Has analytic contact been established?: Refocusing political, organizational, and theoretical debates into a clinical issue

Abstract

This paper will examine the current crisis in psychoanalysis in terms of the profession's decline, the apparent lack of patients, the ongoing debate over what constitutes psychoanalysis versus other therapies, and the lack of clinical focus in those debates. The concept of analytic contact will be introduced, and clinical material is used to showcase this concept as a bridge from the circular political debates to a more meaningful examination of what is psychoanalytic. In addition, case material will explore how patients tend to fight off the establishment of analytic contact in favor of safer, less threatening modes of relating. The author suggests that most patients fight off analytic contact and try to shift the treatment into something less analytic. It is up to the analyst to detect this, interpret it, and notice any countertransference collusion that may occur. Although the state of psychoanalysis as a profession is less than stellar in the eyes of the public, and the profession is apt to sabotage itself with endless debates about what constitutes true analytic work, the end is not necessary near. This paper proposes analytic contact to be the more useful focus of research and productive area of clinical exploration. If the decline of our field is to turn around, it will be on the clinical battlefront, not in terms of the theorizing among disagreeing groups of territorial analysts afraid of losing their political high-ground. The concept of analytic contact assumes that a deep exploration of intrapsychic phenomena, conflicts, and defenses, all within the realm of the transference, is the best clinical method of helping the mentally troubled individual. This genuine chance of change is best administered by a trained psychoanalyst. This simple idea is something the profession has contaminated with its often pointless arguments over frequency, analyzability, couch, and so forth. The clinical material will show that what happens in the room between analyst and patient is what best defines the true psychoanalytic treatment.

Keywords:

• Contact
• transference
• analytic
• debates

Notes

¹This is somewhat parallel to a gifted golf instructor who has told me, “I am here to teach people how to play golf. I am here to show them how to play better, more enjoyable golf. Some people show up and only want to talk about golf but never want to learn about their golf game. Others only want to learn how to hit the ball the greatest distance; I call them the ‘size matters’ crowd. They don't care about the more complex aspects of the game and the parts of the game that actually result in winning scores. With all these types of people, I try and engage them in the learning of golf. But, some people turn it into something else. I can try and turn that around and sometimes it works. Other times it doesn't work, and it becomes a series of meetings in which the person tells me all about what the latest golf magazine says and nothing else happens. They leave with the same lousy swing they showed up with. It's a crazy world but what can you do!”