The Clinical Exchange
Techniques Derived from Self and Motivational Systems
Routledge – 2001 – 272 pages
In this practical sequel to the same authors' Self and Motivational Systems (TAP, 1992), Lichtenberg, Lachmann, and Fosshage offer ten principles of technique to guide the clinical exchange. These principles, which pertain equally to exploratory psychotherapy and psychoanalysis, integrate the findings of self psychology with recent developmental research that has refined our understanding of the self as a center of experience and motivation. The ten principles of technique not only provide a valuable framework for attending to a wide range of motivations, but lead to basic revisions in the theory and technical management of affects, transference, and dreams.
"One hundred years after Freud and Breuer initiated the saga of psychoanalytic technique, Lichtenberg, Lachmann, and Fosshage have written he most up-to-date, comprehensive, and readable guide to the practical clinical management of the therapeutic exchange. Theoretical sophistication and clinical experience, combined with the wisdom gained from decades of active teaching, research, and therapy, allow the authors to choose just the right amalgam of time-tested techniques and contemporary insights. The Clinical Exchange will stand as a landmark in the development of technique."
- Ernest S. Wolf, M.D., Chicago Institute for Psychoanalysis
"Building on their synthesis of developmental research, their innovative conceptualization of the five motivational systems, and their subsequent technical suggestions regarding 'model scenes,' Lichtenberg, Lachmann, and Fosshage have written an exciting and broad-ranging book on technique. It should inspire th neophyte, enhance the work of the seasoned practitioner, and challenge the assumptions of all those who study the clinical exchange."
- Jack Novick, Ph.D., and Kery Kelly Novick, Michigan Psychoanalytic Institute
"This is Greenson in a different key, a primer of psychoanalytic technique from the perspective of self psychology and infant observation, with so much process material from a single analysis that you not only see why the analyst does what he does, but can compare his inferences with your own, no matter what your clinical orientation. The format is so effective that by the end you feel as if you have had several years of supervision with the authors. The Clinical Exchange provides as generous a sample of the analyst's work as systematically presented as any book on technique that I know."
- Henry F. Smith, M.D., Psychoanalytic Institute of New England, East
Introduction. Case Summary and Effects of Lived Experiences on the Patient's Self and Motivation Systems. Clinical Exchange: 1983, 1985, 1987, 1989, 1990: Ten Principles of Technique. Affective Experience: The Golden Threat in the Clinical Exchange. Transferences: How We Understand and Work with Them. Dreams: The Special Opportunity to Explore Provided by Sleep Mentation. Sexuality, Affection, and Erotization: Implications for the Treatment of Sexual Abuse. Modes of Therapeutic Action and How Our Technical Recommendations Promote Them. Challenging Questions and Our Responses.
Joseph D. Lichtenberg, M.D., is Editor-in-Chief of Psychoanaytic Inquiry, Director Emeritus of the Institute of Contemporary Psychotherapy and Psychoanalysis, and past President of the International Council for Psychoanalytic Self Psychology. He has authored and edited numerous books and articles, including Craft and Spirit: A Guide to the Exploratory Psychotherapies (Analytic Press, 2005) and, with Frank Lachmann and James Fosshage, A Sprit of Inquiry: Communication in Psychoanalysis (Analytic Press, 2002).
Frank M. Lachmann, Ph.D., is a founding faculty member of the Institute for the Psychoanalytic Study of Subjectivity, Training and Supervising Analyst, Postgraduate Center for Mental Health, and Clinical Assistant Professor at the NYU Postdoctoral Program in Psychotherapy and Psychoanalysis. He has contributed over 100 articles to the journal literature, and is author of Transforming Aggression (Aronson, 2000), and co-author of Self and Motivational Systems (Analytic Press, 1992), The Clinical Exchange (Analytic Press, 1996), and Infant Research and Adult Treatment (Analytic Press, 2002).
James L. Fosshage, Ph.D., is Cofounder, Board Director, and faculty member, National Institute for the Psychotherapies, NYC; founding faculty member, Institute for the Psychoanalytic Study of Subjectivity, NYC; and Clinical Professor of Psychology, New York University Postdoctoral Program in Psychotherapy and Psychoanalysis.