Dancing With the Unconscious: The Art of Psychoanalysis

This article examines psychoanalytic work as an art and uses the metaphor of dance between two unconscious minds to describe the rich creativity of mental life. Free association, transference/countertransference, and dreamwork are each discussed for their creative dimensions and their coupling in the cure. A compelling session with dream analysis of a transsexual patient is presented verbatim (along with the author's inner thoughts) to illustrate the art of dance that takes place between analyst and analysand.     

THE COUNTERTRANSFERENCE: EROTIC,EROTISED AND PERVERSE3

The author begins by drawing attention to the dearth of psychoanalytic theory on the sexual countertransference, which he attributes largely to embarrassment associated with the personal superego and to fear of censure by the psychoanalytic community. After a review of the relevant literature, he points out that the term ‘countertransference’ arose in the context of misbehaviour by the early analysts and that the countertransference was originally seen as something to be controlled and suppressed, partly for the sake of the reputation of psychoanalysis. Theoretical and normative reasons are adduced for the disappearance of sexuality from psychoanalytic scenarios, and the wish for sexual contact with patients is discussed. While it may be deemed perfectly normal for an analyst to have erotic feelings towards patients of either sex, psychopathology is, in the author's view, involved only if he acts out. Clinical illustrations are given of manifestations of the sexual countertransference in its erotic, erotised and perverse forms, which the author considers it important to distinguish. He concludes that the relative absence of theory on the subject means that not enough clinical use is made of the sexual countertransference, which he sees as of great potential value to therapist and patient alike.     

The development of a dream from concrete realization to symbolic story

This paper is based on material from an analysis with a girl who was four years old at the time she started analysis. I relate how we worked with her feeling of vacillating, between invading and being invaded by the object, and how she was finally able to let go of her omnipotent control to a higher degree than before. Inspired by Hanna Segal and Donald Winnicott, I trace our progress from; (1) a denial of separation; (2) the analysand establishes a certain sense of separation by creating her own “space”. Through splitting and projective identification, she rids herself of feeling dependent and helpless, feelings that she cannot bear to acknowledge. The analyst receives, contains and names these feelings; to a stage where (3) the relationship established through the agency of projective identification is dissolved, and makes way for an ability to experience dependence as well as a recognition of the analyst as a separate person whom the analysand needs and can use.     

Braving the erotic field in the treatment of adolescents*

Abstract

The psychoanalytic literature on erotic transference and countertransference in adolescence is notably sparse, despite the centrality of the developing sexual body/mind. Erotic feelings in the consulting room with an adolescent can feel taboo, causing the analyst to avoid the immediacy of these feelings. Excessive timidity on the part of the analyst can limit the growth of the capacity for containment of sexual feelings and yield what I term ‘erotic insufficiency’ in our work with adolescents. I offer clinical material from a period of erotic transference and countertransference with a 12-year-old boy to consider these ideas. Further, I suggest that the very terms ‘erotic transference’ and ‘erotic countertransference’ can feel defensively remote and antiseptic. I suggest that ‘erotic field’ better captures the subtle, nuanced interplay of feelings.     

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.     

Psychoanalysis is a two‐way street

The paper discusses psychoanalysis as a mutual exchange between the analyst and analysand. A number of questions are raised: What was Ferenczi's and the early psychoanalysts' contribution to the interpersonal relational dynamics of psychoanalytic treatment? Why did countertransference become an indispensable tool in relationship‐based psychoanalysis? Why is the transference‐countertransference dynamic seen as a special dialogue between the analyst and analysand? What was Ferenczi's paradigm shift in the trauma theory? How did he combine the object relation approach with Freud's original trauma theory? The paper illustrates through some case study vignettes the intersubjective and intrapsychic dynamic in the process of traumatization. We can look at countertransference as an indicator of the patient's basic interpersonal experiences and traumas. Finally the paper discusses countertransference in the light of attachment theory, connecting the early initiatives of inter‐relational approaches in psychoanalysis with recent research.     

The death of an analysand: transference, countertransference and desire

This paper is offered as an exploration of transference and countertransference issues when, in the process of analysis, the analysand becomes terminally ill. Written from the point of view of the analyst, eros and boundary issues are discussed. It is proposed that those who are about to die may form particularly intense erotic attachments and that this is characteristic of a speeded up individuation process. The paper is based on the case of a suicidally depressed man who formed an immediate, dependent and erotic transference. After three months, he was diagnosed as having an inoperable lung cancer. From then on the analytic frame was challenged by pressures to act out in a number of different ways. It is argued that gender difference and the heterosexual pairing facilitated the differentiation of adult, sexual and Oedipal feelings from infantile, pre-Oedipal ones. Maintenance of the analytic frame enabled the individuation process to continue to the end.     

Homoerotic Countertransference The Love That Dare Not Speak Its Name?

Despite the recent interest in erotic countertransference and self-disclosure, little has been written about these phenomena when both analyst and patient are the same gender. Since homoerotic feelings can surface in any treatment, regardless of the participants' sexual orientation, this may well be a phobic avoidance that restricts many treatments, as well as our profession. I propose that the analyst's awareness of homoerotic feelings in the countertransference—including struggling with ways to express them—ultimately can create an atmosphere of safety. I offer an extended case example of one man with whom I colluded to ignore frightening aspects of his sexual fantasies. It was only by using my erotic countertransference, especially at a charged and pivotal moment, that I was able to help the patient begin to integrate split-off aspects of his sexuality.     

Working in the countertransference

Ferenczi (1988) described the procedure of mutual analysis, in which the patient and analyst switch roles for part of the time in the analysis. This procedure allowed patients in stalled analyses to make progress and enabled the analyst to overcome certain countertransference blocks but was ultimately rejected for certain drawbacks. Working in the countertransference is a modification of mutual analysis that retains some of its benefits and eliminates some of its drawbacks. In such work, the psychoanalyst's personality and psychodynamics become the center stage of the manifest content of the session; the analyst avoids interpretations of the transference and, instead, elicits the patient's detailed understanding of the analyst's psychodynamics. The analyst does not, however, generally volunteer his free associations or facts about his own life. This process allows deep work with patients with a predominance of projective identification. Working in the countertransference may be preferred in cases of severe psychopathology to other procedures for its lessening of the frequency, severity, and persistence of transference psychoses. The procedure is also a useful supplement to transference analysis with neurotic patients, for whom it can break through blocks caused by anxiety‐laden issues or countertransference impediments.     

Countertransference and Projective Identification Revisited and Applied to the Practice of Group Analytic Supervision

Countertransference and projective identification are two concepts that are very useful when describing the dynamics of atmospheric processes and also more explicit issues in supervision groups. Researching both aspects of interpersonal relationship helps the group analyst to better identify and understand the emotional reactions in the group experience. However, it is important to see the different approaches of these two concepts. Projective identification deals with keenly involuntary and often unperceivable ego-syntonic actions and unconscious thinking related to early identificatory feelings.

While other instances of countertransference are often comparatively easy to perceive, projective identification is considerably more difficult to recognize and therefore more difficult to work through. Concrete examples of countertransference and projective identification predominating countertransference respectively, as well as to commonly occurring, mixed forms of these emotional answers to supervision groups illustrate this.     

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.     

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 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.     

Private Terrors Sexualized Aggression and a Psychoanalyst's Fear of Her Patient

This clinical paper explores the meanings and evolution of an analyst's reaction of fear in relation to her patient's sexualized aggression. From both an intrapsychic and an intersubjective perspective, the author analyzes the coconstruction of this transference—countertransference phenomenon. Case vignettes illustrate the author's attempts to address her patient's sexualized aggression while struggling to free herself from the feelings of intimidation and fearfulness stirred by his sadomasochistic fantasies and patterns of interaction. The analyst's unconscious identification with the patient's disowned femininity and narcissistic vulnerability is seen as central to this countertransference “stranglehold.” Release from the analyst's masochistic position comes through a shift in her own affective participation. The importance of the analyst's recognizing her own unconscious contributions to this sadomasochistic dynamic is emphasized and elaborated. Discussion also focuses on the relevance of gender to the issue of countertransference fear, as illustrated in this particular male patient—female analyst dyad.     

On Some Advantages of Mutual Sexual Fantasy in the Analytic Situation: Commentary on Paper by Christopher Bonovitz

This commentary reflects a fundamental agreement with Christopher Bonovitz' main thesis—fantasy, indeed, cannot be seen as a product of an isolated mind and is intrinsic to the development of both optimal internal and interpersonal richness. The theme of mutual sexual fantasy between analyst and patient in particular is highlighted for discussion. It is argued that, contrary to the more discussed dangers of erotic countertransference feelings, the absence of analysts' reciprocal sexual fantasy has the potential to deaden the analytic relationship and result in a less than satisfactory analytic experience.     

Avoiding unbearable pain

This presentation describes the way in which defence mechanisms and resistance manifested themselves in the analysis of a man with a narcissistic personality disorder. In the course of the analysis, there were changes in the forms taken by the defence and the resistance, signalling important genetic and dynamic conditions in his life. Both represented desperate attempts to avoid the unbearably painful feelings and affects which he had experienced in his childhood, and bore witness to early and primitive defence mechanisms such as denial, splitting and projective identification. The defence can also be seen as an expression of an unconscious fear of being re-traumatised. The idealisation of the analyst in the first years of the analysis can therefore be understood as a precondition for entering into this kind of process. It also represented a defence against aggressive and homosexual feelings in the transference which first became clear during the final phase of the analysis and could then be worked through. At this point, the analyst's reactions to his own unconscious countertransference were of help in understanding what was actually going on. This analysis may also suggest that defects and trauma in the earliest years may be conducive to alexithymia, deficient contact between feelings and words, linked to the risk of developing serious psychosomatic illnesses. This may be a consequence of the fact that the child's feelings and affects were neither accepted, understood nor affirmed in words, or they may even have been met with rejection or ridicule. A connection between narcissistic personality disorders and alexithymia can possibly be seen here.     

Tactics and empathy: Defences against projective identification

In this paper the author argues that interpretations made when the analyst has not done the emotional work of recognising and bearing what kind of object she has become in the patient's psychic reality will be experienced as empty tactics – even lies – rather than interpretations of integrity. However, interpreting from a position of bearing the truth of the patient's perception will be technically difficult and indicate turmoil as the analyst struggles to take in the patient's view of her. If the analyst avoids integrating her own picture of herself with the patient's picture (despite giving voice to the patient's picture) the split inside the analyst will be felt and intensify the patient's need to split. Vignettes demonstrate how the analyst, believing she is trying to understand, may become a projective‐identification‐refusing object and the issue of the analyst's disclosure of her countertransference is examined. Ultimately, the author argues, a capacity to receive and bear projective identification requires empathy with both patient and analyst‐as‐patient's object, engaged in a process about which both are ambivalent.     

Countertransference and changes in the conception of the psychoanalytic relationship

Abstract

The concept of countertransference has a long history in psychoanalysis. This paper sketches the phenomenon referred to by countertransference and the development of the concept, from being signs of disturbance in the analyst to an important road to knowledge about the patient's inner life. The complexity of the questions discussed today – how to understand the concepts of neutrality, abstinence, and empathy; the relative subjective mutuality and symmetry of the analytic situation; the analyst's enactments and self-disclosure of feelings – reflects the complexity of the contemporary view of the patient–analyst relationship. In conclusion, the author presents a model illustrating the disturbing and informative aspects of countertransference together with the conceptual relationship between countertransference on the one hand and empathy and projective identification on the other. Finally, by differentiating between intuitive and irrational levels of functioning, an integrated model for countertransference is presented, synthesising the essence of the concept as it is used today.     

The threat of male-to-female erotic transference

Vignettes from an ongoing psychoanalysis with a patient, Michael, are presented to illustrate the various dimensions of the erotic transference at different phases of the treatment. The relation to power, the experience and expression of aggression, how these may be organized by gender, and the female analyst's countertransference are discussed as potentially fostering or inhibitory in the development of an erotic transference. Traditional sociocultural gender stereotypes kept alive in fantasy can cause female analysts to subtly foreclose the impending threat of an intense erotic transference with male analysands due to a fear of outwardly directed male aggression. It is suggested that the maternal/containing transference can be unconsciously fostered by both analyst and analysand to defensively avoid expression of the aggressivized erotic transference in its full intensity. Similarities and differences in cases of sexual boundary violations with opposite-gender pairings are discussed.     

Listening to the Erotic Commentary on Paper by Eric Sherman

In this commentary I examine homoerotic countertransference within the context of the analyst's erotic countertransference experience. Discussing male analysts' difficulties receiving and experiencing homoerotic feelings as a function of their dominant erotic desires (along gender lines), I propose both cognitive and affective explanations to illuminate their defenses. I suggest that Sherman's erotic countertransference is best understood when viewed as a product of both induced feelings emanating from his patient's dissociated sexual abuse and also his anxiety and shame in response to particular relational configurations with his patient that arouse him. Finally, I point to the site of the transgressive as integral to the construction of erotic desire and suggest shifts that need to occur in the erotic subjectivity of this dyad so that the treatment can move forward.