What is “Good” Technique? How to Teach it? Personal Reflections on Psychoanalytic Training

There is an intense interest in the interactional process across the varying psychoanalytic schools of thought. The analytic relationship itself, in all of its complexity, is the vehicle for our work. These advances raise the question of what we mean by technique these days, a question that has implications for analytic training and supervision. In this paper, the author reflects back on his analytic training experience, specifically at how two of his supervisors regarded technique, how it was taught, and the various ways in which it was communicated. In looking back at these supervisory experiences, the author examines how these teaching analysts embodied some of what they had to teach. The author shows what was mutative across these training experiences in terms of what was needed in order to grow—what facilitated his own development as an analyst and contributed towards the cultivation of his own style.     

Why we need to write openly about our clinical cases

To learn more about what is and is not effective in the psychoanalytic situation, analysts need to develop a library of detailed analytic case material. Open case writing, by not overconstraining readers, allows them enough access to the analytic couple's affective experience to persuade them of the authenticity and validity of the analyst-author's views. They are then free to rethink the material creatively on their own, to use it as they need to, and to learn from others, in order to enhance their analytic skills. Closed case writing hinders readers' creative freedom to understand and interpret, and hence to learn. To encourage analyst-authors to share their affective experiences in the analytic situation more openly, analysts need to establish a constructively collaborative attitude toward playing with clinical material. They need to take for granted that new readers, even authors themselves newly rereading their work, will discover something new. A dialectical process can then be established in which clinical authors and readers contribute to each other in an ongoing imaginative interchange.     

Fromm's Impact on Interpersonal Psychoanalysis: A Well Kept Secret

Erich Fromm was one of the founders of the William Alanson White Institute in New York City and an important contributor to the development of the interpersonal approach to psychoanalysis. Many of Fromm's ideas about psychoanalysis have found their way into the mainstream of analytic thinking. Much of what he taught in supervision and in his lectures had to do with the role of the analyst, the analyst's use of himself in the analytic process and the necessity that the analyst experience what his patient is experiencing. From did not necessarily use terms like projective identification but his understanding presaged much of what analysts talk about today. Fromm himself did not write much about clinical practice. And while he repeatedly expressed his respect for Freud he was explicit in his disagreements. Fromm rejected the notion of the analyst as a blank mirror. Instead, analysis requires a passionate wish for truth both in the analysand and the analyst. Fromm calls this passion biophilic, implying that the unconscious does not only harbor destructive drives that need to be tamed; it also harbors creative drives which, while also irrational, are constructive and need be liberated through the analysis.     

The Write of Passage From Candidate to Analyst: The Experience of Writing Analytic Process

This article describes my experience of learning to write analytic process. It illustrates how the depth of understanding I achieved from learning to write transparently about analytic work was instrumental in the consolidation of my analytic training and my development of an analytic identity. Practicing analysis requires letting our minds function at multiple levels—integrating, synthesizing, free-associating, attending, and maintaining our own reverie—simultaneously. This is a large task for any analyst, much less a beginning analyst. Writing about this process necessitates not only understanding what has transpired in our offices with our patients but also developing the ability to explain that intimate and unique interpersonal dyad to our peers. Learning to do analytic work is not the same as learning to write about it; and writing about psychoanalytic process is very different from participating in it (Reiser, 2000). The goal of writing analytic process is not primarily to tell the story of the patient but to demonstrate our thinking, experience, and understanding as analysts. To do this requires both a depth of understanding of what we do and a mastery of analytic process.

While there may be different ways to synthesize and integrate our analytic training and to accomplish the significant task of progressing from candidate to analyst, learning to write analytic process was pivotal for me. It was a “rite of passage,” culminating in the development of an increased sense of identity, maturity, and confidence as an analyst.     

Seeking an Analytic Identity

Abstract

Rothstein has stimulated all analysts to rethink how we can better commit ourselves to our analytic work. In this paper I focus on factors in analysts' personalities and experiences in their training and practice that contribute to or distract from establishing an analytic identity.

First, I explore analysts' background and motivation. In admissions to psychoanalytic institutes we look for candidates who can see psychoanalysis as an intellectual puzzle to be solved and an emotional involvement to be experienced. We look for earlv conflicts that the candidate can sublimate in the service of analytic functioning. We assume that the capacity to sublimate is only partial and that analysts in their development continue to recognize conflicts in transference—countertransference reactions.

Second, I give some examples of experiences from analysts' training that stimulate the formation of their analytic identities. These include transient identifications and counter-identifications with the training analyst, supervisor, seminar leader, and favorite analytic authors.

Third, I discuss more external factors that influence the development of analytic identity. These include the climate in training and continuing education at the institute. How much does the institute support its members in immersion in psychoanalysis? Economic factors continue to he an important factor in determining individual choice in this immersion.

Finally, I review studies on the effectiveness of psychoanalysis. Dedicated analysts with considerable experience believe that analysis works despite some limitations. Part of high motivation to continue analytic work includes understanding how analytic results differ from the simpler solutions achieved by nonanalytic therapies.     

Elements of analytic style: Bion's clinical seminars

The author finds that the idea of analytic style better describes significant aspects of the way he practices psychoanalysis than does the notion of analytic technique. The latter is comprised to a large extent of principles of practice developed by previous generations of analysts. By contrast, the concept of analytic style, though it presupposes the analyst's thorough knowledge of analytic theory and technique, emphasizes (1) the analyst's use of his unique personality as reflected in his individual ways of thinking, listening, and speaking, his own particular use of metaphor, humor, irony, and so on; (2) the analyst's drawing on his personal experience, for example, as an analyst, an analysand, a parent, a child, a spouse, a teacher, and a student; (3) the analyst's capacity to think in a way that draws on, but is independent of, the ideas of his colleagues, his teachers, his analyst, and his analytic ancestors; and (4) the responsibility of the analyst to invent psychoanalysis freshly for each patient. Close readings of three of Bion's 'Clinical seminars' are presented in order to articulate some of the elements of Bion's analytic style. Bion's style is not presented as a model for others to emulate or, worse yet, imitate; rather, it is described in an effort to help the reader consider from a different vantage point (provided by the concept of analytic style) the way in which he, the reader, practices psychoanalysis.     

Projective identification,containment and sojourn in the psyche: Clinical notes on a specific type of transference-countertransference interaction

Abstract

This paper suggests that the interplay between transference and countertransference is considered to be a valuable channel of communication. The author puts an emphasis on the containing function of the analyst. The patient strives for an experience of an object (analyst) that tolerates and copes with the patient's projections. There are some moments when analysts feel themselves to be invaded, controlled or abused by their patient's products. As Bion has postulated, this situation takes the form of a sojourn in the analyst's psyche. Clinical vignettes are given to provide support for the ways in which the analyst contains and elaborates the projections of the patients in his or her own mind and the therapeutic role that these processes have.     

Minderwertigkeitsgefühl und Machtstreben als Koproduktion?

At least analysts consider our own therapeutic approach as the preferable method, even if seen as very difficult. These difficulties are easier to understand from the viewpoint of intersubjectivity and interaction when looking at the origins of the problems as well as at the therapeutic process. Therapists seem with such patients to be more quickly tangled up in the field of the own ambivalence in relating, of omnipotence phantasies, illusions of independency and the striving for recognition as it is the case with other patients. Organising the practice along their own needs, the often devaluative diagnostics, the superior role of the therapist and the economic dependence of the analyst, even if covered up by the health care system, all that is a provocation for narcissistic patients, just as their seeming unrelatedness and lack of motivation, their pseudo-autonomy and the hardly bearable devaluations amount also to a provocation for the analyst. He/she is irritated about his/her usual role. From our theoretical point of view, we consider the narcissistic disturbance as a coproduction with the contribution of the therapist beyond his/her own idiosyncratic parts on the basis of the disawoed dimensions of grandiosity in our profession. Such narcissistic “interaction figures” are unavoidable and even necessary in practice. Relational experiences made in a presymbolic phase should become verbalizable through the entangled acting-out (unconscious communication) of both participants. The analysis of coproductions then, the recognition of the respective contributions, the patient‘s experience of equality and difference pave the way for developments in direction of more workable compromises in the narcissistic conflict area between being oneself and relating to others.     

On psychoanalytic writing

Analytic writing constitutes a literary genre of its own. It involves the linking of an analytic idea (developed in a scholarly manner) with an analytic experience created in the medium of language. What makes this literary genre so demanding is that experience-including analytic experience-does not come to us in words. This fact generates a paradox that lies at the core of analytic writing: analytic experience (which cannot be said or written) must be transformed into 'fi ction' (an imaginative rendering of experience in words) in order to convey to the reader something of what is true to the emotional experience that the analyst had with the patient. The author discusses a clinical passage from one of his recently published papers in an effort to demonstrate some of the conscious and unconscious thinking that goes into his writing. He then looks closely at the way the language works in a successful piece of theoretical analytic writing. The paper concludes with a discussion of a number of facets of the author's experience with analytic writing including the psychological 'state of writing', which is at once a meditation and a wrestling match with language; experimenting with the form (structure) of an analytic essay; and the question of originality in analytic writing.     

Psychoanalytic training experience and postgraduate professional development: A survey of six decades of graduate analysts

This exploratory study explored the training and post‐training experience of graduates of the Chicago Institute for Psychoanalysis. All living graduates of the past six decades were invited to complete a survey that addressed their training analysis, classroom work, supervision and other training experiences as well as their degree of post‐graduation involvement in teaching, supervising, study groups and other professional endeavors. They were also asked to rate their sense of themselves as psychoanalysts and their satisfaction with their analytic career. Further, they were encouraged to provide spontaneous narrative data. Our findings contribute to the current understanding of the careers of psychoanalysts – including that there is a difference in generational cohorts regarding professional satisfaction, identification as an analyst, and experience of training. We also found that there are no real differences between analysts who do and do not have analytic patients on some important variables: supporting analysis as a treatment method, identifying oneself professionally with psychoanalysis, and disillusionment with psychoanalysis – which is consistent with other studies. Also discovered were differences between male and female analysts' perception of certain aspects of their training.     

Writing about patients: IV. patients' reactions to reading about themselves

When analysands read about themselves in reports, their reactions range from anger, disappointment, or condemnation to a sense of appreciation or even idealization of the analyst. The eleven interviews reported here reflect only conscious responses; the unconscious layers were not probed for. It should be kept in mind also that the analysts of these patients might report very different stories. Other limitations are the small sample size and the representation only of patients who volunteered. Nonetheless, the information they provide may help analysts consider how and when writing about patients may influence their representation of themselves, the analyst, and analysis itself.     

Traumatic effects of political repression in Chile: A clinical experience1

The author examines psychic trauma resulting from human rights violations in Chile. Starting from trauma theories developed by authors such as Ferenczi, Winnicott and Stolorow, she posits the relevance of the subject's emotionally signifi cant environment in the production of the traumatic experience. She describes the characteristics of the therapeutic process on the basis of a clinical case. She emphasizes the need to recognize the damage that may be produced within the reliable link between patient and analyst, pointing out the risk of retraumatization if analysts distance themselves and apply ‘technique’ rigorously, leaving out their own subjective assessments. Therapists must maintain their focus on the conjunction of the patient's intersubjective context and inner psychic world both when exploring the origin of the trauma and when insight is produced. The author posits repetition in the transference as an attempt at reparation, at fi nding the expected response from the analyst that will help patients assemble the fragments of their history and achieve, as Winnicott would put it, a feeling of continuity in the experience of being.     

Faith and the practising analyst

Abstract: In this brief essay, I reflect on three questions: What is ‘faith’ in a modern and post‐modern cultural context? Do I, a Jungian analyst, have ‘faith’ or do I not? Does having ‘faith’ or not make a difference in the practice of analysis? I make reference to Jung's understanding of ‘faith’ and his frequent disclaimers about making metaphysical claims. I conclude that a post‐credal ‘faith’ is possible for contemporary Jungian analysts, that I do have such a faith personally, and that in my experience this makes a significant difference in analytic practice at least with some patients. Traditional faith statements must be translated into depth psychological terms, however, in order for them to be applicable in post‐modern, multicultural contexts.     

Dreams and the holistic nature of interpersonal psychoanalytic experience

Patients’ dreams and analysts’ dreams about patients are assumed to reflect each analytic participant's attitude and psychic conduct toward the other, and an unconscious overlapping of psychic issues and struggles between them as well. This makes it possible to deal with dreams from one‐person and two‐person models of psychological functioning, as well as from an additional psychic dimension that is assumed to be a creation of the analysis itself. As a source of freely moving experience within both participants, one that is assumed to have a life and direction of its own, this latter dimension of analysis permits patient and analyst to undergo more freely the actual experience of the treatment as a modality that is separate from and prior to positivistically grounded determinations that can be made about either the patient or analyst individually, or about the two of them jointly.

This dimension of analysis is said also to reflect a holism that characterizes conscious and unconscious psychoanalytic experience. Dreams and unconsciously generated dreamlike clinical phenomena are presented to try to illustrate this holistic character of analytic work, and to show how either participant's psychic productions maybe used to evoke significant experiences and further clinical knowledge.     

Discussion of “The Therapeutics of the Fee in Psychoanalysis”

This discussion of Dr. Pauley’s paper (this issue) on the therapeutics of the fee first highlights the various valuable contributions Pauley makes. It applauds his unusual openness in sharing his internal vulnerability with patients around fees, his raising the question about why fee setting is so complicated for analysts and patients alike, his focusing on omnipotent fantasies in the transference and countertransference, and his uncovering of the multiple meanings money has for therapists beyond just their income. Berger picks up on Pauley’s invitation to therapists to be more curious about their own discomforts with money. Drawing on her own teaching, writing and clinical experience, she adds to Pauley’s more global ideas, stressing instead the more specific meaning of money in each treatment dyad. Among these specifics, Berger highlights the chronic avoidance of teaching about money in analytic institutes. She clarifies some Freudian ideas about how money can become tied up with anal witholding, and offers examples of how she got stuck with three patients around setting and raising their fees. Berger describes how these patients’ believed that their fees could mean safety, value or exploitation and how these attribuitions generated countertransference blind spots for her. The discussion urges clinicians to keep digging hard into themselves for the many meanings of money, to pay attention to the devil in their own details, and thereby maximize the richness of their work with patients around a topic so loaded for all of us.     

James Astor in conversation with Warren Colman

In this interview with Warren Colman, James Astor speaks about his development as a Jungian analyst from his own experience of personal analysis in the 1960s to his recent retirement from clinical practice. The discussion covers his long association with Michael Fordham, the child analytic training at the SAP, the infant observation seminars with Fordham and Gianna Henry through which Fordham was able to make new discoveries about infant development, his experience of supervision with Donald Meltzer and the development of his own thinking through a series of papers on the analytic process, supervision and the relation between language and truth. The interview concludes with reflections about the legacy of Michael Fordham and the future of analytic work.     

Intersubjectivity and interaction in the analytic relationship: a mainstream view

The authors conceptualize intersubjectivity as a meta-theory that reflects the inherent nature of human relatedness and is conceptually independent of any particular theory of mind or school of psychoanalysis. Their view of intersubjectivity joins the emotional life of the analyst to that of the patient and places the analytic relationship at the center of the analytic process. They contrast intersubjectivity with traditional classical conflict theory so as to clarify the relevance of intersubjectivity for psychoanalytic clinical theory and therapeutic practice. In so doing, they hope to direct analysts more firmly toward the study of the unconscious dyadic contributions to the affective, inactive, and interactive dimensions of the analytic situation and their impact upon the patient's actions within and experience of the analytic relationship. To illustrate their thesis, two hours from an analysis are presented in detail.