The relational experience in the psychoanalytic situation
10.4081/rp.2022.703
L’Autore esplora le dimensioni psicologiche dell’esperienza relazionale nella situazione psicoanalitica, declinate secondo la tradizione della psicoanalisi interpersonale. Dopo una rassegna della letteratura sul tema, viene illustrato il pensiero originale di H. S. Sullivan sull’argomento, recuperando, attualizzandoli, i tre livelli dell’esperienza prototassico (corpo), paratassico (immagine visiva e sogno) e sintassico (linguaggio). Dopo averne descritto le quattro accezioni con cui tali forme di esperienza relazionale vengono elaborate e concepite nella letteratura psicoanalitica interpersonale, l’Autore evidenzia alcune suggestive analogie con il pensiero di Bion e di Wilma Bucci.
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Roberto Cutajar
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Ricerca Psicoanalitica
esperienza sintassica.
L’esperienza relazionale nella situazione psicoanalitica
https://www.pagepress.org/socialsciences/rp
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Scritti
2022-12-30
2022-07-01
2023-01-31
2023-01-31
Ricerca Psicoanal
Roberto Cutajar
2022/12/30
10.4081/rp.2022.703
Medico e psicoanalista, direttore della Scuola di specializzazione in psicoterapia di orientamento psicoanalitico interpersonale dell’Istituto di Psicoterapia Analitica di Firenze
2037-7851
s1
esperienza sintassica.
it
Wolstein, B. (1985). Self-knowledge through immediate experience. Contemporary Psychoanalysis, 21, 617-625.
L’esperienza relazionale nella situazione psicoanalitica
https://www.pagepress.org/socialsciences/rp/article/download/703/734
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                                    Ricerca Psicoanalitica | pISSN 1827-4625 | Year XXXIII, s1, 2022
                                                                            doi:10.4081/rp.2022.703


                                                                                        WRITINGS



The relational experience in the psychoanalytic situation

Roberto Cutajar*




                                        Is man’s ego firmly enclosed within itself and tightly




                                                              ly
                                      circumscribed within its boundaries of time and flesh?
                                               Do not many of the elements of which the ego




                                                            on
                                     is made up belong to the world before and outside him,
                                          and is not the statement that someone is absolutely

                                                e
                                                  no one else an assumption of convenience,
                                             us
                                          which conveniently overlooks all the steps through
                                          which the consciousness of the individual is united
                                          al

                                                              with the general consciousness?
                                      ci


                                                     Thomas Mann, Joseph and His Brothers
                                 er
                             m




ABSTRACT. – The author explores the psychological dimensions of relational experience in
                     om




the psychoanalytic situation, declined in accordance with the tradition of interpersonal psy-
choanalysis. After a review of the literature on the topic, H. S. Sullivan’s original thinking
on the subject is examined, retrieving and updating the three levels of experience, prototaxic
                -c




(body), parataxic (visual image and dream), and syntaxis (language). After describing the
          on




four meanings through which these forms of relational experience are elaborated and con-
ceived in the interpersonal psychoanalytic literature, the author highlights some suggestive
      N




analogies with the thinking of Bion and of Wilma Bucci.

Key words: Relationship experience; intercorporeality; prototaxic experience; parataxic
experience; syntaxis experience.




Introduction

   I was stimulated to write this article following the intention expressed by
the editorial staff of Ricerca Psicoanalitica to focus on relational move-


   *Physician and psychoanalyst, Director of the School of Specialisation in
Psychotherapy, Institute of Analytical Psychotherapy of Florence.
E-mail: robertocutajar@inwind.it
134                              Roberto Cutajar



ments in Italy by asking the main protagonists to describe a concept they
consider important characterising their theoretical approach, or by sending
a brief contribution/reflection on the topicality of relational orientations in
Italy. Personally, I have carried out my clinical activity for over thirty years
in the area of the psychoanalytic orientation of the American school of inter-
personal relations, which refers to the work and original thinking of the
American psychiatrist and psychoanalyst H. S. Sullivan. This thinking pro-
duced one of the three psychoanalytic schools with which the relational ori-
entation is usually linked (Mitchell, 1988; Greenberg & Mitchell, 1983).
These schools are: interpersonal psychoanalysis, the psychology of Self,
and the English school of objectual relations. I wish to point out that in the
context of the topic selected by the Journal as its focus, I have chosen a fer-
tile concept, one that is a harbinger of further developments, namely the




                                                            ly
concept of the experience of the relationship in the psychoanalytic situation,




                                                       on
clearly formulated by Sullivan in his works, and further explored by later
authors. Here are some of the reasons that support our choice of this impor-
tant concept:
                                                e
                                             us
- the formulation of the concept in Sullivan’s terms can still be considered
    the basis for the description of therapeutic action in interpersonally ori-
                                          al

    ented psychoanalytic psychotherapy, bearing in mind that it allows, as
                                      ci


    we will explain later, to ‘keep within’ this description the concept of the
                                  er



    unconscious, the architrave of the psychoanalytic orientation to therapy;
                              m




- Sullivan’s formulation of the concept can be considered to lie at the ori-
    gin (acknowledged or not in the specialist literature, it does not matter
                       om




    here) of some current developments in the modalities of therapeutic
    action, such as, for example, that of Wilma Bucci (Bucci, 1997; 2021) in
                   -c




    the field of long-term psychotherapy, and/or that of Lorna Benjamin
              on




    (Benjamin, 2003) in short-term interpersonal psychotherapy, thus show-
    ing itself to be an epistemologically heuristic concept and, as mentioned
           N




    above, a harbinger of possible new developments;
- Sullivan’s formulation of the concept has its original basis in Darwinian
    phylogeny, having been inspired in that formulation by the sociological
    school of early symbolic interactionism, a philosophical and cultural
    perspective headed by the Chicago sociological school. This school had
    as one of its main exponents George Herbert Mead and developed its
    concepts in the broader philosophical sphere of American pragmatism,
    which was headed by the Chicago Metaphysical Circle, one of whose
    main exponents was William James, as well as, of course, Chauncey
    Wright, the brilliant and unfortunate American philosopher who first
    proposed, when Darwin was still alive, the origin of consciousness in
    phylogeny as a Darwinian adaptation mechanism to the consequences of
    the interruption of the relationship with the environment. Commenting
    on Mead’s work, as part of his exposition of the thinkers who most influ-
                 The relational experience in the psychoanalytic situation   135



  enced him, Sullivan concurred with T. V. Smith, who pointed out that
  ‘Mead undertook more seriously than many other philosophers the task
  left by Darwin to speculative thinkers, namely the elaboration of a pure
  natural history of the psyche. He soon enunciated the thesis...that the
  psychic is a temporary feature of the empirical interaction between
  organism and environment concomitant with the interruption of that
  interaction’ (Sullivan, 1953, p. 33). Sullivan developed a concept of the
  Self, and more generally of personality development, based entirely on
  this quotation, giving primary importance in child development to the
  interruption of the child-mother bond due to the interference of the lat-
  ter’s experiences of distress;
- significantly, this Sullivanian approach appears consistent with current
  acquisitions in affective neuroscience, in particular the work of the




                                                                 ly
  Estonian-born American psychologist and neuroscientist Jaak Panksepp




                                                          on
  (Panksepp & Biven L., 2012; Panksepp & Davis, 2018). In his The
  Emotional Foundations of Personality. A neurobiological and evolution-

                                              e
  ary approach (2018) he begins to write a natural history of the psyche,
                                           us
  which Mead had hoped for a hundred years earlier. His concept of nested
  BrainMind hierarchies, on which his natural history of personality is
                                        al

  based, articulated in the three processes, primary (emotions rooted in the
                                    ci


  body), secondary (intentional learning in relation to the environment),
                              er



  and tertiary (use of language), acknowledging heuristic value to the
                         m




  three modes of the experience of interpersonal relationships formulated
  by Sullivan (appropriately updated to current conceptions), i.e. the pro-
                 om




  totaxic mode (bodily emotional experience), the parataxic mode (emo-
  tional experience formulated through symbolic but non-verbal visual
             -c




  and sound images with conscious and unconscious intentional value),
        on




  and the syntaxis mode (experience expressed and represented through
  verbal language for the social communication of internal affective states
     N




  and actions);
- yet the formulation of the concept of the experience of the relationship
  which Sullivan elaborated having in mind mainly the psychotherapeutic
  clinic while drawing inspiration from the cited Authors, finds its heuris-
  tic superimposability in the three modes of coding experience elaborated
  by Wilma Bucci, non-symbolic non-verbal (experience coded through
  bodily perceptions and sensations), symbolic non-verbal (experience
  coded through images and sounds with a symbolic non-verbal valence)
  and symbolic verbal (experience coded in a derivative way through lan-
  guage). This model, as is well known, is firmly anchored in scientific
  experimentation. We could say that Bucci’s modes of experience consti-
  tute a modern actualisation of the modes of experience developed by
  Sullivan;
- although one of the earliest criticisms of Sullivan’s thinking was that it
136                              Roberto Cutajar



  was not psychoanalytic, in particular because of its emphasis on the Self
  understood as a precipitated reflection of the evaluation, acknowledge-
  ment, approval and disapproval of others, a concept of Self that Sullivan
  took from Mead, Cooley and Baldwin (Sullivan, 1953) and thus an
  essentially social Self, the subsequent evolution of interpersonal psycho-
  analysis led to the full recovery of the concept of the unconscious within
  that of the experience of the relationship, notably in the prototaxic and
  parataxic modes of experience. In particular, Sullivan’s notions of covert
  (unconscious) relational processes, and of imaginary personifications of
  the relationship (conscious and unconscious images of the Self reflected
  by the other), have given a significant contribution and boost to the def-
  inition of an unconscious, whose contents arise in the context of the
  interpersonal relationship. The idiosyncrasy towards all that is social in




                                                           ly
  the first generation of psychoanalysts (Gill, 1994), and issues of psycho-




                                                      on
  analytic institutional politics have historically contributed to this episte-
  mological error in the evaluation of Sullivan’s thinking. Pier Francesco

                                                e
  Galli was very clear on whether or not to consider Sullivan’s thinking as
                                             us
  psychoanalytic. In the introductory note to the 1993 Italian edition of
  Sullivan’s Colloquio psichiatrico (1954), after pointing out with regard
                                          al

  to Sullivan’s work, that ‘...speaking in terms of psychotherapy and not
                                      ci


  psychoanalysis, was a way of being left alone’, he appropriately quotes
                                 er



  Enzo Codignola, who, in this regard, had already pointed out in the first
                             m




  edition of the book (1966), that ‘A certain prudence was advisable in
  delimiting the scope of Sullivan’s approach with respect to the overall
                       om




  construction of psychoanalytic theory. I believe that today the explicit
  presentation of Sullivan as a psychoanalytically oriented psychiatrist,
                   -c




  and his contribution to the circumscribed area of the treatment of psy-
              on




  chosis, reduces the dimension of the theoretical challenge launched by
  his line of thinking to the stratified stereotypes of traditional psychoan-
           N




  alytic thinking’. On the other hand, the social dimension of psychoanaly-
  sis as a clinical experience has long been widely accepted in the psycho-
  analytic mainstream, especially following the work of Bion, as Ferro
  and Civitarese authoritatively point out when they write that ‘Bion’s con-
  ception of the unconscious is based on the concept of dream-like waking
  thought and the radically social vision of the birth of the subject’
  (Civitarese & Ferro, 2018). In some ways, my contribution was inspired
  by the above passage by Codignola and one should recall that the schol-
  ars wishing to set out in this direction, for a deeper understanding of
  Sullivan’s thinking, can be counted on the fingers of one hand (Amadei,
  2001), and his seminal contribution has been all but forgotten.
- a further reason why I propose the concept of the experience of the rela-
  tionship in the interpersonal perspective is that despite its rootedness in
  Darwinian phylogeny, it frees itself from this biological rootedness in
                The relational experience in the psychoanalytic situation   137



  the secondary (parataxic experience) and tertiary (syntaxis experience)
  levels, attaining a purely cultural perspective which allows the subjec-
  tive and unique experience of the subject to be fully accounted for. Man
  retains an emotional root in phylogeny but expresses his unique subjec-
  tivity in the non-verbal and verbal symbolic experience within the cul-
  tural matrix of the relationship with the other;
- the concept of the experience of the relationship in the interpersonal
  perspective is once again congruent, albeit in a different theoretical
  framework, with other psychoanalytic models that are in vogue today,
  such as Bion’s thinking and Wilma Bucci’s thinking. I will subsequent-
  ly come back to these conceptual and clinical overlaps, although not as
  systematically as I would like to. Sullivan’s theory of interpersonal
  relations also had some interesting implications for cognitive therapy




                                                                ly
  (Safran, 1984).




                                                         on
- finally, Sullivan’s emphasis on the role of the other as the constitutive
  foundation for the Self (along with subsequent developments of this

                                             e
  concept) opens up an interesting heuristic possibility of dialogue with
                                          us
  philosophers belonging to the so-called epistemology of the relation,
  i.e. philosophical thinking that emphasises the importance of the role
                                       al

  of the other in the profound knowledge of human experience. Martin
                                   ci


  Buber is the best known, but I also have in mind Emmanuel Lévinas,
                             er



  Gabriel Marcel, Franz Rosenzweig and Ferdinand Ebner, as well as
                        m




  Ricoer, Patocka and Derrida, and also the Italian philosopher Carmine
  Di Martino, whose books Segno, gesto, parola (Di Martino, 2005) and
                 om




  Il linguaggio e la filosofia (Di Martino, 2012) examine the concept of
  experience in the light of the philosophical approaches of Merleaux-
             -c




  Ponty, Heidegger and, above all, Mead (one of the main original cul-
        on




  tural sources of Sullivan’s concept of experience in the interpersonal
  relationship, as already pointed out), opening up ample possibilities for
     N




  a heuristic dialogue with the thinking of the interpersonal psychoana-
  lytic tradition, a dialogue, for those who wish to undertake it, that is
  certainly a harbinger of new concepts and elaborative possibilities for
  clinical metapsychology. Once again, with regard to philosophical dia-
  logue, the Sullivanian notion of the process of transforming parataxi-
  cal experience (dreams, private images of the Self) into the verbal rep-
  resentation of experience (syntaxis experience of the relationship), a
  process that Wilma Bucci calls ‘referential activity’ and that Sullivan
  calls ‘consensual validation’, can lead to interesting developments in
  the dialogue with certain philosophers of language, such as John L.
  Austin, Walther J. Ong and John R. Searle. I will not discuss these
  heuristic possibilities of Sullivan’s thinking here, nevertheless it is
  important to mention them in order to highlight their innovative value
  that is still present today.
138                              Roberto Cutajar



    Having exhaustively explained the main reasons for selecting the con-
cept of experience of the relationship in the interpersonal perspective and
having exhaustively pointed out the historical rootedness of this concept in
the thinking and work of H. S. Sullivan, I will now present its main con-
stituent psychoanalytic dimensions. I will do this, however, by rereading the
concept in the light of my thirty years’ experience both in clinical practice
and in studying the specific literature on the subject, in a circular relation-
ship that has allowed me to reach an updated and modern view of the con-
cept and, in my opinion, a better vision for its use in clinical practice.


The experience of relationship: a look at interpersonal literature




                                                           ly
    In an article published in 1984, Held-Weiss pointed out that within the




                                                      on
interpersonal tradition and its later developments, the therapeutic action of
transformation and psychic change develops through the interweaving of

                                                e
two processes that mutually interconnect in the clinical practice, the cogni-
                                             us
tive-hermeneutic process and the relational-experiential process (Held-
Weiss, 1984). In the field of relational-experiential processes (a subject that
                                          al

interests us here, as mentioned in the Introduction, although we will not
                                      ci


examine the first type of process), the literature of the interpersonal tradi-
                                 er



tion has from time to time highlighted, as the therapeutic action of relational
                             m




experience in the psychoanalytic situation, the role of a new experience of
the other, for example in the work of the following authors, Fromm-
                       om




Reichmann (1950), Arieti (1974), Thompson (1950), Fiscalini (1988), the
role of a new experience of Self in Wolstein (1981, 1985), the role of a new
                   -c




experience of Self and other that is interconnected with the pathogenetic
              on




patterns of the past, in Tauber and Green (1959), Greenberg (1986),
Levenson (1972), Hoffman (1990), Bromberg (1980), Issacharoff (1979),
           N




and the role of the immediate experience (Ehrenberg, 1974), the experience
of relationship in which one reaches a point of maximum contact, affective
closeness and intimacy with the patient without a fusion, respecting the sep-
arateness and integrity of both participants. Darlene Ehrenberg’s (1992)
concept of ‘peak intimacy’ well expresses the importance and significance
of this moment of intense affective contact. Moreover, Ehrenberg’s concept
of ‘peak intimacy’ in several ways recalls Daniel Stern’s concept of ‘Now
moment’ (mutatis mutandis the conceptual framework of reference, of
course) whose transformative and therapeutic values have been clearly
described by the famous New York psychiatrist and psychoanalyst in one of
his last publications (Stern, 2004). All these authors have made an extraor-
dinary mark, especially after the 1950s, on the interpersonal psychoanalytic
literature that has studied the characteristics of the experience of the inter-
personal relationship which play a significant role in initiating and sustain-
                 The relational experience in the psychoanalytic situation   139



ing the patient’s therapeutic transformation. Kavanagh (1995) sums up, in a
review of the interpersonal literature on therapeutic action, the main
descriptive modes of the transformative factors of the interpersonal rela-
tionship experience. He describes the following elements which can be con-
sidered descriptive dimensions of relational experience (Kavanagh, 1995,
author’s translation): ‘the patient needs an experience not an explanation’,
‘the I-you relationship creates a climate of trust and security for the patient
and is both supportive and nurturing’, ‘a new relational experience can
modify relational patterns with expectations of distrust experienced during
development’, ‘the new experience consists in the different context, the dif-
ferent climate within which dissociated experience or fragments of dissoci-
ated experience emerge through the marginal processes of the field’,
‘importance of the mutual dependence between analyst and patient (thera-




                                                                 ly
peutic symbiosis)’, ‘the new experience consists in the central value of the




                                                          on
transference interpretation’ and the affective way in which it is experienced
by the patient, ‘the patient in proceeding in analysis experiences himself as

                                              e
self-generative of new perceptions and meanings’, ‘the patient experiences
                                           us
the analyst at the same time as very similar to and very different from the
patient’s historical experience of his own significant figures who have
                                        al

marked the development of his personality’, the patient experiences the ana-
                                    ci


lyst in ‘an equal measure of anxiety and security’ (Kavanagh & Kavanagh,
                              er



1995; 2009). All these descriptive dimensions of relational experience pro-
                         m




vide useful and meaningful guidance in clinical practice, but they do not
indicate the psychic levels of the relationship with the patient, or the modes
                 om




of communication through which they occur. The current re-examination of
the modes of relational experience described by Sullivan can, on the other
              -c




hand, advance the understanding of the clinical experience in this direction.
        on
     N




The experience of interpersonal relationships

    Sullivan placed two important cultural foundations at the basis of his
work, represented on the one hand by the tradition of thinking of the early
symbolic interactionism as proposed by the Chicago School of Sociology,
and on the other hand by the psychoanalytic tradition of thinking, revisited
in the light of American dynamic psychiatry, with particular reference to the
thinking of Adolf Meyer, among others. While these two roots constituted
the general source of inspiration for his work, he points out that the specific
interest of his approach is based on two assumptions (I quote his words ver-
batim): ‘The history of our science includes two contributions (Meyer’s
thinking and that of Mead, ed.) that I would like to recall at this point in an
attempt to establish as precisely as possible the reasons in favour of the
interpersonal approach. Needless to say, Sigmund Freud’s work lies at the
140                              Roberto Cutajar



base of this entire phase of psychiatry’ (Sullivan, 1953). But he points out
in The Psychiatric Interview that ‘We are only interested in the early fruit of
Freud’s genius. The phenomena that appear when conducting long inter-
views with the technique of free associations, together with the study of the
transference deformations that accompany or precede the verbal material,
are indeed essential in overcoming the discontinuities that had hitherto pre-
vented the formulation of a comprehensive psychology of psychic contents.
Freud revealed that the specific limitations of personal consciousness orig-
inate in experience. With this discovery he paved the way for the scientific
study of the individual, as opposed to that of the mind, brain and glands’
(Sullivan, 1954). Sullivan acknowledges the contribution of the ‘early
Freud’ by placing emphasis on the real dimension of the experience of the
analyst-patient relationship. Edgar Levenson even posits this aspect as the




                                                            ly
originating concept to any introduction to interpersonal thinking. At the




                                                       on
beginning of his contribution to a Symposium of the American
Psychoanalytic Association, dedicated to the presentation of the various

                                                e
psychoanalytic models (1985), he points out, ‘Paul Valery wrote that an
                                             us
artist with a modern sensibility has to spend his time trying to see what is
visible, and - more importantly - trying not to see what is invisible. He went
                                          al

on to say that philosophers (but, he might have added, also psychoanalysts)
                                      ci


pay dearly for their attempts to do the opposite. If it were possible to encap-
                                 er



sulate a complex psychoanalytic position in a formula, the one just quoted
                              m




could be termed the essence of interpersonal psychoanalysis’. This empha-
sis on the perceived reality of the relationship, rather than its unconscious
                       om




contents, together with its cultural roots in the social psychology of symbol-
ic interactionism, earned Sullivan the label of a non-psychoanalytic thinker
                   -c




because his thinking does not deal with unconscious life, but rather with
              on




conscious, i.e. social, life, attaching greater importance to the ‘I’, namely
the cultural ‘I’. Now, this may be considered true, but the emphasis on the
           N




role and functions of the EGO in Sullivan, is never described in antithesis
to the unconscious processes. There are numerous passages in his work in
which it is possible to point this out, but for the sake of expository conven-
ience I will only mention a few here. In Clinical Studies (1956) Sullivan
defines the unconscious mental process as the ‘rest of the personality’ -
‘From the moment the ego-system begins to emerge, it is possible to distin-
guish three aspects of the personality process fairly early on: first, the alert
and active ego; secondly, that part of the personality which is not readily
accessible to consciousness, i.e., the rest of the personality (which in anoth-
er context might be regarded as the whole personality, of which the ego
would constitute the eccentric part); thirdly, the personality in sleep, during
which the ego is relatively inactive (...)’.In Interpersonal Theory (1953),
Sullivan defines unconscious processes as ‘covered processes’ - ‘At this
point a distinction must be made, which will remain important from child-
                 The relational experience in the psychoanalytic situation   141



hood to the end of life: the distinction between what can be observed by a
participant observer and what can never be observed but must always be
the result of induction based on the observed material. This is the distinc-
tion between the uncovered processes of interpersonal relations and the
covered processes’. In Psychiatric Interviews (1954) with regard to the def-
inition of a clinical interview he points out that - ‘...although only two per-
sons are present in the room, the number of more or less imaginary persons
involved in this group of two is sometimes high. Indeed, it may happen two
or three times within an hour that whole new sets of these imaginary ‘oth-
ers’ are present in the field’. In a passage, quoted by Klerman et al. which
is very explanatory of how Sullivan intended to integrate the unconscious
and infantile experience into his approach to the Self, he points out that ‘A
social or interpersonal approach does not deny the importance of the




                                                                 ly
unconscious mental process, of the infantile experience (...) but these




                                                          on
aspects realise the capacity to determine behaviour by influencing the
patient’s definition of the situation here and now’ (quoted in Klermann et

                                              e
al., 1984, p. 167). Sullivan, in the concept of ‘Definition of the situation
                                           us
here and now’ comprises unconscious mental processes and infantile expe-
rience, and also includes a prospective aspect of the possible evolution of
                                        al

the relationship (Chrzanowski, 1977). Thus, to return to Sullivan’s object of
                                    ci


study mentioned earlier, namely ‘the phenomena which appear when con-
                              er



ducting long interviews’, we can note that the relational experience
                         m




expressed verbally in analytic dialogue (syntactic experience) always
includes experiential experiences pertaining to the preconscious and uncon-
                 om




scious sphere of the relationship (parataxic and prototaxic experience). This
inclusion takes place in the sense that ‘talking to each other’ (Borgna,
              -c




2015), what we feel and what we are able to say to each other to define our
        on




relational situation, the therapeutic relationship, is on the one hand an
expression of preconscious and unconscious processes, while on the other
     N




hand it creates them thanks to the actual affective bond between the two
personalities of the analyst and the patient which is created within a thera-
peutic framework, a setting. The valorisation of the real and social dimen-
sion of the relationship inevitably leads to valorising reciprocal perception
and the contact zones of sensory perception (Sullivan, 1953) as vital sources
of conscious and unconscious experience in the relationship. Freud himself
stated that in defining the reality principle as one of the two principles of
psychic occurrence, sensory and related processes of consciousness became
significant in relation to the external world. Freud wrote in Two Principles
(1919), with regard to the recovery of the implications of the ‘fonction du
réel’ described by Pierre Janet as a deficient function in the neurotic indi-
vidual, that ‘The increased significance of external reality also increased
the importance of the sense organs directed towards the external world and
of the consciousness connected to them. Consciousness now learned to
142                              Roberto Cutajar



understand sensory qualities in addition to the qualities of pleasure and dis-
pleasure, which alone had hitherto been of interest to it’. And a little further
on, ‘A specific function was thus established, which had the task of period-
ically exploring the external world so that the data coming from it was
already well known in case an urgent inner need arose - the function of
attention, whose activity lies in meeting sensory impressions on their path
instead of waiting for their spontaneous appearance’. In this passage, Freud
emphasised the two channels of contact with the outside world, namely sen-
sory perception and the attentional function, just like Sullivan, who identi-
fied in the attentional function the zone of relational contact that would be
altered if the relationship itself conveyed experiences of distress, giving rise
to selective inattention and the various forms of dissociation.
    But let us now proceed to provide a more precise definition of the three




                                                            ly
modes of relational experience described by Sullivan. The prototaxic mode




                                                       on
of experience (1953) ‘may be regarded as the discrete series of momentary
states of the sensory organism, with special reference to the zone of inter-

                                                e
action with the environment. It is as if all that is sensory, all that is repre-
                                             us
sented in the centre, were a luminous picture with indefinite but neverthe-
less vast limits. Each bulb that lights up on the picture for each discrete
                                          al

experience then becomes, if you follow me, the same basic prototaxic expe-
                                      ci


rience. Perhaps this might suggest that I assume that, from the beginning to
                                  er



the end of life, we are exposed to a succession of discrete configurations of
                              m




the momentary state of the organism’. It is clear that in the relationship with
the environment, with the other, a continuous flow of sensory elements is
                       om




generated that are configured into discrete momentary states and that give
rise to emotional mutual recognition. These discrete sensory states, which
                   -c




in other respects can be defined as inter-corporeality, constitute the basis on
              on




which the personality, the Self, is emotionally founded. In the processing of
experience in the parataxic mode, perception continues to be characterised
           N




by momentary states but the different perceptual elements occur together,
are concurrent and are not logically related. Stern (1995) writes that
‘Parataxic symbols are private symbols; that is, the relation between sym-
bol and referent may not be valid for anyone else. Since dreams are com-
posed of these private symbols and are seldom organised logically or coher-
ently, they are the obvious first example of later life experience occurring in
the parataxic mode. But on further reflection, it is clear that a good deal of
waking experience also goes on in the parataxic mode’. He then goes on to
point out, ‘Sullivan believes that much of life is lived in this mode. Since
parataxis is an associative process (i.e., parataxic symbols come together
on the basis of events occurring simultaneously), distortion is not intrinsic
to it. A parataxic symbol may be a distortion, but it need not be one’ (Stern,
1995, author’s translation). Finally, the syntaxis mode of experience is rep-
resented by meaning that has become socially shared through language and
                  The relational experience in the psychoanalytic situation   143



gesture, through consensual validation. Dialogue and communication with
the other, therefore, particularly analytical dialogue, takes place within the
framework of an underlying experience characterised by discrete sensory
states that are transformed into parataxic elements (visual perceptions, hear-
ing, dreams, fantasies) which, from an eminently private meaning, may find
partial explicit recognition in the relationship through their further transfor-
mation into syntaxis experience, which allows their social recognition. One
has to imagine that, like in a ‘nest’ structure (Panksepp & Davis, 2018),
these three modes coexist in the experience of the analyst’s and patient’s
mutual analytic relationship, interacting and influencing each other. It is
important to emphasise the mutual influence of these three relational
dimensions, even though there is some controversy in the literature regard-
ing the interpretation of Sullivan’s position, as some of his passages on the




                                                                  ly
topic express different and opposing positions (Stern, 1995). The experi-




                                                           on
ence of the interpersonal relationship can therefore range from the emotion,
which is subsequently transformed into a visual image such as a dream and

                                               e
is then encompassed in the words that can only express a communicable
                                            us
part of it; the relational experience can also move in the opposite direction
and from the words in the situation of ‘talking to each other’ a fantasy is
                                         al

generated such as a dream, an unconscious visual or sound image, for
                                     ci


example in the prosodic aspect of language (Mancia, 2004). In the interper-
                               er



sonal literature, the relationship between the three levels of experience, as
                          m




mentioned above, is not always seen as characterised by mutual influence
in both directions. Sullivan also considered them, for example, in the con-
                  om




text of a maturational hierarchy of the person, whereby only the evolution
of prototaxic and parataxic experience into syntaxis experience ensured
              -c




psychic health, stating that the hold over experience through language or
         on




gesture, and in any case its access to some level of linguistic representation,
ensured protection from mental illness, thus placing himself in analogy with
     N




Freud when he famously states that ‘where there was an Es, there the
‘EGO’ must take over’. Generally speaking, the interpersonal literature on
the three levels of experience, which we will not examine here, ascribes to
these levels one of the following four meanings: successive stages of child
development, experiential sources of interpersonal difficulties immersed in
distress, ways of defining the unconscious, preconscious and conscious
within the framework of interpersonal theory, enduring modes of experi-
ence in which throughout our lives we creatively elaborate our Selves
(Stern, 1995). One author who treats the three levels of relationship experi-
ence as developmental stages is Bromberg (1980), who emphasises the par-
allel with Piaget’s developmental stages in the evolution from concrete to
representational to abstract conceptual thinking. Of particular importance is
the conception of the three modes of experience in the field of dynamic psy-
chopathology. From early childhood to adolescence the interpersonal bond
144                              Roberto Cutajar



can be invaded by distress, and this provokes certain safety operations of
the Ego such as substitutive processes, like selective inattention, primary
and secondary dissociation of varying degrees of severity (Bucci, 2021),
and ‘as if’ processes. In other words, the relational Ego, which Sullivan
calls the Ego system or the Self system, performs a series of defensive oper-
ations to protect the personality and allow a relational contact with the other
even if in limited or zero conditions of exchange and learning. An example
is the use of verbal language in a parataxic manner in the obsessive person-
ality, where words can have a magical valence with a totally private mean-
ing that cannot be shared socially. As regards the use of the three levels of
experience as ways of defining the unconscious, the preconscious and the
conscious in the framework of interpersonal theory, reference is made to
Donnel Stern, who, in several passages in his work, based himself on




                                                           ly
Sullivan’s assertion that ‘all that is repressed is simply not formulated’




                                                      on
(Sullivan, 1940), and conceptualised parataxic experience as ‘not formulat-
ed experience’ (2003). Finally, the three levels of experience, taken to be

                                                e
enduring modes of experience that we can use throughout life for the pur-
                                             us
pose of the creative elaboration of our Self, include the eccentric position of
Tauber and Green with respect to Sullivan, indeed almost in opposition to
                                          al

Sullivan, regarding the pervasive value of parataxic experience in our lives.
                                      ci


In an important essay, translated into Italian, L’esperienza prelogica (1959),
                                 er



they posit parataxic experience as the ubiquitous basis for all human rela-
                             m




tionships, and the fount and creative source of all new thinking. Parataxic
relational experience, i.e. the experience that generates in reciprocal rela-
                       om




tional experience unconscious images of a sonorous or pictorial visual type,
dreams, is ubiquitous in all our relationships, and is at work in an incessant
                   -c




and continuous manner, beneath the surface of awareness or at its margins.
              on




I believe that Tauber and Green’s creative conception is undoubtedly of
greatest help, both in the psychoanalytic process but also as a creative ele-
           N




ment in our everyday relationships. Through the pre-logical (parataxic)
dimension, the patient shares his personality with the analyst, and the ana-
lyst shares his personality with him, thus becoming part of the drama of the
patient’s life. William Cornell, in chapter three of The Somatic Experience
in Psychoanalysis and Psychotherapy (2015), called ‘Entering the gesture
as if it were a dream: a psychoanalyst encounters the body’, provides a
beautiful example. Many examples are similarly given in the work by
Tauber and Green. I have developed a formula that summarises this
approach, the following interpersonal formula:

                         (b) a A ⤢ B b (a) / f(T)

   This formula represents the evolution over time, represented by the sym-
bol f(T), of the relationship between A (analyst) and B (patient), where a
                 The relational experience in the psychoanalytic situation   145



represents A’s conscious intentionality towards B, b represents B’s con-
scious intentionality towards A, and (a) and (b) represent B’s and A’s uncon-
scious intentionality respectively generated in the reciprocal interactive per-
ception of the other.
    I conclude my presentation of the experience of the relationship in the
psychoanalytic situation by pointing out that I have not dealt with the
question of the interaction between the three levels of experience, i.e. I
have not dealt with the process of consensual validation. I have merely
provided a definition. Lawrence Brown, in his Glossary of Psychoanalytic
Interpersonal Concepts (Brown L.O., 1995), defines it as ‘A term used by
Sullivan for the achievement of genuine mutual understanding. Such an
outcome is the result of interpersonal communication that (1) is fully
based on the structure and meaning of signs and symbols in a shared cul-




                                                                 ly
ture and (2) is derived from experience in the syntaxis mode, so that the




                                                          on
meaning of communication is not based on private or unique meanings or
associations’ (my translation). In the wake of this definition, I would like

                                              e
to conclude this section by quoting Ferro and Civitarese’s reflections that
                                           us
all perspectives concerning the unconscious, and thus also the one we
have just presented, ‘offer us a ‘poetic’ account of experience, which is all
                                        al

that matters to foster the feeling of living a full and authentic life’ (Ferro
                                    ci


& Civitarese, 2018).
                              er
                         m




Current links with other psychoanalytic perspectives
                 om




    At this point, having examined the main constituent elements of rela-
              -c




tional experience in the psychoanalytic situation from an interpersonal
        on




perspective, I would like to highlight the obvious analogies with Wilfred
Bion’s and Wilma Bucci’s thinking. I will not discuss all the analogical
     N




overlapping of these perspectives, which would require a dedicated work
which we propose to do in the future. As far as Bion is concerned, I will
limit myself to pointing out how certain points of his thinking, such as the
oneiric thought of wakefulness, the radically social nature of the genesis
of the subject, find correspondence in Sullivan’s notion of the definition
of the relational situation, where the syntaxis (conscious) experience is
continually nourished and stimulated by the parataxic and prototaxic
(unconscious) experience attached to language through intercorporeality.
As the conscious process gradually offers the possibility of socially
expressing a part of the unconscious and pre-conscious (prototaxic and
parataxic) experience, it ‘poetises’ itself by feeding from the latter’s foun-
tainhead. Again, Sullivan’s important concept of basic experience as sen-
sory perception, finds a substantial analogy with Bion’s B-elements, as
fuelling factors of the daytime dream through their transformation with
146                             Roberto Cutajar



the alpha function. Edgar Levenson (2003), a present-day follower of
interpersonal psychoanalytic thinking, in one of his lesser-known essays
tried to illustrate and clarify the transformations that generate parataxic
experience especially with regard to visual images, ‘I would now like to
suggest that our praxis is organised more around images than words,
more around interactions than explanations. The analytical algorithm -
the steps we take in doing analysis, regardless of metapsychology - and
the unconscious flow of data, are both organised along visuospatial lines:
It occurs to me that questions arise from visual images. One tries to
understand the situation by picturing it or imagining it. Even our tool par
excellence, free associations (and its corollary, detailed enquiry), consists
more of visuospatial images connected and inserted in each other, than of
plain language. The patient’s free associations are usually, but not




                                                           ly
always, in visual, illustrated form, as are dreams’. As far as Wilma Bucci




                                                      on
is concerned, Sullivan’s three levels of experience find a surprising over-
lap with the three modes of encoding experience proposed by the Denver

                                               e
scholar, namely verbal symbolic experience (with syntaxis experience)
                                            us
and non-verbal symbolic experience (with parataxic experience), and non-
symbolic non-verbal experience (with prototaxic experience). Particularly
                                         al

striking is the phenomenological correspondence between the prototaxic
                                     ci


mode and the subsymbolic mode of experience in Bucci (2021), ‘Of great
                                 er



interest to psychoanalysis, subsymbolic processing is dominant in the pro-
                             m




cessing of emotional information and emotional communication: reading
the facial and bodily expressions of others, experiencing one’s own feel-
                       om




ings and emotions. All of these functions require processing that is ana-
logue and continuous, not discrete, and that occurs in specific sense-
                   -c




modes, not in abstract form. We term this processing intuition, body wis-
              on




dom, and other related modes. Crucial information concerning our body
states comes to us mainly in subsymbolic form, and emotional communi-
          N




cation occurs mainly in this mode. Reik’s concept of ‘listening with the
third ear’ is largely based on subsymbolic communication’. It is evident
that a significant consequence of considering the inter-corporeal interac-
tion as the primary source of relational experience in the psychoanalytic
situation, is the absolute unpredictability of the course of the treatment,
since the vis à tergo of the clinical process is no longer only a dissociated,
or disregarded content, but is flanked and intertwined with, and enveloped
by, the part of the inter-corporeal interaction relating to the two specific
persons, who make the encounter unique and unrepeatable. A large part of
the relationship with the patient is thus constitutively unknown and cannot
in any way be explored through a predefined technical procedure. I men-
tion these correspondences because they point to the possibility of initiat-
ing a fruitful dialogue between these perspectives (Jullien F., 2012), in the
foremost interest of the cognitive advancement of our discipline.
                      The relational experience in the psychoanalytic situation               147



Conclusions

    In this paper I have presented a critical and up-to-date description of the
concept of relationship experience in the interpersonal perspective.
Obviously, I have not presented an overview of the interpersonal perspec-
tive with all its constituent elements because this was not the aim of my
report; for example, I have not presented the cognitive-hermeneutic
processes of the relationship, one of many concepts and processes available
in the interpersonal psychoanalyst’s toolbox, just as I have not presented the
other constituent elements of the psychoanalytic situation in the interper-
sonal perspective, such as the elements of the therapeutic framework, which
also have a primary influence on the quality of the relational experience in
the clinic. Instead, I have given a detailed description of an important and




                                                                      ly
perhaps priority concept for understanding the patient’s process of transfor-




                                                               on
mation, which undoubtedly needs further exploration and understanding. A
priority need of psychoanalytic research is to create possibilities for discus-

                                                   e
sion and confrontation on clinical cases, according to methodologies and
                                                us
approaches that allow for an ever better descriptive possibility of the rela-
tional experience in the psychoanalytic situation, with ever better heuristic
                                             al

possibilities of understanding its therapeutic and transformative elements.
                                         ci
                                   er
                              m




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Conflict of interests: the author declares no potential conflict of interests.

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Received for publication: 1 July 2022.
Accepted for publication: 12 September 2022.

Editor’s Note: All claims expressed in this article are solely those of the authors and do not necessarily
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Ricerca Psicoanalitica 2022; XXXIII(s1):703
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