by António Mendes Pedro*
Universidade Autónoma de Lisboa, Portugal
*António Mendes Pedro, PhD, is a Professor of Psychology at Universidade Autónoma de Lisboa and a Visiting Professor at Université Paris XIII. He is also the Director of Center Kairos, in Lisbon, Portugal (Psychology, Psychosomatic and Philosophy) and a founding member of the Portuguese Association of Psychoanalysis and Psychoanalytical Psychotherapy.
The article is based on the communication presented at the 22nd Annual International Forum for Psychoanalytic Education (IFPE) Interdisciplinary Conference, in Ft. Lauderdale, FL, November 11th 2011.
Adress correspondence to: António Mendes Pedro, Universidade Autónoma de Lisboa, Palácio dos Condes do Redondo, Rua de Santa Marta, nº 56 – 1169-023 Lisboa; E-mail: firstname.lastname@example.org; Phone: +351 96 38 52 164.
The bonding, the infra-symbolic mental representation, and the intentionality are at the core of body/mind unity of relational style since one’s earliest age, and of the relational change process. Rhythm analysis of interactions shows that, when caregivers have difficulty in empathizing with their babies and in shielding them from stress and fear, babies cannot anticipate what is going to happen in the relation, thus, subjecting themselves to a state of permanent alertness that will depress them and make them immune-vulnerable. In order for it to effect a change on relational style and on mind/body dialogue, the psychoanalytic encounter makes its discoveries on the origins of human communication. As such, psychoanalysis, in accounting for its own transformations, becomes kreía-analysis and its corresponding epistemic domain, borrowing from the classic Greek, can be defined as philokreía, which is to say, as ‘friend of intimate relations’.
Keywords: Representation; Intentionality; Bonding; Superficial relation; Predictability; Shared mental states; Mind/body unity; Philokreía.
In psychoanalysis, when we look at the psychic and somatic reality through the lens of abstract and generalizing concepts, such as ‘poor ghosts’, ‘operative thinking’, ‘conflictual impasse’, ‘rigid defenses”, ‘alexithymia’, or ‘type A (B, C or D) personalities’, we should not lose sight of the fact that the deepest level of human experience is that of relational exchanges, as experienced in the concrete relationships of our day-to-day lives.
Differently from primates, human babies, in face-to-face communication, lose themselves in the eyes and irises of their mothers, as, later in life, those enamored lose themselves in the sweet gaze of their lovers. Human beings have developed the ability of attributing to others a mental life similar to one’s own, so that intersubjective life is, in fact, the condition proper of human nature and of mind/body unity.
In intersubjective relations, words are an integral part of one’s actions’ inventory. In our personal relationships, there are more or less colored exchanges where form and moment are as important as, if not more important than, the content of the message itself. A parent that, in a thought-through and explicit manner, proclaims via speech act their immense love for their baby may, via non-verbal and implicit contradictory action (e.g., placing themselves inadequately, failing to make eye-contact with the baby, or addressing them in an aggressive tone) express their rejection of that same baby! Body/mind unity involves thoughts and feelings, body movements and concrete actions.
This constructivist concept that takes development, psychoanalysis, and discovery of meaning as emerging from relational interactive systems in context, breaks with the Freudian drive-oriented and intrapsychic positivistic model, according to which thought and affection, mentalization, are by-products of action inhibition. Where human beings are concerned, the determining component will be the background music of intersubjective communication, i.e., the permanent and positive relationships between self and other that consist in discrete actions lived daily.
Representation, intentionality and bonding in the baby´s relational experience
Even if the attachment model is not sufficiently relational and intersubjective, it stands as an excellent starting point in examining early life. Let us consider the famous lab procedure, devised by Mary Ainsworth, known as ‘strange situation’. A twelve-month old baby is twice confronted with the stress of being separated from, and then reunited with, their mother. How is it that, already at that age, a baby develops response strategies as complex as that of the avoiding baby, who does not face his mother or moves towards her when, post-separation, she walks towards him, as if being apart and being rejoined had no import at all, while, at the same time, that same baby shows rather elevated physiological levels of the stress hormone cortisol?
The answer is that such twelve-month old baby has already learned to react with avoidance; not because they are unable to re-experience vital affections and feelings of rejection, but because they have already incorporated the representation of their mother’s aversion and disconnectedness. In other words, the baby has already physically integrated and mentally established the representation of avoidance.
Due to their exceptional abilities to engage in subjective exchanges with others, children, from a very early age, acquire and incorporate their caregivers’ ways of behaving. When caregivers are sensitive to signs and receptive in their responses, the child will react to them with confidence; on the contrary, when caregivers are too intense or intent on controlling their child, the child will show withdrawal from the relation.
Early interactions between babies and their parents bring forth three scientific hypotheses of interest to the issue of mind/body unity and the relational life:
1 – We have to stop considering mental representation as something that is reduced to the symbolic. Mental representation includes representations of objects, images, words, symbols and concepts, as proposed by Freud, but also sequence of events, motivations and objectives, as argued by Stern, and representations of affections, as claimed by Greene. More than a mere content, representation is a process not exclusively based on verbal language; it consists in an implicit and infra-symbolic knowledge, developed since birth, based on actions and emotions. Also, the meaning of action is not, itself, necessarily accessible to symbolic thought; it rather reveals itself mostly in a non-verbal manner, and in between the lines of verbal contents.
Symbolic representations are thus, deeply seeded in infra-verbal implicit knowledge generated in the context of significant interaction, and such implicit knowledge is a part of the vast realm of the Unconscious.
2 – From the age of two to three months, babies begin to perceive affections and actions as intentions, and, accordingly, they develop a remarkable ability to discover the meaning of human actions. A baby will always look for those intentions underlying the behaviors of those who are closest to him/her. The baby learns them, not as contents, as Kleinians used to believe, rather as forms with purposes and motivations, as baby specialists have found out.
The belief that there can be no meaning outside of the symbolic is thus, in our view, also false. Babies do not reflect on significations; they act on the basis of significations generated in them by the actions of their caregivers, with no thought process at all.
Intentionality and meaning constitute, therefore, the basic element of mind/body unity, as confirmed by brain imagery that identifies the existence of intentionality centers activated in the brain, and further corroborated by Rizolatti, in the neuroscientific finding of mirror-neurons that show how we partake in the mental states of those with whom we interact.
The most authentic levels of meaning are not inferred from psychological, religious or ideological theories; they stem from relationships experienced in the present. In the end, it will be those implicit infra-verbal representations that will bring about the meaning of verbal symbolic representations. When one person declares their love for another, the latter will look for confirmation of the words spoken in the eyes and in the touch of the former.
Implicit representation and intentionality are the heart and mind of early relationships, of love relationships, of friendships or of therapeutic rapports. So much so that, in the very experience of empathy, where we genuinely put ourselves in someone else’s place and accept that person as the core centre of our love, the most fascinating aspect is its enactive quality, that movement of availability and creation – the bodily and emotional re-experiencing that becomes represented action. Emphatic persons are, in particular moments, spontaneously and in a relatively involuntary way, led to look each other in the eye, to touch one another, to co-re-sensing, to exchange little mementos, and to mutually adjust. They become capable of complementary creation, and those are the sacred moments where shifts in mind/body equilibrium take place.
3–The third hypothesis we are led to states the anteriority and the primacy of ‘bonding’ – a concept introduced by Klaus and Kennel (1976) – in the development of children’s attachment patterns. We here dispute the view of those who ascribe to babies’ temperament the responsibility for the quality of their parents’ love. In like manner, we a fortiori oppose those psychotherapists for whom the success of psychoanalysis is contingent on the quality of the patient and on the patient’s so-called negative therapeutic reactions. What we have here are different instances of one same mistaken notion – that of an alleged symmetry in relationships – that also leads teachers to complain about students, or men to complain about women.
Our view on rhythm analysis is that it is the parent’s constantly positive emotional involvement, manifest in providing protection, affection and joy, favors synchronization of biological rhythms and the baby’s emotional self-regulation. These, in turn, allow babies to develop self-identification and to love their parents in return. A positive bonding with their parents is the starting point for the baby’s development of harmonious communication and affective harmonization. The emergence of behavioral patterns within interactions is based on the framing principle and on face-to-face tie. Those patterns are brought about by moment by moment sharing, synchronization of emotions and bodily states, mutual resonance, and spontaneous emotional communication. Building upon their parents’ vital affections, babies develop their proto-narrative envelope and their creative attachments, for babies are, truly, the great creators.
If the bonding is negatively charged (when parents act aggressively, with sadness or resentment towards the baby), or not clear (when they are possessive, indifferent or fearful), the baby will not be able to regulate their own emotions, particularly their fears. Now, if, as we learn from Damásio, emotion is the highest direct expression of bio-regulation, then interactive asynchrony will lead to an enduring and highly elevated stress response.
We share, with Gunnar, the awareness of the fact that babies present a highly elevated response to stress at birth, and that their cortisol decrease throughout the first year of life will be contingent on the quality of the bonding, which constitutes a model that, set during childhood, will remain in adult life. This pattern, linked to vital affections, may even prevail over genetic predisposition – we see it when an anxious child stops showing signs of elevated stress in the presence of an autonomous person. Fear, undoubtedly the most frequent emotion amid human beings, is regulated by intersubjective communication. The threat comes less from stressors external to the relationship, like specific life events, than from the caregiver’s inability to protect the baby from fear in the baby’s day-to-day life.
Clinical observation of interactions between a non-empathic mother and her depressed and sick baby
The first eighteen minutes of interactions that took place between Laura – a five-month old baby girl admitted ten days before to a pediatric hospital with severe acute gastroenteritis – and her mother, a depressed young woman, during a session with a psychotherapist, were videotaped and later commented by Fivaz, Bydlowski, Maury and Stern in La recherche clinique en psychopathologie. The following lines are a personal look on that published document; a reading that focuses particularly on rhythm analysis, assessing four variables: (i) movements through the room; (ii) how the baby is hold; (iii) facial orientations and looks exchanged; (iv) taking the initiative to speak and tone of voice.
The mother enters the exam room carrying the baby bottle in one hand and the baby in her arms. She says she is afraid of losing her daughter; she starts feeding her. She holds the baby with a lifted arm, so that mother and daughter are connected by a reciprocal look, in a face-to-face tie. The therapist is a third participant in the overall interaction. This is the first relational pattern.
The therapist says a few words to the mother. She lets the arm that is supporting little Laura drop a little, which results in the baby being tilted back to a horizontal position. In this second pattern, while the mother is looking at her baby, the contact between them holds; however, when the mother turns her eyes to the therapist, the possibility of framing is suspended, and the baby stops looking at her mother. When the mother returns her eyes to the child, her gaze is no longer there.
In this situation, the baby’s gaze is completely directed outwards, outside the relationship. The therapist steps aside, so as to facilitate the contact between mother and baby, but the mother remains passive, incapable of making any movement that will re-establish eye-contact with her daughter; the arm that supports the baby is kept at a horizontal angle. In this third pattern, Laura’s position is that of a newborn, which precludes any kind of framing.
The mother then initiates a long conversation during which she will keep her eyes turned to the therapist, leaving the baby out of the three-party alliance. The mother speaks of the vicissitudes of her life that include more than one miscarriage and a few situations of abandonment, that latest of which by Laura’s genitor. She lives isolated, alone with her daughter. The therapist gets closer to the baby and, from time to time, whispers a few words in the baby’s direction. A fourth relational pattern emerges, more in line to the one that we would be expecting to see with a three-month-old baby.
Laura takes a long look towards the therapist who addresses her, telling her that she is a ‘rather serious baby’. Turning her head sideways, so as to face her daughter, the mother says, in an altered voice, that her daughter ‘never smiles’. A fifth pattern has thus emerged.
The baby manifests her desire to move into a seating position, stirring her legs and head. The mother understands the signs and holds her daughter in an upright position, seating her in her lap. This new pattern marks the shift towards a dyad where the baby is also a participant. Laura looks at her mother’s hands and then directs her gaze in the direction of the therapist. She smiles to the therapist and, for a moment, an exchange of smiles among the three of them occurs. After 18 minutes of interaction, a seventh pattern is set.
The relationship, the neuro-biology and the somatic
Laura’s mother’s bonding is mostly of a negative quality, where feelings of sadness, resentment, disappointment and rejection manifest as predominant. However, emotions of an unclear nature, such as fear, indifference and possession also assume a conspicuous presence in the relationship.
A further significant aspect in this dyad’s relationship is the multiplicity of relational patterns that abruptly emerge and disappear – imprecise, with no fluidity or clear-cut transition points between the states of being alone, being with someone, and being in the presence of a third person. Accordingly, in face of one same event that happens repeatedly, the baby is unable to acquire emotional regularities or to perceive invariants and predictabilities regarding how to behave – how to be – with another person. The baby’s vital affections (Langer), her baseline emotions (Damásio), are, consequently, those of a great insecurity and discomfort, accompanied by primal emotions, like that of a great fear.
For purposes of intersubjective communication, that baby is forced to develop four schemes of mental representation and intentionality:
– She is insufficiently stimulated, and she is stimulated only through facial expression, for she is with a very depressed mother;
– She is occasionally stimulated by a mother who is sometimes physically close to her, but with a diffused investment;
– She is invaded by a sometimes intrusive mother who misreads the baby’s signs;
– She is a baby who is looked at and provided with adequate lap support by a mother who is truly there for her in a peripheral and innate manner.
In her representations and intentionality, such mother interprets her daughter as a baby who is not rewarding, not enriching, and in face of whom she anticipates losses. This mother’s actions evidence, above all, that her ability to share the mental state caused by the negative affection experienced by her daughter is inhibited. In her representations and intentionality, this mother shows no empathy for her baby’s pain. We can hypothesize what a magnetic resonance of this mother would show: activation in the right insula, lack of activation in the right striatum, diminished release of oxytocin and dopamine – a clear picture of mutually re-shaping interactions between the relationship and the brain.
For the baby, this entails a micro-depression and a fragmentation of representations which stabilization cannot but take the form of a superficial representation of relational exchanges. Interactions between mother and daughter are tolerable in those moments where both of them are engaged in something else – watching television, for instance. If, however, they experience the intervention of a positive bonding from a third party, stress and fear decrease significantly, and may lead to relational well-being. Such implicit fashion of relational knowledge, one where inconstant vital affections are predominant, allows us to predict that, in a later stage of her life, Laura will become a woman incapable of self-regulation and with a background of depression. We can hypothesize that she will tend to establish poor and precarious love relationships.
At the present moment, the intentional meaning of non-verbal actions testify to the mother’s inability to regulate her baby’s vital affections and fears, both in her day-to-day life and in continuity. One would be justified in saying that that baby is forced to develop a permanent state of alertness in response to her mother’s different patterns, so as not to lose her once and for all – this is something that involves keeping a high level of stress, combined with immune system’s vulnerability, which plays here a key role to the vital process.
The psychoanalytic intimate encounter
1 – Following the classical perspective, the most significant motivation in a relation is libido, the sexual drive, and the power status within the group. The focus of the analysis developed by the pair will therefore be on intrapsychic conflicts, ghosts and defense mechanisms. The psychoanalytic relation will be centered on recollection of childhood episodes and on the analysis of transference-countertransference processes.
Following the view advocated by contemporary psychoanalysis, the deepest level of human experience is that of the intersubjective experience between two equals, in their unique condition as human, far too human, beings. Here, the analytical relation focuses on seemingly insignificant and everyday life trivial events, and is turned towards the future. Special attention is given to body movements, to the ups and downs of the feelings experienced, and to baseline emotions. Careful attention is paid to every small narrative of little substance, to every little procedural detail. All this ends up constituting the set of elements that lead to affective harmonization – constituting, in fact, the building blocks of mind/body unity and of human life.
2 – The psychoanalytical relation, from its inception, is carried by the psychotherapist’s consistently positive bonding who, like a maestro surrounded by background music, conducts the orchestra from a slightly forward position, building a new rapport, opposite to that of transference relations.
3 – The psychoanalyst uses interpretation mainly to prevent the setting in of transference neurosis, conducive to the resetting of pathologies within the analytic dyad, and thus that of bringing to a halt the risk of perpetuating unending analysis and converting a person with symptoms into an asymptomatic caricatural personality. Interpreting consists in rendering the implicit explicit, in disassembling and making connections between present-day pathological relations that re-enact pathological patterns of early childhood.
4 – The psychoanalyst has ceased to be that person who is supposed to know; they are now a person who loves, and thinks with, the patient, in a complementary way. They are now that person who, through their unconditional parent-like love – ‘Every beloved object is the centre of a paradise’ –, promotes the development of their patients’ assisted self-analysis.
Thus emerges the New Relation, a fundamental concept developed by Coimbra de Matos: A relation that is authentic and spontaneous, with emotional sharing, based on positive affections, increasingly more permanent and fascinating, where new regular and implicit representations of human contact, notably intimacy, gradually begin to form.
5 – By way of progressive transposition, this new relational style will develop incrementally in the patient’s daily relationships – in their love life, in their relationship with their parents, with their friends, with their colleagues or co-workers. A successful psychoanalysis will thus be that which touches the core of the human being, the mind/body core unity – that which changes the relational style.
6 – The intellectual persuasion in psychoanalysis privileges the construction of coherent narratives to the detriment of actions themselves. Following the perspective we endorse, that of action, the analyst would act like parents whose baby is just born do, viz., from the first moment of the encounter onwards, the analyst is to act through interpretation and, above all, to ‘enact’, by co-creating a new way of being-in-relation.
7 – The study of human relations, their genesis, development, vicissitudes and transformation, is currently the focus of psychoanalytical research and clinical practice. The relational psychoanalysis trend has thus been established.
In order to underline the emphasis on research and conceptualization of interpersonal, intersubjective and interactive relationships, we, together with Coimbra de Matos, have put forward the notion of kreía-analysis which, strictu sensu, means ‘analysis of intimate relations’. However, we jointly propose the preferred designation of philokreías, which is obtained from the greek Filos (= friend) plus kreía (= intimate human relations). This materializes a new concept with inaugural potentiality. In fact, philokreía designates one who is a friend of human relations. It further involves the verb kroamai (= to relate with), thus conveying the sense of relationship, of a search for an intimate proximity. We propose that the study of human relations, in their intimacy and reciprocity, subjectivity and intersubjectivity, be acknowledged as the epistemic domain of contemporary psychoanalysis – the scientific domain of philokreía.
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