The analytic third: implications for psychoanalytic theory and technique

The author views the analytic enterprise as centrally involving an effort on the part of the analyst to track the dialectical movement of individual subjectivity (of analyst and analysand) and intersubjectivity (the jointly created unconscious life of the analytic pair--the analytic third). In Part I of this paper, the author discusses clinical material in which he relies heavily on his reverie experiences to recognize and verbally symbolize what is occurring in the analytic relationship at an unconscious level. In Part II, the author conceives of projective identification as a form of the analytic third in which the individual subjectivities of analyst and analysand are subjugated to a co-created third subject of analysis. Successful analytic work involves a superseding of the subjugating third by means of mutual recognition of analyst and analysand as separate subjects and a reap-propriation of their (transformed) individual subjectivities.     

Danger and safety: The analyst as analytic subject

Abstract

This paper considers questions of danger and safety in the analytic relationship in light of the contemporary recognition of analysis as a co-participatory process. In the interest of safety, the psychoanalyst has the responsibility to be persistently curious, particularly about the problems derived from his contact with the analysand. Information about the analyst's impact must be taken to heart; it must be experientially considered. As the process unfolds, the analyst presumes that a portion of its effect will be negative. The analyst aspires not to preempt all negative impact but to create an analytic environment in which the analysand's conscious and unconscious communications about impact may be attended to. The analyst's ability to receive such information is crucial in the establishment of a reliable process capable of addressing and surviving the unanticipated dangers that inevitably emerge and securing the analysand for further self articulation. The analyst can simultaneously attend to being the analyst and being a subject of analysis by regarding all communications from the analysand as representing, at least in part, interpretations of the analyst and the analyst's participation. Illustrative material is presented.     

Eating Disorders: A Bond between Medicine,Culture and Psychoanalysis

Action in connection with the therapeutic process is often equated with acting out. The subtle behaviour that belongs to ?the complicated system of transmitting and receiving unconscious signals? (Sandler), with which the patient attempts to make the analyst behave as the object of transference or to fulfill an unconscious desire, is also described as acting out or micro-acting out (Treurniet). This fine-grained action, however, means nothing; it is not symbolic or communicative action. Its intention is, rather, to trigger effects and induce interactions. It occurs not only on the side of the analysand but also on that of the analyst, and is part of the unconscious communication in the therapeutic process. Presented here are some of the various interactive ways and means with which the analyst is prompted into unconscious action and certain, unnoticed, ways in that he turn ?treats? the patient. The analyst's action responses can bear the character of interpretations with which he may unintentionally reveal how he regards the behaviour of the patient.     

The relational unconscious: a core element of intersubjectivity, thirdness, and clinical process

The relational unconscious is the fundamental structuring property of each interpersonal relation; it permits, as well as constrains, modes of engagement specific to that dyad and influences individual subjective experience within the dyad. Three usages of the concept of thirdness are delineated and contrasted with the concept of the relational unconscious, which, it is suggested, has the advantage of being both consistent with existing views of unconscious processes and more directly applicable to therapeutic concerns. Enactments and intersubjective resistances are viewed as clinical manifestations of the relational unconscious, and the therapeutic action of psychoanalysis results, in part, from altering the structure of the relational unconscious that binds analysand and analyst.     

The working alliance is St. Stephan's cathedral. Epistemological considerations of the Heinrich Deserno lecture, "Analysis and the working alliance" (1990)]

With the term "working alliance", as it was discussed by R.R. Greenson in noted publications, an understanding of work was introduced that corresponds with the dominant contemporary idea of work as a purely instrumental and technical process which is alien to the original "spirit" of Freudian Analysis. The author shows that psychological work, which in analysis is carried out cooperatively by analyst and analysand, needs transference to be successful, a transference with the help of which the analysand is able to discuss and specify his unconscious psychological conflicts. In Greenson's understanding the working alliance--supposedly neurosis-free--appeals to the rational part of the ego and introduces a normative understanding of reality. The transference relationship, by contrast, gives room to those psychic forces which refuse to obey the authority of the ego and its tendencies to conventionalize and suppress unconscious material.     

To Live Before Dying: Commentary on Paper by Anthony Bass

In this commentary, I discuss Anthony Bass's humane, courageous article about the unconscious connection between analyst and analysand. His focus on the meeting of unconscious minds lends a refreshingly democratic tilt to the treatment relationship. His primary emphasis on the unconscious, however, seems to de-emphasize the vital role of consciousness and its capacity to engage the revelations of the unconscious. Similarly, Bass's theoretical focus on a fundamental underlying unity, though of great significance, seems to minimize the importance of separateness and the fact that the analyst and analysand have discrepant experiences. Bass's treatment of Ralph, a patient with terminal cancer, highlights the differences in the experiences of both participants as well as the underlying human frailties they have in common. In this light, I suggest that Ralph's relationship with Bass enabled him to “live before dying,” to separate and gain a sense of integrity before returning to the whole.     

Working with the relational unconscious: an integration of intrapsychic and relational analysis

From its inception, psychoanalysis has tended to idealize the curative value of insight while devaluing the mutative significance of the analytic relationship. This paper argues that applying the construct of the "relational unconscious" in clinical practice offers a possible resolution of this "mind-relationship" rift. From this perspective, transference and countertransference provoke a continual intersubjective/interpersonal enactment of a co-created infantile drama emanating from the internal worlds of analyst and analysand in which a vital form of parental and/or self loving is at stake. Case vignettes demonstrate how to apply the relational unconscious in clinical practice.     

The moment and the next step

In psychoanalytical theory, the immediate future of the analysand has not been in the focus of interest. However, there is a change in the basic assumptions concerning the psychoanalytic process. Change is no longer seen as an inevitable automatic effect of insight into the unconscious. This is especially pertinent in the case of defect pathology. The author asks whether this altered view of the process will be followed by a change in technique. The question is: must change occasionally be stimulated by inspiration, suggestions and assessments from the analyst. While interpretation of the unconscious is still the major focus of analysis, some consideration of the next step of the analysand may also be part of our concern.     

A Picture Book of Internal Events: The Colours of Rage and Love

The views on countertransference in psychoanalytic theory and practice have undergone a change within the last fifty years. From being considered an impediment to analysis, countertransference is today looked upon as an important potential for a tentative understanding of what is unconsciously communicated from the analysand to the analyst. This implies that the analyst is susceptible to the unconscious interaction in the transference and the countertransference, and that he/she becomes conscious as quickly as possible of what is taking place. This applies especially to erotic feelings which are often intensified in analyses with patients with a serious psychopathology, as well as in analyses with patients in regressive phases where projective identification is the dominant factor used as a defence and a communication. Opinions differ as regards the question of how to deal with such a situation, especially whether it is right to be candid about the analyst's countertransference feelings towards the analysand, something most would caution against. In an example from an analysis, the analyst describes how he was influenced by an unconscious erotic countertransference. After three years of therapy with a patient with a serious psychopathology, he developed ?motherly” feelings, which he interpreted as reflecting a child's longing for closeness and physical contact. The result was that a few times, he ?forgot” to indicate the end of the session, which was then prolonged, and also that he embraced her on several occasions before she left the session. One year later, he had intense sexual fantasies and dreams about the analysand, which he experienced as both enticing and alarming, and as an impediment to the analysis. He soon became aware of the element of projective identification in the interaction, and by interpreting the analysand's unconscious communication, he regained his ability to maintain an analytic attitude and clear boundaries.     

One form of self-analysis

Beginning with Freud, psychoanalysts have discovered media through which they may achieve a self-analytic experience (for example, by use of dreams, fantasies, reveries, memories, and even visual images). Each of these media is a kind of "fiction" created by the analyst that provides an imaginative space where he or she may gain access to unconscious life. The author demonstrates how a generative self-analytic experience may be accomplished through the medium of psychoanalytic writing: a fictional autobiographical form of writing through which a self-analytic experience is created that has much in common with the analytic experience created by the analyst and analysand.     

From “disciplined subjectivity” to “taming wild thoughts”: Bion's elaboration of the analysing instrument

Abstract

Freud encouraged the analyst to use his unconscious “as an instrument of the analysis,” but did not elaborate on how this should be done. This recommendation opened the door to a consideration of unconscious communication between the analyst and patient as an intersubjective exchange. Both Wilfred Bion and Erik Erikson emphasised the importance of the analyst's intuition, and the author compares and contrasts these two approaches. Erikson advocated a more cautious attitude regarding the analyst's subjectivity, while Bion promoted a broader application of the analyst's various private reactions to the analysand. A brief vignette from the analysis of a five-year-old boy is offered to illustrate the importance of the analyst's reveries, the mutual process of containment and transformation between analyst and patient, and the co-creation of an analytic narrative.     

The goal as process: music and the search for the Self

This paper explores and compares the processes of music and analysis from the author's experience as a musician, piano teacher and analyst. It explains how the use of music improvisation in analysis (with simple percussion instruments) can powerfully enhance the dialogue between the unconscious and conscious psyche, as well as deepen the relationship between analyst and analysand. This is connected theoretically to Jung's active imagination and Winnicott's concept of play within the analytic encounter. Finally, the question is raised whether analytic trainings could do more to expose trainees to the possibility of using music within the analytic encounter. This touches on the more basic and controversial issue (which often separates analytical psychology and psychoanalysis) of whether expressive therapy should be used in analysis at all.     

Intersubjectivity and the creation of meaning in the analytic process

By means of a clinical illustration, the author describes how the intersubjective exchanges involved in an analytic process facilitate the representation of affects and memories which have been buried in the unconscious or indeed have never been available to consciousness. As a result of projective identificatory processes in the analytic relationship, in this example the analyst falls into a situation of helplessness which connects with his own traumatic experiences. Then he gets into a formal regression of the ego and responds with a so‐to‐speak hallucinatory reaction—an internal image which enables him to keep the analytic process on track and, later on, to construct an early traumatic experience of the analysand.     

Das Ende der Analyse und die postanalytische Beziehung

In this article the author discusses two aspects of psychoanalysis which in contrast to other fields have received little attention in the specialist literature: (a) the end of the analysis and (b) the postanalytical relationship between analysand and analyst. The circumstances of this specialist lag are seen among others as being due to unresolved fears and demands still remaining in the unconscious mind for both sides of the analytical pair. In that the author turns against the metaphor of death as the end of an analysis it is apostrophied as a separation process and developed into aspects, such as objectivity, process of sorrow, loss suffering, gain of relief, return and departure as well as dialectically folded gain of autonomy. In this way separation and binding can be simultaneously understood as essential features of every psychotherapy. The postanalytical relationship patterns will be illustrated according to the various starting positions, therapeutic or training analysis relationship, in each case internal and external reality and again for both sides of the analytical pair. The author is also especially concerned with the practical consequences in the reacquaintance of trainee and trainer. The cooperation on the dissolution of the original fascination of psychoanalysis and its allure is promoted. Both are required to be successful but both must be transferred into the (new) reality, whereby the analyst, even against internal self-resistance, must offer help because the analysand will only gradually be freed from the fascination and allure and be able to mourn and also in time welcome this loss.     

Die vakante Sitzung in Psychoanalyse und Supervision

In psychoanalysis and also in supervision the analyst’s and supervisor’s handling of the question of the vacant or missed session and a possible related fee are evident in word and action. In analysis the analyst and the analysand exchange views. In supervision the debate runs on two levels: the supervisand and the supervisor talk about the therapy processes that happen between the supervisand and the patient including the handling of vacant sessions and related fees. Above that there is a real and actual exchange on the question of vacant sessions in the supervisory relationship. Often the analyst’s, supervisor’s and supervisand’s own conscious views about unacceptability and unreasonable hardship define which so-called exceptions and goodwill arrangements they believe they are obliged to offer with respect to their supervisands and analysands without these having their say. This article illustrates how a (unconscious) “to-have-one’s-say” of analysands in treatment and of supervisands in supervision can be initiated and how this can lead to a deeper understanding of the emotions and conflicts of the analysand and the supervisand as well as the dynamics of transference and countertransference in analysis and supervision. The important aim of the article is not the search for an ideal and universally applicable rule for vacant sessions but rather the analysis, by means of the context-related method, of the themes, beliefs and conflicts emerging in these special relationships, which in turn allows individual insights and suitable ways to approach the topic of the handling of vacant sessions and related fees.     

Associative dreaming: reverie and active imagination

The idea of countertransference has expanded beyond its original meaning of a neurotic reaction to include all reactions of the therapist: affective, bodily, and imaginal. Additionally, Jung's fundamental insight in 'The psychology of the transference' was that a 'third thing' is created in the analysis, but he failed to demonstrate how this third is experienced and utilized in analysis. This 'analytic third', as Ogden names it, is co-created by analyst and analysand in depth work and becomes the object of analysis. Reverie, as developed by Bion and clinically utilized by Ogden, provides a means of access to the unconscious nature of this third. Reverie will be placed on a continuum of contents of mind, ranging from indirect to direct associative forms described as associative dreaming. Active imagination, as developed by Jung, provides the paradigm for a mode of interaction with these contents within the analytic encounter itself. Whether the analyst speaks from or about these contents depends on the capacity of the patient to dream. Classical amplification can be understood as an instance of speaking about inner contents. As the ego of the analyst, the conscious component, relates to unconscious contents emerging from the analytic third, micro-activations of the transcendent function constellate creating an analytic compass.     

The Psychoanalysis Between Sándor Ferenczi and Elizabeth Severn: Mutuality,Unconscious Communication,and the Development of Countertransference Analysis

ABSTRACT

The psychoanalysis between Sándor Ferenczi and Elizabeth Severn was characterized by a controversial counterference analysis, in which the analysand, Severn, took an active lead. She can be seen as the co-creator of the Countertransference Analysis. In the two-person analytic dialogue that Severn and Ferenczi created to resolve the intractable therapeutic impasse in their analytic relationship, a dialogue of the unconscious emerged. Severn believed she was attuned to Ferenczi’s unanalyzed countertransference reaction to her. They had a special kind of relationship where attunement was at an unconscious level. In a sustained analytic encounter, she helped Ferenczi retrieve the experience of being sexually abused, which was the unconscious derivation of his negative countertransference to Severn.     

Beyond the word in psychoanalysis the unspoken dialogue

The practice of psychoanalysis, traditionally, has privileged verbal communication. In relational theory the therapeutic significance of unconscious, semantically unformulated, but nonverbally encoded communications has been recognized. While patients are understood to generate significant nonverbal material for use in the treatment process, similar nonverbal productions from analysts rarely have been acknowledged as useful for treatment. In this paper, I demonstrate a way to recognize and use the nonverbal productions of analysts as well as of analysands within the analytic process. A brief review is offered of contemporary authors who have conceptualized the importance of the nonverbal realm for psychoanalytic treatment. An approach is then described that builds on process conceptualizations derived from the infant research literature. The model, illustrated with two clinical examples, provides a way of conceptualizing “process contours”; on a nonverbal level of exchange between analyst and analysand that becomes the medium for catalyzing the transition from presymbolic interactions to symbolic language. Working on this level, analyst and analysand coconstruct scenes from both the dreaded past and the hoped‐for present/future, which, when reflected on in a joint process of narrative construction, provide a new context for accessing previously dissociated affective experience.     

Embodying analysis: the body and the therapeutic process

This paper considers the transfer of somatic effects from patient to analyst, which gives rise to embodied countertransference, functioning as an organ of primitive communication. By means of processes of projective identification, the analyst experiences somatic disturbances within himself or herself that are connected to the split‐off complexes of the analysand. The analysty’s own attempt at mind‐body integration ushers the patient towards a progressive understanding and acceptance of his or her inner suffering. Such experiences of psychic contagion between patient and analyst are related to Jung’s ‘psychology of the transference’ and the idea of the ‘subtle body’ as an unconscious shared area. The re‐attribution of meaning to pre‐verbal psychic experiences within the ‘embodied reverie’ of the analyst enables the analytic dyad to reach the archetypal energies and structuring power of the collective unconscious. A detailed case example is presented of how the emergence of the vitalizing connection between the psyche and the soma, severed through traumatic early relations with parents or carers, allows the instinctual impulse of the Self to manifest, thereby reactivating the process of individuation.