On symbolic function and its role in psychoanalytic psychotherapy

SUMMARY

One of the curative factors of psychotherapy is that the patient internalises, on the one hand, the therapist's attitude towards himself; and, on the other hand, he/she creates channels and the means to elaborate unmet needs in his/her internal experiential world. I consider the internalisation process in this study in the framework of a gradual symbolisation-reflectiveness process, using the tripartite model of Charles Peirce to conceptualise symbolisation and apply it to an understanding of the evolving psychic process.

My aim is to analyse the organisation of symbolisation-reflectiveness in the psychoanalytic psychotherapy of my patient Thomas, illustrating this with material from the sessions. Thomas's central conflict was connected with early unprocessed separation experiences in the mother-child relationship. These separation experiences manifested themselves as inexplicable panic attacks during the therapy. In the potential space created by basic trust, Thomas was able to integrate feelings of panic within himself by means of his capacity for symbolisation and integrative reflection. The panic was shared, and this enabled him to assess and work through feelings and associations connected with it in the therapy dialogue. I describe sessions from the first, third and fifth years of therapy, which illustrate the integration of Thomas's emotional world in the treatment relationship and the internalisation of his feelings of need through the evolving symbolisation-reflectiveness. The session material illustrates these phenomena and shows how the therapist assists the developing symbolisation-reflectiveness.