Clinical Interaction and the Analysis of Meaning: A New Psychoanalytic Theory

by Theo L. Dorpat, Michael L. Miller

Clinical Interaction and the Analysis of Meaning evinces a therapeutic vitality all too rare in works of theory. Rather than fleeing from the insights of other disciplines, Dorpat and Miller discover in recent research confirmation of the possibilities of psychoanalytic treatment. In Section I, "Critique of Classical Theory," Dorpat proposes a radical revision of the notion of primary process consonant with contemporary cognitive science. Such a revised conception not only enlarges our understanding of the analytic process; it also provides analysis with a conceptual language that can articulate meaningful connections with a growing body of empirical research about the development and nature of human cognition. In Section II, "Interactional Theory," Miller reverses the direction of inquiry. He begins with the literature on cognitive development and functioning, and proceeds to mine it for concepts relevant to the clinical process. He shows how a revised understanding of the operation of cognition and affect can impart new meaning to basic clinical concepts such as resistance, transference, and level of psychopathology. In Section III, "Applications and Exemplifications," Dorpat concludes this exemplary collaboration by exploring select topics from the standpoint of his and Miller's new psychoanalytic theory. At the heart of the authors' endeavor it "meaning analysis," a concept that integrates an up-to-date model of human information processing with the traditional goals of psychoanalysis. The patient approaches the clinical encounter, they argue, with cognitive-affective schemas that are the accumulatice product of his life experience to date; the manifold meanings ascribed to the clinical interaction must be understood as the product of these schemas rather than as distortions deriving from unconscious, drive-related fantasies. The therapist's goal is to make the patient's meaning-making conscious and thus available for introspection.

336 pages, Hardcover

First published August 1, 1992

About the author

Theo L. Dorpat is Clinical Professor of Psychiatry, University of Washington School of Medicine.

Reviews

[Michael Kulyk · Rating 5 out of 5]

Very well written with clear explanations. The authors offer the reader an alternate view of primary process mentation basing their view on findings from developmental psychology, especially Piaget's theory of cognitive development, and neurophysiology. The authors reject Freud's emphasis on unconscious fantasy as being central for understanding psychopathology and instead replace this with that of unconscious pathogenic beliefs that were based on real pathogenic relationships.
Trauma is given a central role in the author's understanding of psychopathology. Trauma being defined as being experience that cannot be assimilated to organizing and conceptual schema making up a person's sense of identity. In fact the author's cogently argue that experience that is mildly discordant with organizing and conceptual schema provides the basis for narrative metacommunications within the psychoanalytic frame, including the metacommunications of phenomena such as dreams, symptoms and resistance.
I have to say that this is one of the few books that I've read that deserves to be called simply brilliant. It really brought together so many threads from a number of different perspectives including classical psychoanalysis, object relations theory, Kohut's psychology of the self, the developmental psychology of Piaget as well as Daniel Stern and Gregory Bateson's double bind theory including the work of Watzlawick, Jackson, Haley etc, I wish I read the book years ago.