The four premises of the Sternian experience theory – the theory of change as a direct corollary
The Sternian theory of change refers to the process of therapeutic advancement and is based on the four previous theses concerning experience. The theory explains how the changes on which advances in therapy are based occur.
This contribution is the latest in a series of articles on the subject. In the first article the Thesis of the stratification of Stern’s experience was deepened, in the second it was discussed the Thesis of the fracture between explicit and implicit experience, while in the third the themes of the form and content of the experience and of the intersubjectivity.
Advertising message The theory of change in the therapeutic advancement process is a natural corollary of the Sternian experience theory based on the four theses analyzed. The theory explains how the changes that make up the progress of the psychotherapeutic path that sees patient and therapist face to face take place.
Although Stern’s goal is to provide a expendable contribution within psychotherapeutic practice, it is not uncommon for him to use examples taken from everyday life in explaining this theory. In particular he often mentions relationships between parents and children or those between lovers. To explain what he means by radical changes, he uses an example of two boys going out together for the first time.
In the same chapter, Stern introduces another similar example.
Or, to describe the concept of intentional correspondence, it refers to the relationship between a father and a few-month-old son in the moments preceding the child’s sleep. Finally, there is also a more explicit statement on the extensibility of the theory to non-therapeutic relationships.
Although the topic is never directly addressed by Stern, it seems that the idea of a possible extension of the theory of therapeutic advancement to non-clinical relationships is implicitly shared by him. If so, the theory would take on an unquestionably philosophical significance in that it would claim to affirm something about the interpersonal relationship as such and the role it plays in changing an individual’s life.
We now come to the description of the theory by summarizing it in its main points.
The great turning point of Sternian consists in proposing as implicit place for change, in the process of therapeutic advancement, the implicit which, by its nature, always lives in the present. No longer the explicit meaning of the patient’s narratives that always refer to the past, but the immediate phenomenal experience that happens here and now. According to Stern, the present is a purely subjective temporal dimension, a moment of kairos, an expansion of chronological time. It can be experienced consciously (with a non-reflective phenomenal consciousness) or in the absence of consciousness. In the first case, the experience enjoys a high level of focused attention and a recording in long-term memory, in the second case, however, what is experienced is not the object of attention and is not recorded in the memory. The periods of time characterized by a continuous phenomenal consciousness form what Stern calls the “episodes of consciousness”, while those lived in the absence of consciousness are called “non-cs holes” (holes of consciousness). The episodes of consciousness are divided into units called “present moments”. These are periods of time with an objective duration that varies between 1 and 10 seconds (which on average is between 3 and 4 seconds) in which the subject lives a conscious subjective experience that represents a circumscribed and meaningful global unity. These moments are characterized by a tripartite internal subjective temporal development in “retention”, “present of the present moment” and “protension”. The three Husserlian terms refer respectively to an “immediate past that still echoes in the present moment, like the tail of a comet “(Stern, 2004), to a present instant that moves like a point on a straight line and to an immediate future already anticipated in the present. However tripartite the present moment is captured as a single experience, a single gestalt.
It is possible to describe the present moment also from the point of view of the dynamic profile outlined by the vital forms that inhabit it: in this sense it acquires an implicit “plot” that can be represented in terms of variation of intensity over time.
Advertising message Lastly, the present moment constitutes the unity of conscious experience also in an objective sense. The continuous flow of experience is made discreet by innate and automatic mechanisms of perception, action and consciousness. The time of 3-4 seconds corresponds in fact to the duration of the units in which we segment the flow of incoming information, to the duration of the “sentences” that make up our behavior and to the time necessary to activate consciousness, a fundamental element for speaking. of “present moment”.
Within a relational context, the present moments can be of three types: the “ordinary present moments”, the “now moments” and the “meeting moments”. The former enjoy the properties we have described so far. The “moments now”, on the other hand, are moments in which something decisive happens that imposes on the subject the need to provide an answer that acts as a solution. These are moments of discontinuity and rupture in which the subjects involved in the relationship are called to the present and forced to redirect their behavior. Lastly, the “meeting moments” are decisive moments of the “moments now”, they re-establish the relationship on a new level making the subjects involved feel the sensation of being together again in an intersubjective sharing of mental states.
The “non-cs holes” (the holes of conscience) instead are periods of time in which what happens “goes unnoticed” and is not recorded in memory. All those activities that we conduct automatically without paying attention and which are destined to be lost belong to this type of experience. In a relationship, the “non-cs holes” are populated by the “relational moves” which correspond to all those behaviors that escape our consciousness, but which constitute a fundamental part of implicit communication.
Present moments and relational moves constitute the grammar of therapeutic advancement. It can predict five different outcomes: radical changes, missed opportunities, progressive changes, new explorations and interpretations.
The radical changes are strong reorientations of the patient-therapist relationship that take place thanks to the onset of a moment now, which breaks out as a moment of breaking the relationship, resolved by the therapist favoring the emergence of a moment of encounter. In these cases there is a significant step forward in the therapeutic advancement of which both parties involved are aware. However, these are always changes that are not caused by an explicit reflective activity (as for example in the interpretations of the meaning of the patient’s experience), but which occur here and now in the folds of the implicit.
Missed opportunities are the failures of the therapist’s attempt to resolve a moment now into a moment of encounter. In these cases the relationship, following the break caused by the moment now, does not find a moment of solution. This sometimes even leads to having to interrupt the therapeutic path since the patient no longer feels he is “being-with” the therapist.
Progressive changes are slow changes that occur gradually without being noticed by either the patient or the therapist. Only after the relationship has reached a new level is it possible to appreciate the change. They are caused by the relational moves that constitute an underground communication made of body movements, postures, expressions, but also of dialogues expressed in a certain way, organizing the speech unknowingly according to a certain syntax, selecting certain terms etc.
The new explorations are new possibilities of explicit experience that emerge only thanks to a variation of the intersubjective field. In this sense, the implicit relationship enables and contextualises the explicit one, allowing you to deal with certain content that is still unexplored.
Finally, interpretations constitute the moment of explicit analysis of the meaning of the patient’s experience. In Sternian theory they have a decidedly reduced role compared to that assigned in traditional therapeutic techniques and operate in an intertwining with the implicit experience: on the one hand they can follow the moments of encounter by interpreting them explicitly, on the other they can precede the moments now favoring the they arise.
With the exception of the last type of outcome, in all other cases these are changes that occur implicitly, without being planned and, sometimes, even without being noticed. Their occurrence in an implicit present makes them extraneous to a reflexive control and to a previous intentionality that could foresee them in advance.
The word in this panorama plays a marginal role in its aspect related to the meaning, but central as regards the expression and the implicit construction of the speech.
It follows that therapeutic advancement is characterized by a certain unpredictability and that the characteristics of the therapist that emerge in this way of considering therapy are the ability to improvise, authenticity, but also inaccuracy and approximation since they give vitality human to relationship. What will emerge will not be the knowledge of therapeutic techniques (however fundamental) but the implicit style that characterizes all the therapist’s behavior.
Therefore, far from the idea that the cognitive understanding of the other is the way to change, Stern argues that it originates from an implicit experience, shared and based on temporal dynamics. In this, therefore, we can see a radical cultural change in the approach to interpersonal relationships: it focuses on the present and on the experience lived directly. According to Stern, the past, the unconscious, the language and the explicit experience of the content, old cornerstones of the theory of the interpersonal relationship must give way to the implicit dimension of the experience, direct, lived in the present, concentrated on the temporal dynamic forms . This dimension of experience precedes,