Content uploaded by Robert Drozek
Author content
All content in this area was uploaded by Robert Drozek on Oct 07, 2018
Content may be subject to copyright.
The Dignity in Multiplicity: Human Value as a Foundational
Concept in Relational Thought
Robert P. Drozek, LICSW
McLean Hospital
This paper explores the foundational status of the concept of human dignity in relational thought. The
author highlights the importance of dignity in everyday clinical work, as well as the role this notion has
played in inspiring what has been called the “relational turn”in psychoanalysis. Utilizing concepts
from ethical theory and current analytic ideas regarding the multiplicity of self-states, the author
sketches a model of psychic experience in which dignity plays a defining role. This model emphasizes
the ongoing dialectic between dignity-based processes (in which Self and Other are experienced as
unconditionally valuable) and processes in which we experience Self and Other as only conditionally
valuable, or in many cases of pathology, unconditionally bad. A dignity-based vision of analytic
process is proposed, wherein analyst and patient are engaged in the co-construction of an intersubjec-
tive space that is progressively more consistent with their intrinsic worth as human beings. It is
suggested that, by explicitly affirming human dignity as an overarching value of relational thought,
we would be encouraging continuous revision of our theories in order to further reflect the worth of the
human subject, a process that could lead to more humane theories of analytic work.
There are few concepts more central to human experience than the idea of dignity. This concept
underlies a range of near-universal intersubjective experiences—the notion that there are basic
human rights, and that all of us deserve to have these rights respected; our aversion to taking
actions that might seriously harm other people; our feelings of revulsion when confronted with
torture and abuse; our sense that there is something fundamentally wrong with treating other
people exclusively like objects; and the difficulty we have comfortably treating ourselves simply
like objects, at least without psychic ramifications. Implicit in these experiences is the idea of
dignity. Human beings are not just objects. Rather, we have a special sort of worth that is
intrinsic and unconditional, that is, not dependent on factors apart from our common humanity.
Somewhat surprisingly, the idea of dignity has not received much attention in the analytic
literature. Yet dignity serves as a quietly foundational concept in psychoanalysis, regularly
exerting its influence on analytic theory and practice while rarely receiving the recognition it
deserves. In particular, as I hope to illustrate in this paper, concerns about dignity have played a
pivotal role in encouraging what has been called the “relational turn”in psychoanalysis.
Unfortunately, when it comes to dignity, relational thought is unable to explain this notion in
a satisfying way. I suggest that, by continuing to conceptualize value as deriving from other
Correspondence should be addressed to Robert P. Drozek, LICSW, McLean Hospital, 115 Mill Street, Mail Stop 222,
Belmont, MA 02478. E-mail: robertpdrozek@gmail.com
Psychoanalytic Dialogues, 25:431–451, 2015
Copyright © Taylor & Francis Group, LLC
ISSN: 1048-1885 print / 1940-9222 online
DOI: 10.1080/10481885.2015.1055170
factors (e.g., needs, affects), we have not yet made sufficient space for the possibility of intrinsic
value within psychoanalytic thought.
Utilizing concepts from ethical theory and current analytic ideas regarding the multiplicity
of self-states, I propose a model of psychic experience in which dignity plays a defining
role. This model emphasizes the ongoing dialectic between dignity-based processes (in
which Self and Other are experienced as unconditionally valuable) and processes in which
we experience Self and Other as only conditionally valuable, or in many cases of pathology,
unconditionally bad. I trace out some clinical implications of these ideas, proposing a
dignity-based vision of analytic process, in which analyst and patient are engaged in the
co-construction of an intersubjective space that is progressively more consistent with their
intrinsic worth as human beings.
DIGNITY AND FREEDOM
To begin, I provide some background on dignity from philosophy and political theory, the
disciplines that have addressed this topic most extensively.
1
We can distinguish between two
views on dignity, the restricted and universal models. In the restricted view, which was
common prior to the Enlightenment, dignity refers to the elevated worth of people posses-
sing certain qualities, such as high social status or a “dignified”manner. In the universal
view, dignity refers to our ascription of unconditional or intrinsic value to ourselves and
others as human beings, not dependent on factors unique to specific people or classes of
people.
This conception derives most directly from the ethical ideas of the eighteenth-century German
philosopher Immanuel Kant. Kant (1785/1997) defines dignity as the “unconditional, incompar-
able worth”of human beings (p. 42). For Kant, dignity is closely related to ethics and morality.
As Kant puts it, “A human being . . . is not a thing and hence not something that can be used
merely as a means, but must in all of his actions always be regarded as an end in itself”(p. 38).
When we ascribe unconditional rather than strictly conditional value to other people, we
experience a feeling of respect for them as people. In this motivational state, we are more likely
to be motivated by their desires and interests, and less likely to relate to them exclusively like
objects that might either satisfy or frustrate our own wishes.
2
For many of us in the Western democratic world, this view of dignity has become so infused
into our shared cultural identity that it is difficult to imagine contemporary life without it. We
hear it in the dictum “All men are created equal,”according to which no person is “more
worthwhile”than another. We see this model of dignity in our notions of human rights and social
justice, wherein all human beings deserve to be treated with a basic level of respect and care.
This view is connected to our democratic ideals, in which all people are entitled to a government
1
The following constitutes a selective treatment of dignity, highlighting topics that I find most interesting and
relevant to relational practice. For a more extensive review of the concept, see Rosen (2012).
2
Within philosophy, Kant has been rightly criticized for endorsing an overly rationalistic and individualistic view of
the person. In this paper, by integrating Kant’s phenomenological ideas about dignity and freedom with current analytic
ideas regarding multiplicity and intersubjective process, I hope to preserve Kant’s humanistic insights while avoiding the
aforementioned pitfalls of his model.
432 DROZEK
in which they have a voice, and in which their needs, values, and interests hold some degree of
motivating power.
3
To take one prominent example of this, in the recent U.S. Supreme Court
decision affirming marriage equality, Justice Anthony Kennedy writes that the Constitution
grants same-sex couples “equal dignity in the eyes of the law”(Obergefell v. Hodges, 2015).
Why do we value ourselves and others in this special way? This question can be approached
from multiple perspectives—biological, evolutionary, sociological, and as I hope to illustrate,
psychoanalytic. I focus on the most popular answer to this question within philosophy and
contemporary culture—the connection between dignity and freedom. Consider this description
of freedom by the philosopher Robert Kane (2002):
From a personal or practical standpoint, we see ourselves as free agents capable of influencing the
world in various ways. Open alternatives seem to lie open to us. We reason or deliberate among them
and choose. We feel it is “up to us”what we choose and how we act. . . . This “up to us-ness”also
suggests that the origins or sources of our actions are in us and not in something else over which we
have no control. (p. 5)
In this model, freedom involves experiencing ourselves as a source of meaning and value,
rather than just a causal by-product of factors distinct from ourselves. While philosophers
emphasize the importance of this experience in our deliberations about “what to do,”this
capacity extends beyond moments of deliberation—it is a deep part of our identities, encom-
passing our sense that we are somehow responsible for who we are and how we live. Many
philosophers posit this freedom as the phenomenological basis for human dignity. Since we
experience ourselves as a source of meaning rather than simply as receptacles for other peoples’
meanings, we take ourselves to have an intrinsic worth, or dignity. To the degree that we
experience other people in an analogous way, we naturally take them to have dignity as well.
Implicit in this formulation is the psychoanalytically relevant distinction between subjects and
objects. Objects are valued by people; they cannot value themselves, other objects, or people.
Human subjects, on the other hand, are unique sorts of entities that possess the capacity to
endow things with value, and it is in virtue of this capacity that we take human beings to have a
special sort of value, what I am calling dignity (Aron, 2005, pp. 691–692).
These ideas may not seem particularly relevant to analytic work. After all, our patients often
do not feel like they are “free,”“a source of meaning,”or “unconditionally valuable.”However,
I believe that all of us, even our most impaired patients, have intermittent access to the freedom
philosophers are highlighting. Consider the person filled with self-hatred, who struggles with a
sense of meaninglessness, who cannot live up to her own standards, who does not even feel like
her standards are her own. Even this person has moments of the freedom mentioned above:
when she feels like genuine possibilities are open to her, and when she feels like she—not other
people, not past versions of herself, not unconscious parts of herself—is choosing what to do,
even if she is only deciding between “going to the store”and “staying home.”
The analytic theorist who best articulates these ideas is Irwin Hoffman (1998): “There is a
‘space’between the source of influence and its impact, a gap in which I am present as an agent,
3
This notion of dignity places strict limits on tendencies toward prejudice, social injustice, cruelty and indifference to the
needs of others, and unfair treatment on the basis of the “idiosyncratic”qualities that distinguish us from one another, such as
race, social status, gender, and sexual orientation. Despite these aspirational implications of the dignity idea, it functions only as
an ideal that can never be fully realized, existing in paradoxical tension with the tendency to ascribe only conditional or negative
value to Self and Other, as we see in experiences like self-loathing, insecurity, hatred of others, racism, homophobia, and so on.
THE DIGNITY IN MULTIPLICITY 433
as a choosing subject”(p. xi). Hoffman refers to this as an “active mode”of experience, in which
the subject serves as a “source of construction”(1995, p. 107), and as “a responsible, free agent,
not merely an organism responding to internal and external pressures”(2000, p. 827).
I refer to this capacity as agentic freedom. This idea is strictly phenomenological in nature,
referring to our experience of ourselves as free agents, without implying that we are
“actually”free in any objective sense. This view of freedom encompasses two key analytic
ideas—subjecthood and agency. First, it entails an experience of oneself as a subject, an “I”
that has the ability to reflect on itself as an object (a “me”)inaworldofotherpeoplewho
can be seen as both subjects and objects (Aron, 2000; James, 1890/1950). This notion of
subjecthood includes Benjamin’s (2000) view of the person as a distinct, independent subject
who is fundamentally similar to other subjects, and Fonagy and colleagues’(2002) model of
the self as agent, “the mental processes or functions that underpin representations of the self”
(p. 24).
Agentic freedom also implies an experience of agency—the capacity to play an active role in
co-constructing meaning within relational contexts. However, unlike many recent models of
agency (Gentile, 2010; Rustin, 1997; Slavin, 2010; Weisel-Barth, 2009), this freedom is not
associated with psychological health, nor does it derive from optimal developmental experi-
ences. Rather, it is grounded in the structure of human consciousness and thus is accessible to
everyone. Since many patients lack a robust sense of freedom at the start of analytic work, and
since analysis has such a powerful impact on the sense of agency, we often fail to notice the
freedom patients possess independently of analytic intervention, simply in virtue of being
human.
Considered from a developmental perspective, agentic freedom simply presupposes that the
subject possesses what Daniel N. Stern (1985) calls the “verbal self,”which encompasses a
range of capacities that develop during the second year of life—the acquisition of language;
the faculty of symbolic thought; “the capacity to make the self the object of reflection”
(p. 165); the ability to refer to Self and Other using verbal labels (e.g., “I,”“me”); and the
capacity to construct complex representations of oneself in relation to others—as a subject, as
an objective entity in a world populated by other objective entities, and as a person performing
actions that have been observed as well as imagined. Taken together, these developmental
milestones entail an expansion of the child’s sense of possibility:“The infant can now
entertain and maintain a formed wish of how reality ought to be, contrary to fact”(p. 167).
Armed with a sense of oneself as a subject, a sense of oneself as an object, and the capacity to
imagine, represent, and initiate possibilities beyond the present reality, the child begins to
develop a sense of herself as a source of meaning, rather than just a recipient of other people’s
meanings. This experience serves as the rudimentary basis for a growing sense of freedom and
dignity.
DIGNITY AND THE RELATIONAL TURN
With this conception in place, I want to propose that concerns about human dignity have played
a central role in inspiring and fueling the advent of relational thinking in psychoanalysis. I thus
offer something of a historical interpretation of what has been called “the relational turn.”Ido
not, however, argue that classical theory is somehow “actually”at odds with human dignity, or
434 DROZEK
that relational thought is more consistent with it.
4
I find this topic less interesting than the
question of how the dignity idea influences theory development and clinical practice. By
focusing specifically on dignity to the exclusion of other concerns, I hope to shine a spotlight
onto an undertheorized but foundational area of psychoanalytic discourse.
To begin, I suggest that dignity played a powerful role in relationally-oriented theorists’
dissatisfaction with classical theories of motivation. We hear this dissatisfaction in Fairbairn’s
(1952) suggestion “that a relationship with the object, and not gratification of impulse, is the
ultimate aim of libidinal striving”(p. 60); in Winnicott’s (1971) insight, “it is not instinctual
satisfaction that makes a baby begin to be, to feel that life is real, to find life worth living”
(p. 133); and in Mitchell’s (1988) criticism, “Freud regards what is distinctively human and
special in mankind as a tenuous overlay upon a rapacious, bestial core”(p. 74). A common
ethical sentiment runs throughout these comments, which is repeatedly echoed throughout the
relational lexicon: Human beings are not simply animals, biological organisms, or inanimate
objects. In my view, relational thinkers have seen such formulations not just as inaccurate or
unpersuasive, but as potentially demeaning. By conceptualizing motivation in specifically
human terms—that is, in terms of relationships—these theorists were attempting to construct
theories that were more consistent with the dignity of the analytic subject.
Dignity has also played an important role in the epistemological developments accompanying
the relational turn. When arguing against the idea of the analyst as a “blank-screen,”theorists
have been taking issue with an authoritarian view of the analytic situation, in which pathology
resides primarily in the patient, and transference consists of the patient “transferring”that
pathology/distortion onto the all-knowing analyst (Hoffman, 1998). Relational thinkers have
seen this model as contrary to the patient’s dignity, especially the parts of the patient aligned
with health and nondistorted “reality”(Aron, 1996). By highlighting the “irreducible subjectivity
of the analyst”(Renik, 1993), these authors have been working to equalize the balance of
knowledge and power between analyst and analysand, thereby developing a model of analytic
process more consistent with the patient’s dignity.
5
Along similar lines, interest in dignity has contributed to our enhanced recognition of the
analyst as a real person in the analytic situation. We can observe this recognition in a range of
theoretical advances—an increased appreciation of the bidirectional, mutual patterns of influence
in analytic work (Beebe & Lachmann, 2002); a growing emphasis on the nongeneric and unique
qualities of the analyst (Hoffman, 1998); the rise of interventions in which the analyst’s
subjectivity plays a more explicit role (Davies, 1994); and the loosening of classical strictures
4
While aspects of classical thought might seem to contradict the person’s worth, other features can be seen as
affirming that worth, for example its commitment to expanding the freedom of the analytic subject (Fenichel, 1941;
Freud, 1923/1961), and its view of that subject as the (often unconscious) source of her own experiences and meanings
(see Kennedy, 1993; Schafer, 1976). Throughout this paper, rather than categorically affirm or dismiss entire theories, I
prefer to focus on the theoretical strategies and assumptions employed in specific theories. This constitutes a selective
yet progressive approach to theory construction, allowing us to revise those concepts that have outlived their usefulness
without abandoning earlier innovations that continue to enrich our practice.
5
This sentiment has manifested itself in the prevalence of “co”-terms in relational thought (e.g., co-construction,
co-creation), also leading many theorists to view relational theory as a more democratic or “egalitarian”view of
analytic work. As Wachtel (1986) suggests, despite the natural asymmetry of clinical work, “in one sense patient and
therapist are assuredly equals—both are ‘more simply human than otherwise’and equally deserving of respect and
human dignity”(p. 67).
THE DIGNITY IN MULTIPLICITY 435
on technique, such that analysts are free to intervene in more authentic and creative ways with
their patients (Aron & Starr, 2012; Ferenczi, 1932/1988).
With these advances, relational theorists have not simply been highlighting the essential
intersubjectivity of analytic work—they have been reacting against the classical tendency to
objectify the analyst, to frame her as an “analytic instrument”without fully appreciating her
status as a unique person. As Aron (1996) writes, “Just as psychoanalytic theory has focused
on the mother exclusively as the object of the infant’s needs while ignoring the subjectivity
of the mother, so too psychoanalysis . . . has considered the analyst only as an object”(p. 75).
By emphasizing the importance of the analyst as a real person, relational authors have been
working to affirm her as a source of meaning in the analytic situation, and thus to construct
models more expressive of the analyst’s dignity. Interestingly, affirming the analyst’s dignity
is not just about the analyst—by positioning the analyst as an equivalent subject in clinical
work, relational theorists have been embracing the idea that the patient’s health is dependent
on her ability to respect the analyst as a distinct subject, and thus that “individual”well-being
is constituted by the capacity to honor the dignity of both Self and Other (Benjamin, 1995;
Drozek, 2010a).
The idea of dignity is also implicit in relational theory’s evolving commitment to issues of
social justice. Neil Altman (1995) suggests that relationally-oriented theories are particularly well-
equipped to explain “the racial, cultural, and social class status of patient and analyst, as well as the
institutional context of their work”(p. 56). This point is displayed prominently throughout our
literature, which focuses on justice and equality across numerous domains, including sexuality
(Mitchell, 1978), gender (Harris, 2005), race (Leary, 2000; Straker, 2011), culture (Aggarwal,
2011; Ipp, 2010), social class (Gaztambide, 2012), and violence (Young-Bruehl, 2011).
This interest is not simply a reflection of the shared sensibilities of relational analysts—it is
related to their endorsement of the universal model of dignity under discussion, which empha-
sizes the equal worth of all human beings, and therefore exists in tension with policies and
practices that devalue people who might be seen as “not me.”This endorsement has recently led
to a renewed ambitiousness in psychoanalytic theory—the idea that psychoanalysis has a role in
transforming not simply the individual person but also our cultural institutions, in a manner that
expresses “cooperation, compassion, and concern for the interests of the collective, especially
the dignity of each person”(Suchet, 2007, p. 884). As Hoffman (2009) proposes,
At its best a critical rather than conformist psychoanalysis should emerge as a bastion in our culture
that will stand for human freedom, for the dignity of the individual, for the meaningfulness of
community, and for the sacrosanct integrity of every moment of experience. (pp. 1064–1065)
Finally, I suggest the idea of dignity is related to another pervasive pattern in relational
thought—an aversion to framing experience in universal terms, and a preference for honoring
uniqueness in human life. We see this tendency in all areas of relational discourse—an emphasis
on specificity over generality in theories of motivation (Eagle, 1984; Hoffman, 1995); an
abandonment of “objective”theories of technique (Tublin, 2011); a shift away from linear,
stage-based theories of development (Coburn, 2002; Seligman, 2005); and the proliferation of
“experience-near, clinically based conceptualizations”throughout our literature (Foehl, 2010,
p. 48). When arguing against the idea of universal or “innate”motivation, Stephen
Mitchell (1988) reflected, “As soon as one establishes a motive as innate, one ironically closes
436 DROZEK
it off somewhat from analytic inquiry and thereby loses the opportunity to deepen an apprecia-
tion of its origins and resonances within the individual’s particular relational matrix”(p. 62).
By postulating universal drives as the basis of experience, classical thought was positing a
generic and a priori factor (e.g., libido, aggression) as the main determiner of meaning in human
life. I believe that relational thinkers have seen this approach as undermining the dignity of the
person—her status as a unique source of meaning, co-creating messy, unpredictable patterns of
meaning with other meaning-making subjects. By placing a primary emphasis on the analy-
sand’s unique relational experiences, these theorists have been advancing an approach to
psychoanalysis not just more consistent with the dignity of analysands in general, but with
the dignity of any particular person who might approach the analytic process.
EXPLICIT VIEWS ON DIGNITY IN RELATIONAL THOUGHT
As noted earlier, few analytic writers devote extended attention to the topic of dignity. By
reviewing some references to dignity throughout our literature, we can begin to consider the
specifically psychoanalytic contributions to the dignity idea in human experience.
It is widely accepted that respect for the patient’s dignity is the foundation for analytic work.
As Thomas Ogden (2005) puts it,
For me, what is most fundamental to psychoanalysis is the principle that an analyst treats his patient
—and all those his patient’s life impinges upon—in a humane way, in a way that at all times honors
human dignity. This principle is the North Star of psychoanalysis; it is a point of reference in terms
of which all else is located. When an analyst is not being humane, what he is doing with the patient
is not recognizable to me as psychoanalysis. (p. 19)
For Ogden, the ethical foundation of psychoanalysis is the principle that the analyst should
always honor and respect the dignity of the patient. This view is mirrored by the American
Psychoanalytic Association, whose Ethics Code states, “The psychoanalytic relationship is pre-
dicated on respecting human dignity.”While there are different opinions about what this looks like
in practice, most practitioners would agree that it disallows many behaviors understood to be
unethical—lying to a patient for one’s own gain, physically striking a patient, having sex with
someone in treatment with you. The dignity of the person is also implicit in the principle that we
should be dedicated to the well-being, growth, and flourishing of our patients. If we did not value
our patients as people, most likely we would not care about their pleasure, pain, or desires.
A number of theorists emphasize the importance of dignity in human development and
motivation. In his “Credo,”Ghent (1989) associates dignity with self-worth, positing “a need
for a feeling of self-worth, dignity, self-esteem”as a fundamental source of motivation (p. 207).
Shengold (1979) invokes dignity when introducing his famous idea of soul murder:
There is an inherent moral protest in the term. Soul murder is a crime characterized by man’s
inhumanity to man. One man uses his power over another to crush his individuality, his dignity, his
capacity to feel deeply (to feel joy, love, and even hate). (p. 536)
When the parent persistently acts to negate the child’s dignity, the child adopts “a mind-
splitting or a mind-fragmenting operation,”consciously experiencing the abusive parent as
THE DIGNITY IN MULTIPLICITY 437
“good”while dissociating the parent’s badness, thereby creating a rigidified structural split in the
personality (p. 539).
More so than any other psychoanalytic theorist, Peter Shabad gives dignity a foundational
role in his theory of development. In Shabad’s (2001) view, when parents are able to validate
the child’s unique capacities, the child develops “a sense of worth or personal dignity, and of
having a special part to play within the human community”(p. 193). However, when parents
are unable to appreciate the uniqueness of the child—often due to their own narcissism—the
childcontortsherselftocomplywiththeparents’needs and ideals: “Eventually, these
children grow up to feel their lives are not their own, but the playthings of powers far
greater than themselves”(p. 195). Here, health is characterized by experiencing oneself as
worthwhile and creatively free, whereas pathology is marked by a lack of worth and freedom,
and a desperate search for these things that forecloses the possibility of free and creative
experiences in relationships.
Drawing parallels between the story of “the incredible shrinking man”and analytic change,
Donnell B. Stern (2010) emphasizes the increased dignity that accompanies the process of
narrating one’s life in the real or imagined presence of another person:
Prior to constructing his tale in the explicit terms of his diary, he has become an object in his own
life, a figure suffering chaotic, incomprehensible events for no apparent reason and with little feeling.
The emergence of meaning from what has felt to him like senselessness, helplessness, and despair
confers agency and therefore dignity. He is once again a subject. (p. 109)
In Stern’s view, dignity is aligned with agency and freedom, the ability to serve as a source of
one’s own experience. However, such freedom is not associated with the idea of a unified self.
Rather, it involves “our freedom to tell many self-stories at once—in other words, our freedom
to inhabit multiple states of being simultaneously”(p. 122).
Given that dignity concerns the worth of the person, it is understandable that many self-
psychologists devote attention to the topic (Jacobs, 2008; Ornstein, 1993). As Orange (2013)
observes, “Self psychology, with its awareness of the many forms of shame and degradation, has
placed the restoration of human dignity in the center of the therapeutic project”(p. 110).
Developing these ideas along intersubjective lines, Jessica Benjamin proposes a model in
which the dignity of both analyst and patient is vital to the therapeutic enterprise. Benjamin’s
(1995) theory of intersubjectivity is centered on the development of the capacity for mutual
recognition, our ability to experience the Other as “a separate and equivalent center of sub-
jectivity”(p. 7). Benjamin also frames her ideas in terms of mutual respect, or the capacity for
each person “to respect the other subject as an equal”(p. 8), which necessarily entails respecting
the differences between them (p. 23n).
The idea of dignity is deeply embedded in these insights—as noted earlier, the “uncondi-
tional worth”of humanity implies the equal worth of all human beings. In this model,
successful development entails the acquisition of the capacity for mutual recognition of
dignity—our ability to value both Self and Other unconditionally, in the context of a relation-
ship with another subject who is able to do the same. In her recent work, Benjamin (2009)
employs the idea of dignity when discussing the importance of the analyst accepting respon-
sibility for therapeutic ruptures, and the role of this approach in restoring mutual recognition in
the dyad:
438 DROZEK
An important sign of re-opening thirdness is being restored to the capacity to hear multiple voices—I
can hear both your voice and mine as can you without one cancelling the other out; I can hear more
than one part of yourself, you can hear more than one part of yourself. . . . It is now possible to
recognize the presence of multiple voices and parts of self. (p. 442)
Benjamin (2009) relates this process to developing “agency and responsibility”for patient
and analyst (p. 450), also linking it to the dignity of both participants (p. 447; see also
Benjamin, 2011). Combining her notion of mutual respect with these newer ideas on multi-
plicity, we arrive at a radical statement of the role of dignity in therapeutic process. Not only
does psychoanalysis enable patient and analyst to simultaneously experience dissociated parts
of themselves in the dyad, but this enhanced capacity for multiplicity entails an enhancement of
freedom for both parties, and an ability to value themselves and others while experiencing
multiple (potentially contradictory) configurations of Self and Other within oneself and the
relationship. Here we see the dignity in multiplicity, an idea I hope to further develop for the
remainder of this paper.
DIGNITY AS A PSYCHOANALYTIC CONSTRUCT
I now want to make an observation about the role of dignity in clinical practice, namely that we
naturally assume our patients are worthwhile, and that they are worthwhile in what might be
called an “unconditional”sense. Even in the messiness of day-to-day analytic work—when we
feel bored with our patients, when we are primarily interested in how they are making us feel,
when they are not doing (or feeling, or thinking) what we want them to, when we feel irritated
with them, when we even hate them and respond accordingly—we simultaneously assume our
patients are worthy of respect and care. This is what I mean by “unconditional”or “intrinsic”
valuing—valuing the other person as a person, regardless of the other bidirectional, “positive,”
and “negative”valuing that unfolds continuously and implicitly in the relationship. Such valuing
is not exclusively dependent on how we feel about the patient, or on whether our needs are
getting met—in the terms I am using here, it is unconditional.
6
This assumption plays a powerful role in how we approach analytic practice. While we rarely
notice the presence of dignity (e.g., a basic level of respect for Self and Other) in our patients’
narratives, the absence or contradiction of dignity in Self or Other (e.g., profound self-neglect,
self-hatred, externally directed rage) makes the analyst’s ears perk up: “There is something
important to be explored here.”We want to understand why they feel that way, in light of their
history, contemporary experiences, internalized representations of Self and Other, and so on. The
assumption of dignity thus serves as the context for our explorations of our patients’various
ascriptions of value to themselves and others.
6
In suggesting that we “assume”our patients are worthwhile, I do not want to imply (a) that such assumptions are
always consciously or explicitly formulated, (b) that we only value our patients positively, or (c) that we should only
value them positively. As I discuss later, we simultaneously ascribe a wide range of values to our patients (e.g., positive,
negative, conditional, unconditional), often unconsciously and always in response to the intersubjective dynamic in the
relationship at the time. I see this tension between different types of valuing (within and between members of the dyad) as
one of the central dialectics in analytic process, a dialectic that collapses when either party rigidly insists that one or the
other person “should”only engage in a particular sort of valuing.
THE DIGNITY IN MULTIPLICITY 439
At the same time, we automatically take ourselves to have a similar sort of value. In fact, it is
because of these assumptions that we seek to resolve the difficult impasses that receive so much
attention in our literature. Convinced that both of us are worthwhile, we are able to summon the
faith that there must be a way of being together in which the dignity of both participants can be
respected.
As an analytic construct, dignity has some unique features. First, the assumption of dignity
makes an often-unacknowledged claim to objectivity. When assuming our patients are worth-
while, we do not feel like we are simply expressing our personal feelings—“I value you.”We
feel like we are making a statement about the patient’sactual worth—“You are valuable, even if
you don’t feel that way about yourself.”If a patient tells us she is bad, evil, and undeserving of
love, we do not ask ourselves if she is really a bad person: “I really need to get to the bottom of
this, so that I can see if she is worthy of respect and care.”Rather, when our patients say these
sorts of things, we automatically assume they are wrong. Interestingly, when patients affirm they
are bad, or that their worth is dependent on some “extrinsic”quality (e.g., appearance, material
success), there is little they can say or do to make us agree with them.
There is also an ethical dimension to the dignity idea. Traditionally, analytic constructs are
descriptive in nature, highlighting the subject’s conscious and unconscious experiences without
explicitly taking a stand on the value of these experiences. While relational authors readily
highlight the role of the analyst’s personal values in shaping her theoretical contributions (D. B.
Stern, 2012), analytic constructs themselves are usually not essentially valuational in nature. In
contrast, dignity seems to straddle the experiential and valuational realms, describing an
experience of worth while also affirming that worth. This feature partially explains why dignity
has not achieved a place of explicit prominence in psychoanalysis—as an ethical concept, it can
appear to fall outside the boundaries of “psychoanalysis proper.”
7
Despite the importance dignity holds in clinical practice, traditional psychoanalytic models
tend to provide an unsatisfying explanation of this concept. Since its inception, psychoanalysis
has conceptualized value as a derivative rather than primary phenomenon—we value things that
lead to drive satisfaction, or that satisfy our needs. In relational thought, we conceptualize values
as deriving from affects—we value things that generate positive feelings in us, whether in our
early relational contexts or contemporary lives.
8
Such explanations do not do justice to our experience of dignity. To say we value other
people in this special way because “they satisfy our needs”or “they make us feel good”paints
an excessively self-oriented picture of dignity—it sounds thin and even demeaning. This model
7
For those of us with postmodern leanings, this can all start to feel a little uncomfortable. How can we situate an
objective, valuational concept within the confines of a contextual, descriptive psychoanalysis? While I find this question
fascinating, I do not offer a full answer to it here. As a provisional response, I suggest that affirming dignity does not
mean embracing epistemic objectivism across the board. I can affirm the worth of humanity without abandoning the
belief that anything else I might say about this worth (e.g., what it looks like empirically, what contradicts it) is
necessarily structured by personal, intrapsychic, and cultural factors. In this way, human dignity occupies a position
analogous to “the objective world”in Hoffman’s (1998) dialectical-constructivism—while we strongly believe that it
exists, we remain perpetually agnostic about the accuracy of our statements about it, since in principle there is no
objective standpoint that anyone can occupy to determine the truth value of the statement in question.
8
For examples of need-based models of value, see Fairbairn (1952), Sullivan (1953), Klein (1975), Kohut (1984),
Greenberg (1991), and Lichtenberg, Lachmann, & Fosshage (1992). For examples of affect-based perspectives on value,
see Kernberg (1976), Spezzano (1993), Sandler & Sandler (1998), and Teicholz (2010).
440 DROZEK
also contradicts the insight mentioned earlier, that often this valuing is not dependent on how
we feel, or whether our needs are being met. From our perspective as human beings, we value
other human beings because they deserve it, because they are the sorts of beings who are
valuable.
Furthermore, by positing some extra factor within the subject as determining the worth she
ascribes to other people, this model presents an overly passive view of dignity, neglecting the
fact that we often feel like we are choosing to value ourselves and others in this special way, and
that other people can choose to value us as well. This is a disempowering vision of dignity,
dissociating the agency involved in dignity out of the subject and placing it into “needs”and
“affects”(see Schafer, 1976).
In making these arguments, I am not suggesting that psychoanalytic practitioners believe that
all values derive from needs and affects, or that we lack a sense of agency in determining our
values. Rather, I am concerned that, by employing the aforementioned derivative models of
value, we are inadvertently committing ourselves to concepts that undermine the dignity of the
person, despite the fact that we are naturally committed to affirming that dignity. To preserve our
everyday experience of dignity, we need a psychoanalytic construct that allows for the possibi-
lity of derivative and intrinsic value, affirming the idea that human beings are the recipients and
the source of the value we ascribe to one another. Such a construct would be more consistent
with the nuanced and dialectical vision of human value we already naturally employ in analytic
work.
Psychoanalysis also has difficulty explaining the universality of dignity. Ironically, this is
especially true in relational thought, which dispenses with universal drives in favor of a model
where “all meaning is generated in relation”(Mitchell, 1988, p. 61). While such a model can
explain why children who experience care and validation develop the capacity to value them-
selves and others unconditionally, it has difficulty explaining why children who never experi-
ence such things still develop a sense of themselves as having dignity, an inner resilience
enabling them to seek out new contexts more consistent with their worth and the worth of
others. Shengold (1979) articulates the problem thus:
Despite the vulnerability of children and the prevalence of bad parents, a completely successful soul
murder is probably rare. Why this should be so is mysterious; part of the explanation is innate
endowment. What was it that enabled one of my patients with two psychotic parents to become, from
age four on, the real parent in the family—a sane caring person who was able to help her siblings and
even take care of her psychotic parents? I have no adequate answer. (pp. 549–550)
If all meaning derives from relational experiences, it is difficult to explain how someone who has
never been valued still develops a sense of dignity.
The philosophical ideas reviewed earlier provide some interesting resources to address this
problem. In these models, dignity is related to the phenomenology of freedom—since we
experience ourselves as a source of meaning rather than just as receptacles for other peoples’
meanings, we take ourselves to have an intrinsic worth as subjects. I have suggested that all of us
have intermittent access to this experience. These considerations lead to a far-reaching clinical
idea: Regardless of our patients’degrees of pathology, they can encounter a sense of themselves
as intrinsically valuable. This experience is not dependent on their relational histories—it is
grounded in the structure of human consciousness, and so it is open to everyone. The sense of
dignity serves as an unparalleled psychic anchor in clinical work, leading patients to believe that,
THE DIGNITY IN MULTIPLICITY 441
despite their histories of trauma and neglect, they deserve something better in the future.Inmy
view, psychoanalysis is the intersubjective process by which we help patients transform their
beliefs about “what they deserve”into a hope and desire for a previously unforeseen possibility,
and ultimately into a genuinely new experience of Self-in-relation-to-Other.
THE DIGNITY IN MULTIPLICITY
In this section, I sketch the broad outlines of a model of psychic experience and development in
which dignity plays a defining role. The model is based on the assumption that all of us have
intermittent access to a sense of ourselves as intrinsically valuable. This experience has a
powerful impact on the basic directionality of intersubjective process across time, naturally
leading us to seek out modes of relatedness in which we experience ourselves as having more
positive and less conditional value. To the degree that we identify other people as similar to us,
there also exists an experiential thrust toward valuing them more positively and less condition-
ally, such that our actions, feelings, and thoughts are more consistent with their dignity. Dignity
thus operates as an almost gravitational force in intersubjective experience, a gradient continu-
ously nudging us towards a deeper respect for ourselves and others. This, I believe, is what Dr.
Martin Luther King, Jr., was affirming when he said, “The arc of the moral universe is long, but
it bends towards justice.”At the personal and cultural level, human experience is not, nor can it
ever be, ethically neutral. This applies even to so-called “pathological”processes that, on their
face, seem to contradict the dignity of Self or Other.
I will first articulate, although not fully defend, some of my basic assumptions. I expand the
notion of value beyond its more “conscious”or “ethical”connotations, defining it simply as
taking something to be a source of meaning. At the conscious level, we regularly experience
ourselves as an “I”ascribing value to aspects of our relational lives, whether we are taking some
person, thing, or event to be “good”or “bad,”or considering if we “should”or “should not”
perform a certain action. Following Mitchell (1988), I conceptualize unconscious process in
terms of relational configurations, our templates for what it means to be in relationship with
others. However, I see our motivational connection to these configurations in terms of value:
unconsciously or implicitly, we constantly ascribe a range of values (e.g., positive/negative,
conditional/unconditional) to representations of our experiences in relationships.
In this model, I take the category of value to have a primary motivational status—all other
psychic phenomena (e.g., cognitions, affects, desires, fantasies) can be viewed as expressions of
our ascriptions of value to certain ways of being with others, influenced by our embeddedness in
past and contemporary relational contexts. If we assume that our valuations are not motivation-
ally dependent on desires and affects, then we open up the possibility of intrinsic value within
psychoanalysis—we can value other people for their own sake, regardless of how they make us
feel or whether they meet our needs.
It is important to draw a distinction regularly blurred in the discussions of dignity reviewed
earlier—the distinction between dignity and self-esteem. Dignity refers to the intrinsic worth of
the human subject. From the first-person perspective, we experience this worth intermittently,
when we reflexively value ourselves as an “I”that serves as a source of meaning. Self-esteem
refers to the positive or negative value we ascribe to ourselves as Selves (i.e., as objects of the
“I”) in the relational modes we occupy in intersubjective experience. While we implicitly ascribe
442 DROZEK
unconditional value to ourselves as subjects, we simultaneously ascribe other forms of value to
various unique, historically influenced representations of ourselves and others. I suggest that this
dialectic between “the value of the Subject”and “the value of Self and Other”lies at the heart of
personality development and motivation. In addition to emphasizing the dialectic between
different relational configurations or self-states, I am interested in the dialectic within our
different configurations, specifically between our ascription of unconditional value to ourselves
and others as subjects and our valuations of Self and Other as objects, the latter of which can be
more or less experientially consistent with the person’s dignity.
As other authors have noted, the child’s first relational configurations derive from her
unique experiences in early familial contexts. The child gradually comes to value herself
and the caregiver in a manner consistent with the caregiver’s valuations of herself and the
child. These valuations form the basis of the child’s earliest relational configurations. When
the caregiver is able to value herself and the child unconditionally—when she does not feel
like she has to choose between maintaining her dignity and honoring the child’s dignity—
child and caregiver co-create a mutually responsive dynamic, in which both parties are able
to value each other simultaneously (see Drozek, 2010b). As the child develops the sense of
a verbal self and starts to value herself as a subject, she begins to experience a flexible and
progressive harmony between herself and other people as subjects—“I am at the center of
the world but so are you”—and herself and other people as Selves/Objects—“Iam
valuable to myself but also to you; you matter to yourself, and you also matter to me”
(Benjamin, 1995). For ease of reference, I refer to this capacity as dignity-based
experiencing.
No caregiver ascribes only intrinsic value to her child. Most commonly, the caregiver ascribes
unconditional value to aspects of the child (e.g., behaviors, affective states, attitudes) and
conditional value to the child herself, dependent on whether she displays qualities the caregiver
values. Or she ascribes unconditional badness to aspects of the child, and conditional badness to
the child when she exhibits those qualities. Over time, the child adopts similar patterns of
valuing, as Sullivan (1953) illustrates with his ideas about “good me”and “bad me.”This
conditional valuing of the child is often related to the caregiver’s valuations of herself—“I
ascribe conditional value to myself, and unconditional value to these parts of myself. I need you
to be a very specific sort of person with me, so that I can actualize the parts of myself that have
intrinsic worth.”
This conditional valuing is a normative part of human development. In my view, it does not
cause serious problems as long as the child also develops the capacity for dignity-based
experiencing. Even if we feel like we have to “earn our worth”in various ways, we still have
access to an experience in which we are a source of meaning and value no matter what. In this
view, the capacity for dignity-based experiencing serves as the intersubjective buffer for all of
the non-dignity-based processes endemic to human experience. Here psychopathology involves
either the absence of the capacity for dignity-based experience (as we see in cases of severe
trauma and neglect), or impairments in this capacity when another configuration is motivation-
ally prominent (as we see in traditional “neuroses”). Without dignity, desire becomes despera-
tion, insecurity becomes self-hatred, and anger becomes rage.
To illustrate: When the caregiver cannot value herself and the child simultaneously, or if the
child is unable to experience the caregiver as valuing her, the child never encounters a mode of
relatedness in which Self and Other have a basic sense of worth. Instead, the child values parts
THE DIGNITY IN MULTIPLICITY 443
of herself (e.g., attractiveness, the ability to perform well in some way, a specific relational
stance), taking her worth to be dependent on her ability to actualize those parts. As develop-
ment unfolds, the child desperately seeks to cultivate those qualities the caregiver valued most,
and to avoid qualities the caregiver devalued—“If I am the sort of person who feels these things
or behaves in these ways, no one will ever want to be with me.”This is the province of
compulsion, when we feel like we have to perpetually work to create a certain vision of reality,
and to prevent other visions of reality from materializing. We do this not only to make
ourselves worthwhile, but because we believe this is what it means to be in a relationship
with another person.
Perhaps most tragically, there are instances in which the caregiver ascribes badness to the
child as a person. When the caregiver ascribes badness to herself but lacks the capacity for
dignity-based experiencing, she can become addicted to modes of relatedness where she con-
stantly situates this badness outside of herself (e.g., in the child), simultaneously ascribing value
to some aspect of herself actualized in these dynamics (e.g., a sense of power, self-righteous
rage, externally directed aggression). Here, the caregiver needs the child to be bad so that she
does not have to be, so that she can access the parts of herself she takes to be most valuable.
Under these circumstances, the child can develop tendencies towards self-hatred and masochism
—she sees herself as essentially bad (Fairbairn, 1952), unworthy of relationships with others,
while unconsciously valuing the qualities in others (e.g., power, aggression) she now associates
with her own badness.
9
As noted earlier, as the child develops the sense of a verbal self and gains the capacity for
agentic freedom, she starts to implicitly value herself as a subject. If her earliest relational
configurations contradict the intrinsic value of the Self (e.g., if she ascribes badness or only
conditional value to herself), the child encounters an experiential discrepancy between her
valuation of herself as subject and her valuations of herself as Self. This discrepancy
manifests itself in the vague but powerful feeling that she deserves something better than
the roles that have been forced upon her, even though she has never experienced anything
other than those roles. This yearning for “something better”does not stem from the child’s
past experiences or from the operation of some drive or need, but from the child’simplicit
recognition of her dignity, deriving as we have seen from the structure of human
consciousness.
The child now finds herself in a dilemma. While she longs for a mode of relatedness more
consistent with her dignity, such a mode is often not readily available to her. In a creative attempt
to resolve this dilemma, the child naturally tries to assume a relational position to which she
ascribes more positive and less conditional value. This solution can take various forms—
granting some other valued relational mode (e.g., with other family members, with peers)
increased prominence within her psychic economy; attempting to negate the demeaning rela-
tional mode, perhaps by avoiding the relationship in question; adopting some valued role she has
9
We see a similar state of affairs when the caregiver is indifferent or neutral to the child. In many cases, the caregiver
fails to ascribe either positive or negative value to the child, leading to minimal interaction with the child and significant
neglect of her needs. Since the child takes the caregiver to be a source of value, and since the caregiver fails to value the
child, the child takes herself to lack value, that is, she ascribes negative value to herself as a person. This analysis is
consistent with many patients’belief that it is somehow their fault they were neglected, and with their vague sense that, if
they had been “better”in some way, their caregivers would have been more responsive to their needs and desires.
444 DROZEK
observed or imagined but never experienced herself; if participation in such a role is not possible
for her, occupying this role in fantasy; and experimenting with a valued role formerly held
exclusively by the caregiver, as exemplified in Freud’s (1920/1955) “fort/da”example and Anna
Freud’s (1946) ideas about “identification with the aggressor.”These new configurations often
become the person’s primary manner of defending against configurations in which she ascribes
unconditional badness or only conditional value to herself.
The experience of dignity can also impact the value we ascribe to other people. As noted
earlier, when we take other people to be fundamentally similar to us, we naturally value them
as subjects. If our most prominent relational configurations contradict the dignity of others
(e.g., when we ascribe badness or only conditional value to them), then we can encounter an
experiential discrepancy between our valuation of them as subjects and our valuations of them
as Selves. This incongruity manifests itself in vague feelings of guilt and shame—“This person
deserves more than I am giving her”—as well as chronic feelings of emptiness. While we
might try to escape this dissonance in various ways (e.g., by denying the essential similarity
between us; by defensively focusing on the other person’s wrongs or defects), such feelings
can often be alleviated only by coming to value the other person under a wider range of
conditions, thereby adopting a mode of relatedness more experientially consistent with the
other person’s dignity.
THE DIALECTICS OF DIGNITY IN CLINICAL PROCESS
I would now like to share some preliminary ideas about what it might look like to conceptualize
analytic work along dignity-based, value-oriented lines. To ground these ideas, I draw on Philip
Bromberg’s pioneering work on the intersubjective nature of dissociative process. In Bromberg’s
(2006) view, the analytic process can be seen as “the ongoing collision of multiple subjectivities
contained within and between patient and analyst”(p. 105), in which both parties dissociate their
“not-me”self-states in the therapeutic relationship, often without awareness and always in
response to the intersubjective dynamic unfolding between them. According to Bromberg
(2010), “It is through the open, joint processing of each partner’s not-me experience that the
potential for expanded symbolization of self-meaning emerges”(p. 21). Through collaborative
analytic work, both members of the dyad gain access to their previously dissociated experiences.
Where the patient had rigidly dissociated her self-states from one another, she gains an expanded
capacity to “stand in the spaces”between contradictory self-states, leading to an increased sense
of wholeness and “the coexistence of self-continuity and self-coherence across self-states”
(Bromberg, 2006, p. 27; see also Bass, 2012).
Developing these ideas along the lines I have been proposing, I suggest that analyst and
patient are continuously ascribing a range of values to various unique configurations of Self and
Other in the clinical situation, in light of their respective histories, psychosocial/cultural con-
texts, and the intersubjective dynamic unfolding between them in the present moment. While
some of these values are symbolically accessible, most of them operate outside the awareness of
both participants—we reflexively register the valuational patterns of the other person, which in
turn affects the values we ascribe to Self and Other in the next moment, which then influences
the value they ascribe to us, and so on, in the infinitely complex messiness of clinical
experience.
THE DIGNITY IN MULTIPLICITY 445
Examples of such patterns include valuing Self and Other “only if”we display
certain qualities (e.g., attractiveness, intelligence, particular valued attitudes or relational
approaches); devaluing Self and Other when we display other qualities (e.g., aggression,
obstinacy, self-centeredness); and ascribing badness to ourselves and others as
people. Both parties’valued configurations often fit together seamlessly for some time,
leading to a relative sense of equilibrium within each person and within the relationship.
For example, I might reflexively ascribe conditional value to myself, dependent on my
ability to meet the damaged Other’s emotional needs, and conditional value to the other
person, depending on whether she allows me to rescue her. This configuration can
mesh naturally with my patient’s configuration, in which she values herself as
compliantandpassive,takingherworthtobe contingent on the responsiveness of her
caretaker.
Such dynamics often proceed “under the therapeutic radar,”since they allow us to feel
valued in ways most comfortable for us. We call such patients “analyzable,”and we are
satisfied with the work. However, to the extent that such dynamics start to experientially
contradict the dignity of either party, disruptions in the relationship inevitably arise. When
working with patients who lack the capacity for dignity-based experiencing, or when working
in areas of the personality where our capacities for mutual respect are diminished, the dyad has
a narrower range of conditions under which Self and Other can be experienced as valuable, and
a wider range of conditions under which Self and Other can be experienced as bad or without
value. This is the territory of “impasse”or “enactment”—both people feel like their valued
modes of relatedness are unavailable to them, and they are far more vulnerable to ascribing
badness to Self and Other. You are bad because you are keeping me from what is most valuable.
Each person feels like she must choose between retaining her dignity and preserving the dignity
of the other person, a dynamic Benjamin (2004) aptly calls the split-complementarity of doer
and done-to.
In these moments, when conceptualizing intersubjective process in terms of dignity, I am
particularly interested in our explicit and implicit ideas about how each party “should”be with
the other—behaviorally, affectively, attitudinally, and characterologically. “I/you can only be
good if . . ..”“You are/I am bad because. . ..”
10
This is where the analyst’s self-disclosures can
become such an integral part of the therapeutic process. These disclosures often serve as the
starting point for the mutual exploration of the bidirectional valuational patterns that have come
to grip the dyad. “When you tell me that we’re not allowed to talk about your feelings here, I
think I’ve been judging you a bit, maybe even wanting to make you feel bad for not doing what I
assume is best for you. I think I’m afraid that, if we can never talk about how you feel, then my
hands are kind of tied, and I’ll never be able to help you.”And later: “This idea of me ‘trying to
make you feel bad’and you rebelling against me . . . Does this remind you of anything else
that is meaningful for you?”Through the joint exploration and processing of these
10
Perhaps most commonly, we become quietly obsessed with the patient changing in a specific way: In order for me
to experience myself as worthwhile, I need you to display certain qualities. These “qualities”are often related to our
preferred theoretical orientation: a renouncement of infantile libidinal aims, increased self-cohesion, an expanded
relational repertoire, an enhanced capacity for mutual recognition, the ability to “stand in the spaces,”and so on. Or
these qualities stem from our assumptions about the ideal manner for the patient to approach analytic work: lying on the
couch, free associating rather than taking action in sessions, reflecting on internal states instead of employing behavioral
strategies, exhibiting curiosity about the analyst’s subjectivity, and so on.
446 DROZEK
often-unformulated valuational patterns in analyst and patient, each party becomes progressively
more able to symbolize her own valuational patterns, also gaining insight into their historical
antecedents, the role they play in contributing to the present dynamic, the impact these patterns
have on the other person, and the ways in which they might limit the richness of intersubjective
experience.
On the part of the analyst, these disclosures often serve a transformational as well as a
communicative function. Through exploring, identifying, and representing the aforementioned
patterns, we progressively express our willingness to value Self and Other in different ways.
These are the conditions under which I have been valuing myself and you up until this moment,
but I am opening myself up to the possibility that these valuations might be transformed by our
relationship together. Or, stated somewhat differently: I am not going to let the person I have
been up until now determine what (at this very moment) we can become together.Whenweare
able to take this step, this often liberates the patient to do the same, such that each party begins
to value Self and Other under a wider range of conditions. Returning to my earlier example, I
become able to value my patient even when she is not simply the compliant receiver of help
(e.g., when she displays aggressiveness toward me) and able to value myself even when I
cannot fulfill my role of being the effective caretaker for her. In turn, the patient begins to
value me even when I am not the perfectly attuned caretaker, and to value herself when she has
internal experiences (e.g., vulnerability, a desire for attention) that she associates with her own
badness.
11
In this view of therapeutic action, each dyad must find a way to co-create a mode of
relatedness in which both parties can value the other person under a wider range of
conditions, even when she is displaying qualities to which we reflexively ascribe negative
(or only conditional) value. This leads to a mutually responsive and respectful dynamic
progressively more consistent with the dignity of both parties. Such a dynamic transcends
mutual respect as normally understood. Thecapacitytovalueaperson’s humanity in general
is not the same as valuing Self and Other in all of our multiplicity. Throughout the work, not
only do we come to know Self and Other at a deeper level of complexity (i.e., all of the
unique Selves that I am in relation to you, all of the unique Selves that you are in relation to
me), not only do we come to respect each other, but we come to value Self and Other at a
greater degree of complexity, even when that which is known is simultaneously devalued.
Here, the ability to “stand in the spaces”between contradictory self-states is directly related
to the capacity for dignity-based experiencing. When we ascribe unconditional value to Self
and Other in all of our evolving complexity, we are able to summon the courage to
simultaneously access experiences that exist in a state of dialectical tension with the dignity
of Self and Other.
11
Following Benjamin (1995), I assume there is a natural correlation between valuing oneself and valuing others (see
Drozek, 2010a). As noted earlier, the conditional valuing of others often implies the conditional valuing of oneself—I
value myself only under certain conditions, and I value you when you help me meet these conditions. Similarly, the
ascription of badness to others as people frequently implies the ascription of badness to oneself—I devalue you in order
to escape from my own badness. However, when I am able to value you even if you do not help me satisfy the conditions
for my worth, I open myself up to the possibility that Ican be valuable under a wider range of conditions (e.g., when you
are not bolstering my self-esteem). And when I am able to value myself even if I cannot meet the conditions for my
worth, I place less pressure on you to make me feel worthwhile, thus opening myself up to valuing you under a wider
range of conditions (e.g., when you are not complying with my ideal vision of you).
THE DIGNITY IN MULTIPLICITY 447
CONCLUSION: DIGNITY AS A FOUNDATIONAL VALUE IN RELATIONAL THOUGHT
In this paper, I have suggested that many developments associated with the relational turn were
driven not simply by theoretical considerations, but by a shared ethical vision among relational
theorists and practitioners—the commitment to cultivating a psychoanalysis more consistent
with the dignity of the human subject. This idea is compatible with recent work emphasizing the
humanistic dimensions of psychoanalytic thought (Altman, 1995; Aron & Starr, 2012). In
closing, I would like to make explicit an idea largely implicit in the literature considered here,
namely that our theories are partially answerable to the intrinsic worth of the person. Greenberg
and Mitchell (1983) were getting at something similar when they proposed that, in addition to
Kuhn’s (1977) criteria of accuracy, consistency, scope, simplicity, and fruitfulness, a theory
should be evaluated based on “how compelling it appears to be, on its underlying vision of
human life”(p. 407).
To the above list I would add an ethical criterion—the extent to which a theory is consistent
with and expressive of the dignity of the person. Obviously, there will be disagreement about
how a theory might satisfy or violate such a criterion, and our opinions about such matters will
be shaped by our own values, culture, theoretical orientation, and personal preferences. Such
ethical considerations are already influencing theory development in psychoanalysis, and there is
good reason to make these concerns explicit: How does the theory (or concept) embody the
worth of the person? How might it contradict that worth? By explicitly attending to such
questions, we would be encouraging continuous revision of our theories in order to further
reflect the dignity of the subject, a process that could lead to progressively more humane theories
of analytic work. Such an approach would constitute an ethically grounded mode of theory
construction, privileging care and empathy over disinterested knowledge (see Levinas, 1981/
1998). We need to respect the people we are trying to understand, in our clinical work but also in
the theories we espouse. If a theory or concept can only explain an experience by undermining
the dignity of the person (e.g., in the case of the derivative models of value considered in this
paper), we have preliminary reason to doubt the explanation itself, on ethical grounds.
Some readers may question the relevance of this point to relational thought. After all, we
have come so far, and our theories paint a much more humane picture of human experience
and analytic practice. While I agree with this view, I am not prepared to conclude relational
theory is immune to these problems. This position is supported by Mitchell’s (1988) main
work, where he systematically argued against theoretical tendencies that undermine the
person’s dignity (e.g., portraying human beings as passive, driven by infantile needs, deter-
mined by antecedent causes, motivated by universal motivations), tendencies that he illu-
strated are employed by relationally-orientedaswellasclassicaltheorists(pp.62,151–172,
242–243). From the perspective of dignity, not all relational theories are created equal. In this
pluralistic psychoanalytic landscape, all theories contain diverse elements operating simulta-
neously at multiple levels of discourse, some of which affirm the worth of the person and
some of which undermine it.
By explicitly endorsing human dignity as an overarching value of relational thought, we
would be shifting the locus of power from our theories to the worth of our common humanity.
This approach naturally sets limits on the authority any theory or idea can attain. The theory’s
power would not derive from its popularity, history, or political affiliation—it would derive from
the theory’s ability to explain and affirm the inherent worth of the person, and its power would
448 DROZEK
be limited to the degree that it undermines that worth. In this way, dignity would be serving as a
“third term”that mediates our relationships to our theories, simultaneously affirming the value of
humanity, whether in ourselves or in the people we are trying to help.
REFERENCES
Aggarwal, N. K. (2011). Intersubjectivity, transference, and the cultural third. Contemporary Psychoanalysis,47,
204–223. doi:10.1080/00107530.2011.10746451
Altman, N. (1995). The analyst in the inner city: Race, class, and culture through a psychoanalytic lens. Hillsdale, NJ:
The Analytic Press.
Aron, L. (1996). A meeting of minds: Mutuality in psychoanalysis. Hillsdale, NJ: The Analytic Press.
Aron, L. (2000). Self-reflexivity and the therapeutic action of psychoanalysis. Psychoanalytic Psychology,17, 667–689.
doi:10.1037/0736-9735.17.4.667
Aron, L. (2005). The tree of knowledge: Good and evil: Conflicting interpretations. Psychoanalytic Dialogues,15,
681–707. doi:10.1080/10481881509348859
Aron, L., & Starr, K. (2012). A psychotherapy for the people: Toward a progressive psychoanalysis. New York, NY:
Routledge.
Bass, A. (2012). Negotiating otherness: The analyst’s contribution to creating new ways of being and relating in the
analytic process: Commentary on paper by Frank Summers. Psychoanalytic Dialogues,22, 162–170. doi:10.1080/
10481885.2012.666158
Beebe, B., & Lachmann, F. M. (2002). Infant research and adult treatment: Co-constructing interactions. Hillsdale, NJ:
The Analytic Press.
Benjamin, J. (1995). Like subjects, love objects: Essays on recognition and sexual difference. New Haven, CT: Yale
University Press.
Benjamin, J. (2000). Intersubjective distinctions: Subjects and persons, recognitions and breakdowns: Commentary on
paper by Gerhardt, Sweetnam, and Borton. Psychoanalytic Dialogues,10,43–55. doi:10.1080/10481881009348520
Benjamin, J. (2004). Beyond doer and done to: An intersubjective view of thirdness. The Psychoanalytic Quarterly,73,
5–46. doi:10.1002/(ISSN)2167-4086
Benjamin, J. (2009). A relational psychoanalysis perspective on the necessity of acknowledging failure in order to restore
the facilitating and containing features of the intersubjective relationship (the shared third). The International Journal
of Psychoanalysis,90, 441–450. doi:10.1111/ijp.2009.90.issue-3
Benjamin, J. (2011). Acknowledgment of collective trauma in light of dissociation and dehumanization. Psychoanalytic
Perspectives,8, 207–214. doi:10.1080/1551806X.2011.10486306
Bromberg, P. M. (2006). Awakening the dreamer: Clinical journeys. Mahwah, NJ: Analytic Press.
Bromberg, P. M. (2010). Minding the dissociative gap. Contemporary Psychoanalysis,46,19–31. doi:10.1080/
00107530.2010.10746037
Coburn, W. J. (2002). A world of systems: The role of systemic patterns of experience in the therapeutic process.
Psychoanalytic Inquiry,22, 655–677. doi:10.1080/07351692209349011
Davies, J. M. (1994). Love in the afternoon: A relational reconsideration of desire and dread in the countertransference.
Psychoanalytic Dialogues,4, 153–170. doi:10.1080/10481889409539011
Drozek, R. P. (2010a). “Finding the value”in intersubjective and clinical process: Towards a valuational model of
relational motivation: Reply to commentaries. Psychoanalytic Dialogues,20, 582–596.
Drozek, R. P. (2010b). Intersubjectivity theory and the dilemma of intersubjective motivation. Psychoanalytic Dialogues,
20, 540–560.
Eagle, M. N. (1984). Recent developments in psychoanalysis: A critical evaluation. New York, NY: McGraw-Hill.
Fairbairn, W. R. D. (1952). Psychoanalytic studies of the personality. Hove, UK: Brunner-Routledge.
Fenichel, O. (1941). Problems in psychoanalytic technique. New York, NY: Psychoanalytic Quarterly.
Ferenczi, S. (1988). The clinical diary of Sándor Ferenczi (M. Balint & N. Z. Jackson, Trans., and J. Dupont, Ed.).
Cambridge, MA: Harvard University Press. (Original work published 1932)
Foehl, J. C. (2010). The play’s the thing: The primacy of process and the persistence of pluralism in contemporary
psychoanalysis. Contemporary Psychoanalysis,46,48–86. doi:10.1080/00107530.2010.10746039
THE DIGNITY IN MULTIPLICITY 449
Fonagy, P., Gergely, G., Jurist, E. L., & Target, M. (2002). Affect regulation, mentalization, and the development of the
self. New York, NY: Other Press.
Freud, A. (1946). The ego and the mechanisms of defense (C. Baines, Trans.). New York, NY: International Universities
Press.
Freud, S. (1955). Beyond the pleasure principle. In J. Strachey (Ed. & & Trans.), The standard edition of the complete
psychological works of Sigmund Freud (Vol. 18, pp. 1–64). London, UK: Hogarth Press. (Original work published
1920)
Freud, S. (1961). The ego and the id. In J. Strachey (Ed. & & Trans.), The standard edition of the complete psychological
works of Sigmund Freud (Vol. 19, pp. 1–66). London, UK: Hogarth Press. (Original work published 1923)
Gaztambide, D. J. (2012). “A psychotherapy for the people”: Freud, Ferenczi, and psychoanalytic work with the
underprivileged. Contemporary Psychoanalysis,48, 141–165. doi:10.1080/00107530.2012.10746495
Gentile, J. (2010). Weeds on the ruins: Agency, compromise formation, and the quest for intersubjective truth.
Psychoanalytic Dialogues,20,88–109. doi:10.1080/10481880903559088
Ghent, E. (1989). Credo—The dialectics of one-person and two-person psychologies. Contemporary Psychoanalysis,25,
169–211. doi:10.1080/00107530.1989.10746289
Greenberg, J. R. (1991). Oedipus and beyond: A clinical theory. Cambridge, MA: Harvard University Press.
Greenberg, J. R., & Mitchell, S. A. (1983). Object relations in psychoanalytic theory. Cambridge, MA: Harvard
University Press.
Harris, A. (2005). Gender as soft assembly. Hillsdale, NJ: The Analytic Press.
Hoffman, I. Z. (1995). Review of Oedipus and beyond by J. Greenberg. Psychoanalytic Dialogues,5,93–112.
Hoffman, I. Z. (1998). Ritual and spontaneity in the psychoanalytic process: A dialectical- constructivist view. Hillsdale,
NJ: The Analytic Press.
Hoffman, I. Z. (2000). At death’s door: Therapists and patients as agents. Psychoanalytic Dialogues,10, 823–846.
doi:10.1080/10481881009348586
Hoffman, I. Z. (2009). Doublethinking our way to “scientific”legitimacy: The desiccation of human experience. Journal
of the American Psychoanalytic Association,57, 1043–1069. doi:10.1177/0003065109343925
Ipp, H. (2010). Nell—A bridge to the amputated self: The impact of immigration on continuities and discontinuities of
self. International Journal of Psychoanalytic Self Psychology,5, 373–386. doi:10.1080/15551024.2010.508197
Jacobs, L. (2008). Dialogue, confirmation, and the “good”.International Journal of Psychoanalytic Self Psychology,3,
409–431. doi:10.1080/15551020802337476
James, W. (1950). The principles of psychology (Vol. 1). New York, NY: Dover. (Original work published 1890)
Kane, R. (2002). Introduction: The contours of contemporary free will debates. In R. Kane (Ed.), The Oxford handbook
of free will (pp. 3–41). New York, NY: Oxford University Press.
Kant, I. (1997). Groundwork of the metaphysics of morals. Cambridge, UK: Cambridge University Press. (Original work
published 1785)
Kennedy, R. (1993). Freedom to relate: Psychoanalytic explorations. London, UK: Free Association Books.
Kernberg, O. F. (1976). Object-relations theory and clinical psychoanalysis. New York, NY: Aronson.
Klein, M. (1975). Love, guilt, and reparation, & other works, 1921–1945. New York, NY: Delacorte Press.
Kohut, H. (1984). How does analysis cure? Chicago, IL: University of Chicago Press.
Kuhn, T. (1977). The essential tension. Chicago, IL: University of Chicago Press.
Leary, K. (2000). Racial enactments in dynamic treatment. Psychoanalytic Dialogues,10, 639–653. doi:10.1080/
10481881009348573
Levinas, E. (1998) Otherwise than being, or, beyond essence (A. Lingis, Trans.). Pittsburgh, PA: Duquesne University
Press. (Original work published 1981)
Lichtenberg, J. D., Lachmann, F. M., & Fosshage, J. L. (1992). Self and motivational systems: Toward a theory of
psychoanalytic technique. Hillsdale, NJ: The Analytic Press.
Mitchell, S. A. (1978). Psychodynamics, homosexuality and the question of pathology. Psychiatry,41, 254–263.
Mitchell, S. A. (1988). Relational concepts in psychoanalysis: An integration. Cambridge, MA: Harvard University
Press.
Obergefell v. Hodges, 576 U. S. –––– (2015).
Ogden, T. H. (2005). This art of psychoanalysis: Dreaming undreamt dreams and interrupted cries. London, UK:
Routledge.
Orange, D. M. (2013). Those old wineskins: Greenberg and Mitchell on Heinz Kohut’s“mixed model”.Contemporary
Psychoanalysis,49, 103–112. doi:10.1080/00107530.2013.10746535
450 DROZEK
Ornstein, P. H. (1993). Chapter 12: Chronic rage from underground: Reflections on its structure and treatment. Progress
in Self Psychology,9, 143–157.
Renik, O. (1993). Analytic interaction: Conceptualizing technique in light of the analyst’s irreducible subjectivity.
Psychoanalytic Quarterly,62, 553–571.
Rosen, M. (2012). Dignity: Its history and meaning. Cambridge, MA: Harvard University Press.
Rustin, J. (1997). Infancy, agency, and intersubjectivity: A view of therapeutic action. Psychoanalytic Dialogues,7,
43–62.
Sandler, J., & Sandler, A.-M. (1998). Internal objects revisited. Madison, WI: International Universities Press.
Schafer, R. (1976). A new language for psychoanalysis. New Haven, CT: Yale University Press.
Seligman, S. (2005). Dynamic systems theories as a metaframework for psychoanalysis. Psychoanalytic Dialogues,15,
285–319.
Shabad, P. (2001). Despair and the return of hope: Echoes of mourning in psychotherapy. Northvale, NJ: Aronson.
Shengold, L. L. (1979). Child abuse and deprivation soul murder. Journal of the American Psychoanalytic Association,
27, 533–559.
Slavin, J. H. (2010). Becoming an individual: Technically subversive thoughts on the role of the analyst’s influence.
Psychoanalytic Dialogues,20, 308–324.
Spezzano, C. (1993). Affect in psychoanalysis: A clinical synthesis. Hillsdale, NJ: The Analytic Press.
Stern, D. B. (2010). Partners in thought: Working with unformulated experience, dissociation, and enactment. New York,
NY: Routledge.
Stern, D. B. (2012). Implicit theories of technique and the values that inspire them. Psychoanalytic Inquiry,32,33–49.
Stern, D. N. (1985). The interpersonal world of the infant: A view from psychoanalysis and developmental psychology.
New York, NY: Basic Books.
Straker, G. (2011). Shaping subjectivities: Private memories, public archives. Psychoanalytic Dialogues,21, 643–657.
Suchet, M. (2007). Unraveling whiteness. Psychoanalytic Dialogues,17, 867–886.
Sullivan, H. S. S. (1953). The interpersonal theory of psychiatry. New York, NY: Norton.
Teicholz, J. G. (2010). The Achilles heel of psychoanalysis: Meditations on motivation: Commentary on paper by Robert
P. Drozek. Psychoanalytic Dialogues,20, 569–581.
Tublin, S. (2011). Discipline and freedom in relational technique. Contemporary Psychoanalysis,47, 519–546.
Wachtel, P. L. (1986). From neutrality to personal revelation: Patterns of influence in the analytic relationship
(a symposium)—On the limits of therapeutic neutrality. Contemporary Psychoanalysis,22,60–70.
Weisel-Barth, J. (2009). Stuck: Choice and agency in psychoanalysis. International Journal of Psychoanalytic Self
Psychology,4, 288–312.
Winnicott, D. W. (1971). Playing and reality. London, UK: Routledge Classics.
Young-Bruehl, E. (2011). Psychoanalysis and social democracy: A tale of two developments. Contemporary
Psychoanalysis,47, 179–203.
CONTRIBUTOR
Robert P. Drozek, LICSW, practices psychotherapy and social work at McLean Hospital. He is a
graduate of the Fellowship in Psychoanalytic Psychotherapy at Boston Psychoanalytic Society
and Institute. He is in private practice in Belmont, Massachusetts.
THE DIGNITY IN MULTIPLICITY 451