Interaction in the psychoanalytic situation

In psychoanalytic psychotherapy we are primarily interested in psychic change and how to facilitate it for the better. Change is a universal property of matter, living or inanimate: everything in nature is influenced by everything else; interaction is ubiquitous. In the early years of psychoanalysis, the prevailing view was that therapeusis was essentially informational—insight and awareness would bring about changes in the ways one would experience events and respond to them. Over time, there has been a subtle shift from the informational perspective to the transformational, where insight is often retrospective rather than the active agent. The growing awareness of the need to be deeply recognized and responded to by another human being is reflective of this shift and has loomed ever larger in the interactive arena known as psychoanalysis. This paper focuses on a single facet of the need for recognition by another—the role of enacted response in effecting psychic change. It also addresses another level of the meaning of interaction: Whereas the internal interaction between perception and response has tended to be looked upon, in psychoanalysis, as unidirectional, the present discussion draws attention to the complexity of the bidirectional interaction between perception and response.     

Time and the psychoanalytic situation

Implicitly or explicitly, time dominates the psychoanalytic situation. The precision, consistency of duration, and regularity of analytic sessions enhance the patient's ego boundaries, counteracting the regressive effects of timelessness induced by free association. The extended overall duration of psychoanalysis and the high frequency of sessions favor the development of transference neurosis. The interpretation of the transference in the here and now of the analytic situation illuminates the past, and as a result, the patient's self-image and that of the world become better integrated. The sense of time in the analytic situation for both patient and analyst varies along with the vicissitudes of transference and countertransference.     

Words and wordlessness in the psychoanalytic situation

The difference between words and wordlessness in the psychoanalytic situation is examined in the context of a detailed clinical example. Various pairs of terms that have been used to account for this difference are mapped onto it: word and act, thought and feeling, public and private experience. Each of these sets of differences suggests certain relations between consciousness and the unconscious, and each implies a position about the nature of language. All three prove to be incomplete or inadequate ways of accounting for the difference between words and wordlessness in the clinical setting. The divergence, though, is well described by the difference between self-reflection and unformulated experience. Reflection is then presented as situated in the unformulated background meanings that contextualize it. It is because of this contextual embeddedness that self-reflection can have the kind of depth, resonance, power, and nuance more commonly associated with the nonverbal. In the creation of an explicit meaning, we simultaneously reconfigure the wordless background, thereby creating new possibilities for other meanings.     

Staging the psychoanalytic situation in supervision

Fantasies, parapraxes, and associations that figure significantly in the transference-countertransference process between patient and analytic candidate also work their way into the relationship between the candidate and the supervisor--sometimes in disguised fashion. The author illustrates this observation with vignettes and shows how, with the help of Lorenzer's concept of scenic understanding, the interaction pattern observable in the supervision can be utilized for the understanding of the material presented by the patient.     

Caring and coercive aspects of the psychoanalytic situation

Certain ambivalent reactions to undergoing analysis add content and intensity to the analysand's transference and to some extent to the analyst's countertransference. A significant share of these reactions may be attributed to the structure of the psychoanalytic situation. Among other things, analysands' reactions feature fantasized and sometimes realistic experiences of being coerced by their analyst's counter-transferences. However, to achieve a clear view of these coercive experiences, they must be considered in relation to another, equally weighty structural feature: ambivalent reactions to the analyst's concerned care. Observation suggests that an intervention can be experienced, simultaneously or sequentially, as both coercive and caring, and that, when analyzed, each of these experiences is usually found to be saturated with mixed feelings.     

Some thoughts on the psychoanalytic situation.

This article develops ideas set out in a previous study on the "archaic matrix of the Oedipus complex" versus the fully developed Oedipus complex (their similarities and their differences), applying these to a study of the psychoanalytic situation. The central hypothesis is that there is a correspondence between the psychoanalytic situation and the structure of the mental apparatus. The author supposes that our perception of the world is intimately linked to the primary maternal relationship, to our wish to fuse with the mother once more, and to the accompanying fear such a wish inspires. To deal with this we create enclaves where the regressive wish can be satisfied without fear of ego dissolution. The author suggests that the psychoanalytic situation is one such enclave. She examines its specific features in the light of the structure of the mental apparatus as she defines it.     

Different differences: revelation and disclosure of social identity in the psychoanalytic situation

The authors propose a taxonomy of social identities, suggesting that three different classifications of identities can be distinguished. These comprise those that are innate and visible, such as race or gender; those that are innate, but invisible, such as sexual orientation; and those that are acquired or achieved, such as marital status or political affiliation. The authors argue that each of these categories has different implications for the revelation or disclosure of aspects of the therapist's identity, as well as for transference-countertransference dynamics. These points are illustrated with brief clinical examples.