In Search of the Person in the Patient: An Interpersonal Perspective on “Roles in the Psychoanalytic Relationship”: Commentary on Paper by Richard Almond

Abstract

I am postulating an irreconcilable discrepancy between psychoanalytic metapsychology and praxis. Metapsychology reaches for the abstract, for the general class of which the patient is an ostensible member—said class, somewhat tautologically, demonstrating the validity of the professed metapsychology. Yet, from the Interpersonal view, therapy depends on grasping the highly idiosyncratic way the patient plays out his or her life both in and out of the therapy room. Abstracting the patient concretizes the process and reduces information. As a consequence, the clinical material falls short of utilizing the rich, recursive patterning of the therapist's exchanges with the patient, failing to fully realize the uncanny enmeshment of unconscious gears that so defines the psychoanalytic mystique.

Notes

¹I beg forbearance if, for the sake of simplicity, I refer to patients as generally “he” because this patient is male.

²I had a similar criticism of another paper I discussed. Again, a patient was presented, and interpretations and formulations were made without any reference to the patient's social context or idiosyncratic meanings (Levenson, 2006).

³For a particularly lucidly articulated application of complexity theory to psychoanalysis, see Harris (2005).

⁴Or free-association, which does essentially the same thing: It looks into the scotoma, the blind spots.

⁵See Gill (1982) for distinction between interpretations of transference awareness and content and Menninger for the “therapeutic cycle” (see also Menninger & Holzman, 1958).