Analytic Situation Research Articles

Explicating the implicit: The local level and the microprocess of change in the analytic situation

This paper proposes a method of examining the micro‐events of the analytic process that borrows heavily from developmental research. The increasing importance of illuminating the microprocess of interaction to understanding the process of change in analytic treatment is emphasised. A set of constructs and terminology is proposed for the study of the moment‐to‐moment interactive process in psychoanalytic therapy referred to as the local level. A theory of therapeutic action based on ‘local‐level’ process is then explicated. Its central element involves a step‐by‐step process of ‘fitting together’, which leads to changes in implicit knowing through alteration of emotional procedures.

A Visit to the Budapest School

Within the past ten years, there has been a growing interest among American psychoanalysts in the work of Sandor Ferenczi and his followers, the so-called Budapest School. Several collections of essays on Ferenczi have appeared, while his correspondence with Freud and his Clinical Diary were finally published and translated. In this paper, I will give an overview of the historical importance of the Budapest School analysts, and then focus on three overlapping areas of their interest that have been and will continue to be particularly challenging. First, their exploration, stimulated by Ferenczi, of clairvoyance and telepathy, as these relate to the analytic situation, to transference and countertransference. Second, the mother-child dyad in the first year of life and the importance of trauma in early development. Third, the theory of psychosis.

Psychic reality in the psychoanalytic process.

The case is made for regarding psychic reality as synonymous with subjective (conscious) experience, which is inherently open to, but not reducible to, unconscious determinants. Both analyst and analysand engage in the analytic relation and interaction from the perspective of their respective psychic realities. Thus, components of the analytic relation--transference/countertransference, alliance, and real relation--are forms of psychic reality. The tensions of subjectivity and objectivity are discussed in relation to the analytic situation, especially with regard to whether the patient's or the analyst's psychic reality is to be given priority or preference. The same reality, situation, or relationship can be viewed from different perspectives and subjected to varying interpretations without any one being exclusively true or false-each may be partially true and/or partially false. The patient's recounting of his history is a part of the patient's psychic reality that intersects with a necessarily divergent account constructed by the analyst. The ensuing dialogue seeks a form of real coherence that is mutually realistic and makes realistic sense for both parties. Reliance on subjective psychic reality becomes a possible, but precarious and potentially misleading, basis for analytic understanding without other observational (verbal and behavioral) or objective data.

Irreducible subjectivity and interactionism: A critique

The authors offer a critique of the privileging of subjectivity in psychoanalysis characteristic of what Hanly has called interactionism, with specific reference to the work of Renik. First, Renik's argument for the irreducible subjectivity of the analyst is explored and critiqued from a philosophical perspective. The need for and plausibility of a subtler notion of objectivity that takes into account the limitations of human subjectivity and that analysts can meaningfully pursue is defended. Second, Renik's ‘re‐visioning’ of psychoanalysis, which follows from his notion of irreducible subjectivity, is explored and critiqued. Renik's view of enactments is contrasted with a ‘totalistic’ perspective of countertransference that allows for important, finer conceptual distinctions. Renik's conceptualisation of countertransference enactments is characterised as a ‘special case’ of countertransference as a vice. Next, Renik's view of transference is critiqued for privileging the adaptive dimensions of transference, and for potentially sidelining archaic dimensions. Finally, Renik's conclusions and ‘revisioning’ of psychoanalysis are shown to follow from his modifying or jettisoning certain features of the analytic situation and process. These features and their implications are elaborated on. The conclusion outlines the extent to which the arguments presented can be extended to other advocates of interactionism.

Irreducible subjectivity and interactionism: a critique.

The authors offer a critique of the privileging of subjectivity in psychoanalysis characteristic of what Hanly has called interactionism, with specific reference to the work of Renik. First, Renik's argument for the irreducible subjectivity of the analyst is explored and critiqued from a philosophical perspective. The need for and plausibility of a subtler notion of objectivity that takes into account the limitations of human subjectivity and that analysts can meaningfully pursue is defended. Second, Renik's 're-visioning' of psychoanalysis, which follows from his notion of irreducible subjectivity, is explored and critiqued. Renik's view of enactments is contrasted with a 'totalistic' perspective of countertransference that allows for important, finer conceptual distinctions. Renik's conceptualisation of countertransference enactments is characterised as a 'special case' of countertransference as a vice. Next, Renik's view of transference is critiqued for privileging the adaptive dimensions of transference, and for potentially sidelining archaic dimensions. Finally, Renik's conclusions and 're-visioning' of psychoanalysis are shown to follow from his modifying or jettisoning certain features of the analytic situation and process. These features and their implications are elaborated on. The conclusion outlines the extent to which the arguments presented can be extended to other advocates of interactionism.

Mapping the landscape: Levels of transference interpretation

The author argues that there are distinctly different kinds of transference interpretation, each of which might be valid in particular circumstances in analysis, but which contain and imply different understandings of what is meant by a ‘transference interpretation’. She suggests that transference interpretations may be at any one of four different levels, and she describes these levels as ranging from interpretations that point to links between current events in the analysis and events from the patient's history, through interpretations that link events in the patient's external life to the patient's often unconscious phantasies about the analyst and the analysis, to interpretations that focus on the use of the analyst and the analytic situation to enact unconscious phantasy configurations, sometimes pulling the analyst into the enactment. Material from four consecutive sessions of an analysis is presented to illustrate how all levels of transference interpretation may be part of a lively and meaningful analysis, but how the level of interpretation may change as the level of understanding deepens within a session and from one session to the next.

Freud and Klein on the concept of phantasy

In summary, I think Freud's idea is that the prime mover of psychic life is the unconscious wish, not phantasy. The 'work' of making phantasies and the 'work' of making dreams are parallel processes in which forbidden unconscious wishes achieve disguised expression and partial fulfilment. For Freud himself, especially in his central usage, and even more for his immediate followers, phantasies are conceived as imagined fulfilments of frustrated wishes. Whether they originate in the system conscious or the system preconscious, they are an activity of the ego and are formed according to the principles of the secondary process. That is not the whole story, however, because phantasies may get repressed into the system unconscious, where they become associated with the instinctual wishes, become subject to the laws of the primary process, and may find their way into dreams and many other derivatives. For Freud and for French psychoanalysts particularly, there are the primal phantasies, 'unconscious all along', of the primal scene, castration and seduction, also capable of being directly incorporated into dreams and expressed through other derivatives. For Klein phantasy is an even more central concept than for Freud and it has continued to be used by her successors with only minor changes. In Klein's thinking unconscious phantasies play the part that Freud assigned to the unconscious wish. They underlie dreams rather than being parallel to them--a much more inclusive definition of phantasy than Freud's. The earliest and most deeply unconscious phantasies are bodily, and only gradually, with maturation and developing experience through introjection and projection do some of them come to take a verbal form. Freud's central usage, the wish-fulfilling definition of phantasy, is a particular type of phantasy within Klein's more inclusive definition. And, as in Freud's formulation, conscious phantasies may be repressed, but in Klein's formulation this is not the only or even the main source of unconscious phantasies. In Klein's usage, unconscious phantasies underlie not only dreams but all thought and activity, both creative and destructive, including the expression of internal object relations in the analytic situation. Finally, it is my tentative suggestion that conceptual and clinical focus on the concept of phantasy, especially unconscious phantasy, as in Britain and France, tends to involve a heightened awareness of the unconscious--hardly surprising, since unconscious phantasy is such a fundamental aspect of the unconscious. I have suggested that, although there are many individual variations, the structural model and the self-psychology, relational and intersubjectivist models tend to discourage focus on the dynamic unconscious.

Freud and Klein on the concept of phantasy.

In summary, I think Freud's idea is that the prime mover of psychic life is the unconscious wish, not phantasy. The 'work' of making phantasies and the 'work' of making dreams are parallel processes in which forbidden unconscious wishes achieve disguised expression and partial fulfilment. For Freud himself, especially in his central usage, and even more for his immediate followers, phantasies are conceived as imagined fulfilments of frustrated wishes. Whether they originate in the system conscious or the system preconscious, they are an activity of the ego and are formed according to the principles of the secondary process. That is not the whole story, however, because phantasies may get repressed into the system unconscious, where they become associated with the instinctual wishes, become subject to the laws of the primary process, and may find their way into dreams and many other derivatives. For Freud and for French psychoanalysts particularly, there are the primal phantasies, 'unconscious all along', of the primal scene, castration and seduction, also capable of being directly incorporated into dreams and expressed through other derivatives. For Klein phantasy is an even more central concept than for Freud and it has continued to be used by her successors with only minor changes. In Klein's thinking unconscious phantasies play the part that Freud assigned to the unconscious wish. They underlie dreams rather than being parallel to them--a much more inclusive definition of phantasy than Freud's. The earliest and most deeply unconscious phantasies are bodily, and only gradually, with maturation and developing experience through introjection and projection do some of them come to take a verbal form. Freud's central usage, the wish-fulfilling definition of phantasy, is a particular type of phantasy within Klein's more inclusive definition. And, as in Freud's formulation, conscious phantasies may be repressed, but in Klein's formulation this is not the only or even the main source of unconscious phantasies. In Klein's usage, unconscious phantasies underlie not only dreams but all thought and activity, both creative and destructive, including the expression of internal object relations in the analytic situation. Finally, it is my tentative suggestion that conceptual and clinical focus on the concept of phantasy, especially unconscious phantasy, as in Britain and France, tends to involve a heightened awareness of the unconscious--hardly surprising, since unconscious phantasy is such a fundamental aspect of the unconscious. I have suggested that, although there are many individual variations, the structural model and the self-psychology, relational and intersubjectivist models tend to discourage focus on the dynamic unconscious.

On "Telepathic dreams?": an unpublished paper by Robert J. Stoller.

In 1973 Robert Stoller wrote a paper on a series of dreams-his own and his patients'--that he reluctantly found himself calling "telepathic." He never submitted the paper for publication, though he returned to the topic of unconscious communication and telepathy with increasing fascination in the years before his death. Publication of Stoller's paper seems particularly opportune just now. In it he pleads for open-minded examination of data, however alien to current scientific belief those data seem. In the past, despite numerous published reports of possibly telepathic experiences in analysis, their investigation remained relatively one-sided, since a technical posture of anonymity with patients constrained analysts from revealing that a communication struck them as telepathic. This has limited what analysts have been able to learn about the information actually exchanged, how it was exchanged, and whether the communication was experienced as uncanny by the patient. Recent attention to the intersubjective nature of the analytic situation has led to a deemphasis of anonymity, opening freer dialogue that may facilitate the rigorous investigation Stoller calls for. Such investigation may further analytic understanding of unconscious mental function and communication in the clinical setting, and lend perspective to the growing body of carefully controlled experimental research on anomalous mental phenomena.

On Unconscious Communications and Covert Enactments: Some Reflections on Their Role in the Analytic Situation

By means of an extended clinical example, this paper focuses on the impact that unconscious communications in the form of nonverbal behavior may have on the course and outcome of an analysis. Responding to sudden catastrophic illnesses in their fathers, patient and analyst created enactments aimed at blinding them to hard truths about their relationships with this parent. Serving as powerful resistances that led to a stalemate and all but ended treatment, these nonverbal enactments had to be recognized, confronted, and understood by both participants before analytic work could be resumed and progress achieved in this analysis.

The Analysis of Preconscious Phenomena and Its Communication

Thoughts and feelings of both patients and analysis may be influenced by perceptions that remain outside of conscious awareness. A preconscious communication exists between patient and analyst. Appreciation of the preconscious elements of communication may enable a better understanding of what may be otherwise experienced as a mysterious occurrence. Transference-countertransference interactions create a place to observe the manifestation of preconscious phenomena. This paper addresses how the analytic method enables the discovery of consciously unrecognized stimuli or selective attention to certain phenomena which have created a sense of the uncanny or surprising. Both intersubjective reflection and more formal, systematic methods, which include logic and reasoning, serve to illuminate these events. The paper discusses and illustrates the role of preconscious communication in the analytic situation and its relation to the analytic process.

Timing—the time for intervention

In this paper, Freud's recommendations regarding the timing of interventions are reviewed, especially the work of pointing out and interpreting resistance-phenomena. This is compared to recent developments in psychoanalytic technique. Interventions, their timing and effect are illustrated by clinical material from three psychoanalyses. The possibility of integrating the different recommendations is discussed. An overall experience is that the most demanding work is that of making resistance-phenomena observable for both parties in the analytic situation. It is demonstrated how this precondition can be developed through the analyst's experience of the interaction, and thus give the time for intervention.

Reflections on psychic reality.

The author explores the nature and development of psychic reality and draws the following conclusions: (1) psychic reality is equivalent to subjective (conscious) awareness. (2) Psychic reality is open to unconscious influences, both as to content and motivation. Psychic reality thus is not equivalent to unconscious fantasy or transference, but can include effects of both. (3) Psychic reality can also include objective experience. (4) The capacities for internal psychic experience and knowledge of objective reality externally are modes of experiencing that develop early and achieve gradual integration through integrative play. (5) Psychic experience, and therefore psychic reality, cannot be regarded as exclusively subjective or objective, but as inherently both. The ways in which subjectivity does not preclude or exclude objectivity are discussed and related to transitional experience. (6) The inherent subjectivity of psychic experience precludes any form of direct intersubjective communication, that is, unmediated communication from subject to subject. The tensions of subjectivity and objectivity are discussed in relation to the analytic situation, in which perspectives of patient and analyst differ and reflect their respective psychic realities, each with its own validity and uncertainty and openness to unconscious needs, fantasies and motives.

At Death's Door: Therapists and Patients as Agents

This paper explores the interrelationship between patients' exercise of will to make advances in an analysis and their readiness to forgive their analysts for their human limitations. There is a thin line between idealization of the analyst, probably a necessary component of the process, and resentment of the analyst for his or her privileged position in the world and in the analytic situation itself. The patient's “progress” emerges as a kind of reparative gift, one that implicitly overcomes the patient's tendency to withhold such change out a sense of chronic, malignant envy. Particularly poignant in terms of its potential to elicit the patient's reparative concern is the situation in which the analyst is struggling with his or her mortality because of aging or life-threatening illness. In this essay two clinical vignettes are presented to illustrate some of the issues that this situation poses. One begins with an elderly patient appearing at the door of the analyst's (the author's) home the day of his return from the hospital after coronary bypass surgery. The other begins with an analyst who is terminally ill appearing at the door of a patient who is threatening suicide. The two stories are compared in terms of their implications for human agency, the exercise of will, and the coconstruction of meaning in the face of mortality in the analytic process.

Why we need to write openly about our clinical cases.

To learn more about what is and is not effective in the psychoanalytic situation, analysts need to develop a library of detailed analytic case material. Open case writing, by not overconstraining readers, allows them enough access to the analytic couple's affective experience to persuade them of the authenticity and validity of the analyst-author's views. They are then free to rethink the material creatively on their own, to use it as they need to, and to learn from others, in order to enhance their analytic skills. Closed case writing hinders readers' creative freedom to understand and interpret, and hence to learn. To encourage analyst-authors to share their affective experiences in the analytic situation more openly, analysts need to establish a constructively collaborative attitude toward playing with clinical material. They need to take for granted that new readers, even authors themselves newly rereading their work, will discover something new. A dialectical process can then be established in which clinical authors and readers contribute to each other in an ongoing imaginative interchange.

Mutual Containment in the Analytic Situation

The patient's containment of the analyst's affect occurs in a broad range of situations that extend far beyond the more visible instances when the analyst is directly expressive of his or her own affects. This paper begins to explore how patients help analysts contain various kinds of affects within the analytic process, particularly more routine and less heroic types of containment. Although this containment is generally a far less prominent feature of analytic work than is the containment provided by the analyst for the patient, it is omnipresent. Routine elements of containment that the patient provides for the analyst involve working with the knowledge of the limits of the other—including the possibility that in a long-term treatment the patient will often get to know quite well some of the quotidian aspects of the analyst's personality and its relation to the patient's conflicts. Mutual aspects of containment are extremely important in the expression and titration of anger and disappointment, desire, hope, humor, and the negotiation of psychic possibility within the analytic dyad.

The Problem and Place of Physical Contact in Analytic Work: Some Reflections on Handholding in the Analytic Situation

(2000). The Problem and Place of Physical Contact in Analytic Work: Some Reflections on Handholding in the Analytic Situation. Psychoanalytic Inquiry: Vol. 20, No. 1, pp. 65-81.

Recovery of affect and structural conflict

This paper deals with fragmented or dispersed affects states with special reference to deep depression. The clinical material presented consists of two patients; a seriously depressive man, and a female patient with a schizoaffective psychosis which has been treated and followed up by the author since the end of the 60s. The hypothesis is that, in a serious depression, as well as in traumatic states in general, the genuine affect tends to be dissected into its two constituents: a diffuse bodily excitation and dismantled drive-instinctual urges devoid of affective meaning. The author arrives at the conclusion that the analytic situation represents a metaphorical frame where the recovery of affect becomes possible when the disruptive experiences of the past are dealt with in the transference. The integration of affect signifies a major structural achievement, making the perception of reality possible without sacrificing affective experience and genuine interest in life. The author deals with the foundations of the structural theory and proposes that the early frame of primary identification comes to play a crucial rôle in the advanced psychic organisation. On the one hand, it carries the capacity of psychic representation and metaphorical thinking. On the other hand, as projected onto the future, it defines the frame of the ego-ideal and forms the basis for metaphorical interpretation of the superego demand.

Intersubjectivity and Interaction in the Analytic Relationship: a Mainstream View

The authors conceptualize intersubjectivity as a meta-theory that reflects the inherent nature of human relatedness and is conceptually independent of any particular theory of mind or school of psychoanalysis. Their view of intersubjectivity joins the emotional life of the analyst to that of the patient and places the analytic relationship at the center of the analytic process. They contrast intersubjectivity with traditional classical conflict theory so as to clarify the relevance of intersubjectivity for psychoanalytic clinical theory and therapeutic practice. In so doing, they hope to direct analysts more firmly toward the study of the unconscious dyadic contributions to the affective, enactive, and interactive dimensions of the analytic situation and their impact upon the patient’s actions within and experience of the analytic relationship. To illustrate their thesis, two hours from an analysis are presented in detail.

Well-Tempered Bagatelles--A Meditation on Listening in Psychoanalysis & Music

Well-Tempered Bagatelles—A Meditation on Listening in Psychoanalysis & Music 1 Alexander Stein Teach me half the gladness / That thy brain must know, / Such harmonious madness / From my lips would flow, / The world should listen then, as I am listening now. —Percy Bysshe Shelly Listening is a cardinal feature of psychoanalytic work. Its elemental importance transcends and unifies all other components of theory and technique. No matter an analyst’s theoretical orientation, and irrespective of the conceptual frame in which the listening is organized or of its focus at any given moment during an analytic session, listening is an activity underlying every aspect of the analytic interaction occurring within the auditory sphere. Separately, a consideration of signal moments of the early part of the twentieth century reveals the coincidental emergence of psychoanalytic thought and the onset of fundamental alterations in music (such as serialism, 12-tone rows, and experimentation with sonority and form). A primary part of the overall task undertaken by early twentieth century composers was the implementation of a replacement system for governing the organization of sound in time. The implications for the project of psychoanalytic listening pioneered by Freud were no less momentous: to listen to the sounds of the human experience in a radically different, and profoundly deeper, way. Both psychoanalysis and contemporary music clearly derive from the breadth of each of their respective histories: Freud no more created the notion of the unconscious, ex nihilo, than could Schoenberg have written his first 12-tone works without benefit of the entire musical corpus which preceded him. Each is rooted in systems of thought, aesthetics [End Page 387] and scholarship accumulating since antiquity, yet each is possible only in the twentieth century. This essay critically examines these two ostensibly different yet related forms of listening—in music 2 and in psychoanalysis—with a view to yielding an expanded understanding of the nature of and relationship between unconscious processes and the ways in which we hear the evanescent discourse between analyst and analysand. The aesthetic, philosophical, and psychological links between and among conscious and unconscious emotional responses in listening to music and in the analytic situation form a complex fugue of inter-weaving yet, at least at first blush, seemingly discontiguous themes. But this dense polyphony finally coalesces in two areas common to both—engaged, attuned listening and, most importantly, the communication of feeling. What follows, then, is founded on this rather simple premise. Not so simple, however, are the ways in which feelings are communicated and registered. In this regard, I will explore the contention that essentially all listening is predicated upon entrenched constructs of harmony, tonality and by-now axiomatically-accepted ideals of beauty, consonance, and dissonance. What are the implications of an unheard, that is, unconscious, internalization of hierarchies of harmoniousness and well-temperedness on psychoanalytic listening—for both analyst and analysand—where contending with the resurgence of or resistance against unconscious conflict necessarily calls for recasting established ways of thinking and feeling? For analysts, this question exceeds the bounds of ‘attunement’ in its traditional sense or of closely monitoring countertransference responses in that it speaks to an immanent mode of listening which would be left unaddressed, at least explicitly, by even the most thorough psycho-analysis. It also prompts a reconsideration of what is, in fact, heard in even the most creative and attuned listening. Simply put, the issue is to re-think not only what is heard but how it is heard. I will address this first in a primarily musical context, commencing with a terse historical accounting of consonance, dissonance and the evolution of the most accepted system of temperament. [End Page 388] To be intelligible, we accept that our communication must adhere to particular rules and must conform to the codicils of grammar and syntax which govern usage and meaning. Of course, rules change, reflecting the stylistic fashions of a given time or place, validating, re-validating, nullifying, or transforming acceptable doctrine. Similarly, the rebellious anarchy which is one moment’s avant garde is inevitably subsumed by some radicalized successor. The fluidity of rules, whether musical or linguistic, being occasioned by such forces as politics, an individual’s charisma, technological innovation...