A common ground in clinical discussion groups: Intersubjective resonance and implicit operational theories

Clinical discussion groups based on the Three-Level Model for Observing Patient Transformations (3-LM) enable us to reflect on the clinical common ground shared by psychoanalysts who have different theoretical frameworks. The very existence of this common ground is controversial. While analysts such as Wallerstein support it, others, like Green, think it is just a myth. In their 2005 controversy Wallerstein and Green proposed an observation procedure that might clarify this matter. This procedure bears great similarity to the one used by clinical discussion groups that apply the 3-LM. The study of numerous theoretically heterogeneous groups that use this model shows that communication is possible in crucial areas. We may thus conclude that a partial and dynamic common ground exists. At a phenomenological level, certain fragments of material produce a shared resonance that enriches clinical understanding for the whole group. Communication is also possible with regard to the conceptualization of patient changes, although some controversial issues persist at this level. Finally, at the level of theoretical explanations, divergences concerning abstract theories do not prevent a fertile interaction among 'in vivo' personal implicit theories. The latter give rise to the actual operational frameworks underlying participants' approach to clinical problems.