Copyright (c) 2012 John L. Jerz

The Present Moment in Psychotherapy and Everyday Life (Stern, 2004)
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While most psychotherapies agree that therapeutic work in the 'here and now' has the greatest power to bring about change, few if any books have ever addressed the problem of what 'here and now' actually means.
 
Beginning with the claim that we are psychologically alive only in the now, internationally acclaimed child psychiatrist Daniel N. Stern tackles vexing yet fascinating questions such as: what is the nature of 'nowness'? How is 'now' experienced between two people? What do present moments have to do with therapeutic growth and change?
 
Certain moments of shared immediate experience, such as a knowing glance across a dinner table, are paradigmatic of what Stern shows to be the core of human experience, the 3 to 5 seconds he identifies as 'the present moment.' By placing the present moment at the center of psychotherapy, Stern alters our ideas about how therapeutic change occurs, and about what is significant in therapy. As much a meditation on the problems of memory and experience as it is a call to appreciate every moment of experience, The Present Moment is a must-read for all who are interested in the latest thinking about human experience.
 
JLJ - Read on to find out about the useful concepts of "moving along", "vitality affects", and "sloppiness."
 
Stern's ideas are the first I have come across, after those of Bossel, which offer potential for guiding the behavior of a machine in efforts perceived as "artificial" intelligence.
 
Stern points out that the study of "mind" is incomplete without noting that the human mind is designed to interact with other minds - to capture and be captured by the nervous system of others.
 
Cocreating behavior - the stumbling, backtracking, exploratory wanderings we undertake with others - is perhaps the activity most worthy of study in examining the human mind. 
 
From Stern, we get the typical "shrink" perspective on the human mind. Any attempt to make psychology a "science" comes up against the scope and reality of perhaps nature's most complex creation - a creation which (in normal use) is not an entity unto itself but a part of an even more complex reality.
 
The "present moment" is important because it is the link to the health of the mind - the gestalt that is the mind attempts to continuously make sense of a changing world and the place of the mind itself in it. Stern paints a picture of the mind as he sees it - a fragile yet powerful "something" that defies explanation to all except those who attempt the "Everest" of understandings. 

xviii The present moments of most interest are those when two minds meet.
 
p.3 It is remarkable how little we know about experience that is happening right now.
 
p.4 This book places the present moment at center stage and holds it there.
 
p.5 Chronos is the objective view of time used not only in science but also in most of our psychologies. In the world of chronos, the present instant is a moving point in time headed only toward a future.
 
p.6 In a narrative, the now that is being talked about has already happened. It puts past and future nows into relation. It is not a direct experience. Only the telling is happening now.
 
p.7 Narrative provides us with a psychological way of fitting our lives into the reality of chronos.
 
p.8 Phenomenology is the study of things as they appear to consciousness, as they seem when they are in mind. This includes: perceptions, sensations, feelings, memories, dreams, phantasies, expectations, ideas - whatever occupies the mental stage... It is about the mental landscape we see and are in at any given moment.
 
p.16 The feelings experienced... trace a time-shape (a temporal profile) of analogic risings and fallings. In other words, they are carried on vitality affects (dynamic time shapes) that contour the experience temporally. A lived story unfolds within each present moment. It is made of many small experiences that are put together in the subjective present. The storyline... rides on the temporal feeling shape of the contoured affects. The unfolding micro-story resolves the novelty or problem.
 
p.34 A subjective experience must be sufficiently novel or problematic to enter consciousness and become a present moment. Present moments form around events that break through ordinariness or violate expected smooth functioning. Thus, they require mental (and perhaps physical) action... the present moment carries an implicit intention to assimilate or accommodate the novelty or resolve the problem. This can be experienced as a sense of moving or leaning forward toward some unrevealed but progressively implied goal as the present moment is traversed.
 
p.35 So far we have referred only to the psychological meaning of intention, namely to commit an action (mental or physical) with a goal in mind, and to adjust the means to the ends.
 
p.35 The present moment, thus, has psychological work to do. Its work is the very mobile task of constantly dealing with or preparing to deal with what is happening in an almost constantly changing world. It takes the sequences of small, split-second events that the world throws at us and pulls them together into coherent units that are more useable for adaptation... The present moment is a gestalt. It organizes sequences or groupings of smaller perceivable units... that pass below focused consciousness into higher order units
 
p.36 Vitality affects emerge as the moment unfolds. This is captured in terms such as accelerating, fading, exploding, unstable, tentative, forceful, and so on.
 
p.37 A temporally dynamic perspective is critical to many of the ideas presented in later chapters of this book
 
p.38-39 The present moment is partially unpredictable as it unfurls. You cannot know exactly how the present moment will turn out because you are riding its crest and the ride isn't over yet. Each small world of a present moment is unique. It is determined by the local conditions of time, space, past experience, and the particularities of constantly shifting conditions in which it takes its form.
 
p.60 Intentions are key to both narratives and the present moment as a lived story. Intentions provide the thrust... Whatever is experienced during the new present moment is temporally dynamic... This unfolding has a feeling of forward movement, of directionality oriented toward some goal that gets more specified en route. The present moment is going somewhere. It may reach that destination, or stop abruptly and never get there... it has a momentum.
 
p.64 Everything we do, see, and hear from people has a temporal contour... These temporal contours of stimulations play upon and within our nervous system and are transposed into contours of feelings in us. It is these contoured feelings that I am calling vitality affects... By vitality affect, I mean the subjectively experienced shifts in internal feeling states that accompany the temporal contour of the stimulus... Vitality affects are intrinsic to all experiences in all modalities, domains, and types of situations.
 
p.66 Vitality affects are also a pervasive feature of modern dance, under various guises and styles
 
p.69 vitality affects are part of all our experiences... They make up not only the style or manner of doing things, but provide the feeling behind our experience. They put dynamic time back into experience.
 
p.70 We have been surprisingly blind to temporal dynamics, especially micro-temporal dynamics, even though we live them every moment and even though we cannot begin to explain the specialness of an interpretative performance without them.
 
p.70 In sum, vitality affects acting with the intentional-feeling-flow provide a line of dramatic tension that gives a feeling-coherence to the unfolding of the present moment. The vitality affects act like a temporal backbone on which the plot is hung. They also help the chunking process by containing the phrase within one envelope. They give the present moment the dramatic feel of a lived story.
 
p.70-71 In summary, the present moment is subjectively experienced as a lived story. And it can be objectively described as an experience that has a narrative format, structurally and temporally
 
p.76 Nature has designed our brain and mind so that we can directly intuit others' possible intentions by watching their goal-directed actions (even without knowing the goal).
 
p.76-77 Our nervous systems are constructed to be captured by the nervous systems of others, so that we can experience others as if from within their skin, as well as from within our own... Other people are not just objects but are immediately recognized as special kinds of objects, objects like us, available for sharing inner states... We naturally parse others' behavior in terms of the inner states that we can grasp, feel, participate in, and thus share.
 
p.77 In short, our mental life is cocreated. This continuous cocreative dialog with other minds is what I am calling the intersubjective matrix.
 
p.82 If these mechanisms work so well that we live completely in an intersubjective matrix, why are we not constantly captured by the nervous systems of others and permeated by their experience? [JLJ - perhaps written before cell phones and texting allowed this to happen]
 
p.86 In all perspectives on motivated human activity, intention is central. Some psychological element is needed to push, pull, activate, or somehow put events in motion.
 
p.86-87 Intentions, in one form or another, and in one state of completeness or another, are always there, acting as the engine driving forward action, story, or mind.
 
p.87 We see the human world in terms of intentions. And we act in terms of our own. You cannot function with other humans without reading or inferring their motives or intentions. This reading or attributing of intentions is our primary guide to responding and initiating action. Inferring intentions in human behavior appears to be universal. It is a mental primitive. It is how we parse and interpret our human surroundings... Recognizing and deciphering intentionality is a reasonable starting point for adaptation and survival.
 
p.95 This new view assumes that the mind is always embodied in and made possible by the sensorimotor activity of the person, that it is interwoven with and cocreated by the physical environment that immediately surrounds it, and that it is constituted by way of its interactions with other minds. The mind takes on and maintains its form and nature from this open traffic. The mind emerges and exists, from intrinsic self-organizing processes, interacting with other minds. Without these constant interactions there would be no recognizable mind.
 
p.105 The first [motive] is a need to read the intentions and feelings of another.
 
p.106 If we cannot orient ourselves in time and space, we become confused and anxious, and searching behaviors are put in motion to solve the discomfort.
 
p.149 Moving Along is the term the Boston CPSG uses for the everyday dialog that moves a therapy session forward, at least in time. It is what the therapist and patient do together.
 
p.150 Moving along captures the often ambling, loosely directed process of searching for and finding a path to take, of losing the way and then finding it (or a new one) again, and of choosing goals to orient to - goals that are often discovered only as you go along. This is the view of the process at the local level as it is unfolding.
 
p.150 Two elements make up moving along: present moments of which one is simply aware and present moments that enter consciousness.
 
p.156 Moving along, while it is happening, is largely a spontaneous, locally unpredictable process... Often the theme at hand is well known, but one still doesn't know what will happen next. (If the therapist thinks she knows, she is treating a theory and not a person.)
 
p.156-157 Sloppiness results from the interaction of two minds working in a "hit-miss-repair-elaborate" fashion to cocreate and share similar worlds. Because the process of chaining together (sometimes very loosely) relational moves and present moments is largely spontaneous and unpredictable from move to move, there are many mismatches, derailments, misunderstandings, and indeterminacy. These "mistakes" require a process of repair. The term sloppy has become a legitimate concept in a scientific discourse thanks to dynamic systems theory where such a phenomenon is crucial... I have described these derailments and slippages as "missteps in the dance"
 
p.158 the moving along process is by its nature improvised.
  Progressively, we begin to appreciate the crucial role of sloppiness and view it not as error or noise in the system but rather as an inherent feature of interactions. The sloppiness of the process throws new, unexpected, often messy elements into the dialogue. But these can be used to create new possibilities. Sloppiness is not to be avoided or regretted but rather is necessary to understand the almost unlimited cocreativity of the moving along process.
 
p.158 each move and moment creates the context for the one that follows... each relational move and present moment is designed to express an intention relative to the inferred intentions of the other. The two end up seeking, chasing, missing, finding, and shaping each other's intentionality. In this sense also, the moving along process is cocreated.
 
p.159 The products of sloppiness are thus emergent properties that come into being from the roughly equal contribution of two minds... Sloppiness creates something that needs to be lived through and worked out rather than understood.
 
p.164 It is important to emphasize that sloppiness is potentially creative only when it occurs within a well-established framework. Without that, it is only disorder. 
 
p.165 Sloppiness has, indeed, surprised us. It has gone from a big problem in understanding treatment to one of the keys in grasping its enormous creativity. This insight would not have been possible without a dynamic systems theory perspective applied at the local level of present moments. 
 
p.172 As they move, they pass through an emotional narrative landscape with its hills and valleys of vitality affects, along its river of intentionality (which runs throughout), and over its peak of dramatic crisis. It is a voyage taken as the present unfolds.
 
p.181 In complex systems with multiple, independent and interdependent variables (like the weather or psychotherapy) change occurs in a nonlinear fashion, where one cannot predict the exact moment of change or the specific form it will take. These discontinuous leaps occur when the variables interact such that an "emergent property" appears. It represents a new element created by the auto-organization of the system and can throw the system into a new state.
 
p.182 Moving along can prepare the way for new explorations of explicit material.
 
p.197 The past must somehow get folded into the present experience. Without that, the past cannot play any role in current life, and there can be no psychic determinism and no psychodynamics. On the other hand, present experience must be able to alter the past, by diminishing its influence, by reselecting which past elements will play the major influencing role, or simply by changing the past…because we only live in the present subjectively, the action of the past on the present and the action of the present on the past must be played out in the present moment.
 
p.198-199 We do not remember a fixed historical past, we can only "remember" the present. In this view, memories are more present-centered than past-centered. Their function is to make life as we are currently meeting it more familiar and easier to adapt to
 
p.218 I have tried to show that... the past is only "alive" when on the stage of the present moment. The past plays a constant role in influencing what we experience from second to second.
 
p.220 This is an emergent property of the moving along process, a process that is unpredictable, sloppy, dynamic, and cocreated - an ideal milieu for the irruption [JLJ - a breaking or bursting in] of emergent properties.
 
p.225 If one accepts that sloppiness is not only necessary but potentially creative, and not necessarily psychodynamically determined but inherent in the moving along process, one treats it differently... The clinical question becomes not why that misunderstanding occurred, but where may it lead us, now, that is interesting.
 
p.244-245 Moving along is the process of proceeding through the session at the local level. This process finds its way as it proceeds. Its path is not known in advance. It consists of the relational moves and present moments that strung together make up the session. It is characterized by attempts to achieve a greater and more coherent intersubjective field. This, however, involves much unpredictability about what will happen next because the process is extremely inexact, nonlinear, and sloppy. Because of the nature of the process, it gives rise to many emergent properties, such as now moments and moments of meeting.
 
p.245 The present moment is structured as a micro-lived story with a minimal plot and a line of dramatic tension made up of vitality affects.
 
p.246 Temporal dynamics are changes in time or over time, particularly shifts in the force, intensity, quality, form, or rhythm of an experience over time. As used in the book, it usually refers to what might best be called micro-temporal dynamics because the changes occur over seconds.
 
p.246-247 Vitality affects are subjective experiences. They consist of the temporal dynamics of changes in feelings consisting of analogic shifts, split second by split second in real time, of affects, thoughts, perceptions, or sensations. For instance, the felt acceleration and then explosion of anger. They generally occur in parallel with the temporal contours of stimulation. Vitality affects are subjective experiences. Temporal contours of stimulations, in contrast, are objectifiable events. There is incomplete isomorphism between temporal contours and vitality affects. Vitality affects are synonymous with temporal feeling shapes, feeling shapes, or temporal shapes.

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