The Ethic of Honesty: The Fundamental Rule of Psychoanalysis (Contemporary Psychoanalytic Studies 2)

The Ethic of Honesty

Contemporary Psychoanalytic Studies 2

Editor Jon Mills Associate Editor Roger Frie Editorial Advisory Board Neil Altman Howard Bacal Alan Bass John Beebe Martin Bergmann Christopher Bollas Mark Bracher Marcia Cavell Nancy J. Chodorow Walter A. Davis Peter Dews Muriel Dimen Michael Eigen Irene Fast Bruce Fink Peter Fonagy Gerald J. Gargiulo Peter L. Giovacchini Leo Goldberger James Grotstein

Otto F. Kernberg Robert Langs Joseph Lichtenberg Nancy McWilliams Jean Baker Miller Thomas Ogden Owen Renik Joseph Reppen William J. Richardson Peter L. Rudnytsky Martin A. Schulman David Livingstone Smith Donnel Stern Frank Summers M. Guy Thompson Wilfried Ver Eecke Robert S. Wallerstein Otto Weininger Brent Willock Robert Maxwell Young

The Ethic of Honesty The Fundamental Rule of Psychoanalysis M. Guy Thompson

Amsterdam - New York, NY 2004

Cover Design: Paul Pollmann The paper on which this book is printed meets the requirements of ‘ISO 9706: 1994, Information and documentation - Paper for documents Requirements for permanence’. ISBN: 90-420-1118-1 ©Editions Rodopi B.V., Amsterdam - New York, NY 2004 Printed in The Netherlands

For

Hugh Alexander Crawford Analyst, Teacher, Friend in Memoriam

Other books published by M. Guy Thompson The Death of Desire: A Study in Psychopathology (1985) The Truth About Freud’s Technique: The Encounter with the Real (1994)

He that has eyes to see and ears to hear may convince himself that no mortal can keep a secret. —Sigmund Freud

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Contents Foreword

xi

Preface

xiii

One

The Fundamental Rule

1

Two

Thinking Through Free Association

21

Three

The Way of Neutrality

39

Four

The Rule of Abstinence

61

Five

Phenomenology of Transference

79

Six

The Enigma of Countertransference

95

Seven

Therapeutic Ambition

109

Eight

The Existential Dimension to Working Through

123

Concluding Unscientific Postscript

143

About the Author

145

References

147

Index

153

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Foreword

Rarely do we come across a book that has the force and cogency to provoke us to reevaluate the most fundamental tenets of our profession. When this is successfully accomplished, the reader often embraces a deep and supple transmogrification of professional identity, thus leading to a robust appreciation for the immediate impact the author has induced. This is precisely what this contribution aims to bestow, a work that is capable of transforming the psychoanalytic domain. As one of the most brilliant psychoanalytic scholars of our time, M. Guy Thompson revolutionizes our understanding of the axiomatic principles upon which psychoanalysis is based. Through a careful exegesis of Freud’s texts, he persuasively shows how the fundamental rule of psychoanalysis is almost universally misunderstood to mean free association, when it is in fact a pledge to honesty. Contextualized in the subjective lived experience each analyst faces, Thompson demonstrates how Freud’s technical mandates are nothing less than ethical imperatives on which to behave. This project is a very atypical endeavor amongst psychoanalytic scholarship, for it seeks to critique and challenge the very principles upon which psychoanalysts base their trade. Sedulously delineating the logic and phenomenology of psychoanalytic technique, Thompson systematically examines Freud’s technical principles in a way that sheds light on their obscurity. With facile clarity, he elucidates such enigmatic concepts like neutrality, abstinence, therapeutic ambition, and working through into readily recognizable truisms about the reality of the interior and how the clinical encounter unfolds. This work is a thoroughly fascinating exploration into the philosophical dimensions of psychoanalytic doctrine that truly offers an exceptional contribution to the literature. There is no other book of its kind: his command of the subject matter is subtly rich, astute, and lucid. Whatever position the reader adopts toward his interpretation of Freud and contemporary practice, one will acquire immense respect for the author and the nuances he illuminates. Jon Mills Editor Contemporary Psychoanalytic Studies

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Preface

The book you hold in your hands concerns the technical principles of psychoanalysis, which is to say, the overriding principles from which all the elements of psychoanalytic technique are derived. This is not a “how to” book. Its purpose is to provoke and unsettle, but ultimately invite you to question your most sacred assumptions about what psychoanalysis is and what it is capable of obtaining. Customarily, a book of this kind would proceed to situate its arguments in a theoretical milieu which follows an established tradition, or sets out to inaugurate a new one. I have no intention of doing either. When I speak about psychoanalytic principles I am neither referring to technical interventions that should be followed by rote nor theoretical constructions that are idiosyncratic to the analyst who conceives them. Hence a technical principle and a theoretical formulation are not the same thing; a word about the distinction between them may prove useful in grasping the underlying premise of this book. There has been considerable attention paid to the formulation of theory throughout the history of psychoanalysis and many of the arguments waged pertain to the presumed correctness of one theory over the other. Hence, there is an extraordinary amount of concern given to theoretical formulations that are often so convoluted that they remind one of the age-old argument as to how many angels can dance on the head of a pin. Perhaps the most prevalent argument today concerns advances that are said to have been made in the manner with which analysts are treating their patients and the theoretical underpinning with which their techniques are justified. Admittedly, I have been less than successful over the course of my professional career—going back some thirty years or so, first in London and subsequently in San Francisco—with couching my views in such a fashion as to fit into one psychoanalytic school or other. The distinctions currently employed between, for example, drive theory and the relational perspective, or one-person versus two-person psychology, or the nuance that is said to distinguish even further the relational perspective from the interpersonal one, or even the plea for a three-element psychology that advocates the presence of an analytic “third,” have left me skeptical as to how necessary or even relevant these matters are to the treatment experience in which every analyst dwells. Though one’s penchant for theory can be gratifying as an end in itself, it has been my observation that theories have never played a significant role in the formulation of what analysts actually do. Moreover, their tendency to generalize from the particular assumes a universality that is fundamentally foreign to the clinical situation. Analysts learn from

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experience, and what they in turn derive from their experience are principles that guide them in their clinical activity. In other words, a principle has priority over theory because theories are derived from the experiences that principles presuppose. How are the two interrelated? According to the Oxford English Dictionary (1973), a theory is a conception or mental scheme of something to be done, or of the method of doing it. It is also a systematic statement of rules or principles to be followed, or a statement of what are held to be the general laws, principles, or causes of something known or observed, as distinct from the practice of it. Finally, a theory is a hypothesis that is proposed as an explanation, hence a mere hypothesis, speculation, conjecture. One can see from this list of definitions that theories derive from principles that, in turn, serve as the source from which a theory may be formulated. Further, a theory is merely conjecture, speculation, hypothesis; it is neither the data (in this case, one’s experience) on which one’s views are founded nor is it the basis on which one’s knowledge is conceived. If an analyst doesn’t derive his theory from experience then he is obliged to borrow from the experiences of others; hence, his clinical formulations are like castles in the air, pretty to look at but without a foundation. In contrast, a principle is depicted as a beginning, source, and foundation; that from which something originates or derives, or the ultimate basis of the existence of something. It is also a fundamental truth or proposition on which other propositions depend. Finally, it is the fundamental assumption forming the basis of a chain of reasoning. Hence, principles are fundamental to what may ultimately become theoretical formulations, or they may serve as ends in themselves, depending on how wedded to theory the analyst may be. To put it another way, a principle is the origin of what we know. In the context of psychoanalysis, principles and technique are necessarily interdependent because the one relies on the other for the development and articulation of each. A hundred years ago Freud’s experience as a clinician gave rise to principles of technique from which his theoretical formulations were derived. Yet there is no necessary relationship between the theories Freud formulated and the principles upon which they are founded. This is what is both maddening and unique about psychoanalysis: it does not particularly lend itself to theory because it pertains to experiences (both those of analysts and patients) that are unpredictable, unrepeatable, and where the unconscious is concerned, unfathomable. Freud had no theories when he started and was tinkering with and rethinking them to the day he died. What he never wavered from, however, were the principles upon which his clinical work and the theories he derived from them were based. These principles have wavered little in the century that has followed since their conception. Thus the history of psychoanalysis may be characterized as a Babel of tongues (theories) that have endeavored (to a considerable degree, unsuccessfully) to make

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sense of what experience tells us. What are these principles and what is the source of their power? This book is about the principles upon which the practice of psychoanalysis is founded, a return to the basics from whence it came. To this end, I neither assume nor offer a necessary or clearly articulated theoretical orientation. Instead, I examine the fundamental principles upon which psychoanalytic practice is based, beginning with the fundamental rule of psychoanalysis: the pledge to be honest as articulated by Freud and, with modifications, remains so today. My method is to examine these technical principles and their tributaries phenomenologically, which is to say, from the analyst’s lived experience, by exploring their internal consistency as they emerge from a clinical context. Let me explain what I take phenomenology to mean and how I employ the term in this study. Whereas the term, phenomenology, is invoked in a common sense sort of way with increasing frequency in the psychoanalytic literature, the way I conceive it is rooted in the philosophical discipline that was initiated by Edmund Husserl (1931) and subsequently modified by Martin Heidegger (1962). Typically taken to mean that which pertains to the person’s experience, phenomenology is a discipline that arose around the same time Freud was formulating his treatment philosophy. Its method is devoted to subverting the over-conceptualization of human existence with which the modern era is identified by bracketing theoretical explanations and returning us, in our naiveté, to the ground of our native experience. According to Edie (1962), Phenomenology is neither a science of objects nor a science of the subject; it is a science of experience. It does not concentrate exclusively on either the objects of experience or on the subject of experience, but on the point of contact where being and consciousness meet. It is, therefore, a study of consciousness as intentional, as directed towards objects, as living in an intentionally constituted world [i.e., one founded on intersubjectivity]. (p. 19)

Phenomenological inquiry differs from conventional scientific investigation in that science is not concerned with nor is it able to study experience, per se; its manner of investigation is directed instead to objects of perception, the nature of which is said to exist independently of the subject who conducts the investigation and whose reality is presumed to exist independently of the investigator. Hence science is unable to account for the experience of the subject who engages in research because the subject’s experience is (alleged to be) separated from and, consequently, inaccessible to the object of scientific investigation, no matter what the object may be, whether material, conceptual, or imaginary.

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Diametrically opposed to this standard of investigation, phenomenology seeks to examine the nature of the world as experienced, whatever the object of inquiry may be, including one’s self, one’s thoughts, and one’s experience of others. In other words, instead of applying a theory that presumes to account for what is happening “in” the patient one is analyzing, the phenomenologist goes directly to the person himself, by examining his experience of his relationship with this person. This is not a matter of speculation but of determining the ground of experience at the moment it is transformed through the interhuman bond shared with others. Following Husserl’s (1900) call to return to “the things themselves,” a generation of phenomenologists, including Martin Heidegger, Max Scheler, Jean-Paul Sartre, Maurice Merleau-Ponty, Paul Ricoeur, and Immanuel Levinas set out to investigate their experience of the world in a radically different manner than the one to which scientists or philosophers were accustomed. According to Safranski (1998), Husserl and his followers [W]ere on the lookout for a new way of letting the things approach them, without covering them up with what they already knew. Reality should be given an opportunity to “show” itself. That which showed itself, and the way it showed itself, was called “the phenomenon” by the phenomenologists. (p. 72)

Ironically, phenomenology resists definition because, like experience itself, its method is antithetical to theoretical and causal explanation. Its point of departure is its rejection of the conceptualizing tendencies of the hard, human, and social sciences. In the preface to his Phenomenology of Perception, Merleau-Ponty (1964) suggested that phenomenology is necessarily difficult to define because it [R]emains faithful to its nature by never knowing where it is going. The unfinished nature of phenomenology and the inchoative atmosphere that has surrounded it are not to be taken as a sign of failure; they were inevitable because phenomenology’s task was to reveal the mystery of the world and of reason. (p. xxi)

Phenomenology shares with psychoanalysis the view that explanation is inadequate to the task of understanding what is given to experience and shares with psychoanalytic treatment the task of determining the nature of suffering itself. In other words, instead of posing the scientific question of what causes one to be this way or that, the phenomenologist asks, “What does it mean that I experience the world this way or that?” Once the meaning-question is substituted for that of causation one enters the realm of phenomenology, because in raising this question one accepts the inherent mystery of existence, the puzzle of which has

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never been solved and after all this time is not likely to be. This feature of phenomenology (that the object of experience can never be decisively separated from the subject who experiences it) is both intentional and intersubjective, because my experience of the other is always unremittingly mine, with all its attendant ambiguity and baggage. In recent years a so-called paradigm-shift is said to have shaken the foundations of psychoanalysis and has even altered its course. I refer to the emergence in the American psychoanalytic community of the relational and intersubjective perspectives that posture their views as advances over Freud’s technical formulations. Whereas it is claimed that a two-person psychology is distinct from a one-person paradigm and a relational perspective can be distinguished from a biological one, I perceive these developments as essentially theoretical in nature and thus offer nothing novel or original in the way of technical innovation, despite their claims to the contrary (see for example, Stolorow, Atwood, Brandchaft, 1994, pp. 3-29). In as much as this model is depicted as a departure from the classic drive perspective, I perceive in Freud’s technical formulations a sensibility that faithfully approximates a phenomenological orientation, even when his theories contradict his clinical intuition. Approached from this angle, psychoanalysis is already phenomenological in its latency because it has always favored interpretation over explanation, and because it relies on the experience of the patient to guide the treatment, not what the psychoanalyst claims to know. Yet despite the phenomenological nature of psychoanalytic inquiry, there has always been a tendency among analysts—beginning with Freud—to extrapolate theories from experience (or from the theoretical constructs of others) that presume to explain what they are unable to see with their eyes. Whereas the phenomenologist resists engaging in speculation as a matter of course, psychoanalysts appear to thrive on it, in effect wanting it both ways: to offer, in one breath, interpretations that endeavor to deepen the patient’s experience, while in the next offering explanations for what is presumed to have “caused” the patient to be such and such a way in the first place. In contrast, the phenomenologist admits from the beginning of his inquiries that he does not know where he is going and does not pretend to. Hence the phenomenologist’s perspective is sceptical instead of theoretical, because it is rooted in a philosophy of perpetual inquiry that is surprisingly compatible with Freud’s technical principles. Indeed, Freud’s principles of technique make little sense outside of a phenomenological context. It is my thesis that the fundamental pivot around which the psychoanalytic experience revolves is the self-disclosure that each patient affects through the act of free association. It will be surprising to some and

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perhaps ironic to others that, after a century of debate and discussion, there is still no universal agreement as to what free association is and whether it is indispensable to the psychoanalytic conception of the treatment or superfluous to it (See Kris (1982), Mahony (1987, pp. 1656), and Gill (1994, pp. 79-100) for edifying reviews on the history of free association in the psychoanalytic literature.). I believe that free association is not only ubiquitous to the analytic experience (even for those analysts who reject this principle), but that one’s understanding of what it entails turns on a fundamental premise which has been systematically omitted from the psychoanalytic literature since Freud introduced it: the (explicit or implicit) promise to conceal nothing from one’s analyst, i.e., the pledge to be honest or candid. If the psychoanalytic enterprise may be characterized as one of lifting the veil from what we typically conceal—even from ourselves—then the practice of psychoanalysis is an inherently dangerous proposition. If we are to place ourselves at risk with what we are about to discover about ourselves—the analyst as well as the patient (cf Bion)—then it behooves us to proceed with a measure of caution. It is one thing to say this and another to put it in effect, to be wedded to it. Since the inception of psychoanalysis Freud took pains to harness the potential for inflicting harm on one’s patients by formalizing a set of constraints that were conceived as rules, or recommendations, to follow. Between 1905 and 1915 he crafted a series of technical recommendations that were paradoxically intended to restrain psychoanalysts from the temptation of doing too much (therapeutic ambition) for their patients, while protecting themselves (the rule of abstinence) and their patients (the rule of neutrality) from the risks unavoidably courted in this enigmatic treatment methodology. Instead of providing instructions about the do’s and don’t’s of the analytic experience, Freud offered nothing more palpable than a set of first principles that merely assigned the respective roles that analyst and patient should play. Although some have complained about the paucity of instructions Freud offered, we have come to appreciate from our clinical experience the limits of what analysts can be told what to do, no matter how many years of instruction or supervision they may accrue. If anything, analytic candidates today are over-trained. Their work is scrutinized, supervised, and evaluated by analysts who, try as they may, cannot possibly know what it is like to be in the room with the person the candidate is treating. Freud did not write a manual on how to conduct psychoanalysis because he concluded that everything of a positive (i.e., interventionistic) nature should be left to tact and the analyst’s own judgement, whereas the principles themselves should remain, like a moral fable, of a cautionary nature. In this sense, Freud’s technical recommendations are nothing less than ethical precepts, because their purpose was to formulate a working terminology with which the analyst’s

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experience could be articulated and communicated to colleagues. Thus, the Hippocratic counsel, “do no harm,” remains the paramount consideration, not the utilitarian goal of success by any measure. Ultimately, analysts must come to terms with these principles in their own way and interpret them to the best of their ability. Yet, a typical, contemporary study of psychoanalytic technique leaves little to chance and less to the imagination (e.g., Greenson, 1967; Glover, 1955; Fenichel, 1941; Sharpe, 1978; Etchegoyen, 1999), written as though it should be obvious what should—indeed, must—be done, when, and to what degree. The principles themselves are now so diluted that analysts no longer know what to make of them, let alone how to adapt them to their necessarily idiosyncratic personalities. This, however, is not an historical account but a practical one for my purpose is to show that psychoanalysis has not, as some insist, “progressed” over the course of the last century but, on the contrary, has lost something in the transition: I am referring to its edge. It is my impression that psychoanalysis, like an old codger, is dying, and we have no one to blame but ourselves. I know I am not alone in this, though I suspect this assessment will shock some in parts of America who do not appreciate the gravity of the situation. American culture has turned against it, and who can blame them? In parts of Europe and South America psychoanalysis is on the cutting edge, because it still has an edge that cuts. This was always its intention, Freud’s intention, to cut, wound, elicit bleeding, if not blood then passion, suffering, angst. The best patient was the one whose back is against the wall, ready to take a leap over the precipice, given a chance or hope to exist. Only a fool could be expected to endure what would follow. It was no, as Frieda Fromm-Reichmann suggested, bed of roses. Yet there was a time when psychoanalysis flourished in this country when elsewhere it just managed to hang on. In Europe psychoanalysis was the pet of the intelligentsia, while in America it became medicalized and its doctors got rich with grand promises and unrealistic expectations. In America psychoanalysis has rarely been concerned, as it is in Europe, with the problem of human existence—la condition humain—that speaks to the enduring fact of our suffering and the elusive promise of deliverance. Instead, its goal has become one of relieving that old saw, mental illness, diagnosable, to be sure, whose anticipated cure holds the hope that one eventually will recover, if you are lucky. Following this model, debates have accrued around the collective myth that one can separate the good analysts from the bad, the well trained from the incompetent, the well suited from the incorrigible. By what criteria is one expected to distinguish the one from the other?

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The battle-lines on which these distinctions are inexorably drawn can be located on the pages of every psychoanalytic journal, and the idolatry in our culture for what is currently fashionable has no rival in no other culture on this earth. Conventional wisdom has dismissed Freud as a brilliant innovator but a lousy therapist, not because one can demonstrate that Freud’s clinical work was inferior (by current standards) but because his views are said to be woefully out of fashion. Yet, in Europe Freud has not suffered the bad press he has endured from day one over here. Why the difference in perspective? Perhaps because Europe, the birthplace of existentialist philosophy, phenomenology, scepticism, and the avante garde, remains an existential culture to this day, the one in which Freud was born and out of which his views were derived. There, Freud is still perceived, a hundred years hence, as a radical, the first in a long line of subversives including Ferenczi, Reich, Groddeck, Klein, Fromm-Reichmann, Laing, Lacan, and others, who collectively cut against the grain of America’s penchant for the pragmatic. Yet, all of them, no matter how original, old-fashioned, or contemporary their views appear to us today, acknowledged their lineage to Freud, paid him tribute, and shared with him a view of human nature that is unremittingly disturbing. Like Freud, they believe you must swallow the poison and pay the price if you seriously expect to change. It seems to me—I know this is heresy—that all the progress psychoanalysis has made since Freud’s death has amounted to little, if any, improvement in our understanding of the human condition. In the last halfcentury, or so, we have cultivated, developed, and perfected the life out of it. Its edge has dulled, a consequence of what is left of a social acceptance that fuels what remains of its diminishing popularity. There is an irony here, an anomaly between talk about its “improved” methods on the one hand and the repression of its edge on the other. Many seem to have forgot (while others apparently never knew) that it was Freud who introduced us to our dark side, which is just as authentic (Winnicott) as the face we perceive in the mirror. Is it more ethical to conceal our dark side and, hence, “protect” others from ourselves, or to be what we authentically are and go to sleep with a clear conscience? This is an admittedly ethical question, not a psychological one. It was Freud who introduced the principles of morality, character, ethics, into the fabric of psychoanalysis and inaugurated in its wake a novel conception of honesty, becoming the greatest moral essayist since Montaigne (Harold Bloom). Psychoanalysis was always been and is even today about truth, about disclosing what we dare about ourselves to an other. In fact, it is concerned with no other question (Sterba). Not the truth of science or jurisprudence, but the truth (even the law) of the jungle, and of the price we invariably pay when we suppress it. This is why psychoanalysis was always supposed to be radical from the start, because it championed the

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act of lifting the veil and giving voice to what lurks beneath our protestations to the contrary. Despite all the talk about the parameters of effective treatment methodology, or the emergence of cutting edge (incomprehensible?) theories into practice, we are still, a century after trying, more or less at sea with the patients we encounter each day. We are still, no matter how much we protest to the contrary, no matter how many years of experience we have accrued, flying by the seat of our pants. There is nothing wrong with this because that was always as it should be, as in looking through a glass darkly. How effective, skilled, or adept any of us are or may eventually become as clinicians is just as difficult or impossible to assess today as it was a century ago, no matter how much supervision, oversight, or scrutiny we are subjected to. All that we have to go on, as a beacon in the darkness ahead, are what we had in our discipline’s infancy: a set of first principles that, if sufficiently elastic, guide us in that necessarily isolated, unremittingly lonely, universe of the treatment situation. To this end, I endeavor to show how the essential, albeit unpopular, features of psychoanalysis are in danger of being forgotten, overlooked, and suppressed by successive generations of analysts who, ironically, have the most invested in its survival. Yet this otherwise grim picture has been offset in recent years by the promise of increasing numbers of authors (Ellman, 1991; Roazen, 1995; Lohser and Newton, 1996; Haynal; 1989) who are presenting Freud in a more sober and objective light. Over the past fifteen years I have sought to counter the common wisdom that characterizes Freud as the instigator of what is erroneously depicted as classical technique, whose contribution bears little, if any, relation to the so-called orthodox psychoanalytic perspective (Thompson: 1985; 1994; 1996a; 1996b; 1998a; 1998b; 1998c; 2000a; 2000b). A host of kindred spirits has set out to correct these misconceptions over the past forty years in startling accounts of how Freud actually worked. Lipton (1977), Racker (1968), Stone (1961), and Kanzer (1980), for example, published a handful of papers between the 1950s and 1970s that depicted Freud as decidedly un-analytic in his clinical behavior. Yet the drum rolls grow louder every day from those who champion a so-called contemporary, relational perspective (cf Mitchell and Aron, 1999) that ironically mirrors Freud’s clinical technique in unanticipated ways—while couched in alleged counterpoint to Freud’s clinical example. It is not my purpose to take on, chapter and verse, the recent developments of psychoanalytic theory and technique in America or to demonstrate where they emulate Freud at one turn or aspire to improve upon him at another. Such a task would necessarily extend beyond the scope of this project and would add nothing of substance to my posi-

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tion. You will have to judge for yourselves the degree to which the principles contained in these pages are contemporary, classical, or irrelevant. Before concluding I should like to say something about the terminology I employ in this study. Psychoanalysis is laden with a conceptual vocabulary that serves to both deepen and obfuscate the phenomena under discussion. Technical terms are of vital importance to any undertaking and each of the empirical and social sciences, schools of philosophy, and the arts employ them accordingly. When invoking such terminology, however, it is also necessary to employ terms with which everyone is already, innately familiar in order to convey precisely what the author intends by invoking them. Every analyst uses terms in his or her own idiosyncratic fashion, so one’s characterization of them is unavoidably “original” whether the author intends it to be or not. Moreover, some of the most basic analytic terms are so far divorced from common usage they inadvertently serve to distance analysts from the very phenomena they endeavor to approximate. Such terms point to the phenomena of our investigation but, in so doing, sometimes alienate us from our ability to see the phenomena for ourselves. The concept of transference is an apt example. What does the concept of transference presume to tell us that we do not already know about the relationship between two people? Is it so far removed from the context of our everyday encounter with others that we fail to see the person to whom this conceptual designation is applied? or does it bring the other person into focus, by helping us listen to and, finally, hear the phenomena spoken? In the service of the latter, I take each of the technical principles on which psychoanalytic technique is rooted and explore them from a phenomenological perspective, which is to say, the manner in which they are encountered in the treatment. In other words, I endeavor to go beyond the conceptual designation itself, with the plethora of literature that supports it, by getting to the thing itself. Throughout this study, I endeavor to ask, what is the fundamental rule of psychoanalysis? free association? neutrality? abstinence? transference? countertransference? therapeutic ambition? working through? I have chosen these eight conceptual designations as representing the eight technical principles upon which psychoanalytic treatment is founded. I submit that the fundamental rule is fundamental for a reason, because the outcome of every treatment experience relies on the patient’s capacity to sit in judgement by another, at a considerable degree of risk, with no guarantee of the outcome. Though I have not devoted a chapter to the means and methods of interpretation, I have treated this topic throughout this study in more or less degrees of significance. Whereas many analysts insist that interpretation is the principal tool of every psychoanalytic encounter, I have assigned it a more measured, though nonetheless essential, role. The chapters on free association, neutrality, transference, therapeutic ambi-

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tion, and working through illustrate my view that interpretation sometimes interferes with and, at other times, furthers the psychoanalytic enterprise which, after all is said and done, has no other purpose than to return the analytic patient to the ground of his or her originary experience. I have said all I have to say on this topic in the variety of contexts in which it arises. To devote another chapter to this topic alone would serve no discernible purpose. Though this work is not theoretical in nature—indeed, my purpose is to demonstrate the marginal role that theory properly plays—it is impossible to discuss technical principles without situating their role in a context. The context is and always will be the problem of the patient’s suffering and what, if anything, the relationship between analyst and patient can do about it. With these questions in mind, I hope I have succeeded in addressing what psychoanalysis is by speaking to its essential latency, stripped of conceptual designations that are burdened by a disproportionate reliance on unnecessary speculation. By returning to the thing of psychoanalysis itself, the what and wherefore from whence it came, I hope to have taken if only a small step toward reclaiming the possibility of enjoying an experience with it, as it moves around, within, and between us. M. Guy Thompson March 29, 2003 San Francisco

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One

The Fundamental Rule

Psychoanalysis is both a collection of ideas and a method based upon those ideas whose goal is the right way to live. Hence, psychoanalysis is an “ethic” in the sense that it concerns the manner by which individuals conduct themselves. Derived from the Greek ethike tekhne, meaning “the moral art,” ethike is in turn derived from the Greek ethos, meaning “character.” Both the character of a person who aspires to behave ethically and the customs of a people by which one’s standards are measured derive from the concept. Morality, a subsidiary of ethics, pertains to distinctions between right and wrong and good and bad, whereas ethics, according to the Greeks, concerns the pursuit of happiness, the nature of which produces a state of equanimity by obtaining freedom from mental anguish. If psychoanalysis is an ethic whose goal is liberation from psychic conflict, then the nature of that conflict must have something to do with the way one lives, thinks, and behaves. While the character of an individual is no doubt decisive in the outcome of a patient’s treatment, the psychoanalytic experience essentially revolves around a kind of work that is performed and accomplished, the outcome of which succeeds or fails. Yet the conventional standard of “success” could never serve as the measure of the treatment outcome since the task of the analytic experience is to come to terms with those failures, losses, and disappointments that we have never managed to accept. By analyzing the customs of a given patient—the manner by which that person lives—that patient is in a better position to change what needs to be changed and discover a better life. If psychoanalysis is an ethic then what kind of ethic does it foster? What are the rules by which it is administered and what is the basis of its method? In Freud: The Mind of the Moralist, Philip Rieff (1959) argued that the basis of Freud’s conception of psychoanalysis rested on what he characterized as an “ethic of honesty.” According to Rieff, “Psychoanalysis… demands a special capacity for candor which not only distinguishes it as a healing movement but also connects it with the drive toward disenchantment characteristic of modern literature and of life among the intellectuals” (p. 315).

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Freud’s prescription for society’s overzealous efforts at controlling our irrepressible impulses was the treatment method he conceived, psychoanalysis. It served to give the neurotic a second chance for a more satisfying existence by replacing secretive repressions with a more honest effort at coping with life’s inevitable disappointments. As Rieff points out, “We first meet the ethic of honesty in characteristic Freudian guise—as merely a therapeutic rule: …the patient must promise ‘absolute honesty’ ” (p. 315). Of course, Freud never explained what he meant by honesty so that, like so many of his technical principles, one is obliged to ferret out his intention in roundabout ways. For the purposes of my argument, I believe Freud saw the honest individual as one who is genuinely himself in his dealings with others; in other words, a person without guile or subterfuge, yet comfortable with conducting himself in this manner. Hence, Freud viewed the honest individual as one who has nothing to hide, a person who is true to his or her word. In this chapter I shall undertake to explore what candor entails in light of the role that honesty plays in the psychoanalytic encounter. If we allow that the capacity for candor to which Rieff refers is the basis for Freud’s analytic technique, it remains to be seen what the fundamental rule is comprised of. Moreover, what, in turn, is the fundamental rule’s relationship to free association? Are they, as analysts typically assume, one and the same, or does a relation exist between them that serves to distinguish one from the other, comprising separate though related concepts? I believe a distinction should be made between the two terms, a distinction that is vital to the ethic of honesty that Rieff situated at the heart of Freud’s psychoanalytic technique. By employing this tack, I hope to show that Freud conceived the therapeutic aspects of psychoanalysis as an ethic, and that free association is not only an act in which the patient is engaged, but an activity that, in order to be real, is necessarily experienced as a facet of the hereand-now relationship with the analyst. I shall begin by asking: what is free association and how is this technical principle different from the fundamental rule? The fundamental rule is a contract that analytic patients are asked to enter into in the early stages of analysis (I discuss whether such formal instruction is always necessary below). Freud called it a pledge or a promise. In effect, when patients agree to free associate they promise to do so. On the other hand, the act of free associating isn’t a pledge but a spontaneous form of conversation in which patients are invited to participate throughout the course of the treatment. In fact, free association does not refer to associations, as such. For example, the word association test by which one is asked to respond to a word with the first thing that comes to mind was not what Freud intended by this term. The English term, free association, was Strachey’s deliberate mistranslation of the German freier Einfall, which combines the words “free” and “irruption.” In the original German

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it connotes a thought that spontaneously comes to mind as it “falls” into consciousness. The term, association, conveys an entirely different sense that, when applied to this context, leads to the mistaken assumption that patients are asked to connect an idea with the first thing that comes to mind. To free associate in the manner that Freud intended is simply an admonition to be candid during the therapy session. It entails nothing more complicated than the willingness to speak spontaneously and unreservedly, as one sometimes does when not the least self-conscious about what is being disclosed to another person. Obviously, Freud’s conception of free association wouldn’t make much sense unless one appreciates the degree to which we ordinarily conceal most of what spontaneously comes to mind in the course of conversation. Seen from this angle, the fundamental rule—wherein I consent to reveal the thoughts that occur to me—is a precondition for grasping the nature of free association as it was originally conceived. Free association is not an artificial process but rather a form of verbal meditation that nevertheless requires considerable discipline to perform. Moreover, it entails speaking unreservedly while remaining attentive to what is being disclosed, something we don’t ordinarily do. Most of us either speak impulsively without awareness of what we say or think through everything we are about to disclose before speaking. Once patients realize the frequency with which they customarily resist disclosing things about themselves, they come to appreciate why complying with this rule plays such an integral role in the treatment experience. Hence, a patient’s capacity to free associate hinges on the willingness to comply with this rule. Yet conventional depictions of the fundamental rule typically characterize it as being synonymous with free association. For example, Laplanche and Pontalis (1973) depict the fundamental rule as the [R]ule which structures the analytic situation: the analysand is asked to say what he thinks and feels, selecting nothing and omitting nothing, from what comes into his mind, even where this seems to him unpleasant to have to communicate, ridiculous, devoid of interest or irrelevant. (p. 178)

This is a fairly apt definition of what the fundamental rule is typically taken to mean, insofar as it equates the fundamental rule with the act of free associating. The view that the fundamental rule relies on an ethical imperative that invokes a moral conflict is not mentioned. Thus, in “Five Lectures on Psychoanalysis,” published in 1910, Freud enumerates three possible ways of reaching the unconscious and seems

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THE ETHIC OF HONESTY to look upon them as of equal status. These ways are the working out of ideas of the person who performs the main rule, the interpretation of dreams, and the interpretation of parapraxes. (p. 178)

According to this description the fundamental rule (of free association) is nothing more than a means of gaining access to unconscious material. There is no mention of the rule’s ethical imperative or the crisis of conscience that compliance with this rule inevitably engenders. While this view admittedly acknowledges the role of self-disclosure, it is nevertheless an impoverished form of disclosure that ignores the moral dilemma that Freud devised this technical principle to foster. Alternately, Laplanche and Pontalis depict free association as “a method according to which voice must be given to all thoughts without exception, which enter the mind, whether such thoughts are based upon a specific element… or produced spontaneously” (p. 169). Hence, their depiction of free association more or less repeats what they said about the fundamental rule. Lest their intention to equate the two rules be in doubt, they add, “The rule of free association is identical with the fundamental rule” (p. 170). Laplanche and Pontalis’ treatment of these technical principles is not an isolated affair but typical of how the two terms are customarily depicted (see Stone, 1961; Fenichel, 1953, pp. 318-330; Kris, 1982; Glover, 1955, pp. 18-34; Gill, 1994, pp. 79-100).1 For another example, in Psychoanalytic Terms and Concepts, published by the American Psychoanalytic Association under the editorship of Moore and Fine (1990), free association (and the fundamental rule, which is not listed in their glossary under a separate heading) is characterized as follows: The patient in psychoanalytic treatment is asked to express in words all thoughts, feelings, wishes, sensations, images, and memories, without reservation, as they spontaneously occur. This requirement is called the fundamental rule of psycho-analysis. In following the rule, the patient must often overcome conscious feelings of embarrassment, fear, shame, and guilt. His or her cooperation is motivated in part by knowledge of the purpose for which he or she is in analysis—to deal with conflicts and overcome problems. (p. 78)

Like Laplanche and Pontalis, Moore and Fine also overlook the ethical component to the fundamental rule and emphasize instead its simple 1 The only exception to this practice that I was able to find in was in Kanzer (1972) and, more recently, Mahony (1987, p. 19), who merely cites Kanzer’s paper. However, Kanzer’s distinction between the two technical rules only touches on the so-called two-person relationship aspect of the fundamental rule which he contrasts with (what he terms as) the otherwise “narcissistic” nature of free association, while overlooking the ethical dimension to the fundamental rule.

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“requirement.” According to their characterization of this rule patients are motivated to comply with it, not due to their conscience, but for a strictly utilitarian purpose: in order to “overcome problems.” In other words, the rule’s efficacy is reduced to nothing more than a task that one accomplishes or doesn’t. There is no hint of the need to unburden oneself in principle, of the quest to know oneself, or the need to feel closer to others by confiding in them. Finally, there is no acknowledgement of every human being’s yearning for self-discovery as an irrepressible human impulse. More of the same can be found in Rycroft’s (1968) A Critical Dictionary of Psychoanalysis, where he characterizes the fundamental rule as, “The injunction that [the patient] do his best to tell the analyst whatever comes to mind without reservation” (p. 11). Rycroft emphasizes the historical context in which the fundamental rule was first introduced as an alternative to the use of hypnotism. Rycroft reminds us that before Freud formulated the free association method, access to the unconscious was limited to the employment of a hypnotic trance or state. Subsequently, free association made it possible for patients to reveal their repressions to their analysts by simply speaking unreservedly, while remaining conscious of doing so. Free association technique relies on three assumptions: a) that all lines of thought tend to lead to what is significant; b) that the patient’s therapeutic needs and knowledge that he is in treatment will lead his associations towards what is significant except insofar as resistance operates; and c) that resistance is minimized by relaxation and maximized by concentration. (p. 54)

As with the other characterizations of the fundamental rule we just examined, the conclusion one derives from Rycroft’s treatment of it is that the fundamental rule and free association are essentially identical.2 To summarize what we have gleaned from Laplanche and Pontalis, Moore and Fine, and Rycroft about the relationship between the fundamental rule and free association: a. b.

2

All the authors cited equate the two rules as identical. In so doing, they overlook the ethical precept on which the fundamental rule is founded.

In a private communication, Rycroft acknowledged that a distinction between the fundamental rule and free association should have been noted by him, an oversight that he intended to address in a future edition of his book.

6 c. d. e.

THE ETHIC OF HONESTY Hence, they reduce analytic treatment to a psychological process that is characterized by the act of free association (and its interpretation) alone. In turn, free association is conceived as merely one means among others (e.g., dream interpretation and analysis of parapraxes) of gaining access to the patient’s unconscious. Finally, the importance of candor and its impact on the interpersonal dimension of the treatment situation is virtually ignored by their respective characterizations of this rule.

I now compare Freud’s characterization of the fundamental rule with the ones we have examined. Freud introduced the fundamental rule (Grundregel in German) for the first time in the second of his six technical papers, “The Dynamics of Transference” (1912a). This was after his analyses of Dora (c1900) and the Rat Man (c1909), his most famous analytic patients. This collection of six technical papers, published between 1911 and 1915, comprised his most exhaustive treatment of the analytic experience, outlining Freud’s so-called classical technique (See Thompson, 1994, for an exhaustive study of Freud’s technical papers.). Though Freud only belatedly grasped the significance of this rule after some twenty years of treating patients, it finally occurred to him that the need for such a rule was not only desirable but even ubiquitous to the analytic experience. Non-compliance exemplified transference resistance. A year earlier Freud hinted at the need for such a rule in the lectures he delivered at Clark University in 1911. Strachey, however, claims that the rule was alluded to earlier still in The Interpretation of Dreams (1900), “… in a passage where Freud urges the patient to overcome his ‘internal criticisms’ while reporting the content of his dreams” (in Freud: 1912b, ff. p. 107). Strachey believes this was the first time Freud explicitly invoked the fundamental rule, albeit in the context of dream analysis. Yet, he overlooks the fact that Freud made no mention on that occasion of the requisite pledge to disclose one’s associations. The reference cited by Strachey only pertains to free associations as such, in the limited context of dream analysis.3 Hence, Strachey also equates free association with the fundamental rule in that he fails to grasp that neither the act of speaking unreservedly (frier Einfall) nor the pledge to do so (the fundamental rule) had crystallized in Freud’s mind as early as 1900. Although Freud admonished his patients to verbalize their thoughts as early as 1900, he had yet to implore his patients to do so, hence compelling them to unre-

3 In fact, Freud did employ the German Assoziation when instructing patients to “associate” dream elements to what comes to mind, but not when instructing patients about the fundamental rule, when he referred to Einfall instead. Strachey mistakenly confuses the two meanings as the same.

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servedly. Again, it is the actual promise to bare all that entails the fundamental rule, not the simple act of doing so. FREUD’S INSTRUCTIONS TO HIS PATIENTS The first time Freud (1913) finally brought the two concepts together was in the fourth of his technical papers, “On Beginning the Treatment.” There, Freud describes how analysts might introduce their patients to the fundamental rule and the free association method. This brief recommendation comprises the most thorough description Freud was to offer on the relationship between the technique of free association and the fundamental rule. What the material is with which one starts the treatment is on the whole a matter of indifference—whether it is the patient’s life history or the history of his illness or his recollections of childhood. But in any case the patient must be left to do the talking and must be free to choose at what point he shall begin. We therefore say to him: “Before I can say anything to you I must know a great deal about you; please tell me what you know about yourself.” The only exception to this is in regard to the fundamental rule of psycho-analytic technique that the patient has to observe. This must be imparted to him at the very beginning: “One more thing before you start. What you tell me must differ in one respect from an ordinary conversation. Ordinarily you rightly try to keep a connecting thread running through your remarks and you exclude any intrusive ideas when they occur to you and any side-issues, so as not to wander too far from the point. But in this case you must proceed differently. You will notice that as you relate things various thoughts will occur to you which you would like to put aside on the ground of certain criticisms and objections. You will be tempted to say to yourself that this or that is irrelevant here, or is quite unimportant, or nonsensical, so that there is no need to say it. You must never give in to these criticisms, but must say it in spite of them—indeed, you must say it precisely because you feel an aversion to doing so. Later on you will find out and learn to understand the reason for this injunction, which is really the only one you have to follow. So say whatever goes through your mind.” (pp. 134-135)

Next, Freud invokes the free association method in his famous railroad car analogy: “Act as though, for instance, you were a traveler sitting next to the window of a railway carriage and describing to someone inside the carriage the changing views which you see outside” (p. 135). Then, in the next sentence, Freud introduces the pledge that is contained in the fundamental rule: “Finally, never forget that you have promised to

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be absolutely honest, and never leave anything out because, for some reason or other, it is unpleasant to tell it” (p. 135) [Emphasis added]. This critical sentence brings the fundamental rule into relief by drawing a distinction between the promise to comply and the act of free associating. Despite his insistence that patients struggle with the imposition of this rule, Freud acknowledged the inherent difficulty that submitting to such a rule entails: Much might be said about our experiences with the fundamental rule of psychoanalysis. One occasionally comes across people who behave as if it had been made for themselves. Others offend against it from the very beginning. It is indispensable and also advantageous to lay down the rule in the first stages of the treatment. Later, under the dominance of resistances, obedience to it weakens, and there comes a time in every analysis when the patient disregards it. We must remember from our own self-analysis how irresistible the temptation is to yield to these pretexts put forward by critical judgment rejecting certain ideas. (ff. p. 135)

Yet the point Freud takes such pains to emphasize has been systematically omitted from the characterizations of the fundamental rule we examined earlier. In contrast, Freud was not merely invoking a psychological activity, but a form of commitment that entails a pledge to be honest with another person. By invoking a pledge to be truthful Freud also crystallized the specific feature of free association that distinguishes it from conventional forms of self-reflection: the promise to hold nothing back. Whatever we are tempted to conceal, by the very incidence of our temptation to, we are nevertheless compelled because of this rule to direct our attention to the things we instinctively suppress. In other words, the kind of truth that psychoanalysts seek to determine isn’t wedded to a correspondence with someone else’s. Instead, psychoanalytic truth is restricted to what patients typically conceal. Hence, the kind of truth sought by analysis is limited to what patients fear to disclose. Whatever remains concealed (or “unconscious”) at a given stage of ones treatment constitutes the kind of truths that analysis is capable of unearthing. Apart from this narrow criterion, so-called objective truth has little relevance to the outcome of a person’s treatment. Though this was a novel idea when Freud introduced it, the efficacy for invoking this rule was a logical extension of his thesis, formulated fifteen years earlier, explaining the etiology of neurosis: that harboring secrets elicits a breach in one’s perception of reality that subsequently manifests psychic conflict. In Freud’s analysis of Dora, for example, the central theme that ran through his report of the case concerned the prevalence of secrecy in the genesis of her psychopathology. Freud believed that when life challenges us with disappointments too painful to bear, we instinctively repress our experience of those disappointments

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by momentarily forgetting them. In Dora’s case, Freud (1905a) attributed her hysterical symptoms to somatic displacements of forbidden desires and concluded that the only hope for relief from her symptoms lay in, “the revelation of those intimacies and the betrayal of those secrets” (1905a, p. 8) (See my detailed treatment of Freud’s analysis of Dora in Thompson, 1994, pp. 93-132.). Psychoanalysis aspires to undo the effect of such secrets by baring them to someone who won’t condemn the patient for harboring them in the first place. Then why did Freud’s treatment of Dora end in failure? When Freud analyzed Dora in 1900 he had only recently conceived the method he had substituted for hypnosis, his so-called talking cure. But Freud didn’t realize then that only someone who is uncommonly honest would be willing to spontaneously disclose the contents of her mind. Dora resisted her analysis bitterly and was convinced throughout her brief treatment experience that Freud was an agent of her father. Consequently, she never relented her opposition to what she construed as Freud’s efforts to bend her to his will. Freud was still a decade away from acknowledging the need to augment the free association method with a second rule that would bind his patients to him in common cause, by taking him into their confidence. It was only later when he realized that unless patients agree to self-disclosure in principle they will lack the motivation to work through their resistance to the anxiety that self-disclosure elicits. Yet, the majority of analysts have subsequently ignored this principle entirely. Klein’s use of “deep” interpretations (which ostensibly bypass the patient’s ego and, hence, resistance) dispenses with the fundamental rule as a matter of course, and with it the efficacy for a working alliance. Similarly, Lacan’s use of the “short session” as a means of throwing patients off balance circumvents the interpersonal dynamics that the fundamental rule was intended to engender. These are only two of the most extreme examples of post-Freudian analytic schools (notwithstanding that both schools claim to be Freudian) that have either ignored the fundamental rule or abandoned it outright. The more recent (and presumably, “friendlier”) relational perspective rejects the imposition of such a rule in principle. Consequently, analysts have felt obliged to manipulate their patients with a host of technical “innovations” over the second half of the last century in order to compensate for the patient’s resistance to self-disclosure, in the form of more active interpretation. The failure of Dora’s analysis alerted Freud to another critical lesson that has virtually vanished from the psychoanalytic literature: the problem of analyzability. Because self-disclosure is critical to the success of every analytic treatment, patients need to actively embrace the admonition to be candid. Though she was never explicitly admonished to abide

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by this rule, it is doubtful that Dora, because of her tender age, possessed the self-discipline she would have needed to comply with such a rule in the first place. PSYCHOANALYSIS AND JURISPRUDENCE When Freud finally introduced this rule in 1912, the pledge to be honest added an ethical dimension to psychoanalytic technique that had heretofore been implicit, but not explicit. It was so central to Freud’s conception of the treatment that he deemed it fundamental. Why? Though it was the only rule that he claimed to impose on his patients, there were other, equally indispensable, rules that Freud advised both analysts and their patients to follow, including neutrality, abstinence, therapeutic ambition, confidentiality, working through, and so on. What was so special about this one? Freud designated this rule fundamental because he came to the conclusion after considerable trial and error that honesty epitomizes both the means and the end of every analytic encounter. By inviting his patients to be honest and enlisting their pledge to do so, Freud transformed the analytic patient at the beginning of analysis from a person who simply tells stories into a moral agent who determines what is true by saying it. It is significant, for example, that only the patient is in a position to determine what the truth is. Unlike a court of law in which a witness’s testimony may be challenged so that a jury may decide what is so, Freud advised analysts against the practice of confirming what patients confess by questioning their family or friends. Freud concluded that the patient’s word is the sole authority for what is true because the kind of truth psychoanalysis obtains is not objectively verifiable (See Thompson, 1994, pp. 101-109, for an example of this in Freud’s analysis of Dora, where her version of events was unreservedly accepted in favor of her father’s.). Instead, the kind of truth it entails is derived from the patient’s experience, as it unfolds in the course of analysis. Yet, psychoanalysis probably has more in common with jurisprudence than with psychiatry or psychology. In a court of law, for example, the goal (allow me this fiction) is to get to the truth. To this end, jurors must keep an open mind by not permitting themselves when formulating their opinion to be swayed by personal bias or prejudice. Instead, they are counseled to base their conclusions on the evidence presented and nothing more. Indeed, the only rationale for overturning their verdict or obtaining a new trial is if it subsequently comes to light that their decision was contaminated by the omission of evidence, false testimony, and so on. The utter objectivity (or neutrality) that jurors are expected to employ in their deliberations more closely approximates the attitude of the psychoanalyst than that of the psychiatrist, for example, who relies instead on his accumulated knowledge of theory and diagnostic nomenclature. By his behavior, the analyst endeavors to instill the

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same attitude that he has adopted for himself in his patients: an openended, unprejudiced curiosity toward their mental and emotional condition, their behavior, the problems with which they are confronted and the means typically employed when addressing them, however inadequate they may be. In effect, patients are invited to play the role of juror at their own inquisition, while assuming the role of Inquisitor. The analyst plays the part of the judge who knows what the rules are and whose task is to monitor their observance, while leaving any conclusions to the patient who must follow, for better or worse, his own predilections. In the end, the patient’s task is to determine the ethical code he will live by, whatever it may be since, once adopted, it will be his and his alone. Yet, is it really necessary, despite the ethical component to free association, to formally instruct one’s patients at the beginning of the treatment, as Freud did? Ironically, the ethical insistence that each of us already lives by before entering analysis suggests that the act of instructing patients about the fundamental rule has, in this day and age, become redundant. The tension that arises in the course of every treatment experience and the resistance that patients mount against it are consequences of the truism that whenever human beings speak to one another they assume they are telling the truth (or are supposed to). Most contemporary analysts, however, feel uncomfortable instructing patients for other reasons. They may, for example, not wish be perceived as an authority figure in their relationships with patients and argue that formal instruction would compromise their efforts to maintain neutrality (we will turn to the question of neutrality in Chapter Three). On the other hand, analysts who reject analytic neutrality in principle (such as contemporary so-called relational analysts) object to instruction because they opt for more frequent interpretations in lieu of eliciting the patient’s free associations. It seems to me, however, that formal instruction has become redundant, not because contemporary analysts adopt a more friendly or laissez-faire form of analysis, but because patients already implicitly know that they are expected to be candid upon entering therapy. Moreover, one’s capacity for candor indicates the degree of secretiveness and, hence, psychopathology in a given patient. Most patients enter analysis eager to get things off their chest, so by the time they come to notice they are concealing this or that from their analyst they are predisposed to examining their motives for doing so when pointed out to them by their analyst. Patients who exhibit borderline or psychotic symptoms, for example, are less likely to be candid than those who are simply neurotic, though there are exceptions in either case. One could even argue that the degree to which a patient is capable of candor will determine the extent to which that patient is able to embody

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the analytic attitude. On the other hand, analysts who do not value candor will construe the analytic attitude differently: as the patient’s capacity to entertain interpretations when presented to them. Naturally, the analyst’s own attitude, as Freud points out, also goes a long way in educating patients as to what is expected of them. This is why analysts who are secretive with their patients are less likely to expect their patients to be candid with them. Such analysts usually feel more comfortable offering deeper and more frequent interpretations in lieu of emphasizing the patient’s capacity for self-disclosure. Moreover, such analysts probably do not feel that truth plays an important role in the analysis and see no reason to expect their patients to be honest with them in the first place. Even when the patient’s candor is instinctively taken on faith, however, Freud came to the unsettling conclusion that much of what we say is patently untrue and that the things that remain unsaid weigh so heavily on the individual that they exacerbate the psychological conflicts their already suffer. In the analytic situation the tension increases even further once patients realize that what is being scrutinized in their disclosures has less to do with the veracity of what they say than the degree to which they unreservedly participate in the disclosedness of what they customarily conceal. Hence, the truth value of what is disclosed is measured by the fact of its disclosure, not its content. This is why the type of honesty psychoanalysis entails cannot be reduced to a conventional standard of morality, such as the claim of never telling a lie or observance of a set of norms. Because it is rooted solely in the patient’s word, what is verbalized becomes a matter of honor, determined by no other measure than the patient’s conscience. Due of its inherently personal nature, the truth elicited can never be empirically validated because it can only be elucidated through its transmission from one human being to another. Hence, the task of analysis is to uncover what is hidden, not for the purpose of ever finally “knowing” what is concealed but in order to engender a form of transformation that only the act of unburdening oneself can elicit. This is why analytic truth is a solitary truth for which each of us is, alone, responsible. Whether they like it or not, analytic patients must resign themselves to serving as both judge and jury as to how successful their endeavor has been. It is a solitary endeavor because there is no court of appeals and no higher authority that can determine the outcome for them. This is probably the most critical factor that delays the termination of treatment. Freud recognized that no one could be expected to wholeheartedly embrace the fundamental rule due to the anxiety that compliance evokes. But his insistence that patients make their peace with this rule anyhow assumes that none of us can escape the moral obligation to adopt a standard of truth we can live by, and one we can live with. In effect, Freud held a mirror to our face and compelled us to decide

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where to stand, whether to disclose who we are or conceal it. The consequence of this choice continues to stare us in the face for as long as we live because no one can ultimately evade, however much one may try, the weight of one’s own accountability. Obviously, no one discloses everything; besides, the “quota” of one’s disclosures is not the point. All analytic patients keep secrets that they are simply not willing to share. But because we select what we disclose—and, contrariwise, keep to ourselves—we are nevertheless accountable for the discretion we exercise in these matters, even if we are not always conscious of doing so. Hence it is our choice, and it alone, that determines what ethic we live by and the consequent guilt we must bear. FREUD’S CONCEPTION OF THE SUPEREGO Although morality preoccupied Freud throughout his lifetime, the enthusiasm with which analysts have subsequently explored this theme has been tepid at best. Even Freud was never satisfied with his formulations of the role it presumably plays in the treatment situation, including his efforts to situate its efficacy in the language of psychic agency. His decision to assign ethical values to the superego, for example, only partially explains the dynamics that account for the search for one’s truth and the desire to be an honest (i.e., honorable) person. In The Ego and the Id Freud (1923) suggested that one of the consequences of the prohibition against incest and patricide was the child’s identification with the same-sex parent, thus incorporating the parent’s prohibitions, edicts, and values into him- or herself. This is supposed to give the child a capacity for guilt that in turn prompts the child’s ego to repress those wishes that the superego deems unacceptable. Hence, the superego is a moral agency in that it serves as an antenna for the customs of the society in which one lives. As the child grows older and replaces the parent with other relationships, he fosters an increasingly sophisticated set of ideals, possibilities, and limitations that helps organize the individual’s definition of success and failure through the weight of public opinion. According to Freud, the superego serves as a conscience by which we decide what is permissible and what is not, what is likely to be rewarded and what is liable to be punished. In effect, the superego helps us navigate through the treacherous waters of our culture in order to obtain the maximum measure of reward. Hence, it serves an inherently utilitarian purpose by protecting us from being locked up or killed or simply hated for being the person we have become. But how can such

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an agency account for the patient’s capacity to obey the fundamental rule? I don’t believe that it can. Because the superego is driven by dynamics that derive from the frustration of not getting one’s way, it serves as a motive force whereby the individual renounces prohibited aims while replacing them with those that are acceptable (i.e., rewardable). If one’s capacity for honesty was regulated by the superego, then the pursuit of honesty would serve a strictly utilitarian aim: the relief of frustration. Yet experience tells us that honesty can just as easily increase frustration as relieve it because some of the ethical precepts we aspire to are not rewarded by society but are opposed to it. Since one’s code of conduct always takes account of reality—whether, for example, to conform or rebel—the code one chooses to live by is ultimately determined by the ego, not the superego. Thus the relationship between the ego and superego is more complex than we sometimes appreciate. One implication of this observation is that the ego is responsible for our experience of psychic freedom whereas the superego is responsible for the vicissitudes of political freedom. Freud concluded that there are necessary limitations to the degree of political freedom a given culture is prepared to allow its citizens. Our rebellion against such restrictions are discouraged through punishment and we are encouraged to submit to them through reward. This inherent political instability in every culture—including democratic ones—in turn influences the degree of psychic freedom that any human being is realistically capable of achieving. Because the superego is a creature of our encounter with society, we are predisposed to think the thoughts and desire the experiences that the culture in which we live values. This serves to explain why psychic freedom and political freedom are necessarily intertwined—and equally compromised—and why the individual’s ego is more responsible for the development of conscience than the superego. Freud said as much when he attributed a given individual’s capacity to benefit from psychoanalytic treatment to one’s character (recall that the term, ethic, is etymologically derived from the Greek ethos, meaning character). But what did Freud understand character to mean? Freud addressed the role of character in at least three different contexts: a) the patient’s capacity to delay gratification, “in favour of a more distant one, which is perhaps altogether uncertain” (1915b, p. 170); b) the capacity to develop a positive transference through which patients are able to sacrifice their narcissism in the service of a therapeutic goal (i.e., by submitting to the reality principle and forsaking the pleasure principle); and c) the capacity to be honest, by observing the fundamental rule in the face of continuing hardship and suffering. Because it is so basic, the fundamental rule also permits analysts a measure of elasticity in the employment of all the other rules in their arsenal, because all analytic rules, each in its own particular way, are in

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the service of honesty. When one re-reads Freud’s technical recommendations in this light the sense one derives from them is refreshingly simple, yet profoundly radical when measured by contemporary standards. Indeed, Freud’s technical recommendations read more like meditations on the inherent hypocrisy of our culture than a panacea for the relief of mental anguish. The question of character was so pivotal to Freud’s (1905b) conception of the treatment experience he even insisted that “patients who do not possess a… fairly reliable character should be refused” analysis (p. 263). Freud (1913) also cautioned that, “It is a bad sign if one’s patient has to confess that while he was listening to the fundamental rule of analysis he made a mental reservation that he would nevertheless keep this or that to himself” (p. 138). And in his paper “On Psychotherapy” (1905b), Freud went so far as to equate his conception of the psyche (or mind) with morality. I would remind you of the well-established fact that certain diseases, in particular the psychoneuroses, are far more readily accessible to mental influences than to any other form of medication. It is not a modern dictum but an old saying of physicians that these diseases are not cured by the drug but by the physician, that is, by the personality of the physician, inasmuch as through it he exerts a mental influence. I am well aware that you favor the view which Vischer, the professor of aesthetics expressed so well in his parody of Faust: “I know that the physical often influences the moral.” But would it not be more to the point to say—and is it not more often the case—moral (that is, mental) means can influence a man’s moral side? (p. 259)

The moral injunction that the fundamental rule imposes on the clinical situation also serves to enlist each patient’s active participation in the treatment. Once obliged to be candid, patients discover that now they must wrestle with the extraordinary weight of their conscience, and to live with it. Yet, the resolve to be honest doesn’t necessarily make one’s life less complicated; if anything, it is likely to make it more difficult. Perhaps its principal virtue is its capacity to expose the secrecy at the bottom of our anxieties. If this is true, then psychoanalysis is limited in the scope of pathological conditions it can relieve, because only those who suffer a guilty conscience can be analyzed. GUILT AND AUTHENTICITY But what is the basis of this guilt and what terrible secret could account for it? According to Heidegger (1985), we feel guilty for simply being who we are whenever we defy the forces of convention (pp. 307-320). Hence, Heidegger’s conception of guilt—an existential guilt that I bear

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when I take responsibility for my actions—is a corollary of the neurotic guilt I sometimes suffer when I defy my superego. Heidegger, however, doesn’t see this kind of guilt as always neurotic, but in some instances courageous so it is open to interpretation. Somewhere along the borderland between Freud’s and Heidegger’s respective conceptions of guilt, Sartre (1956) conceives a form of guilt that I suffer when I refuse to bear responsibility for who I am: the “fundamental choice” at the base of my personality. Perhaps one of the most controversial aspects of Sartre’s philosophy concerns his notion of authenticity and its correlate, bad faith. Sartre believed that the etiology of psychopathology could be traced to one’s efforts to “fix” oneself into being someone one is not: a false self. Not to be confused with Winnicott’s use of this term,4 Sartre saw falsity as the consequence of confusing one’s false ego (a product of conforming with others) for the person one genuinely is; i.e., aspects of oneself that one typically conceals from others. One cannot, in fact, ever remain one person throughout one’s lifetime because beneath the facade of personality lurks a consciousness5 that assumes different guises in relation to the situation encountered, sometimes compromising the neurotic’s sense of personal identity. It was this aspect of Sartre’s conception of the false self that influenced Laing’s (1960; 1961; 1967) work with schizophrenics, whom he believed had been so mystified by their social environment it had corrupted their sense of agency. Heidegger and Freud’s respective conceptions of guilt are nonetheless surprisingly similar. Whereas Heidegger says that guilt is the consequence of refusing to follow the herd and acting authentically, Freud sees guilt as the consequence of defying the internalized dictates of parental and societal authority embodied in the superego. Both Heidegger and Freud hold that the path to mental health is to find one’s voice and to make one’s choices one’s own instead of complying with the expectations of others. The difference lies mainly in how to exorcize the punitive elements of such introjects from one’s being. Whereas Heidegger approaches this phenomenon as a feature of the human condition, Freud sees it as a feature of psychopathology. Yet existential guilt and neurotic guilt are not opposites but complementary and a useful addition to the psychoanalytic process. Though Heidegger’s and Sartre’s respective conceptions of guilt veer off in different directions, both lend credence to Freud’s rationale for the fundamental rule: the pledge to behave authentically in the course of the analytic hour. But they also undermine his formulation of the superego by suggesting that guilt—whether neurotic or existential—is the conse4 Though Winnicott (1960) employs the term, “false self system,” in his own work, it bears little resemblance to Sartre’s earlier coinage of this term. 5 Which Freud depicts as the unconscious, but which Sartre conceives as one’s freedom.

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quence of repression, not its source. Hence, we feel guilty as a consequence of suppressing those anxieties that are an inevitable consequence of living, by circumventing the sacrifices that honesty necessarily entails. Similarly, Rieff (1959) proposed that guilt is a consequence of the neurotic’s unwillingness to pay the price for the happiness he aspires to. Ironically, neurotics prefer to hold their aspirations in check than to suffer the disappointments that the pursuit of happiness entails. This led Rieff to conclude that, “neurosis is the penalty for ambition unprepared for sacrifice” (p. 308). Rieff noted that as early as 1885, during his long engagement to Martha, Freud had already formulated the dynamics of the neurotic personality, engendered by a society that restricts its citizens to only those gratifications that are deemed appropriate. Quoting from a letter Freud wrote to his then fiancé: We [neurotics] economize with our health, our capacity for enjoyment, our forces… [and] save up for something, not knowing ourselves for what. And this habit of constant suppression of natural instinct gives us the character of refinement… Why do we not get drunk? Because the discomfort and shame of the hangover gives us more “unpleasure” than the pleasure of getting drunk gives us. Why don’t we fall in love over again every month? Because with every parting something of our heart is torn away… Thus our striving is more concerned with avoiding pain than with creating enjoyment. (pp. 309-310)

Hence the pledge to be honest about all those aspirations we secretly harbor but dare not admit is the key to overcoming the guilt we have accrued while suppressing them. This suggests that the kind of guilt that Freud was concerned with isn’t the kind that is caused by the failure to conform but, rather, an existential guilt that is a consequence of having compromised oneself in the service of conforming to a society that is opposed to our gratification in principle. Paraphrasing Freud, Rieff (1959) concludes: What makes neurotics talk is “the pressure of a secret which is burning to be disclosed.” Neurotics carry their secret concealed in their talk, “which, despite all temptation, they never reveal.” (pp. 316-317)

This helps explain why the analyst’s task is a necessarily unpopular one, because his role is to mention the unmentionable by eliciting what is obvious but remains obstinately unspoken. Though admittedly effective as a means of disclosing repressions, the need for such a rule is also an indictment of the disingenuous society to which all of us belongs. This disturbing observation was finally brought home in a paper where

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Freud (1910) confessed his pessimism about the prospects psychoanalysis could expect from a society that is predisposed against it. Suppose a number of ladies and gentlemen in good society have planned to have a picnic one day at an inn in the country. The ladies have arranged among themselves that if one of them wants to relieve a natural need she will announce that she is going to pick flowers. Some malicious person, however, has got wind of this secret and has had printed on the programme which is sent round to the whole party: ‘Ladies who wish to retire are requested to announce that they are going to pick flowers.’ After this, of course, no lady will think of availing herself of this flowery pretext, and, in the same way, other similar formulas, which may be freshly agreed upon, will be seriously compromised. What will be the result? The ladies will admit their natural needs without shame and none of the men will object. (p. 149)

Rieff suggests that the analyst is the malicious person in Freud’s analogy, just as the ladies represent culture. The moral to the story, Rieff (1959) concludes, is that We must accept our “natural needs,” in the face of a culture which has censored open declarations of [them]. In championing a refreshing openness, Freud disclosed the censoring of nature, thus to ease the strain that had told upon our cultural capacities. (p. 316)

What, then, can the neurotic hope to obtain from analysis if it is incapable of protecting us from those forces in society that inevitably conspire against us? Given its limitations, what measure of difference can we expect it to effect? According to Freud (1910): A certain number of people, faced in their lives by conflicts which they have found too difficult to solve, have taken flight into neurosis and in this way won an unmistakable, although in the long run too costly, gain from illness. What will these people have to do if their flight into illness is barred by the indiscreet revelations of psychoanalysis? They will have to be honest, confess to the instincts that are at work in them, face the conflict, fight for what they want, or go without it. (pp. 149-150)

By insisting that candor is the precondition of every analytic encounter, Freud established an undeniable interdependence between the act of free associating and the fundamental rule on which it relies. Yet, there is an undeniable risk, Rieff (1959) admits, [I]n the ethic of honesty of which Freud [was] aware. Some lives are so pent-up that a neurosis may be “the least of the evils possible in the circumstances.” Some of those “who now take flight into illness” would find the inner conflict exposed by candor insupportable, and “would

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rapidly succumb or would cause a mischief greater than their own neurotic illness.” Honesty is not an ethic for weaklings; it will save no one. (p. 322)

Perhaps this explains why psychoanalysts today seem uncomfortable with the characterization of psychoanalysis as a moral enterprise whose aim is to further honesty. What do we stand to gain by becoming more honest, anyway? Does it make us better people, more committed to the community in which we live? Not necessarily. In fact, Rieff warns that “psychoanalysis prudently refrains from urging men to become what they really are,” in part because analysts fear “the honest criminal lurking behind the pious neurotic” (p. 322). Yet despite its dangers, Freud believed that honesty, though costly, is less expensive in the long run than its alternative, a society of morons whose ultimate glory is to cow to social convention, in hope of being rewarded for it. After all, this is the same society Freud held accountable for making us neurotic in the first place, by compelling us to conceal the views, inclinations, and aspirations society opposes. Like the existentialists, Freud believed that being true to one’s convictions should always hold precedence over blindly complying with someone else’s standard of behavior. The view that individuals and society are necessarily opposed is a key to understanding Freud’s conception of analysis and the specific form of alienation it is limited to relieving. At bottom, it is a kind of alienation that is an inescapable consequence of living. Nietzsche, Sartre, and Heidegger shared with Freud a characterization of contemporary culture in which the individual is a perpetual outsider, a romantic in a postmodernist world who must bear the burden of his convictions and make what peace he is able with the relentless forces of convention. From this perspective, psychoanalysis is unremittingly subversive. Its principal goal is to uncover the latent truth about ourselves by disclosing it. Whatever we do with that truth, and whatever effect we permit it to have on our destiny, is ultimately between ourselves and our conscience.

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Two

Thinking Through Free Association

We have seen how the act of free associating and the pledge to do so have been systematically confused in the analytic literature, inadvertently instilling a psychological bias into the free associative situation instead of an ethical one. Yet any effort to determine the exact features of free association is complicated by the problem that there is little agreement in the psychoanalytic literature as to what it entails. Is free association, for example, a performance that one can perfect over time, or is it an experience whose elucidation is thwarted by the simple effort of performing it? Having shown in Chapter One that the free association method is not identical with but is, nonetheless, dependant on the fundamental rule for its efficacy, I now turn to how free association is typically conceived and contrast the conventional characterizations of it with a phenomenological model, i.e., rooted in the patient’s experience. At the risk of simplification, I begin by dividing the vast number of characterizations of the free association method6 into two broadly defined camps: a) those who believe that it entails everything that patients utter in their analysis; and b) those who view it as a state of mind that patients aspire to but only fleetingly approximate. Admittedly, there are endless possible variations between the two extremes, each necessarily derived from a given analyst’s conception of the treatment situation. Instead of attempting to enumerate each one I shall endeavor to synthesize these variations into their essential elements by bringing the basic premise on which each of these perspectives rely into focus. CLASSICAL CONCEPTIONS OF FREE ASSOCIATION Lipton (1977) argues that virtually everything a patient says subsequent to having been introduced to the fundamental rule comprises the pa6 See, for example: Bergmann, M., 1968; Bordin, E., 1966; Chrzanowski, G., 1969; Coltrera, J. and Ross, M., 1967; Fromm, E., 1955; Kelman, H., 1962; Loewenstein, R., 1956; Marmor, J., 1970; Rosner, S., 1973; Seidenberg, H., 1971; and Zilboorg, G., 1952. See also Mahony, P., 1987, pp. 16-56 for a more comprehensive bibliography on the psychoanalytic literature on free association.

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tient’s free associations, including arbitration of fees, holiday arrangements, and any ostensibly practical matter; in effect, the entirety of what the patient says over the course of the treatment experience. According to Lipton, a free association is simply anything that is open to interpretation; in other words, virtually everything that a patient says (pp. 266267). Yet, Lipton notes that nothing a patient says to the analyst is open to interpretation (and hence can be deemed a free association) until after the fundamental rule has been introduced to the patient; in other words, until after the patient has agreed to comply with the injunction to free associate. Only then, Lipton insists, do a patient’s otherwise innocuous verbalizations become genuine associations, as such. The reason for this qualification is because, “The technique of analysis is collaborative by definition and can be used only after the patient has been told the fundamental rule” (p. 267). Hence, the fundamental rule is transformative in that it binds the analyst to the patient in common cause, and to the degree that it engenders doubt in the patient’s verbalizations, thereby placing everything a patient says into question. Whereas Lipton includes virtually everything a patient utters during the analytic hour as a free association (with the above qualification), Greenson (1967) adopts a more narrow definition that conceives it as a state of mind that is distinct from a conventional conversation. In Greenson’s view, the sole purpose of free association is to elicit regression in the patient: In classical psychoanalysis the predominant means of communicating clinical material is for the patient to attempt free association. Usually this is begun after the preliminary interviews have been concluded. In the preliminary interviews the analyst has arrived at an assessment of the patient’s capacity to work in the psychoanalytic situation. Part of that evaluation consisted of determining whether the patient had the resilience in his ego functions to oscillate between the more regressive ego functions as they are needed in free association and the more advanced ego functions required for understanding the analytic interventions, answering direct questions, and resuming everyday life at the end of the hour. (p. 33)

Hence, Greenson conceives the free association experience as a rarefied form of awareness that should be distinguished from the kind of communication that is experienced in ordinary speech. Moreover, the analyst is expected to monitor the patient’s performance whenever free associations occur in order to guard against behavior that is antithetical to psychoanalytic aims. According to Greenson, this is because [F]ree association may be misused in the service of resistance. It is then the task of the analyst to analyze such resistances in order to reestablish the proper use of free association. It may also occur that a pa-

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tient cannot stop free associating because of a breakdown of ego functions. This is an example of an emergency situation in the course of an analysis. The analyst’s task then would be to attempt to re-establish the ego’s logical, secondary-process thinking. He may have to employ suggestion and direct commands in order to do so. This is an unanalytic manoeuvre, but it is indicated in the above instance because we may be dealing with an incipient psychotic reaction. (p. 33)

For Greenson, free association is merely a device that serves to elicit the patient’s regression to an infantile state, which is then subjected to analysis. This view explains why Greenson pays an inordinate degree of attention to the possibility of “breaking down” under the weight of anxieties that free association may manifest, creating an “emergency situation.” Since these considerations (what the patient can and cannot endure and whether analysis is a suitable form of treatment) are determined by a patient’s capacity to be analyzed, it is of critical importance to Greenson that patients who present themselves for analysis be screened in order to determine their capacity for submitting to such an experience. What, then, are the preconditions for analyzability as Greenson conceives them? The patient is asked: a) to regress but also to progress; b) to be passive and to be active; c) to give up control and to maintain control; and d) to renounce reality testing and to retain reality testing. In order to accomplish this, the analytic patient must have resilient and flexible ego functions. This appears to be in contradiction to our earlier description of a neurosis as being a result of an insufficiency in ego functions. But what is characteristic of the analyzable neurotic is that his defective ego functioning is limited to those areas more or less directly linked up to his symptoms and pathological traits of character. Despite the neurosis, the treatable patient does retain the capacity to function effectively in the relatively conflict-free spheres. (p. 361)

Greenson concludes that because the free associative process pulls analytic patients in two directions at once, analysts should insure that their patients are capable of adapting to such pressures. On the one hand, they are expected to regress and while in a state of regression they are asked to split themselves in half, then employ their observing ego in the task of dispassionately observing the primitive aspect of their ego in a regressive state. The capacity to perform this function—to effectively split oneself in two—is characterized by Greenson as a skill that one can learn to perfect over time. Psychoanalytic therapy requires that the neurotic patient have an ego with sufficient resilience to shift between his opposing ego functions and to blend them, taking into account the limitations that his neurotic

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THE ETHIC OF HONESTY conflicts impose… In order to approximate free association, the patient must be able to give up his contact with reality partially and temporarily. Yet he must be able to give accurate information, to remember, and to be comprehensible… He must have enough ego resilience so that he has the mobility to regress and the ability to rebound from it… To put it succinctly, he must develop the ability to shift between the working alliance and the transference neurosis… [Finally] we ask the patient to let himself be carried away by his emotions in the analytic hour so that he can feel the experience as genuine. But we do not wish him to become unintelligible or disoriented. (p. 362)

Greenson depicts what amounts to a feat of mental gymnastics—approximating the mechanism of splitting—as the essence of free association. Consequently, he reduces the free association experience to a mental condition that occasions regression to an earlier stage of development, in turn eliciting a state of suggestibility that permits patients the wherewithal to critique the state of regression they have obtained. Hence, Greenson conceives the purpose of free association as one of eliciting material that was previously inaccessible to conscious awareness, thus gaining access to repressed material. While their respective views are ostensibly opposed, Lipton and Greenson converge in their view that free association is supposed to foster an interpretive response by the analyst. Both Lipton’s and Greenson’s characterizations of free association overlook the ethical component of the fundamental rule stated earlier, the pledge to be honest with one’s analyst. Though Lipton and Greenson diverge in much of their respective conceptions of free association, they agree that the goal of free association serves no other function than to further analytic interpretation. FREUD’S CONCEPTION OF FREE ASSOCIATION I shall now compare Lipton and Greenson’s respective views about the free association experience with Freud’s characterization of it that we reviewed in the previous chapter. As we saw then, Freud depicts the free associative act as one that is inextricably dependent on the fundamental rule, the ethical imperative to be honest. Is free association, as Lipton and Greenson imply, merely a means to an end, or is it, as Freud implies, an end in itself? It can hardly be exaggerated that free association served as the raison d’être for Freud’s conceptualization of the psychoanalytic method, even in the so-called later phase of Freud’s clinical career. John Dorsey, who was analyzed by Freud during the last decade of Freud’s life, reported that free association comprised the entirety of his treatment experience with him. According to Dorsey (1976), “Full obedience about the importance of not withholding… any mental content for any reason whatsoever was my one psychoanalytic rule” (p. 29) (See also Lohser, B. and Newton, P., 1996.). Influenced by the hypnotic

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method promoted by Bernheim and Charcot, Freud initially conceived of free association on the model of a surgical procedure. When employing hypnosis with his patients Freud induced a hypnotic trance before proceeding to “operate” on the contents of their unconscious. While under hypnosis, the patient’s repressed ideas could be elicited via spontaneous disclosure, though the manifestation of such disclosures relied entirely on hypnotic suggestion. Even though this method was useful for eliciting unconscious material, its therapeutic value was limited because the patient’s symptoms invariably returned once the effect of the hypnosis wore off. Hypnosis was subsequently replaced with the free association method, which, unlike the effects of hypnotic trance, allowed patients to disclose the thoughts that came to mind without the prodding of the analyst. Instead of contriving to reverse the patient’s repressions while under hypnosis, the analyst could instead interpret the patient’s associations in order to decipher their meaning. Yet, interpretation proved to be no more successful in the long run than hypnosis. Despite the advantage of remaining conscious during the treatment experience, it wasn’t the patient’s awareness that formulated the meaning of his disclosures but the analyst’s. Knowledge about the patient’s unconscious was indirectly conveyed, via the analyst, back to the patient who, now under the influence of the positive transference, was urged to adopt the analyst’s interpretations. This technique only repeated the same dilemma that was encountered with hypnosis. Since the newer method also relied on suggestion, the patient’s unconscious wishes eventually manifested alternative symptoms that served to thwart the short-lived gains of the analyst’s interventions. Freud subsequently refined the free association method into its final form when he introduced the fundamental rule, circa 1912. Henceforward, he enlisted the patient’s pledge to be as candid as possible by agreeing, at least in principle, to disclose whatever comes to mind. Now it was the patient’s spontaneous utterances that assumed center stage, while the importance of interpreting the patient’s disclosures receded. Once Freud realized that the suppression of secrets instigated the conflicts that his patients typically suffered, free association was viewed as an opportunity to disclose such secrets to another person, in this case, the analyst. Seen in this light, Greenson’s conception of free association was stuck in the second stage of its evolution, when the practice of inducing patients into a regressive (hypnoid) state of suggestibility was the agent of psychic change. Virtually any use of free association that conceives it as a means of interpreting manifest content, however innovative or original one’s interpretations may be, repeats the same error. Freud eventually abandoned interpretation as a mutative component of analysis

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because it deprived patients of the opportunity to spontaneously disclose the hidden content of their conflicts.7 By Freud’s reckoning, the recollection of repressed memories serves a far greater purpose than the retrieval of pathogenic material: it is the principal vehicle by which psychic change is fostered. In “On Beginning the Treatment,” Freud (1913) reported that he abandoned his earlier, “intellectualist,” approach because it relied exclusively on interpreting the patient’s associations: “Indeed, telling and describing [the] repressed trauma to [the patient] did not even result in any recollection of it coming into his mind” (p. 141). Lipton’s and Greenson’s respective conceptions of free association rely almost entirely on analytic interpretation in order to fathom the unconscious meanings of the patient’s discourse, while dismissing the efficacy of self-disclosure as a mutative agent. Yet, despite the importance that Freud gave to the patient’s capacity for candor, it is patently obvious that most of what patients say during the course of treatment is of marginal significance. Patients are nonetheless admonished to disclose everything that comes to mind because no one can know beforehand when something of significance will be uttered. Moreover, things that appear trivial today may in hindsight prove monumentally important later. Then what determines the qualitative value of the patient’s free associations when contrasted with their voluminous quantitative content? Are some associations, in effect “freer,” or more mutative, than others? This was one of the questions Merton Gill (1994) raised in his book, Psychoanalysis In Transition, published shortly before his death. There, Gill adopted Lipton’s thesis that free association amounts to “whatever the patient says in response to the request to follow the fundamental rule” (p. 81). Gill argues that Lipton’s thesis conforms precisely with Freud’s depiction of free association, although he confesses that, “Freud cannot be quoted directly to this effect” (p. 81). Yet Gill insists that free association is such a commonplace phenomenon that patients do not need to “learn” it because everyone already knows how to do it before entering therapy. Moreover, in apparent contradiction to his own view on the matter, Gill also cites Freud as saying, “The adoption of the required attitude of mind toward ideas that seem to emerge ‘of their own free will’ and the abandonment of the critical function that is normally in operation against them [i.e., censorship] seems to be hard of achievement for some people” (quoted in Gill, p. 82). Though this citation appears to dispute Gill’s claim that Freud concurred with his viewpoint, I agree with Gill’s contention that, “Freud’s 7 While the importance of permitting the patient to discover for himself the meaning of his symptomatology has been emphasized by the interpersonal school in America, this stratagem was actually Freud’s innovation, which Sullivan adopted and incorporated into his own technical schema.

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view of free association is that it [entails a form of] expanded communication, essentially logical and coherent, but including certain kinds of material ordinarily excluded from conversation” (p. 83). Gill nevertheless appears to contradict his own characterization of the so-called ordinariness of “expanded communication” when admitting that, “Freud’s discussion of free association implies that the ideas that are included in the expanded communication are not present in ordinary states of mind [and that] they emerge because the relaxation of resistance leads to an altered state of consciousness” (p. 85) [Emphasis added]. While I agree with Gill’s characterization of free association as an expanded form of communication, his difficulty in recognizing that it also entails an unconventional state of awareness in order to affect such communication is due, I suspect, to his failure to grasp the role of the fundamental rule in this endeavor, without which the communication that transpires between patient and analyst are probably no different than those shared with anyone else. Because Gill failed to appreciate the fundamental rule’s impact on the free association experience, he was obliged to employ a more active technique to compensate for its absence, epitomized by the analysis of transference. An interventionist at heart, Gill suggested that analysts focus all their efforts on the patient’s resistance to free associating, thereby rejecting the inherently passive (embodied in the analyst’s neutrality) stance that Freud advocated. Consequently, Gill gives more weight to analyzing the resistance that patients employ against self-disclosure than to furthering the patient’s capacity for self-disclosure. The implications of this oversight are considerable. Admittedly, we disclose things as a matter of course every day so, as Gill suggests, it entails a perfectly commonplace activity. But the type of disclosure invoked by analysis is unique because the matters disclosed are confided in the strictest confidence. By the same token, the person to whom one’s secrets are disclosed listens to them in a manner that isn’t typically encountered. The analyst listens in order to hear what is usually overlooked. Obviously, this involves an uncommon degree of participation by the person who performs the disclosing, otherwise free association would be reduced to a game of hide and seek. That is why (Gill’s protestations to the contrary) patients learn to disclose with greater attentiveness and fidelity over time, cueing their associations to the reactions (including interpretations) of the analyst. FREE ASSOCIATION AS SELF-DISCLOSURE To genuinely free associate isn’t simply a means of “reporting” the contents of one’s mind, but an act of revelation by which the inner recesses

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of one’s being are bared to another person. Hence, acts of self-disclosure serve to change the people who perform them because they alter the situation in which patients share their confidences. Acts of disclosure invariably elicit anxiety because the contents of one’s mind say a great deal about the person who confides them. Free association wouldn’t arouse anxiety in the first place if patients weren’t reluctant to discover what they harbor. The fact that patients don’t know what they are about to disclose at a given moment is another reason why free association provokes the measure of anxiety that it does. Resistance to selfdisclosure—what I term disclosure anxiety—isn’t, however, confined to the analytic situation. We experience it as a matter of course because we are always finding ourselves in one situation or another that unexpectedly takes us by surprise. Though we cling to the belief that we are capable of some forms of behavior but not others, analysis confronts us with the reality that we are fundamentally other than we take ourselves to be. Analysis heightens this source of anxiety because its principal motive is to discover precisely those aspects of ourselves that we typically conceal. How do we customarily cope with this anxiety when it insinuates its way into our lives at every turn? Typically, by not thinking about it. We put the source of our concerns aside and obfuscate our anxieties through all manner of distractions. Consequently, the kind of selfdisclosure free association entails requires giving what we say an uncommon measure of thought, but a kind of thinking we aren’t accustomed to. What kind of thinking does it entail? Lipton (1977) argues that thinking is inconsequential to free association because self-disclosures occur independently of rationality. According to this thesis, free association merely serves the function of providing material for the analyst to interpret because it isn’t necessary for the patient to think about what he is saying. Yet Lipton is critical of those analysts who interpret excessively on the one hand and employ too much silence on the other because, in his view, the treatment situation is a collaborative one that approximates a conventional conversation. Ironically, Lipton’s view that the psychoanalytic dialogue more or less approximates a conventional conversation is consistent with Freud’s clinical behavior, even if Freud viewed such conversations as incidents of an altered form of consciousness. Many of his former patients reported that Freud was so actively engaged with them that their conversations amounted to “a straightforward dialogue” (Racker, 1968, p. 35) (See my treatment of Freud’s “non-classical” treatment behavior in Thompson, 1994, pp. 230-240.). Freud concluded that one’s capacity to free associate isn’t necessarily compromised by a dialogue format, in contrast to what has evolved as the more conventional psychoanalytic monologue. Lipton nonetheless argues that thinking, per se, plays a minimal role in the kind of conversation free association entails because,

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for Lipton, conversation serves no other purpose than that of providing the analyst with material to interpret. Lipton’s contention that the treatment experience necessarily minimizes the need for reflective awareness is symptomatic of the problem that the art of conversation is the most neglected component of psychoanalytic technique. There is an extraordinary amount of discussion in the analytic literature about what to interpret and how, but little concerning how to talk to analytic patients and how to listen to them. While no one questions that words comprise free association, there is little agreement concerning how such words, once uttered, should be treated. Despite the plethora of interpretative schemes available, all of them can essentially be reduced to serving one of two aims: a) to guess what is hidden from awareness; or b) to enable patients to free associate further. All the interpretations in the world, however, cannot substitute for the simple act of confiding, an activity for which the patient is alone responsible. Yet patients who try to free associate for the first time discover that saying what comes to mind without censorship isn’t as easy as it appears. Freud was so impressed with his patients’ resistance to complying with this rule (i.e., the act of free associating) that he amended it with the pledge to be candid, thereby enlisting their active cooperation. But if the analyst’s admonition to engage in self-disclose engenders resistance as a matter of course, why call the patient’s associations free? And if they are free, how is one to conceive what manner of freedom they foster when the device by which such disclosures are elicited is prompted by a rule one is expected to observe? Indeed, is the very notion of freedom antithetical to the means by which the unconscious becomes manifest, or is it a necessary determinant of the revelations that self-disclosure fosters? Apparently, free association means different things to different analysts, eliciting little in the way of agreement about the phenomenon itself. So what would free association entail if one were to conceive it as free? There are any numbers of ways by which free association can be said to elicit free associations. In a strictly political sense, free association grants permission to say whatever one is moved to without consequence. Hence the analytic contract is rooted in the permission to speak frankly. Since psychoanalysis assumes freedom of expression it would be impossible to free associate in a culture that circumscribes the speech act amongst the members of its society, even if the words exchanged are in confidence. While totalitarian societies are by definition oppressive, Freud believed that virtually all “civilized” societies are inherently repressive, including the most ostensibly democratic ones. This uneasy assessment of Freud’s own culture inspired serious reservations among his followers about the feasibility of psychoanalysis as an instrument of gov-

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ernment-sanctioned mental health treatment schemes. With the exception of the now-defunct alliance between psychoanalysis and American psychiatry, psychoanalytic treatment has traditionally been relegated to the margins of a given society’s treatment philosophy. Freud concluded that those who wish to gain psychic freedom must pay the price of submitting to the realities in which they live by a reaching a necessarily uneasy accommodation with their society. On a more practical level Freud (1910) advocated acknowledging, at least to oneself, what one’s wishes happen to be and then decide what one intends to do about them—whether, for example, “to face [their] conflict[s], fight for what they want, or go without” (pp. 149-150). This is perhaps the most compelling example of why psychoanalysis is inherently subversive, because it favors the psychic freedom of the individual over the repressive forces of one’s culture. Yet most analysts insist that free associations are not free, but determined. Laplanche and Pontalis (1973), for example, insist that, “Freedom is not to be understood here, in fact, as implying any absence of determination: the first goal of the rule of free association is [simply] the elimination of the voluntary selection of thoughts” (p. 170). In other words, because the words elicited by free association are unconsciously determined, nothing that is manifested by this method is presumed to be free in the literal sense of the word (if one understands by freedom those acts that are strictly voluntary). Ironically, Laplanche and Pontalis’ thesis, adopted by the analytic community at large, inadvertently equates freedom with volunteerism and spontaneous revelation with determinism. In my view, the fact that emotions, attitudes, and behavior are “determined” by unconscious wishes simply indicates that the unconscious is freedom in its essence. If, as Nietzsche offered, one can do as one will but cannot will as one will, then the unconscious determinants of one’s will are necessarily free, but not determinably so. In fact, the words uttered in psychoanalysis are determined by one’s freedom, if one understands freedom as that which cannot be dictated. In other words, the unconscious freely determines—i.e., without constraint or predictability—the speech acts that are manifested through the act of free associating. But what determines the unconscious? Heidegger would probably say, nothing. Freedom and determinism, in the manner that Freud conceived them, are more or less identical. Both Lipton and Gill inadvertently confirmed this insight when they suggested that everything patients say are free associations. Ultimately, free associations are free because the mind has no alternative but to think what freely (i.e., unpredictably) occurs to it. Once it passes into consciousness it is “out there,” in-the-world in the Heideggerian sense. It was this intuition that inspired Freud to conceive the free association method. That being said, some free associations are arguably freer than others. Once patients begin to appreciate the degree to which their words

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are unconsciously (i.e., freely) determined, they recognize that what appear to be obstacles to their freedom are actually employed by it (See Merleau-Ponty, 1962, pp 434-456, for more on the phenomenology of freedom.). Yet if the mind is freedom itself, how does it contrive to “resist” its own freedom? Some forms of freedom—unconscious defenses, for example—seem to wage war against others, unconscious desires. The aim of analysis is to give oneself permission to finally think the thoughts that spontaneously insinuate their way to the surface, and then to experience them, first by giving them voice, then by pondering their significance. FREE ASSOCIATION AS A MODE OF THINKING In the final analysis, psychoanalysis makes a distinction, an uneasy one to be sure, between what one is capable of thinking and what one is liable to do. The one doesn’t bear a predictable or even necessary relation to the other. Since we are always of two minds about which course we are liable to follow—whether to give voice to our thoughts or resist—Freud concluded that candor was the only means available for subverting the secrecy to which we generally incline, while permitting us recourse to persist in whatever measure of secrecy we choose. Obviously, just talking wasn’t what he had in mind. Given the freedom (and obligation) to say what comes to mind, Freud observed that analytic patients, when exercising the opportunity presented to them, often say little of consequence and indulge in a manner of discourse—what Heidegger terms “empty speech”—that conceals more than it reveals (See Lacan, “The Function and Field of Speech and Language in Psychoanalysis,” in 1977, pp. 40-56, for a variation on Heidegger’s conception of empty speech.). Rather than valuing verbalization for its own sake, Freud concluded that some associations are truer to the spirit of free association than others. He even complemented patients on the production of “good” associations while dismissing the more impoverished ones as incidents of dis-association, a form of resistance. What, then, would genuinely free associating entail? Freud never spelled it out, but he was assuredly not advocating the mere reporting of a patient’s life passing by, the railway car analogy notwithstanding. He characterized free association as a form of reverie through which conscious volition (a form of resistance) is spontaneously relinquished, momentarily free of the intellectual gymnastics patients customarily employ when left to their own devices. Indeed, the instruction to simply verbalize whatever pops into one’s head may elicit comical caricatures of the analytic process that not a few literally minded patients have indulged in, often to the consternation of their puzzled analysts. Freud never in-

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tended that the act of self-disclosure should produce a form of psychobabble. He merely invited his patients to talk about themselves with a view to taking stock of their experience of doing so, one step at a time, as their life unfolds in the here-and-now of the psychoanalytic moment. Unavoidably ambiguous, this process occasions a singular frame of reference, a verbal meditation in the truest sense of the word. But what does verbalizing meditatively entail? In addressing this question, I have found it useful to consider Heidegger’s conception of empty speech and its antithesis, meditative thinking.8 Heidegger’s understanding of language is that its purpose is to disclose the deepest recesses of what we are capable of thinking, with the proviso that we attend to our speech acts “thoughtfully.” Heidegger (1966) characterized meditative thinking as a kind of thinking, “which is open to its content, [and] open to what is given” (p. 24). In other words, free association, to the degree it approximates meditation, cannot be reduced to just talking because it includes listening as well, with the aim of hearing what one says while giving thought to one’s disclosures at the moment they are spoken. Thus Heidegger contrasts meditative thinking with a form of conceptualization (or ratiocination) we are educated throughout childhood to master, a calculative and inherently academic form of thinking that is foreign to the kind of thinking we are capable of performing outside the confines of formal education. Indeed, ratiocination is a kind of thinking we employ without truly thinking, a form of intellectualization that comes naturally to neurotics. Heidegger characterizes this type of thinking as one that, “computes and races from one prospect to the next… [that] never stops [or pauses to] collect itself” (p. 46). Similarly, Freud (1913) condemned (what Heidegger characterizes as) calculative forms of conceptualization in one of his most important papers on technique, “On Beginning the Treatment,” where he denigrated the days when psychoanalysts suffered from an intellectualistic bias (p. 141). Freud even admonished patients against reading about psychoanalysis while in treatment in order to rely on their experience of it instead, for the same reason advocated by Heidegger: as a purgative against conceptualizing what can only be only be made available through one’s originary experience. By 1913 Freud concluded that the need to fathom the ultimate cause of one’s suffering—as though knowing why one is neurotic has mutative value—is antithetical to the spirit of submitting to free association. Though Freud didn’t know it, this is an 8 Since the terms, meditation and thinking are virtually synonymous, in bringing them together Heidegger parts company with the conventional form of thinking that is based on ratiocination, alerting us to an altogether different mode of thinking that is specifically “meditative,” derived from Aristotle’s distinction between calculative and contemplative thinking.

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inherently phenomenological manner of thinking, not a rationalistic (i.e., scientific) one (See Thompson, 1996b, for a more detailed discussion on the phenomenology of thinking.). Seen in this light Gill’s preference of transference interpretations over genetic ones obtain little in the way of diminishing the neurotic tendency toward intellectualization. On the contrary, it may encourage it. While analysis of transference is undeniably an important component of the treatment experience, its overemphasis reduces analysis to a rationalistic comprehension of psychic process, as if that were the decisive element in the outcome. Contrary to what his critics have claimed, Freud introduced the free association method in order to thwart intellectualization, by indoctrinating patients into a type of thinking that is so naked in its naiveté that it is impossible to attain it through conventional modes of understanding, such as occurs in education. Indeed, formal education suppresses the capacity for meditative thinking instead of developing it. How Freud stumbled upon free association in the first place is not altogether clear, though it is usually attributed to Ludwig Börne, a wellknown author of his day. Börne suggested that if aspiring authors were to simply write down everything that comes to mind for a few minutes every day they would soon learn how to write without difficulty. Freud (1900) also credited the German philosopher Friedrich Schiller as another inspiration for this method. In The Interpretation of Dreams, he quotes Schiller as saying: “It seems a bad thing and detrimental to the creative work of the mind if Reason makes too close an examination of the ideas as they come pouring in” (p. 103). Freud even confessed that Schiller’s depiction of a method (in Schiller’s case for artistic creation) that entails “a relaxation of the watch upon the gates of Reason” more or less approximated his conception of free association.9 Though not identical, their respective methods advocate the discipline of allowing one’s mind free expression without the customary interference (or censorship) that reason typically employs. When applied in a clinical context, however, free association is more complicated than this simple instruction implies because it includes the presence of another person. Free Association has also been compared to the Catholic confessional because (as we saw earlier) guilt is the principal catalyst that prompts analytic patients to unburden themselves of their secrets. But while the Catholic ritual is devoted to the confession of sins actually committed, psychoanalysis is concerned with the disclosure of secret ideas, typically of an innocent nature. Another difference is that whereas the sinner is conscious of the sins committed, 9 Although Freud’s views on the matter developed further subsequent to having made this remark in 1900, as was noted in Chapter One, above.

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the secrets that account for the neurotic’s guilt are primarily unconscious, hence necessitating the free association method to uncover what they are. Allowing the mind to wander by its devices while perusing its contents as they occur is nothing less than a plea to unreservedly experience one’s experience while giving such experience thought, free association in its essence (See Thompson, 2000a, for a more thorough critique of the role that experience plays in psychoanalytic technique.). Yet, any number of analysts, including Lipton and Gill, appear to confuse free association with the simple recapitulation of one’s thoughts. Moreover, substituting the capacity for reverie with the act of “regurgitating” thoughts devoid of significance or affect encourages intellectualization, thus thwarting the opportunity to spontaneously experience what one is saying by hearing it. Indeed, the inherent subtlety of free association probably accounts for the variety of enigmatic and confusing depictions of its ostensible purpose and application, many of which appear to minimize its significance altogether. Unfortunately, Freud’s depiction of free association as being analogous to a railroad journey did little to clarify matters and probably distorted them even further. Some commentators have perceived in his characterization of this method a solipsistic depiction of the psychoanalytic situation, the so-called one-person hypothesis. It seems to me that such criticisms are the product of seriously misunderstanding what Freud said. On closer examination, the central thread running through the railroad car analogy was intended to illustrate: a) the relationship between the train passenger and his experience of the journey as it unfolds; and b) the relationship between the passenger and his companion, the person to whom his experience is being disclosed. The combination of the two facets of free association transforms the journey into an opportunity for self-discovery. The fact that the patient requires someone to whom to disclose one’s thoughts in order to have such thoughts in the first place confirms that Freud’s views on the matter anticipated what more recently is attributed to the inherent “intersubjectivity” of the situation (I have discussed the so-called intersubjective dimension to psychoanalytic discourse in considerable detail in Thompson, 1985.). The mistaken assumption that this process is solipsistic (i.e., rooted in a one-person psychology) is probably the consequence of an increasing emphasis on the epistemological component of psychoanalysis over its inherently phenomenological structure, which is to say, the lived experience of the treatment situation. Whereas the epistemological point of view assumes the ability to comprehend one’s experience is of critical importance, the phenomenological view holds that the ability to experience one’s self-disclosures is the mutative element of psychoanalysis. Thus the patient’s subsequent understanding of that experience, while no doubt comforting, is not essential to the outcome of treatment and in extreme cases may compromise it.

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If the actual experience of free association has precedence over the quota of knowledge that can be derived from it, then the goal of analytic interpretation must serve to accommodate this factor. Whereas interpretation plays an indispensable role in every treatment experience, its purpose has been profoundly distorted over the course of the past century and oftentimes exaggerated. There are times, for example, when interpretations may interfere with the patient’s ability to free associate. When properly employed, a good interpretation subverts the hyper-rationality neurotics are prone to employ by shocking them, in Zen-like fashion, into a less defensive (i.e., rationalistic) state of consciousness. At best, interpretations help to break the “causal chain” of neurotic fixations while undermining the patient’s dependence on abstract explanations. Instead of merely replacing one set of assumptions with another, interpretations ideally bolster the patient’s frustrating efforts to accommodate the experience of “not-knowing,” an indispensable precursor to a properly analytic (i.e., sceptical) sensibility. This relatively conservative use of interpretation was also advocated by Winnicott (1990) who, toward the end of his career, employed interpretations only when, “a communication [has] been made that needs acknowledgment [by the analyst]” (p. 66). Winnicott refrained from employing interpretations either as a substitute for what patients are momentarily incapable of disclosing or in anticipation of what they are perfectly capable of determining anyhow, if given sufficient time to do so. Winnicott concluded that the principal task of psychoanalysis is to create a (transitional) space in which patients are free to explore their experience by speaking it. Properly employed, interpretations are never intended to replace one explanation with a cleverer one, nor should they serve to merely translate unformulated intuitions into more carefully crafted presentations. Instead, the mutative power of interpretations relies on their capacity to subvert explanations altogether by eliciting a different manner of thinking. Ideally, the analyst’s interpretations serve to bring the patient’s associations into focus, by helping him participate more fully in the act of self-disclosure (see Thompson, 1985, p. 150-192). PHENOMENOLOGY OF FREE ASSOCIATION This aspect of free association is nowhere more aptly demonstrated than in Heidegger’s characterization of meditative thinking, or Gelassenheit. Though it enjoys parallels with Asian philosophy, Heidegger’s concept of meditation was derived from Husserl’s (1931) phenomenological method of “seeing” and the views of the fourteenth-century German mystic, Meister Eckhart (Schürmann: 1978, pp 192-213). Husserl’s method of philosophical inquiry rejected the rationalist bias that has dominated West-

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ern thought since Plato in favor of a style of reflective attentiveness that seeks to disclose the individual’s experience (See Husserl, 1931, for his critique of the phenomenological study of experience.). Loosely rooted in a sceptic device called epoché, Husserl’s method entailed the suspension of judgement while relying on the intuitive grasp of knowledge, free of presuppositions. Sometimes depicted as the science of experience, Husserl’s phenomenological method adapted elements of sceptic philosophy to a radical critique of human experience (See Wachterhauser, 1996, for a study of the relationship between scepticism and phenomenology and Thompson, 2000b, for a more exhaustive examination of the relationship between scepticism and psychoanalysis.). According to Natanson (1973), “The radicality of the phenomenological method is both continuous and discontinuous with philosophy’s general effort to subject experience to fundamental, critical scrutiny: to take nothing for granted and to show the warranty for what we claim to know” (p. 63). This sounds easy, but it entails an unusual combination of discipline and detachment to suspend, or bracket, compelling theoretical arguments or what we assume from second-hand information. The phenomenological method serves to momentarily erase the world of speculation by returning us to our primordial experience, whether the subject of inquiry is the nature of anxiety, the enigma of love, or the vicissitudes of the psychoanalytic treatment experience. Suspending belief in what we ordinarily take for granted or infer by conjecture diminishes the power of what we customarily embrace as objective reality, a close-knit collection of anonymous opinions whose authority rests more or less entirely on how many people embrace a given point of view. After studying with Husserl in his youth Heidegger subsequently distanced himself from what he characterized as Husserl’s subjectivistic tendencies. Whereas Husserl conceived of human beings as having been constituted by states of consciousness, Heidegger argued that consciousness is peripheral to the primacy of one’s existence (i.e., Being), which cannot be reduced to one’s consciousness of it. From this angle, one’s state of mind is an effect rather than a determinant of existence, including those aspects of one’s existence that one is not conscious of. By shifting the center of gravity from consciousness (psychology) to existence (ontology), Heidegger altered the subsequent direction of phenomenology, making it at once both personal and mysterious. One of the consequences of Heidegger’s modification of Husserl’s conception of phenomenology was its increased relevance to psychoanalysis. Whereas Husserl gave priority to a depiction of consciousness that was fundamentally alien to the psychoanalytic conception of the unconscious, Heidegger offered a way to conceptualize experience that more readily accommodated those aspects of our existence that lie on the periphery of sentient awareness. Though Heidegger owed a considerable debt to Husserl’s conception of phenomenology, his philosophi-

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cal method was probably influenced even more by Meister Eckhart’s notion of meditative thinking, or Gelassenheit, usually translated into English as composure, resignation, or releasement, as in letting go (See Reiner Schürmann’s excellent account of Eckhart’s notion of Gelassenheit in 1978, pp. 16-17; 81-82; 111-121; 191-213; 225-226.). For Eckhart, Gelassenheit depicts a kind of submission or relaxation of the will, as in giving way or giving oneself to God. Whereas Western philosophy has traditionally utilized the will as the principal means of obtaining knowledge, an indispensable prerequisite for engaging in Gelassenheit is to relinquish one’s reliance on wilful endeavors altogether. Naturally, any characterization of thinking that eschews conscious volition is fundamentally foreign to a style of conceptual thought that is essential to scientific investigation and scholarship. Heidegger saw the closing of the millennium as a dangerous moment in history, not because we are on the brink of a nuclear holocaust but because we have forgotten how to think and, because of this forgetfulness, we are in danger of losing our humanity. What manner of thinking does he offer as an alternative? According to Heidegger (1968), this question is best answered by enumerating the things that meditative thinking (i.e., free association) is not suited for: 1. 2. 3. 4.

Thinking does not bring knowledge as do the sciences. Thinking does not produce usable, practical wisdom. Thinking solves no cosmic riddles. Thinking does not endow us directly with the power to act. (p. 159)

According to J. Glenn Gray, in his introduction to Heidegger’s What Is Called Thinking? [This conception of] thinking is not so much an act as a way of living or dwelling—as we in America would put it, a way of life. It is remembering who we are as human beings and where we belong. [In other words] a gathering and focusing of our whole selves [and taking to heart] what lies before us. (In Heidegger, 1968, p. xxii)

Thus Heidegger’s version of Gelassenheit offers the possibility of engendering an experience with language that supersedes conventional forms of communication. By conceiving phenomenology as a means of eliciting truths through acts of self-disclosure, Heidegger was able to employ meditative thinking as a device for revealing what is customarily overlooked or repressed (See Thompson, 1994, pp. 51-92, for a critique of Heidegger’s conception of truth.). When we apply Heidegger’s way of thinking to those acts of self-disclosure that are fostered by free association, our conception of thought itself can be understood as the moment

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of actually hearing what we disclose when taking another person into our confidence. Hence, free association is free, but only to the degree that we are able to step back and let the world take its course, by giving way to the thoughts that come to mind in the course of conversation. Though unconventional by ordinary standards, Heidegger’s views on meditation are consistent with the etymological foundations of term for thought. For example, the etymology of the English, think literally means to seem or to appear and is derived from the German dunken, meaning, “to form in the mind.” While current usage emphasizes thought as conception, its roots suggest an inherently meditative cast that has been corrupted over the centuries, victim to the increasing dominance of science and technology and a model of education that emphasizes the accumulation and memorization of knowledge, what we in America call “know how.” Heidegger’s characterization of meditative thinking as one of giving voice to what appears in the mind, takes form, and seems to be the case, conforms precisely with what thought meant in pre-Socratic times (See Thompson, 1996b, for a detailed examination of Heidegger’s conception of language and thought in relation to the psychoanalytic experience.). If psychoanalysts hope for such a manner of thinking to be elicited when they invite their patients to free associate, a precondition for their patients’ compliance would have to include their ability to resign themselves to a measure of thoughtful attentiveness that would, in turn, enable them to hear themselves speak—thought in its essence. Perhaps this is why, despite our best efforts, the quality of experience we typically obtain in the analytic hour is superficial at best. This is not a matter, however, of simply hitting the mark or missing it because there are degrees to which each of us is capable of experiencing what we hear ourselves saying, no matter how attentive we may be. Psychoanalysis seeks to transform the experiences we typically take for granted into “happenings” in which we are able to participate more fully, over an indeterminate measure of time. Hence this second order of experience elicits a dimension of self-awareness that psychoanalysis is ideally suited for, even if it does so under the guise of treating “psychopathology.” This is why the kind of experience psychoanalysis is capable of obtaining is ordinary and uncommon—ordinary because each of us is perfectly capable of attaining it, but uncommon because few of us bother.

Three

The Way of Neutrality

If the fundamental rule is the technical principle by which patients are obliged to free associate, then surely the analyst should adopt a complementary frame of mind that is, in turn, capable of considering a patient’s disclosures without prejudice or condemnation. Even if the name we have given this attitude—neutrality—elicits a measure of controversy, no technical principle more aptly characterizes the basis of the psychoanalyst’s conduct. Indeed, no technical term more aptly distinguishes psychoanalysis from other forms of psychotherapy. Yet Freud didn’t even introduce the term until 1915, some twenty years after his treatment philosophy had been established. Since its introduction in the last of Freud’s six papers on technique, “Observations on Transference-Love” (1915b), neutrality has become the raison d`être for psychoanalytic technique. One of the obstacles in discussing this technical principle is that its employment has changed dramatically since it was first conceived. The first indications of this shift occurred after the Second World War in the late 1940s and early 1950s when Freud’s analytic cases were characterized by some of his own followers as ineffectual (Kanzer and Glenn: 1980; Kris: 1951). Ironically, the most frequently voiced criticism of Freud’s analytic cases, then and now, is the alleged absence of classical analytic interventions. I believe these criticisms serve to demonstrate the extent to which analytic technique has changed over the course of the last century and the degree to which it has diverged from Freud’s conception of it. In fact, classical technique, as it is now conceived, only vaguely depicts Freud’s clinical behavior. What accounts for this remarkable transformation in such a critical aspect of his treatment philosophy? More importantly, how have these developments altered the outlook of psychoanalysts today? These are some of the questions I intend to explore in this chapter. I shall begin by reviewing representative characterizations of neutrality in the psychoanalytic literature and then compare and contrast them with Freud’s depiction of it. In The Analytic Attitude, Roy Schafer (1983) depicts neutrality as the following: The analyst remains neutral in relation to every aspect of the material being presented by the analysand… In his or her neutrality, the analyst

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THE ETHIC OF HONESTY does not crusade for or against the so-called id, superego or defensive ego. The analyst has no favorites and so is not judgmental. The analyst’s position is, as Anna Freud (1936) put it, “equidistant” from the various forces at war with one another. The simplistic, partisan analyst, working in terms of saints and sinners, victims and victimizers, or good and bad ways to live, is failing to maintain the analytic attitude. (p. 5)

Hence, Schafer contends that analysts who are unable to maintain a position that is “equidistant” from all the forces they encounter in the treatment situation fail to maintain an analytic attitude, or neutrality. In contrast, the analyst who remains neutral is attempting to allow all of the conflictual material to be fully represented, interpreted and worked through. The neutral analyst is also attempting to avoid both the imposition of his or her personal values on the analysand and the unquestioning acceptance of the analysand’s initial value-judgements… It is particularly important to maintain his neutrality in relation to parental figures and spouses for, to some extent, the analysand is identified with them and is vulnerable to the same value judgments that may be passed on them. Also, the analysand may be referring to other people in order to represent indirectly, as in a dream, some disturbing feature of his or her own self. For this reason too the analyst must take care to regard these others neutrally… To achieve neutrality requires a high degree of subordination of the analyst’s personality to the analytic task at hand. (p. 6)

According to Schafer, subordination of the analyst’s personality should be understood in terms of “the analyst’s appropriate moderation, regulation and often simply curtailment of any show of activity of a predominantly narcissistic sort” (p. 6). Schafer allows, however, that there are times when analysts cannot be expected to maintain their neutrality, when they are permitted to abandon their analytic attitude and reveal the feelings, criticisms, and expectations they harbor about their patients. Schafer adds, however, that such exceptions should be permitted only on those occasions when the patient’s behavior … [M]ay seriously disrupt the continuity or effectiveness of the analysis or threaten the basic welfare of the analysand. These factors include the analysand’s constant precipitation of life crises, prolonged absences, non-payment of fees, acts of gross delinquency, physical illness, toxicity, suicidal depression, schizophrenic regression, etc. (p. 6)

What are the basic elements of Schafer’s views concerning the nature of neutrality? First, he conceives it as an attitude that every analyst should endeavor to adopt throughout the course of the treatment. Neutrality entails, but isn’t necessarily limited to: a) remaining non-judgmental; b) taking care to conceal from the patient personality traits—such as overt friendliness—that the analyst doesn’t ordinarily

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conceal; and c) maintaining a naive and unanticipatory attitude toward anything one’s patient say. While I concur with some of the features of Schafer’s characterization of neutrality, there are some that I seriously question. The principal point that concerns me is the axiomatic nature of Schafer’s conception of neutrality and his insistence that it should be employed throughout the course of treatment, allowing the minor exceptions noted above. According to Schafer, whenever neutrality is breached psychoanalytic treatment as such has been suspended. Non-analytic moments should be minimized accordingly. One could conceivably employ a graph which quantifies analytic incidents against those that are deemed non-analytic in order to determine “how much” analysis is taking place or how little. At a certain point one may breach the criteria of the prescribed analytic experience and lapse into a diluted—no doubt, inferior—form of psychotherapy. Worse, one may have polluted the therapeutic experience beyond repair by abandoning the provision for neutrality that Schafer feels is essential to classical technique. Schafer contends that the most common violation of neutrality is therapeutic ambition, a consequence of the analyst’s narcissism. Though he doesn’t spell out what manner of narcissism he means, Schafer seems to imply that analysts who behave in an overtly friendly manner are especially prone to narcissism because: a) expressions of affection are inappropriate in an analytic setting; and b) the only reason analysts are so motivated is in order to elicit the patient’s approval. Such behavior fuels the patient’s narcissism as well as the analyst’s and dilutes the experience of optimal frustration needed in order to effect psychic change. Hence Schafer concludes that the employment of neutrality serves to thwart the patient’s narcissistic impulses while keeping the analyst’s narcissism in check. I shall come back to Schafer’s characterization of neutrality later, but for now I shall turn to Moore and Fine’s (1990) compendium of analytic terms for their depiction of analytic neutrality. This book is an official publication of the American Psychoanalytic Association and serves as a reference for analytic candidates in training. They define neutrality as The stance of the analyst generally recommended for fostering the psychoanalytic process. Central to psychoanalytic neutrality are keeping the countertransference in check, avoiding the imposition of one’s own values on the patient, and taking the patient’s capacities, rather than one’s own desires as a guide… The concept also defines the recommended emotional attitude of the analyst, one of professional commitment for helpful, benign understanding that avoids extremes of detachment and over involvement.

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THE ETHIC OF HONESTY The analyst’s neutrality is intended to facilitate the development, recognition and interpretation of the transference neurosis and to minimize distortions that might be introduced if he or she attempts to educate, advise or impose values on the patient based on the analyst’s countertransference.… Avoiding the imposition of values upon the patient is an accepted aspect of psychoanalytic neutrality. However, there is increasing recognition that the analyst’s values are always operative, especially those involving the search for truth, knowledge, and understanding, and those emphasizing orientation toward reality, maturity, and change. (p. 127)

According to this definition, analysts should be especially wary of imposing even the slightest hint of their own values onto patients; yet the authors qualify this aspect of neutrality by acknowledging that the search for truth, respect for reality, and even the wish to effect change are values that all analysts necessarily “impose” on their patients as a matter of course. To summarize this view of neutrality: a) the analyst’s countertransference intrudes on his or her capacity for neutrality; b) the analyst’s values (excepting the qualifications noted above) should be concealed from one’s patient; c) the patient should set the agenda for the course of analysis, not the analyst; and d) neutrality entails an “emotional attitude” every analyst is expected to adopt, characterized by benign understanding. The necessity for qualifying the imposition of this rule is obvious. Since the goal of treatment is at least indirectly “imposed” on patients, the need to impose goals (or at least allow for their existence), even when they are not explicitly spelled out, must be exempted from neutrality in order for the treatment to unfold. Treatments without any goal whatsoever, no matter how understated those goals might be, would serve no ostensible purpose. In any case, such an arrangement would necessarily impose on patients the experience of confusion, since there would be no basis on which collaboration could be founded. Yet, by what measure are Moore and Fine prompted to reduce one’s capacity for understanding to an “emotional attitude”? Even if the capacity for understanding could be reduced to an emotion, how could it be regulated or controlled? Surely the capacity for understanding lies outside the sphere of one’s emotions and even serves as a foil to their imposition when manifested in the analyst’s countertransference. Hence, the authors fail to recognize the elasticity that was inherent in Freud’s conception of neutrality, just as they fail to note that neutrality was introduced in the first place as a means of complimenting the patient’s free associations. Schafer and Moore and Fine construe neutrality as a technique that one can apply in working with patients instead of an attitude that the analyst endeavors to adopt. The implications of this error will become clearer as we continue.

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The next reference to analytic neutrality I cite is provided by Jean Laplanche and J.-B. Pontalis (1973), in their psychoanalytic glossary, The Language of Psychoanalysis. There they suggest that neutrality is one of the defining characteristics of the attitude of the analyst during the treatment. The analyst must be neutral in respect of religious, ethical and social values—that is to say, he must not direct the treatment according to some ideal, and should abstain from counseling the patient; he must be neutral too as regards manifestations of transference (this rule usually being expressed by the maxim, “Do not play the patient’s game”); finally, he must be neutral towards the discourse of the patient.… Freud gives the clearest indication of how neutrality should be understood in his “Recommendations to Physicians Practicing Psychoanalysis” (1912b). In this paper, he castigates “therapeutic ambition” and “educative ambition” and deems it wrong to set a patient tasks, such as collecting his memories or thinking over some particular period of his life. The analyst should model himself on the surgeon, who has one aim and one aim only: “… performing the operation as skillfully as possible.” (p. 271)

Indeed, Freud’s 1912 paper offers the most exhaustive examination of neutrality he ever attempted, though he had not yet introduced the term, “neutrality,” as a technical principle at the time the paper was written.10 In fact, Freud never actually invoked the term neutrality (Neutralität in German) specifically; he used the term indifference instead. Strachey translated Freud’s original Indiferenz into neutrality in lieu of indifference because he felt the term more aptly captures what Freud intended to convey. Most authors—and I would concur—agree with Strachey’s editorial decision. Remember, however, that the word itself was of little significance to Freud and that he used it just once in all of his writings; it is only in retrospect that it has become a technical principle. However important or not the term itself may be, the paper in question was devoted almost entirely to the appropriate mental attitude (i.e., neutrality) psychoanalysts are counseled to adopt with their patients. One of only six papers on technique that were published between 1911 and 1915, Freud conceived the series as a technical manual for the clinical practice of psychoanalysis. It was the only time he endeavored to do so. Though he returned to the subject now and then during the course of his life the principal elements of what he had to say about the matter are contained in those six papers (See my critique of 10

He only introduced it three years later in the last of his technical papers. “Observations on Transference-Love” (1915), apparently the only time Freud specifically invoked it.

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Freud’s technical papers in Thompson, 1994.). “Recommendations to Physicians Practicing Psychoanalysis” is the third paper in the series. It is preceded by a brief discussion on dream interpretation (1911) and an exhaustive examination of transference published a year later (1912a), then followed by the three remaining papers—“On Beginning the Treatment” (1913), “Remembering, Repeating and Working-Through” (1914), and “Observations on Transference-Love” (1915b)—all of which share the same subtitle. Hence the “Recommendations to Physicians” paper is the anchor of the entire series and is essential for a proper understanding of the others. The paper is divided into nine parts, each pertaining to a facet of what we now call neutrality. Freud wrote the paper for the purpose of acquainting practicing analysts with an unusual form of attentiveness that entailed the employment of “evenly suspended attention,” the nature of which is probably more familiar to practitioners of Buddhist meditation than to the typical physician or scientist, or even philosopher.11 In describing the most salient features of this attitude, Freud advised analysts against striving to remember what their patients told them because, “as soon as anyone deliberately concentrates his attention to a certain degree, he begins to select from the material” instead of giving everything they say equal weight (p. 112). Besides, analysts who think they know what is important to remember and what isn’t are invariably mistaken because “the things one hears are for the most part things whose meaning is only recognized later on” (p. 112). Freud conceived this paradoxical form of attentiveness as a compliment to the fundamental rule of analysis,12 the patient’s pledge to be candid. In order to grasp the manner in which the rule on neutrality was originally conceived it is necessary to appreciate the degree to which the fundamental rule to be candid dominated Freud’s technique. Once he determined that neurotic conflicts are the consequence of repressed secrets, Freud realized that the patient’s free associations could be interpreted by the analyst in order to unearth what those secrets might be. By uttering whatever comes to mind patients inadvertently divulge clues to what their unconscious conceals. The success of this procedure, however, is incumbent on obeying the fundamental rule, the pledge to disclose one’s thoughts without censorship. As we noted in Chapter One, when patients agree to comply with this rule they effectively swear a pledge of honesty, even if their execution of this pledge is invariably imperfect. From that time forward, analytic technique was predominantly concerned with the therapeutic ramifications of instilling rapport between analyst and patient and only tangentially with determining causa11

Phenomenology being the singular exception. This was only the second time that Freud used this term; the first was in “The Dynamics of Transference,” published the same year (1912a). 12

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tion of symptoms. Once the need to instill rapport became the basis of Freud’s technique he began to examine more closely how analysts could best help their patients abide by the fundamental rule. If analysts wanted their patients to treat their (i.e., the patient’s) thoughts, feelings, and inclinations with equal weight, then the analysts themselves must treat everything that is disclosed to them in a reciprocal manner and a complementary frame of mind. Freud believed this recommendation was so central to the outcome of treatment that he claimed everything “achieved in this manner will be sufficient for all requirements during the treatment” (p. 112). The analyst’s commitment to the rule of neutrality also makes it necessary to refrain from writing notes during analytic sessions, for the simple reason that taking the time to jot them down entails a use of the mind that detracts from the free-floating attentiveness that neutrality is intended to foster. Though note taking is a habit that scientifically trained analysts are loath to abandon Freud was merciless in his insistence on this recommendation. Analysts who argue that psychoanalysis should conform to the criteria of the empirical sciences find this recommendation especially hard to swallow; indeed, most analysts are so opposed to this feature of neutrality they refuse to relinquish the opportunity to write notes at will. Yet this feature of neutrality is by no means extreme in comparison with the others. I suspect that analysts who find the admonition against writing notes repugnant are also opposed to most of the other features of neutrality that Freud describes in this paper. An unrepentant—if inconsistent—champion of science himself, Freud nevertheless dismissed the notion that psychoanalysis could ever be subjected to anything like a scientific study or report (p. 113-114). Deep down we all know scientific reports prove nothing and serve little purpose than to air the beliefs of the analysts who write them. Knowing that data can be cooked this way or that, Freud questioned why analysts should be expected to engage in such a facile game. Though an admirer of science, Freud also recognized its pitfalls and went so far as to insist that the treatment situation should be protected from the potential for abuse that academic institutions commit as a matter of course. Freud offered his most eloquent depiction of neutrality when arguing against mingling scientific standards with treatment objectives: “Cases which are devoted from the first to scientific purposes and are treated accordingly suffer in their outcome; while the most successful cases are those in which one proceeds, as it were, without any purpose in view, allows oneself to be taken by surprise by any new turn in them, and always meets them with an open mind, free from any presuppositions” (p. 114).

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Even the intention of publishing a case before the treatment was completed may contaminate the delicate balance of attentiveness and relaxation that Freud urged his fellow analysts to adopt. While he never said so, this was probably one of the lessons brought home to Freud as a consequence of his failed treatment of Dora, which he had intended to publish at the beginning of her analysis (Thompson: 1994, pp. 97-98). The point I believe he is trying to make here is that analysts need to protect themselves from knowing too much about matters that are inconsequential, by encumbering themselves with details that will only subvert their principal task: that of keeping an open mind to everything their patients tell them. Though Laplanche and Pontalis (noted above) cited therapeutic ambition as only one feature of neutrality (in Freud’s counsel to model oneself on the example of the surgeon), this recommendation is usually cited out of context and, hence, taken to mean that Freud (1912b) coldheartedly suppressed all feelings of sympathy for his patients (See Gay, 1988, p. 249; also Thompson, 1994, pp. 122-124 for more on the misinterpretations that have derived from Freud’s admonition against therapeutic ambition.). Let’s examine this recommendation in its entirety. I cannot advise my colleagues too urgently to model themselves during psychoanalytic treatment on the surgeon who puts aside all his feelings, even his human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possible. Under present day conditions, the feeling that is most dangerous to a psychoanalyst is the therapeutic ambition to achieve by this novel and much disputed method something that will produce a convincing effect upon other people. This will not only put him into a state of mind which is unfavorable for his work, but will make him helpless against certain resistances of the patient, whose recovery, as we know, primarily depends on the interplay of forces in him. The justification for requiring this emotional coldness in the analyst is that it creates the most advantageous conditions for both parties: for the doctor a desirable protection for his own emotional life and for the patient the largest amount of help that we can give him today. A surgeon of earlier times took as his motto the words, “I dressed the wounds, God cured him.” The analyst should be content with something similar. (p. 115)

Obviously, Freud’s admonition to model oneself on the surgeon assumes an altogether different connotation than the one that is customarily depicted when the rule is not read in its entirety. The so-called emotional coldness Freud is accused of is based on an incomplete reading of the text. He was simply reminding analysts that it isn’t they who perform miracles but the interplay of forces in the patients themselves, forces that are as inaccessible to manipulation (by analysts) as the will of God. In other words, if one examines the context where Freud invoked the model-of-the-surgeon analogy, he was merely steering analysts from the

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temptation of committing hubris: the wish to behave like gods who divine to shape the course of a patient’s life. One should recall that an act of hubris was the principle theme in the first part of the Oedipus trilogy that featured so prominently in Freud’s theory of neurotic conflict. Whereas the first part of the trilogy (Oedipus Rex) was devoted to the tragic circumstances of Oedipus’ downfall after ignoring the counsel of the Oracle,13 the second part of the trilogy (Oedipus at Colonus) portrayed how Oedipus, having been blinded by his own hands, finally relinquished the hubris of his youth and achieved a measure of humility. His “blindness” in the story may be construed as a metaphor for having relinquished his most precious gifts—cleverness and ambition—a preliminary step on a journey that culminates with the possibility of obtaining equanimity (i.e., neutrality). The degree of patience this entails is necessarily elusive because ambition resists our most concerted efforts to relinquish it. After all, psychoanalysts are ambitious people; they have to be in order to survive the sacrifices entailed in undertaking their training. Hence the training experience is more liable to arouse hubris than to instill humility, an observation Freud had in mind when he formulated this technical principle. By the same token educative ambitions arouse a similar measure of hubris when analysts assume that they know what their patients should do with their lives once the treatment has ended. No doubt every analyst feels disappointed now and then with the choices patients opt for when the analysis reaches its terminus. Oftentimes, they find themselves walking a thin line between inadvertently supporting a foolish decision by saying nothing or indirectly advising against an alternate course by merely questioning a patient’s motives. Maintaining silence in the analytic situation, as in life, can speak volumes and one never knows what patients read into those moments. Freud concluded that analysts inadvertently abandon neutrality when they believe they know what is good for their patients, as though blessed with a capacity for prognostication that is denied other mortals. This is a typical example of when hubris is a consequence of countertransference and the analyst is seduced by the heady role of “savior” instead of the more modest one of interlocutor. A few years later Freud (1919) elaborated on this feature of neutrality when contrasting it with one that (he thought) depicted the Zurich school.

13 The Oracle advised Oedipus to stop trying to find the answers to everything that concerned him and to simply let matters well enough alone. Oedipus, in his eagerness to prove that nothing was beyond his intellect to solve, ignored his counsel and subsequently destroyed himself by the irrepressible force of his ambition.

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We refused most emphatically to turn a patient who puts himself into our hands in search of help into our private property, to decide his fate for him, to force our own ideals upon him, and with the pride of a Creator to form him in our own image and see that it is good. I still adhere to this refusal, and I think that this is the proper place for the medical discretion which we have had to ignore in other connections. (p. 164)

Another example of neutrality may be found in the fourth paper of the series, “On Beginning the Treatment” (1913). According to Laplanche and Pontalis (1973), the development of a viable transference relationship depends entirely on the correct employment of neutrality, when they quote Freud as saying that It is certainly possible to forfeit the first success if from the start one takes up any other standpoint than one of sympathetic understanding, such as a moralizing one, or if one behaves like the representative or advocate of some contending party. (Cited in Laplanche and Pontalis, p. 271)

Let us examine this partial citation in its entirety in order to avoid any possible misunderstanding. When he wrote it, Freud (1913) was apparently concerned with a very practical matter: how early in the treatment should analysts offer interpretations? The next question with which we are faced raises a matter of principle. It is this: When are we to begin making our communications to the patient? When is the moment for disclosing to him the hidden meaning of the ideas that occur to him, and for initiating him into the postulates and technical procedures of analysis? The answer to this can only be: Not until an effective transference has been established in the patient, a proper rapport with him. It remains the first aim of the treatment to attach him to it and to the person of the doctor. To ensure this, nothing need be done but to give him time. If one exhibits a serious interest in him, carefully clears away the resistances that crop up at the beginning and avoids making certain mistakes, he will of himself form such an attachment and link the doctor up with one of the imagos of the people by whom he was accustomed to be treated with affection. It is certainly possible to forfeit this first success if from the start one takes up any standpoint other than one of sympathetic understanding, such as a moralizing one, or if one behaves like a representative or advocate of some contending party—of the other member of a married couple, for instance. (p. 139-140) [Emphasis in the original]

Freud’s characterization of sympathetic understanding as epitomizing neutrality in its essence may confuse those analysts who equate a neutral

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attitude with the so-called coldness of the surgeon, noted by Laplanche and Pontalis. The two technical recommendations, written a year apart, seem to contradict each other. In the first recommendation (1912b, p. 115) Freud emphasizes the need to withhold sympathy (in the service of neutrality), while in the second (1913, p. 140) he advocates the expression of sympathy in the form of understanding. Laplanche and Pontalis concur that an attitude of sympathy epitomizes neutrality when they cite a reference from Studies on Hysteria in which Freud (Freud and Breuer, 1895), in probably his first allusion to this principle, characterized neutrality as an attitude in which One works, to the best of one’s power, as an elucidator [Aufdlarer] (where ignorance has given rise to fear), as a teacher, as a father confessor who gives absolution, as it were, by a continuance of his sympathy and respect after the confession has been made. (p. 282)

Yet Schafer argues that the expression of sympathy diverges from neutrality when involving oneself in a patient’s domestic quarrels (see above). According to this view, if one’s patient is embroiled in an argument with a spouse, neutrality requires that the analyst should avoid “taking sides.” Repeating what Schafer (1983) said earlier, “It is particularly important to maintain his neutrality in relation to parental figures and spouses for, to some extent, the analysand is identified with them and is vulnerable to the same value judgements that may be passed on them” (p. 6). Hence, Schafer construes neutrality as an attitude that requires analysts to be opaque with their patients, to subordinate their personalities and conceal their personal opinions, not only when it seems appropriate to do so but repeatedly and throughout the course of treatment. Yet when Freud warns against adopting a moralizing tone in the recommendation just noted, he says nothing about taking no sides whatsoever. On the contrary, he advises against becoming an advocate for the contending party, such as the patient’s spouse. The idea of neutrality isn’t, strictly speaking, served by taking no sides, but by giving the impression of always being on the patient’s side, regardless of the foolishness a patient is bound to get into. Indeed, how could analysts appear to sympathize if they are noncommittal to everything about which their patients complain? The expression of sympathy—i.e., commiseration—shows that analysts are supportive of their patient’s dilemma by not insinuating a note of disapproval in response to their tribulations, however biased or confused a given patient might be. Whereas Freud construed neutrality as a vehicle for instilling rapport, Schafer conceives it as exemplifying a neutered, non-position from which analysts are forbidden to either condemn or commiserate with a patient’s prejudices. In practice, strict ad-

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herence to such a technique would be experienced by patients, not as unintrusive and benign, but as distinctly disinterested in the everydayness of their concerns—ironically, the same attitude that analysts (erroneously) attribute to Freud’s surgeon analogy! I do not believe this distinction is simply a matter of how much or how little sympathy an analyst should express at a given moment—it depicts how classical analysis is typically conceived. Why have so many analysts—the vast majority of them, it seems—had so much difficulty in understanding what the rule of neutrality was specifically intended to convey? No doubt those analysts who are not familiar with Asian philosophy or the Classical literature of the Hellenistic period will have difficulty appreciating the subtlety of Freud’s conception of neutrality. Relatively few analysts, for example recognize the affinity between neutrality and Keats’s notion of negative capability, or the phenomenological method of epoché, or Heidegger’s Gelassenheit (see Chapter Two), all of which have their respective sources in scepticism. We do not know precisely when Freud conceived neutrality or who inspired his conception of it, but just as he owed a debt of gratitude to the sceptics (by way of Michel de Montaigne) in his formulation of the free association method (See Chapter Two), he probably derived his notion of neutrality from the sceptics as well (See Thompson, 2000b, for a detailed exposition of how the sceptics influenced Freud’s psychoanalytic method.). There is an undeniably sceptical flavor to the freefloating attentiveness Freud advises analysts to adopt, epitomized by his claim that we are limited in what we can know at any given time of a patient’s treatment because any conclusions we may reach are incumbent on future developments. Freud’s emphasis on the primacy of subjective knowing—i.e., knowledge that is rooted in personal experience—over theoretical or technical instruction is consistent with a sceptical sensibility. What other aspects of Freud’s technique are consistent with a sceptical form of inquiry? The sceptics (J. Annas and J. Barnes: 1994) opposed dogmatism (the claim to know something with confidence) of every persuasion and advocated the use of epoché, the withholding of assent or dissent, or suspension of judgement, as a palliative against it. The term sceptic comes from the Greek skeptikos which means to inquire or to be thoughtful. Like the psychoanalyst today the ancient sceptics sought to inquire into the nature of their experience by abandoning prejudice and suspending one’s claim to knowledge. This entails a capacity for detachment that includes the practice of aphasia, remaining silent when tempted to offer an opinion, and apatheia, not letting our feelings get the better of us. As a method, sceptic philosophy sought to deepen the weight of experience by inquiring into the source of one’s suffering, the experience of which we tend to suppress. Hence, the sceptics were the first philosophers to organize those trends in Greek philosophy that emphasized

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subjectivity over objective knowledge. By relying on personal experience instead of adopting what others claimed to know, scepticism helped philosophers accept the intrinsic mystery of their existence with a benign form of indifference. According to Hallie (1964), “Scepticism [was] the hope of living normally and peacefully without metaphysical dogmatism or fanaticism” (p. 7). The sceptic philosophers in turn emphasized ethics, the proper way to live, over epistemology, which concerns the basis of what we claim to know. Consequently, they were more concerned with a person’s character than what he claimed to know, how that person conducted his life, and how he was said to have faced his own death. The equanimity with which Socrates, for example, accepted his death without protest was an inspiration for sceptic philosophers and exemplified the ideal to which they aspired. Hence, they saw philosophy as a form of therapy that could obtain peace of mind, or equanimity (ataraxia). Through the disciplined use of epoché, the sceptics endeavored to rid themselves of theory, opinion, and belief. Once this was accomplished they claimed it was possible to elicit a state of equanimity, which has been depicted as openmindedness, gentleness, and openheartedness. Like the psychoanalyst, the sceptics refrained from assuming a position of their own and endeavored instead to expose contradictions that were inherent in the other person’s belief system. It wasn’t that the sceptics were necessarily opposed to entertaining claims to knowledge in principle; they even acknowledged that theory, if assigned its proper context, could be useful because it was necessary to learn theory in order to overcome it. They argued instead that since no one can ever know what the truth is, it is impossible to predict whether a course of action will culminate in success or failure. One can’t even be certain, they argued, what success or failure are comprised of. But even if one were able to determine what success entails, the Sceptics countered that failure is oftentimes a prelude to success and that success, if it occurs, is fleeting, so the quest for equanimity could never rely on such a standard. More importantly, in order to practice epoché (or neutrality) effectively, analysts need to genuinely harbor no opinion. If they entertain opinions but conceal them they risk becoming devious in a manner that violates the spirit of openness that neutrality is intended to foster. Freud believed it is better to have things out in the open and deal with the consequences later than to systematically conceal our beliefs from our patients. Neutrality serves to complement the fundamental rule by imploring both parties, patient and analyst alike, to put their cards on the table and to play their hands as candidly as possible. The reason this requires such discipline is that analytic patients demand answers and

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assume their analysts must have them. The only defense analysts ultimately have against providing such answers, on the one hand, or concealing them, on the other is to genuinely have no answer in mind. From the perspective of neutrality the analyst essentially empties his or mind of the chatter with which it is typically consumed and simply listens to what patients say, instead. This entails the discipline of notknowing (in contradistinction to knowing), a feature of the analytic relationship that in consistently rejected in most training schemes. Another impediment to determining what Freud’s notion of neutrality entails is its relation to abstinence—the effort entailed in resisting a patient’s demand for love. Though separate concepts, many analysts equate the two as identical while others, such as Laplanche and Pontalis (1973) characterize abstinence as, “a simple consequence of neutrality” (p. 3), implying a kinship that can be misleading. Adding to the confusion, Freud never bothered to provide definitions for either term, the consequence of a writing style that preferred to allow the context in which terms were invoked to suggest their meaning. Further, though the “Recommendations to Physicians” paper was devoted entirely to the rules of neutrality and abstinence, it was written three years before these technical principles were even added to his technical nomenclature. Freud also had the habit of weaving a discussion of one concept into his treatment of the other, but without saying so. For example, in the analyst-as-surgeon analogy where Freud (1912b) admonishes analysts to “put aside all [their] feelings, even human sympathy” (p. 115), he is actually invoking abstinence, not the rule of neutrality. Then, in the very next sentence where he warns “the feeling that is most dangerous to a psychoanalyst is the therapeutic ambition to achieve… something that will produce a convincing effect upon other people,” he is invoking the rule of neutrality. Hence, the subtle distinction that inheres between the fundamental rule and free association is also repeated when comparing neutrality with abstinence. Due to the confusion that persists about the two concepts, the prevalent view of neutrality is rooted in the (erroneous) assumption that it entails keeping the analysts’ affect in check. In fact, neutrality isn’t specifically concerned with affect but with the way analysts divide their attention during the analytic hour, which is to say, with the analysts’ state of mind and the manner by which they bring their thoughts to bear on what their patients confide. Feelings enter the picture only when they serve to inhibit the analyst’s capacity to maintain a neutral attitude, prompted by the analyst’s countertransference. On the other hand, abstinence is concerned with the analyst’s affect, but not in the manner that Schafer’s notion of subordinating the personality implies. Instead, the rule of abstinence pertains exclusively to those feelings that prompt analysts to behave seductively. Nothing in Freud’s conception of neutrality or abstinence calls for analysts to subordinate

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their personalities in the sense of disguising their feelings about the things their patients say to them.14 The expression of anger, impatience, disappointment, irritation, and concern are tangential to the rule of abstinence and even to the rule of neutrality. Hence, one of the principal myths about neutrality is that it requires one to adopt an affect-less attitude, most likely because it is virtually impossible to do so. Another reason the distinction between neutrality and abstinence has become so muddled over time is because both terms were introduced in the same paper, “Observations on Transference-Love” (1915b), only a few sentences apart. There, Freud endeavored to help analysts cope with the incredible demands their patients exact during the course of treatment. But the nature of such demands is actually quite narrow, because it entails the sometimes explosive and inherently unpredictable erotic longings that patients transfer onto their analysts. The startling incidence of these phenomena led Freud to conjecture that transference feelings are instigated by one’s unfulfilled longing for love which crop up in the course of analysis as they do in all our other relationships. What sets analytic transference feelings apart from non-analytic ones is that in the former analysts aren’t in a position to relieve their frustration yet, by the same token, mustn’t allow themselves to be indifferent to them when they arise. While analysts mustn’t make it their business to satisfy such longings, neither should they play their hands too closely to their chest. That being said, it isn’t so easy to grapple with the demands every analyst encounters, since it requires an inordinate measure of authority and tact to fulfill one’s role without guile or manipulation. Some analysts, Freud learned, resorted to lecturing their patients that it would simply be “wrong” to return their patients’ love and hoped that this awkward prohibition would put an end to the matter. Others took the opposite tack and insisted that their patients were somehow obligated to fall in love with them as a feature of their transference neurosis. Some even encouraged their patients to fall in love at the beginning of their treatment, as though such feelings could be manufactured on command! Freud countered that either extreme breaches neutrality because it violates the ethical standard on which analytic relationships are supposed to be founded. If analysts expect their patients to comply with the fundamental rule of analysis—to bare all without censorship—they, in turn, must learn to accept the entire range of their patients’ experience without falling prey to manipulation, no matter how trying or tiresome it becomes. 14

Indeed, contemporary analysts increasingly advocate the need to disclose their countertransference reactions with patients instead of concealing them. I shall address this question more thoroughly in Chapter Six.

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Why did Freud choose this paper specifically to finally designate neutrality (actually, indifference) as a technical term when previously it was simply implied? What was it about the patient’s erotic demands that prompted him to devote another paper to a technical principle he had treated at length already (1912b)? Freud was apparently startled by the degree of duplicity that some analysts engaged in when confronted with their patients’ transference behavior, not unlike the startled reaction of Joseph Breuer to Anna O.’s declaration that he had fathered her child!15 Indeed, it wasn’t long after that famous treatment (circa 1882) that Freud replaced hypnosis with the free association method. The unprecedented innovation of speaking spontaneously without reservation suddenly gave neurotic patients the responsibility for serving as authors of their destiny instead of feeling victimized by it. It wasn’t until later, however (in 1912), that Freud introduced the fundamental rule of analysis. As we noted in Chapter One, the fundamental rule is not identical with free association but complements it (See Thompson, 1994, pp. 155-174 for more on this.). Though we have treated this problem in some detail already, I shall briefly summarize the salient points of the matter to emphasize its relevance to neutrality. The following year (1913) Freud turned to how the two rules should be distinguished from each other (pp. 134-135). Whereas free association is a form of communication in which patients utter whatever thoughts come to mind, the fundamental rule is the patient’s pledge to verbalize such thoughts without censorship. The imposition of this rule—the only one, Freud (1913) says, that patients are asked to follow (p. 134)—confirms that analytic treatment is rooted in a commitment to honesty. This commitment, however, applies to analysts as well; otherwise patients would lose their respect for what amounts to a double standard. Freud was sensitive to and increasingly wary of the standard of morality practiced by society in general and the casual duplicity that the public expected from their physicians, specifically. This was the context in which Freud conceived the ethical standard that analysts were subsequently admonished to follow. Some analysts apparently wondered what was the ostensible harm in bending the truth just a little for the sake of expediency; why, others wondered, should they be expected to restrict themselves to the same rule as their patients when it wasn’t they, after all, who needed treatment? In a similar vein, what would be the harm, they rationalized, in giving their patients the love they craved initially, then slowly wean them off it when they become more independent? Freud’s (1915b) reaction to such rationales for duplicity was typically blunt.

15

Breuer summarily broke off the treatment for fear he would lose self-control.

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My objection to this expedient is that psychoanalytic treatment is founded on truthfulness. In this fact lies a great part of its educative effect and its ethical value. It is dangerous to depart from this foundation. Anyone who has become saturated in the analytic technique will no longer be able to make use of the lies and pretenses which doctors normally find unavoidable; and if, with the best intentions, he does attempt to do so, he is very likely to betray himself. Since we demand strict truthfulness from our patients we jeopardize our whole authority if we let ourselves be caught out by them in a departure from the truth. (p. 164)

This was the context in which Freud finally alluded to a specific term that acknowledged the critical importance of honesty and the respect for truth that became a cardinal principle of the analytic experience: Besides, the experiment of letting oneself go a little way in tender feelings for the patient is not altogether without danger. Our control over ourselves is not so complete that we may not suddenly one day go further than we had intended. In my opinion, therefore, we ought not to give up the neutrality (Indiferenz) towards the patient, which we have acquired through keeping the counter-transference in check. (pp. 163-164)

Having now invoked neutrality for the first time, Freud then compares it with its closely related cousin, the rule of abstinence. If analysts treat their patients honestly and keep an open mind to everything they say, they will eventually unleash in those patients a newfound freedom that elicits even greater demands. Indeed, analysts may err in behaving too openly by leading their patients to surmise that their uncompromising acceptance of everything they fantasize about (including the analyst) is silently encouraged, if not actually courted. Patients may conclude that their analysts are secretly in love with them and, armed with this newfound source of gratification, their motivation to change will be compromised accordingly. This is the principal reason why, says Freud, “The treatment must be carried out in abstinence… I shall state it as a fundamental principle that the patient’s need and longing should be allowed to persist in her, in order that they may serve as forces impelling her to do work and to make changes, and that we must beware of appeasing those forces by means of surrogates” (p. 165). One of the reasons, then, for introducing the rule of abstinence was to compensate for the unavoidable consequences of neutrality. Some patients hoped to substitute their analyst’s intended role as elucidator with the more pleasing one of lover or intimate. Freud treated these developments as axiomatic of the patient’s resistance to treatment and in-

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troduced abstinence as a prophylactic against inadvertently succumbing to seduction. Hence abstinence entails moderation of how much openness (neutrality or indifference) analysts should employ, depending on the situation. Abstinence also serves as an insurance against expressing more sympathy than is prudent. Though Laplanche and Pontalis depict abstinence as a subsidiary of neutrality, abstinence often serves as a foil to neutrality, and vice versa. Since the essence of neutrality is rooted in openmindedness patients frequently construe it as a demonstration of the analyst’s love. In the transference this is taken personally as though intended for that patient alone. On the other hand, when analysts withhold sympathy for fear of encouraging erotic fantasies they risk inhibiting those aspects of the transference that encourage patients to engage in the necessary work, epitomized by their capacity for candor. How can analysts be expected to reconcile the seemingly irreconcilable contradiction between the rules of neutrality and abstinence? The answer is surprisingly simple, though not so easy to execute. Contrary to the impression given by Schafer, neutrality was never intended to be employed universally, at every moment of one’s analysis. Instead, it is applied with discretion, depending on the issues at play with each patient. Recall that the rule of neutrality is intended to help the analyst adopt an uncommon degree of openmindedness toward the patient’s experience in all its variety and device. Whereas the rule of abstinence admonishes analysts to hold their feelings in check, neutrality serves as a corrective against becoming excessively clever, manipulative, coercive, deceptive, therapeutically ambitious, or authoritarian. On the other hand, neutrality may be carried too far. Were it feasible for analysts to engage in neutrality full-bore—an impossibility—their role would be relegated to playing the part of a permissive patron. Patients would interpret their inactivity as a sign of implicit agreement to everything they say and the analysis would lose its tension. This is why neutrality needs to be employed selectively. Moreover, analysts already do this without knowing it. For example, analysts often breach neutrality when they offer interpretations. While at its most benign level interpretations are intended to gently undermine the patient’s dogmatic assumptions, when carried to extremes they may hinder the patient’s capacity to question their assumptions and even encourage patients to replace their own assumptions with those of the analyst. This dilemma has prompted some analysts to dispense with interpretations entirely, but Freud warned against taking this strategy to extremes by ignoring common sense. In his “Recommendations to Physicians” paper (1912b) he advocated alternating a neutral frame of mind with an ordinary one, by “swinging over according to need from the one mental attitude to the other” (p. 114). Moreover, some aspects of neutrality are inherently more universal than others. For example, the admonition against therapeutic ambition should be applied in all cases at all times

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because it isn’t the analyst’s role to guide the treatment but the patients. This entails a capacity for openmindedness that less a technique than a capacity analysts must endeavor to cultivate over time. Virtually all the other aspects of neutrality are employed selectively, depending on the circumstances of the case in point. The same principle applies to the rule of abstinence. Some patients, for example, may require a great deal of abstinence whereas others may benefit from considerably less (See my discussion of Freud’s employment of neutrality with the Rat Man in Thompson, 1994, pp. 230-240.). Freud’s analysis of the Rat Man is an apt example of how neutrality and abstinence were typically alternated in his clinical technique. Recent conceptions of neutrality have diverged so markedly from Freud’s that he is now criticized for not having exercised even more neutrality than he customarily employed. Freud, for example, shared a number of activities with the Rat Man that many analysts today criticize, such as sending his patient a post card while (Freud was) on holiday, loaning him a book, asking to see photographs of his girlfriend, and even offering to feed him a meal during the course of a session (Thompson: 1994, pp. 205-240). Langs (in Kanzer and Glenn [Eds.],1980) reflects the opinion of a large number of analysts when he suggests that Freud’s behavior deviated from strict analytic neutrality (pp. 215-216). He even argues that Freud’s display of sympathy and concern “endangered” the analytic frame by narcissistically gratifying his patient (p. 227). Mahony (1986) concurs with Langs’ view and adds that Freud was “frequently intrusive [and] reassuring,” talked too much, and was even “aggressively helpful” (p. 90). Some of Freud’s critics condemn the paucity of transference interpretations in virtually all of his published cases, including that of the Rat Man. Gill (1982) suggests that the preponderance of genetic interpretations over transferential ones, compounded by the short duration of his analytic cases, culminated in a superficial treatment experience by contemporary standards. Together, these criticisms paint a portrait of Freud as a clinician who: a) failed to attend to the unconscious dynamics of the patient’s current situation; b) breached analytic neutrality with acts of systematic over involvement; and c) preferred to investigate the underlying causes of neurotic conflict rather than with helping patients work through their transference neurosis. Virtually all of these criticisms, however, are based on the notion that neutrality is designed to promote an experience of deprivation in the treatment situation whereas Freud portrayed neutrality as a technical principle that was rooted in noninterference (Lipton, 1977). Freud never suggested that neutrality should

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serve as a vehicle for withholding gratification specifically.16 Instead, he conceived of neutrality as a means for facilitating rapport. From this perspective, Freud’s treatment of the Rat Man is an excellent example of how neutrality (and abstinence) should be employed with analytic patients. At a critical point in the Rat Man’s analysis he suddenly turned against Freud in a moment of fury and accused him of plotting to marry him off to his daughter, Anna. Shocked by his own outburst, the Rat Man became worried that Freud would retaliate by terminating the treatment. A tense period ensued during which Freud neither denied the Rat Man’s accusations nor interpreted their content; instead, he remained noncommittal, yet vitally interested in what might account for his patient’s accusations. Many analysts would have simply interpreted the Rat Man’s negative transference in order to ease the intensity of the situation. By suggesting that the patient’s feelings don’t, in fact, pertain to them (the analyst) personally, they endeavor to nullify the patient’s aggression while insuring the continuation of the treatment. In light of conventional standards, it is remarkable that Freud chose to say nothing. It should be remembered, however, that he had said nothing earlier to encourage the manifestation of his patient’s negative transference (in the manner that abstinence is currently employed) nor, once it became manifest, did he say anything to discourage it. Freud maintained a position of neutrality by: a) bearing witness to his patient’s feelings while considering them with an open mind; b) not seeking to “interpret away” the power of the moment because it happened to make him uncomfortable; and c) giving the situation more time, thus permitting his patient to come to terms with his feelings himself. This incident and Freud’s handling of it proved to be pivotal; the Rat Man’s symptoms subsequently abated and the treatment was terminated. What can be concluded about Freud’s conception of neutrality based on his handling of the Rat Man’s transference reaction? I believe the most significant feature of Freud’s behavior was that he offered no interpretations. Indeed, Freud seldom offered transference interpretations but he never said why. Drawing from the comments that he made about the way neutrality should be employed, however, one can assume he suspected that transference interpretations bear the risk of encouraging patients to intellectualize their feelings instead of working through them. Many analysts feel relieved when their patients demonstrate some understanding about the nature of their aggression, presumably because such “insight” may prevent them from holding the analyst accountable. If this stratagem is employed excessively, however, the treatment may be 16

It is likely that Freud’s critics have confused neutrality with the rule of abstinence here, though even if this were the case it doesn’t alter how these technical principles were conceived by Freud in the first place.

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reduced to little more than an intellectual catalogue of why patients feel this or that, but with no alteration to the underlying structure of their conflicts. Freud favored genetic interpretations over transference ones because they help to educate patients about the role unconscious forces play in their behavior. While genetic interpretations are just as liable to breach neutrality as transferential ones, Freud apparently felt they were less likely to inhibit one’s ability to work through the transference neurosis while abiding by the fundamental rule (See Thompson, 1994, pp. 192-204 for more on working through; see also Chapter Eight below.). If anything, Freud’s gestures of friendship with his patients facilitated the spirit of openness that neutrality is intended to foster (see Chapter Five, below). Besides, Freud was inordinately friendly with his patients and even socialized with those who became colleagues. The “extraanalytic” examples of Freud’s behavior that his critics accuse him of committing were not uncommon, and it is well documented that he was unusually amiable and talkative with his patients as a rule, especially when measured by conventional standards (Lipton, 1977). Haynal (1989) quotes numerous examples from former patients who reported that Freud engaged in straightforward dialogues with them, and Racker (1968, pp. 34-35) was obliged to conclude that if neutrality is supposed to impose limitations on how much analysts should say, Freud was most certainly not a classically neutral analyst, not by the standard of so-called classical technique that has evolved since Freud (For more on how the current depiction of “classical” analytic technique diverges from Freud’s see Thompson, 1994; and Lipton, 1977.). Whatever neutrality is intended to foster it was never meant to prohibit analysts from simply being themselves. One should bear in mind that neutrality is not really a technique in the narrow sense but a state of mind whose goal is to further rapport. Knowledge is inherently mysterious, ambiguous, and inexact; we can approximate it but never know it precisely. By suspending judgment about the nature of what is happening around and within ourselves, we become more wary of our assertions and less invested in proving they are correct. The sceptics concluded that the only truths we ever know are derived from personal experience, so they are subject to revision because our experience is constantly changing. This can prove unnerving to some because life always takes them by surprise and they can never be sure of the outcome. When the unexpected occurs they may try to escape their experience by seizing on objective truths instead. Once adopted, however, such “truths” only alienate them from their experience even more, further engendering psychic conflict. This, the sceptics argued, is the source of our mental anguish—to be divorced from the primacy of one’s experience while searching ever further afield for a truth that is ultimately unknow-

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able. If anything, the possibility of obtaining equanimity is only compromised further when we use knowledge to serve as a buttress against the inevitable suffering our experience engenders. Unfortunately, this tendency is only compounded by those analysts who employ interpretation as a ploy to “translate” their patient’s experience into a ready-made theory instead of helping patients overcome their search for answers, in principle. Despite his allegiance to science, Freud’s vision of human existence was a sceptical one that places him in a tradition of philosophers that reaches back more than two thousand years. Its basis is simple but its means are necessarily inexact. By keeping an open mind to what one’s patients have to say, analysts can help them obtain at least a measure of relief from mental anguish and worry. If patients are expected to be truthful about the particulars of their experience then analysts need to open their minds to what those experiences are. Freud suggested that the most reliable means of doing so was by “keeping the countertransference in check,” but what does that entail? If analysts hope to employ neutrality with a measure of flexibility and common sense then they need to have mastered the task of applying some neutrality to themselves. Their own experience of analysis and self-analysis should have fostered the wherewithal to accept their own idiosyncrasies, limitations, jealousies, fears, and anxieties, in effect, the totality of the person they have become. If they are unable to do so, or worse, they discover they are at odds with themselves and compensate by suppressing the weight of their own experience, they will probably impose the same grief onto their patients, no matter what kind of training they experienced. Like free association, neutrality is a form of meditation. It engenders a form of attentiveness that is accepting of how we situate ourselves in the world. It entails nothing more convoluted than learning how to be honest with ourselves and with the world. That is why Freud’s conception of neutrality is not just a technique because it entails our manner of being. The dialectic of analytic knowledge—when the analyst knows to say something and when to let others do the talking—engenders a sense of give that is inherent in Freud’s treatment philosophy. He knew that psychoanalysis could never be perfect because its concern is with human frailty. It instills a capacity for non-intervention in the face of insurmountable pressures to do something. It is perhaps paradoxical that doing nothing would be the preferred means for the task of effecting change. That is why the efficacy of analysis can never be measured by determining how much neutrality to employ or how little, but by knowing when it is prudent to be neutral and when to take a position.

Four

The Rule of Abstinence

Having differentiated the fundamental rule of psychoanalysis from free association in Chapter One, and the rule of neutrality from abstinence in Chapter Three, I shall now return to the rule of abstinence to examine in greater detail the logic underpinning this technical principle. In A Critical Dictionary of Psychoanalysis, Rycroft (1968) describes the rule of abstinence as One of the rules of psychoanalytical technique… though it is not clear what the patient should be made to abstain from. In Freud (1915b) the phrase, “The treatment must be carried out in abstinence,” refers specifically to the fact that “analytical technique requires of the physician that he should deny to the patient who is craving for love the satisfaction she demands.” (In Rycroft, p. 1)

Rycroft adds that four years later Freud amended his earlier, comparatively passive, depiction of abstinence with the suggestion that analysts need to play a more active part in the observance of this technical principle than was previously foreseen in order to mitigate the gratification that patients are wont to derive from their treatment experience. Quoting Freud, Rycroft continues, “If, owing to the symptoms having been taken apart and having lost their value, his [the patient’s] suffering becomes mitigated, we must reinstate it elsewhere in the form of appreciable privation; otherwise we run the danger of never achieving any improvements except quite insignificant and transitory ones” (In Rycroft, p. 1 [Emphasis added]). The earlier definition suggests a relatively conservative role on the part of the analyst whereas the later one employs a more active role. Both definitions are intended to instill (in the analyst) an attitude that is founded on principles that are unique to psychoanalysis—that the delay of gratification is essential to this perspective and that without it the treatment experience would be diluted, if not entirely ineffectual. Insofar as Freud introduced this principle in order to distinguish psychoanalysis from suggestive (and, hence, more gratifying) treatment modalities, it is also a distinguishing feature of Freud’s treatment philosophy in particular when compared with subsequent modifications in psychoanalytic tech-

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nique. My purpose in this chapter is not to defend the rule of abstinence, but to explore Freud’s rationale for introducing this technical principle and in order to distinguish its role from that of neutrality. To begin, I shall review how the rule of abstinence is typically depicted in the psychoanalytic literature and then compare and contrast those depictions with Freud’s characterization of this technical recommendation. According to Greenson (1967): Freud (1915b) made the important recommendation that the treatment should be carried out, as far as possible, with the patient in a state of abstinence… The patient’s symptoms, which drove him into treatment, consist in part of warded-off instincts seeking satisfaction. These instinctual impulses will turn to the analyst and the analytic situation as long as the analyst consistently avoids offering the patient substitute gratifications. The prolonged frustration will induce the patient to regress, so that his entire neurosis will be re-experienced in the transference. (pp. 275-276)

Greenson believes that the rule of abstinence forbids the analyst from unnecessarily gratifying the patient both in as well as outside of the treatment setting, because to do so “[would] rob the patient of his neurotic suffering and his motivations to continue treatment” (p. 276). Greenson continues: Analysts who behave toward their patients with a constant open warmth and emotional responsiveness will find that their patients tend to react with a prolonged positive and submissive transference. The patients of these analysts will have difficulty in permitting themselves to develop a negative, hostile transference.… The transference gratifications they receive from their warmhearted analysts prolong their dependency on such supplies of satisfaction and make them ward off the negative transference. (p. 276)

“Warmhearted” analysts, Greenson suggests, miss the purpose of analytic treatment, which (according to Greenson) serves to remind their patients why they sought treatment in the first place and guards against inadvertently relieving them of their suffering prematurely. Since gratification lurks at every turn the unwary analyst may unwittingly serve as a collusive agent in the patient’s ceaseless quest for satisfaction. Greenson continues, There are other forms of transference gratification and provocation which can arise from the analyst’s unconscious wish to be the guide, mentor, or parent of the patient. This usually leads the analyst to give advice, to make small talk, to be excessively reassuring, or to be overconcerned. (p. 277)

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Greenson concludes that supportive gestures fly in the face of strict analytic behavior, although it is not clear how one is supposed to measure the point at which the analyst’s expression of concern would begin to violate Greenson’s understanding of this technical principle. It is important to realize that the way the classical psychoanalyst handles the relationship between the patient and himself is both unique and artificial and runs counter to the way human beings usually relate to one another. It is a tilted and uneven relationship in that the patient is expected to let himself feel and express all of his innermost emotions, impulses, and fantasies while the analyst remains a relatively anonymous figure. (p. 278)

Apparently, Greenson regards the role of abstinence as the mutative element of the analytic treatment par excellance. By it, the analyst achieves his or her objective by inducing an “artificial” relationship. By deliberately inducing frustration in the patient, the analyst is able to cause a state of regression whose manifestation is subsequently analyzed and theoretically worked through. Though Greenson allows that analysts should always take pains to guard against excessive detachment and unresponsiveness, he nevertheless insists that abstinence, however much or little is employed, remains the sine qua non of the psychoanalytic treatment experience. As we shall see, this is a markedly different emphasis than the one Freud employed in his technical recommendations. Approaching this topic from a more ambiguous perspective, Laplanche and Pontalis (1967) propose that abstinence is the rule [A]ccording to which the analytic treatment should be so organized as to ensure that the patient finds as few substitutive satisfactions for his symptoms as possible. The implication for the analyst is that he should refuse on principle to satisfy the patient’s demands and to fulfil the roles which the patient tends to impose upon him. In certain cases, and at certain moments during the treatment, the rule of abstinence may be given explicit expression in the form of advice about the patient’s repetitive behavior which is hindering the work of recollection and the working out. (pp. 2-3)

Laplanche and Pontalis caution, however, that the rule of abstinence, though essential to psychoanalytic principles, is a controversial feature of psychoanalytic technique that has engendered considerable debate among analysts. Hence they suggest it is important to draw a distinction, “between abstinence as a rule to be followed by the analyst … and those active measures which he takes in order to get the patient to abstain from certain things of his [i.e., the patient’s] own accord” (p. 3). Laplanche and Pontalis note that the use of interpretations is the

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principle vehicle of abstinence, especially when they are repeated so often that they assume the character of an injunction. In contrast to Greenson, Laplanche and Pontalis argue that employing interpretations in the service of abstinence necessarily breaches neutrality. This is the reason why, “the majority of analysts have serious reservations about recourse to active measures of this type—notably on the grounds that in this way the analyst may with justice be accused of expressing repressive authority” (p. 3). As we noted in Chapter Three, Freud introduced the rule of abstinence in his “Recommendations to Physicians Practicing Psychoanalysis” (1912b) when discussing his analyst-as-surgeon analogy (pp. 17-18), but it wasn’t until three years later, in “Observations on Transference-Love” (1915b), that he actually invoked the technical term (abstinenz) that depicts this principle for the first time. This brief but instructive passage as the most exhaustive statement Freud ever offered on the subject: The treatment must be carried out in abstinence. By this I do not mean physical abstinence alone, nor yet the deprivation of everything that the patient desires, for perhaps no sick person could tolerate this. Instead, I shall state it as a fundamental principle that the patient’s need and longing should be allowed to persist in her, in order that they may serve as forces impelling her to do work and to make changes, and that we must beware of appeasing those forces by means of surrogates. (p. 165)

A principal feature of Freud’s characterization of abstinence is the view that analysts should not adopt any role other than one of a surrogate, and that the love felt for the analyst, though genuine as far as the patient’s experience of it (see Chapter Five, below), was nonetheless artificially contrived by virtue of the rarefied nature of the therapy relationship. In Freud’s view, patients typically feel love at one time or other their analysts due to the unnatural unusual) effects of the analyst’s use of neutrality. But even when the analyst’s neutrality (i.e., non-judgemental attitude) is experienced by patients as a sign of benevolence and even forgiveness for sins committed, the implications that patients are prone to make of such experience are inflated due to the privation that many patients have suffered in their lives. Thus the imbalance of the analytic relationship is not unlike that of a parent and child. Like a parent, analysts should be wary of succumbing to the view that the patients’ positive transference for the analyst is sufficient as a means for overcoming their conflicts. Freud argued that because analytic patients are neurotic, or worse, they are virtually incapable of deriving real or lasting satisfaction from the attachment they form to the analyst. He points out that because the transference is rooted in the patient’s expectation of an eventual reward, the patient should never be encouraged to expect such a reward will

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ever be granted. It goes without saying that no matter how much a patient may wish it, the analyst can never become the patient’s lover, comrade, or benefactor, any more than one’s parents would be expected to assume such a role for their children. The shock of the inevitable disappointment patients typically suffer offers an opportunity, but obviously no guarantee, for a psychical alteration in the patient’s neurotic fantasies by abandoning the essentially passive quest for the analyst’s favor and substituting a more serviceable alternative in its place. There are compelling reasons why the analyst needs to be cautious with each patient’s expectations of what psychoanalysis can be expected to offer, and what it cannot. If a patient, for example, believes that her17 love for her analyst will some day be returned, she will find the isolation that her neurotic conflicts impose on her momentarily relieved in proportion to the power of her attachment to the analyst. The neurotic is already accustomed to such wanting because she has been waiting for something like this to happen all her life. If given some encouragement she may be willing to wait a lifetime for the analyst to finally fulfill the role of benefactor to her deprivation. Meanwhile, the treatment has been dissipated by such fantasies (often unadmitted) and the progress of therapy is impeded accordingly. Besides, says Freud, “ethical motives unite with the technical ones to restrain [the analyst] from giving the patient his love” (p. 169). But even when one’s ethics allow a measure of latitude (despite his counsel Freud was affectionate with his patients compared with contemporary standards), this technical principle should help to guide the analyst through this inherently difficult course. With a note of irony, Freud cautions that The aim [the analyst] has to keep in view is that this woman, whose capacity for love is impaired by infantile fixations, should gain free command over a function which is of such inestimable importance to her; that she should not, however, dissipate it in the treatment, but keep it ready for the time when, after her treatment, the demands of real life make themselves felt. He must not stage the scene of a dograce in which the prize was to be a garland of sausages but which some humorist spoilt by throwing a single sausage on to the track. The result was, of course, that the dogs threw themselves upon it and forgot all about the race and about the garland that was luring them to victory in the far distance. (p. 169)

17

Freud frequently uses the feminine pronoun when speaking about his patients. When appropriate I have retained this custom to avoid grammatical confusion when citing relevant passages from Freud’s commentary.

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Naturally, there is no guarantee that however circumspect or proper the analyst behaves the outcome will be a desirable one. The employment of privation is necessarily inexact and the effects are always unpredictable. No analyst ever knows the full impact of such measures, even when patients complain about them. Whereas some analysts (such as Greenson) employ abstinence so excessively that the absence of complaint is cause for concern, Freud walked a narrow line between the expression of sympathy on the one hand and employment of abstinence on the other. He concluded that a positive, even friendly treatment experience is quite serviceable, depending on the specific needs of each patient. That being said, psychoanalytic treatment was never intended to provide satisfaction in the conventional sense but to enhance the patient’s capacity for bearing hardship, thus learning something of value from the disappointments and frustrations suffered. If the patient hopes to genuinely benefit from what the treatment has to offer, says Freud, then the patient, “has to learn from [the analyst] to overcome the pleasure principle, [and] to give up a satisfaction which lies to hand but is socially not acceptable, in favor of a more distant one, [but] which is perhaps altogether uncertain” (p. 170). Perhaps the most illuminating example in Freud’s depiction of this technical principle can be gleaned from the garland of sausages analogy. Although abstinence is intended to induce privation, Freud cautioned that excessive deprivation could be dangerous because no one can be expected to tolerate it. Besides, even if patients are so guilt-ridden they readily endure such deprivation with minimal complaint, it is unlikely that the effects of such hardship would be therapeutic. Patients, no matter how much they suffer in their treatment, should be led to assume that something beneficial would eventually happen because of their privation. But what type of reward should they be allowed to expect? Not a sexual one, to be sure, nor even an intellectual one, or one rooted in fantasy, for these are precisely the kinds of reward that neurotics typically thrive on. Freud suggested that the love patients feel for their analyst (embodied in the transference neurosis) is all that they can realistically expect to derive from their analyst, because what they can expect to derive is limited to just a “taste” of what may be obtained after the treatment is terminated —with someone else. Whereas Greenson and other so-called classical analysts view deprivation as the springboard from which psychical change is fostered, Freud cautioned against such stringent measures because they are liable to produce interminable analyses, the opposite conclusion from Greenson’s! The examples of abstinence we have noted so far are inherently passive in nature because they refer less to what analysts impose on patients than what they withhold. Three years after he addressed this issue in the transference-love paper (1915b), Freud returned to the subject in an address he presented before the Fifth International Psycho-Analytical

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Congress in Budapest, in September 1918 (subsequently published as “Lines of Advance in Psycho-Analytic Therapy” [1919]). Inspired by Ferenczi’s experiments with technique (which Freud had initially supported), Freud used this occasion to broach the feasibility of more active interventions. Freud allowed that virtually any use of interpretation is essentially an active measure whose efficacy is justified as an aid in thwarting (or at any rate understanding the nature of) the patient’s unconscious gain from his or her symptoms. If the relative absence of the analyst’s use of interpretation is experienced by patients as gratifying then their liberal employment should be expected to elicit the opposite effect. Recall that the symptom is a substitutive form of gratification that becomes manifest when genuine satisfaction is unavailable. Whenever the analyst interprets a patient’s symptoms as comprising an unconscious source of gratification then the patient’s gain from such symptoms should be compromised. Most interpretations, whether they are in the form of genetic, transference, or resistance interpretations, are supposed to serve a single purpose: to thwart the (unconscious) gain patients derive from their symptomatology or from their (transference) relationship with the analyst. That is why the use of interpretation is essentially a means of instilling abstinence in the patient’s treatment experience: Interpretation is essentially a tool of abstinence. Every analyst learns to modulate the amount of abstinence to employ in a given case, depending on the patient in question, and the degree to which the analyst deems is warranted, according to the analyst’s conception of what transference entails. Therefore, Freud’s views about abstinence are meaningless until situated in the context in which his conception of transference arose. Freud’s views about transference were, in turn, derived from his conception of human nature. What, then, were Freud’s views about human nature and how can they help us understand the role that abstinence properly serves? Briefly, Freud saw human existence on a continuum between the search for pleasure on one end and the experience of disappointment on the other. Thus people must learn to live with their most primitive needs, the consequence of which suggest that they will remain, for however long they may live, at their mercy. In Freud’s estimation, our needs conspire to pivot around the experience of unrequited love, initiated in infancy and repeated throughout one’s existence. Escape is impossible because the anxieties manifested by one’s longing and the ineradicable conditions that prompt it are hardly understood and, as far as we know, never will be. Though we seek to relieve our frustrations at every turn, our efforts to minimize them often exacerbate them even further. Thus the work of analysis should serve to increase rather than diminish the conditions that manifest our anxieties in the first place, by bringing the patient closer to the

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object of desire but without satisfying it. This continuum of agony, anxiety, and momentary relief in turn organizes the interpersonal relationship between analyst and patient in the form of the transference neurosis. If one disagrees with Freud’s stoic characterization of human existence and what it suggests about the nature of suffering then his recommendations about the employment of abstinence will undoubtedly seem unnecessarily harsh or misguided, and a relic of an outdated, authoritarian era. One of the principal features, for example, of contemporary relational theory is the rejection of the transference neurosis and a softening of the analyst-patient relationship. Indeed, the very concept of abstinence has become a casualty of the endeavor to give Freud’s treatment philosophy a kinder and more “postmodern” cast. Yet these developments are neither new nor inherently postmodern. Analysts have debated a similar softening of the analytic relationship as least as early as Ferenczi who is even championed by some as having anticipated the postmodern turn in contemporary culture. In fact, the surgeon analogy that Freud employs in order to elucidate the handling of abstinence and the air of detachment analysts are advised to adopt is probably based on a model of the scientist singlemindedly devoted to the task at hand. No doubt some of Freud’s detractors see in this model not someone to be admired but, on the contrary, closer to the image of the unrepentant scientist who was a creature of the Enlightenment, an era when intellectuals thought everything could be reduced to rationalist principles alone. Though for many science displaced religion as the ultimate authority that could explain the mysteries of human existence, some believed that science and religion are perfectly compatible, though sometimes serving contrary aims. From this latter perspective science was perceived as an instrument of God’s plan, through which we became the beneficiary. For those who embraced reason as the pinnacle of human achievement (a view that goes all the way back to Plato), the notion that science is divinely inspired was far more appealing than one that was opposed to religion in principle. On the other hand the Romantics were opposed to Reason and rejected the notion that anyone, God or scientist, could ultimately know everything or, for that matter, anything. Like the sceptics of old, they held authority at arm’s length and turned to the self in preference over external (i.e., objective) sources of knowledge. Despite the negative press that has recently been heaped on the Romantics, they should nevertheless be credited for having rejected the scientific pursuit of veracity and precision, seeking instead an “inner” truth that could only be obtained through inspiration, meditation, and creativity. The Romantic conception of truth, like that of the sceptics, was subjective instead of objective and more personal than divine. Byron, Shelly, and D. H. Lawrence in Britain and Hegel, Herder, and Schopenhauer in Germany epitomized the Romanticist spirit when they argued that whatever ema-

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nates from one’s self is of intrinsically greater value than what can be learned from a distance. Unlike the scientists of the Enlightenment who saw culture as constantly improving as a consequence of “enlightened” discoveries, the Romantics were more dubious about technological advances and the theories with which they were typically explained. Instead they adopted a more practical attitude by insisting that the only way to obtain happiness on earth is by accepting reality for what it is instead of wasting one’s life searching for utopia. They were realists in an age that was inebriated with idealism and conservative at a time when progress was embraced for its utilitarian benefit. Whereas the Enlightenment looked to the future for Humankind’s salvation the Romantics looked to the past, favoring tradition, history, and the unpredictable nature of human experience over ideas, experimentation, and hypotheses. Yet postmodern thinkers have dismissed Romanticism as just another example of the Enlightenment’s fixation on the self, a concept that has come into considerable question (See my article, “Postmodernism and Psychoanalysis: A Heideggerian Critique of Postmodernist Malaise and the Question of Authenticity” (2003) for a discussion of the relationship between scepticism and contemporary postmodernist thinking.). Moreover, political Romanticists such as Rousseau were just as Utopian in their thinking as scientists were, envisioning a future in which liberal democracies would bring an era of freedom and equality for all, a vision that now appears as both naive and unrealistic. Now, as we embark on the twenty-first century, such idealism has been replaced with a modern form of scepticism that more nihilistic than the sceptics of old who were more optimistic about life and even saw themselves as therapists of the soul. Indeed, Montaigne, whose scepticism has traces of modernism and Romanticism alike, has had a greater impact on sceptical philosophers (e.g., Schopenhauer, Nietzsche, Wittgenstein, Heidegger) over the past two centuries than any other philosopher, most of whom (especially Nietzsche and Heidegger) both anticipated and influenced postmodernism’s de-centering of the subject. It would seem that only some Enlightenment values are deserving of revising whereas others appear to be descriptive of what it means to be human. In fact there are remnants of both Stoicism and scepticism in the Romantic perspective (Everson, 1998), each quietly insinuating its way into Freud’s views about human nature and his conception of psychoanalysis. For example, Romantics emphasized the development of character over the accumulation of knowledge and the importance of tolerating suffering over the search for a means of eradicating it. Whereas the Romantics were willing to forgive the dark side of the human condition and accept our inherent limitations, the scientists who arose from the

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Enlightenment insisted we could transcend such limitations by organizing our lives along rationalist (i.e., modernist) principles. Hence, the rationalists, who thought everything could be explained, quantified, and organized into a coherent body of knowledge that would be accessible to anyone who was educated, sought to purify unreasonable aspects of the self by endeavoring to reform its power to corrupt (a presage to contemporary recovery treatment programs), whereas the Romantics held that life is inherently mysterious and unknowable and that we should live our lives from strength of character and tolerance of the unknown. The tension between the two sentiments were ultimately irreconcilable and the conflict that crystallized between them persisted into the nineteenth and twentieth centuries, culminating in the industrial revolution, the triumph of modern technology (Heidegger, 1977), and its zenith in a twentieth-century that brought the world to the precipice of global ruin (See also Thompson, 1994, pp. 69-87, for a detailed account of technology’s evolution over the past three centuries.). The impact of this legacy on the development and history of psychoanalysis has been enormous. On the one hand psychoanalysis is a treatment model derived from medicine and rooted in empirical science, while on the other it is an art that is rooted in sceptic-Romantic principles, whose subject matter—the unconscious—can never be known in the conventional meaning of the term. Freud was a creature of this paradox and helped perpetuate it, a Romantic at heart though a scientist by temperament, which his occasional scepticism straddling the two. Symington (1986) argues that Freud should be viewed as a hybrid of the traditional antipathy between the modern scientific temperament and Romanticism because many of his basic assumptions about human nature were derived from the Romanticist era, including his preoccupation with dreams and his belief in the unconscious, a concept that was taken seriously by D. H. Lawrence and a host of philosophers, including Schopenhauer, Nietzsche, and Hartmann (though I would add that the kernel of the Romanticist spirit is indebted to the ancient sceptics, subsequently “modernized” by and embodied in the essays of Montaigne). According to Symington, Freud was also a Romantic in his disillusionment with the principles of the Enlightenment, which failed to explain the mental phenomena he was trying to understand. He turned to the types of explanation favored by the Romantics, in particular myths of old, those of classical Greece. He believed that in these myths were encapsulated man’s deepest conflicts. The most famous, that of Oedipus Rex, he believed expressed man’s core neurosis and from it all other mental disturbances flowed. (p. 80)

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Similarly, Solomon and Higgins (1997) have noted the inherent contradiction between the Enlightenment and anti-Enlightenment (scepticRomanticist) parts of Freud’s personality: [Freud’s] ideas established the framework for twentieth-century thinking about the mind, human nature, the human condition, and the prospects for human happiness. His anti-Enlightenment ideas that we often do not and cannot know what is going on in our own minds—that we are basically irrational, necessarily unhappy creatures—would become the premise, or at least the problem, for generations of philosophers and social thinkers. On the other hand, Freud’s very Enlightenment idea that the mind is ultimately a material entity (namely, the brain), analyzable in terms of neurology, energy circuits, and the language of physics, still defines the science of the mind. [Yet, Freud never wavered from his view that] unhappiness was inevitable, and civilization was its cause. (p. 118)

Another trait Freud adopted from the sceptic-Romanticist heritage was his reluctance to provide answers by posing questions instead, the nature of which offers no definitive solution. The inherent ambiguity in Freud’s style of writing led many of his critics to dismiss him as a poor and uneven scientist, forever changing his opinion and fostering controversy instead of respect. Yet Freud’s penchant for speculation, riddles, and detective mysteries was the product of painstaking and extraordinary discipline. He grew increasingly sceptical in his thinking as he grew older and eventually realized that the basic problems of human existence offer no ultimate answers. This is an avowedly sceptical and Romanticism attitude, not a scientific one. Perhaps the most obvious example of Freud’s innate Romanticism is the emphasis he reserved for love in his thoughts about the human condition. In this Freud has no parallel amongst twentieth-century scientists and provides a context in which his views about abstinence may be understood. Though Freud believed that the quest for love is the guiding principle of every human endeavor, he also recognized that it doesn’t bring heaven on earth but frustration, disappointment, and more suffering (See Thompson, 1994, pp. 247-374, for more on Freud’s views about the human condition.). The weight of such suffering may be momentarily reprieved, but for the most part it must be shouldered, tolerated, and finally accommodated. Whereas some will choose to live their lives in the shadows of isolation and anguish, others will bear whatever sacrifice they must in order to make their lives more rewarding. Freud’s conception of abstinence was based precisely on this dilemma. An innovator at heart, Freud advocated bold experimentation in the development of his technique, so long as it was faithful to the principles

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on which his treatment philosophy was founded. Abstinence, perhaps more than any technical intervention, deserves careful study, both because it is an undeniably active intervention and due to its incalculable effect on the patient. For all the emphasis on the analyst’s passivity, activity is undeniably indispensable to every psychoanalytic practitioner, but how much activity should the analyst dare to employ? This is no easy matter to determine, not least because every analytic intervention is at least partly active so that its passive component can do little more than to curtail its considerable power. But Freud (1919) also reminds us that since neurotic fixations are more or less intractable to begin with, analysts must employ at least some activity, occasionally bordering on the reckless, if a desirable outcome is to have any chance of success. You will remember that it was a frustration that made the patient ill, and that his symptoms serve him as substitutive satisfactions. It is possible to observe during the treatment that every improvement in his condition reduces the rate at which he recovers and diminishes the instinctual force impelling him toward recovery.… What, then, is the conclusion that forces itself inevitably upon us? Cruel as it may sound, we must see to it that the patient’s suffering, to a degree that is in some way or other effective, does not come to an end prematurely. If, owing to the symptoms having been taken apart and having lost their value, his suffering becomes mitigated, we must re-instate it elsewhere in the form of some appreciable privation; otherwise we run the danger of never achieving any improvements except quite insignificant and transitory ones. (p. 162-163)

Freud enumerated three sources of the patient’s satisfaction—a state of affairs that, in his view, works against the treatment—that every patient enjoys during the course of analysis, each of which grows in intensity as the treatment, to the degree it is effective, brings relief to the patient’s suffering. Consequently, each should be monitored scrupulously so that the analyst can act to minimize their potentially negative impact. The three sources of substitutive satisfaction are: a) everyday distractions, including sources of amusement; b) the effect of friendships and the consequences of falling in love; and c) the transference relationship with the analyst. The first source of satisfaction is one that every analyst encounters as a matter of course. The urge to take holidays and divert expenditure of income on amusements in lieu of paying the analyst’s fees are examples of resistance because they imperil the course of treatment. Freud is also referring to the nature of the patient’s preoccupations outside the analytic situation and how they may deprive patients of the wherewithal to persevere with therapy, even when such expenditures do not threaten the treatment financially. Such preoccupations are oftentimes of a secretive nature that patients oftentimes conceal. Once discovered, Freud in-

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sisted that analysts should interpret them immediately and to even encourage the patient to not only analyze their unconscious motives but to summarily abandon such activities as well. Such interventions obviously entail abandoning neutrality entirely or at least to a degree that some analysts may find objectionable. Freud was forgiving on this score and left it to the analyst’s judgement as to when to employ abstinence and to what degree, but his thinking on this matter is clear: sooner or later, the analysts will be compelled to meet such behavior in more or less explicit terms. Naturally, patients are free to ignore such interventions but obedience was not what Freud intended, for it is ultimately the patient’s conscience that must guide his or her behavior, not the dictates of one’s analyst. This is no doubt a fine line to draw and a murky one for some analysts, but one nevertheless that every analyst must and the more consistently the better. The problem of falling in love (with someone other than one’s analyst) is a more complicated affair because one of the treatment objectives is to facilitate this very possibility when the absence of love in a patient’s life is symptomatic of a neurosis. The problem comes down to the timing of its occurrence and its subsequent impact on the treatment. Freud rightly questions whether a person in love will be motivated to persist with analysis and many patients opt to terminate at this juncture, construing this development as a sign they have been cured of their neurotic conflicts. In his efforts to avoid such dilemmas, Freud advised his patients against changing their marital status or even their career until the treatment was over. By today’s standards this seems unreasonable and, at the least, unrealistic. One should remember, however, that in Freud’s day treatments rarely lasted more than a year, not an unreasonable amount of time to devote oneself to treatment objectives. Now that treatments typically last five years or ten and even more it would be cruel to expect patients to comply with such a degree of abstinence while virtually putting their lives on hold. It must also be acknowledged, however, that our conception of the psychoanalytic treatment experience has changed markedly as a consequence of this consideration. Originally, psychoanalysis was conceived as an intensive treatment regimen that was commissioned six days a week for up to a year or so, during which patients were expected to devote themselves completely to its edicts. Nowadays the analyst is rarely, if ever, the center of a patient’s life but serves instead as a witness who merely follows the journey that patients set out to travel. Analytic treatments are not only lengthier than before, the frequency of sessions has been reduced from six days a week to five or four and, increasingly, three and even two. Many analysts now argue—and I count myself among them—that frequency of sessions does not vouchsafe a treatment predicated on psychoanalytic

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principles because the variables are too complicated to warrant a predictable outcome. Besides, frequency does not insure intensity and the resistance to treatment can effectively seize on any treatment arrangement that the analyst happens to favor. It is best to be flexible while committed to generating the most optimal conditions that may enable patients to make the most of their experience, whatever their conditions. Many analysts are increasingly willing to see patients three times a week or two, depending on the needs and resources of the patient, even abandoning the sacred couch! This would have been a sacrilege in Freud’s day for the reasons noted earlier. If, as is now the custom, the duration of treatment is openended and the more or less expectable termination date (previously a year, at the outside) has been eliminated, the frequency of sessions per week should be reassessed accordingly, though some analysts apparently resist this modification.18 The alteration of this arrangement (from what it was) to what is now suggests that the role of abstinence today has also suffered modification. Indeed, more and more analysts today increasingly question the degree to which abstinence should be employed, if at all. As Laplanche and Pontalis observe, most contemporary analysts reject the active measures that Freud recommended out of worry that such tactics will induce a type of negative transference that is resistant to interpretation. Yet it is not difficult to err on the other extreme of this issue by omitting abstinence altogether, inciting what Greenson fears may result in such an excessively “happy” circumstance that the treatment could prove interminable. This brings us to Freud’s third example of substitutive satisfaction that patients typically employ as a source of resistance: the relationship they enjoy with their analyst, or the transference. Here Freud (1919) allows that “some concessions must of course be made… greater or less, according to the nature of the case and the patient’s individuality,” but he also cautions that [I]t is not good to let [this source of gratification] become too great. Any analyst who out of the fullness of his heart, perhaps, and his readiness to help, extends to the patient all that one human being may hope to receive from another, commits the same economic error as that of which our non-analytic institutions… are guilty. Their one aim is to make everything as pleasant as possible for the patient, so that he may feel well there and be glad to take refuge there again from the trials of life. (p. 164) 18 Which is to say, they wish to maintain the frequency arrangement—five or six days a week—that was typical when treatments were limited to a year, while insisting on treating such patients for indefinite periods of time, ten years or more, though now the standard that is mandated by the International Psychoanalytic Association is a minimum of four times a week and five in Great Britain.

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Freud concluded that, “in analytic treatment all such spoiling must be avoided” (p. 164). It is difficult to imagine an analyst today who would not concur with this admonition, however loathe such analysts may be concerning excessively active measures. But how, precisely, is the analyst to execute such an admonition in practice? What should be denied and what granted, since the needs each patient brings into therapy vary to a considerable degree? According to Freud, As far as his relations with the physician are concerned, the patient must be left with unfulfilled wishes in abundance. It is expedient to deny him precisely those satisfactions which he desires most intensely and expresses most importunately. (p. 164)

Comments such as these have led some analysts to devise analytic interventions that go beyond what Freud intended. Lacan, for example, took the position that patients, no matter what they say, don’t really want to change and that efforts to effect a working alliance are illusory (Fink, 1997, p. 3). Lacan’s most infamous innovation, the so-called short session, is a perfect example of a treatment philosophy that is rooted almost entirely on the principle of abstinence. Convinced that the standard fifty-minute session is too gratifying because it allows patients to do what they please within the context of a secure length of session—in effect, to fritter it away if they wish—Lacan instituted an unpredictable length to each session, some lasting no more than a few minutes, in order to keep his patients off guard. Patients never knew precisely when a session would be ended or why, but the shock of its sudden occurrence ostensibly served to remind them that the last thing their analyst is concerned about is to satisfy their expectations. (Whether and to what extent this technique actually helped Lacan’s patients overcome their obsessional neuroses is a question that continues to be debated in contemporary Lacanian circles.) Such measures are no doubt, perhaps inadvertently, encouraged by Freud’s admonition against unnecessarily protecting one’s patients from the inevitable slings of frustration and disappointment, a point that is reflected but perhaps exaggerated in Melanie Klein’s conviction that envy is an essential ingredient of the patient’s transference. Klein believed that analysts who are overtly friendly with patients unwittingly elicit destructive elements of the patient’s envy that, in turn, unnecessarily compromise the treatment (Etchegoyen, 1998). Such dogmatic pronouncements about every patient’s presumed experience verge from the relatively sceptical sensibility of Freud’s original thesis, that love plays a paramount role but the contours of a given patient’s intolerance and consequent defensiveness of love’s disappointments are impossible to

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predict and even difficult to ascertain. No doubt envy is a universal experience, but it is dangerously reductive to suggest that such a destructive emotion can serve as a fundamental determinant of every human being’s symptomatology. Such pronouncements, however, are not rare among analysts; indeed, they appear to be essential to the creation of a new and necessarily novel school of psychoanalysis, even when—as in the case of both Klein and Lacan—the analyst insists that it is firmly rooted in Freud’s original formulation. Another example of the tendency to take Freud’s admonition about abstinence further than he apparently intended can be found in Greenson’s commentary on the subject. It should be remembered, however, that in Greenson’s estimation the purpose of analysis is to further regression in the patient’s transference with the analyst, whereas with Freud the goal is to elicit the patient’s free associations. This difference in emphasis serves to show that the same technique may represent divergent conceptions of the treatment when employed by different analysts, since the respective aims of Freud, Klein, and Greenson, and Lacan could not be further apart. Whereas Greenson (1967) appears to mock those analysts whom he characterizes as employing a “warmhearted” technique (pp. 275-278), Freud was notoriously open with his patients and opted to err on the humane side of the equation. Consequently, Freud has been admonished by contemporary analysts for not having employed more abstinence with his patients in conformity with current standards (as noted in Chapter Three, above; see also Thompson, 1994, pp. 205240, and 1996a, for a detailed explication of Freud’s relationships with his patients.). Haynal (1989, pp. 1-18), Racker (1968, pp. 33-36), Blanton (1971), Doolittle (1956), Ruitenbeek (1973), Lohser and Newton (1996), and Roazen (1996) are only some of the recent authors who cited sources that were compiled from Freud’s former patients, all of which served to demonstrate an extraordinary degree of affection, sympathy, and compassion in the manner with which Freud treated them (See also Thompson, 1996a, for an example of Freud’s relaxation of abstinence with his patient, the Rat Man.). Yet analysts who reject Freud because of his alleged classical aloof manner are more liable to question the value of abstinence than those who follow in his footsteps. Hence, the interpersonal school founded by Sullivan seldom discusses abstinence as an abiding feature of psychoanalytic technique (especially in the treatment of psychotics) and abstinence was summarily rejected as a technical principle in the school that was founded by Jung (Beebe, 1997). It should also be noted that the fewer sessions per week a patient is scheduled for treatment, the more difficult it becomes to enforce the standard of abstinence Freud advocated. Hence, analysts who work with patients less frequently may be tempted to compensate by adopting an inordinately aloof affectation,

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though the deliberate employment of such interventions may compromise the development of a positive transference. However much Greenson and Lacan may have derived from Freud’s views about abstinence notwithstanding, Freud’s employment of abstinence was conservative when compared with contemporary, so-called classical standards. In general, he believed that the measure of abstinence adopted should be tailored to fit the needs of a given patient. It is common sense, for example, to employ more abstinence with patients who demand excessive attention or expressions of affection from their analysts, while relaxing such measures with patients who are socially phobic or obsessively preoccupied with guilt. Moreover, if the employment of abstinence is to be effective, then the culture in which the analyst works should be taken into account. In Britain, for example, the use of abstinence is hardly noticed due to the formal strictures of the culture. In the United States, however, where informality is common currency, abstinence should be employed more conservatively lest its effects be experienced as a punitive form of behavior. Such considerations, however, are only generalizations and it goes without saying that the personality traits of each patient are the most important determinants of the technical measures a given analyst may employ. That being said, the last thing on Freud’s mind would have been to dispense with abstinence altogether. Such a tack would only prolong the treatment and possibly jeopardize the outcome. Ultimately, this third category of resistance employed by patients—the relationship shared with their analyst—is the fulcrum on which the patient’s experience of abstinence is rooted. Hence it would be folly to suggest that the transference is nothing more than a manifestation of resistance and that abstinence is a most serviceable means of manipulating it. Transference phenomena are more varied than we oftentimes suspect and, lest we forget, there are compelling reasons why Freud was loath to employ abstinence more excessively than he did. If the transference is indeed the heart of the treatment experience, then it is imperative to understand its function and the purpose it ostensibly furthers.

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Five

Phenomenology of Transference

A protracted debate has persisted throughout the history of psychoanalysis concerning transference phenomena and how they resemble or diverge from ordinary relationships outside the analytic situation. There isn’t even a consensus, for example, as to whether the entirety of the analytic relationship is determined by the transference or if “extratransferential” aspects of the analytic relationship can be said to exist, such as, for example, the so-called working alliance, the real relationship, or the personal relationship. I believe these questions are a consequence of conflicting conceptions of transference, compounded by the uncertainty as to whether or not transference is merely a technical term for a variety of phenomena that are ubiquitous to the human experience. In this chapter I shall explore certain aspects of the transference that are perfectly ordinary outside of analysis, and then endeavor to show how Freud’s views about the nature of love, friendship, and rapport inspired his conception of the transference and the complications that inhere in its resolution. The psychoanalytic conception of transference is so central to what analytic treatment entails that it would take more time than I have at my disposal to summarize the entirety of its clinical significance in a single chapter. Nor shall I endeavor to offer an exhaustive overview of how transference has been treated in the vast literature on this topic, nor even a summary of the principal contributors to this crucial question. I have broached this issue elsewhere and needn’t repeat myself here (Thompson: 1985: pp. 82-7; 118-35; 1994: pp. 37-49; 175-91; 192-204). Rather, I shall examine Freud’s conception of the transference with the aim of unearthing previously neglected elements of what the concept was originally intended to explain; in other words, I shall endeavor to determine specifically what transference is and the manner in which it is experienced by patient and analyst alike. In so doing, I shall examine the question of transference from an angle that is best suited to helping the individual practitioner to come upon it, as it were, phenomenologically; which is to say, from a perspective with which the analyst is already familiar—or at any rate was before having been prejudiced by the conceptual designation of “transference.”

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In other words, how did we experience the phenomenon of transference before it became a psychoanalytic concept? To begin with, Freud’s views about transference were rooted almost entirely in his observations about the nature of love. A Romantic, he conceived psychoanalysis as a matter of the heart. Since psychopathology, in Freud’s estimation, was a consequence of unrequited love, he conceived transference as the vehicle through which patients repeat an experience of tragic proportions, but with hopes for eventual recovery. Hence, the analytic situation is an encounter between two people, brought together with complementary, if not identical, aims: for the analyst, to permit the inevitable disappointment that must follow; for the patient, to delay this disappointment for as long as possible. We speak of transference as a phenomenon that is aroused by memories—conscious and unconscious—that are typically associated with a parental figure. These memories are in turn “transferred” onto the person of the psychoanalyst who, over time, reminds the analytic patient of frustrations previously encountered. Though the phenomena that are aroused in the treatment refer to relationships with figures from one’s past, it is not, strictly speaking, the relationship with a parental figure that manifests the transference experience, but rather the relationship with one’s analyst. Any number of questions invariably arise when one endeavors to examine transference with a view to determining precisely what it is. Is it, for example, a mechanism? Is it a psychological phenomenon or an ontological one? Does it concern the state of one’s mind or the way that a person behaves? And more to the point, what is it exactly that is “transferred?” With these questions in mind, I shall begin by examining how the analytic literature typically depicts transference. The American Psychoanalytic Association’s glossary of psychoanalytic terms and nomenclature offers that transference pertains to The displacement of patterns of feelings, thoughts and behavior originally experienced in relation to significant figures during childhood onto a person involved in a current interpersonal relationship. (Moore and Fine: 1990, p. 196)

In other words, they equate the material of transference phenomena—what is being transferred—with “feelings, thoughts and behavior,” an admittedly wide range of phenomena. They continue: Since the process involved is largely unconscious, the patient does not perceive the various sources of transference attitudes, fantasies and feelings (such as love, hate and anger). The phenomenon appears unbidden from the point of view of the subject and is at times distressing. Parents are usually the original figures from whom such emotional patterns are displaced, however siblings, grandparents, teachers, physi-

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cians and childhood heroes also act as frequent sources. Transference is a type of object relationship, and insofar as every object relationship is a re-editing of the first childhood attachment, transference is ubiquitous. (pp. 196-197)

This otherwise unremarkable depiction of transference serves to show how encompassing this concept can become when trying to pinpoint precisely what transference is, in contrast to non-transferential phenomena—if indeed non-transference phenomena in the context of analytic treatment exist. In other words, is there a distinction that can be made between the two, or is everything that occurs in the analytic relationship, by definition, transferential? This question is not as easy to answer as one might assume because the very concept of transference already lends itself to an inherent difficulty. According to Laplanche and Pontalis (1973), The reason it is so difficult to propose a definition of transference is that for many authors the notion has taken on a very broad extension, even coming to connote all the phenomena which constitute the patient’s relationship with the psychoanalyst. As a result, the concept is burdened down, more than any other, with each analyst’s particular views on the treatment, on its objectives, dynamics, tactics, scope, etc. The question of the transference is thus beset by a whole series of difficulties which have been the subject of debate in classical psychoanalysis. (p. 456)

In Freud’s earlier writings he discussed transference in terms of wishes, i.e., unfulfilled longings that patients in treatment invariably complained about. It was only subsequent to his introduction of the Oedipus complex that the emphasis on transference shifted to the influence of parental figures. Hence a tension developed between, on the one hand, some thing that the individual was said to experience—a wish or a longing—and some one to whom that wish or longing was directed, epitomized by the parent but extending to other significant figures as well. It wasn’t until 1912, however, that Freud finally wrote an exhaustive paper, “The Dynamics of Transference” (1912a) in which he addressed what transference was presumed to entail. According to Freud, “It must be understood that each individual, through the combined operation of his innate disposition and the influences brought to bear on him during his early years, has acquired a specific method of his own in the conduct of his erotic life—that is, in the preconditions to falling in love which he lays down, in the instincts he satisfies and the aims he sets himself in the course of it” (p. 99).

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If we hope to understand what Freud conceived transference to entail, then we must take into account the nature of love and endeavor to determine how each of us experiences love for the first time. Freud continues: “This produces what might be described as a stereotype plate (or several such), which is constantly repeated—constantly repeated afresh—in the course of the person’s life, so far as external circumstances and the nature of the love-objects accessible to him permit, and which is certainly not entirely insusceptible to change in the face of recent experiences” (pp. 99-100) [Emphasis added]. According to Freud, our earliest experience of love and the person with whom we share this experience become hallmarks of what we, from that point onward, anticipate and expect to be repeated. The earliest experience, as it were, becomes ingrained, analogous to a “stereotype plate.” Though this experience assumes a defining principle, it can, nevertheless, alter and change whenever we undergo another, subsequent, experience that, by dint of its power, is capable of overwhelming and hence replacing the earlier one. This need is so ubiquitous that Freud observes, “If someone’s need for love is not entirely satisfied by reality, he is bound to approach every new person whom he meets with libidinal anticipatory ideas” (p. 100). The indiscriminate nature of love accounts for the observation that children love their mother no matter what she is like as a person; no matter how much or little the mother, in turn, loves the child, even if the mother abuses the child or neglects him in some fashion. Later, when the child is an adult, he is attracted to women whom he secretly despises, because they serve to remind him of his mother, for whom he, perhaps, does not yet realize the contempt he harbors against her, for reasons he is not yet able to comprehend. Whether one conceives of this longing as having issued from one’s instinctual drive for relief of tension (per Freud, 1915a), or having derived from the primary maternal object (per Fairbairn, 1952), the practical consequences are the same: the child’s longing for the satisfaction of his need to love and be loved “elects” from the child’s environment an object to whom the child may devote his efforts, however compliant or indifferent that object may be. If the case proves to be the latter the child has no recourse but to turn to his own resources for comfort. This is why Freud’s conception of fantasy is essential to comprehending his views about the nature of the transference. If the child’s frustration becomes insupportable and he is unable to derive satisfaction from a longing for love that is inescapable, he nevertheless has recourse. He doesn’t necessarily have to bear the disappointments that unrequited love engenders when he is capable of creating a condition in his fantasy life that compensates for what is lacking in reality (his object relationships). This qualification is critically important, particularly in light of more recent psychoanalytic theories that have distanced themselves from

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this aspect of Freud’s thesis. Instead of emphasizing the traumatic effects of reality brought about by deprivation or abuse, Freud emphasizes instead how human beings are so resourceful that they are often too resourceful for their own good. Consequently, when children suffer more frustration than they can bear they withdraw from reality (the source of their frustration) by adopting a fantasy that serves to placate their frustration. This is subsequently repeated in the therapy relationship when the analyst becomes a readily accessible object of such longings. But why should the experience of this longing be more intense in the analytic situation than outside of it? Anyone who has been thwarted in love as a child and consequently feels incapable of achieving a measure of happiness is bound to harbor this longing and seek its fulfillment with every person she meets. The analyst isn’t singled out above the rest, as though he were the prototypical object of such longings, but is simply included with everyone else as a potential object of this perennial quest. In effect, transference is nothing more than a predisposition to love each person with whom we find ourselves in relation, depending on the expectations we harbor entering into it and the quota of unmet needs that remain unsatisfied. This isn’t to say that there is anything inherently pathological about such expectations; after all, they are axiomatic in every human encounter. Analysis even contrives for patients to feel welcome in their endeavors and are quietly encouraged to develop such feelings for their analyst. But whereas other relationships either comply with or reject a person’s entreaties for love, the analyst brings these entreaties into the open, discusses them, explores their origin and purpose, and avoids the need to accept or reject them. Following the rule of neutrality, analysts simply inquire into the nature and depth of such feelings, but never dictate what those feelings should be (See Thompson, 1994, pp. 37-50, for a more detailed treatment of Freud’s views on the matter.). To summarize, when we try to satisfy our longing for love with others and encounter frustration, we withdraw. We consequently repress our longings, harbor them in the unconscious and transform them into fantasies, the power of which is increased proportionate to the degree of repression previously employed in order to protect ourselves from the situation from which we withdrew. Since the original wish for satisfaction has been subjected to repression, the analyst must work against this trend when it becomes repeated in the treatment; otherwise, the outcome of analysis will follow the same course as any of the patient’s other efforts to protect herself from disappointment and humiliation. The libido (whether wholly or in part) has entered on a regressive course and has revived the subject’s infantile imagos. The analytic treatment now proceeds to follow it; it seeks to track down the libido,

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If the yearning for love is the secret quest that every neurotic patient disguises and if the transference is essentially a means of transforming the analyst into a compliant benefactor, we can begin to appreciate how the transference not only serves as a vehicle for the patient’s willingness to endure the treatment, but may also serve as a vehicle for resistance to the treatment experience whose true purpose the patient is only beginning to grasp. Though we speak of transference as a basic principle, Freud believed it was necessary to account for the variety of guises that its essential movement periodically assumes in the context of the treatment experience. Even if transference is essentially a longing for love, this longing can provoke just as many reactions in the transference as it does in everyday relationships. Hence Freud distinguishes amongst three categories of the transference experience.19 We must make up our minds to distinguish a positive transference from a negative one, the transference of affectionate feelings from that of hostile ones and to treat the two sorts of transference to the analyst separately. Positive transference is then further divisible into transference of friendly or affectionate feelings, which are admissible to consciousness, and transference of prolongations of those feelings into the unconscious. As regards the latter, analysis shows that they invariably go back to erotic sources. (p. 105)

In the most general terms, then, the positive, or affectionate, transference, should be distinguished from a negative, or ambivalent, transference, which would appear to be the formers opposite. The latter is typically conceived as harboring a resistance to complying with the aims of the treatment whereas the positive serves as a vehicle for cooperation. Obviously, it isn’t that simple. The so-called positive transference is further divided in two: the friendlier, more compliant variety versus a sexually-charged edition that seeks to bask in the analyst’s good will while abandoning the need to address the conflicts that one entered analysis to examine. The friendlier, or “unobjectionable” transference, is more or less conscious, whereas the erotic transference is predominantly unconscious and even more resistant to the aims of the treatment than the negative. The point to keep in mind is that transference does not neces-

19 Kohut also noted the “idealizing” aspects of transference—a feature of what Freud would have probably included as one’s positive regard for the analyst—though Freud, in turn, did not construe this feature of the transference as necessarily antithetical to its resolution.

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sarily serve as resistance to the treatment; at times it serves as the principal motive to persist in it, even while arousing obstacles against it. [T]ransference to the doctor is suitable for resistance to the treatment only in so far as it is a negative transference or a positive transference of repressed erotic impulses. If we “remove” the transference by making it conscious, we are detaching only these two components of the emotional act in the person of the doctor; the other component, which is admissible to consciousness and unobjectionable, persists and is the vehicle of success in psychoanalysis exactly as it is in other methods of treatment. (p. 105)

In other words, the longing for love that every human creature is born with, which is never abandoned for as long as one lives and remains unsatisfied during the course of treatment, is both the real and transferential aspect of the patient’s affective relationship with the analyst. The sharp distinction that is typically drawn between the two by contemporary analysts is replaced with a more ambiguous destiny in Freud’s treatment of this issue because transference, in Freud’s conception of it, is essentially another word for love (See Thompson, 1994, pp. 175-191, and Bergmann, 1987, pp. 144-194, for a more thorough account of Freud’s conception of love.). The inability to obtain satisfaction from the symptomatic displacements of one’s libido produces a measure of frustration and resistance that insinuates its way into the transference with the analyst. This is why the “unobjectionable” aspect of the transference—that portion of the patient’s relationship with the analyst that seeks to see the treatment through—ultimately determines the outcome. Hence, the unobjectionable component of the transference is rooted in every patient’s capacity to love, i.e., the ability to sacrifice an immediate gratification for one that is fleeting but ultimately more rewarding in the long-run; in effect, the ability to put one’s house in order. In the transference, this entails the capacity to submit to a heartfelt disclosure of what is customarily concealed. Perhaps the most often heard criticism of Freud’s analytic technique was the paucity of transference interpretations offered and his reluctance to analyze the transference neurosis, leaving him vulnerable to accusations of handling the transference ineffectually. This is ironic since it was to the resolution of transference that Freud specifically attributed the success of his analytic cases. This point emerged as a guiding principle in his paper on “The Dynamics of Transference” (1912a), where Freud noted that analytic cures could only be obtained through the transference and not by “intellectual” understanding alone. Indeed, the need to understand everything to the nth degree is a typical form of obsessional

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resistance. Freud even confessed that abandoning a predominantly intellectual path was a major shift from the way psychoanalysis had been conceived in its earliest days. On the other hand, there is little evidence that Freud ever offered anything more than cursory transference interpretations in any of his published treatments. How, then, did he typically handle the transference if not to analyze its manifestations? In the fourth of his technical papers, “On Beginning the Treatment,” Freud (1913) remarked that transference, from a strictly technical point of view, is essentially “a proper rapport with one’s patient” (p. 139). While the manifestation of transference is always the product of the patient’s unfulfilled longing for love, Freud nevertheless insisted that analysts should do nothing to inhibit such feelings when they occur, even when they form the nucleus for the transference neurosis. Since the transference represents the only therapeutic use that patients ultimately obtain from the analyst, the analyst’s behavior should be such that it serves to facilitate the expression of those feelings, by giving them voice. One of the principal lessons Freud learned from his failed analysis of Dora was the degree to which neurotics harbor secrets (See Thompson, 1994, pp. 93-132, for a thorough discussion of Freud’s analysis of Dora and its relevance to his developing technique.). Though Freud understood the nature of her transference with him and noted as much in his case report, he had failed to grasp the significance of the patient’s incapacity for self-disclosure and the importance of enlisting Dora’s cooperation in the treatment. His analysis of the Rat Man nine years later, in turn, taught him how devious patients are capable of behaving when keeping such secrets to themselves (See Thompson, 1994, pp. 205-240, for a detailed discussion of Freud’s analysis of the Rat Man.). To Freud’s great fortune, however, the Rat Man exhibited a surprising capacity for spontaneous self-disclosure despite the manifestation of intense, negative transference reactions, alerting Freud to the value of the patient’s capacity for rapport in the treatment outcome. Once Freud realized the ubiquitous nature of secrecy at the heart of the transference neurosis and the technical measures called for in order to check its power, he improvised what would emerge as the two axiomatic rules of psychoanalytic treatment: a) First, that it is imperative to establish a rule of thumb whereby patients agree to be as truthful as they can while omitting nothing that comes to mind: the fundamental rule of analysis; b) Secondly, analysts by the same token should take everything they are told with a grain of salt; in other words, they should assume that their patients are telling the truth, but reserve judgement about the veracity of what they say: the rule of neutrality. Freud’s failure to affect a viable degree of rapport in his treatment of Dora (since he had not yet realized the importance of eliciting candor from his analytic patients) taught him the value of candor in the treatment situation. From that time forward Freud’s principal goal was to cre-

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ate the most optimal conditions possible for facilitating rapport. The patient’s capacity for candor now served a dual purpose: a) the revelation of secrets and, b) the resolution of transference. It was at this juncture that Freud’s conception of analysis shifted from determining causation to instilling rapport. If the purpose of psychoanalysis is to uncover what is hidden from awareness by helping patients unburden themselves of their secrets, then rapport is the only vehicle through which self-disclosure can be elicited. Whereas “active” analysts feel the need to compensate for the patient’s resistance by analyzing the transference and the associated resistance to candor, Freud favored a technique that insured the optimal opportunity to overcome the resistance in the first place. Consequently, he preferred to work almost exclusively with the unobjectionable portion of the positive transference through which patients are able to take the analyst into their confidence. This relatively neglected feature of the transference proved to be the linchpin of Freud’s psychoanalytic technique. There are any number of terms that have been offered in an effort to characterize the peculiar form of relationship that the unobjectionable transference entails, including the working alliance (Zetzel, 1958), the real relationship (Gill: 1982, pp. 85-106), the personal relationship (Lipton, 1977), and so on. These terms, however, beg the question since whatever this relationship entails must in turn be modeled upon a form of relation that is in principle available to all of us, and one with which we are at least vaguely familiar. In the final analysis, the analytic relationship is essentially concerned with the capacity to share confidences, so that the analyst becomes that person in whom the patient endeavors to take into her confidence. This feature of the relationship is, Freud insisted, fundamental. In effect, the patient treats the analyst like a confidante or a friend, a person in whom she is able and, more importantly, willing to confide. In other words, the kind of relationship that psychoanalysis entails is a form of friendship. But what manner of friendship is it, and what, specifically, does friendship actually entail? Moreover, how does one’s notion of friendship inform the context in which Freud’s conception of transference arose? Any endeavor to answer such questions must also account for the observation that the nature of friendship has changed dramatically in modern times, dating from the demise of religion in the sixteenth-century and the increasing reliance on secular institutions, which resulted in alternative methods for acquiring self-knowledge. In a paper titled “The Catalytic Role of Crucial Friendship in the Epis-

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temology of Self-Experience,”20 Masud Khan explored the pivotal role that friendship plays in the development of self-experience, contrasting post-sixteenth-century accounts of friendship in European culture with earlier attitudes. According to Khan, “In the sixteenth-century, the process of the a bsence of the presence of God in man’s consciousness had started in a definitive and irreversible way in European cultures… [and] reached its climax in Nietzsche’s declaration… in 1885 [that] ‘God is dead’ ” (1974, p. 99). Khan observed that the erosion of God’s presence in the culture at large coincided with increasing interest in science, replacing a theistic interpretation of our place in the cosmos with a secular model. Many argued that whereas previously humans had been conceived in the image of God, now they simply served as a model for man-made machines. Khan, however, questioned the validity of this conclusion and suggested instead that “the human individual, from time immemorial, has always needed someone other than himself to relate to and to know himself with” (p. 99). In other words, it is through the mediating influence of other people that man finds the measure of himself and never, strictly speaking, “by himself” alone. Khan believed that before the demise of God in popular culture, human beings did not rely on each other in the same way they do now. As religious faith weakened people experienced greater isolation and felt the absence of someone in their lives to whom they could turn, not merely for companionship but for the purpose of baring their souls and to plumb the depths of their existence. Michel de Montaigne was probably the first example in literature of a person who relied on a friend in order to engage in disciplined self-inquiry. His unique friendship with Etienne de La Boétie not only offered an extraordinary source of intimacy which was sorely missed after his friend’s death, it also inspired his famous journey of self-discovery, outlined in the voluminous Essais. In contrast, it hadn’t been necessary for St. Augustine, centuries earlier, to rely on friendship in order to pen his Confessions because Augustine, unlike Montaigne, had turned to God for inspiration.21 For this reason Montaigne was the precursor to Modern Man, the quintessential loner who, having rejected his reliance on God to heal his soul turned to a friend to serve the same function. A self-confessed student of the Classics, Montaigne was especially indebted to Aristotle’s views about the nature of friendship, outlined in 20

Subsequently published in The Privacy of the Self, 1974, pp. 99-111. I am not suggesting that Montaigne was an atheist; he was a devout Catholic and discussed his belief in God frequently in his essays. The point I wish to make, however, is that whereas Augustine turned to God specifically for the purpose of understanding himself, Montaigne turned to his love for a friend to serve this role. 21

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his Nicomachean Ethics (1963, pp. 1155a-1163b). There he distinguished amongst three forms of friendship, each of which corresponded to the things in life that we find most compelling: a) friends who offer a source of pleasure; b) friends with whom we engage in politics and commerce; and finally c) those friends whom we love simply for being themselves. According to Aristotle, this last form of friendship was the only one that is capable of enduring. Since this type of friendship is uniquely characterized by the impulse to conceal nothing, it also offers a means of learning something about oneself. In his own examination into the nature of friendship (1925: vol. I, pp. 243-260) Montaigne argued that the third category of friendship, characterized by Aristotle as “true” or “genuine,” was superior to the others for a number of reasons. Friends who provide a source of pleasure can vanish as easily as they appear. They don’t really want to know about our troubles and we take pains to conceal things that might sour the relationship. On the other hand friends whom we establish for financial or political benefit are oftentimes people we don’t even like, but because we rely on them for practical gain they are critical to our survival so we take care not to offend for fear they may turn against us. Montaigne emphasized that in any case, nothing can be done to preserve such friendships because we grow weary of them just as easily as they tire of us. Besides, these people are not really essential to our happiness and, even if we grow fond of each other, there always remains an unbridgeable distance between us. The true friend relieves us of such anxieties and for that reason enjoys a treasured status in the type of relationship we are capable of fostering. Montaigne isn’t, however, suggesting that all of relationships comprise one form of friendship or another; he took considerable pains to distinguish friendship from other intimate relationships with which it is sometimes confused, such as the relation between a child and parent. Whereas the child’s relationship with the father, for example, is rooted in respect, friendship, like the transference relation in psychoanalysis, is rooted in the exchange of confidences. Montaigne argues that a child could never wholeheartedly take his father into his confidence because their relationship is contaminated with obligations and expectations that inevitably interfere with one’s capacity for candor, a point Freud noted three centuries later. Similarly, tensions arise between most siblings despite (or, perhaps, because of) the ties that exist between them. And while some siblings grow uncommonly close to one another, others learn to hate and even despise the other, so the relationship with one’s sibling does not always guarantee a bond of intimacy. A more ambiguous category of relationship concerns sex, the nature of which renders friendship problematical because lovers are too pos-

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sessive of each other to tolerate the self-sacrifice that friendships take for granted. When we endeavor to form friendships with those who feel attracted to us—or even those with whom we were previously lovers —there remains the doubt that the only reason this person courts one’s friendship is for unacknowledged or ulterior motives, concerning the possibility of revenge or seduction. Even the hint of sexual tension can foster doubts and paranoia that render the potential for genuine candor problematical. Due to their complexity and mutual obligation, the same can be said for marital relations, epitomized by contractual obligations that engender expectations, which invariably manifest the occasional crisis. Admittedly, at the time in which Montaigne lived marriages were usually arranged by one’s parents and served as a practical and oftentimes political alliance that compromised the likelihood of growing intimate together. Yet, even today when people typically marry for love, the marriage is nonetheless occasioned by obligations that inspire a measure of secrecy and deception, if only to protect the other’s feelings and to insure the survival of the union. The marital relation, especially where children are concerned, is so complicated it invariably gives rise to tensions, frustrations and, when successful, compromise. The form of intimacy created is unique in the depth of love it is capable of fostering, but it also exacts an inevitable burden that is the consequence of sharing a destiny together with all its attendant sorrows and inescapable misfortunes. Indeed, the marital contract is such that it aims at survival and one’s fear of betrayal or failure is in proportion to the fidelity with which the married partners assume their vows. This is why the sexual dimension of marriage offers the most frequent source of tension, oftentimes the cause of dissolution itself. These considerations inspired Montaigne to suspect that the absence of sexual desire is the key to the unique form of freedom that genuine friendship aspires to. Whereas sex joins people together in passionate and unpredictable ways, friends forgo this source of pleasure and endeavor to prove the value of their friendship in alternative, aim-inhibited fashion. This feature of friendship may explain why self-disclosure is both easier and more urgently anticipated in friendship and why similar tensions are repeated in the analytic relationship. Since the raison d’être of friendship is epitomized by the confidences shared, all that matters is the ease with which friends are able to offer and in turn elicit confidences with each other. Hence, one’s confidences aren’t offered by the pressure of obligation but as a gift; in effect, a gift of love. Montaigne concluded that friendship is characterized by two essential criteria: First, by an uncommon degree of forgiveness, elements of which Freud included in his conception of neutrality (see Chapter Three). This is because friends typically overlook the faults and idiosyncrasies that drive others to distraction. Furthermore, whereas mere acquaintances are ready and even eager to condemn each other for al-

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leged misdemeanors, a friend will instinctively reject condemnation and offer a friend the benefit of the doubt. This is the very attitude that analysts endeavor to adopt toward their patients, the effects of which fuel the positive transference and facilitate the capacity for rapport. Second, friendship is characterized by an unusual degree of generosity. Patients make extraordinary demands on their analysts, seldom realizing the frustration such demands inevitably exact on the person who, after all, is being paid to help them. A good friend—and a conscientious analyst—never complains about this uneasy arrangement, even when appreciation for the sacrifice endured goes unacknowledged. A friend gives to his or her friend in a way that no one else is able or willing to, because their relationship is specifically predicated on this assumption. Both of these qualities serve to embolden friends to make use of each other and to participate in a form of candor that is otherwise inconceivable. Montaigne subsequently applied the skills learned from his friendship with La Boétie to his appointment as advisor—in effect, the “psychotherapist”—to the King of France. In his essays, he went to some lengths to outline the difficulties encountered when serving in this capacity and the measure of tact and diplomacy that was necessary in helping one’s charge without committing offense. He offered a series of recommendations on how counselors who undertake this profession should conduct themselves, many of which are suggestively similar to Freud’s technical recommendations. For example, when outlining the necessary qualifications for serving in this role, Montaigne observed that We need good ears to hear ourselves judged of by others; and since there are few who can stand it without being stung, those who venture to undertake it must employ a peculiar form of friendship, for it is an act of love to undertake to wound and offend in order to benefit. (Vol. IV, p. 307) [Ives translation slightly revised.]

The endeavor to influence others concerning their most intimate affairs presumes a capacity for friendship on both sides of the equation: for the counselor who must gain the trust of the person to whom he offers advice; and for the patient who must be able to accept such counsel (or analytic interpretation) without resentment. However, this form of “friendship,” whether systematized in the guise of a treatment situation or spontaneous in the case of a confidante, is incapable of flourishing in the absence of intermittent breaks in the time spent together. Friends do not typically live together and when they do they may compromise and even destroy the relationship. The boundaries provided by regular absences (duplicated in the analytic relationship) allow time for each to regroup and recover from the stings and frustrations that accumulate when together. Even in this era in which marriage is characterized as a friend-

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ship that includes sex, excessive time together can undermine the intimacy shared and dilute sexual attraction. Though Aristotle believed that friendship requires frequent contact in order to flourish, excessive contact may prove equally problematical. Masud Khan characterized Montaigne’s relationship with La Boétie as a perfect example of what he called “crucial friendship,” an intense form of friendship in which the confidences shared are so personal they occasion a transformation in the personality of one of the participants. Khan suggests that this type of friendship also characterized Freud’s relationship with Fliess. In the same way that La Boétie served as someone to whom Montaigne could bare his soul, Freud’s correspondence with Fliess served a similar function. Whereas Montaigne’s friendship with La Boétie culminated in death, Freud’s friendship with Fliess culminated in a falling out which Khan believes may be unavoidable in friendships that occasion a transformation in one’s self-experience. The termination of the transference relationship at the end of analysis suffers a similar fate. Freud was thirty-two years old when he met Fliess and on the threshold of his most important discoveries. In their correspondence Freud shared virtually everything with him, his doubts, anxieties, his innermost feelings as well as progress and setbacks with his patients. It was during this period that Freud was also immersed in his self-analysis. Because self-analysis by itself is not a genuine treatment experience, it was probably Freud’s bond with Fliess that provided the fuel that rendered his self-discoveries palpable. In fact, Freud acknowledged in a letter to Fliess (dated November 14, 1897) that self-analysis was not all that he had hoped due to the absence of an “other” in whom he could confide: My self-analysis remains interrupted. I have realized why I can analyse myself only with the help of knowledge obtained objectively (like an outsider). True self-analysis is impossible; otherwise there would be no (neurotic) illness. (Masson: 1985, p. 281)

Khan suggests that Fliess, though Freud failed to realize it at the time, served as this “actual other” without which the gravity of the analytic experience would prove negligible, since there would be no one to whom one is able to reveal oneself. According to Khan, With the hindsight available to us through Freud’s researches and analytic method, it is not difficult to ascertain how much of Freud’s relation to Fliess has all the patent characteristics of a transference-relationship: his lurid over-idealization of Fliess, his over-estimation of Fliess’s intellect, his impassioned dependence on Fliess’s judgement and approval, and its transience. It lasted twelve years, had its climax, and then it sundered. (p. 108)

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Freud and Montaigne’s respective uses of friendship nevertheless diverged in significant ways. Whereas Montaigne idealized his friendship with La Boétie even after his death, Freud’s feelings about Fliess changed dramatically, prompting him to adopt a more somber attitude about the limits of friendship and the unconscious dimension of its power. Contrary to Montaigne, Freud derived a more complicated assessment about the forces that determine its significance and the undercurrents that may lead to its termination. Freud experienced a change in his self-development due to the candid nature of the rapport he shared with Fliess over a period of twelve years, whereas Montaigne experienced similar changes in his personality due to the mourning he endured following La Boétie’s death. It wasn’t the intensity of the friendship itself that transformed Montaigne's personality but the subsequent trials of self-disclosure, manifested through the composition of his essays. Because of Freud’s painful and decisive falling out with Fliess, he must have realized the potential power that self-disclosure is capable of harnessing—and how quickly a friendship is transformed when a previously serviceable dependence on it expires. Though Freud never explicitly equated the transference with friendship, his views about friendship obviously informed his conception of the transference in a variety of ways, including his subsequent conception of the transference neurosis and the importance he gave to rapport as the principal catalyst for change. Hence, he was able to make use of the most ordinary and spontaneous experience with which all of us are in some measure familiar, and contrived a therapeutic technique that helps instigate our longing for love in the analytic relationship. Freud would have probably never made this discovery had he not appreciated the ubiquitous nature of love and the means by which it invariably insinuates its way into every relationship, but especially friendship. For example, in Group Psychology and The Analysis of The Ego (1921), Freud categorized friendship as one of those “aim-inhibited” forms of affection that has at its base the same longing for love that is manifested in sexual relationships, but that [I]n relations between the sexes these impulses force their way towards sexual union, but in other circumstances they are diverted from this aim or are prevented from reaching it, though always preserving enough of their original nature to keep their identity recognizable (as in such features as the longing for proximity, and self-sacrifice). (pp. 90-91)

In Freud’s view, the strength of friendships—their longevity, duration, devotion, and self-sacrifice—are only possible because the satisfaction to which we all aspire is unobtainable. Hence, the obsessive and devotional quality of crucial friendship is a compensation for non-

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gratification as well as a respite from the emotional upheavals that sexual relations thrive on. This also explains why friendships—and by extension, the patient’s transference to the analyst—are invariably frustrating, because the gratification we seek in all our relationships is necessarily thwarted in friendship. Indeed, the experience of feeling thwarted and our acceptance of this unspoken condition is the test upon which every friendship is finally measured. In effect, the transference neurosis is a form of friendship, manifested by the trials of aim-inhibited love. The inexorable course of the treatment and sacrifices suffered finally bring home to the patient the measure of love that genuine friendship entails. For Freud, the “higher” one’s capacity for love—which is to say, the more self-sacrificing—the more suffering one must endure for the sake of rendering one’s repressed libido available. In other words, one’s capacity for enduring frustration is the measure of one’s capacity for friendship—and an optimal analysis. In the transference, this is occasioned by a steady diet of frustration and disillusion. In Freud’s relationship with Fliess, he discovered that the depth of their friendship and his inordinate dependence on it finally exacted a costly but necessary price: the friendship itself. Freud had changed so much during the course of it that he finally outgrew the relationship and, like a treatment that has finally served its purpose, no longer needed it. Once the treatment is terminated, most patients find it impossible to continue a relationship with their analyst once the conditions for their intimacy dissolve. Even if the analyst is agreeable, or they become colleagues, the erstwhile patient usually feels her former analyst knows too much to feel comfortable in her presence. Ideally, according to Khan, One could argue that what is unique about the clinical situation is that the analyst survives both the loving and the hating of the patient as a person, and the patient as a person at the resolution of the relationship survives it, too, and is the richer for it. (p. 111)

The ability to finally let go of the relationship and all of the attendant expectations is a measure of the patient’s growth and newfound independence. If its absence can be suffered without bitterness and offer new hope for the challenges ahead, then the analysis will have delivered all that any treatment can realistically hope for: the comfort of a friendship that was unique in the depth of its undertaking, and transformative in the lessons experienced.

Six

The Enigma of Countertransference

I have endeavored to show that the fundamental principles of psychoanalytic technique cannot be taken alone in absentia if one expects to benefit from their counsel. Since each interpenetrates the others, in order to understand the function of one it is necessary to examine its facility in relation to the rest. The eight technical principles that are essential to psychoanalytic treatment may, however, be further divided into pairs. We saw earlier, for example, how the fundamental rule to be honest is dependent on the capacity to free associate (Chapters One and Two). Later, we observed why neutrality, if employed unabated and extended to its logical conclusion, would finally undermine the treatment experience were it not for the employment of abstinence to serve as its limit (and vice versa, since the one inevitably imposes a restraint on the efficacy of the other). Similarly, the manifestation and subsequent handling of the transference cannot be effected without recourse to monitoring the persistent intrusions of one’s countertransference, whatever one takes this technical principle to mean. Over the past fifty years a veritable sea-change in the psychoanalytic conception of countertransference has engendered considerable confusion and debate concerning how this technical principle should be conceived and how, in turn, it should be applied in a clinical context. Indeed, in a relatively brief period of time countertransference has been transformed from a cautionary principle whose purpose is to alert analysts when, unbeknownst to themselves, they are obstructing the analytic process, into one that reduces this principle to simply depict the analyst’s experience, conscious and unconscious alike. Yet some analysts retain the original meaning of the term while others have adopted the more recent one, often without explanation or preparation for the benefit of the reader. The purpose of this chapter is to review some of the implications of this shift while appealing for a return to the original sensibility that Freud gave to this term. While doing so, I shall also undertake to explore the (now-neglected) relationship between countertransference and therapeutic ambition, and argue that the unbridled use of interpretation may serve as a previously unrecognized source of countertransference intrusion.

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There are essentially two ways of handling the material gleaned from patients during the course of their analysis: The first holds that unconscious material should ultimately be verbalized in the patient’s own words; the second that the more reliable means of gaining access to the patient’s unconscious is through the analyst’s ability to interpret the patient’s free associations, according to a preconceived scheme. The more or less endless variety of interpretative schemes employed by analysts falls somewhere between these two divergent points of view. Like virtually all of Freud’s technical recommendations, the literature on countertransference has changed significantly over the course of the last century. Thus I would be the first to acknowledge that countertransference is a technical principle that resists generalization. A given analyst’s opinion as to the proper handling of countertransference necessarily depends on the theory each analyst employs and how the theory is applied to the clinical situation. According to Laplanche and Pontalis (1973), “Some authors take the counter-transference to include everything in the analyst’s personality liable to affect the treatment, while others restrict it to those unconscious processes which are brought about in the analyst by the transference of the analysand” (p. 93). The classical perspective conceives countertransference as essentially an unconscious phenomenon that impedes the analytic process, while more recent so-called contemporary perspectives construe it as virtually anything that the analyst experiences in the course of a patient’s treatment. This second, broader, perspective is the culmination of significant innovations in analytic technique over the last fifty years or so. Noteworthy is the contribution of Melanie Klein whose emphasis on primitive stages of development shook the psychoanalytic community to its foundations, and C. G. Jung who conceived the analytic relationship—including both transference and countertransference phenomena—as an inherently “transpersonal” process. Both theorists are featured in the approaches to countertransference I shall undertake to review below. Perhaps one of the most articulate exponents of Klein’s thesis was the Argentinean analyst, Heinrich Racker, whose influence on contemporary perspectives of countertransference has been considerable. The basic elements of Racker’s contribution are outlined in his seminal Transference and Countertransference (1968), published shortly after his death. There Racker distinguishes between two types of countertransference: a) countertransference affects, or positions, and b) countertransference thoughts, or ideas. The following is an admittedly lengthy quotation, so please bear with me while I repeat it in its entirety. Racker begins with his account of “an analyst’s”22 case report:

22

Racker’s? Presumably, but he doesn’t say.

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An analysand repeats with the analyst his “neurosis of failure,” closing himself up to every interpretation or repressing it at once, reproaching the analyst for the uselessness of the analysis, foreseeing nothing better in the future, continually declaring his complete indifference to everything. The analyst interprets the patient’s position towards him, and its origins, in its various aspects. He shows the patient his defense against the danger of becoming too dependent, of being abandoned, of being tricked, or of suffering counter-aggression by the analyst, if he abandons his armor and indifference towards the analyst. He interprets to the patient his projection of bad internal objects and his subsequent sado-masochistic behavior in the transference; his need of punishment; his triumph and “masochistic revenge” against the transferred parents; his defense against the “depressive position” by means of schizoid, paranoid, and manic defenses (Melanie Klein); and he interprets the patient’s rejection of a bond which in the unconscious has a homosexual significance. But it may happen that all these interpretations, in spite of being directed to the central resistance and connected with the transference situation, suffer the same fate for the same reasons: they fall into the “whirl in a void” (Leerlauf) of the “neurosis of failure.” Now the decisive moments arrive. The analyst, subdued by the patient’s resistance, may begin to feel anxious over the possibility of failure and feel angry with the patient. When this occurs in the analyst, the patient feels it coming, for his own “aggressiveness” and other reactions have provoked it; consequently he fears the analyst’s anger. If the analyst, threatened by failure, or, to put it more precisely, threatened by his own superego or by his own archaic objects which have found an agent provocateur in the patient, acts under the influence of these internal objects and of his paranoid and depressive anxieties, the patient again finds himself confronting a reality like that of his real or fantasied childhood experiences and like that of his inner world; and so the vicious circle continues and may even be re-enforced. But if the analyst grasps the importance of this situation, if, through his own anxiety or anger, he comprehends what is happening in the analysand, and if he overcomes, thanks to this new insight, his negative feelings and interprets what has happened in the analysand, being now in this new positive countertransference situation, then he may have made a breech—be it large or small—in the vicious circle. (pp. 141-142)

What can one derive from Racker’s formulation of countertransference noted above? First, that some patients experience a “neurosis of failure” as a consequence of the frustrations experienced in the course of analysis which, in turn, explains how they may engender a resistance to their work with the analyst. Racker suggests that such patients arouse in the analyst a fear of his own failure, manifested by the patient’s resistance to treatment. Yet, the analyst, says Racker, is mistaken in assuming this reaction is the consequence of his feelings of failure, per se, because such feelings are in fact (unconsciously) projected “into” the analyst as a

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means of getting rid of them. Hence, transference and countertransference alike, according to Racker, should be conceived as nothing more than a mode of communication that is always occurring between patient and analyst, even though the analyst, due to the nature of this phenomenon, doesn’t experience it as such. On the contrary, the analyst experiences such feelings as his own. Consequently, what the analyst experiences during the course of the analytic hour must be interpreted in the context of what he presumes is occurring in the patient’s unconscious in order to conjecture that the feelings experienced by the analyst actually belong to the analyst’s patient. As noted earlier, Racker’s conception of countertransference is informed by his adaptation of Klein’s theory of schizoid and depressive stages (or positions) of development and the effects the patient’s unconscious defenses (in this case, projection) exert on the analyst’s affective experience. The vignette repeated above demonstrates an example of Racker’s conception of countertransference affects. I shall now turn to Racker’s depiction of countertransference thoughts. At the start of a session an analysand wishes to pay his fees. He gives the analyst a thousand-peso note and asks for change. The analyst happens to have his money in another room and goes out to fetch it, leaving the thousand pesos upon his desk. During the time between leaving and returning, the fantasy occurs to him that the analysand will take back the money and say that the analyst took it away with him. On his return he finds the thousand pesos where he had left it. When the account has been settled, the analysand lies down and tells the analyst that when he was left alone he had fantasies of keeping the money, of kissing the note goodbye, and so on. The analyst’s fantasy was based upon what he already knew of the patient, who in previous sessions had expressed strong disinclination to pay his fees. The identity of the analyst’s fantasy and the patient’s fantasy of keeping the money may be explained as springing from the connection between the two unconsciousnesses, a connection that might be regarded as a “psychological symbiosis” between the two personalities. To the analysand’s wish to take money from him (already expressed on previous occasions) the analyst reacts by identifying himself both with this desire and with the object towards which the desire is directed; hence arises his fantasy of being robbed. For these identifications to come about there must evidently exist a potential identity. One must presume that every possible psychological constellation in the patient also exists in the analyst, and the constellation that corresponds to the patient’s is brought into play in the analyst. A symbiosis results, and now thoughts spontaneously occur in the analyst corresponding to the psychological constellation in the patient. (pp. 142-143)

In this clinical example Racker suggests that the reason the thought (that his patient may attempt to steal his money) occurred to the analyst

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was not because the analyst knew the patient so well that he could anticipate the thoughts that may occur to his patient (although Racker confirms this is in fact so), but because of a “symbiosis” of identification occurring between their respective unconsciousnesses. In other words, the suspicion that his patient may attempt to steal from him was an incidence of unconscious, transpersonal, communication, originating in the unconscious of the patient and transmitted into the mind of the analyst, appearing in his consciousness as a spontaneous idea. Racker depicts “unconscious communication” as the essence of countertransference, not because it prevents the psychoanalyst from analyzing the patient effectively but on the contrary, because Racker conceives countertransference as the unconscious transmission of thoughts and feelings from the patient to the analyst. The peculiar characteristic of these phenomena are that insofar as the analyst’s experience is concerned, thoughts and feelings that appear to originate in himself are in fact originating in the unconscious of the patient. Despite the inherently speculative nature of Racker’s proposition, he treats it as a psychic “fact” which prompts him to abandon what his experience indicates by substituting in its stead a presumption of what is occurring between his unconscious and his patient’s. Or does he? In fact, Racker acknowledges that his original suspicion (that his patient may attempt to steal his money) was based on what he already knew about his patient’s attitude concerning payment of fees. The suspicion that his patient may contrive to deprive him of his money in the first place was the consequence of his experience of the patient, not a theory that presumes to account for it. Only after this suspicion occurs to him does Racker attribute the source of it to Klein’s theory of projective identification. I would be the first to acknowledge that there is no way of proving whether Racker’s thesis is or is not valid; its efficacy depends entirely on an article of faith. Yet while acknowledging that the notion his patient may steal his money is based on what he knows about his patient, Racker ignores what his native intuition tells him and attributes his suspicion to an invisible “mechanism” that is presumed to exist in the minds of himself and his patients. Even if one allows that such phenomena possibly occur in the course of analytic treatments, on what experience is Racker’s conviction founded? Virtually none. Indeed, the credulity of his experience is abandoned and replaced with his ability to speculate about what he believes may be going on in his and his patient’s respective unconscious. On the other hand, were Racker’s thesis correct and one were to assume that the patient’s unconscious is indeed capable of transmitting thoughts and feelings to the unconscious of the analyst, then why should the transmission of one person’s unconscious feelings to an-

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other’s always originate in the patient? Isn’t it feasible, in fact logical, that the unconscious feelings and thoughts of the analyst are also projected into the unconscious of his patient? If the analyst’s experience (as a source of knowledge) is as unreliable as Racker implies, then who can say who is experiencing whose feelings at a given moment? Might not the patient’s thoughts and feelings also be attributed to the unconscious projections of his or her analyst? Racker doesn’t raise this possibility, but there is no discernible reason not to. The answer, were one to ask this question, is obvious. Such a theory would render the analytic relationship an impossible stew of random thoughts and feelings, occurring to both participants throughout the treatment experience, with no discernible means of determining whose thoughts or feelings they actually belong to. The result would be chaos. Another example of Racker’s thesis about the nature and etiology of countertransference phenomena visits the same dilemma. The following is a report of an incident with an analytic candidate who was apparently training at a Psychoanalytic Institute with which Racker was affiliated. A woman candidate associated about a scientific meeting at the Psychoanalytic Institute, the first that she had attended. While she was associating, it occurred to the analyst that he, unlike most of the other training analysts, did not participate in the discussion. He feels somewhat vexed, thinking that the analysand must have noticed this, and perceiving in himself some fear that she consequently regarded him as inferior. He realized that he would prefer her not to think this and not to mention the occurrence; for this very reason, he pointed out to the analysand that she was rejecting thoughts concerning him in relation to the meeting. The analysand’s reaction shows the importance of this interpretation. She then produced many associations related to transference which she had previously rejected for reasons corresponding to the countertransference rejection of these same ideas by the analyst. The example showed the importance of observation of countertransference as a technical tool; it also showed the relation between a transference resistance and a countertransference resistance. (p. 147)

In this example the analyst, who fears his patient was looking down on him, hesitates to mention his concern. Instead of suppressing this thought he brings himself to disclose it and then interprets his reluctance to doing so as “evidence” that the patient shares a similar resistance. Racker concludes that had he not offered this interpretation (of his reluctance to verbalize this thought) he would have committed countertransference resistance, not “countertransference,” per se. Why? In Racker’s view, countertransference resistance pertains to the analyst’s resistance to interpreting the countertransference that is always transpiring between the patient and analyst, whereas originally the hesitation to acknowledge one’s experience of the situation might have been interpreted as simply an incidence of countertransference, pure and simple.

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Now that the original (Freud’s) sense of countertransference has been replaced by Racker’s (via Klein) innovation, he is obliged to conceive a new term, “countertransference resistance,” to account for what the concept of countertransference originally conveyed. The implications of this innovation are considerable, because by it the very notion of experience has been abdicated in preference of a theory that the analyst embraces in order to explain what is going on between himself and his patient. In contrast to Racker’s thesis about the nature of countertransference I shall now turn to Winnicott’s observations concerning its evolution as a psychic phenomenon. This account was written in 1960, by which time most of Racker’s papers had been published. Winnicott, like Racker, was profoundly influenced by the writings of Melanie Klein, but Winnicott was also faithful to Freud’s technical recommendations and throughout the course of his analytic career endeavored as best he could to draw from both Freud’s and Klein’s psychoanalytic contributions. The following demonstrates his misgivings about the direction that the psychoanalytic literature on countertransference had taken in 1960. Here Winnicott responds to a paper that was presented at a conference in which he had participated along with the Jungian analyst, Michael Fordham. The paper Winnicott is responding to had been presented earlier in the conference by Fordham. Winnicott (1960) begins: I think that the use of the word countertransference should now be brought back to its original use. We can use words as we like, especially artificial words like counter-transference.… But countertransference is a term that we can enslave, and a perusal of the literature makes me think that it is in danger of losing its identity. There is now quite a literature around the term, and I have tried to study it… The meaning of the word counter-transference can be extended, however, and I think we have all agreed to extend it a little so that we may take this opportunity to look at our work afresh… (p. 158)

Winnicott goes on to recount his views about transference and to emphasize the degree to which it differs from an ordinary relationship. For Winnicott, the critical difference between ordinary relating and the handling of the transference is that in the latter the analyst is engaged in a professional role. Even if the phenomenon of transference is repeated in other contexts, the means by which the analyst responds to this phenomenon is narrowly determined by the act of carrying out his or her professional task. If one allows that transference phenomena are also related to a dimension of the patient’s experience that is more or less personal, the analyst’s reaction to the patient’s transference is not of a personal nature but a professional one.

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The point that Winnicott is taking such pains to emphasize is that the very concepts of countertransference and transference alike have something to do with the job or profession that the analyst is engaged in, and that the breakdown of one’s professional attitude is more or less basic to what the term countertransference is intended to depict. Winnicott continues: I would rather be remembered as maintaining that in between the patient and the analyst is the analyst’s professional attitude, his technique, the work that he does with his mind. Now, I say this without fear because I’m not an intellectual and in fact I personally do my work very much from the body-ego, so to speak. But I think of myself in my analytic work working with easy but conscious mental effort. Ideas and feelings come to mind, but these are well examined and sifted before an interpretation is made. This is not to say that feelings are not involved. On the one hand I may have stomach ache but this does not usually affect my interpretations; and on the other hand I may have been somewhat stimulated erotically or aggressively by an idea given by the patient, but again this fact does not usually affect my interpretative work, what I say, how I say it or when I say it. The analyst is objective and consistent, for the hour, and he is not a rescuer, a teacher, an ally, or a moralist. The important effect of the analyst’s own analysis in this connection is that it has strengthened his

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own ego so that he can remain professionally involved, and this without too much strain. In so far as all of this is true, the meaning of the word countertransference can only be the neurotic features which spoil the professional attitude and disturb the course of the analytic process as determined by the patient. (pp. 161-162)

Winnicott insists that the definition of countertransference should remain a simple one: whatever spoils the analyst’s capacity to use his or her mind in a professional manner. Further, he argues that the work the analyst is engaged in should be stated in equally simple terms: the analyst is engaged in mental work, by employing the use of his mind. This is an inherently active affair, says Winnicott, not a passive one. While Winnicott is responding to a perspective on countertransference that belongs to Fordham, it is an apt depiction of Racker’s conception of it as well. Though often depicted as a proponent of the object relations perspective, Winnicott’s technique is in many respects more consistent with Freud’s technical recommendations than Klein’s. Indeed, Freud would concur with Winnicott that countertransference is that which unconsciously impedes the work that the analyst is endeavoring to do. How then does Winnicott distinguish between countertransference and non-countertransference considerations in his work with patients? His work with borderline patients is instructive: The borderline psychotic gradually breaks through the barriers that I have called the analyst’s technique and professional attitude, and forces a direct relationship of a primitive kind, even to the extent of merging. This is done in a gradual and orderly manner, and recovery is correspondingly orderly, except where it is part of the illness that chaos must reign supreme, both without and within. In the training of psycho-analysts and the like we must not place students in the position of being related to primitive needs of psychotic patients, because few will be able to stand it, and few will be able to learn anything from the experience. On the other hand, in a properly organized psychoanalytic practice there is room for some patients who force their way across the professional borderline, and who make these special tests and demands that we seem to be including under the term countertransference in this discussion.… For instance, I got hit by a patient. What I said is not for publication. It was not an interpretation but a reaction to an event. The patient came across the professional white line and got a little bit of the real me, and I think it felt real to her. But a reaction is not countertransference. Would it not be better at this point to let the term countertransference revert to its meaning of that which we hope to eliminate by selection and analysis in training of analysts? (p. 164)

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I now turn to Freud’s conception of countertransference and compare it with the respective positions advocated by Racker and Winnicott. Freud said relatively little about countertransference, his most exhaustive statements on the matter appearing in his papers on transference, notably “Observations On Transference-Love,” (1915). This was the same paper in which Freud introduced the technical terms abstinence and neutrality. Though separate concepts, these three technical principles, abstinence, neutrality, and countertransference, are inextricably linked, so that none is intelligible without reference to the others. Freud couched the few remarks he offered about countertransference as violations of the technical principles on which he based his work as an analyst: a) analytic neutrality; b) the rule of abstinence; and c) absolute honesty. I shall review each in turn and then compare the gist of what he says with the remarks about countertransference offered earlier by Racker and Winnicott. The violation of analytic neutrality is, in Freud’s view, the most typical example of countertransference, because of the inherent difficulty in maintaining the degree of equanimity that neutrality entails. As I have noted elsewhere (Thompson, 1996a, 1996b), neutrality is not so much a technique that can be administered as a state of mind that is oftentimes fleeting and sometimes inaccessible. One of the most frequent violations of neutrality is the commission of therapeutic ambition, epitomized by the analyst’s willingness to resort to excessive, sometimes intrusive measures in the service of psychic change. In Freud’s estimation most breaches of neutrality are incidents of this nature. In his “Recommendations to Physicians Practicing Psychoanalysis” (1912) Freud alludes to this technical principle in the following: I cannot advise my colleagues too urgently to model themselves, during psychoanalytic treatment, on the surgeon who puts aside all his feelings, even human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possible. Under present day conditions, the feeling that is most dangerous to a psychoanalyst is the therapeutic ambition to achieve by this novel and muchdisputed method something that will produce a convincing effect on other people. (p. 115)

Therapeutic ambition entails the feeling that one (the analyst) must do something to produce a “convincing effect” on the patient, by guiding the treatment or manipulating the transference with a view to making something happen, oftentimes when therapy appears stuck or the patient exhibits resistance: This will not only put him into a state of mind which is unfavorable for his work, it will make him helpless against certain resistances of the patient whose recovery, as we know, primarily depends on the inter-

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play of forces in him. The justification for requiring this emotional coldness in the analyst is that it creates the most advantageous conditions for both parties: for the [analyst], a desirable protection for his own emotional life, and for the patient, the largest amount of help that we can give him today. A surgeon of earlier times took as his motto the words, “I dressed his wounds, God cured him.” The analyst should be content with something similar. (p. 115)

Violations of neutrality in the service of therapeutic ambition are, in Freud’s estimation, the most heinous, and not uncommon, example of countertransference, though it should be added that countertransference often entails violations of abstinence as well. Whereas violations of neutrality are typically committed when the analyst directs the treatment, violations of abstinence are committed when the analyst, in the words of Winnicott, drops his “professional role.” Indeed, the most common incidence of this infraction (abstinence) is when the analyst loses control of his emotions. In “Observations On Transference-Love” (1915), Freud characterized abstinence as the following: I have already let it be understood that analytic technique requires of the physician that he should deny to the patient who is craving for love the satisfaction she demands. The treatment must be carried out in abstinence. By this I do not mean physical abstinence alone, nor yet the deprivation of everything that the patient desires, for perhaps no sick person could tolerate this. Instead, I shall state it as a fundamental principle that the patient’s need and longing should be allowed to persist in her, in order that they may serve as forces impelling her to do work and to make changes, and that we must beware of appeasing those forces by means of surrogates. And what we could offer would never be anything else than a surrogate, for the patient’s condition is such that, until her repressions are removed, she is incapable of getting real satisfaction. (p. 165)

Easy enough to say, but this admonition is not so easy to apply. It requires an extraordinary measure of tact and experience to determine whether a given analyst’s employment of abstinence is excessive on the one hand or too lax on the other. Analysts commit errors of judgement despite their best efforts to follow these principles, and it is questionable whether such mishaps should be characterized as countertransference infractions. As far as Freud was concerned, so-called countertransference violations require a considerable degree of heedlessness that a simple error in judgement does not warrant. Typically, countertransference occurs when the analyst acts from hubris, when, without thinking the potential consequences through, the analyst behaves without thinking, or worse, with a sense of conviction that is contrary to the mental attitude that neutrality (i.e., suspension of judgment) entails.

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I now turn to the third and last example of countertransference noted by Freud, pertaining to acts of dishonesty. Why this term when honesty is not even a technical principle, as such? Even if honesty is not ordinarily depicted as a technical term, Freud went to considerable lengths to insist on its observance. In fact, the capacity for honesty presupposes every technical recommendation that Freud advised. Analysts who are incapable of honesty or minimize its importance are more liable to commit countertransference and hence violate the spirit of the analytic contract, if not its letter. Citing Freud (1915b): Anyone who has become saturated in the analytic technique will no longer be able to make use of the lies and pretenses which a doctor normally finds unavoidable; and if, with the best intentions, he does attempt to do so, he is very likely to betray himself. Since we demand strict truthfulness from our patients, we jeopardize our whole authority if we let ourselves be caught out by them in a departure from the truth. (p. 164)

The entirety of Freud’s treatment philosophy could even be characterized as the search for truth and fidelity to the analyst’s conscience (In Thompson, 1994, I offer such an assessment.). Indeed, the fundamental rule of analysis is rooted in precisely this principle. By Freud’s reckoning, self-disclosure and honesty are more of less identical. This may explain why the most elusive incidence of countertransference is that of commissioning a deception with a patient, and why the potential for countertransference is a necessarily subjective one, because it hinges entirely on the tension between the analyst’s conscience and his behavior. How, then, does Freud’s conception of countertransference compare with the ones offered by Racker and Winnicott? Perhaps the most obvious difference between Freud and Racker’s respective formulations is the latter’s failure to situate countertransference (and what Racker terms “countertransference resistance”) in the context of neutrality. Having removed his conception of countertransference from this technical principle, Racker reduces its significance to the dynamics of unconscious communication. Violations of analytic behavior are in turn characterized as countertransference resistance, which is in turn depicted as the failure to recognize when the source of one’s (the analyst’s) unconscious experience should be inferred to originate in the patient’s unconscious. Because countertransference (according to Racker) is presumed to be ubiquitous to the analyst’s experience, “countertransference resistance” is treated as the analyst’s failure to recognize when his thoughts and feelings originate in the patient’s (unconscious) transference with the analyst. Winnicott’s objection to this trend in the post-Freudian psychoanalytic literature echo’s Freud’s technical recommendations more or less

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precisely, when he proposes that countertransference should return to its original meaning. Hence countertransference, properly speaking, alludes to a failure on the part of the analyst: that of insuring a necessary boundary between patient and analyst. Whereas Freud characterizes this attitude as one of neutrality, Winnicott characterizes it as one of professionalism. The point they set out to make with their respective characterizations of countertransference, while not identical, are nonetheless founded on the same observation: that psychoanalytic treatment is best characterized as the effort to further a state of mindfulness, and that any act by the analyst that undermines this effort is contraindicated, or countertransference. Freud recognized both a conscious and unconscious component to the treatment situation that always involves two people who possess respective personalities. When Freud conceived countertransference he was concerned with one principal concern, that of insuring the protection of the patient from abuse by the analyst. Analysts who implicitly deny the existence of an “ego” or “person” (i.e., the inherently conscious aspects of the treatment experience) and attribute everything that transpires between the analyst and patient to unconscious processes render the concept of experience virtually meaningless (See Thompson, 2000a and 2000b for more on the relationship between experience and the unconscious.). In so doing, they undermine the patient’s search for his or her individuality, which persists throughout every patient’s treatment experience. Ironically, Racker’s characterization of analyzing countertransference doesn’t provide safeguards against committing therapeutic ambition but encourages it. Whereas Freud’s conception of the analytic situation relies on the patient’s capacity to learn from experience by deepening it, Racker’s conception of the treatment obfuscates the role of the patient’s experience by fostering a dependence on the analyst, whose function is to compensate for its absence. In practice, this amounts to nothing less than a mystification of the patient’s experience, sanctioned by the authority of the analyst. Indeed, Racker’s conception of countertransference provides the analyst with unlimited power to impose upon the patient’s experience whatever the analyst imagines the patient’s experience is or should be. Laing termed the act of dictating to other the content of other’s experience a form of mystification, properly speaking (Thompson, 1996c; 1998). Ironically, Freud’s conception of neutrality was intended to protect analytic patients from precisely this kind for abuse, by protecting the patient from the analyst’s therapeutic ambition. Thus the role that Racker advocates analysts to adopt encourages them to commit therapeutic ambition as a matter of course. This problem is so central to the violation of neutrality and the problem of keep-

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ing the countertransference in check that we shall next explore its dynamics in more detail.

Seven

Therapeutic Ambition

Of all the recommendations in Freud’s papers devoted to technique, therapeutic ambition is possibly the most obscure. There is such a minimum of instruction as to what Freud intends by this principle and so little in the way of concrete examples that it is left to each psychoanalytic practitioner to decipher its meaning for themselves. This technical principle was first introduced (some would argue, buried) in the context of the rules of abstinence and neutrality. It is not clear whether Freud’s reference to this rule was intended as a technical principle in its own right or for the purpose of fleshing out the other, allied principles. More frustrating still is Freud’s failure to cite even one example of what he means by therapeutic ambition in the context of the treatment experience. Moreover, therapeutic ambition is not listed in Strachey’s index to the Standard Edition, nor is it noted in any of the psychoanalytic glossaries currently in print, neither by Laplanche and Pontalis (1977) or the American Psychoanalytic Association (Moore and Fine, 1990). Even the (otherwise exhaustive) treatments of psychoanalytic technique by Fenichel (1941; 1953; 1954) or Greenson (1967) fail to mention, let alone examine, the concept. Perhaps these omissions explain why this technical principle has been neglected in contemporary psychoanalytic publications, although it is frequently invoked as a matter of course by analytic practitioners as a rough and ready depiction of that moment when analysts, in their wellintentioned efforts to counter a patient’s resistance, overstep the bounds of clinical common sense. Indeed, it strikes me as such an important principle that no psychoanalytic treatment could be effectively employed without some notion of what it is intended to depict and how one’s conduct should be informed by it. I would even propose that virtually all of Freud’s technical recommendations are, to varying degrees, concerned with this principle. The overzealous use of interpretation is probably the most common violation of the rule against therapeutic ambition. Perhaps some schools of analysis, due to their relatively active treatment philosophy, are more prone to this problem than others. Hence it is possible that such schools will view this technical rule differently than I. Since no concrete definition of therapeutic ambition has ever, as far as I can determine, been

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offered, I shall select examples of what I believe are faithful to Freud’s admonition against such ambition and those that I perceive to be at odds with it. As with all the technical principles on which psychoanalytic treatment is founded, there are no inherently right or wrong solutions to such queries. Every analyst bears the responsibility of determining for himself how each principle should be employed, and it is ultimately on his or her shoulders alone that the responsibility for one’s conduct must rest. I begin with a review of the context in which Freud first invoked therapeutic ambition. The term was offered only once in the corpus of Freud’s technical writings in a brief passage amongst the technical recommendations examined in his paper, “Recommendations to Physicians Practicing Psychoanalysis” (1912b). You will recall that this was the paper where Freud introduced the concepts of neutrality and abstinence. Freud’s treatment of these technical principles, however, is both illuminating and confusing. At one moment he distinguishes between neutrality and abstinence and in the next invokes them in such a way that they appear to be, if not interchangeable, at least interdependent. Nowhere is the ambiguity between the two technical principles more pronounced than in a passage from the 1912 paper where Freud introduces the admonition against therapeutic ambition. There he collapses violations of neutrality and abstinence into a hybrid that he terms “therapeutic ambition,” implying that the three rules (i.e., neutrality, abstinence, therapeutic ambition) are inextricably entangled. Freud (1912) begins his discussion with what is arguably the most frequently cited passage from his technical papers: “I cannot advise my colleagues too urgently to model themselves during psychoanalytic treatment on the surgeon who puts aside all his feelings, even his human sympathy, and concentrates his mental forces on the single aim of performing the operation as skillfully as possible” (p. 115). This portion of the citation is specifically concerned with the recommendation that analysts should adhere to the rule of abstinence by holding their feelings (of sympathy, among others) in check, so as not to inflame the patient’s erotic transference. Freud then turns specifically to the problem of therapeutic ambition (in reference to rule of neutrality) in the same passage we noted earlier: Under present-day conditions the feeling that is most dangerous to a psycho-analyst is the therapeutic ambition to achieve by this novel and much disputed method something that will produce a convincing effect upon other people. This will not only put him in a state of mind which is unfavorable for his work, but will make him helpless against certain resistances of the patient, whose recovery, as we know, primarily depends on the interplay of forces in him. (p. 115) [Emphasis added]

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Insofar as the above citation is concerned, therapeutic ambition includes those instances in which analysts violate neutrality for the purpose of “producing a convincing effect” on their patients. Freud concludes his depiction of therapeutic ambition with: A surgeon of earlier times took as his motto the words: “I dressed his wounds, God cured him.” The analyst should be content with something similar. (p. 115)

What does Freud intend by invoking therapeutic ambition in this manner and how can one be expected to recognize when therapeutic ambition has been committed? As noted earlier, the only time Freud discussed therapeutic ambition was in the context of introducing the rules of abstinence and neutrality. We also noted that in “Observations on Transference-Love” (1915), Freud integrates the three technical principles to a considerable degree. Thus any failure to adhere to either neutrality or abstinence is consistent with therapeutic ambition because their incidence violates Freud’s admonition to “keep the countertransference in check” (p. 164). In order to appreciate how frequently therapeutic ambition may be manifested it is useful to note that neutrality and abstinence serve complementary, but not identical aims, sometimes converging and other times diverging in their respective roles. Violations of abstinence are consistent with countertransference reactions, for example, when analysts are unaware of feelings they harbor for a patient, or when they encourage the patients’ idealization of them. Whereas violations of abstinence may be attributed to what analysts feel for their patients, violations of neutrality are more likely to occur when analysts are too invested in understanding everything their patients experience, often exhibited by the excessive use of interpretation. Moreover, therapeutic ambition is liable to be committed, not merely when the analyst falls in love with a patient or, contrariwise, dislikes the patient, but when the analyst suffers feelings of inadequacy because the treatment is not progressing along the lines he want it to. In such instances analysts may endeavor to “compensate” for their (perceived) inadequacy with increased effort or cunning, when they are determined to succeed at all costs. Hence therapeutic ambition is not only a breach of neutrality, but may even be passed off as a “treatment strategy” in its own right (as we saw with Racker, above). This explains why Freud suspected therapeutic ambition is the most common source of countertransference because, more than any of the other technical principles, ambition is the most contrary to the analytic attitude. But how can one determine whether a given course of action is a consequence of therapeutic ambition or a daring innovation in tech-

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nique? Moreover, how can one hope to recognize when “activity” is an incidence of therapeutic ambition or a carefully considered departure from classical treatment criteria? I wish there was a way of determining the answer to such questions in the abstract so that they could, in turn, be applied to a given situation, but there isn’t. All the technical principles on which psychoanalytic treatment is founded should be applied with flexibility, intelligence, and caution and then tailored to fit the personality of each analyst. The rigidly “correct” analyst may be just as dangerous to a patient as one who is recklessly innovative. Consequently, of all the technical principles at one’s disposal, therapeutic ambition is the most difficult to define and the most elusive to recognize. In the absence of explicit criteria with which to characterize its precise features, I shall turn to examples of analytic behavior that successfully avoid therapeutic ambition on the one hand, and those that commit therapeutic ambition on the other. I begin with comments offered by Frieda Fromm-Reichmann, who displayed an uncommon degree of preoccupation with this issue even though her methods were not classically Freudian.23 Although most of her work was with psychotic patients and many of her clinical examples refer to “psychiatric” practitioners, it goes without saying that her remarks are also intended for psychoanalysts, whether the patients in treatment are psychotic or neurotic. Because analysts are more likely to commit therapeutic ambition with schizophrenic patients than with neurotic ones, it stands to reason that success in monitoring one’s performance with a more disturbed population would offer an optimal preparation for the analysis of more responsive, classically-analyzable patients. Moreover, it is noteworthy that Fromm-Reichmann was enormously grateful to Freud for his psychoanalytic innovations, particularly those aspects of his treatment philosophy that are conservative, or inactive, in their orientation and, hence, relatively benign. In “Notes on Personal and Professional Requirements of a Psychotherapist” (Bullard, 1959), FrommReichmann states that the most important capacity for analytic work is the ability to listen, the most inactive feature of psychoanalytic treatment (p. 65). She was especially concerned with what she characterized as the “insecure” psychiatrist (or psychoanalyst), a person who, due to excessive anxiety and ambition, is more likely to find the passive nature of psychoanalytic treatment difficult to integrate into his or her need to become a more “successful,” clinician. Such a practitioner, says FrommReichmann, 23 Ironically, much of Fromm-Reichmann’s clinical philosophy is in perfect harmony with the way Freud actually worked, but not with so-called classical analysts whose subsequent treatment philosophy diverged from Freud’s in significant ways. For more on the truth about Freud’s alleged classical treatment philosophy see Thompson, 1994; Lohser and Newton, 1996; Lipton, 1977.

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[M]ay be so preoccupied with the idea that his patients have to get well for the sake of his reputation that he… deafens himself against and disregards the patient’s real needs in striving for improvement. Or the insecure psychiatrist may feel that the patient must understand whatever the doctor feels called upon to point out, disregarding the question of whether or not the patient is ready to follow at the time… The patient is liable to feel that he’s being used as a means of strengthening the psychiatrist’s reputation rather than as an object of treatment in his own right. (p. 71)

The above example (of what Fromm-Reichmann characterizes the insecure analyst) may be difficult to recognize in practice. While some patients may indeed sense that their analyst is using them for their professional ends, others are not as liable to notice or, if they do, to object. Analytic candidates in training, for example, tend to identify with their analysts to such a degree that even the selection of their analyst may depend entirely on the analyst’s professional reputation. Such patients hope that something of the “great” analyst will rub off on them, so instead of protesting when they might otherwise feel maligned they are willing and oftentimes eager to collude with the analyst in order to insure that their treatment will be perceived to have been successful. In this case the therapeutic ambition of the patient is just as great as that of the analyst. Whereas a more cautions (and presumably, self-confident) analyst will recognize such ambitions in their patients as they arise and interpret them as facets of the patient’s transference, the insecure analyst will be too preoccupied with his or her own narcissism to notice. Looking back at Freud’s (1912) admonition that the aim of therapeutic ambition is to achieve “something that will produce a convincing effect upon other people” (p. 115), one wonders whether Freud was referring to patients in analytic treatment or the colleagues (and potential sources for referrals) that the analyst is hoping to impress. In either case the effect is the same: a portrait of the analyst who is more invested in the conventional standard for success than the analytic one. Another proponent of the attitude Freud sought to foster among his followers was Otto Allen Will, Jr., a former analytic patient of both Frieda Fromm-Reichmann and Harry Stack Sullivan. Will was in turns an analytic patient, student, and colleague of Fromm-Reichmann at Chestnut Lodge Sanitarium while he was training at the Washington Psychoanalytic Institute (during the late 1940s and early 1950s) and succeeded her as Director of Psychotherapy at Chestnut Lodge after her death (Thompson & Thompson, 1998). He was subsequently Director at Austen Riggs Center in Stockbridge, MA, an “open ward” facility famous for its compassionate treatment of psychotic patients.

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Will employed a psychoanalytic technique that was even more neutral (i.e., non-intrusive) than Freud’s, disclaiming all pretensions to knowledge about the source of his patients’ distress or even the requirements that should be met to insure a successful outcome. In this respect Will characterizes the ancient sceptic (i.e., un-dogmatic) attitude about the limitations of knowledge and what the outcome of therapy is presumed to entail (See Thompson, 2000b, for a thorough discussion on the relationship between the Ancient sceptical philosophical tradition and psychoanalytic technique.). Again, it is ironic that a “non-Freudian” should exemplify Freud’s admonition against therapeutic ambition more eloquently and explicitly than the typical so-called classical analyst. In a moving tribute to Fromm-Reichmann Will reminisced about her influence on his career and the lessons he attributed to his association with her and Sullivan. Will (Silver & Cantor [Eds], 1990) openly acknowledged his difficulty with coming to terms with this attitude and the trials he was obliged to endure while incorporating it into his clinical perspective. Influenced by some of my reading and colleagues, I began to stay still—to listen to and observe some of the people called “crazy” in contrast to treating them with procedures designed to reduce or eliminate their troubling behavior at almost any cost. For me this task was not easy. Reluctant to confront facts of uncertainty and ignorance, I wanted understanding, clarity, and explanations… I wanted to be an authority in charge of events in the professional and personal fields in which I lived. It took me some time to learn that the field into which I had now stumbled was the wrong one for someone with these ambitions. (p. 132)

Although Will never invoked the terms neutrality or therapeutic ambition24 when describing his perspective, they epitomize the technical principles closest to his heart. Will continues: I have come to some peace in that I don’t expect to know “everything”—or perhaps very much—of myself or of anyone else. To those who are my patients I say quite simply that not only am I unable to read minds, I’m not even very clever at piecing together accurately the possible meanings of subtle behaviors. I ask the other fellow to spell it out for me, and very often he or she does it well enough for our purposes. I also say that the other fellow can keep secrets, but I ask him or her to note the purpose of doing so. The patient has a right to privacy even in my office. (p. 137)

24

Ironically, these were such obvious catch-words for Freudian analysis that the interpersonal school opted not to employ them for fear it would be confused with “classical” analysis.

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According to the above Will was apparently even “neutral” (i.e., openminded, non-intrusive) about the sanctity of the fundamental rule, concluding that the patient’s resistance to comply with this rule is also an inalienable right of every patient that, when exercised, is still open to query and reflection. Will recognized that analytic patients are typically ill at ease in their relationships with others or they wouldn’t be in therapy in the first place. This is a point the therapeutically ambitious analyst may fail to consider at those times when he assigns a patient’s resistance to his own failure as a therapist. According to Will: The people who come to consult with me have trouble in their dealings with people. Certainly that observation is not news to anyone. These patients seek to become more comfortable in their human relationships, and speak of such matters as affection, closeness, relatedness, love, etc. They speak of the rarity of such in their lives, and the need to do something that will be of help. I am no expert in dealing with these phenomena, so we set ourselves to the task of defining their meaning as best we can. In the course of such investigations we usually discover that I am somehow lacking in the full possession of these virtues. If we continue our meetings, this leads us to some idea about acceptance of imperfection and the need for trust. (p. 139)

The analytic attitude that Will situates at the heart of the analytic perspective is admittedly not easy to adopt, or even to embrace in principle. Failure and success become meaningless concepts in the total acceptance of the person in treatment. There is so little room for ambition in this treatment stratagem that even the wish to be “helpful” may sometimes be a hindrance, yet we want to desperately, otherwise we wouldn’t have wandered into this profession in the first place. Futility is courted at every turn because it is impossible to sustain confidence that one is effective or accomplished, let alone innovative or original. How can the analyst cope with the lack of self-confidence that this treatment philosophy requires, not only at the beginning of one’s analytic career but in perpetuity? Often I feel futile as a therapist when I hear, again and again, “You don’t help. You don’t understand. You are cold and indifferent. You are of no use. You have no idea of a good relationship or of love. Nothing changes.” I do take the best look I can at such charges, knowing that the patient may have a valid point and that his or her observations may be in some ways correct. Often all I can say is, “I wish I could give you a helping hand. But since I’m not being very good at that—at least for now—let’s go on together, and see what we can find. (p. 140)

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Will’s ruminations about the inherent limitations of what analysts are able to give their patients epitomize the three technical principles under discussion: a) the monitoring of one’s countertransference; b) the acknowledgement that the analyst is incapable of reading minds but should be willing to be open to his own; and c) the wisdom in guarding against therapeutic ambition. Perhaps the most important lesson Will learned from his career as a psychoanalyst was his attitude concerning the limitations of analytic understanding, a hallmark of the Sullivanian tradition (See Levenson’s illuminating treatment of this issue in The Fallacy of Understanding: An Inquiry into the Changing Structure of Psychoanalysis, 1972.). Will confessed to understanding very little about the nature of psychopathology and even less of the analytic process. He was there to learn these things from his patients, rooted in the to and fro of the relationship that unfolded between them. This is not a scientific sensibility but a sceptical one, because only the sceptic is willing to accept his ignorance in such matters. It is perhaps ironic that this attitude would appear to have had a deeper impact among Sullivan’s followers than Freud’s and that the interpersonalists tend to credit Ferenczi for this perspective when, in fact, it originated in Freud.25 Analysts want to understand and there is much wisdom in what they have learned and can teach us. Wisdom and understanding, however, are not necessarily the same thing. The sceptics believed that wisdom could only be attained when one is able to abandon all pretensions to knowledge and adopt, in its place, a capacity for openminded (or openhearted) inquiry. One cannot genuinely inquire while professing to know what will be discovered. Thus it is impossible to hear what is said when the answers to one’s queries are predetermined in light of a theory that has been elevated to the status of omniscience. In analysis, answers are never finally determined because every discovery leads to even deeper conundrums that foment doubt, puzzlement, and further inquiry. It occurs to me this is precisely what Freud intended by the term, therapeutic ambition. As a technical principle, it is perhaps even more encompassing than all the other technical principles because it characterizes the basis of how every analyst presents him- or herself to the world. I shall now turn to examples of what strike me as, not an analytic form of inquiry, but a therapeutically ambitious one. We discussed earlier Racker’s use of interpretation and the manner with which he couched the problem of countertransference. I suggested then that, despite his presumption that his technique offered a more enlightened method of working with the countertransference, his innovations served therapeutic ambition instead. This observation is no doubt startling to some because in Racker’s assessment of Freud’s analytic technique he

25

Indeed, this was one of the reasons why Freud valued Ferenczi so highly.

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lauds Freud for his openness, congeniality, and tact. Racker (1968, pp. 23-70) even argues that Freud should not be labeled a “classical” analyst because he was more engaged with his patients than contemporary classical Freudian analysts, and because Freud was more conversational with his patients than classical analysts are. In Racker’s (1968) estimation: [T]he best vision of what Freud thought can be obtained if we look at what he did. In his case histories of “Dora” (1905) and “The Rat Man” (1909), we find some sessions reproduced nearly verbatim, which permit us to see how he worked. Above all, these sessions show with how much freedom Freud unfolded his whole creative personality in his work with the patient, and how actively he participated in each event of the session, giving full expression to his interest. (pp. 34-35)

I have discussed Freud’s alleged “activity” elsewhere (1996a; 1996b) in the context of the rule of neutrality and how analysts tend to reduce neutrality (i.e., the need to keep an open mind) to how little the analyst should speak during a therapy session. I have also cited Racker (1994) as one of the few analysts who recognized the striking contrast between Freud’s work as a clinician and contemporary classical analysts. However, Racker seems to construe Freud’s uncommon degree of openness and candor with his patients as a license to offer as many interpretations as he (Racker) likes. This form of activity, however, is inconsistent with neutrality when taken to such extremes. In fact, this is precisely the context in which Racker commits therapeutic ambition, when he abandons the inherent ignorance (or scepticism) that neutrality engenders in favor of analytic “instruction” or dogmatism. I shall return to Racker’s lapses into therapeutic ambition momentarily, but first I shall turn to the interpretative technique of Wilfred Bion, another influential psychoanalytic innovator who advocates an unusual degree of activity in his work. The following vignette is what Bion (Klein, M., Heimann, P., Money-Kyrle, R. E. [Eds.], 1957) describes as “the essentials” of two sessions with a schizophrenic patient whom he had been treating for five years, five days a week, in psychoanalysis. This is offered as an example of how Bion makes use of interpretation, employing a Kleinian perspective. Interpretations, according to Bion, should be offered in language that is simple, exact, and mature: Patient: I picked a tiny piece of my skin from my face and feel quite empty. Bion: The tiny piece of skin is your penis, which you have torn out, and all your insides have come with it. Patient: I do not understand… penis… only syllables and now it has no meaning.

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You have split my word ‘penis’ into syllables and now it has no meaning. Patient: I don’t know what it means, but I want to say, ‘if I can’t spell I can’t think.’ Bion: The syllables have now been split into letters; you cannot spell—that is to say you cannot put the letters together again to make words, so now you cannot think.

The following day, the exchange goes as follows: Patient: I cannot find any interesting food. Bion: You feel it has all been eaten up. Patient: I do not feel able to buy any new clothes and my socks are a mass of holes. Bion: By picking out the tiny piece of skin yesterday you injured yourself so badly you cannot even buy clothes; you are empty and have nothing to buy them with. Patient: Although they are full of holes they constrict my foot. Bion: Not only did you tear out your own penis but also mine. So today there is no interesting food—only a hole, a sock. But even this sock is made of a mass of holes, all of which you made and which have joined together to constrict, or swallow and injure, your foot. (pp. 229-230)

I allow that it goes without saying this sort of material can be interpreted any number of ways, but I am not concerned here with whether Bion’s interpretations are meaningful or meaningless, right or wrong, good or bad. No one is in a position to make that determination with authority and we cannot even be sure how Bion’s patient experienced Bion’s interpretations himself, even if Bion is apparently convinced they were right on the money. What I find remarkable in these interpretations is the extraordinary arrogance with which they are offered, the dogmatic nature of their delivery, and the utter lack of humility and caution in the way Bion presents them to his patient, as though they were messages from the gods with Bion serving as the role of the Prophet. Since the patient doesn’t know why he suffers and is unable to make sense of his own symptoms Bion concludes that the analyst needs to compensate for what the patient doesn’t know about himself, by employing frequent interpretations of the patient’s unconscious drives and defense mechanisms. Though Bion is concerned with determining what the patient’s experience is and how it is manifested in the patient’s transference with the analyst, he presumes that the patient is incapable of determining what his own experience entails. Bion’s analytic theories are complex and many of his followers would argue that to condemn his clinical behavior without recourse to their theoretical rationale is to ignore the most important aspect of Bion’s contribution to psychoanalysis. Moreover, Bion modified his theories subsequent to the above clinical

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example, so one could surmise that his clinical technique was modified also (though we have no concrete evidence to this effect).26 I would submit, nonetheless, that it is possible to offer a compelling theory that has little relevance to how the analyst actually works. Bion’s clinical vignette reveals more about his technique (at that time) than anything he might argue theoretically, and this is the problem with theory in principle. It is both Bion’s attitude and the force of his interpretations that exemplify the hubris of therapeutic ambition (I acknowledge that many socalled Modern Kleinians have abandoned deep interpretations of this nature). Though Bion (as did Racker and, for that matter, Klein) cites Freud in his account of this vignette as a role model, there is nothing remotely consistent with the way Freud analyzed patients after 1910 and Bion’s analytic technique (See Thompson, 1994, pp. 230-240, for more on this point.). Both Bion and Racker, however, cite Freud freely in their respective arguments. Racker (1968, pp. 34-35) even cites Freud’s treatment of Dora as “evidence” that his inordinately active interventions are consistent with Freud’s clinical technique. What he fails to acknowledge, however, is that Dora, by Freud’s admission, was a failed treatment for numerous reasons, in no small measure because she was an unsuitable patient for analysis and because Freud’s interventions were simply too active. Freud subsequently modified his technique by introducing the fundamental rule, the basis of which served to enlist the analytic patient as a collaborator in the treatment experience instead of merely a “repository” for his interpretations (See Thompson, 2001, for a detailed inquiry into Freud’s introduction of the fundamental rule and the reasons that motivated him to employ it, after his analyses of Dora (circa 1900) and the Rat Man (circa 1909).). Moreover, at the time Freud treated Dora he had not yet developed his conception of neutrality, which subsequently became a correlate to the fundamental rule. Henceforth, Freud took extraordinary pains to structure the analytic situation so that the meaning of the patient’s conflicts could be verbalized (and, hence, uncovered) by the patient, not the analyst. Freud’s belated innovations of neutrality and abstinence were intended to serve as countermeasures to each other so that neither would dominate the treatment. Whereas neutrality entails a measure of inactivity, abstinence entails inactivity on some occasions and activity on

26 According to Neville Symington (2003), Bion confided to a student many years later in Brazil that the use of interpretations exemplified in this vignette “was the work of a different analyst,” suggesting he had long since abandoned the use of stereotypical interpreations in his clinical work, though this has never been documented.

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others (the refusal to comply when a patient asks for love is an example of inactivity, whereas offering interpretations in response to such entreaties is an example of activity). Both Racker and Bion advocate an unprecedented measure of activity in the form of deep interpretations. The session that Bion reports with the patient above is an apt example of this technique. Moreover, such inherently active forms of analytic interventions are rooted in rationalist principles, not analytic ones. Because the patient doesn’t know why he suffers and has not enjoyed the opportunity to make sense of his symptoms himself, Bion concludes that the analyst should compensate for the patient’s apparent ignorance by freely employing interpretations that approximate what the patient has (thus far) been incapable of disclosing. The “correctness” of such interpretations is, in turn, proven by the theory on which Bion’s interpretations rely which is allegedly confirmed by the purported success of the treatment, a circular argument that is founded in little more than shifting sand. The Kleinian outlook is notorious for the directness of its technique and the dogmatic tenor of its claims, while offering little evidence for the so-called successful outcome of such interventions. Whereas Freud had the courage to publish his failures and offered them as lessons for the benefit of future analysts, Racker and Bion publish only what they claim are “effective” interventions, as though the correctness of the intervention could ever insure the outcome of the treatment. This is therapeutic ambition in its essence. How Bion could possibly know, for example, that his patient’s remarks are manifestations of his unconscious wish to tear Bion’s penis to bits I cannot say. Neither do I know what his patient meant by his bizarre remarks. That, it seems to me, is the point; how can we know, unless we take the time to secure the most optimal conditions so that, in time, the patient can tell us himself? R. D. Laing (1982), in a reference to Bion’s case report, aptly summarized this dilemma with the observation that It is difficult to imagine what the patient could say that could tell Bion anything he does not think he [already] knows. Bion’s view is based on, and follows from, Bion’s way of listening… Anything anyone says can be heard and processed in this very unusual way. It is difficult to imagine anything anyone could say which could possibly reveal to Bion that his constructions could be wrong… [Indeed} it is difficult to fathom the difference between Bion’s psychoanalytic fantasies and what is usually called a psychotic delusional system. (p. 52)

Laing proposes that if the reader did not already know that Bion was the psychoanalyst in this clinical vignette his remarks would appear just as delusional as his interlocutor. Indeed, without knowing who the two protagonists are, Bion’s responses to what his patient is presumed to be experiencing could, in turn, be interpreted as the ravings of a para-

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noid schizophrenic. Of course, we know that Bion was not a paranoid schizophrenic, but a highly respected and revered analyst who impressed a generation of practitioners with his intellect and imagination, though he appears to have suffered greatly himself. This makes it all the more distressing that he would conduct himself in this fashion. Why do Bion’s behavior and the use of interpretations like it constitute therapeutic ambition? The most compelling reason is that it exemplifies the analyst who touts himself as what Lacan has characterized as the one “who is supposed to know.” It is the same kind of behavior we witnessed in Racker’s interpretation of what he construed to be “effects” of projective identification. In Freud’s view, therapeutic ambition is a violation of neutrality and a common source of countertransference. Bion’s behavior characterizes the kind of analyst who lacks the patience to wait and hasn’t the time to waste on such matters. Moreover, Bion appears to be confident that he is in a better position to determine what is in his patient’s mind than his patient is, because he knows more about the theory of psychic process than his patient does or, for that matter, ever will. The analyst’s task, as Bion sees it, is to translate what his patient confides to him into a language that Bion believes approximates the patient’s unconscious. As Laing so eloquently states, anyone can play the game of translating a patient’s utterances into any language one chooses, including Pig Latin. But what purpose does this ultimately serve? According to Bion, the “correct” interpretation has the power of changing one’s mind. I have my doubts, along with many, I suspect, less endowed analysts, that this is ever actually the case. Bion is not interested in what his patient is trying to communicate to him because he (Bion) is so taken with the originality of his interpretations. Two weeks after the exchange Bion reported above, his patient, a tear welling from his eye, tells him “tears come from my ears now.” What is he communicating to Bion with this statement? Perhaps it is his way, the only way he is able, of responding to the barrage of interpretations, day after day, year after year, he has been subjected to in a relationship where nothing even approximating a conversation between them has ever occurred. According to Laing: If someone I had been seeing five times a week for five years were to say to me that tears were coming from his ears… I might be caught by his talent to say so much in so little. I might be glad there were no tears in my ears or eyes. I could not help but feel that the tears in his ears might betoken a sense on his part, which I could not help but share, of something sad, maybe even pathetic, about our relationship. (p. 52)

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I concur with Laing’s sentiments on the matter that there is something of an abyss between Bion and his patient. Increasingly, countertransference is perceived as nothing more than the analyst’s experience of the situation instead of that which obstructs the possibility of the patient owning his experience. While I applaud the increased attention paid to the analyst’s experience and the role it plays in the treatment constellation, it seems to me something is missing in Bion’s portrayal of the analytic situation. Increasingly, success has become the hallmark of the “effective” analyst; indeed, recent commentaries on Freud’s treatment philosophy tend to emphasize his lack of success with patients. I believe the time has come to question what we take our goals to be and the methods we employ to achieve them. Therapeutic ambition, no matter how clever or well intentioned, is not liable to bridge the abyss that such ambition engenders, because its effects are more likely to serve as the source of such alienation, not its redemption.

Eight

The Existential Dimension to Working Through

By now, you will have noticed at the beginning of each chapter I have characterized the technical principle I was about to introduce as one of the most subtle, enigmatic, obscure, or difficult to grasp of all the technical recommendations. Perhaps this says something about the way Freud characterized his conception of technique or the enigmatic nature of psychoanalysis itself. I make no apologies for this; psychoanalysis is, above all else, a mysterious affair and if I have succeeded in making it appear even more enigmatic than it did before you read this book then I will have achieved my purpose in writing it. That being said, Freud’s conception of working through is arguably the most subtle of all his technical rules. Like so many of the technical principles we have examined thus far, Freud’s comments about the nature of working through are also an exercise in brevity. The term, “working through,” crops up here and again, but the 1914 paper where he introduced it was the only place where Freud offered a concrete description of what it was intended to mean. More remarkable still, working through has no precise definition. Like so many of the other technical principles in Freud’s arsenal—e.g., neutrality, abstinence, free association, transference, countertransference, resistance—a careful examination of what Freud actually said about working through offers a significantly different characterization of its nature than the one typically portrayed in the psychoanalytic literature. In the most general terms, the notion of working through is almost always invoked in the context of the patient’s resistance to treatment. Hence one of the questions that invariably arises when resistance is discussed is what is it, specifically, that the patient is resisting? And what, in turn, is the patient expected to “work through”? In addressing these questions I shall begin with representative comments from the analytic literature depicting how working through is typically conceived. Beginning with the glossary of the American Psychoanalytic Association, Psychoanalytic Terms and Concepts, Moore and Fine (1990) propose that

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THE ETHIC OF HONESTY It is the goal of working through to make insight more effective, that is, to bring about significant and lasting changes in the patient. . . It may involve merely repeating and elaborating the usual analytic work, extending and deepening the analysis of the resistances, which need to be overcome repetitively and progressively and, in some cases, require special intervention. Prior interpretations often require expansion or modification so, they become more comprehensive or to the point, identifying basic themes or highlighting countless ways in which the conflictual situations are imbedded in [the patient’s] character structure. (p. 210)

Moore and Fine depict working through as the act of repetitiously “working over” an intractable issue with the aim of persuading the patient to embrace an unpleasant reality, by finally accepting the analyst’s interpretation despite one’s reluctance to doing so. In effect, they conceive working through as simply complying with an interpretation that the patient was heretofore unable or unwilling to accept. It should be noted that this depiction of working through relies more or less entirely on a given patient’s capacity for rationality, brought to bear in order to overcome his or her resistance to the analyst’s conception of reality. The “intellectual” feature of this characterization of working through is obvious and should be contrasted with others that perceive it in a more ambiguous light. Compare, for example, Moore and Fine’s definition of it with the one offered by Laplanche and Pontalis (1977). They argue that Freud … [S]eems to suggest that working-through constitutes as fundamental an aspect of the treatment as do recollection of repressed memories and the repetition that occurs in the transference. In point of fact the article in question leaves us in considerable doubt as to what Freud means exactly by working- through. Some points, however, are made clear: a. Working-through applies to resistances. b. It generally follows the interpretation of a resistance that has apparently had no effect… c . Working through permits the subject to pass from rejection or merely intellectual acceptance to a conviction based on lived experience (Erleben)… In this sense, it is by “becoming more conversant with this resistance that the patient is enabled to carry out the working-through.” (p. 488) [Emphasis added]

Compared with the definition offered by Moore and Fine, Laplanche and Pontalis emphasize the critical importance of the patient’s subjective experience, the nature of which psychoanalytic treatment endeavors to deepen. In their view working through entails the act of getting past a purely intellectual understanding of something and becoming more or less “convinced” of it, which is to say, to experience it, heart and soul.

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Consequently, the experience of working through is transformative in that it changes one’s way of seeing the world. More recently, some have taken the process of working through to include the behavior of the analyst as well as the patient. According to Laplanche and Pontalis: In the Freudian texts… working-through is unquestionably treated as a form of work accomplished by the analysand. Those authors since Freud who have insisted on the necessity for working-through have also emphasized the part invariably played in this process by the analyst. Witness, for example, this passage from Melanie Klein: “The necessity to work through is again and again proved in our day-to-day experience: for instance, we see that patients, who have at some time gained insight, repudiate this very insight in the following sessions and sometimes even seem to have forgotten that they had ever accepted it. It is only by drawing our conclusions from the material as it reappears in different contexts, and is interpreted accordingly, that we gradually help the patient to acquire insight in a more lasting way.” (p. 489)

Klein’s treatment of working through reflects the increasingly popular convention that it pertains to something that is repetitiously manifested throughout the treatment experience and requires considerable effort (by the analyst) in order to affect a weakening of the patient’s resistance. Viewed from this perspective working through amounts to a “reworking” of the same interpretation, repeated over and over, until the patient finally gets it. Whereas Laplanche and Pontalis adopt a more ambiguous tone toward the nature of working through, their citation of Klein is more or less consistent with the view offered by Moore and Fine, which reduces working through to a rationalist form of activity. The Kleinian conception of working through entails the capacity to obtain insight into the nature of one’s unconscious symptom formation by “understanding” the role it plays in one’s psychical reality. Though Klein is not alone in this, she represents a group of analysts who advocate a conception of the analytic process that is governed by the patient’s capacity to: a) understand the reasons for one’s resistance to change, and b) effect change by virtue of such understanding. Hence, working through is conceived as a “wearing down” of the patient’s resistance by the intellectual force of the analyst’s interpretation and, ultimately, his insistence on it. I now turn to Freud’s comments about the nature of working through and compare his treatment of this phenomenon with the preceding. Recall that Freud’s comments pertaining to working through appear at the very end of a lengthy discussion about the nature of memory and the repetition compulsion, a concept that Freud introduced in this paper for the first time (see Thompson, 1994, pp. 192-204). For the sake of preserving the context in which Freud’s conception of working

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through arose, I shall begin my discussion at the point where Freud is reviewing the dynamics of resistance and the means for overcoming it. Freud begins with the observation that First and foremost, the initiation of analytic treatment in itself brings about a change in the patient’s conscious attitude to his illness. He has usually been content with lamenting it, despising it as nonsensical and under-estimating its importance; for the rest, he has extended to its manifestations the ostrich-like policy of repression which he adopted towards its origins. Thus it can happen that he does not properly know under what conditions his phobia breaks out or does not listen to the precise wording of his obsessional ideas or does not grasp the actual purpose of his obsessional impulse. The treatment, of course, is not helped by this. (p. 152)

Despite the caveat that patients go into analysis in order to relieve their suffering, they are nevertheless reluctant to address the basis of such suffering directly. Instead, they prefer to “lament” their suffering, Freud says, even though complaining has no discernible effect on the suffering itself. In light of the above, Freud suggests that if patients genuinely hope to benefit from the treatment, they must first find the means to change their attitude about what their suffering is about. [The patient] must find the courage to direct his attention to the phenomena of his illness. His illness itself must no longer seem to him contemptible, but must become an enemy worthy of his mettle, a piece of his personality, which has solid ground for its existence and out of which things of value for his future life have to be derived. (p. 152)

Freud observed that the symptoms patients complain about—the same symptoms that bring them into therapy—are paradoxically gratifying. Hence, the symptom about which we complain is nothing less than a contrivance created for the purpose of relieving a form of suffering that is even more intolerable than the symptom itself (See my discussion about the role of contrivance in the analytic setting in Thompson, 1994, pp. 78-87.). Whichever guise a symptom may assume—whether, for example, one of anxiety, depression, hypochondria, sexual inhibition, and so on—it also serves as a source of solace that the patient comes to cherish and protect. This is the reason patients unconsciously resist the analyst’s efforts to get to the bottom of what prompted their symptoms in the first place. This ingenious conception of the symptom alerts us to the paradoxical role that Freud’s notion of working through entails. In fact, “working” through and the “work” of analysis are essentially the same thing, phenomenologically speaking. Recall that the only work patients are asked to perform in the course of their treatment is deceptively elusive. Patients are not asked, nor are they expected, to change the behavior they

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complain about, nor are they admonished to improve their manner of living or to adopt this course of action in place of another. All they are asked to do, to the best of their ability, is to adopt the fundamental rule as their guiding principle: to disclose whatever comes to mind and to ponder its significance. Yet no sooner do they begin to disclose the manifest content of the (unconscious) motives that foster their symptomatology than the act of free association breaks down. Every effort to inquire into the nature of their suffering and the purpose it serves is resisted while they continue to act out their unconscious motives instead of examining them. Consequently, the source of their complaint remains safe from exposure while it continues to serve its secretive function. This is why, according to Freud, “[The analyst] celebrates it as a triumph for the treatment if he can bring it about that something that the patient wishes to discharge in action is disposed of through the work of remembering” (p. 153). But what does “remembering” specifically entail? Contrary to conventional wisdom, the patient’s capacity to remember should not be confused with the simple act of recollection. Remembering, in the sense that Freud employs it, entails the ability to recognize the historical dimension to what the patient is currently experiencing. In order to genuinely experience the here and now of the analytic moment one must be able to situate one’s experience in an historical context. In other words, if I hope to make sense of the manner by which I have become the person I am and the means by which I perpetuate that person at every turn, I must submit to the work of determining my origins. The act of remembering, however, isn’t as simple or straightforward as it appears. There is a knack to remembering that belies the logic of a “good memory,” because the only means by which we are able to approximate it is through the experience of free association. Hence, free association is a state of mind—“remembering”—that is at one moment succumbed to and the next resisted because what every analytic patient would prefer to do, despite protestations to the contrary, is not to remember but to forget. Resistance to this task is unavoidable because the kind of thinking to which we are all accustomed—the rational use of the intellect—is resistance in its essence (See Thompson, 1985, pp. 1-23, for a more exhaustive discussion on the relation between rationality and resistance.). Though patients are invited at the beginning of analysis to be as candid as they can, every analyst allows the patient the privilege of circumventing this rule to the degree that the patient finds necessary. It is axiomatic that analytic patients are in fact “free” (in the political sense, if not the psychical one) to indulge their impulses or defenses as they please, as long as they commit themselves to observing the fundamental

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rule in principle (See Chapter Two for a more exhaustive discussion on this point.). According to Freud: [The analyst does not hinder the patient] from carrying out unimportant intentions even if they are foolish; one does not forget that it is in fact only through his own experience and mishaps that a person learns sense. There are also people whom one cannot restrain from plunging into some quite undesirable project during the treatment and who only afterwards become ready for, and accessible to, analysis. (p. 153) [Emphasis added]

There is an unavoidable tension between the need to get things off one’s chest while at the same time resisting the obligation to reveal what comes to mind. One of the ways of easing the pressure is to act out one’s torment in roundabout ways. Hence Freud wasn’t interested in circumventing the (patient’s) resistance but sought instead to capitalize on the tension that the treatment experience engenders and even thrives upon. Yet the handling of resistance is paradoxical because the treatment confers upon every patient the unfettered freedom to employ it. Some analysts have sought to surmount this paradox by resorting to analytic methods that dispense with the fundamental rule altogether, substituting in its place the so-called analysis of resistance (Gray, 1994). But what do such analysts conceive resistance to entail if they circumvent the very conditions that elicit its manifestation? Without the tension that the fundamental rule engenders there would be nothing left for the patient to resist. The capacity to endure the paradoxical nature of the treatment experience is the key to resolving the conflict from which pathogenic conflicts are derived. Instead of merely “analyzing” the resistance as an end in itself Freud argued that patients should also endeavor to “overcome” the resistance as well. But how? The first step in overcoming resistance is made, as we know, by the analyst’s uncovering the resistance, which is never recognized by the patient, and acquainting him with it. Now it seems that beginners in analytic practice are inclined to look on this introductory step as constituting the whole of their work. I have often been asked to advise upon cases in which the doctor complained that he had pointed out his resistance to the patient and that nevertheless no change had set in; indeed, the resistance had become all the stronger, and the whole situation was more obscure than ever. The treatment seemed to make no headway. This gloomy foreboding always proved mistaken. The treatment was, as a rule, progressing most satisfactorily. (p. 155)

Thus the act of bringing a patient’s attention to an incidence of resistance seldom, in and of itself, prompts the resistance to disappear. Whereas non-analytic interventions (which rely on suggestion) merely

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encourage patients to adopt more desirable behavior, Freud conceived the analytic method in fundamentally different terms. How did Freud characterize the key to this perspective? One must allow the patient time to become more conversant with this resistance with which he has now only become acquainted, to work through it, [and] to overcome it, by continuing, in defiance of it, the analytic work according to the fundamental rule of analysis. (p. 155)

This highly condensed passage contains the essence of what Freud envisioned the principle of working through to entail. For him the “work” of working through should never be confused (as Klein insisted) with “working over” one’s resistance; instead, it entails the task of persevering when the work of analysis (compliance with the fundamental rule) breaks down. In effect, working through is a form of recovery, the nature of which overcomes one’s resistance to submitting to the task one is already engaged in. Ironically, the term “overcome”—Überwinden in German—has aroused objections from those who suggest it introduces a combative element into the otherwise neutral stance that analysts are encouraged to adopt. Paul Gray (1994), for example, has characterized Freud’s conception of working through as overbearing and even unanalytic. According to Gray: To “work upon,” to “overcome,” [and] to “deal with” resistances involve technical measures that are often different from those used in analyzing defenses. Yet Freud was unequivocal in his recognition that the key to effective, lasting therapeutic results lay in reversing the pathological alterations that the defense mechanisms have wrought on the [patient’s] ego. This is illustrated by his observation: “Indeed, we come finally to understand that the overcoming of these resistances is the essential function of analysis and is the only part of our work that gives us the assurance that we have achieved something with the patient.” (p. 38) [Quoted citation attributed to Freud; emphasis added by Gray.]

Gray interprets Freud’s citation (above) as confirmation that Freud was the first to advocate the analysis of defense, hence implying that the technical innovation of “resistance analysis” advocated by ego psychology has its source (and implicit justification) in Freud himself. Yet in seeming contradiction to his own contention, Gray hastens to ask, “What was it that Freud, if he was not analyzing defenses, had primarily relied on to influence the ego?” (p. 38). Gray raises this question not once, but repeatedly. After all, if Freud invented resistance analysis (as Gray claims), then why did Freud fail to actually analyze the resistance of the patients he treated? At a loss to offer an answer, Gray admits to his puzzlement at his own question. In my view, the problem is not whether

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Freud failed to practice what he preached but what he took the proper handling of resistance to entail. Apparently, it meant something altogether different to Freud than it has to a generation of ego psychologists. The tendency among analysts today involves increasingly ingenious methods of subverting the patient’s resistance once it becomes manifest by pointing it out and discussing it. The analyst is advised to address the resistance when it occurs, explore the feelings that may have prompted it, elicit whatever associations come to mind, and so on. Hence, analysts who “analyze” the resistance endeavor to turn the tables on it by making the resistance, not merely an artifact of the treatment, but the focus of it. During the course of such analysis the patient is obliged to momentarily halt free associating while the analyst, having temporarily suspended neutrality, interrogates him about what he is resisting and why. Once the resistances have been pinpointed, labeled, and analyzed accordingly, the patient is left with what is presumably a better understanding of the resistance in question, even if one’s comprehension of it does little to diminish or transform it. Though Gray insists that this form of intervention was sanctioned by Freud, there is nothing in Freud’s technical papers or the many accounts of his treatment philosophy that give credence to Gray’s contention. On the contrary, Freud’s writings suggest that he was relatively passive in his treatment methods. The work of analysis, as was stated earlier, is not the responsibility of the analyst, but rather the task—indeed, the obligation—of the patient. According to Lohser and Newton (1996): Working through the resistance [for Freud did] not mean, as it does today, that the analyst engaged in its lengthy exploration and interpretation but, rather, that the patient was to work through it by aggressively pushing through it, or acting in spite of it, and re-dedicating himself or herself to free association. The purpose of the analyst’s interpretation of resistance is not to examine the content of the resistance or the nature of the anxiety underlying it but, rather, to point out to the patient that some behavior that he or she does not understand to be resistance is [in fact] resistance. (p.166)

When faced with a patient’s opposition to the treatment—which is to say, to engage in candid self-disclosure—Freud preferred to simply wait for the patient to resume free associating whenever the patient is ready to, thereby permitting the patient’s unconscious to disclose itself by its own accord, in its own time, over however much time it entailed, but within limits. He believed that patients need to actually come up against their resistance by learning to struggle with it and, eventually, learn to accommodate the anxieties that their defenses aim to suppress, until a time when they are able to be with their anxieties, to the degree they are able to tolerate. Yet Gray perceives in Freud’s conservative pre-

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scription a treatment strategy that is allegedly intrusive, if not abusive. According to Gray (1994): Dropping full-scale hypnosis or hypnotic trance from psychoanalytic technique did not result in the exclusion of suggestion… to influence the patient. Just as strong positive transference was the earlier vehicle for the trance-hypnosis which entirely excluded the ego’s participation, so positive transference became the vehicle for influencing the patient’s participation in the analytic process. The authoritarian element, although applied with a different emphasis, was nevertheless preserved. (p. 38)

Gray argues that Freud’s conception of working through amounts to nothing more than a disguised form of suggestion. Overcoming one’s resistances, by his definition, entails the act of employing one’s will to abandon them, simply because that is what the analyst wants the patient to do. Moreover, Gray maintains that Freud: 1) relied solely on suggestion in his handling of resistances; 2) used his authority as a means of coercing his patients to abandon them; and 3) relied exclusively on the positive transference as the vehicle for working through them. If this is indeed what Freud proposed Gray would be correct in characterizing such tactics as pre- or un-analytic devices. But does this depiction of working through accurately characterize Freud’s analytic method? I don’t believe that it does. Perhaps the reason Gray came to the conclusions he did was his failure to note the subtlety with which Freud envisioned the experience of working through, at the deepest level. An example of Gray’s oversight is his (mis)understanding of how Freud intended overcoming (Überwinden) one’s resistances to work. In German, Überwinden means, “to get over something” by finally facing it and eventually “coming to grips” with it. It has the same connotation, for instance, as when overcoming a loss by accepting the loss as a new facet of one’s existence. The philosopher who most passionately rhapsodized about the need for overcoming painful aspects of life by facing them was Friedrich Nietzsche who, by Freud’s admission, anticipated many of his most radical ideas. The capacity (or virtue) for overcoming one’s fears was a prominent feature of Nietzsche’s conception of the ideal or “super” man, the Übermensch in German, or “overman.” For Nietzsche, the ideal person is one who resolves to overcome the weight of existence by accepting reality for what it is. Similarly, overcoming ones resistance to unanticipated and at times unwelcome interpretations hinges on the ability to accommodate the anxieties elicited when one is broadsided by an alternative point of view. Overcoming the resistance to unveiling ourselves to others entails “working through” the inescapable

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fear of coming to terms with who we are, by taking in what others make of us, wherever the chips may fall. That doesn’t mean that once we accept our vulnerability and make our bed in it that our resistance to this arrangement lets up. In the treatment, working through simply entails the wherewithal to persevere with the “work” of analysis the best we can, despite our resistance to it. In counterpoint, the analyst endeavors, as best he can (see Chapter Seven), to adopt an inherently passive role in the treatment, not as Gray supposes, an active one. When communication breaks down, as it inevitably does, or when an interpretation fails to elicit more inquiry, Freud (1914) advised that The [analyst] has nothing else to do than to wait and let things take their course, a course which cannot be avoided nor always hastened. If he holds fast to this conviction he will often be spared the illusion of having failed when in fact he is conducting the treatment on the right lines. (p. 155)

Freud never implied that adopting such a passive role—a feature of neutrality—was going to be easy. He readily acknowledged that the demands of the treatment situation are just as arduous for analysts as they are for their patients. This working-through of the resistances may in practice turn out to be an arduous task for the subject of the analysis and a trial of patience for the analyst. Nevertheless it is a part of the work which effects the greatest changes in the patient and which distinguishes analytic treatment from any kind of treatment by suggestion. (p 155-156)

It is ironic that Freud would characterize his conception of working through as the singlemost feature of technique that distinguishes it from alternative, more “suggestive,” forms of treatment when Gray’s account characterizes it as the most suggestive feature of Freud’s treatment philosophy. What could explain such a blatant misunderstanding of Freud’s tightfully-wound description of this technical principle? One possible explanation is that analysts today tend to conceptualize resistance in the broadest possible terms, whereas Freud conceived it in the narrowest terms. Whereas contemporary analysts tend to situate resistance as resisting any aspect of the treatment that is believed to be in the patient’s interests, Freud restricted its occurrence to that of resisting candor, in effect to halt one’s participation in the act of self-disclosure. As we saw in Chapter Two, self-disclosure is epitomized by nothing more onerous than disclosing what happens to be on one’s mind. The most extreme (and stereotypical) example of resistance is probably opting to say nothing, but we know it is more complicated than that because resistance cannot be reduced to silence alone. On the contrary,

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some patients talk ad nauseam; they freely “dissociate” in place of associating and effectively say nothing, keeping the content of their revelations as close to the surface as possible. To free associate requires more than simply speaking out loud because it assumes one’s compliance with the spirit of the rule as well as the letter of it. To genuinely “free” associate assumes nothing less than—forgive me—opening one’s heart to another person, by taking that person into one’s confidence and confessing one’s innermost existence. Hence “working through” the resistance entails the ability to recover the capacity for candor that was momentarily lost. If, in the final analysis, resistance is nothing more than a “loss of heart,” then working through is the wherewithal to open one’s heart again, by succumbing, in spite of one’s reluctance to do so, to the dialectic of free associative activity. Obviously this takes time. Working through relies on the passage of time and the time it takes to let time assume its proper function in the treatment. When Freud insists that analysts must “wait and let things take their course” he is invoking a conception of time that is existential in nature. Indeed, psychoanalysis is essentially a device that arranges for time to employ its effect upon us. The couch, the inexorable pace, the pregnant pauses that epitomize its odd conversational conventions are all contrivances that Freud devised in order to resurrect our neglected relationship with time. Few analysts have recognized this inherently phenomenological dimension to Freud’s treatment philosophy (For a singular exception see Loewald, 1980, pp. 43-52; 138-147; see also Leavy, 1989.). This isn’t a matter of imposing suggestion or authority but of revealing those aspects of ourselves that we are finally able to disclose, by submitting to our experience of the moment. But how can one’s resistance to experience be altered if the analytic situation is, by its nature, beyond one’s control? Given the importance of experience to this endeavor and the crucial problem as to how one’s experience may be affected, there is a striking absence of inquiry into its nature in the psychoanalytic literature. Freud and his followers grasped the significance of experience from a “common sensical” perspective but saw little reason to explore its philosophical implications. Yet the enigmatic nature of free association and the patient’s resistance to it are impossible to grasp without recourse to the place experience contributes to the treatment situation. Nowhere is its relevance more obvious than in Freud’s conception of working through, a principle that speaks specifically to the experience of free association and the resistance that patients mount against it. Perhaps its neglect in the analytic literature is due to the emphasis that is customarily reserved for investigating the patient’s unconscious, which, due to its latency, is presumably impossible to experience, per se. In-

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stead, analysts typically rely on conjecture and inference—both of which are “experience-distant” activities—in order to guess at what its contents and machinations might be. Yet it is the conscious, experiencing, agent who submits to analysis in the first place and who proceeds to uncover what was previously hidden by attending to one’s verbalizations. This is why the task of analysis is not simply one of deciphering what is obstinately hidden but one of finally coming to grips with one’s unconscious, in the singular act of disclosing it. It is nevertheless possible to resist experience and even suppress it by engaging in intellectualization, repression, splitting, denial, projection, and other defensive maneuvers. Given the forces we mount against it, what can we say about what experience specifically entails, and how may one deepen it in the context of the treatment situation? These critical questions deserve more attention than I can allow in the space that I have left and will be addressed more fully in the future. In the meantime, I indicate how these questions relate to the problem of working through in my conclusion to this chapter. According to the Oxford English Dictionary, experience derives from the Latin experientia, meaning “to try” or “a trial.” It is also cognate with the word “peril,” lending to the term a gravity that is typically overlooked. Experience is specifically defined as, “the fact of being the subject of a state or condition;” “of being consciously affected by an event;” “to feel, suffer, and undergo.” On a deeper level still, a properly phenomenological rendering of experience implies both intentionality and intersubjectivity, since it is the subject—“I”—who experiences something that is inherently “other” than oneself. In effect, my experience is me in the context of my being-in-the-world. Experience also pertains to a quality of consciousness, since I can experience something only to the degree that I am aware of it. This is the quality of experience Freud was invoking when he said, “it is only through [one’s] own experience (Erlebnis) and mishaps that a person learns sense.” But is that all there is to say about it? Are there greater or deeper degrees of experience that I am capable of obtaining but neglect to avail myself of, or is it all or nothing, a matter of being aware or unaware of the topic at hand? We touched on these questions earlier when we examined the experience of free associating (Chapter Two) and the quality of consciousness it specifically entails. We concluded then that free association entails more than simply permitting one’s thoughts come to mind because I never merely “observe” what occurs to me; I also experience it. It should be obvious by now that the conventional notion of experience hardly accounts for the elasticity of the phenomenon. In fact, the concept of experience is as perennial as it is enigmatic, going all the way back to the 4th Century BC and the Sceptics who were the first Western philosophers to reject rationality as the arbiter of wisdom by replacing it with the primacy of experience instead (See Thompson,

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2000a and 2000b for a more detailed exploration of how the sceptic treatment of experience anticipated the modern invention of psychoanalysis.). More than a millennium later, beginning with Michele deMontaigne in the Sixteenth-century and more recently Husserl, Heidegger, and Freud in our own, a host of philosophers, theologians, and thinkers from other disciplines made experience the cornerstone of their inquiry into the human condition. Despite the attention given to experience, there is a tendency in psychoanalysis to dispense with the concept altogether, or to retain it as a hollow principle that has abandoned its sense of relevance and proportion. In a critique of Susan Isaacs’ views concerning the relationship between fantasy and experience, R. D. Laing challenged Isaacs’ (and with her, the psychoanalytic) characterization of unconscious fantasy as a mode of experience. According to Isaacs: Through external experience, fantasies become elaborated and capable of expression, but they do not depend upon such experience for their existence. (Quoted in Laing: 1969, p. 4)27 Isaacs avers that our conscious, waking experience of the external world elicits both conscious and unconscious fantasies (as a means of relieving the frustrations encountered in experience), but that such fantasies are nevertheless not exclusively dependent on experience for their existence. She argues that Unconscious fantasies form the operative link between instincts and mechanism. When studied in detail, every variety of ego-mechanism can be seen to arise from their origin in instinctual impulses… [Hence] a “mechanism” is an abstract general term describing certain mental processes which are experienced by the subject as unconscious fantasies. (Ibid, p. 5) [Emphasis added]

Laing wonders how it is possible to experience something the nature of which one is completely unaware (i.e., unconscious) of experiencing. The implications of such a thesis for the use of psychoanalytic interpretation are significant. One of the basic principles of Isaacs’ theory, for example, is that the patient is always at the mercy of defense mechanisms that, even after they have been interpreted, continue to act upon the patient and always will. In turn, such defenses are conceived as fundamentally alien to the patient’s agency and will always remain so. The purpose of interpretation is to alert the patient to the existence of 27 Isaacs, S., “The nature and function of phantasy.” In Riviere, J. [Ed.], Developments in Psycho-Analysis. London: Hogarth Press, 1952.

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such defenses so that one may account for their effects. This is consistent with Gray’s (1944) view that the aim of the treatment situation is one of “reversing the pathological alterations that the defense mechanisms have wrought on the [patient’s] ego” (p. 38). It is little wonder that, given their respective conceptions of “defense,” these authors are unable to account for the nature of experience as such since, by it, the very notion of experience is virtually negated. In a study devoted to the exploration of experience from a phenomenological perspective, Laing (1967) set out to “translate” the psychoanalytic conception of mechanism into a language of personal experience: Under the heading of “defense mechanism,” psychoanalysis describes a number of ways in which a person becomes alienated from himself. For example, repression, denial, splitting, projection, introjection. These “mechanisms” are often described in psychoanalytic terms as themselves “unconscious,” that is, the person himself appears to be unaware that he is doing this to himself. Even when a person develops sufficient insight to see that “splitting,” for example, is going on, he usually experiences this splitting as indeed a mechanism, an impersonal process, so to speak, which has taken over and which he can observe but cannot control or stop. There is thus some phenomenological validity in referring to such “defenses” by the term “mechanism.” But we must not stop there. They have this mechanical quality because the person as he experiences himself is dissociated from them. He appears to himself and to others to suffer from them. They seem to be processes he undergoes, and as such he experiences himself as a patient, with a particular psychopathology. But this is so only from the perspective of his own alienated experience. As he becomes de-alienated he is able first of all to become aware of them, if he has not already done so, and then to take the second, even more crucial step of progressively realizing that these are things he does or has done to himself. Process becomes converted back to praxis, [and] the patient becomes an agent. (1967, pp. 17-18) [Emphasis added]

Another analyst influenced by Klein, Hans Racker, employs Klein’s notion of unconscious fantasy (here elaborated by Isaacs) in his interpretation of the analyst’s countertransference “experience” of the patient’s unconscious fantasies. Because the very concept of experience has been relegated to nonsense, analysts such as Racker and Isaacs are free to distort its meaning to serve their clinical end: that of becoming the arbiter of what the patient’s experience is and what that experience is said to be up to. More disturbing still is their conviction that their respective patients will never be afforded the opportunity of ever finally recovering their experience, because they assume to do so is not even possible. Returning to Isaacs, Laing (1969) counters that

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In my experience, self does not experience the experience of other directly… [Yet] from the perspective of self seeing other, Isaacs infers from her experience of the other’s actions certain things about the other’s experience, [in the same way that] an adult infers what a baby experiences. (p. 6)

In other words, Isaacs conceives the interpretive process along the lines of a mother who is endeavoring to make sense of her baby’s experience, since the baby is unable to tell the mother what the baby’s experience is. While allowing that adult patients are able to tell us about their experience, Isaacs is convinced that such patients are nonetheless capable of experiencing feelings and ideas they are unaware of experiencing, and which, by this reasoning, require the analyst to tell them what such experiences are. Laing continues: Isaacs, in referring not simply to imagination, daydreams, or reveries, but to “unconscious fantasy,” is making two types of inference… namely: she is inferring something about the other’s experience, and she is inferring that this is something of which the other is unaware. This seems to mean that there is a whole type of experience, as well as specific “content” of experience, of which the other who “has” the imputed experience knows, or may know, nothing. From her premises, corroboration of her self’s inferences by explicit testimony from other is not necessary to confirm these particular inferences. (p. 6)

As far as Isaacs is concerned, confirmation of such inferences about the patient’s “unconscious” experience is supported solely by: a) the “correctness” of her theory; and b) the patient’s “progress” in analysis whatever that means. Indeed, by dint of this theory, the patient is ipso facto incapable of ever actually “knowing” what his unconscious experience is, since such experience is, by definition, unconscious. Laing remarks at the marvel of such a thesis in the way it leaves the patient out of the loop, so the speak, whenever the analyst endeavors to determine the content of the patient’s experience, by ignoring the patient’s account of what his experience is. According to Isaacs, it is unnecessary to wait for or expect one’s patient to undergo, let alone suffer, his own experience, to be moved by it, and finally come to terms with it, because the analyst and the analyst alone is able to do this for him. Isaacs concludes that it is virtually impossible for patients to ever experience (i.e., be aware of) their experience themselves—or even to corroborate the accuracy of the analyst’s interpretations that purport to determine what their experience is said to be. Despite the views of mainstream psychoanalysts, such as Klein, Isaacs, Racker, and Bion, experience has been the object of fascination for philosophers from ancient times to the present. Even Hegel, an ide-

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alist in other respects, argued that change is possible only to the degree that we are capable of accounting for our experience of the ideas with which we typically wrestle. Hegel rejected the common sense notion of experience that reduces it to the simple awareness of an event, in the manner, for example, that I experience writing this sentence, by arguing that when I truly experience something I am also affected by it, because it comes as a shock (See Thompson, 1996c and 1997 for a more detailed account of the phenomenology of experience.). Hence experience necessarily confronts me with frustration because it violates my familiar view of things by forcing something new into consciousness. Due to its intrinsically unsettling nature Hegel concluded that experience also elicits despair because it disturbs my previous accommodation of reality. Consequently, my capacity to experience subverts what is familiar by changing my point of view and, hence, “who” I am. More recently, Heidegger examined the revelatory aspects of experience in addition to its strictly transformative role emphasized by Hegel. Heidegger focused on the interplay between experience and selfdiscovery by proposing that experience doesn’t merely change the world I inhabit but also reveals things I hadn’t realized before. Consequently, experience elicits truths about myself and my view of the world. More over, Heidegger was drawn to the inherently practical task of determining the ground of personal existence and how to make peace with it, honestly and authentically. Heidegger discovered that if a person is prepared to employ a degree of forethought and discipline to the task, experience could be nudged in a certain direction in order to achieve a specific goal. By anticipating my experience with a conscious aim in mind I can use that experience to gain insight into the person I am and the world I inhabit. Experiences don’t just “happen” in random, haphazard fashion; I am also capable of resisting experience, avoiding the weight of it, and even forgetting painful experiences I have suffered in the past. In turn, the degree to which I am able to experience something to the core of my being—whether eating a meal, falling in love, even undergoing a psychoanalysis—is determined by how willing I am to submit (i.e., give myself over) to the experience in question. Hence, there are degrees to experience; it isn’t all or nothing. These considerations about the nature of experience offer profound implications for the role of the psychoanalyst and the means by which interpretations are used in order to transform what the patient experiences and how. Laing observed that Heidegger’s conception of experience already presupposes an act of interpretation that, in turn, determines what I am inclined to experience in the first place. Our experience of another entails a particular interpretation of his behavior. To feel loved is to perceive and interpret, that is, to experience,

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the actions of the other as loving… [Hence] in order for the other’s behavior to become part of self’s experience, self must perceive it. The very act of perception [and hence experience] entails interpretation. (In Laing, Phillipson, Lee, 1966, pp. 10-11) [Emphasis added]

According to Laing, everything a patient in analysis experiences is the end result of interpretations the patient has already, surreptitiously given to all that he is even capable of experiencing throughout the course of the therapy relationship.28 Hence what the analyst says is never actually heard in the way the analyst necessarily intends it, because it is unceremoniously and unconsciously interpreted by the patient according to his or her interpretative schema, a culmination of everything the patient has previously experienced (and understood by those experiences) in the course of a lifetime. In other words, every analytic patient experiences the world according to a personal bias that is inherently resistant to anything that contradicts it. The dogmatic nature of the patient’s views, held together by a lifetime of neurotic maneuvers, accounts for the resistances that analysts invariably encounter when employing their interpretations. Since both the analyst and patient are always, already (unconsciously) interpreting everything the other says, what is actually heard by each and in turn experienced is impossible to communicate directly, because every account of one’s experience entails the use of words which, when uttered, are de facto interpretations of that experience. This constantly changing interplay of speech, recognition, and misunderstanding accounts for the extraordinary difficulty that analysts encounter in their endeavor to effect change, since the change they aspire to effect is at the mercy of the patient’s originary experience, the nature of which is, for the most part, impervious to change and no less difficult to determine. Analysts need to be wary of the temptation to offer interpretations at random with the hope that some will simply “stick,” and endeavor instead to learn the means by which his interpretations actually affect the patient (transference) and, in turn, why the patient’s responses affect him (countertransference) the way they do.29 In every communication with the patient, the analyst aims to: 1) learn what the patient’s inter28

This view of interpretation has been called hermeneutic by some (see Sass, 1998), but the hermeneutic literature is not identical with and, at turn, is even antithetical to the phenomenological perspective developed by Husserl or Heidegger. 29 Here I employ transference and countertransference in the generic sense of pertaining to the patient’s and analyst’s subjective experience, respectively. For more on an explicitly phenomenological understanding of transference and countertransference see Chapters Five and Six.

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pretative framework is; 2) determine the means by which that interpretative framework constructs a “world” (the transference neurosis) that is attributed to the analyst; and 3) offer the patient a wider range of interpretations to consider, with a view to helping the patient overcome his innate resistance to experiencing something new, or foreign, but also forgotten. In his resistance to this process the patient employs alternative “interpretations” of his own that serve to distance him from painful experiences (the reality principle) while eliciting other, more pleasing (the pleasure principle) experiences in their place. Should an unanticipated experience slip through the patient’s carefully wrought net of defenses, he will nevertheless instinctively limit the degree to which he is ready to permit the experience to affect him and, hence, transform that experience. Heidegger concluded that experience never simply transpires, in the abstract, but is necessarily suffered, in the existential sense. Since we always have a hand in what we experience and the degree to which we permit our experience to affect us, no one can ever actually impose an experience on another person. It is nevertheless possible, through coercion, intimidation, or seduction to engender an experience that the other person may, in hindsight, wished not to have succumbed to. Such experiences can, in turn, be repressed and, hence, harbored “unconsciously.” This conception of experience is perfectly consistent with Freud’s formulation of free association and the painstaking dynamics of working through one’s resistance to change. These considerations may help to explain why the act of interpreting the patient’s disclosures with the aim of aligning them with “past” experience is a slippery slope upon which every analyst has tripped. The likelihood of transgressing the boundaries that designate the respective roles assigned to analyst and patient alike is built into the fabric of the analytic relationship because its outcome depends on the manner in which such interpretations are offered. Interpretation is an undeniably invaluable and perhaps indispensable resource, but only when employed for the purpose of helping patients gain access to a dimension of their experience that is dormant, thus effecting the opportunity of coming to terms with a lost, unincorporated dimension of experience, however painful such experience may be. It seems to me too many analysts employ interpretation as a means of translation and indoctrination in place of the more frustrating goal of revelation and discovery. Such analysts seem to believe only they have the means of determining what is unconscious because only they know the theories that can decipher what it means. Some analytic schools are admittedly more invested in this form of sorcery than others. When analysts choose to dispense with interpretations altogether (as per D. W. Winnicott) or effect a more sceptical perspective (as per Otto Will), they are sometimes accused of abandoning psychoanalysis altogether. Freud

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probably instigated this error and every subsequent analytic school has embellished it further. To give Freud his due, he eventually realized after trial and error that the underlying purpose of interpretation is a necessarily modest one: that of simply helping patients to hear and, hence, experience what they are themselves capable of saying in their own words. When employed with such caution the interpretive act is less likely to elicit the depth of resistance that the Kleinian approach (for example) often engenders. Every analytic patient is alone in this endeavor, not because it implies a one-person psychology, but because only the patient can speak from his or her experience, and because only the patient can say what that experience is. In the final analysis, psychic change is realized, not through insight alone, but by the wherewithal to relinquish designs that are not tenable in the first place. Because we all suffer from the burden of an existence that frustrates and disappoints at every turn, psychoanalysis was never cut out to serve as a mechanism for “success.” Rather, its greatest resource is the change it is capable of fostering, if not in the social arena in which we live then, perhaps, within “ourselves.” What patients work through during the course of their analysis is nothing less than a grudging acceptance of who they are and what, more importantly, they are not, in a world in which they are “thrown” because the world is never entirely their making. It is perhaps fitting to give Freud (1910) the last word on the matter in a passage where he offers the choice—existential, to be sure—that every analytic patient must face at the terminus of their treatment: A certain number of people, faced in their lives by conflicts which they have found too difficult to solve, have taken flight into neurosis and in this way won an unmistakable, although in the long run too costly, gain from illness. What will these people have to do if their flight into illness is barred by the indiscreet revelations of psychoanalysis? They will have to be honest, confess to the instincts that are at work in them, face the conflict, fight for what they want, or go without it. (pp. 149150)

This is bitter medicine, indeed, but one that therapy patients are never obliged to swallow because it is always their option to accept these terms or decline. Although they are never obliged to, they are nevertheless obligated, whether they like if or not, to live the choices they make and, finally, to make their peace with them, for better or worse.

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Concluding Unscientific Postscript

I have tried to show how Freud’s conception of honesty pervades the entirety of his psychoanalytic method and the manner in which it haunts every psychoanalytic encounter. I hope you have judged this book on the basis of what I have set out to do and not on the basis of what I have not set out to. I have attempted a sober assessment of Freud’s technical method in light of subsequent formulations, and I have criticized Freud where I believe he was wrong or defended him where I think he was right. Moreover, I have brought my attention to bear on the eight technical principles upon which Freud’s analytic method derive and situated those principles in the here and now of the analytic situation. I have not critiqued Freud’s theories in any detail as I do not believe they have much bearing on the method itself. These principles have proven sufficiently elastic over the course of the last century to serve as the basis for virtually every psychoanalytic school that has followed; there are no doubt many more that will be entertained in the years ahead, perhaps just as many as in the century that preceded it. I have endeavored to mine a measure of therapeutic wisdom from the corpus of Freud’s example. Insofar as my views do not fall into a discernible psychoanalytic school or theory, it is obvious that my reading of Freud and, perhaps, of psychoanalysis itself is an unconventional one. You will have to judge for yourselves whether the considerations I have emphasized speak to your own experience. I know how difficult it is for analysts as well as their students to bracket theoretical considerations while pondering the vicissitudes of their experience. The pressure to think theoretically is admittedly enormous and in my estimation is the single most feature of psychoanalysis that has prompted its gradual decline. Though I have taken some analysts to task for views that are antithetical to mine, I do not dismiss their contributions to psychoanalysis nor have I suggested that their contributions are insignificant. I have been strictly concerned with the task of examining what the psychoanalytic conception of honesty entails and why it is important to give this question the credence it warrants. To this end I have characterized the analytic endeavor as an ethic, or agogi (i.e., way) that must be tailored to the person of each practitioner. I have couched my observations with a minimum or jargon and, when technical terminology was unavoidable, as clearly and succinctly as possible. If I have failed to render my views with sufficient clarity I have no one to blame but myself.

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Finally, I have not presented my views in tandem with the latest theoretical fashion, nor have I acknowledged many of the most recent contributions to matters of technique. This is not because I am unaware of these developments but because my intention was to explore a dimension of analytic inquiry that is latent in virtually all psychoanalytic schools and their respective theories. You may recognize in the pages you just read conclusions that you have arrived at yourself, though you may have gotten there by different means. Though I have limited this study to technical principles that were originally articulated by Freud, I hope you will not assume that I think of myself as a Freudian (whatever that means). I readily admit that the questions raised here are not new or novel but perennial, going all the way back to the roots to which every psychoanalyst is indebted. As such, these questions will never go away because the wisdom they yield can never be exhausted. In conclusion, I have tried to show that the problems encountered by the psychoanalytic endeavor are too complex, subtle, and enigmatic to assume that any theory, no matter how sophisticated or compelling, could ever do them justice. Perhaps, in order to be psychoanalysts, we should become, not students of analysis in the narrow sense, but of the human condition. If I have inspired you to reconsider what your experience contributes to your clinical adventures, then my purpose in writing this book has been rewarded. M. Guy Thompson San Francisco

About the Author

M. Guy Thompson, Ph.D., is Founder and Director of Free Association, Inc., San Francisco, Training and Supervising Analyst, Psychoanalytic Institute of Northern California, San Francisco, and on the faculty of the California School of Professional Psychology, Berkeley, California. Dr. Thompson is Past President of the International Federation for Psychoanalytic Education, President of the Northern California Society for Psychoanalytic Psychology, and on the editorial boards of Psychoanalytic Psychology and the Journal of Phenomenological Psychology. He is the author of The Death of Desire: A Study in Psychopathology (1985), The Truth About Freud’s Technique: The Encounter with the Real (1994), and over sixty journal articles and book reviews on phenomenology, psychoanalysis, and schizophrenia. Dr. Thompson is in considerable demand as a speaker and has lectured extensively worldwide, including Canada, Mexico, Great Britain, Australia, and Spain. He practices psychoanalysis in San Francisco, California.

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References

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Kris, E. (1951) Ego psychology and interpretation in psychoanalytic therapy. Psychoanalytic Quarterly. 20: 15-30. Lacan, J. (1977) Ecrits—a selection. New York: W. W. Norton and Company. Lacan, J. (1992) The seminars of Jacques Lacan: Book VII, the ethics of psychoanalysis - 1959-1960. (trans. Dennis Porter) New York: W. W. Norton and Company. Laing, R. D. (1967) The politics of experience. New York: Pantheon Books. Laing, R. D. (1969) Self and others. [second edition] London: Tavistock Publications. Laing, R. D. (1972) Metanoia: Some experiences at Kingsley hall, London. In H. M. Ruitenbeek (Ed), Going crazy: The radical therapy of R .D. Laing and others (pp. 11-21). New York: Bantam Books, 1972. Laing, R. D. (1982) The voice of experience. New York: Pantheon Books. Laing, R. D., Phillipson, H., & Lee, A. R (1966) Interpersonal perception: A theory and a method of research. London: Tavistock Publications. Laplanche, J. & Pontalis, J.-B. (1973) The language of psychoanalysis. London: Hogarth Press. Leavy, S. (1988) In the image of god. New Haven: Yale University Press. Leavy, S. (1989) Time and world in the thought of Hans Loewald. In Psychoanalytic Study of the Child, vol. 44. New Haven: Yale University Press. Levenson, E. (1972) The fallacy of understanding: An inquiry into the changing structure of psychoanalysis. New York: Basic Books. Lipton, S. (1977) The advantages of Freud’s technique as shown in his analysis of the Rat Man. International Journal of Psychoanalysis. 58: 255-73. Loewald, H. (1980) Papers on Psychoanalysis. New Haven: Yale University Press. Loewenstein, R. (1956) Some remarks on the role of speech in psychoanalytic technique. International Journal of Psycho-Analysis, 37: 460-468. Lohser, B. & Newton, P. (1996) Unorthodox Freud: The view from the couch. New York: The Guilford Press. Mahony, P. (1986) Freud and the Rat Man. New Haven: Yale University Press. Mahony, P. (1987) Psychoanalysis and discourse. London and New York: Tavistock Publications. Marmor, J. (1970) Limitations of free association. American Medical Association Archives of General Psychiatry, 22: 160-165. Masson, J. M. [Ed] (1985) The complete letters of Sigmund Freud to Wilhelm Fliess: 1887 - 1904. Cambridge, MA and London: The Belknap Press. Merleau-Ponty, M. (1962) Phenomenology of perception. (trans. Colin Smith) London: Routledge & Kegan Paul. Mitchell, S. & Aron, L. (1999) Relational psychoanalysis: The emergence of a tradition. Hillsdale, N. J.: Analytic Press. Montaigne, M. (1925) The essays of Montaigne. (4 volumes; trans. George B. Ives) Cambridge: Harvard University Press. Moore, B. & Fine, B. (1990) Psychoanalytic terms and concepts. New Haven: Yale University Press and the American Psychoanalytic Association. Natanson, M. (1973) Edmund Husserl: Philosopher of infinite tasks. Evanston: Northwestern University Press. Nietzsche, F. (1966) Thus spoke Zarathustra. New York: The Viking Press. Onions, C. T. [Ed.] (1973) The shorter Oxford English dictionary on historical principles. (3rd edition) Oxford: The Clarendon Press.

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Index

Abstinence, the rule of, 61-77 divergent conceptions of, 75-76 Freud’s characterization of, 64-68 Greenson on, 62-63 Laplanche and Pontalis on, 63-64 in psychoanalytic literature, 62-64 Abstinence (abstinenz): or analyst activity, 72, 73 and the analyst’s affect, 52-53 countertransference violation of, 105, 111 definitions of, 61-62 Freud’s characterization of, 105 neutrality compared to, 52-53, 55-58, 58(n.16), 119-120 and sympathy, 66, 76 and therapeutic ambition, 110, 111 and unpredictable sessions, 75 Acceptance: and forgiveness, 90 of human imperfection, 115, 141 of natural needs, 18 of truth and reality, 69, 131, 141 See also Resistance Affection, with patients, 65, 76 Agogi (way), 143 Alienation from experience, 136 Ambiguity: of Freud’s writing, 71, 123 between neutrality and abstinence, 110 of verbal meditation, 32 Ambition. See Therapeutic ambition American Psychoanalytic Association (APA), 4, 80, 109, 123-124 Analogies, Freud’s: analyst as surgeon, 25, 43, 46, 52, 64, 68, 70-71, 104, 110-111 garland of sausages, 65, 66 railroad car, 7, 31, 34

Analysis resistance. See Resistance Analyst, the: affect of, 52-53, 96-98 analysis of, 102-103 criticisms of Freud’s technique as, xx, xxi, 39, 57, 59, 76, 85, 122 narcissism of, 41 personality of, 40, 113 prognostication by, 47-48 real reaction or countertransference by, 103 silence by, 47, 50, 58 subordination of personality of, 40 See also Therapeutic ambition Analyst-patient relationship. See Patient-analyst relationship Analysts: advised to withhold sympathy, 46, 56, 76 authoritarian, 118, 131 the behavior of, 10-11, 117-118 countertransference of, 60, 101-102 Freud’s recommendations to, 43, 44, 44(n.12), 48-49, 52, 56, 64-66, 104, 110 Freud’s technical principles for, xviii inactivity and activity by, 119-120, 130-132 insecure, 113 as interventionists, 27, 56, 130 neutrality behaviors, 40-41, 60, 132 note-taking by, 45 the patience of, 132 patients falling in love with, 53-54 professional role of, 101-102, 105, 107, 114

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as students of the human condition, 144 the training of, xviii, 47, 103, 113 truthfulness of, 54-55, 56, 106 use of abstinence by, 57 See also Countertransference Analytic relationship. See Patientanalyst relationship Analyzability, the problem of, 9, 23 Anger, fear of analyst’s, 97 Anna O. case, 54 Annas, J., 50-51 Anxieties: accommodating, 130 disclosure of, 28 manifesting, 67-68 secrecy at the bottom of, 15 Aristotle, 88-89, 92 Aron, L., xxi Arrogance of interpretation, 118 Art of psychoanalysis: conversation the, 28-29 the science or, 45, 70-71 Attachment to the analyst. See Transference, analytic Attentiveness, free-floating, 44, 45, 50 Atwood, G., xvii Austen Riggs Center, 113 Authenticity, and guilt, 15-19 Authoritarian attitude, 118, 131 Awareness of resistance, the patient’s, 128-129, 130, 135-136 Barnes, J., 50-51 Beebe, J., 76 Behaviors: conscience guiding, 73 disruptive, 40 therapeutic ambition, 116-122 Being, consciousness an effect of, 36 Bergman, M., 85 Bernheim, H., 25 Bion, W. R., xviii, 117-119, 120-122, 137 Blanton, S., 76 Bloom, H., xx Böne, L., 33 Brandchaft, B., xvii

Breuer, J., 49, 54(n.15) Bullard, D., 112 Byron, G. G., 68 Candor. See Honesty (candor) Cantor, M., 114 The catalytic role of Crucial Friendship in the Epistemology of SelfExperience (Khan 1974), 87-88, 88(n.20) Causation, vs. the meaning-question, xvi-xvii Censorship: the abandonment of, 26, 33, 44, 54 difficulty of speech without, 29 Change: doing nothing and effecting, 60 experience as impervious to, 139 psychic, 141 working through resistance to, 140 Character: analyzable, 9, 23, 112 the question of, 14-15 strength of, 69, 70 three contexts for the role of, 14 Charcot, J. M., 25 Choices, existential, 16, 141 Classical psychoanalysis, xxi, 6 and abstinence, 63 and free association, 21-24 Freud seen as not practicing, 59, 112(n.23), 116-117 and neutrality, 39, 49-50, 59, 117 and therapeutic ambition, 112, 112(n.23) See also Psychoanalysis Clinical practice, Freud’s, xxi, 57-58, 65 criticisms of, xx, xxi, 39, 59, 76, 85, 112(n.23), 116-117, 122 See also Technical principles, Freud’s Code of conduct determined by the ego, not the superego, 14 Collaboration, patient-analyst, 119 Commiseration, 49

Index Communication: countertransference as, 98 “expanded,” 27 to the patient, timing of, 48 from or to the patient, 120-121, 139-140 “unconscious” transpersonal, 99-100 Concealment and psychoanalytic truth, 8 Confession, Catholic vs. free association, 33-34 Confidences, sharing, 87, 89 Conscience: behavior guided by patient’s, 73 fidelity to the analyst’s, 106 the superego as, 13 Contract, the patient’s. See Fundamental rule of analysis Contradiction, resistance to, 139 Conversation, psychoanalytic technique and the art of, 28-29 Counselors, suggestions for, 91 Countertransference: abstinence violated by, 105 affects or positions, 96-98 classical perspective on, 96 disclosure by the analyst, 53(n.14) the enigma of, 95-108 Freud’s conception of, 104-106 honesty violated by, 106 hubris a consequence of, 47, 105 impeding professional work, 101-102, 105 keeping it in check, 60, 111 neutrality violated by, 42, 104-105 original and recent meanings of, 95 as a psychic phenomenon, 101-103 Racker’s thesis about, 96-100, 106, 116-117, 119 a real reaction is not, 103 and therapeutic ambition, 95, 104-105, 122

155

thoughts or ideas, 96, 98-101, 139-140 as “unconscious communication,” 99, 106 violations or infractions, 105 Winnicott on, 16, 101-103, 140 See also Analysts; Transference “Countertransference resistance,” 100-101, 106 Creativity vs. reason, 33 A critical dictionary of psychoanalysis (Rycroft), 5, 5(n.2), 61 Criticisms of Freud. See Clinical practice, Freud’s Crucial friendship. See Friendship Cultures, abstinence in differing, 77 Defense mechanisms: conceptions of, 134, 135-136 freedom to indulge, 127-128 overcoming, 129 Denial of ego, 107 Deprivation and abstinence, 66 Determinism: of free association, 30 Freud’s view of freedom and, 30 Dialogue: Bion’s psychoanalytic, 117-118 Freud’s, 59 the psychoanalytic, 28-29, 139-140 See also Clinical practice, Freud’s Disclosure: anxiety, 28, 127 of confidential secrets, 87, 89, 91 encouraging, 114 the tension of resisting, 128 truth value and the fact of, 12-13 without censorship, 44 See also Language Dishonesty as countertransference, 106 Displacement of the libido, 85 “Dissociating,” 133 Doolittle, H. (‘H.D.’), 76 Dora (Ida Bauer) case, 6, 8-9, 10, 46, 86, 117, 119

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Dorsey, J., 24 Duplicity, rationales for, 54-55 The Dynamics of transference (Freud), 6, 44, 81, 85-86 Eckhart, M., 35, 37 Edie, J., xv Education, formal, 33 Educative ambition, 43, 47 Ego: analyst denial of his, 107 opposing functions of the, 23-24 relationship between superego and, 14 The ego and the id (Freud), 13 Ego psychology, 129, 130 “Empty speech,” 31, 32 Enigma of countertransference. See Countertransference Enlightenment thinking vs. Romanticism, 68-70 Epistemology: ethics over, 51 in psychoanalysis, 34 Epoché, the phenomenological method of, 36, 50-52 Equanimity (ataraxia), 51, 60 Erotic (positive) transference, 84-85 Etchegoyen, R. H., 75 Ethic: code of conduct, 14 of the Fundamental Rule of analysis, 3-5 psychoanalysis as an, 1, 143 See also Morality Ethic of honesty. See Honesty, the ethic of Everson, S., 69 Existence, human: Freud’s vision of, 60, 70-71 Heidegger on, 36, 69, 138, 140 and human nature, 67-68 the problem of, xix, 71, 141, 144 Existential dimension: of suffering experience, 140 to working through, 123-141 See also Working through Existential philosophy, European, xx, 131

Experience: alienation from, 136 analysts learning from, xiv concepts of, 134-138 degrees of, 138 early “stereotype plate,” 82 as “happenings,” 38, 138 Hegel on, 137-138 Heidegger on, 138, 140 ignoring the patient’s, 137 inference of the patient’s, 137 interpreting the patient’s, 117-118 the nature of, 133-134 of “not-knowing,” 35, 52 patient inability to experience his own, 137 phenomenology of, 134-135, 138 of psychoanalysis as uncommon and ordinary, 38 relying on the patient’s, xvii, 10 resistance to, 133 revelatory aspects of, 138 sceptics on rationality and, 134-135 the science of, 36 the suffering of, 140 truth from personal, 59-60 the unconscious and, 107, 118 See also Free association; Working through Failure, neurosis of, 97 Fairbairn, R., 82 The fallacy of understanding (Levenson), 116 False self, concepts of the, 16, 16(n.4) Family of the patient, neutrality toward, 40, 49 Fantasy: experience and unconscious, 135-137 Freud’s conception of, 82-83 symbiotic, 98 Fear: accepting reality and overcoming, 131-132 of analyst’s anger, 97 and defenses, 97, 115, 134

Index Feelings: intellectualizing vs. working through, 58-59 neutrality of inquiry into, 83 Feminine pronoun, Freud’s use of, 65, 66(n.17) Fenichel, O., 109 Ferenczi, S., 66-67, 68, 116, 116(n.25) Fine, B., 4-5, 41-42, 80-81, 109, 123-124, 125 Fink, B., 75 Fleiss, W., 92, 93, 94 Fordham, M., 101, 102, 103 Free association: classical conceptions of, 21-24 confusing the fundamental rule with, 3-6, 21 determinism of, 30 to elicit regression in the patient, 22, 25 the freedom of, 29, 38, 127-128 Freud on the fundamental rule and, 7, 18, 54-55 Freud’s conception of, 24-27 to further analytic interpretation, 24 the German terms for, 6(n.3) and honesty, 2-3 intellectualizing vs. experiencing, 34-35, 130 as a mode of thinking, 28-29, 31-35 the phenomenology of, 35-38, 127 and the pledge of honesty, xviii, 44, 52 the raisond'être for psychoanalytic technique, 24 as remembering, 127 resistance to, 130 as revelation not reporting, 27-28 as self-disclosure, 27-31 and splitting the ego, 23-24 things not suited for, 37 thinking through, 21-38 and verbalization, 31

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as whatever the patient says, 21-22, 26 See also Experience Freedom: and determinism, 30 to employ resistance, 128 of free association, 29, 38, 127-128 psychic vs. political, 14, 29-30 as volunteerism, 30 Freud: The mind of the moralist (Rieff), 1, 2, 17, 18-19 Freud, A., 40 Freud, M., 17 Freud, S.: on abstinence, 52, 57, 64-67, 76-77 analytic neutrality of, 57-58 clinical behaviors of, xxi, 57-58, 65 Freud, S., criticisms of clinical technique of, xx, xxi, 39, 57, 59, 76, 85, 122 Freud, S.: Enlightenment and Romanticist personality of, 70-71 friendship of with patients, 57, 59 on neutrality, 43-57 as not a “classical” analyst, 59, 112(n.23), 116-117 philosophies influencing, 69-71 sceptic-Romanticist heritage of, 70-71 writing style of, 52, 65, 65(n.17), 71, 123 Freud, S. (writings of): (1897), 92 (1900), 6, 33 (1905 b), 15, 39, 44, 53, 64, 104-106, 111 (1910), 3-4, 30, 141 (1911), 44 (1912a), 6, 6, 44, 44, 81, 81, 85-86, 85-86 (1912b), 43, 44, 44(n.12), 48-49, 52, 56, 64, 104-105, 110 (1913), 7, 26, 32, 44, 48, 86

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(1914), 44, 123, 132 (1915b), 15, 39, 44, 53, 64, 66, 105, 111 (1919), 47-48, 66-67, 72, 74-75 (1921), 93 (1923), 13 and Breuer (1893-95), 49 See also specific titles Freud’s clinical practice. See Clinical practice, Freud’s Friendship: breaks in, 91-92 capacity for, 94 crucial, 92-93 and frustration, 94 outgrowing a, 94 with patients, 57, 59, 75 and psychoanalysis, 87-88 three forms of, 89 a transference relationship, 92-93 two criteria of, 90-91 Fromm-Reichmann, F., xix, 112-113, 112(n.23), 114 Frustration: the analyst’s, 115 and fantasy, 83 friendship and enduring, 94 of longings, 84, 93, 105 prolonging patient, 61, 62, 75, 105 Fundamental rule of analysis, xv, 1-19 analysts ignoring the, 9, 128 conventional characterizations of, 3-6 difficulty of compliance with, 8 equated with free association, 3-6 first invocation of, 6, 54 free association relying on, 18-19 Freud’s characterization of, 6-9, 10, 52 and neutrality, 44, 51-52, 54-55, 86, 115 overlooking the ethical component of, 3-5 the patient’s pledge to the, xviii, 9, 25, 44 resistance to, 115, 128

right of non-compliance with, 115 Generosity of friendship, 91 Gill, M., xviii, 26-27, 30, 33, 34, 57, 87 Glenn, J., 39, 57 Glossary, a psychoanalytic, 43, 80 Goals of treatment. See Treatment, psychoanalytic God, the demise of, 88 Gratification, transference, 62-63 Gray, P., 128, 129-131, 136 Greek philosophy, 36, 47, 50-51, 68, 70 Greenson, R., 22-24, 25, 26, 62-63, 66, 74, 109 Group psychology and the analysis of the ego (Freud), 93 Guilt: and authenticity, 15-19 existential, 15-16 existential and neurotic, 16-17 vs. unconscious secret ideas, 33-34 Hallie, P., 51 The handling of dreaminterpretation in psychoanalysis (Freud), 44 Happiness: avoiding pain and pursuing, 17 and length of treatment, 74 Hartmann, H., 70 Haynal, A., 59 Heart: opening one’s, 133 sharing confidences of the, 87, 89 Hegel, G. W. P., 68, 137-138 Heidegger, M., xvi, 30, 32(n.8), 37, 135, 138, 139(n.28), 140 Heidegger, M. (writings of): (1962), xv, xvi, 69 (1966), 19, 31, 32, 36-37 (1968), 37 (1977), 70 (1985), 15-16 Heimann, P., 117 Helpful, being, 115

Index Herder, J. G., 68 Higgins, K., 70-71 History of psychoanalysis, xiii-xiv, xix as art or science, 45, 70-71 and countertransference perspectives, 95-96 free association in the, xviii and the neutrality principle, 39, 43-44 “progress” and, xix, xx and treatment duration standards, 73-74 Honesty (candor): the analyst’s capacity for, 106 the dangers of, 19 between friends, 87, 89, 91 fundamental to the analytic encounter, 2, 10, 54, 106, 143-144 the patient’s capacity for, 11, 12, 14, 23, 87, 128, 133 the pledge of, xviii, 44, 54 resistance to, 132-133 self-disclosure identical to, 106 See also Self-disclosure Honesty, the ethic of, 1 the analytic endeavor and, 143 countertransference violation of, 106 and free association, 2-3 Hubris, committing, 46-47, 105, 119 Human nature: Freud’s views of, 67-68 as irrational and unhappy, 71 psychoanalysts as students of, 144 Husserl, E., xv, xvi, 35-37, 135, 139(n.28) Hypnosis, 131 employing, 5 or free association and interpretation, 25, 54 Identification, projective, 98-99 Imperfection, accepting human, 115, 141

159

Intellectualization: neurotic tendency toward, 33, 85-86, 127 of transference, 58-59 vs. living experience, 34 and working through, 124 Interference, avoiding. See Neutrality International Psychoanalytic Association, 74 Interpersonal school of psychoanalysis, xvii, xxi, 9, 11, 68, 114(n.24) Interpretation: by the analyst, xvii by the patient, 139 correctness of, 120 “deep,” 9, 119, 120-122 dispensing with, 140 and free association, 35 Freud’s abandonment of, 25-26, 119-120 genetic or transference, 57, 59 hermeneutic, 139(n.28) Kleinian, 119, 120 the mutative power of, 35 and neutrality, 56-57, 117 not offering transference, 58-59 repetitious reworking of, 125 three types of, 67 a tool of abstinence, 67 of transference, 85-86 treatment of the topic of, xxii-xxiii underlying purpose of, 141 Winnicott on, 35, 104, 105, 106-107 See also Therapeutic ambition Intersubjectivity of psychoanalytic discourse, 34, 139 Interventions by analysts, 27, 56, 130 interpretations as, 117-118, 139-140 and resistance analysis, 129-130 types of, 25, 39, 67, 72-73, 116-122 Intimate relationships, 89-90 Isaacs, S., 135-136, 135(n.27), 136, 137

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THE ETHIC OF HONESTY

Judgment, suspension of. See Neutrality Jung, C. G., 76, 96, 102 Jurisprudence vs. psychoanalysis, 10-13 Kanzer, M., xxi, 4, 39, 57 Keats, J., 50 Khan, M., 87-88, 88(n.20), 92, 94 King, “psychotherapist” to the, 91 Klein, M., 9, 75, 76, 96, 97, 98, 99, 101, 117, 129, 136, 137, 141 on interpretation, 119, 120 on working through, 125 Knowing. See Epistemology Knowledge, dialectic of analytic, 60 Kohut, H., 84(n.19) Kris, A., xviii Kris, E., 39 La Boétie, E. de, 88, 91, 92, 93 Lacan, J., 9, 31, 75, 76, 121 Laing, R. D., 16, 120, 121-122, 135, 136-137, 138-139 Thompson on, 107 Language: employed in this study, xxii Freud’s writing style and, 52, 65, 66(n.17), 71, 123 of psychoanalysis, xxii, 43, 101, 117-118 “translating” the patient’s, 117-118, 121-122, 140 The language of Psychoanalysis (Laplanche and Pontalis), 43 Laplanche, J., 3, 4, 5, 30, 46, 48, 52, 56, 63-64, 74, 81, 96, 109, 124-125 Lawrence, D. H., 68, 70 Leavy, S., 133 Lee, A. R., 138-139 Levenson, E., 116 Levines, I., xvi Libido, accessibility of the, 83-84, 85 Lines of advance in psycho-analytic therapy (Freud), 47-48, 66-67, 72, 74-75 Lipton, S., xxi, 21-22, 24, 26, 28-29, 30, 34, 57, 59, 87, 112(n.23)

Listening: Bion’s way of, 120 to hear what is overlooked, 27 inactivity of treatment using, 112, 117 in silence, 47, 50, 58 Loewald, H., 133 Lohser, B., 24, 76, 112(n.23), 130 Love: aim-inhibited, 93, 94 for the analyst, 66 capacity to, 85 experiencing, 138-139 Freud’s emphasis on, 71 as indiscriminate, 82 the longing for, 84, 93, 105 the nature of, 82-85 problem of patient falling in, 73 universal need for, 53, 65 unrequited, 80, 82, 84 See also Transference, analytic Lover relationships, 90 Mahony, P., xviii, 4, 21(n.6), 57 Manual, technical. See Technical papers (Freud) Marital status of patient, 73 Martial relationships, 90 Masson, J. M., 92 Maternal love object, 82 Meaning: of suffering, xvi of symptomatology, 26(n.7), 119 See also Interpretation Meditative thinking (Gelassenbeit), 35-36 Heidegger’s views on, 37-38, 50 and neutrality, 60 and ratiocination, 32 Memories: the recollection of repressed, 26 remembering the patient’s words and, 44 transferred onto the analyst, 80 Memory, the nature of, 125-126 Mental health, making choices as path to, 16, 141 Merleau-Ponty, M., xvi, 31 Mindfulness of treatment, 107 Mitchell, S., xxi

Index Monet-Kyrle, R. E., 117 Montaigne, M. de, 50, 69, 70, 88-89, 88(n.20), 90, 91, 92, 93, 135 Moore, B., 4-5, 41-42, 80-81, 109, 123-124, 125 Morality, 1 equating the psyche (or mind) with, 15 patients as agents of, 10 of the psychoanalytic enterprise, 19, 143 and the superego, 13-14 See also Ethic Myths, Greek, 70 Narcissism, the analyst’s, 41 Natanson, M., 36 Natural needs, accepting our, 18 The nature and function of phantasy (Isaacs), 135(n.27) Negative transference: and abstinence, 62 and neutrality, 86 Neurosis: and repressed secrets, 44, 86 transference, 49, 66, 94, 140 “Neurosis of failure,” 97 Neutrality: abstinence compared to, 52-53, 55-57, 58(n.16), 119-120 analyst’s commitment to, 44-46, 60 aspects of, 40-41 as attitude or technique, 42 common violations of, 41, 104-105, 111 the consequences of, 55-56 countertransference violation of, 104-105, 107-108 definitions of, 41-42, 43 employed selectively, 56 exceptions to maintaining, 40, 72-73 failure to maintain, 40 and forgiveness, 90 and free association, 54-55 Freud on, 44-49, 71-72, 104-105, 132

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the fundamental rule and, 44, 51-52, 54-55, 86 of jurors, 10 Laplanche and Pontalis on, 43 literature characterizing, 39-43 as meditation, 60 Moore and Fine on, 41-42 as neutralität or indiferenz, 43, 55 and non-interference, 57-58 and professionalism, 101-102, 105, 107, 114 the raisond'être for psychoanalytic technique, 39, 55 Schafer on, 39-41 a state of mind, 104 and therapeutic ambition, 104-105, 110, 111, 117-118, 121 toward the patient’s family, 40, 49 universality of, 56-57 See also Way of Neutrality, the Newton, P., 24, 76, 112(n.23), 130 Nietzsche, F., 10, 30, 69, 70, 88, 131 Notes on personal and professional requirements of a psychotherapist (Bullard), 112 Note-taking by analysts, 45 Nothing: doing, 60, 105 saying, 58, 132-133 “Not-knowing,” the experience of, 35, 52 Objectivity: of analysts or jurors, 10 and subjectivity, 50-51 Observations on transference-love (Freud), 15, 39, 44, 53, 64, 105, 111 Oedipus trilogy, 47, 70 On beginning the treatment (Freud), 7, 26, 32, 44, 48, 86 On psychotherapy (Freud), 15, 39, 44, 53, 64, 104 One-person hypothesis, xvii, 34

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Openness rule, and neutrality, 56, 57, 76, 117 Oracle’s advice, the, 47, 47(n.13) Outgrowing a relationship, 94 Overcoming (oberwinden) resistance, 129, 131 Pain and suffering. See Suffering Parent-child relationships, 82, 89 Patient transference. See Transference, analytic Patient-analyst relationship: and abstinence, 64-68, 74-75 the analyst’s personality and, 40, 113 of collaboration, 119 and confidentiality, 114 of friendship, 57, 59, 75, 94 and the honesty instruction, 11-12, 115 imbalance of, 64 and language, xxii, 101, 117-118 and overcoming resistance, 128-129, 131-132 and overzealous interpretation, 117-118 patient satisfactions during, 72-75 as “psychological symbiosis,” 98 rapport in the, 44-45, 48, 57, 59, 115 softening of, 68 and taking sides, 49 and translation, 117-118, 121-122, 140 See also Transference, analytic Patients: abstinence to fit needs of, 77 agreement to the Fundamental rule by, xviii, 9, 25, 44 the analyzability of, 9, 23, 112 avoiding spoiling, 74-75 benefitting from psychoanalytic treatment, 14-15 borderline, 103 complaining by, 115 disruptive behaviors of, 40 everyday distractions of, 72-73 fears and defenses of, 97, 115, 131, 134 interpretations by, 139, 140

as juror and inquisitor, 11 as moral agents, 10 neurotic or psychotic, 112 pronouns for, 65, 66(n.17) the question of the character of, 14-15 relying on the experience of, xvii schizophrenic, 117-118, 120 self-awareness of resistance, 128-129, 130, 135-136 sympathy withheld from, 46, 76 therapeutic ambition of, 113 three sources of satisfaction for, 72-75 and transference, 53-54 Patient’s work, psychoanalytic treatment the, 130, 141 Payment of fees, patient, 98 Perception and interpretation, 138-139 Phantasy. See Fantasy Phenomenological structure of psychoanalysis, 34 Phenomenology: the epoché method of, 36, 50-52 of experience, 134-135, 138 of free association, 35-38 of freedom, 30-31 of interpretation, 139-140, 139(n.28) and psychoanalytic theory, xv-xvi and scepticism, 36 of thinking, 33 Phenomenology of perception (Merleau-Ponty), xvi, 31 Phenomenology of transference, 79-84 and non-transferential phenomena, 81 positive vs. negative, 84-85 See also Countertransference; Transference Phillipson, H., 138-139 Philosophers: existential European, xx, 131 on experience, 137-138 Greek, 36, 47, 50-51, 68, 70 Plato, 36, 68 Playing the patient’s game, 43

Index Pleasure principle, 14 Pledge, the patient’s. See Fundamental rule of analysis Pontalis, J.-B., 3, 4, 5, 30, 46, 48, 52, 56, 63-64, 74, 81, 96, 109, 124-125 Positive transference: the capacity to develop, 14 conscious and unconscious, 84-85 the relationship of unobjectionable, 87 and working through, 131 Postmodernism and psychoanalysis (Thompson), 69 Postmodernism, 68, 69 Postscript, concluding unscientific, 143-144 Principles: analytic vs. rationalist, 120 definition of, xiv priority of over theory, xiv See also Technical principles, Freud’s Privacy, patient’s right to, 114 The privacy of the self (Khan), 87-88, 88(n.20) Privacy of the self (Montaigne), 88-89, 88(n.20) Prognostication by analysts, 47-48 Projection by the patient, 98, 121 See also Transference Promise, the patient’s. See Fundamental rule of analysis Psychiatry, alliance between psychoanalysis and American, 30 Psychic conflict, liberation from, 1 Psychical reality, 14, 140 Psychoanalysis: in America, xvii, xix duration and depth of, 73-74, 117-118, 121 enigmatic nature of, 123, 144 epistemological component of, 34 as an “ethic,” 1, 143 in Europe, xx, 131

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existential dimension of working through, 123-141 and jurisprudence, 10-13 loss of edge in, xix, xx modern trends in, xiii, xvii, 144 as a moral enterprise, 19, 143 paradigm shift in, xvii phenomenological structure of, 34 popularity and decline of, xix, xx, 17-18, 30, 143 post-Freudian, 9, 144 the principal task and goals of, 35, 42, 45, 66, 76, 122, 136 principles vs. theories of, xiv-xv, 143 “progress” in, xix, xx, 70-71 radicalism of, xx-xxi relational perspectives on, xvii, xxi, 9, 11, 68, 114(n.24) society’s predisposition against, 17-18, 30 successful, perceptions of, 113, 120, 122 suffering as the context of, xxiii, 67-68, 126 taking notes during, 45 as uncommon and ordinary experience, 38 vs. scientific study, 45, 70-71 See also Classical psychoanalysis Psychoanalysis and psychotherapy: Selected papers of Frieda Fromm-Reichmann (Bullard), 112 Psychoanalysis in transition: A personal view (Gill), 26-27 Psychoanalysts. See Analysts Psychoanalytic terms and concepts (Moore & Fine), 4-5, 109, 123-124 Psychoanalytic treatment. See Treatment, psychoanalytic Publishing a patient’s case, 45-46 Quarrels, neutrality toward patient’s, 49

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Racker, H. (writings of): (1968), xxi, 10, 29, 59, 76, 96-101, 96(n.22), 99-101, 103, 104, 106, 107, 111, 116-117, 120, 121, 136, 137 (1994), 117, 119 Railroad car analogy, 7, 31, 34 Raison d'être for psychoanalytic technique, 39, 55 Rapport: the need to instill, 44-45, 48 and neutrality, 57, 59 the patient-analyst relationship of, 44-45, 48, 57, 59, 115 and self-disclosure, 87, 93 transference as, 86 Rat Man (Ernest Lanzer) case, 6, 57-58, 76, 86, 117, 119 Ratiocination, 32 Rationalism as resistance, 127 Rationalists, 69-70, 125 Reality: accepting, 69, 131, 141 escaped through fantasy, 83 psychical reality vs., 14, 140 See also Truth Reality principle, 14, 140 Reason: opposition of Romantics to, 68 and science, 68 Recommendations to physicians practicing psycho-analysis (Freud), 43, 44, 44(n.12), 48-49, 52, 56, 64, 104, 110 Recovery, working through a form of, 129 Religion, 88 and science, 68 Remembering: analysts are not to try, 44 patient’s work of, 127 Remembering, repeating, and working-through (Freud), 44, 132 Repetition compulsion, 125-126 Repression: guilt the consequence of, 16-17 of longings, 83-84 and resistance, 126

Reputation, the analyst’s professional, 112, 113, 114 See also Therapeutic ambition Resistance: analysis, 129-130 to contradiction, 139 dis-association a form of, 31 as focus of treatment, 130 and free association, 22-23 Freud on the dynamics of, 126-128 to the fundamental rule, 115, 128 learning to struggle with, 130 narrow or broad, 132 and patient satisfaction sources, 72-75 patient’s awareness of, 128-129, 130, 135-136 silence as, 132 steps in overcoming, 128-129 transference and countertransference, 100-101, 106 willful abandonment of, 131 See also Acceptance Revelation. See Free association Rieff, P., 1, 2, 17, 18-19 Riviere, J., 135(n.27) Roazen, P., 26 Romanticism vs. Enlightenment thinking, 68-70 Rousseau, J.-J., 69 Ruitenbeek, H., 76 Rule of abstinence. See Abstinence (abstinenz) Rycroft, C., 5, 5(n.2), 61 Safranski, R., xvi St. Augustine, 88, 88(n.21) Sartre, J.-P., xvi, 16, 16(n.5), 19 Sass, L., 139(n.28) Satisfaction: denying, 75 three sources of patient’s substitutive, 72-75 Sausages analogy, 65, 66 Scepticism, 59 and Freud’s ideas, 36, 50-51, 116 and phenomenology, 36

Index and psychoanalytic technique, 114 and Romanticism, 69-70 Schafer, R., 39-40, 49, 56 Scheler, M., xvi Schiller, F., 33 Schopenhauer, A., 68, 69, 70 Schürmann, R., 35, 37 Science: of experience, 36 psychoanalysis as an art or, 45, 70-71 and reason, 68 and the surgeon analogy, 25, 43, 46, 52, 64, 68, 104, 110-111 vs. treatment objectives, 45 Science of experience. See Phenomenology Scientific investigation vs. phenomenological inquiry, xv-xvi, 116 Secrets: and confidences, 87, 89 neurosis the consequence of repressed, 44, 86 purpose of patient’s, 114 Self-acceptance by the patient, 141 Self-analysis, 92 Self-disclosure: experiencing, 34 free association as, 27-31, 37 and friendship, 87-89, 90, 93 and the fundamental rule, 3-4, 9, 86 honesty identical to, 106 learning, 27 as a mutative agent, 26, 87, 93 patient agreement to, 9, 25 the power of, 93 resistance to, 130, 132-133 through free association, xvii-xviii, 3-4 See also Honesty (candor) Self-discovery: and experience, 137, 138 of meaning of symptomatology, 26(n.7), 119

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Self-knowledge: about resistance, 128-129, 130, 135-136 and friendship, 87-89 Self-sacrifice and friendship, 90, 93, 94 Sessions, psychoanalytic treatment: breaks between, 91-92 frequency and duration of, 73-74, 74(n.18), 76, 117-118, 121, 133 as interminable if happy, 74 “short,” 9, 75 See also Treatment, psychoanalytic Sexual relationships, 93 and candor, 89-90 Shelly, P. B., 68 Sibling relationships, 89 Silence: maintaining the analyst’s, 47, 50, 58 as resistance, 132 and saying nothing, 58, 132-133 Silver, A.-L., 114 Society: as inherently repressive, 29-30 opposition of individuals and, 19 the predisposition against psychoanalysis in, 17-19, 30 Socrates, 51 Solomon, C., 70-71 Speech: meditative thinking and empty, 31, 32 and saying nothing, 58, 132-133 “translating” the patient’s, 117-118, 121-122, 140 See also Free association; Language Splitting the ego, 23-24, 136 Sterba, R., xx Stereotype plate, early experience as, 82 Stereotypical interpretations, 119(n.26) Stolorow, R., xvii Stone, L., xxi

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Strachey, O., 2-3, 6, 6(n.5) Studies in hysteria (Freud & Breuer), 49 Subjectivity: of the patient’s psychoanalysis work, 130, 141 and psychoanalytic discourse, 34, 139 vs. objective knowledge, 50-51 of working through, 124, 125 Subversiveness of psychoanalysis, 19, 30 Suffering: avoiding pain and, 17 conceptualizing the cause of, 32-33 of experience, 140 liberation from psychic conflict and, 1 and love, 71 the meaning of experiencing, xvi and personal experience, 59-60 premature relief from, 62-63, 72 the problem of the patient’s, xxiii, 126 psychoanalysis and, 67-68 tolerating, 69, 71 Sullivan, H. S., 26(n.7), 76, 113, 114, 116 Superego, Freud’s conception of the, 13-15 Surgeon analogy, Freud’s, 25, 43, 46, 52, 64, 68, 104, 110-111 Symington, N., 70, 119(n.26) Sympathy: abstinence balanced with, 66, 76 and understanding, 48 withholding, 46, 56, 76 withholding and expressing, 49 Symptoms: in analysis, 67, 126 as substitutive satisfaction, 72-75 types of, 126 Taking sides, the analyst, 49 Tears from his ears, 121 Technical papers (Freud): the history of, 6, 43-44

Observations on TransferenceLove (1915b), 39, 44, 53, 62, 64, 66, 104-106, 111 On psychotherapy (1905b), 15 Recommendations to physicians practicing psycho-analysis (1912b), 43-44, 44(n.12), 48-49, 52, 56, 64-66, 104, 110 Remembering, repeating, and working-through (1914), 44, 123, 132 The dynamics of transference (1912a), 6, 44, 81, 85-86, 113 Technical principles, Freud’s: countertransference violations of three, 104-106 eight conceptual designations of, xxii encountered in the treatment, xxii, 143 Freud’s formalization of, xviii, 43-44 and hypocrisy, 15 integration of three, 111 neutrality the retrospective one of, 43-44 the pairings of, 95 a phenomenological perspective on, xxii theoretical formulations compared to, xiii-xiv this study limited to, 144 treatment founded on the eight, xxii Technology, 70 Terminology of psychoanalysis, xxii, 4-5, 109, 123-124, 143-144 original and later, 101 See also Language Theory, psychoanalysis: derivation of from principles, xiv, 143 interpersonal school of, xvii, xxi, 9, 11, 68, 114(n.24) the marginal role of, xxiii, 119, 121, 144 See also History of psychoanalysis Therapeutic ambition, 43, 109-122

Index analytic behaviors avoiding, 112-116 analytic behaviors committing, 116-122 difficulty of defining, 112 an encompassing principle, 116 encouragement to commit, 107-108 Freud’s admonition against, 46, 56-57, 104-105, 110 Freud’s invocation of, 110-112 Fromm-Reichmann on, 112-113, 112(n.23), 114 literature ignoring, 109 and overzealous interpretation, 109-110, 116, 117-119, 119(n.26) protecting the patient from, 107 as source of countertransference, 95, 104-105, 122 the technique least-documented, 109 as treatment strategy, 111-112 Thinking: conscious and unconscious, 84-85, 107 etymology of thought and, 38 free association as a mode of, 28-29, 31-35 phenomenology of, 33, 37 ratiocination vs. meditative, 32, 32(n.8) Romanticism vs. Enlightenment, 68-70 See also Free association Thompson, M. G. (writings of), xxi (1985), 34, 35, 79, 127 (1994), 10, 44, 46, 57, 59, 69, 70, 71, 76, 79, 83, 85, 86, 106, 112, 119, 125, 126 (1996a), 76, 104, 117 (1996b), 33, 117 (1996c), 107, 138 (1997), 138 (1998), 107, 113 (2000a), 107, 135 (2000b), 36, 50, 107, 114, 134-135

167

(2001), 119 (2003), 69 Thompson, S., 113 Thoughts. See Fantasy; Thinking Time: the effects of, 132, 133 for working through, 129 Timing, treatment. See Sessions, psychoanalytic treatment Training of psychoanalysts, xviii, 47, 103, 113 Transference, analytic, 139-140 the concept of, xxii as crucial during treatment, 77 definitions of, 80-81 Freud’s definition of, 81 Freud’s observations on, 53-54, 64-66 literature depicting, 80-81 negative, 58 neglected elements of, 79 the patient’s envy and, 75-76 the power of, 65 questioning the nature of, 80 resolution of, 85-86 as substitutive satisfaction, 74-75 “unobjectionable” aspect of positive, 84, 85, 87 and unrequited love, 80, 82, 84 See also Patient-analyst relationship; Phenomenology of transference Transference and countertransference (Racker), 96-98 Transference neurosis: and deprivation, 66 as friendship, 94 working through the, 59, 140 Transference-love: Freud’s technical paper on, 15, 39, 44, 53, 64, 104-106, 111 neutrality of analysts and, 54 three forms of, 84-85 See also Countertransference; Love “Translating” the patient’s language, 117-118, 121-122, 140

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THE ETHIC OF HONESTY

Treatment, psychoanalytic: conscious and unconscious aspects of, 84-85, 107 efficacy of, 60 end of relationship after, 94 existential choice upon ending, 141 the failures of, 9, 46, 86, 119 falling in love during, 73 the goals of, 35, 42, 45, 66, 76, 122, 136 inherent limitations of, 115-116, 141 as interminable if happy, 74 as mindfulness, 107 the outcome of, 1, 45, 94 paradoxical nature of, 128 passive nature of, 112-113, 132 a patient’s work the task of, 130, 141 and professionalism, 101-102, 105, 107, 112, 114 resistance as focus of, 130 standards for successful, 113, 122 time allowed for, 133 and truthfulness, 54-55, 106 Treatment sessions. See Sessions, psychoanalytic treatment Truth: acceptance of, 141 freedom to enjoy telling the, 29, 38 the fundamental rule of, xv, 1-19, 54-55 Heidegger’s conception of, 37 patient’s responsibility for analytic, 12 the patient’s unverifiable, 10 psychoanalysis is about, xx-xxi, 143 in psychoanalytic publishing, 120 Romantic conception of inner, 68-69 See also Reality Two-person psychology, xvii Unconscious, the: belief in, 70 disclosing and facing, 134 experience and, 107, 133-134

fantasy, 135-137 as freedom, 30 interpretation of the patient’s, 117-120 Understanding: limitations of analytic treatment, 115-116 sympathetic, 48-49 Universality, and generalization, xiii-xiv Values: imposition of the analyst’s, 42 neutrality of the analyst’s, 43 Verbalization, and free association, 31, 32 Vicious circle of countertransference, 97-98 Violations of neutrality, countertransferance, 41, 104-106, 107-108, 111 Wachterhauser, B., 36 Way of neutrality, the, 39-60 What is called thinking? (Heidegger, M.), 37 Wieck, F. D., 37 Will, O. A., Jr., 113-116, 140 Winnicott, D. W. (writings of), xx (1960), 16, 101-103, 140 (1968), 16(n.4), 104, 105, 106-107 (1990), 35 Wishes, unfulfilled, 75, 83-84 Wittgenstein, L.J.J., 69 Words: feminine pronoun, 65, 65(n.17) interpreting the patient’s, 117-118 listening to the patient’s, 27, 112, 120 and terms in German, Freud’s, 6(n.3), 35-36, 43, 55, 61-62, 129, 131 Work of psychoanalytic treatment: the patient’s, 130, 141 remembering my origins, 127 Working through: concepts of, 123-124 the existential dimension to, 123-141

Index Freud’s comments on, 125-129, 132-134 Gray’s views on, 129-132 intellectual feature of, 124 Kleinian conception of, 125 literature depicting, 123-125 patient’s resistance the context of, 123, 124, 125 as rationalist, 125 and remembering, 127 as repetitious, 125 as subjective experience, 124 time needed for, 129 as transformative, 125, 141 See also Experience Writing style, Freud’s. See Freud, S. Zetzel, E. R., 87

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