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The therapeutic relationship exists within multiple levels of reality – including that of ordinary life and that of the therapeutic frame. This interplay between these two levels of reality gives rise to paradoxical experiences for both participants. Certain >principles< or >rules< of technique can be understood as a means of enabling the therapist to cope with what is usually referred to as >boundary< issues. It is essential that the analyst or therapist demonstrate capacity to shift playfully from one level of reality to another. The >rule< of abstinence and the asymmetry of desire that exists between the two participants are discussed. Gratification within the therapeutic frame is paradoxical in that gratification at one level of reality leads to privation at another level of reality. These paradoxical experiences for both patient and analyst are examined in relation to projective identification and to the analyst's countertransference.
This article highlights the analysis of the patient's experience of the analyst's subjectivity in the psychoanalytic situation. Just as psychoanalytic theory has focused on the mother exclusively as the object of the infant's needs while ignoring the subjectivity of the mother, so, too, psychoanalysis has considered the analyst only as an object while neglecting the subjectivity of the analyst as the analyst is experienced by the patient. The analyst's subjectivity is an important element in the analytic situation, and the patient's experience of the analyst's subjectivity needs to be made conscious. Patients seek to connect to their analysts, to know them, to probe beneath their professional facade, and to reach their psychic centers much in the same way that children seek to connect to and penetrate their parents’ inner worlds. The exploration of the patient's experience of the analyst's subjectivity represents one underemphasized aspect of the analysis of transference, and it is an essential aspect of a detailed and thorough explication and articulation of the therapeutic relationship. The paper explores controversies regarding the analyst's self-disclosure and countertransference.
The psychoanalytic situation provides many opportunities for people to observe their analysts closely. These observations are inevitably woven into the fabric of patients’ transference experience. Because the observations can be uncomfortable for the analyst, there is a constant temptation to ignore or deny the plausibility of patients’ perceptions. They can be, and often are, quickly reinterpreted as derivatives of sexual or aggressive urges. Psychoanalytic drive theory, with its emphasis on impulse rather than observation as the force behind transference experience, can encourage counter-transferential disclaimers and lead to blind spots. Some technical suggestions are offered to avoid this tendency and are based on a relational understanding of the nature of transference.
The three papers by Modell, Aron, and Greenberg are discussed in terms of their relationship to a new paradigm for understanding the psychoanalytic situation. The paradigm is called social-constructivist to capture both the idea of the analyst's participation and the idea of construction of meaning. It is argued that these theorists, as well as many of the authors they cite as part of a broad movement in the field, do not consistently meet the criteria for this paradigm, although they seem to be aiming for it. An important source of inconsistency and confusion derives from the confounding of the two axes: drive-relational and positivist-constructivist. Many relational theorists who hold fast to the idea that analysts can grasp the truth of both their own experience and that of the patient are no closer to the constructivist point of view than was Freud. The call by Aron and Greenberg for greater attention to the patient's resisted experience of the analyst's subjectivity is discussed in terms of its potential benefits and problems. The ritualized asymmetry of the psychoanalytic situation is said to have important functions, including prevention of excessive involvement and protection of the unobjectionable positive transference and of a degree of idealization. Modell's notion of paradox, which makes the therapeutic relationship seem >real< and >unreal< at the same time, is seen as a special instance of the always precarious social construction of reality. It is argued, moreover, that the social and individual aspects of experience are interdependent. Neither is reducible to the other, and both should be understood, like many other issues in the new paradigm, in terms of a dialectical interplay of figure and ground in experience.
This article presents the author's reactions to a client who saw him for one visit, came 20 minutes late, demanded ideal >parenting,< called during the following two weeks, and one day left flowers in his waiting room. The focus is on the failed meeting, the meeting that did not take place, loss, and longing. The aim is to go beyond diagnostic categories to the place where therapy fails, the edge of what is therapeutically possible. Dwelling with therapeutic incapacity in a full and detailed way – letting >it< speak – may help to stimulate evolution of capacities needed to work with individuals who now slip away from what therapy can do.