Vulnerable Self Research Articles

An analysis of the use of the therapist's ‘vulnerable self’ and the significance of the cross-fertilization of humanistic and Jungian theory in the development of the relational approach

In this article the author examines some of the similarities and differences between Martin Buber and Carl Jung. Both men suffered abandonment by their mothers at an early age. Buber's mother left the family home; Jung's mother became mentally unstable. The author suggests that these early developmental experiences in both of the analysts’ lives influenced their theoretical and philosophical development. She introduces a case study as a method to examine both similarities and differences between Buber and Jung's approaches. The major distinction between the humanistic and Jungian approaches to therapy, she argues, is an understanding and use of the unconscious in the therapy relationship. She suggests that the relational approach in psychotherapy has benefited from a cross-fertilization of theoretical approaches, and in particular sees a fusion of Buber and Jung as offering the therapist ways of reflecting that increase the capacity for effective therapy.

Relational Theory: A Refuge and Compass

Relational theory offers a structure from which to understand and treat the interpersonal and intrapsychic legacy of severe childhood trauma. During the course of treatment, particularly with such traumatized patients, therapists are challenged to tolerate and make meaning of intense feelings in the transference-countertransference matrix. Relational theory’s ideas regarding adaptation to and perpetuation of the relational patterns of early life, dissociation of disavowed and intolerable self-states, and the inevitability of mutual enactments provide an organizing framework in which to weather and make bearable the unbearable. In addition, relational theory invites and supports the clinician in the vital task of meeting the patient’s vulnerability with his or her own authentic and vulnerable self. The following case material demonstrates the use of relational theory to find and to work at the intimate edge (Ehrenberg in Relational psychoanalysis: innovation and expansion, Analytic Press, Hillsdale, pp 3–28, 2005) where the impossible becomes possible.

Shiva’s dance of the relational interface

In the midst of the turbulence of digitally mediated world redefining our sensory experiences, whether in the form of artificial life, biological robotics, trans-humanism, virtual identity, we note a concern about the vulnerability of the self. As Greenfield (2009) notes that when this individual sense of self is threatened (e.g. electronic surveillance), our very worst fears are ignited, since there no longer exists a ‘fire wall’ of group identity, family or social identity, between the inner self and the outside world. Sennett (1998) in his book, The Corrosion of Character, draws our attention to the turbulence of fragmented self and notes that in the brave new economy, the fragmented or dislocated nature of self-experience moves to the fore, thereby setting the scenario for an emotionally adrift and vulnerable self, losing control of the purpose of life and feeling the loss of the sense of the self. (ibid:130). It is held that central to the turbulence of the self and society, is the dominance of technologic of seeing things in terms of the I–It relation, objects of calculation, moving away from the I–Thou framework of judgement. It is this shift from judgement to calculation (Weizenbaum 1976) which leads to perceiving human relations, may they be social, cultural, ethical, economic, governance, in terms of I–It relations. The summary on Martin Buber’s I and Thou (SparkNotes Editors 2014) notes that Buber looks at modern society and finds: ‘how it is entirely built up based on the mode of I–It. Politics, economics, public institutions, even much of personal life, are all fundamentally grounded in the fact that we view every other being as an It, rather than as a Thou. Modern man has come to feel alienated fundamentally because modern society is exclusively an It-world. Existential angst, worries of meaninglessness, and the sense of impending doom that most modern human beings feel at some point in their life (often in the dead of night, when they cannot sleep) are all the result of our strict reliance on experience to the exclusion of encounter’. Bloch (2010) and Scott (2002) give a deep insight into Buber’s I–Thou and I–It relations, in which Buber sets out a philosophy of relating. The experiencing I in an I–It relation is an objective observer rather than an active participant in this mode of engaging the world. In the I– Thou relation, we are present with others; it is the presence of others which influences our own sense of presence (Gill 2015) and creates an environment for us to be active participants rather than just mere objective observers. In our multipolar world of reality (observed) and actuality (the world as it is), I–It and I–Thou relations, in many ways, intersect, overlap, converge and diverge, making us seek a balance between these relations in a way that valorises their purpose and impact. In this perspective, we may say that we are seeking a relational interface of balance in the sense of harmony, kyosei, Yin-Yang, Symiotics, Swikriti (Gill 2009). The Dancing Shiva or Nataraja (Ramachandran 2012) depicts the very spirit of balance of actuality and reality of our universe, and from our perspective, provides a holistic model for conceptualising, creating and building relational interfaces. In viewing metaphysic as ‘beyond’ the physical, Rao (2014) gives an insight into the idea of subject (I, Thou) and object (It). In accepting, One-Godhead as the ‘ultimate’, Monotheistic religions (e.g. Judaism, Christianity and Islam) accept duality of subject (the worshipper) and the Object (the Worshipped—the God). He further says that although Monism (Non-dualism) appears to deny Godhead, it accepts God as having an ontological status at least ad hoc. What is of interest to us in the case of the K. S. Gill (&) University of Brighton, Brighton, UK e-mail: kgillbton@yahoo.co.uk

La Autoetnografía Crítica y el Self Vulnerable como Investigadora

Este ensayo presenta la autoetnografía crítica como una estrategia innovadora para conducir investigaciones en comunidades marginadas y vulnerables. Como se usa en este ensayo, es una combinación de la autoetnografía, la etnografía y la pedagogía crítica por la cual la investigadora se hace participante en el estudio, dirigiéndose al interior para examinar el Self y la complejidad de las perspectivas usando la lente de la pedagogía crítica. La reflexividad y la introspección intensas apoyan este estudiodel Self como participante para ir más allá del recuento de hechos tan objetivamente como sea posible, que es lo que ocurre con la autobiografía, para reconocer que la investigadora interpreta los hechos de su vida a partir de las perspectivas culturales que se han formado por años debido a sucesos y circunstancias socioculturales, socio-históricas, sociopolíticas y socioeconómicas que le han ocurrido. Subsecuentemente como investigadora que es miembro de la cultura dominante enalgunas categorías puedo ver y entender como opresora de la gente que vive en las comunidades donde hago mis investigaciones.

Subjectivité et vulnérabilité chez Ricœur et Levinas

En quoi le soi, tel que Ricœur nous le donne à voir, peut-il être dit vulnérable? Nous soutiendrons que cette vulnérabilité peut être appréhendée à trois niveaux: réflexif, des capacités humaines et ontologique. Cependant, si Ricœur nous aide bien à penser la fragilité humaine et à définir ainsi une conception nouvelle du soi, la vulnérabilité reste envisagée dans le cadre d’une réflexion sur l’agir humain dont elle est en quelque sorte le versant négatif. L’autonomie, comme point d’orgue de l’agir, demeure la visée à atteindre. Ce point de référence à partir duquel la vulnérabilité est pensée mérite selon nous d’être questionné: nous permet-il d’en prendre toute la mesure? Nous mettrons à l’épreuve la conception ricœurienne de la vulnérabilité en nous appuyant sur l’éthique levinassienne. Levinas opère, en effet, un double renversement. Non seulement la vulnérabilité prend-elle la première place mais, de plus, celui qui est vulnérable, c’est d’abord autrui et non le soi.

Encountering the ageing body in modernity: fear, vulnerability and “contamination”

This paper attempts to understand the exclusion of ageing people within contemporary society through developing a model around the notion of the “encounter with the ageing body”. It is divided into three parts. In the first, I develop a model of the encounter through combining Sara Ahmed’s notion of “affective economies” with Shildrick’s theory of the encounter with the “vulnerable self”. I argue that the fear of ageing becomes embodied within the encounter with the ageing body. Specifically, the fear is vulnerability: within the encounter, the youthful self is forced into the recognition of his/her own vulnerability. Modernity requires that this be disavowed, with the ageing body banished to the margins through sequestration to foreclose the possibility of a repeat. In the second section, I discuss the nature of vulnerability within modernity. I explore two approaches to this: in the first, the vulnerability is to the threat of death, which has become particularly problematic within modernity; in the second, the vulnerability is the loss of subjectivity resulting from the ageing body’s failure to correspond to constructions of the ideal body within contemporary capitalism. In the final section, I evaluate whether recent social shifts promise a brighter future for ageing people, arguing that although the situation is not black and white, there is, nevertheless, unfortunately currently relatively limited potential for real change for older people.

A Disorder of a Vulnerable Self: Anorexia Nervosa Patients’ Understanding of Disorder and Self in the Context of fMRI Brain Scanning

In this article, we aim to explore patient perspectives regarding the etiology of anorexia nervosa (AN) in the context of participating in brain research for AN. This is a qualitative study using semistructured interviews with 12 young AN patients. Data were analyzed according to thematic analysis method. This study shows that patients’ language used to express their understanding of the etiology of AN was characterized by psychological terms such as personality, self-esteem, control, and coping rather than neuroscientific terms.Participants held a complex understanding of the causes of AN, acknowledging a brain–mind relationship. However, participants expressed the hope that brain sciences could contribute to identify an objective, physical proof for AN, that would validate their illness, increase understanding, and reduce blame. The study suggests that prevailing biological explanations promoted by brain research did not encourage simplistic perspectives on causation among patients. Instead, patients viewed biological-based theories and brain science as a means of validating their illness.

Healing a Vulnerable Self

Mental health problems (MHPs) such as stress and depression are among the leading causes of work disability. In this article we explore how women with MHPs experience sickness absence and subsequent return to work. We conducted 16 semistructured interviews and employed constructivist grounded theory for the analysis. We found that whereas sickness absence constituted a major threat to positive self-images, the experience had potential as a personal growth experience: Although some women felt handicapped, others became stronger and more self-confident. The core of the experience was not the return to work but a process of healing a vulnerable self--the ability both to refocus attention from symptoms to other life goals and to maintain or reconstruct a positive self-image. Supportive health care and acknowledgment from others facilitated the healing process.

Unpacking Alchemy: Commentary on Paper by Noelle Burton

I appreciate Noelle Burton's courageous paper in which she movingly demonstrates how the analyst's opening to her own vulnerable child self, as evoked by the analytic interaction, creates parallel openings between the patient and analyst and within the patient. At the same time, I wonder if there is a not-fully-mentalized enactment occurring in the analytic process—an enactment that is reflected in certain aspects of Burton's clinical narrative. And I wonder if the containment of Burton's childlike feelings—a central focus of her paper—is even more interactive than she has recognized. These questions are, however, overshadowed by the paper's significant creative (clinical and conceptual) contribution.

Why do young people with CFS/ME feel anxious? A qualitative study

Young people with chronic fatigue syndrome or myalagic encephalopathy (CFS/ME) (CFS/ME) experience higher levels of psychological distress than healthy controls and young people with other chronic illnesses, and it was recently demonstrated that 38% of this population scored above the clinical cut-off on the Spence Child Anxiety Scale. Subscales of social and separation anxiety were consistently high across gender and age groups. In this study, we used qualitative methods to help us understand more about these two types of anxiety in young people with CFS/ME. Eleven young people (age 12-18) were interviewed. Interviews were self-directed by the participants and were wide ranging. The transcripts were analysed using interpretative phenomenological analysis. Five superordinate themes were identified: social loss and adjustment; introduction of uncertainty and unpredictability; the vulnerable self; individual differences; and contributions towards recovery. Many themes were identical to those described in young people coping with other chronic illnesses in adolescence. In addition, young people with CFS/ME describe experiences associated with the perceived illegitimacy of this condition, namely: feeling unable to explain their illness; bullying from peers; disbelief; and distrust from adults around them. This becomes an additional challenge for these young people. Clinicians need to be aware of these problems, and offer appropriate support.

Living an unfamiliar body: the significance of the long-term influence of bodily changes on the perception of self after stroke

The aim of this study is to illuminate the significance of the long-term influence of bodily changes on the perception of self after stroke by means of narrative interviews with 23 stroke survivors. A phenomenological-hermeneutic approach inspired by the philosophy of Merleau-Ponty and Ricoeur is the methodological framework. Zahavi's understanding of the embodied self and Leder's concept of dys-appearance along with earlier research on identity guide the comprehensive understanding of the theme. The meaning of bodily changes after stroke can be understood as living with an altered perception of self. Stroke survivors perceive their bodies as fragile, unfamiliar and unreliable and tend to objectify them. The weak and discomforting body that 'cannot' demands constant, comprehensive awareness to keep itself in play. These long-term and often permanent consequences of bodily weakness may turn stroke survivors' intentionality inwards, away from external activities and projects and relationships with others. Negative judgements from others are added to lost roles and positions and threaten the vulnerable self. Stroke survivors try to regain familiarity with their body by their life-long project of testing its boundaries. Mastering important tasks helps them strengthen their self-concept. Health care workers should be aware of the embodied self and engage in long-term dialogues with stroke survivors to strengthen positive perceptions of body and self. More research is needed to understand destructive post-stroke phenomena such as fatigue and pain and to find effective methods to help stroke survivors regain wholeness of body and self.

Integrity in patients’ stories: ‘Meaning-making’ through narrative in supportive cancer care

Introduction‘Personal integrity’ refers to a ‘state of being whole, entire, undiminished’. To help patients preserve a sense of integrity, care needs to be responsive to their individual illness experience. This study explores ‘holistic assessment’, a consultation in which patients with cancer tell their illness story to a health professional who responds to the integrity of their story and the whole person, in contrast to the reductionist approach taken by specialists treating the disease. MethodologyAn ethnographic study of two UK centres that provide CAM therapies to patients with cancer, using non-participant observation of thirty four holistic assessments with a maximum diversity sample of patients. Sessions were audio-recorded and transcribed. The data were analysed using a narrative approach with the support of Atlas.ti software. ResultsDuring holistic assessment, patients told long stories about their illness experience. A typology of stories emerged: ‘factual’, ‘emotional’ and ‘moral’, with over-arching processes common to all: Loss, uncertainty and conflict, embracing or resisting change. Patients’ stories provided a ‘window’ into their inner experience, in a collaborative activity with the listener. This provided cues and information about supportive care needs and also contributed to a process of personal meaning-making for patients. DiscussionMaking meaning is an important part of adjusting to a life-threatening illness. Holistic assessment allows patients to express and integrate their vulnerable self, alongside the strong image many feel the need to project in everyday life. The need for holistic assessment within mainstream care has recently been recognised in the UK.

Woman as Vulnerable Self: The Trope of Maternity in Levinas's Otherwise Than Being

Much due criticism has been directed at Levinas's images of the feminine and “the Woman” in Time and the Other and Totality and Infinity, but less attention has been paid to the metaphor of maternity and the maternal body that Levinas employs in Otherwise Than Being. This metaphor should be of interest, however, because here we find an instance in which Levinas uses a female image without in any way seeming to exclude women from full ethical selfhood.In the first three sections of this paper I explain how maternity functions in Otherwise Than Being. I argue that maternity is used as (1) an image of the vulnerability or passive sensibility that characterizes the relation with the Other, as well as (2) a metaphor for Levinas's account of ethical responsibility as substitution. In the final section of the paper, I defend the claim that Levinas's maternal metaphors are not disparaging to real, empirical women. I also discuss a remaining worry that feminists may have about the metaphor: namely, that it characterizes pregnancy and motherhood in ways that challenge some pro‐choice assumptions.

Vulnerable Self, Poor Understanding of Others' Minds, Threat Anticipation and Cognitive Biases as Triggers for Delusional Experience in Schizophrenia: A Theoretical Model

It remains unclear what processes lead to the establishment of persecutory delusions in acute phases of schizophrenia. Recently, it has been argued that persecutory delusions arise from an interaction among a range of emotional, cognitive and social factors. In this work, we explored this possibility by first discussing the relevant aspects of recent theoretical models of the causes of persecutory delusions. Then, we offered an analysis of the literature, illustrated with clinical observations suggesting that persecutory delusions are triggered during stressful intersubjective transactions by the interactions of (a) an alteration in empathetic perspective taking and in pragmatic understanding of others' minds; (b) a perception/representation of the self as vulnerable or subordinate and of the other as dominant and threatening; and (c) a hyperfunctioning of the threat/self-protection system when faced with perceived danger. Implications for future research and treatment of people suffering from this symptom are discussed.

On Hegel, History, and Reading as if for Life: Response

On Hegel, History, and Reading as if for Life:Response Nicholas Dames (bio) Of course, if water boils in a pot, steam comes out of the pot and also pictured steam comes out of the pictured pot. But what if one insisted on saying that there must also be something boiling in the picture of the pot? Ludwig Wittgenstein, Philosophical Investigations It is no less than an origin myth for literary scholars: the image of David Copperfield, alone with his dead father's book collection, finding solace from cruelty and neglect in the prolonged, immersive reading of fiction. When I think of it, the picture always rises in my mind, of a summer evening, the boys at play in the churchyard, and I sitting on my bed, reading as if for life. Every barn in the neighbourhood, every stone in the church, and every foot of the churchyard, had some association of its own, in my mind, connected with these books, and stood for some locality made famous in them. (56) This moment's recurrent presence in criticism can be ascribed to its power to summon up memories of childhood fantasy and the barrier books can build between a vulnerable self and the hostile world. D. A. Miller, for instance, wrote of the subject of this scene as "David himself, cognate and first cognition of myself" (193). Martha Nussbaum took from the passage a title for an essay, "Reading for Life," which begins with a prolonged reading of "this wonderful passage (which is even more wonderful read in full)" (230). David's bouts of solitary reading offer at least one category of bookish selves—scholars—with precisely the kind of foundational self-image that, in other contexts, comes in for critique. It is useless to cite the passage and pretend that it fails to move us—or move me, at least—to the kind of poignant self-regard that Miller openly, and Nussbaum covertly, celebrate. But it is worth asking with what kind of reading, exactly, the passage asks us to identify. Not [End Page 437] necessarily the objects of David's immersion—the "Roderick Random, Peregrine Pickle, Humphrey Clinker, Tom Jones" and the rest that make up David's small patrimony—but the ontology of reading fiction that the passage so successfully evokes (55). A clue might be furnished us by Nussbaum's peculiar omission of the "as if" in Charles Dickens's well-known phrase "reading as if for life." The wrinkle, or slight gap, opened up by those two words suggest at least some distance, however small, between David and the motives that drive him to read—between him, that is, and the "life" that his books either hold off or provide. The oddity of that "as if" hovers over the entire passage, which is, after all, composed of a series of virtual encounters: between David-the-narrator and David-the-young-reader; between young David and his perceptual surround, the boys at play in the churchyard; between David's neighborhood and the imaginary locales for which they stand; and, of course, between David and the fiction he reads. The process of identification, of saying "that, there, is also this here," is pervasive but also necessarily imperfect, only "as if" it is complete. The lure of identifying with David, that is, risks masking the only partially possible identifications available to him in his reading. Nussbaum's elision of Dickens's "as if" is taken up, as it were, by the papers delivered at the 2010 NAVSA by Rae Greiner, Jonathan Farina, and John Plotz, whose separate investigations of Victorian "virtuality" are unusually attentive to precisely the imperfections or hesitations involved in virtual thinking. In Farina's case the link is explicit: his study of the "as if" locution in Victorian fictional prose makes clear the stakes involved in ignoring this crucial, but easily overlooked, bridge between different orders of representation. Greiner and Plotz, however, are equally invested in exploring an ontology of fiction where less than full immersion is the norm, and a form of identification that is less than complete. What is striking about this endeavor is how it cuts against a strong, if rarely articulated...

What I Never Wanted to Tell You: Therapeutic Letter Writing in Cultural Context

Therapeutic letter writing has been viewed by psychologists as a powerful form of creative writing in health care settings. I explore the cultural contexts that have aided its popularization to shed fresh light on debates about its psychological function and efficacy. I draw on the sociologist Frank Furedi's analysis of 'therapy culture' to argue that contemporary ideologies of the vulnerable self have stimulated this practice, particularly in the form of letters written not-to-be-sent. I conclude by considering models of developmental letter writing that attempt to challenge these ideologies, including narrative therapists' provocative method of corresponding with clients.

Not ‘going there’: limits to the professionalisation of our emotional lives

This article takes as its starting point the thesis that there has been a shift towards emotional openness in Anglo-American societies and that, as a result, we are increasingly at ease with talking to professionals, those who are trained to listen, when faced with difficulties in our emotional lives. Such assumptions are implicit, if unexamined, in recent mental health policy in the UK. Drawing on findings from the first British general population study of views and experiences of emotional support, it is argued that, while there has indeed been a cultural acceptance of the notion that it is good to talk, this has not translated into a retreat into professionalised spaces. How, then, can we understand these limits or, to draw on a popular idiom, why do people choose not to 'go there'? To begin to answer these questions, four areas are explored: the persistence and significance of non talk-based. responses to emotional difficulties, the constraints of and on emotions talk, evidence for an emergent vulnerable self in need of professional intervention and wider cultural beliefs about need, privacy and the role of strangers.

Thinking About What We Know and What We Do Not (Yet) Know: Thoughts Stimulated by Anna Ornstein's, “Do Words Still Matter? Further Comments on the Interpretive Process”

While affirming the overall congruence of her clinical approach and Ornstein', the author delineates the distinction between defenses initially described by Kohut and Ornstein and a defense later identified by Brandchaft. Although the former protects a vulnerable self developed in malattuned environments, the latter, structures of pathological accommodation, bears the imprint of the malattuned environment; the defensive behavior carries the mark of the narcissistic injury in some amalgamation with the child's response to it. The author links the tenacity of these defenses to attachment ties, for efforts to eliminate them may threaten patients with annihilation anxiety. Ornstein and Brandchaft agree that both forms of defense may co-exist. The author briefly underlines a similarity between a case described by her and one described by Ornstein, and draws attention to the need to continue the investigation of defensive structures to improve clinical efficacy with such challenging patients. Al afirmar la cong...

Four Scenes and an Epilogue

‘Back and forth autoethnographers gaze . . . outward on social and cultural aspects of their personal experience; then ... inward, exposing a vulnerable self that is moved by and may move through, refract, and resist cultural interpretations’ (Ellis and Bochner, 2000: 739). The article presents an autoethnography in a format of four scenes and an epilogue. The scenes move from personal family memories, through memories of first professional encounters with a ‘poor’ woman client, and an encounter with volunteers from a human rights organization that fight to eradicate poverty, to an educational moment as a social work lecturer who guides her students in their search for their own way to work with people in poverty. The epilogue aims to connect the four scenes and to point at the personal, social, cultural, and political roots of a critical social work agenda regarding poverty.

Promises of Peace and Passion: Enthusing the Readers of Self-Help

Promises of Peace and Passion: Enthusing the Readers of Self-Help