Subjective reality, objective reality, modes of relatedness, and therapeutic action

This paper describes a dialectic believed to be at the heart of therapeutic interaction within a relational model. The diabetic consists of the interr elationship of two modes: the dyadic and the triadic. In the dyadic mode, t he analyst responds with aspects of his or her self that singularly reflect the patient's subjectivity. This mode of attunement is uniquely suited to bringing the patient's experience into a place where it can then be seen an d Known. In the triadic mode, realities are recognized that are important t o, but still outside off the subjectivity of the patient. The analyst invit es the patient to see him- or herself not only from inside his or her own s pace, but also from a point outside, through the perspective of others. The analyst is charged with asymmetric but not exclusive responsibility for negotiating and sustaining a fluid and flexible relationship between these modes. Optimally, this occurs through spontaneous and authentic engagement informed by intuition, empathy, and clinical judgement. However when this dialectic loses its robust and Kinetic quality (as frequently occurs in app roaches ranging from the classical to the postmodern), an impermeable dyad is formed by extruding potentially triangulating aspects of reality (and su bjectivity). This can result in curiosity and the openness of uncertainty b eing replaced by closed-mindedness and proclamation.