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 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 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.     

The creative process and psychoanalytic insight

The paper looks at the prevalence of audio-visual culture and how it is endemic in our everyday lives. It explores how popular culture emerges in the consulting room and some of the dilemmas posed for the therapist. It goes on to consider how popular culture connects to narratives, dreams and the formation of images in the clinical context. Some clinical vignettes explore audio-visual material in relation to their possible therapeutic message. One suggestion is made that the prevalence of popular culture could intensify anxieties associated with watching and looking and at the same time increase our desires to dismiss and submerge these anxieties. Popular culture in the consulting room reflects a world outside. Psychodynamic psychotherapy and the Media Arts can bring each other into ‘mutual illumination’.     

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 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 psychoanalytic process: the developmental and the integrative

Psychoanalysis is a treatment that focuses on intrapsychic events and activates integrative tendencies to promote-insights. Almost from the time it originated, however, it was also promoted as a therapy informed by the interpersonal, inducing change through experiences generated within the psychoanalytic situation. In recent years the interpersonal or object relations approach has come to be categorized as "developmental," a term that fosters no end of ambiguities. The resulting confusion compromises the study of the actual developmental process on the one hand and the structure-enhancing features of transactions on the other. This encumbers research on the psychoanalytic process. The author distinguishes the intrapsychic from the interpersonal, the integrative from the developmental, and the two very different realms of psychological activities currently advanced as "developmental."     

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.     

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.     

A core process in psychoanalytic treatment

A core mechanism of the psychoanalytic process is described. This involves the effects of treatment on an ongoing "unconscious intrapsychic process," which has specific points of vulnerability to pathology. The concept of an intrapsychic process described by the author in previous publications is an expanded formulation of the idea of thought as trial action and of the signal theory of anxiety. The psychoanalytic method alters the functioning of the ego astride this unconscious process, strengthening its control over anxiety, defense, trauma, and symptom formation. This is mutative in the psychoanalytic method.     

Further observations on the psychoanalytic process

The psychoanalytic process remains a fascinating and valuable concept, albeit an incompletely understood and controversial one. The author reviews the ideas in his 1984 essay and looks back on some of the critiques and proposals that followed that paper. He suggests that the concept of the psychoanalytic process is viable and useful despite its shortcomings. Consideration is given to the goals of psychoanalytic treatment as they relate to the "process" and how the "process" may be helpful in determining whether or not a patient is "in" analysis.