05/22/2019, 11:23, Vienna  DEUTSCH / ENGLISH

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Meeting Patients

Author: Steven Stern


My recently published first book, Needed Relationships and Psychoanalytic Healing: A Holistic Relational Perspective on the Therapeutic Process (Routledge, 2017), has a complex narrative with many moving parts, but, at its core, it is about the deceptively simple idea of meeting patients: in the analytic moment, and cumulatively over time. I am not the first to use this term to characterize analytic engagement. Winnicott (e.g., 1960) wrote about analytic interaction as a “live adaptation to patients’ needs.” He understood that, for many patients, such adaptations required working outside of “standard” analytic technique, at least initially (Winnicott, 1962). More recently, the developmental researcher and theorist, Louis Sander (1962, 1995, 2008), introduced the phrase, “moments of meeting,” to characterize the collaboration and coordination between a parent and infant in service to the child’s developmental and emotional needs. Later, the Boston Change Process Study Group (D.N. Stern et al. 1998), of which Sander was a member, applied Sander’s concept to adult analytic therapy dyads.

Sander’s concept of moments of meeting is one in a matrix of related process concepts and terms he generated in his attempt to capture the movement of a good-enough mother and infant, understood as a non-linear dynamic system, toward progressively effective coordination in the service of the infant’s development. His term for this evolving coordination was relational fittedness: a joining of directionalities which was achieved through progressive specificity of recognition by the caregiver of the infant’s states and needs, and with this recognition, progressive specificity of connection—i.e., the responsive behaviors aimed at meeting the child’s emergent states and needs. Listen to Sander’s (2008) frame-by-frame narrative of, and commentary on, a now often-cited video segment taken of a member of Daniel Stern’s research team—a father holding his baby daughter in his arms—as he is talking informally with other members of the team, standing together on a lawn during a home visit with one of their neonatal subjects:...

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