Table Of ContentSelf-Agency in Psychotherapy
The Norton Series on Interpersonal Neurobiology
Allan N. Schore, PhD, Series Editor
Daniel J. Siegel, MD, Founding Editor The field of mental
health is in a tremendously exciting period of growth and
conceptual reorganization. Independent findings from a variety of
scientific endeavors are converging in an interdisciplinary view of
the mind and mental well-being. An interpersonal neurobiology of
human development enables us to understand that the structure and
function of the mind and brain are shaped by experiences,
especially those involving emotional relationships.
The Norton Series on Interpersonal Neurobiology will provide cutting-edge,
multidisciplinary views that further our understanding of the complex
neurobiology of the human mind. By drawing on a wide range of
traditionally independent fields of research—such as neurobiology, genetics,
memory, attachment, complex systems, anthropology, and evolutionary
psychology—these texts will offer mental health professionals a review and
synthesis of scientific findings often inaccessible to clinicians. These books
aim to advance our understanding of human experience by finding the unity
of knowledge, or consilience, that emerges with the translation of findings
from numerous domains of study into a common language and conceptual
framework. The series will integrate the best of modern science with the
healing art of psychotherapy.
A Norton Professional Book
Self-Agency in Psychotherapy
Attachment, Autonomy, and Intimacy
Jean Knox,
PhD, MBBS, MRC Psych.
W. W. Norton & Company
New York • London
Portions of Chapters 3 and 4 reprinted from: Knox, J. (2009). Mirror neurons
and embodied simulation in the development of self-agency. Journal of
Analytical Psychology 54, 3: 307–324. Reprinted by permission of Wiley-
Blackwell.
A modified version of this paper appears as Chapter 5: Knox, J. (2009). When
words do not mean what they say: Self-agency and the coercive use of language.
Journal of Analytical Psychology 54, 1: 25-41. Reprinted by permission of
Wiley-Blackwell.
A modified version of this paper appears as Chapter 6: Knox, J. (2007). The fear
of love: The denial of self in relationship. Journal of Analytical Psychology 52,
5: 543–564.
A modified version of this paper appears as Chapter 8: Knox, J. (2009). The
Analytic Relationship: Integrating Jungian, attachment theory and
developmental perspectives. British Journal of Psychotherapy 25, 1: 5–23.
Reprinted by permission of Wiley-Blackwell.
Case material described in Chapter 8: Courtesy of Warren Colman.
Figure 2.1 reprinted from Petkova & Ehrsson, 2008.
Figures 3.1 (Figure AB-20 Diecephalon) and 3.2 (Figure AB-7
Forebrain/Midbrain/Hindbrain) courtesy of HOPES: Huntington’s Outreach
Project for Education at Stanford (http://hopes.stanford.edu).
Figure 4.1 reproduced with permission from The Symbolic Species: The Co-
evolution of Language and the Human Brain, by Terrence Deacon, 1997, New
York: Norton. Courtesy of Terrence Deacon.
Copyright © 2011 by Jean Knox
All rights reserved
For information about permission to reproduce selections from this book, write
to Permissions, W. W. Norton & Company, Inc., 500 Fifth Avenue, New York,
to Permissions, W. W. Norton & Company, Inc., 500 Fifth Avenue, New York,
NY 10110
Library of Congress Cataloging-in-Publication Data
Knox, Jean, 1948–
Self-agency in psychotherapy: attachment, autonomy, and intimacy / Jean Knox.
p. cm.
Includes bibliographical references.
ISBN: 978-0-39370689-5
1. Self. 2. Attachment behavior. 3. Autonomy (Psychology)
4. Intimacy (Psychology) 5. Psychotherapy. I. Title.
BF697.K635 2011
155.2—dc22
2010031963
W. W. Norton & Company, Inc., 500 Fifth Avenue, New York, N.Y. 10110
www.wwnorton.com
W. W. Norton & Company Ltd., Castle House, 75/76 Wells Street, London W1T
3QT
Contents
Acknowledgments
Introduction: What Does Self-Agency Mean?
PART I
The Relational, Developmental, and Neurobiological Foundations of Self-
Agency
Chapter 1. The Challenges to Psychoanalytic Theories From Developmental
Research
Chapter 2. Developmental Research on the Embodied and Relational Roots of
Self-Agency
Chapter 3. The Neurobiology of the Self and of Self-Agency
Chapter 4. From Action and Imitation to Empathy and Mentalization
PART II
Clinical Aspects of Self-Agency
Chapter 5. When Words Do Not Mean What They Say: Self-Agency and the
Coercive Use of Language
Chapter 6. The Fear of Love: The Loss of Agency in Relationship
Chapter 7. The Abuse of an Object and Relating Through Incorporation
Chapter 8. The Analytic Relationship: Integrating Psychodynamic, Attachment
Theory, and Developmental Perspectives
Chapter 9. The Effect of the Therapist’s Clinical Approach on the Patient’s
Sense of Self-Agency
Postscript: Negative Attribution in Infancy and in Psychotherapy
References
Acknowledgments
I AM GRATEFUL TO A NUMBER OF PEOPLE who have helped me at crucial stages in
writing this book. The invitation from Allan Schore and Deborah Malmud to
write a book on self-agency enabled me to see that it would fill a significant gap
in the psychotherapy literature—that it is a book whose time has come. My
many discussions with colleagues who are researching in related fields have
been invaluable in enabling me to widen the scope of my study and to include
the relevant articles from other disciplines. I would particularly like to thank
James Astor, Joe Cambray, Linda Carter, Warren Colman, Sue Gerhardt, George
Hogenson, Georgia Lepper, John Merchant, and Jo Tucker, who have all
contributed greatly to my understanding of the theoretical issues and their
clinical applications that I explore in this book. Pramila Bennett has been a very
great help in preparing the book for publication. All of these have also offered
constant friendship and support, for which I am always grateful. My thanks to
Vani Kannan and the Norton team.
I am also grateful to Beatrice Beebe, Peter Fonagy, Raya Jones, Jaak
Panksepp, Bruce Reis, Oliver Turnbull, and Vittorio Gallese for their helpful
comments on some of the ideas explored in this book or on draft chapters, or for
helping me to locate relevant articles. I would also like to thank Nadia Fina,
Brett Kahr, Jane Ryan, Steven Flower, Massimo Giannoni, Andrew Samuels,
and Caterina Vezzoli for offering me opportunities to present my ideas to
clinical colleagues in seminars and conferences, occasions that provide useful
feedback and opportunities to revise and refine my ideas. I am also grateful to
my patients who have given their permission for the case illustrations in the
book.
I am also very grateful to Helen Campbell-Hart for permission to use her
print Cityscape for the front cover and to Susan Moxley for her help in preparing
it for publication. And my thanks to John, Olivia, and Gareth for their
encouragement and support.
Earlier versions of Chapter 5, “When Words Do Not Mean What They Say: Self-
Agency and the Coercive Use of Language” and Chapter 6, “The Fear of Love:
The Loss of Agency in Relationship” were published in the Journal of Analytical
Psychology. An earlier version of Chapter 8, “The Analytic Relationship:
Integrating Jungian, Attachment Theory, and Developmental Perspectives,” was
published in the British Journal of Psychotherapy. I am grateful to Wiley-
Blackwell for permission to use these articles.
Description:A discussion of the self, both in and out of therapy.For each of us, our thoughts, beliefs, desires, expectations, and fantasies constitute our own sense of a unique identity. Here, Jungian and relational psychoanalyst Jean Knox argues that this experience of self-agency is always at the heart of ps
