing clinical sensibilities highlighting the qualities and
perspectives that complexity theory can bring to our psychoanalytic
work. Estelle Shane further illuminated the nuances of this approach in
her integrative discussion of the panel.
To the appreciation of all, Bill augmented his thoughtful review of
complexity theory with a creative, compelling, and often amusing,
powerpoint presentation depicting the key elements of the theory. A
placid group of llamas illustrated an underpinning precept pointing out
that although an individual (llama or human being, as the case may be)
may be considered a complex system in its own right, in the more
contextualist world of relationships, each comprises a reciprocally
organizing component of the larger system within which it is embedded.
Demonstrating the often powerful short-range effect that interactions
can have with an unforgettable snapshot of two babies pointing at one
another ensconced in backpacks on their respective parents' backs,
followed by the juxtaposition of the delicate flutter of butterfly wings
with the gathering force of a tornado halfway across the world, Bill
provided us a with a multi-model experience of complexity theory's many
concepts.
Bill's presentation brought the familiar world of psychoanalytic
thinking to bear on terms largely foreign to our field, and, in so
doing, added new levels of description to our clinical understandings,
expanding on the ways in which we can think and work. Many of those
terms are words that hold within them aspects of the crucial attitudes
and presuppositions Bill aptly attributes to the theory as informing the
therapist's stance toward the patient and the therapeutic relationship
itself. Elaborating on the mathematically-derived term
"incompressibility," for example, Bill ultimately describes the ways in
which each individual's experiential world comprises its own shortest
description. In other words, lived, subjective experience can no longer
be considered reducible to theoretical concepts, diagnostic categories,
or any construct that provides the clinician with an illusion of
certainty about the patient or the therapeutic process. As unsettling
as this may be, it is also one of the great beauties of a complexity
sensibility, as the cases of both Joye and Amy demonstrated. Permission
to tolerate the seemingly unending uncertainty that accompanies so many
treatments, and the belief that change can emerge in a nonlinear way,
are among the great gifts of this perspective.
The challenge in reviewing this panel lies in the incompressibility
of Bill's presentation, together with the poignant and often
heart-wrenching cases included in the panel. Experiencing the poetic
imagery of the paper and slide show, and the ways in which each case was
illuminated by them, and illuminated each other, enhancing still further
Bill's presentation, was its own shortest description. Nonetheless,
employing another complexity systems term more familiar to us, I will
attempt to frame a number of elements from this panel that struck me as
significantly relevant and clinically useful.
Expanding on the relatively recent contextualist emphasis on the
essential embeddedness of psychological experience in interpenetrating
subjective worlds (Stolorow, Atwood and Brandshaft, 1994), the
application of systems thinking to psychoanalysis provides us with
process language that eliminates linear directionality in construing
psychoanalytic action in favor of a sensibility of emergence. The cases
of both Dr. Amy Eldridge and Dr. Joye Weisel-Barth depict such an
emergence of relatedness and change that could not have been predicted
in a linear fashion, though both were working in a manner that
emphasized deep empathic immersion in the experiential world of their
patient.
Amy adhered to a customary self psychological stance with "Lisa",
empathically developing understanding, and then explicating that
understanding, together with connections between Lisa's feelings of
shame and defectiveness and her childhood relational experiences. The
treatment may be viewed as fostering the kind of new relationship that
can compensate for deficits in Lisa's self structure. But what
explanation can self psychology give to the power of Amy's seemingly
simple statement that what Lisa needs in order to heal is available only
in a relational context? Complexity theory provides the additional
sensibility of comfort with not knowing, and not needing to know, where
exactly the impetus for change lies within the matrix of each
participant's individual history, the history of the therapeutic couple,
and the dyad's current mode of relating. All of these factors, and
more, contributed elements to the interaction that generated the
emergence, in a non-predictable manner, of a seemingly isolated moment
encompassing Lisa's spontaneous ability to embrace the hope contained in
her relationship with her analyst.
Joye's work with "Katherine", an exceedingly traumatized woman
struggling to survive an endless series of ongoing traumas, of necessity
had to encompass a stance on the analyst's part that relinquished any
dependence on traditional theory. In "waving bye-bye to neutrality,"
Joye opened the treatment to an authentic relational encounter between
two people stretched to their emotional limits with one another. This
work highlights the struggle in any treatment situation to contend with
the location of the dyad along a continuum between fluidity and
randomness, on one hand, and stability and order, on the other.
Complexity theory posits the potential for change to be contingent on
the system's proximity to the "tipping point," that place in which there
is enough randomness for perturbations to the system to generate change,
and sufficient stability to support that change. Though the story of
this 25-year-long experience is far from over, Joye's capacity to hold
on to Katherine's humanity throughout the ordeal underlies her ability
to maximize the advantage of proximity to tipping points reached at
various times in the treatment.
In conclusion, I have attempted to highlight, or frame, just a few of
the invaluable concepts comprising complexity theory and their relevance
to the case material presented and our work as a whole. I was obliged to
bypass others, thereby doing less than justice to the panel as a whole,
an incompressible entity, as I mentioned above. However, I find much
comfort and hope in Bill's summation of this incredibly... well, complex,
topic, in which he underscored a key element of this theory, and
valuable truth about human nature. To wit: "there is more to the
patient, and to us, than what we know thus far: there is more to us
than our history, our enactments, and our current, arrived-at
conclusions; there is more to us than we can ever know."
Thank you Bill, Amy, Joye, and Estelle, for gifting us all with the
emergence of this beautiful, seemlessly choreographed, elaboration of a
most viable and invaluable new perspective on our unfolding encounters
with our patients.
Nancy VanDerHeide, Psy.D., Ph.D., is
President-elect at the Institute of Contemporary Psychoanalysis in Los
Angeles where she also teaches and is a training and supervising
analyst. She is Associate Editor for the International Journal of
Psychoanalytic Self Psychology and Assistant Editor for Psychoanalytic
Dialogues. She has a private practice in Beverly Hills,
CA.
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