Roles in the Psychoanalytic Relationship

Abstract

Who we are depends on the situation we are in. Psychoanalysis, like any other recurrent social activity, is conducted under the influence of implicit social roles. Our technical emphasis on free association and other unstructured aspects of the analytic setup tends to minimize awareness of the degree to which both analyst and patient orient around role expectations. The analyst's role is the result of enculturation during training and after; the patient's role is a product of character, transference, and analytic influence. This paper explores the way in which the alternation and tension between role and nonrole aspects of the psychoanalytic relationship is at the center of therapeutic process and change. The author illustrates the way in which role and nonrole aspects of process appear in a case study, both over longer stretches of time and in particular moments. Understanding the importance of analytic roles clarifies some dilemmas and contradictions in older discussions of technique and modern relational theory.

Notes

¹I am indebted to Jane Kite, Ph.D. (2006) for drawing my attention to this statement.

²It is worth noting that Freud as a clinician was liberal in his use of the relationship to establish trust and authority with his patients (Lohser & Newton, 1996). The “classical” technique that has come to be seen as his creation reflects certain of his technical recommendations, combined with a greater stringency of the second generation of psychoanalytic leaders.

³There is a voluminous literature in sociology and social psychology on the subject of social roles and role theory, including its application to physician–patient relationships (Parsons, 1953). A simple definition of role theory states that “it addresses the manner in which social situations are structured by extensive sets of rules or expectations” (Almond, 1995)

⁴For a more extensive discussion of the concept of communitas in therapeutic situations, see Almond (1974).

⁵For convenience, I use male pronouns in talking about both patients and analysts generally.

⁶I was not unaware of the numerous possible transference meanings of Mr. G's complaining, including his envy of my nurturing function, his need to display himself in a position of masochistic surrender, and so on. What is presented here is the interpretive level that I felt he could hear at this point.

⁷The link between Freud's development of psychoanalytic technique and rites de passage is not as unlikely as it might seem: Many writers have noted Freud's heritage from Jewish tradition, and Bakan (1965) specifically links psychoanalytic technique to the mystical aspects of this part of his experience. Hoffman (1998), as previously noted, picks up on this in his use of Turner's concept of communitas to characterize the leveling state that I would suggest is created in nonrole moments, that are part of rites de passage.