Tuesday, 17 December 2013

A critique of Martha Stark’s model

[this is still a draft ... so far written for Body Psychotherapy audience]

Stark’s groundbreaking work addresses several issues – all of great significance in the historical development of psychotherapy: the therapist’s phenomenological stance; the therapist’s relational stance (not quite the same thing); the mind-over-body dualism; the systemic perspective; the post-modern, pluralistic shift generally and psychotherapy integration specifically.

On all these dimensions, tectonic paradigm shifts have occurred over the last 100 years; assumptions that were taken for granted a century ago have been questioned and a diversity of positions and theories has evolved around each one of them.

The problem with Stark’s contribution is that she conflates the different dimensions (and how they interact with each other) into one - too simplistic - narrative. This creates problems, especially for Body Psychotherapy, which need to be addressed.

Stark structures her argument around one main line of development: from what she calls ‘one-person psychology’ to a modern intersubjective ‘two-person psychology’, with a middle position which she – half-tongue-in-cheek, but on the basis of a serious, valid and helpful distinction – calls ‘one-and-half-person psychology’. This is a valid and significant line of development. It’s essentially a phenomenological-philosophical argument, which refuses to reduce humans to objects and establishes a fundamental and qualitative difference between the epistemology of natural versus human sciences: rocks do not talk back and they do not have a mind of their own. We can treat people as research objects (from what philosophy calls a ‘third-person’ perspective), but that research in and of itself will never arrive at valid truth claims regarding the human meeting of minds, or intersubjectivity. Between humans we need to admit the always already present subjective perspectives and therefore cannot get around interpretation, i.e. hermeneutics (see Habermas) which gives rise to an entirely different category of truth claims when it comes to intrapsychic or interpersonal phenomena. This anti-reductionist position postulates that in human affairs we need to recognize the other in an unpredictable and open dialogue (Gadamer) from a ‘first-and-second-person’ perspective.

In the world of psychotherapy, Buber’s famous phrase ‘I-Thou’ is well-known as capturing these ideas and attitudes. This begs the question of its opposite and what role ‘I-it’ relating may have in therapy. Here Stark comes to a surprising – for somebody who describes a linear historical development – and helpful, integrative position: she gives validity to all three possibilities and states that they all have their uses at different times with different clients.
This integrative attitude is neatly expressed by Ken Wilber’s phrase ‘transcend and include’ (Wilber’s four quadrants, by the way, are a very useful contribution to the distinction between ‘I-Thou’ and ‘I-it’, introducing a whole new level of sophistication, which Stark’s model does not include).

The problem for Body Psychotherapy is that in addition to describing these shifts – across the whole field, including psychodynamic and humanistic traditions – from one-, to one-and-a-half to two-person psychology, she also sees a development in bodymind and relational terms: from a classical psychoanalytic emphasis on knowledge, insight and mental understanding, towards the importance of felt, embodied experience towards intersubjective relating. But this is conflating several distinct dimensions – and in all of them changes have indeed occurred simultaneously over the last century – but to superimpose them on one line of development is a category error, mixing apples and oranges.

The various ways in which different traditions actually take changes in all these dimensions on board, and whether they dismiss earlier positions or do indeed ‘transcend and include’ them, creates a very confusing, pluralistic field, that is not neatly captured by Stark’s outline. Different traditions combine the various dimensions in entirely different - and contradictory – ways. So the only way to capture this and gain clarity would be to create a multi-dimensional space of historical development, along several separate axes, each with their own continuum:

1. between ‘I-it’ and ‘I-Thou’ stances
2. between ‘exclusively mental’ and ‘holistic’ approaches
3. between ‘working alongside’ the client as an ally and ‘working opposite’ the client as a relational other (which is not the same as ‘I-it’ versus ‘I-Thou’, and not reducible to it – see Gomez, Lavinia)
4. between ‘challenging’ and ‘supportive’ stances
5. between ‘individualistic’ and ‘systemic’ perspectives
6. between ‘pure approaches’ and ‘integrative hybrids’

This may create some more clarity, but only up to a point. There are further axes we can think of, and the closer we look at them, most of them are not actually linear axes along a polarized continuum in the first place.

For Body Psychotherapy, the most pressing distinction is the recognition that - whatever the constellated bodymind phenomenology the therapist focuses on – it is always possible to either take an ‘I-it’ or an ‘I-Thou’ stance. It is perfectly possible to be intersubjectively engaged with the other’s mind via insight and knowledge. Equally, it is perfectly possible to take an objectifying stance towards the other’s body and experience. These two dimensions – the phenomenological one (from one-, to one-and-a-half to two-person psychology) and the bodymind one (from knowledge to experience to holistic relational experience) – need to be kept distinct, if we want to gain an overview over the variety of approaches actually being practiced within the field.

Some of these problems in Stark’s contribution can be usefully addressed by complementing it with an integrative model which has gained popularity over the last 20 years in the UK as well as globally. Petruska Clarkson’s model (1994) tries to establish a comprehensive spectrum of relational modalities between client and therapist, comparing these to kinship bonds, thus validating an integrative multiplicity of therapeutic relating. But it falls short of grasping the paradoxical essence of the dynamic whole which is the body-mind system of the therapeutic relationship (Soth ).

Thus, a holistic and phenomenological two-person psychology as body-mind process (possibly extending into many-persons psychology) still awaits formulation (Stark, xxxx), but a starting point is the integral-relational notion of the ‘Fractal Self’ I have suggested elsewhere (Soth xxxx), by extending the concept of parallel process to include bodymind (Reich’s functionalism) and inter-subjective dynamics and unconscious process (Soth, 2007).

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