Intersubjective Clinical Theory
Intersubjectivity is the psychological study of dyadic mutuality and two way influence in the clinical encounter. The focus of this theory is on the patient/therapist relationship and on the ways in which subtle interactions within that relationship dominate the clinical situation. The therapist focuses on and interprets the movement and meaning of processes of mutual recognition and negation, interpreting both small and large enactments, as well as nuanced relational encounters in the consulting room, by way of understanding both the patient's and the therapist's psychological participation in such moments.
Along with Feminist and Queer theories, Intersubjective theory challenges notions of objectivity and was largely born from a critique of positivism and focus on power relations embedded in authority of knowledge. Intersubjective theory challenges traditional conceptualizations of a patient's independent bounded mind, as well as of the therapist embodying an authoritarian position in the clinical encounter. Drawing from Winnicott’s theory of object usage -- the process by which an infant “destroys” their primary object, finds that the object survives their destruction, and then is able to surrender omnipotence and recognize the other as a separate fully autonomous person -- psychoanalyst and theorist Jessica Benjamin first introduced and defined Intersubjectivity as the idea that mutual recognition is an intrinsic aspect of the development of the self. Intersubjectivity is thus a developmental trajectory in which recognition of the other is inconsistently maintained. Clinically, we ask the question, how has the patient come to recognize the other as an equivalent subject?
Feminist and Queer Theory
Feminist, Queer and Intersubjective theories all agree that in a dyad there exist multiple subjective truths. While these truths may differ or contradict each other, the contradictions are not understood to invalidate the experience of truth. Rather, these theories all see each individual's experience of the world as fundamental to one's sense of what is true and real.
Feminist and Queer theories add depth to our clinical work in their ability to unify the subjective experience with communal or systemic narratives. When taken as objective fact, these narratives limit our articulation of self and contribute to the experience of having multiple consciousnesses, both of our true self and the socially constructed self.
We choose to look specifically at feminist and queer theories that hold the complexity of how social narratives are formed. Specifically, we embrace frameworks that include race, gender, sexuality, class, nationality, and other social identities. These identities have complicated ways of interacting with each other within the subjective and communal experience and their points of intersection are often the sites of greatest subjective invisibility. Feminist and Queer theorists use the language of "borderlands" or the "margins," calling attention to the unique consciousness that occurs in these spaces.
By utilizing these ideas in conjunction with Intersubjective theory, we are able to move deeply into the complex and vital moments of in-betweeness in the clinical encounter. By taking the intra-psychic experience into the social and systemic realm, we can more fully conceptualize what is occurring within relational enactments, moments of impasse, and the self states we experience in response to systemic and interpersonal aggressions.