Helplessness and the exercise of power in the analytic session

Abstract

This paper describes a clinical situation in which the analyst may be provoked to become overactive if he feels that his attempts to reach his patient are frustrated. Lack of tolerance for feelings of helplessness may leave him unable to sustain a receptive stance, and he may be drawn into enactments which lead to a power struggle with his patient.

I will try to describe situations where such enactments were compelling. I will also consider what enabled me to extricate myself from the activity, at least intermittently, to re‐establish an analytic attitude in which understanding and containment were priorities.

From time to time I was able to recognize and accept my helplessness and relinquish my attempts to reach the patient. These moments of recognition led to a shift of atmosphere in which a feeling of sadness replaced the more familiar confrontational mood. In these sadder moods the patient felt I was more available, and he too seemed more able to contemplate loss.

Theoretical ideas that enabled me to recognize some of the mechanisms at play included an understanding of narcissistic mechanisms, a recognition of previous ideas of power and dominance such as Freud’s Bemächtigungstrieb, and the role of dominance in the resolution of the Oedipus complex. My previous work on the dread of humiliation allowed me to be sensitive to the way helplessness can come to be associated with being looked down on and humiliated.

Key words:

• helplessness
• humiliation
• power
• the analytic situation

Notes

1. Kohut (1972) has given vivid descriptions of what he calls narcissistic rage. This arises when narcissistic grandiosity is thwarted and the patient feels humiliated and degraded. Kohut suggests that the patient attempts to soothe an internal narcissistic wound and restore a sense of self‐worth by re‐establishing a narcissistic superiority.

2. The patient was in the fifth year of a five times per week analysis.

3. “It has always been emphasized that he took only strikingly handsome boys and youths as pupils. He treated them with kindness and consideration, looked after them, and when they were ill nursed them himself, just as a mother nurses her children and just as his own mother might have tended him. As he had chosen them for their beauty and not for their talent, none of them –& became a painter of importance. Generally they were unable to make themselves independent of their master, and after his death they disappeared without having left any definite mark on the history of art” (Freud, 1910, p. 102).

4. White (2010) has suggested that Freud was reluctant to develop the concept of bemächtigungs‐trieb because it was too close to some of the ideas of Adler such as a striving for power and masculine protest which he did not approve of, although he later showed some interest in them.