2024 Author: Harry Day | [email protected]. Last modified: 2023-12-17 15:43
St. Petersburg
It is difficult to imagine a modern psychoanalytic approach that denies the deeply interactive nature of the psychotherapeutic enterprise. All agree that psychoanalysis is a type of psychological help that comes from the relationship between two people. The healing agent is not a pill, not a book. Psychoanalysis is not a technique that can be learned and "applied" to clients. This is a process that unfolds within emotionally rich relationships, which, on the one hand, are limited by "ritual" and professional roles, and on the other hand, become over time for both participants "more than real"
In our time, in all psychoanalytic approaches, the therapeutic relationship is viewed as both wholly professional and wholly personal. There is no way to separate one from the other, both elements are always present in the process, thus creating a paradoxical (transitional) space within the therapy.
If for both participants it does not become "personal", real, charged, exciting, killing, nourishing, etc., then a certain depth of experience will never be achieved. These will be superficial relationships in the “psychologist-client” register that simply will not “reach” the deep layers of the client experience. This requires that for both it becomes "personal". Otherwise, therapy will remain just an "art of explanation." This is the dimension of the reciprocity of the therapeutic relationship.
Personal does not necessarily mean warm, caring, or friendly; being cold, aloof, sadistic, judgmental is also personal. The therapist's feelings (and even who he is as a person) inevitably become woven into the fabric of interaction with the client, growing into the structure of the couple. Mutual affectivity is one of the ingredients in the therapeutic action of psychoanalysis. Verbal study of relationships is different (analysis of the transference-countertransference matrix, mutual enactments, etc.). [There are other ingredients too]
There are no cold and warm theories, personal and impersonal. There are psychoanalytic theories that allow for greater personality manifestation, and there are those that do not recommend it (based on conceptual and methodological premises). And in the second case, a quieter analyst does not mean cold, aloof, etc. - with all this, he can be emotionally deeply connected with the client and passionately involved in the process.
[Theory and technique generally cannot (and should not) be prescribed in isolation from the personality of the therapist.]
It is not theories that are alienated, but therapists, and they can belong to any psychoanalytic school. And this alienation may manifest itself not necessarily through silence and passivity, but also through verbal activity, spontaneity and inappropriate self-disclosure, and whatever. No intervention has a universal meaning; it can be useful in one context and harmful in another. And behind it can be a variety of conscious and unconscious motivational elements.
Speaking about the professional component of a therapeutic relationship: if there is no technical “framing”, then we will find ourselves lost in endless enactments, and we will have no reference points at all from which we could understand and deal with what is happening.
The professional "stratum" structures the ongoing processes in a certain way and allows the most secret and complex registers of our inner world to emerge within this relational "container". This is a dimension of the asymmetry of the therapeutic relationship.
In life, relationships do not analyze themselves, and we need a certain skeleton of professional roles, obligations, etc., which will further grow and fill with the flesh of the developing emotionally rich interaction between us.
Coming back to "personal", I recall a quote from Stephen Mitchell:
“Until the analyst enters affectively into the patient’s relational matrix, or rather finds himself inside it - if the analyst is in some sense not fascinated by the patient’s pleas, is not formed by his projections, if he is not an antagonist and is not frustrated by the patient’s defenses - treatment will never be fully utilized, and a certain depth within the analytic experience will be lost."
The same goes for the client.
Most often it takes time. But sometimes this happens almost immediately, and sometimes it can be scary to allow such an intensity of relations, and before this stage, years of more careful and "preparatory" interaction pass before the doors of the most personal rooms of the inner world open. Sometimes, in order to get into one room, you need to go through a number of others, which can also take time.
And - in the end - for both participants it becomes "more than real".
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How interesting it is to study the historical vicissitudes of this long and difficult path, which psychoanalytic theories have overcome to this point. How much resistance there was at one time in recognizing the inevitability of countertransference, then its usefulness, then the existence of a "real" relationship between the therapist and the client (which were conceptualized in the middle of the 20th century in the form of numerous alliances - "healing alliance", "working alliance", " therapeutic alliance ").
In recognition of the client's influence on the therapist (Bion's “interpersonalization” of the concept of projective identification; Levenson's concepts of transformation, Sandler's role responsiveness, etc.), the therapist’s influence on the client (Gill's “interpersonalization” of the transference concept, numerous concepts of intersubjectivity).
The inevitability of enactments, then the usefulness of enactments (as a constituent element of the so-called mutative action of psychoanalysis) …
… and many more confessions on a theoretical level, which I once grouped into two categories for convenience.
1) More and more retraction of the therapeutic position "inward" of the therapeutic relationship. And all psychoanalytic schools now agree that we cannot be located "outside" of our relationship with clients.
2) The increasing pulling of the therapeutic position "inside" the therapist's own subjectivity, which is now declared as "irresistible" (also by all psychoanalytic schools, albeit with different reservations and understanding of this statement).
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