The concept of termination and the evolution of psychoanalytic thought

Termination is a post-Freud contribution to the psychoanalytic process, which is never complete. The concept is illuminated in its analytic history and development. A formal well-defined terminal phase led to a tripartite psychoanalytic process which derived from and contributed to advances in psychoanalytic theory and knowledge. The terminal phase is a valuable addition and conclusion, but may be invested with irrational expectation and analytic myth. Various features and formulations of the terminal phase are explored, and the limitations of termination are noted.     

Comments on the Ikonen and Rechardt papers on the death drive and the origin of shame

In this paper, psychoanalysis is viewed as a method in opposition to the reigning spirit of our age with its demands for fast and measurable results. The concept ?the psychoanalytic room” is introduced in order to grasp the uniqueness of psychoanalysis and how it distinguishes itself from what is ordinarily held to be included under the category of work. The psychoanalytic room is explored in both a concrete and metaphoric sense and is discussed in relation to the concept of time, reality, Ogden's concept of the analytic third, and, inspired by Winnicott, children's play. The playroom of the child and its similarity with the analytic room is illustrated by the book ?Benny's Bathtub” by the Danish author Flemming Kvist Møller.     

Turning aggression on the self: a study of psychoanalytic process

The concept of turning aggression on the self is studied, and some clinical vignettes are presented which demonstrate the use of this concept as a guide to the formation of an "ideal" for one kind of analytic intervention with one kind of analytic surface. Pertinent literature is reviewed, and assumptions implicit to the analyst's activity are discussed. This endeavor is viewed in the larger context of attempts to arrive at a clearer understanding of the psychoanalytic process.     

Suggestion and psychoanalytic technique

The role of the analyst's suggestive influence on the course and outcome of psychoanalytic treatment is explored, and traditional and newer perspectives on analytic technique are contrasted. The intersubjective critique of the neutral, objective analyst in relation to suggestion is examined. The inevitable presence and need for suggestive factors in analysis, and the relationship of suggestion to transference susceptibility, are emphasized. The manner in which the analysis of suggestive factors is subsumed in transference analysis as part of traditional technique is highlighted.     

Some observations on the psychoanalytic process

The author's aim is to delineate the psychoanalytic process and to distinguish it from the psychoanalytic situation, the transference neurosis, "insight," and psychoanalytic technique in general. Freud's 1913 views provide the basis for a concept of the psychoanalytic process centered on the recognition and interpretation of resistances and on the patient's reactions to the analyst's interventions. This clinically observable "unit" of the process is described and compared with Bernfeld's "facts of observation." The proposition is advanced that the process does not come to an end with the termination of analysis. It continues postanalytically in the form of the patient's more objective and more effective capacity for self-observation. The paper closes with a warning about the "pitfalls of perfectibilism" and with a plea for the elevation of the not-so-good analytic hour.     

Negativism and countertransference

The purpose of this work is to explore the phenomenon of negativism and the analyst's response to it during the course of analytic work with a patient in whom negativism is a central behavioral pattern. Melville's short story, "Bartleby the Scrivener," describing in telling detail the response of a sympathetic lawyer to profound and pervasive negativism in his legal scribe, is discussed as a literary analogy to the analyst-analysand dyad. Aspects of the concept of negativism within psychoanalysis are discussed. The potential usefulness of understanding certain unexpected countertransference responses to pervasive negativism is explored, as this is a relatively neglected area of psychoanalytic technique. A case is presented describing the analysis of a patient whose character, like Bartleby's, is a mixture of profound negativism along with schizoid, obsessional, and masochistic elements.     

Therapeutic strategy and psychoanalytic technique

The role of therapeutic strategy within psychoanalytic technique is described. An antistrategic bias inherent in certain aspects of the "classical" technique is explored in relation to the historical development of psychoanalysis. Clinical expertise, which includes the making of strategic or tactical choices, is relegated to the "unofficial," due in part to this negative bias impeding the study of technical differences in favor of general agreement about a theory of technique that may differ considerably from actual clinical work. A case is presented that illustrates strategic choices in the management of a severe character resistance in a supervised analysis. Some consequences of a negative bias against therapeutic strategy as it relates to psychoanalytic training is described.     

Technique and final cause in psychoanalysis: Four ways of looking at one moment

This paper argues that if one considers just a single clinical moment there may be no principled way to choose among different approaches to psychoanalytic technique. One must in addition take into account what Aristotle called the final cause of psychoanalysis, which this paper argues is freedom. However, freedom is itself an open‐ended concept with many aspects that need to be explored and developed from a psychoanalytic perspective. This paper considers one analytic moment from the perspectives of the techniques of Paul Gray, Hans Loewald, the contemporary Kleinians and Jacques Lacan. It argues that, if we are to evaluate these techniques, we must take into account the different conceptions of freedom they are trying to facilitate.     

Toward a definition of psychoanalytic neutrality

The word and concept of neutrality play an important but confusing role in the history of psychoanalysis. Does neutrality imply indifference? The origin of this ambiguity is traced to the fact that Freud himself never used the word "neutrality" (Neutralitaet) in his own writings. (His term Indifferenz was translated as "neutrality" by Strachey.) The essence of the controversy that has simmered in the psychoanalytic literature ever since is contained in the question: "Is remaining true to the concept of neutrality somehow antithetical to the analyst's genuine involvement with the patient?" In this paper, I examine the feeling and power aspects of the word and suggest that the concept of neutrality becomes clinically useful when the analyst asks himself the question, "Neutral to what?" The analyst's awareness of his motives for recognizing and addressing certain conflicts and for overlooking others is heightened. With three clinical vignettes as illustrations, I explore the role of the concept of neutrality in deepening our understanding of (1) the analytic relationship; (2) The influence, on the conduct of the treatment, of the analyst's goals and theoretical persuasion regarding how the goals are to be achieved. As examples, I use the current debates over the relative value of the analyst's focusing his attention on: (a) the patient's mind in the hour rather than his life outside the hour and, (b) transference over nontransference interpretation. Finally, I emphasize the far-reaching implications of adding an explicit concept of "external reality" to A. Freud's exclusively intrapsychic definition of the "objective" analyst's position of neutrality as equidistant from id, ego, and superego. The addition of this fourth point to the analyst's "compass" widens the analytic field toward which the analyst is neutral. The concept of neutrality with respect to specifiable conflicts is thereby also broadened to include (a) interpersonal conflict within the psychoanalytic relationship and (b) conflict within the analyst. With these explicit additions, the concept of neutrality with respect to conflict becomes congruent with the current emphasis on the nonauthoritarian two-persons aspects of the psychoanalytic relationship, without detracting from the primary analytic goal of deeper understanding of intrapsychic conflict.     

Recent developments in the technical approaches of English-language psychoanalytic schools

This paper summarizes developments in the major approaches to psychoanalytic technique derived from the ego psychology, Kleinian, British independent, self psychology, intersubjectivist, and interpersonal schools over the past fifty years. The author proposes that two major contemporary currents may be differentiated from each other, namely, the psychoanalytic "mainstream"--derived from contemporary Kleinian, contemporary Freudian, and British independent sources, and the "intersubjectivist-interpersonal-self psychology" current. In significant contrast to these two major currents within the English-language psychoanalytic approaches, the French psychoanalytic school has evolved a unique third approach to analytic technique. The author proposes that these three currents constitute the dominant trends regarding technique in contemporary psychoanalytic practice. The paper concludes with a brief outline of the characteristics of each of these technical approaches.     

On a soma-psychotic part of the personality: a clinical and theoretical approach to the somatic

Inspired by Bion, the concept of a soma-psychotic part of the personality is suggested. The authors present four clinical vignettes to illustrate certain clinical phenomena in which the body played a key role in the patient's personal history, during the analytic process, or both. Certain aspects of analytic technique with these severely disturbed patients are briefly referred to, including the analyst's reverie and transformational capacity, and some observations made in these cases lead to tentative generalizations on mental functioning and psychosomatic unity. A theoretical model is constructed to contain both data and conclusions, and to offer a solution for the integration of the somatic in psychoanalytic theory.     

The sound-hand

Through clinical vignettes taken from the analytic treatment of an autistic child, the paper explores Bion' s notion of selected fact in relation to the post-Jungian theoretical speculation on the emergent mind. The issue of the subjectivity of the analyst is considered and explored in this light. A review of some neuroscience research contributions to a possible understanding of dialogue, empathy and rhythm is briefly described, particularly in terms of its potential usefulness for the psychoanalytic mind when working with autistic children. In general, the notions of ‘temporal shapes’ (Alvarez) and ‘sound-object’ (Maiello) provide support for the theoretical and clinical explorations of the issue of rhythmic interactions. Rhythmic sounds are distinguished from stereotypical and meaningless sounds produced by the analysand, whether or not they are accompanied by body movements, and their function of activating representations and amplifications in the analyst's mind is explored in the stage of treatment when the child does not yet speak. The Jungian concept of amplification is considered and revisited in this context.     

Psychoanalytic attitude as a step in the transference/countertransference relationship

When the psychoanalytic treatment process reactivates the "primary oral conflict" in the patient, the author recommends that the analyst put off transference interpretations in favor of reacting with the "analytic attitude". Only after the relationship between patient and therapist has been restabilized, can the elaboration of the early conflicts be considered. The concept of the analytic attitude is essentially a synthesis of "holding" and "containing" functions.     

Becoming (and Remaining) an Analyst in Latin America

The following overview of the development of psychoanalysis in Brazil and in Porto Alegre outlines the current situation and the challenges to psychoanalysis in my country. I will explain my own experiences on becoming an analyst, the main reasons for my choice, my main influences, and my evolution as a clinical psychoanalyst and as a member of psychoanalytic and psychiatric institutions. I include my main contributions to psychoanalysis and consider two broad areas of interest: psychoanalytic technique and its teaching, and the relationship of psychoanalysis and culture. As for the former, my main interests are studies on countertransference and analytic neutrality, to which I will propose a comprehensive concept. As for the latter, I discuss a culture that contrasts vividly with the one in which Freud created the discipline, psychoanalytic views on violence and perversity, psychoanalytic institutions, and the application of analytic ideas for the understanding of some artists and their work.

I will also describe some general features of my country and the development of psychoanalysis in it; report my experiences as a candidate and an analyst; and offer some information about my evolution as an analyst through papers I have written over the past 30 years.     

Letting go: some thoughts about termination

Termination of analysis is discussed from three perspectives. First, considered as a vicissitude of the analytic relationship, termination contains essential elements of the psychoanalytic process itself. Cycles of attachment, loss, mourning, and internalization mark moments in, as well as overviews of, every analysis from its beginning to well past its termination. Second, Freud's approach to the subject of termination is explored and widened, with an emphasis on its relation to mourning and on the depth and permanence of analytic transference--two dimensions relatively neglected by Freud, perhaps for personal reasons. Finally, clinical issues are presented that are meaningful to the author in his work with analysands, including his work as a training analyst.     

NEUTRALITY IN THE FIELD: ALPHA‐FUNCTION AND THE DREAMING DYAD IN PSYCHOANALYTIC PROCESS

Analysts have interpreted the concept of neutrality in a variety of ways, beginning with Strachey's use of that word to translate Freud's (1915) term, Indifferenz. In this paper, neutrality is linked to Freud's notions of free association and evenly suspended attention. A history of psychoanalytic attempts to clarify the concept are presented, with special attention to issues of ambiguity and the patient's role in the determination of neutrality. Neutrality is further elaborated in relation to the bipersonal field as described by the Barangers and contemporary field theorists. Understood in terms of the field, neutrality becomes a transpersonal concept, here conceived in terms of alpha‐function and a dreaming dyad. Two clinical examples cast in the light of a Bionian perspective are discussed to suggest an alternative understanding of analytic impasses and their relation to alpha‐function and neutrality.