Mutative Interpretation and Close Process Monitoring in a Study of Psychoanalytic Process

The significance of the ego in "The Ego and the Id" and its unfulfilled promise

It is not well known that The Ego and the Id, where Freud presented his second model of the mind, and introduced a new role for the Ego, was ignored by many of the major theorists that followed. I will attempt to demonstrate the importance of this new view of the ego for clinical psychoanalysis, and what has been lost by its being ignored.

Interpreting Interpretation

Interpretation of the latent meaning of manifest content is the core of the traditional approach to psychoanalytic treatment. The main purpose of such interpretation is to enhance the patient's self-knowledge, in particular his or her awareness of unconscious wishes and their embeddedness in inner conflicts. An assumption of classical psychoanalysis is that veridical interpretations-as Freud put it, interpretations that tally with what is real in the patient-will be especially effective therapeutically. These basic assumptions have been called into question, as reflected in such concepts as "narrative truth" and the overriding importance of the patient's "assured conviction" regarding interpretations. Also called into question is the therapeutic value of "deep" interpretations intended to uncover repressed impulses. To an important extent, these have been replaced by interpretations of defensive processes just below the surface of consciousness, and interpretations that make connections among different experiences, both of which are intended to help the patient understand how his or her mind works. There is also an increased emphasis on nonsemantic aspects of interpretation, as well as some degree of skepticism toward the therapeutic value of interpretation itself, along with an increased emphasis on the implicit interpretive aspects of the therapeutic relationship. Finally, representative research is presented on the relation between transference interpretation and therapeutic outcome.

Child versus adult psychoanalysis: two processes or one?

Child analysis continues to be seen as a different technique from adult analysis because children are still involved in a developmental process and because the primary objects continue to play active roles in their lives. This paper argues that this is a false dichotomy. An extended vignette of the analysis of a latency-aged girl is used to demonstrate that the psychoanalytic process that develops in child analysis is structurally the same as that in adult analysis. Both revolve around the analysis of resistance and transference and use both to promote knowledge of the patient's mind at work. And both techniques formulate interventions based on the analyst's appraisal of the patient's mental organization. It is hoped that stressing the essential commonality of both techniques will promote the development of an overarching theory of psychoanalytic technique.

Supervision and self-disclosure: modes of supervisory interaction

A conceptual framework is presented for thinking about supervisory issues raised by candidate self-disclosure. The process of dealing with self-disclosure in supervision brings into bold relief certain dynamics that operate in all supervisory encounters. In responding to these and other tensions stirred by analyst self-disclosure, the supervisory dyad moves in and out of various configurations, or "modes of supervisory interaction." Why these dynamics are intensified when the focus of supervision is on an instance of candidate self-disclosure is explored. To illustrate these ideas, a supervisory hour that dealt with the issue of self-disclosure is presented. A nonjudgmental awareness of the various modes of supervisory interaction enriches the supervisory process.

The analytic role: a mediating influence in the interplay of transference and countertransference

Recognition of the analyst's subjective involvement has led to profound reconsideration of the nature of mutative process. How is it that the analyst can be personally involved in an unconscious way, yet also be an "objective" participant in the relationship? The paper proposes that the analyst's subjectivity is mediated by his or her role. The analytic role conditions how the analyst listens, experiences, and behaves, leading to interactive outcomes different from that expectable from unmodified subjectivity. The paper describes the analytic role in terms of contributions from metapsychology, clinical theory, and tactics. Each affects the function of the analyst-at-work in a different way. The analytic role, learned during training, is maintained by a combination of internalization and ongoing involvement in psychoanalytic activities. A clinical illustration demonstrates how a typical transference-countertransference enactment is influenced by the analytic role. The vignette suggests ways in which the concept of role modifies the effect of subjectivity. Three recent viewpoints--those of Renik, Ehrenberg, and Hoffman--that challenge previous theories of mutative process are discussed in terms of the analytic role. In each case, consideration of role clarifies the nature of the innovative technique or view, and seeming contradictions between it and existing clinical theory.

The eclectic analyst, or the many roads to insight and change

Common wisdom has it that psychoanalysis is composed of a number of discrete bodies of theoretical and technical thought, or "schools." I argue that psychoanalytic schools are not as different from one another as they are commonly supposed to be, particularly in matters of technique. In their daily practice, most analysts do not adhere strictly to the precepts of a specific school, even though they profess to be adherents of that school. Instead, they read widely and adopt those technical procedures and principles that fit their own personality and prove most efficacious with their patients, regardless of the school from which those ideas come. In short, they are eclectic. I present a case to illustrate this eclecticism in my own practice, discuss the widespread nature of such eclecticism among the professions in general, and briefly discuss the significance of eclecticism for psychoanalysis itself.

Neutrality, interpretation, and therapeutic intent

Neutrality is a central concept within the theory of psychoanalytic technique. We spell out the major controversies in which the concept has become embroiled, and provide a definition that we believe coincides with actual psychoanalytic practice. We discuss its merits and weaknesses, noting also the negative consequences of relying on older definitions. We relate neutrality to the interpretive process, indicating ways interpretation protects neutrality and is made more effective by it. We discuss the complex and controversial relation between neutrality and the analyst's therapeutic intent.