Sunday, June 24, 2012

Hyman Spotnitz - The Maturational Interpretation

Editors Note: Hyman Spotnitz is the founder of the school of Modern Psychoanalysis

"The growth of understanding about the curative factors in analytic psychotherapy is reflected in changing emphases in interpretation. It was originally thought that what healed a person was the recall of memories. Treatment was then regarded as incomplete unless, in Freud's words, "all obstacles in the case are explained, the gaps in memory are filled out, and the original occasions of the repressions discovered." When it became evident that the memories were less important than that which prevented their recall, interpretations were made to overcome these repressive forces, manifested as resistance. Later, resistance was recognized as an important source of interpretive data because it told the story of the ego's development. Interpretations stressed the constrictive influence that resistance had exerted and the need to modify it. The analyst worked to resolve resistance in order to create more favorable psychological conditions for ego functioning. Explanations were oriented toward the integration of the ego and the acquisition of insight.

More recently, growing knowledge of the communication function of resistance has stimulated other approaches to interpretation. As yet, these have not dispelled the misleading notion that therapeutic change issues primarily from objective understanding of one's behavior. In the professional literature, interpretation is still most commonly associated with such words as "call attention to," "convince," "point out," "alert," "demonstrate," "prove," "confront," and "unmask." But the use of interpretation primarily for veil-lifting purposes is waning, with the recognition that other aspects of the treatment relationship are often more significant than the development of self-understanding. The patient usually acquires self-understanding, but it is rarely the decisive factor in the case. Objective understanding of his behavior does not invariably make it easier for him to change it. Of course, the therapist has to understand what motivates the patient, but does not intervene just to transmit his insight. Scientific understanding is the raw data for therapeutic understanding; that is, some knowledge of what is going on in the patient which is conveyed to die patient if and when it will unlock the door to personality change. Instead of trying to overcome resistance by explanation the therapist uses interpretation to create the precise emotional experiences which will resolve the problems. When the analyst operates in this way insight emerges as a byproduct of the connections established between the impulses, feelings, thoughts, and memories of the patient and his words.

In many cases I find it helpful to operate on the hypothesis that interpretation is consistently employed for maturational purposes. The treatment itself is conceptualized as a growth experience. The problems which motivate a person to undergo treatment are attributable, in some degree, to inadequacies in his interchanges with the environment from conception onward. These interchanges—physiochemical and biological as well as psychological—occur with different configurations of environmental forces which, in a sense, constitute maturational teams. During infancy, mother and child form the team. When the oedipal level is reached, die child's maturational interchanges are more specifically with his family. Then the societal team takes over, and the reciprocal processes encompass an expanding circle of peers and adults.

The candidate for psychotherapy is a person who is unable to deal comfortably with the exigencies of his life because he sustained some damage in these early maturational interchanges. He commits himself to a series of supplementary interchanges with a therapeutic object because he suffers from the effects of failures, or memories of failures. Deleterious experiences with his natural objects caused fixations or arrests in growth. In attempting to cope with them, he developed maladaptations, certain repetitive patterns which drained off into circuitous processes energy that was required for maturation.

Consequently, he enters treatment with two distinctly different types of problems. One, his maturational needs were not met. Two, his maladaptation patterns prevent him from effectively assimilating the experiences that would reduce these needs. The operation of these patterns blocks maturation.

Maladaptations are not totally reversible, but it is sufficient for the analyst to intervene to loosen their compulsive grip and to nullify the effects of the original blockages. If he does this, the patient usually requires little help in obtaining and assimilating experiences that will meet his maturational needs.

In theory, therefore, the therapist does not intervene to reduce maturational needs directly; nor does he address himself to maladaptations (defenses) that do not interfere with maturation. Rather, he intervenes to lay the foundation for new growth by freeing the patient from the stranglehold of pathological maladaptations. As these patterns are aroused and reactivated in the transference relationship they are studied until the analyst understands how they were set up and why they come into play in a given situation. He relates to the patient in terms of this understanding but does not formulate it verbally to the patient unless the latter desires an explanation that will facilitate his talking and cooperative functioning. In that case, an interpretation is indicated. By and large maladaptive patterns are dealt with when they have been reactivated with sufficient intensity to be reducible."
(pp. 166-167)

Hyman Spotnitz (1966). The Maturational Interpretation. Psychoanalytic Review, Vol. 53C, pp. 166-169

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