Searching for dissociated self‐states: Relational psychoanalytic conceptualization of mind and therapeutic action

Abstract This article reviews the conceptualization of mind and therapeutic action in the relational psychoanalytic tradition. It briefly presents the history of relational psychoanalytic thinking that developed from multifaceted clinical experience that both found lacking and challenged classical theory. The review traces relational theory to interpersonal psychoanalysis, which was extended by object relations theory, self‐psychology and postmodern epistemology. The paper presents dissociation, multiplicity of self and generative enactments as hallmarks of the relational psychoanalytic tradition. Relational psychoanalysis understands the human mind as composed of horizontally organized self‐states. Health is defined as the ability to move flexibly and acceptingly between different self‐states, including those that are hated, feared, shamed and even regressive. The denial or avoidance of self‐states is conceptualized as dissociative experience, a fertile ground for cumbersome enactments in the therapeutic relationship. As for the implications for therapeutic action, relational theory contends that the therapist's dissociated self‐state significantly influences countertransference and can lead to entrenched enactments in the therapeutic process. The article discusses implications of these relational perspectives on both case conceptualization and clinical understanding of the therapeutic situation at hand in different phases of the therapeutic process. The article frequently returns to the work of Winnicott because his work both anticipated the relational turn in psychoanalysis and becomes revitalized in the light of relational theory.