The Analyst's Theory in the Analyst's Mind

Abstract

Each analyst is inevitably bound to and by his or her theories, to the techniques that follow from them, and to the complex and potentially problematic forces and vicissitudes of psychic life and the unconscious. Given this assumption as a starting point, I will describe and attempt to illustrate, using Ferro's Analytic Field Theory, the kinds of theories that may prove most useful to analysts, theories that emphasize process over content and that prepare the analyst's mind for their encounters with their patients. These theories are not the provenance of any one school of psychoanalysis, and extend beyond work with neurotic patients to those patients and areas of the mind that reflect weakened or unrepresented mental states and are in need, not simply of decoding and uncovering, but of mutual and intersubjective construction of thoughts, meanings, and links between mental elements.

Notes

¹Many other authors from very different analytic schools and orientations have expressed a similar view. See, for example, Cooper (1996), Ornstein and Ornstein (2003), and Sandler (1983).

²See, for example, Ornstein and Ornstein (2003) for a similar view: 'There is no way in which any of us can avoid the use of theory in the analytic treatment process. That is, we cannot listen to our patients and interpret the meaning of their communications without having some theory. The naive assumption that empathic listening can be theory free, that such empathic listening can lead directly to the raw data presented by the patient, is a myth' (p. 157). Or Chianesi (2007): 'In writing and in analysis, the 'facts' do not speak unless someone has organized them into a structure that allows them to speak' (p. 27).

Dr. Howard B. Levine is Faculty and Supervising Analyst, Massachusetts Institute for Psychoanalysis; Faculty, Psychoanalytic Institute of New England, East (PINE).

³So as to avoid confusion, especially in this era of scripted psychotherapies, I should say that by technique, I mean all that the analyst does with the patient. This might include the quality of relationship that is to be formed (e.g., formal or warm), the content of what is to be interpreted (e.g., the transference; Oedipal conflicts; defensive activity of the ego; etc.), direction or style of interpretations (e.g., here-and-now or genetic past; questions vs. declarations; decoding or narrative building comments; etc.), and so on.

⁴'The path that starts from the analyst's construction ought to end in the patient's recollection; but it does not always lead so far. Quite often we do not succeed in bringing the patient to recollect what has been repressed. Instead of that, if the analysis is carried out correctly, we produce in him an assured conviction of the truth of the construction which achieves the same therapeutic result as a recaptured memory' (Freud, 1937, pp. 265–266).

⁵See, for example, Hoffman (1994), who advocates 'throwing away the book' and the discussion by Greenberg (2001).

⁶ Bion (1992) noted that even among psychoanalysts, theories are always apt to be seen as suspect or controversial, partly 'because … there are always some theories that are under trial, partly because there are some theories that, though long accepted, seem to require revision, and partly because the application of a theory, perhaps sound in itself, has been defective, and so has led to suspicion of the theory' (p. 92).

⁷See, for, example, Mitrani's (2001) discussion of the analyst's need to take (i.e., occupy and embody) the negative transference.

⁸'Placing theory as the third 'subject' in the analytic field may arouse some puzzlement in analysts who consider theory as a defence. … But theory does not come along in the end and arrive from outside; it is the origin of the [analytic] process and internal to it' (Chianesi, 2007, p. 121).

⁹ Bion (1970) famously said that an analysis ought to consist of two very frightened people encountering each other in the consulting room.

¹⁰Since our theories are apt to be implicit, unconscious, and unintentional, it might be better to say that data is determined and comes into existence determined, in part, by the theories that hold us!

¹¹The patient's remarks are described in the text. The analyst's reading of these remarks are noted in square brackets.

¹²The French make the distinction between interpretations from within the transference, in which the analyst's intervention is inevitably heard as if it was a line spoken in a transference drama, and interpretations of the transference, which name and objectify the transference by making a decoding statement, such as, 'You are reacting to me as if I was your father, when he … '. (See, for example, Sechaud, 2008.)