Sarah Schoen’s research while affiliated with Gracie Square Hospital, New York, NY and other places

This article presents our collaboration as supervisee and supervisor at the Changing the Conversation Conference held in New York City, March 2019. We address racial enactments in supervisory dyads, the absence of institutional holding, and the barriers to speaking candidly about these experiences. We locate these struggles in race as a “forcefield,” in which experiences of difference collide in ways that can both transform and threaten cherished aspects of identity. In the process, we reflect on how legitimate concerns about confidentiality can, in this context, mask analysts’ desires to protect their access to normative privilege, institutional power, and facilitate avoidance of their own racialized shame.

This reply engages with the commentaries to further elaborate the concept of “temporal enactments” with narcissistically compromised patients. With these patients, the ways in which temporal continuity and subjective continuity are inextricable is particularly vivid. As such, temporal enactments illuminate the distinct quality of the analyst’s strain when faced with the loss of the intersubjective temporal field required for the ongoing experience of going-on-being.

This paper addresses the challenges of working with narcissistically vulnerable patients who suffer vast schisms between objective and subjective time. Such patients ward off awareness of temporal limits both because they long to access an authentic sense of personal rhythm and agency, and because they cannot tolerate the encounter with past and present losses that living in real time requires. A clinical vignette centered around the developmental window of fertility illustrates how temporal enactments unfold when the analyst feels forced to choose between inviting the potentials of timelessness and the expansion of continuity and interiority, or acknowledging the urgency to act and the threat of new losses that accompany the patient’s longing to wait for subjective experiences of “readiness.”

Atlas and Aron (2017/2019) invite us to think about the utility of enactments– not only as something that the analytic pair must recognize and work their way out of– but as a form of engagement with the patient’s prospective potential that can only emerge in a rich dyadic field. But what of the problems generated by the analytic dyad’s conscious and/or unconscious avoidance of getting involved enough with one another that those enactments—those “dramatic dialogues” –necessary for transformation can, in fact, develop? Using a clinical illustration, I build on my relational argument for frequency as a necessary (if not sufficient) condition for a psychoanalysis that relies on enactment as the mainstay of therapeutic action. It is frequency that stands a chance of exposing both analyst and patient to enough data that they find their way into, not only out of, those enactments that require contact with otherwise disavowed, yet potentially generative, aspects of self.

The following is a discussion of Tom Wooldridge’s (this issue) paper on primitive anxieties in anorexia and his metaphor of the “entropic body” as a false self “body-state” (Petrucelli, 2014) that functions to omnipotently deny dependency. The focus here is on how, for the eating disordered patient, primitive anxieties related to dependency and containment intertwine with the challenges of rapprochement, in which separation, agency, and awareness of sex difference emerge in a traumatic field. This response emphasizes the clinical utility of conceptualizing eating disorders as disorders of a gendered, agentic self. Wooldridge’s clinical material is discussed with a focus on (a) the salience of gendered enactments in work with eating disordered patients and (b) the relationship between experiences of “entropy” in the clinical dyad and the mutual disavowal of gender-inflected identifications and desires.