The analyst's trust and therapeutic action

The analyst's trust, a neglected topic in psychoanalytic discourse, participates in therapeutic action--through the analyst's emotional openness, "unobjectionable positive counter-transference" (see Fox 1998), the holding environment, and the promoting of adaptive internalizations, among other ways. When the analyst's trust--in the patient, in the analyst's self, and/or in the psychoanalytic process--fails, crucial interactions may occur, capable of destroying treatment, or alternatively, of restoring mutual regulatory functions and potentially leading to important mutative processes. Patients benefit from analysts' becoming sensitive to, having useful ways of thinking about, and working with their states of trust and distrust. The author presents clinical examples to illustrate these points.     

Privacy, reverie, and the analyst's ethical imagination

The author illustrates varying ways of using and thinking about forms of analytic reverie and the analyst's privacy. He discusses a few different registers from which the analyst can illuminate points of transference-countertransference enactment. The modality by which the analyst communicates these formulations of unconsciously held object relations and defenses varies and includes verbal interpretation through symbolic speech, interpretive action (Ogden 1994a), and, at times, interpretations that involve a construction of the analyst's subjectivity put forward to enhance the patient's understanding of enactments of the transference-countertransference. The author develops a concept, the analyst's ethical imagination, defined as the ways in which we consider and anticipate the implications of our interpretations.     

On the analyst's neutrality

It is by the application of the principle of neutrality, born of his respect for the essential otherness of the patient, that the analyst focuses the dyadic analytic work in the service of the patient's growing self-analytic capacity. Thus, the general principle of neutrality is distinguished from the technical tactic of abstinence, the latter being a specific function utilized to facilitate and foster analytic regression. Neutrality can be defined as it applies to the major subfunctions of the analyst's work ego. Perception of the patient's intrapsychic processes (both empathically and cognitively) requires a neutrality of appearance on the analyst's part in order to minimize the distortion of the unfolding transference neurosis. Integration and understanding of the patient's communications require mastery and neutralization of the analyst's own internal processes in order to minimize countertransferential distortions. Appropriate interpretive intervention requires neutrality of action, i.e., mastery of impulses related to power, neutralizing them into the service of the analytic work; tact is defined as a specific psychoanalytic function in this regard. Collaborative ignorance is examined as a specific instance of false neutrality. In this an analytic guise serves to mask a countertransferential conflict. Neutrality serves as an overriding technical principle, not an imperative for perfectionism . Factors intrinsic to the analytic process also influence the application of this principle.     

Infants track action goals within and across agents

The ability to understand that goals and other intentional relations are attributes of individual people is of fundamental importance to social life. It enables us to predict and interpret actions on-line by relating a person's prior and current behaviors, and distinguishing them from the behaviors of other persons. In this paper, we consider the origins of the ability to mark goals as attributes of individual people. Using a visual habituation paradigm to assess infants' tracking of goals, we tested whether infants represented goals are specific to particular agents. Thirteen-month-old infants restricted reaching goals to particular agents, but generalized a conventional linguistic action, labeling, across agents. Nine-month-old showed the former pattern but not the latter. We discuss these findings in the context of developing understandings of person specific and person general action knowledge.     

The analyst's witnessing and otherness

The analyst's active though silent witnessing of the patient's self-inquiry is presented as an essential aspect of the analytic process. Witnessing, though rooted in the analyst's empathy and holding, represents a more advanced development of those functions based on relational muturation from union to self-other differentiation. Self-definition and regard for otherness are seen as intrinsically unitary. Psychoanalytic witnessing is first illustrated and defined, then located as a derivative of negation in the unfolding of the analytic process, next considered in relation to current concerns for intersubjectivity, and finally linked to current shifts in philosophical thought.     

The quality of the analyst's attention

Compiled and edited from lectures on psychoanalytic technique given by the late Karen Horney at the American Institute for Psychoanalysis during the years 1946, 1950, 1951, and 1952. Further lectures in this series will appear in subsequent issues of the Journal.     

Limit setting and the analyst's working through

The American Journal of Psychoanalysis -     

Blocked goals, persistent action: Implementation intentions engender tenacious goal striving

Research on goal attainment has demonstrated that people are more likely to reach their goals when they form implementation intentions. Three experiments tested whether implementation intentions lead to tenacious goal striving following blockage of an initial attempt to reach the goal. In all three experiments some participants were instructed to form an implementation intention and other participants were not. Subsequently, the initial goal-directed attempt of all participants was unexpectedly blocked. Experiment 1 found that implementation intentions resulted in more attempts to realize one’s goal. Experiment 2 showed that when participants formed an implementation intention their repeated attempt was acted out as intensely as their first, blocked attempt. Experiment 3 found that implementation intentions still allow people to seize an alternative, more onerous means to realize their intention. These results imply that implementation intention conserve self-regulatory strength. After goal blockage, the remaining strength can be used to continue goal-directed action.     

Grasp cueing shows obligatory attention to action goals

To understand the grounding of cognitive mechanisms in perception and action, we used a simple detection task to determine how long it takes to predict an action goal from the perception of grasp postures and whether this prediction is under strategic control. Healthy observers detected visual probes over small or large objects after seeing either a precision grip or a power grip posture. Although the posture was uninformative it induced attention shifts to the grasp-congruent object within 350 ms. When the posture predicted target appearance over the grasp-incongruent object, observers' initial strategic allocation of attention was overruled by the congruency between grasp and object. These results might help to characterize the human mirror neuron system and reveal how joint attention tunes early perceptual processes toward action prediction.     

Knowing and not knowing: the analyst's pregnancy

The author examines some of the dynamics associated with the shifting experience of knowing and not knowing as it arises in response to the pregnancy of the analyst. This experience, as well as the thinking process behind it, is ubiquitous in psychoanalytic work, but is particularly apparent in the work demanded by the analyst's pregnancy. An indepth case history is presented to illustrate the ways in which pregnancy in the analyst may powerfully revive important dimensions of the patient's past.     

A crisis in the analyst's life: self-containment, symbolization, and the holding space

Most analysts will experience some degree of crisis in the course of their working life. This paper explores the complex interplay between the analyst's affect during a crisis in her lifeü and the affective dynamics of the patient. The central question is "who or what holds the analyst"--especially in times of crisis. Symbolization of affect, facilitated by the analyst's self-created holding environment, is seen as a vital process in order for containment to take place. In the clinical case presented, the analyst's dog was an integral part of the analyst's self-righting through this difficult period; the dog functioned as an "analytic object" within the analysis.     

Subjective reality, objective reality, modes of relatedness, and therapeutic action

This paper describes a dialectic believed to be at the heart of therapeutic interaction within a relational model. The dialectic consists of the interrelationship of two modes: the dyadic and the triadic. In the dyadic mode, the analyst responds with aspects of his or her self that singularly reflect the patient's subjectivity. This mode of attunement is uniquely suited to bringing the patient's experience into a place where it can then be seen and known. In the triadic mode, realities are recognized that are important to, but still outside of, the subjectivity of the patient. The analyst invites the patient to see him- or herself not only from inside his or her own space, but also from a point outside, through the perspective of others. The analyst is charged with asymmetric but not exclusive responsibility for negotiating and sustaining a fluid and flexible relationship between these modes. Optimally, this occurs through spontaneous and authentic engagement informed by intuition, empathy, and clinical judgment. However, when this dialectic loses its robust and kinetic quality (as frequently occurs in approaches ranging from the classical to the postmodern), an impermeable dyad is formed by extruding potentially triangulating aspects of reality (and subjectivity). This can result in curiosity and the openness of uncertainty being replaced by closed-mindedness and proclamation.