Book Review

By Heather Lee Kilty & Barbara Dewar

Kilty, H. L. & Dewar, B. (2008). Book Review: Relationality: From attachment to intersubjectivity by S. Mitchell (2000). PrOSspect, 15(1), 8.

Mitchell’s book provides an important read for advanced students and practitioners of psychotherapy. He maps the theoretical history of psychoanalytic work from its origins in individualistic, intrapsychic processes to its contemporary focus on relationality, mutuality, attachment and intersubjectivity. He explores the issues and concerns that emerge from these approaches.

The stated purpose of the book is to examine forms of mutuality employing “a framework based on the premise that human minds interact with each other in many different ways, and that the variety of relational concepts pervading the recent analytic literature is best understood, not as representing competing theories, but as addressing themselves to different, interwoven dimensions of relationality” (p. xv).

While the book is weighted more heavily towards an exploration of theory, the writer does touch on important aspects of practice through the use of an occasional clinical case example and an in-depth discussion of clinical challenges in his final chapter. Thus, practicing psychotherapists who deal with challenges in the intersubjective client-therapist relationship will find small, but significant contributions related to expressiveness and restraint, strong feelings of client-therapist love and hate, and issues related to attachment, transference and abandonment.

Don’t expect a neat chronology of distinct periods of psychoanalysis, for Mitchell is exploring interconnected concepts. He has a gift for describing, synthesizing, and exploring the relationships between concepts and models. For example, he looks at connections between object relations theory (Leowald,1970), attachment theory (Fairburn,1952; Bowlby,1960) and theories of intersubjectivity (Stolorow & Atwood, 1992). He examines how these theories can be distilled into a more comprehensive theory of relationality.

In the third chapter, Mitchell outlines four “modes” to describe progressive degrees of organizational sophistication through which relationality operates. Mode one refers to what people actually do with each other in the undifferentiated “presymbolic or prereflective”state (p. 60). Actions and interactions, in parent-child or analyst-client dyads occur and evolve without any organized conceptualization. The second mode is the “shared experience of intense affect across permeable boundaries” (p. 58), whereby, “affect is contagious [and] on the deepest level, affective states are often transpersonal” (p. 61). His mode three describes interpersonal experiences of self in relationship to others both consciously and unconsciously. Mode four, deals with intersubjectivity and the mutual recognition of self-reflective persons who have agency to affect the relationship. New meanings and transformations take place through relationship and sharing of experiential and subjective worlds.

In chapters four and five, Mitchell uses his mode framework to explore various intersections among differently defined stage theories of relational development. For example, he equates his modes three (self-other configurations) and four (intersubjectivity) with elements of Bowlby’s (1960) attachment theory where the child is influenced by the behavior of caretakers. The influence of therapists on clients can also be understood in this way.

In the last chapter, Mitchell suggests that therapists can draw from several theoretical understandings and use mixed approaches in clinical practice to be able to move effectively into deeper relational and expressive intersubjective engagement with clients. In addition, the therapist will also have to attend to each client’s unique cultural, ethnocentric context. The therapy, and by extension the relational interaction, is based on a constructivist process that involves shifting modes of relationship within the intersubjective field.

This book is not an introductory text, but would be a good read for those who have a solid background in psychoanalytic, attachment and intersubjective theories. For the advanced learner, it is mostly an easy read, well conceived and well written. At times his critical analysis is in-depth and some may find it obscure. He adds new insights and his analysis points out conceptual and practical junctures that the reader may be familiar with.

Relationality is explored within the backdrop of post modern constructivist theory, where common themes of earlier psychodynamic movements are seen to intersect, shift and inform these new relational approaches. The experience may stimulate one to read further or to engage in beneficial reflection, critical analysis and dialogue. In this way, we are invited to examine our existing guiding theories and client therapeutic processes and to make connective leaps of our own.


Heather Lee Kilty (Ph.D.) has offered a counseling practice for over 25 years. She has taught Therapeutic and Professional Communications, Diversity, Leadership and Applied Research to nurses and Canadian Women in a Global Context and Classical and Contemporary Discourses in Women’s Studies at Brock University.

Barbara Dewar (Ph.D.) has offered a psychotherapy practice for over 23 years and is familiar with the use of the intersubjective in therapy with clients, and in the supervision of psychotherapists. She is co-founder of Espritedu Training of Psychotherapy Associates.