Review by Gwendolyn Pla, PhD, MSW

Psychoanalytic Inquiry, Vol. 35, No. 4, May-June 2015
~Alexandra Murray Harrison, M.D., editor~

This issue is a must-read for all who are interested in relational psychoanalysis.  The contributors who presented eight articles were Beatrice Beebe and Frank Lachmann;  Steven H. Cooper; Peter Fonagy; Kay M. Long, Lindsay Clarkson, Shelly Rockwell, and Lynne Zeavin, ; Joseph D. Lichtenberg;  Colwyn Trevarthen,; Gisele Apter; and J. Timothy Davis.  A prologue and an epilogue were contributed by the editor, Alexandra Murray Harrison.

Six of the articles were theoretical.  The articles by Apter and Davis included clinical cases. All of the writers discussed the importance of the implicit processes in each dyad concerning the process of mutual regulation and therapeutic action.

Beebe and Lachman discussed the importance of Tronick’s theory of mutual regulation and the importance of repair following disruption.

Cooper discusses Tronick‘s point that change processes must be determined and explored within each dyad.    Change is not so much a matter of theory and techniques but the unique relationship in each dyad.

Fonagy discussed Tronick’s work on the basis of attachment theory. He finds that there is a synergy between attachment processes and “the development of the child’s ability to understand interpersonal behavior in terms of mental states” (p. 359). It’s not all just “cut and dried.” Fonagy holds a more nuanced view about the child’s capacity to reflect on interpersonal relationships with others.

Long et al. discussed the differences between the Kleinian perspective and that of the portion of Tronick’s model that is related to the co-creation of meaning by the dyad. Long points out that the Kleinian perspective is organized around the analyst’s interpretation.  This would appear markedly different from Tronick’s perspective on the dyad’s activities of making meaning together.

Lichtenberg, in consideration of a developmental perspective, found similarities between Tronick’s formulations, and some, but not all, elements of motivational systems theory.  He suggests that  co-creation of meaning can be found in the attachment, affiliative, and caregiving systems, but “meanings mean a kaleidoscope of different  affects, intentions, and goals when applied to the regulation of physiological requirements … and a complex range of  reactions to situations and states that trigger aversive responses; and the diversity and unpredictability of sensuality and sexuality” (p. 394).

Trevarthen reviewed multidisciplinary research using observation of mother and babies that led to intersubjectivity, mutual regulation, and social connectedness,

Although very similar in outlook, he points out that he and Tronick have taken different paths to a common understanding.  At the same time, Trevarthen is mildly critical of Tronick, suggesting that his theory is abstract like the models physicists use. He also objects to Tronick’s characterization of meaning making as a messy process.

Apter’s clinical material is discussed from the perspective of how Tronick’s mutual regulation model is helpful to mothers and children and discusses how neither child therapy nor parent therapy in isolation is helpful in meeting the needs of the dyad.  He discusses the importance of promoting the dyadic engagement for both mother and baby.

Davis reviewed Tronick’s Dyadic Expansion of Consciousness Model.  He provided case material from the treatment of a nine year old boy and pointed out that meaning-making from Tronick’s point of view can often include interventions that are typically considered non-analytic, such as parent work, work with teachers and schools, and occupational therapy.  Davis argues that this broader approach helps a patient have a greater understanding of himself and his world.