The psychoanalytic process

Analysts differ in how they conceptualize the psychoanalytic process, according to their understanding of the psychoanalytic theory of mental functioning in general and the nature of pathogenesis in particular. Emphasizing that psychoanalysis is a psychology of mental conflict, the authors see the psychoanalytic process in terms of the dynamic interplay between the manifestations of the patient's unconscious and the analyst's interventions. What analysts communicate to analysands serves to destabilize the equilibrium of forces within the mind, leading to the analysands' growing understanding of the nature of their conflicts and how they deal with them. Psychoanalytic process, accordingly, cannot be distinguished or separated from psychoanalytic technique.     

The priority of primary process categorizing: experimental evidence supporting a psychoanalytic developmental hypothesis

Earlier work has provided experimental evidence for the existence of the primary and secondary process mental organization posited by Freud and has demonstrated that primary process effects are the more active unconsciously (Brakel et al. 2000). Primary and secondary processes were assessed by a categorization test in which qualitatively different principles could be used. In new experiments using the same stimuli, another significant implication of Freud's model was tested: that primary process mental organization has developmental priority. In these experiments, which studied 559 participants ranging in age from 3 to 80, it was found (1) that primary process mentation predominates in preschoolers; (2) that it is not until around age 7 that primary process organization is supplanted by secondary process organization; and (3) that after age 7 the predominance of secondary process organization remains remarkably stable throughout the life span.     

The psychoanalytic process and its components

Certain problems in defining the psychoanalytic process emerged during the five years in which a COPE study group was attempting to clarify the concept. There was agreement about the bed-rock criteria to be included in a definition: e.g., transference, resistance, a dynamic unconscious, intrapsychic conflict, defense, infantile sexuality, insight which causes change, and change which brings insight. The disagreements centered on the locus of the psychoanalytic process, the best way to conceptualize change, and the methodological problem of validating whether specific interventions cause specific claimed effects. Confusion about how to account for the interactional aspect of the psychoanalytic situation in a manner consistent with a one-person psychology emerged as an important source of the difficulty in arriving at a satisfactory definition of the psychoanalytic process.     

The teaching and learning of psychoanalytic developmental psychology

I have described three areas in psychoanalytic education where I believe greater attention to existing methods is necessary so as to facilitate the learning of certain principles of development. Explanations might be enhanced by including constructivist with reductionist elements; metapsychology might be clarified in a way that would make the "developmental" more available to analytic scaffolding; and finally, the technical precepts that help focus on the emergence of regressive trends should be broadened to permit enhanced awareness of the progressive trends as well.     

The elusive concept of the psychoanalytic process

Although the term psychoanalytic process is frequently used, there is no consensual definition of its meaning. Some authors use it to designate a recognizable set of experiences within psychoanalysis. Others, a majority, use it as a synonym for the entire psychoanalytic experience, describing in detail what analysts do to achieve their goals. A range of views may be found between these extremes. A distinction is drawn here between the structure and content of the psychoanalytic process, which is regarded as a specific, definable entity--a red thread--within the psychoanalytic treatment experience as a whole, consisting of a microprocess and a macroprocess. The former is predominantly an amalgam of the patient's and the analyst's highly subjective experiences and entanglements, while the latter is predominantly an amalgam of the infantile and childhood origin of the patient's difficulties, as well as the analyst's conception of these difficulties based on a preferred theory. These ideas are used to formulate a definition of the psychoanalytic process based on clinical experience and are traced here primarily through lessons learned from a patient, Mr. K, over the course of a long and arduous analysis.     

The creative process in psychoanalytic treatment

Conclusion In summary, then, what is conducive to creative functioning is arelaxation of one's rationality: the analyst who feels exhilarated rather than threatened, receptive rather than anxious, at the hint of an appearance of the unexpected, at the peeking out of something that may challenge his understanding, that may not fit the theory neatly—he is the one who is capable of more creativity. The analyst might thus orient himself to give rein to his own inner processes, his inner radar rather than his intellect, and thus without preconceived theoretical expectations aspire to discover anew that which is uncovered ineach patient. It is this which makes each analysis a fresh experience, not a stale rehash, for the therapist; it is this which makes the analysis an authentic encounter for the patient—thus, an adventuring together.Another factor grows out of the above. If the analyst orients himself to think-feel-respondvia that deeper more personal channel of images — closer to the language of dream images early in the history of analysis recognized as the royal road to the unconscious—then he may find his creative responsiveness more liberated, his intuition in general more active for the work of the session. He thereby may enliven his reactivity not only along the pithy, affect-enriched modality of images, but also along other dimensions of intervention involving more nuanced responses of all sorts.Read at the convention of the Metropolitan Academy of Psychoanalytic Training, March 12, 1971, New York City, panel on The Creative Process.     

Rebirth fantasy and the psychoanalytic process

In this paper, Jungian and Freudian perspectives on the fantasy of rebirth are explored and a brief review of the literature on the theme is used to show how that the rebirth fantasy seems to be a universal fantasy in the human mind, connected with the experience of both destruction and creation. In the psychoanalytic process the rebirth fantasy is connected with initial hopes for a better life, but is also a vehicle for creating the analytic pair and for separating from the 'totalitarian object'. An account of clinical work with a patient is given to illustrate the mutual and parallel process of rebirth in both the patient and the therapist. For the patient, the therapy was experienced as an awakening or a birth. The therapist was initially doubtful about the patient's capacity to engage in the analytic process but his involvement and interest were 'born' during the early sessions, enabling the patient to rely on him to lead her out of the claustrophobic power of the totalitarian object.     

Group supervision and the psychoanalytic process

This article attempts to elucidate the psychodynamics of group supervision of group psychotherapists. The significance of the supervisory setting is explored with a particular emphasis on the frame. The regressive interactions in group supervision are regarded as enactments, which are conceptualized as nonverbal communications that are covertly transmitted. Enactments offer a link between the present group (supervisory group) and the absent group (the therapy group that is being supervised). The relationships between the experiential and didactic components of group supervision are also addressed. Clinical vignettes illustrate the interplay between the present and the absent group focusing on the supervisor's interventions.     

The psychoanalytic process: motives and obstacles in the search for clarification

One motive for regarding psychoanalysis as a "process," and for attempting to define its exact nature, is to enable analysts to clarify their criteria for distinguishing authentic psychoanalysis from other therapies that resemble it or are derived from it. In the present climate of theoretical pluralism, any list of defining qualities that could win wide acceptance would of necessity be cast in terms of such general quality as to limit its utility as a precise template. Another motive for holding on to the "process" concept arises from the unpredictable nature of analytic progress in even the most satisfactory cases.     

The psychoanalytic assumption of the primary process: extrapsychoanalytic evidence and findings

No evidence for an assumption of a theory can be gained by data derived from methods dependent on that theory. Three experiments, using methods independent of psychoanalysis, test the psychoanalytic posit that primary process exists as a formal mental mode distinct from secondary process. The three experiments, using a nonpsychoanalytic index for primary process, test for a preponderance of primary process organization in three areas in which Freud observed primary process: (1) in unconscious mental states and during implicit tasks; (2) in the mental productions of preschool children; and (3) in anxiety states, as these are typically associated with unconscious conflict. All three experiments show significant results in favor of the primary process. Further, the three experiments taken together, because they account for seemingly disparate data, lend further credence to the original assumption. These positive results suggest that primary process may be more important than even Freud suspected. Perhaps it is the basic mental organization in many nonhuman mammals and some birds. Primary process organization may also underlie aspects of such basic psychological operations as generalizations in conditioning and assessments-in-action, as opposed to judgments proper, about how one would act. Finally, primary process may play a key role in drive activity. Three types of experiments are proposed to test these far-reaching applications of the primary process concept.     

The analyst's countertransference to the psychoanalytic process1

There is countertransference, not just to individual patients, but to the process of psychoanalysis itself. The analytic process is a contentious topic. Disagreements about its nature can arise from taking it as a unitary concept that should have a single defi nition whereas, in fact, there are several strands to its meaning. The need for the analyst's free associative listening, as a counterpart to the patient's free associations, implies resistance to the analytic process in the analyst as well as the patient. The author gives examples of the self‐analysis that this necessitates. The most important happenings in both the analyst's and the patient's internal worlds lie at the boundary between conscious and unconscious, and the nature of an analyst's interventions depends on how fully what happens at that boundary is articulated in the analyst's consciousness. The therapeutic quality of an analyst's engagement with a patient depends on the freeing and enlivening quality, for the analyst, of the analyst's engagement with his or her countertransference to the analytic process.     

Conceptualizations of the psychoanalytic process

A demonstrable psychoanalytic process involves elaborate and sustained intrapsychic experiences and phenomena for both analysand and analyst. It also includes a complex and at times subtle interpersonal relationship in which each participant is actively sensitive and responsive to verbal and nonverbal input from the other. These interpersonal experiences stimulate further intrapsychic responses which in turn may have further interpersonal effects. Within the framework of the psychoanalytic situation, these combined intrapsychic and interpersonal responses lead first to facilitative and ultimately to definitive changes in the patient's psychological organization and function. A method for demonstrating a psychoanalytic process is described.     

The vanished pregnant body in psychoanalytic female developmental theory

The author contends that the pregnant body-the premier icon of the mature female body-has vanished from our psychoanalytic theory of female development. Until we are able to restore this missing entity on a par with the phallus, the developmental theory for both sexes remains fixated in phallocentricism. The author traces some of the evidence for this claim in a brief overview of the literature, a study of the relevant aspects of the case of Little Hans, and a look at the history of medical teaching, in particular illustrations from the first dissections of female bodies in the sixteenth century, which demonstrate a view of the female body as essentially male. A puzzle remains about the marked tendencies that both males and females had, and still have, to distort the female body image. The author offers a clinical example, and the suggestion that the plasticity of the female form in all its developmental phases may underlie the paradoxical requirement that stable mental representations be established upon an elusive set of shifting images.     

Defense and resistance in the psychoanalytic process

"Defense" and "resistance" are usually regarded as two separate and distinct concepts, the first belonging to psychic functioning in general and the second to therapy, yet this distinction is far from constant. Clinical observations indicate a frequent overlapping of these two mental functions or positions. A patient's behavior may convey the meaning of either or both concepts, and a position or response that one assumes to bespeak resistance may reveal defense instead. This state of affairs may be seen in the analysis of patients with a relatively well-integrated neurotic identity, but its main import is in the analysis of psychosomatic patients and those with severe personality disorders. Insufficient holding experiences during the infancy of these patients do not enable them to develop functional structuralization. Deficient mothering in the first stages of life also prevents the stable differentiation between defense against threats from within and resistance against influence from outside.     

Beauty treatment: the aesthetics of the psychoanalytic process

Psychoanalysts enjoy doing analysis above and beyond its usefulness to patients; one reason for this lies in the aesthetic pleasure the analyst may derive from the analytic process. The author discusses this aesthetic pleasure from the standpoint of meaning making, communication, love, and professional craft. Patients may themselves seek in analysis a certain kind of beauty that is normally a byproduct of good enough empathy and communication. Using Kleinian theory, the author examines the ways in which destructiveness and aggression may be understood in relationship to an aesthetic of psychoanalysis. It is further proposed that the aesthetic and ethical principles of psychoanalysis are indissolubly linked.