What I am asking is: how do we, the therapists, do this without falling into language confusion, role-reversal and even destruction in terms of keeping strict boundaries? This is complex and difficult work, but worth the effort and we should not recoil from it in the name of therapeutic conservatism and the threat of ethical deterioration. This complexity requires creativity in therapy as well as self-examination of boundaries and space. There will be those who prefer to avoid this kind of closeness. But I wish to remember and remind that there is a difference between a destructive breach of boundaries and expanding borders in a flexible and controlled manner. The responsibility of the therapist is first and foremost to differentiate between invasive intimacy that can be destructive, and a healthy closeness that allows healing in a space of honest dialogue with mutuality awareness. Yet and above all, this is not to contradict the fact that the responsibility of this kind of introspection and awareness is on the therapist’s shoulders.
Development of the Intersubjective approach compared to Classical theories
The lesser known Freud can be seen as somewhat Intersubjective (from About Narcissism Freud 1914, Mourning and Melancholy, 1917 in Govrin, A, 2004). However, he perceived the subjective as a human constraint. He believed that it hurts our ability to recognize reality. From here, we can surmise, according to Freud, that healthy development is an act of reducing the subjective. This, in turn, leads to a subjective pathology that the individual forces upon himself. According to Freud, an individual with a narcissistic disorder sees himself in the other and acts towards the other as he wishes that others acted toward him. Freud made a distinction between the inner and the outer–between an internal experience of accepting the other as a separate entity outside of one’s self.
Freud states that the more the external is influenced by the internal (the individual subject) then “there is no more separation – there is more pathology”. According to Freud, reality needs to be more powerful than the internal world of the individual, so that one can be free of that which has been imposed upon him by the outside world. Freud identified depression as the internal truth of the patient, and not the real truth of the external world. There is actually another truth in addition to external reality. It is only the internal truth, according to Freud, that interferes with therapy.
The intersubjective approach and the relational theory that came after it developed in the US. According to Atwood (from Govrin. 2004a), human beings are complex constructs and pathologies: there is a reciprocal relationship between two worlds – that of the patient and that of the therapist. Objective reality is less important. Reality is a product of society and it is imperative to understand it. What matters is that internal reality tends to blur the border between the internal and external. Subjective reality is what matters. The therapist influences and is in turn influenced himself by all that is going on in the sessions.
With regard to the human suffering question, Mitchel and Aron (2013 p.10) claim that Freud related it to the conflict between impulse and unconscious wishes and the Superego. Conversely, those with a relational orientation understand suffering as dissociation between split and fragmented self.
In his interpretation of developmental theories about mother-child developments, Sandler (1985 in Govrin, 2004) proposes that self-establishment can only grow within the confines of a reciprocal parent-child relationship. The great developmental achievement of the child is to be able to experience himself as real by attacking his parents. The child develops a sense of reality through the attack: relationship-connection-approval from his parents is how he learns what is real. Therefore, in a sense, it is not the real event that determines the experience, but his parent’s reaction, which either allows or destroys the experience. An empathetic reaction is the key.
