Self Creation: Psychoanalytic Therapy and the Art of the Possible

by Frank Summers

"Insight" and "Change." The problematic relationship between these two concepts, to which the reality of psychoanalytic patients who fully understand maladaptive patterns without being able to change them attests, has dogged psychoanalysis for a century. Building on the integrative object relations model set forth in Transcending the Self (1999), Frank Summers turns to Winnicott's notion of "potential space" in order to elaborate a fresh clinical approach for transforming insight into new ways of being and relating. For Summers, understanding occurs within transference space, but the latter must be translated into potential space if insight is to give rise to change in the world outside the consulting room. Within potential space, Summers holds, the analyst's task shifts from understanding the present to aiding and abetting the patient in creating a new future. This means that the analyst must draw on her hard-won understanding of the patient to construct a vision of who the patient can become. Lasting therapeutic change grows out of the analyst's and patient's collaboration in developing new possibilities of being that draw on the patient's affective predispositions and buried aspects of self.In the second half of the book, Summers applies this model of therapeutic action to common clinical syndromes revolving around depression, narcissistic injuries, somatic symptoms, and internalized bad objects. Here we find vivid documentation of specific clinical strategies in which the therapeutic use of potential space gives rise to new ways of being and relating which, in turn, anchor the creation of a new sense of self.

300 pages, Kindle Edition

First published February 24, 2005

Reviews

[Hanan AL-Raddadi · Rating 5 out of 5]

Starting my second book by Frank Summers, I knew that understanding is a given. My task, as a reader, became one of creating something from that understanding. Although intended to be a contribution to psychoanalytical theory, the premise of the book extends beyond that.
In clear cohesive language, Summers explain why insight, while an intrinsic part in the clinical process, does not lead directly to change in people’s lives. Building on Winnicott’s concept of potential space, he proposes a new clinical strategy that activates the patient’s dormant potential. This approach gives the patient a more active position rather than simply absorbing interpretations or internalizing the analytic relationship. Summers believes that to understand the patient's present, the analyst must comprehend how the patient perceives the future and how the present relates to that perception. To help the patient build a future they can achieve, the therapist needs to ponder a vision of who the patient can be.
Rich in clinical materials, the book enhances the meaning of the therapeutic action and brings to light what is often implicit in the painstaking task of working through.
Each tile this book offered became part of the mosaic that forms my own understanding of psychoanalytic theory—and for each, I am deeply grateful.

[Don · Rating 5 out of 5]

“How does therapy heal?” Those in the psychoanalytic tradition have always talked about insight leading to personal change, but, as Frank Summers points out, many in this movement have also acknowledged that sometimes insight just isn’t enough. Patients can be helped to understand why they do the things they do, but frustratingly, this doesn’t prevent many of them from still doing those things.

Insight, Summers writes, is necessary for change, but additionally, patients need the opportunity for self-creation. Insight is about the past and the present, and it is brought about by interpretation. Self-creation is about the future, and it is brought about by “potential space,” that is, the therapist encouraging the patient to explore their longings and potential and to experiment with new ways of being.

Summers supports his ideas with findings from infant research and texts by several leading object relations theorists, mostly notably Donald Winnicott. I, for one, find myself convinced by pretty much everything he writes. Moreover, his prose is elegant, his case studies relevant, and for me at least, his treatment suggestions for those with attachments to bad objects and narcissistic injuries are game-changers.