TRANSFERENCE AND
COUNTERTRANSFERENCE
Recognition of the analyst’s subjective involvement has led to pro found 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 func tion ofthe 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 enact ment 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 Hoff man-that challenge previous theories of mutative process are dis cussed 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.
l
he psychology of the analyst and the part played by inter action have become significant aspects of our understand ing of the analytic situation. Central to this discussion is the
Faculty, San Francisco Psychoanalytic Institute; Clinical Professor, Depart ment of Psychiatry and Behavior Science, Stanford University Schoolof Med 1c1ne.
recognition that the analyst is involved with the patient in a subjective way, colored by unconscious ideas, fantasies, and motives. Further, the analyst acts on these motives, altering the analytic relationship. This View has an appeal: it acknowledges the humanness of the ana lyst; it frees the analyst from the pressure of transcending that hu manness in a search for surgical precision and purity. But a view of the analyst as subjective raises a problem: how does the analyst do something useful for the patient if he or she is as subjectively involved as the patient?
The answer to this question has to do with our professional training, our ethical commitments, our dedication both to aiding the patient and to analysis itself. This paper will address the question of how these factors are mediated in the analytic situation in the form of the analytic role. I will try to show that this concept helps us clarify the complex interplay of multiple levels of phenomena from the ana1yst’s side that impinge on analytic process.
Although Freud (1910, 1915) first described countertransfer ence, he did not pursue the subject beyond the recommendation of personal analysis and continuing self-analysis. Recent scholarship has revealed that, Freud was well aware of the complexity and power of countertransference-in particular, Ferenczi’s use of disclosing his countertransference to the patient (Haynal and Falzeder, 1993). It was such experiments with analytic technique that led Freud to view countertransference as something to be brought under ego control by the analyst.
Paula Heimann (1950) asserted clearly that countertransference was inevitable and necessary as part of analytic process. For the fol lowing three decades countertransference was acknowledged as a source of data, but its effects were largely considered problematic if carried into the analyst’s actions. A more elaborated view of counter transference emerged in the work of analysts treating sicker patients. Racker’s discussion of the analyst’s involvement (1972) remains one of the most elaborate. He speaks of countertransference as growing
inevitably from the analyst’s attempts to understand the patient
through indentiiication. In addition to these “concordant counter transferences” there are those that grow from identifying with the patient’s internal objects-“complementary countertransferences.”
interact with the analyst’s own neuroses, producing the actual coun tertransference of the moment.
Until ten years ago it was generally assumed, or hoped, in main stream clinical theory that the analyst’s reactions were restrictedto ideas and affects, with occasional “slips” in action that could be a
cue to the analyst that there were powerful countertransferential forces at work. Recently, Renik (1993a, 1993b) and others (e.g., Lev ine, 1994) have argued that the analyst is of necessity subjectively
involved-"embroiled”-in the analytic relationship, in an ongoing
and largely unconscious way. Renik argues that “enactments,” in
which the analyst actively participates, bring the nature of the
involvement to the analyst’s attention, and make possible the work of understanding. That is, analysis is a retroactive interpretation of action that has already occurred.
Whether or not one accepts Renik’s extension, the question
arises: How do we avoid analysis becoming an arena in which two psychologies simply play themselves out, with benefit to the patient
a matter of chance? How is it that “something new,” something
beneficial, happens? I will argue that the answer lies in the special characteristics of the analyst’s part in the relationship: the analytic role.
THE ANALYTIC ROLE
The concept of role was introduced in the 19305 by George Herbert Mead (an early American sociologist) , Ralph Linton (an anthropolo gist), and jacob Moreno (both a sociologist and the originator of
psychodrama), building on the earlier work of Georg Simmel on the influence of social groups on individual behavior (Wolff, 1950). Role theory addresses the manner in which social situations are structured by extensive sets of rules or expectations. The concept has been extensively developed in psychology and sociology, with a consider able theoretical and experimental literature (Biddle, 1986).
The theatrical metaphor that gave rise to the concept of role emphasizes its inherently interactive quality. There is no role without a real or anticipated other. The sociologist Talcott Parsons (1953) wrote, “The essential criteria of a social role concern the attitudes
both of the incumbent and of others with whom he interacts, in
relation to a set of social norms defining expectations of appropriate or proper behavior for persons in that role” (p. 613). Role activity is not necessarily conscious: “It connotes not only overt actions and performances but also covert expectations held by an observer, or by a group of observers, such expectations serving as the basis for judging the propriety of the enactment” (Sarbin, 1968, p. 546). Role
is also the enabler of interaction: “The establishment and persis
tence of interaction tend to depend on the emergence of and identi
fication of ego and alter roles” (Turner, 1968, p. 558). In other
words, the complex human process of psychoanalysis is con
ducted-especially on the side of the analyst-according to a set of social rules that are shared with an (imagined) audience. These “rules” significantly guide and delimit the potential range and inten sity of the analyst’s behavior in the analytic interaction. From an intrapsychic viewpoint, role is a particular aspect of the functions of
ego ideal, superego, and ego. These functions are maintained
through a combination of imagined or real rewards and sanctions consequent to the degree the analyst’s clinical behavior conforms to role guidelines.
In psychoanalytic thinking the concept of role is present implic itly in the process of oedipal resolution during latency, through iden tification and socialization: the child, forced to relinquish the oedipal object, is offered the alternative of an identiflcatory relation ship with the same-sex parent. But the child does not become the parent overnight. Instead, over a period of years the child is social ized by family, school, and peers to play a role-one that amalgamates the image of the parent with personal traits and wider social expecta tions. Thus, role-playing is motivated by sublimated oedipal wishes
(among other things), but channeled through a set of rules and
expectations provided by social institutions (and, accordingly, moti
vated by ego and superego as well as sublimated drive). Erikson (1968) used role more explicitly in discussing how individual devel opment occurs within the social context of family and culture.
modern professions inculcates roles deeply, underscores their impor tance, and supports roles that are difficult to play. The surgeon, for example, must disinhibit the aggressive impulse, while keeping it under highly specific, yet flexible ego control. More to the point, the psychoanalyst learns a role that is enacted in a conversational situation, yet differs immensely from conversational roles for friends or other professionals.
This paper will outline elements of the analytic role and discuss the factors that support it. It will argue specifically that three levels of psychoanalytic theory-metapsychology, clinical theory, and the largely oral tradition of clinical tactics-each play a part in the forma tion and maintenance of the analytic role. There are two areas that I will not develop. I will not try to describe how the analyst learns
and maintains the role, or how it is integrated with the analyst’s
character, neurosis, and prior experience. This would be an exten sively study in itself (Szasz and Hollender, 1956). I will also not ad
dress the important area of the patient’s role, which again would require a separate essay. Finally, I would like to emphasize again the social quality of the concept of analytic role. There is of course an intrapsychic aspect or correlate of role-analytic identity, or as Schafer (1983) calls it, “the analytic attitude.”This identity or attitude, how
ever, takes on meaning only in a clinical, dyadic situation, in the
form of role expectations.
METAPSYCHCLOGY AND THE ANALYTIC ROLE
Psychoanalytic theories\of mind provide the analyst a special frame work for listening. All analytic theories are templates for interpreting the patient’s associative flow in a way that searches for latent mean ings. An important receptive aspect of the analytic role is the mental activity of formulating hypotheses based on general theoretical mod els. The analyst constructs an ever-shifting model in his or her mind of who the patient is, and of what the salient issues of the moment are. The metapsychological contribution to this model is not in itself sufficient for guiding the analyst’s behavior. Instead, theory of mind provides an orienting function.
way. It is the focus of analytic identity and of organizations. Members of different analytic groups hold to their views and languages in tensely, and often reject those of other schools. Yet there is no simple relationship between metapsychology and technique, nor has one theory been proven of greater clinical efficacy. How do we account
for this? By acknowledging that theories of mind-whatever their scientific merit-serve as credos. Every human group holds such
credos in some form as a way of defining group identity. An analyst asserts and sustains an analytic identity by espousing a particular metapsychology. This identity also links the analyst to a group of like-minded peers, and group membership synergistically supports the individual’s analytic commitment. Metapsychology facilitates the analytic role, even though it does not contain role guidelines.
The analytic enterprise is generally acknowledged to be a diffi
cult one; maintaining a belief in theory as an aspect of ego ideal
reinforces the analytic role. Maintaining group membership serves
as a sustaining force during analytic work. Membership, in turn,
involves adherence to a common set of ideas-for analysts, metapsy chology along with clinical theory.
Metapsychology, via group membership, makes another contri bution to the analytic role: it supports aspects of the role that contrib ute to its power to influence, what could be called the charismatic component. Charisma here is used in a broader sense than when we use it to refer to leadership of mass movements. “Office charisma” describes special qualities of social roles (such as that of psychoana
lyst) that can be activated by certain behaviors. For example, the analyst’s interpretation of preconscious elements of the patient’s
thinking has a specific tactical meaning for the analyst, but is also
in itself a powerful source of influence on the patient’s attention and involvement.
In the analytic role charisma is often activated by “oracular”
CLINICAL THEORY AND THE ANALYTIC RCLE
Psychoanalytic training provides two sorts of information about how to act in the clinical situation. There are a set of general guidelines for playing the analytic role (e.g., “maintain neutrality”); there are
also more specific tactics (e.g., “the patient is not ready to hear
about the positive transference”). Far more is written about general clinical guidelines because they are less specific, more attitudinal, and thus can be discussed in a general way. Tactics are usually taught in supervision, and discussed in case conferences and study groups. They have more relevance to specific clinical situations, and will tend to vary with each patient (and each analyst).
General Role Guidelines
Freud first described the important features of the analytic role
(1912). In keeping with his theoretical underpinnings at the
time-the topographic model and libido theory-Freud emphasized those aspects of the analyst’s role that would aid in absorbing the patient’s unconscious ideas, conveyed in the phrase “evenly hov ering attention.” This position involved “emotional coldness” and surgical dispassion. Intimacy and self-revelation were to be avoided for fear of abetting resistance and engendering insatiability.
In The Analytic Attitude, Roy Schafer (1983) has provided a mod ern elaboration of the attributes of the analytic role: neutrality (not the same as quiescence) ; curtailment of narcissistic activity (usually re ferred to as abstinence); forthrightness (calling a spade a spade); avoiding either/ or thinking (keeping in mind overdetermination, mul tiple function, ambivalence, \and multiple levels of thinking); analyz ing, not reacting (while maintaining courtesy); and helpfulness (a respectful, affirmative attitude).
\'Vhat follows is a compilation of role attributes, expanded from Freud’s and Schafer’s work, to includeiother role features that I
by my own training and experience. Both emphasis and specific
items may vary among different analytic schools of thought.
Attitudinal Guidelines
Professionalism reminds the analyst that while engaged in an in tense, and in many ways personal, relationship, he or she is being paid for a service to the patient. This carries with it a whole group of ethical expectations of the analyst, as well as the expectation ac
corded other providers of service of attentiveness, acceptance of
working conditions, and full and prompt payment by the patient. The analyst’s professionalism provides a framework within which many of the unconventional aspects of the analytic role can operate. Neutrality is defined by Anna Freud (1966) as remaining “equi distant” from ego, id, and superego. She was referring to the pa tient’s structures, but neutrality can be taken equally-given our
awareness of countertransference and the analyst’s involvement-to apply to the analyst’s own psyche. That is, the analyst-at-work is en gaged with the patient by his or her own drives; the superego re strains action impelled by the drives; the ego observes and organizes alternative "interpretive activity. In a general sense, a psychic state in which the analyst has all three systems working roughly equally is likely to avoid rash responses. If the patient says, “I hate you! You’ve n~ever said a kind word to me in three years!” the analyst (being
neutral) will not react with a harsh counterattack (all id), a self
defense (all superego), or even “You are angry today” (all ego). The response might be, “You’re pissed off with me; does it have some
thing to do with my starting late today?” “Pissed off” is id; “my
starting late” is superego; “does it have to do with” is ego.
Curiosity. Like an investigative reporter, the analyst is always ask ing questions. Many of these are not couched in an interrogative form, but may be expressed through silence or the reflection of words or phrases. The analyst also questions internally: affective, asso ciational, and cognitive responses to the patient. This inquiring atti tude serves to make connections to theory (does my punitive feeling indicate the patient is experiencing guilt?); but curiosity also serves to promote a continuing widening of the analytic field. The analyst is always thinking, “What else? . . . and then what else?" This helps
keep the process moving, encouraging both parties to search out
Ajjirmation, or positiveness, emphasizes that the analyst attempts to view every aspect of the patient with equal respect. This is an
aspect of neutrality, of course, but of particular importance since what patients have the most difficulty thinking and talking about are mental contents that are surrounded with guilt, shame, rage, and
other dysphoric, frightening affects.
Helpfulness and an affirmative attitude represent a bias away from neutrality on the dimensions of love and self-esteem. For most pa tients the analytic experience is a difficult one because it brings to the surface ideas, feelings, and self-attitudes that are distasteful and frightening. The analyst must address these forthrightly, and hopes the patient will do the same; knowing that the analyst cares (mani fested in the sublimated form of helpfulness) makes the patient’s job easier. And if the analyst speaks positively about these contents, it counters the patient’s need to protect self-esteem with intransi gent resistance.
lnteractive Guidelines
Attentiveness refers to an aspect of the analytic role that makes
it different from many others-a constant alertness for the unique qualities of every moment. It is an aspect of Freud’s “evenly hovering attention,” and an expression of curiosity. It involves a constant will ingness on the analyst’s part to be open to new interactive informa tion without immediately stereotyping it. All role situations involve a mix of unique and formulaic aspects of interaction; the analytic role is biased toward the unique.
Seylessness, or what Schafer calls “curtailment of narcissistic ac tivity,” aids in one of the most difficult aspects of the analytic rela tionship: keeping the focus dn one member of the dyad. It is difficult because the natural tendency in social systems is for a balance be tween the parties (“How do you do?" “How do you do?”). In fact, giving a person one’s unconditional attention is a rare human gift,
probably because it harkens back to infantile experiences like
“refueling” (Mahler et al., 1975), and “affect attunement” (Stern,
1985), where-from the infant’s point of view-the mother is com
the patient wants to shift the focus to the analyst, and away from him- or herself. The analyst’s steady control of the spotlight beam,
keeping it on the patient (and the interaction), counters both the
patient’s resistance and the analyst’s identificatory “counterresis tance.”
Anonymity is one way the focus is kept on the patient. but it serves a more important function: to minimize information about
the analyst. This in turn invites the patient to make assumptions about the analyst that are heavily based on internal expectations,
i.e., transference. Thus anonymity facilitates the externalizing, the object-related counterpart to the emphasis on the patient’s self, pro moted by the selflessness of the analyst.
Abstinence is a further expression of the last three role character istics. While a modern point of view insists that the analyst gets all sorts of gratifncations in the course of the work (Szasz, 1956), they are not the ones that most role-relations provide. Again, selflessness is the major example in respect to narcissistic gratification. The ana lyst also does not cue (at least not consciouslyl) for object-related gratification. The patient may express love (or hate), but in his or her own time, not when the analyst wants it.
Communicative Guidelines
The analyst minimizes automatic responses (Sandler, 1976) to the patient’s cues. In most interactive situations there is a whole lan
guage of cues, internal rules, and responses that influence one’s
cognitive, affective, or judgmental reaction to another, and indicate whether one should continue, tone down, or stop what he or she is
doing. The analyst attempts to modulate reactions to the patient
superego in restraining automatic responses. Then the analyst’s sub jectively driven reaction will be of a more muted quality, making the analyst’s response more likely to be manageable, different, and use ful for the patient.
The relative silence of the analyst assists a number of other guide lines. It facilitates the patient’s self-expression and the focus on the patient’s mental activity. Combined with the unpredictability of inter ventions, it contributes to the power of the analyst’s impact, the charismatic component of role. Intermittent, unpredictable re
sponse is a powerful form of influence. This quality of the analyst’s timing gives his or her words maximum impact.
Forthrightness, another means of emphasis, might seem in con flict with selflessness and anonymity. It is not. The difference is be tween “I noticed that you seem cheerful today” and “I noticed that you seem cheerful today.” That is, the focus remains on the patient. Forthrightness counters learned inhibitions on directness in social situations. A major function of socialization is to train us not to make direct, confrontational statements to people about their impulses, or how they defend themselves characteristically. “You are acting aloof and distant to protect yourself from feeling sad”is not a com ment that would be welcome at a cocktail party, or on a bus. But in analysis we want directness-the analyst’s forthrightness models for
the patient, encouraging directness about affects, fantasies, and
thoughts about the self and the other.
Avoiding either/or thinking is another way in which resistive and counterresistive tendencies are mastered. Impulses and anxiety are
TACTICS AND THE ANALYTIC ROLE
The written literature of psychoanalysis is surprisingly limited in pro viding specific instructions for analyzing. It is largely in supervision of training cases that analysts learn about tactics, in a situation where the uniqueness of each patient, analyst, and dyad can be considered. Analysts develop a repertoire of tactics that grow from the clinical theory of each psychoanalytic school, from training analysis, from supervisory experiences, from personality style, and from the ana lyst’s own evolving ideas about the analytic task.
An example of a fairly detailed set of tactical instructions is
presented in the work of Davison et al. (1990), who have elaborated Paul Gray’s ideas (1986) on “close process monitoring.” This is a technique based on American ego psychology, with emphasis on the interpretation of resistance and defense. Gray suggests that the ana lyst note carefully moments when the patient shows a shift in affect state, indicative of defensive activity in reaction to signal anxiety. By directing the patient’s attention to such moments, the analyst can help the patient recognize his characteristic defensive modes. Davi son et al. give specific advice about doing this, recommending that the analyst (1) intervene on the downslope of the assertive-retractive curse (that is, when the patient has begun to back away from some thing said with energy); (2) look at shifts before addressing causes; (3) intervene with a focus on process, not content alone; (4) empha
size a polarity and a transition; and (5) aim each intervention at
turning aggressive energy away from the analysand’s self. The au thors acknowledge that this approach has limitations at certain times and with certain patients. The recommendations do not address
countertransference issues, and presumably some analysts will do certain of these things better than they will others. Further, as we have seen, tactics arise out of the thinking of a particular school of thought, here modern American ego psychology. Another school would presumably develop a different tactical list (although the ques tion can be raised whether different tactics may lead to the same
overall outcome).
Davison and his collaborators are attempting to create more
school, and from analyst to analyst. The reason for this is that each analyst has a different character, interprets theory differently, and
reacts to the analytic situation and role differently (Kantrowitz,
1992). It is for this reason that the analytic role is delineated for the most part in general guidelines, not with the specificity of, say, mili tary or bureaucratic roles.
Before turning to a clinical illustration it is useful to consider where the analytic role fits into the overall analytic situation. Put most simply, the analytic role modifies and guides how the analyst listens, reacts, and behaves in the complex interplay of qualities that two people bring to treatment. Each of the participants in the ana lytic relationship brings a range of individual characteristics, which mesh in a unique way for each dyad. The qualities involved range from specifics (age, gender, class, occupation) to the personal (his
tory, life situation, conflicts, character) to the interactional (the
transferences and countertransferences that the other evokes). It is
on this complex array of factors that the analytic role acts as an influence at every moment. The following vignette was chosen as an illustration because it has the features of an “enactment,” and thus will allow us to see how role may affect such moments.
CLINICAL ILLUSTRATION
During his childhood Mr. W’s mother frequently told him, privately, that she loved him in a special way. This specialness created two problems: Hrst, it made separation from his mother difficult; by mak ing Mr. W feel that there was no need to relinquish his mother, second it made the resolution of his oedipal conflicts difficult. These problems were compounded by Mr. W’s perception that his father
and older brother were not only bigger and more competent, but
also closer to each other than they were to him. As a child, Mr. W felt he was isolated by these differences from others. A rather brittle obsessional personality structure, which emerged in latency, sufficed to support adequate work and social functioning until Mr. W’s
mother died when he was a young adult. At that point he destroyed his marriage with infidelity and began to abuse drugs and alcohol. He entered psychoanalytic treatment and regained equilibrium. His
work went well, and he met a new woman. After three years of analy sis, however, Mr. W decided to move to a new part of the country
in a burst of “independence” He came to me several years later,
depressed and in trouble in his second marriage, and again involved with another woman.
During the first years of treatment (he gradually increased his visits over several years to four times a week), much of the focus was on Mr. W’s very limited social world, which consisted of his wife and his lover. Dividing his loyalties reduced his anxiety about feeling “trapped” with his wife, but of course put the marriage at risk. He compensated for this by providing financially and emotionally for his dependent wife; this also gave him a feeling of control. In the analysis I frequently pointed out how these patterns delimited his world, and in particular protected him from awareness of feelings
about me. Over time, he gave up the lover, but he continued to
minimize my role in his life except as an observer and commentator on his struggles with his wife. When he did become aware of me, as when he increased to four hours a week, Mr. W had an upsurge of disturbing dreams with violent homosexual and aggressive themes, accompanied by anxiety before and during his sessions. He quickly pulled back from these frightening experiences by again minimizing reference to the analytic relationship.
By the time of the following incident Mr. W had left the unsatis factory relationship with his wife for a woman who was less depen dent, and who insisted he join her in social and outdoor activities.
Nevertheless, he continued to hold on to contact with his wife
around her financial demands on him. The theme of his alienation from the “world of men” had come up increasingly.
Mr. W always paid his analytic bill the day after receiving it. After a week away on vacation with his new girlfriend, he came into his Monday session saying that he had been worrying about his ex-wife after his enjoyable trip. \'Vhen he continued to describe anxiety, I
suggested he might be concerned about feelings toward me after having been away. He denied this, but then reported having bad
He indicated it “bothered” him; he wondered how big a deal it was for me. I first pointed out that these were two different issues-his feelings and the effect on me. Mr. W said, “I was aware of not dis cussing it. It is-I don’t know how much is okay. I don’t have any feeling-” I said he was handling it in a way that would make him feel he wasn’t on solid ground. After a pause he said, “There’s noth ing else I can do.” I said, “You’re assuming I’ll be your banker.” Taking this literally, Mr. W indignantly pointed out that I couldn’t
charge him interest, that he had always paid me on time, that his
request was common practice, and that he was only going to be a few days late in payment-what was the big deal? I said that I thought this was an important issue, that he expected to be able to tell me about the late payment rather than ask, because he had “taken care” of me in the past with his prompt payment.
Mr. W was furious about being thwarted and exposed, but un derstood that the issue was that he wanted to manage his relationship with me much as he managed his relationships with women-by
keeping distance and control. He continued to mull over the situa
tion for the following several hours. He related a long dream in
which there were two big buildings, “large phallic things” that were swaying, but there was “safety in separation.” In the next few weeks Mr. W began to talk more about his father and brother. He began to realize that what he assumed was their exclusion of him was in fact his own alienation, and that he was actually interested in me and what I was like.
Commentary. With most patients I would not have made an issue of a few days’ delay in payment. But here I was responding to a transference enactment of the sort of relationship W had with
the women in his life. I felt excluded from an acknowledged place in the patient’s emotional life, and bought off by being “taken care of” by his dutiful analytic behavior. I had drawn Mr. W’s attention repeatedly to the sadistic, morally questionable aspect of his behavior with women and his use of their dependence to control them by drawing them in and pushing away. Now I was feeling this treatment myself, if in a more subtle form. But despite the subtlety, my subjec tive reaction was quick and irritated. I felt, “Wait a minute! Not so
fast!” and I acted, not in an analyzing way (“\/Vhat do you think
the patient reacted defiantly, I became more judgmental (“You’re assuming I’ll be your banker”). Only on the third pass did I take a more neutral stance, relating the patient’s action to a more general pattern of behavior (his entitlement to control and unilateral rights, because of having “taken care” of me for so long).
My quick, irritated reaction stemmed from a number of counter transference themes. For several years I had listened to Mr. W talk
about his hostile treatment of others in ways that stimulated my aggression (by identification), as well as my conscience (in reaction). I also had felt “handled”in a way that effectively kept me from being acknowledged as a player in Mr. W’s psychic life. Now my nose was being rubbed in my exclusion-how could I object to his plan when he had been such a good payer? Well, I could! The emotional inten sity of my reactions, both felt and acted on, cued me to the impor tance of the situation, and aided me, as I regained my bearings, in pointing up elements of the situation that were habitual in Mr. W’s relationships.
Mr. W did not like my action, but there was relief in my taking an active position, my caring enough to challenge him. His provoca tion and my reactive “outburst” led to several changes in our rela
tionship. First, I became a player instead of an observer on the
sidelines. Second, I directly thwarted Mr. W’s use of his position of
“provider” to mistreat me. Third, recognizing the pattern once I was drawn into it, I was able to work on the issue analytically toward helping him understand his behavior (and mine).
DISCUSSION
How does understanding the analytic role help clarify this incident? Let us begin from how such enactments are now often interpreted
(for example, Renik, 1993b): I was caught up in an unconscious
countertransferential response to Mr. W’s announcement about late payment. I reacted in a challenging, punitive way, out of a combina tion of my own neurosis and the mistrust the patient had generated in me. Then I became aware enough of what was going on to self
correct, and to use the incident to explore a major theme of Mr.
But I think this event was more complex. Mr. W both feared
and wanted a real sense of engagement with me. He began the analysis barricaded behind controlling relationships with women. My theory helped me tolerate his seeming exclusion of me through such metapsychological ideas as defense and conflict (both preoedipal and oedipal), through clinical guidelines regarding the interpreta tion of resistance, and through tactical considerations having to do with timing. The analytic role helped keep me involved in a positive way, and specifically directed my attention and interpretive activity to Mr. W’s fears of closeness and his struggle with those fears. That is, my countertransference reactions to Mr. W’s treatment of women were processed through the guideline of neutrality: to remain silent, when hearing how he kept his estranged wife on the string through gratification of her financial demands, would not have been neutral. These interventions proved useful in that Mr.W recognized increas ingly the sadistic, controlling nature of his involvement, and began to see that it also had something to do with his avoidance of men, father figures particularly.
Thus, the analytic role already played a part in setting the stage for this moment. Mr. W could have avoided the financial crunch; he was ready to test me out. Although his unconscious fantasies about coming to grips with me were deeply disturbing, my steadiness in the analytic role for over three years helped him to feel that he could now risk overtly challenging me. In addition, although my reaction to his late-payment announcement was countertransference-driven, my role restrained me so that I did not overpower or humiliate him. In the interaction that followed, my role helped me to realize that we were engaged in an enactment, and to respond with increasingly “neutral” interventions. That is, I recognized that I was feeling con trolled and handled by Mr.W, and that my initial response had been to countercontrol and criticize. With the preconscious presence of role guidelines of neutrality, curiosity, and anonymity, I was able to adjust my position to one of interest in exploring the situation. This stance had the effect of modifying my challenge to Mr. W to a level he could tolerate and perhaps identify with. I believe not only that Mr. W helped to precipitate this event, but that he sensed my capacity to shift from a purely reactive position to a more reflective and
an enactment into an analytic experience, not simply a repetition within a transference-countertransference interplay.
Figure 1 reviews the two groups of influences acting on the analyst at work. Those in the lower part of the diagram are the idiosyncratic factors that we usually think of as affecting the analytic process: demographic characteristics, personality traits, and intrapsy chic reactions to the relationship situation itself. In the upper part
are the analytic role contributants. The nature and outcome of a
given analytic event or moment are complexly influenced by both groups of factors. The analyst in a whole variety of ways experiences and acts within his or her role. Both parties know this, and it is this knowledge that in part creates the “as if,” theatrical quality of the analytic encounter. (The “patient role” is the other part.)
As I have indicated, I believe that the construct of analytic role may help clarify some issues in current discussions of interaction. In what follows, I examine several recent views that challenge or extend the traditional analytic position that the mutative process occurs pri marily through insight. One view (that of Owen Renik) concerns the extent of the analyst’s subjective involvement. A second (that of Irwin Hoffman) concerns the patient’s use of the analyst’s involvement as a hook onwhich to hang transference. A third (that of Darlene Eh
renberg) concerns the use of the analyst ’s involvement in the form of se# disclosure and emotionally expressive participation as an aspect of tech nique.
REN|K’S MODEL OF ENACTMENT
Owen Renik has articulated a significant revision of the function of
countertransference and transference-countertransference enact ments in psychoanalytic process (1993a, 1993b). “Everything an ana lyst does in the analytic situation,” Renik (1993a) writes, “is based upon his or her personal psychology” (p. 4). Not only is the analyst subjectively involved at every moment, Renik argues, but much of his or her awareness of involvement is retroactive. The analyst’s side of analytic process includes a constant attempt to monitor these
Fig1u°e 1. The Analytic Role: Contributants and Place in Analytic Process
Social environment of the analyst, past and present (includes supervision, study groups, institutes,
national organizations, reading, writing)
Clinical E Metapsychology
Theory (Models of Mind)
Listiing,
Formulating
Tactics (-- Guidelines Supports
aspects of role behavior
The Analytic Role
l
/Analyst <1
Analytic ProcessPatient 4-* °
Idiosyncratic Influences gender character traitsspecific reaction to patient countertransferences counterresistance
gender, age, work transferences character traits "unconscious plan" specific reaction to
uses this awareness to deepen his or her understanding, enabling
interventions that increase the patient’s understanding. Renik ar
gues that suggestion, the analytic shibboleth, is in fact going on
constantly, both because the analyst desires to influence the patient, and because the patient expects it. Renik implies that it is the post hoc exploration of enactments that makes the suggestive effect a positive one. He does not indicate how this exploration frees itself of the same subjectively driven interplay that has brought about the enactment in the first place.
I believe it is the analytic role that saves Renik’s view from lead ing to a position of complete analytic relativism. Patient and analyst come together on different terms. Yes, they are both subject to the same basic drives and needs for defense. But acting on the analyst is the whole internalized system of ideas, ideals, values, and behavioral norms (as well as the external social supports for the continuing
role-enactment of these beliefs) that are condensed in the concept
of analytic role. In the episode with Mr. W I did indeed act on
subjective feelings about the patient’s sense of entitlement. My ana
lytic role, however, had a significant-I would argue, decisive-in
fluence on how the interaction evolved.
First, it was my interpretation of resistance to the transference (my comment on the impact of his vacation absence) that probably
led Mr. W to mention his plan to pay late. Once he did, my role
An analytic moment like this is, as Renik (1993b) says, a “correC_ tive emotional experience,” formed out of mutual subjective involve ment, action, and mutual influence. It is not corrective in the old, Alexandrian sense of a planned role-playing. Rather, it is corrective in the sense that in the live “theater” of transference-countertrans ference, the patient and I have had an experience that, though famil
iar, fails in a number of ways to correspond to his expectations.
Although I was emotional, I was not punitive or, in the end, control ling. That is, restrained both by role influence and by my understand ing of our idiosyncratic relationship I did not act as the patient or
his internal objects might have-for example, with punitive anger or guilty compliance. Instead I held my ground, forestalled an action resolution, and pushed for discussion. My role helped me create a situation in which the patient too could suspend action while exam ining his feelings and the wider meaning of the event. Such examina tion then set the stage for the patient’s experimenting with new
behavior patterns.
Thus, while Renik is true to a psychoanalytic view in pointing out that the analyst, as well as the patient, is subjectively involved, role mediates the analyst’s affective response and subsequent behavior, thereby leading to a different interactional outcome than would re sult from acting out of sheer subjectivity.
HOFFMAN’S SOCIAL CCNSTRUCTIVIST MODEL
By invoking the analyst’s “objectivity,” Hoffman is resorting to a sort of psychoanalytic deus ex machina inconsistent with his as sumption that what makes the process go is the fact that both parties are subjectively engaged. But he comes nearer the mark when he ascribes that objectivity to the analytic role: “the extra factor of ‘ob jectivity’ that the analyst has to help combat the pull of the transfer ence and the countertransference usually rests precisely on the fact that the nature of his participation in the interaction is dwwent than that of the patient” (p. 417; emphasis added). Nonetheless, the word “objectivity” obscures the complex contributions of the analytic role. In other words, it is the powerful yet generally unacknowledged in fluence contributed by role that leads to a different “enacted” expe rience. Because I reacted to Mr. W in a muted and investigatory way, he could talk about his wishes for control and could safely challenge my authority (presumed to be rigid) without either the total victory that he anxiously wished for or the defeat that he feared. Objectiv ity-in the sense of my perhaps being somewhat less caught up in the affects of our involvement-was involved, but so too were selflessness, curiosity, attentiveness, forthrightness, and the minimizing of auto matic responsiveness.
Awareness of role helps demystify social constructivism. Cer tainly patients seize on real aspects of the analyst’s involvement as they activate transference; Freud pointed this out in his first discus sions of the phenomenon. But instead of resorting to the analyst’s authority by citing “objectivity,” we should consider how the concept of analytic role helps us understand how the analytic process can be helpful, despite the analyst’s possibly unwitting subjective participa tion. Further, we can wonder whether patients also hook their egos, including wishes to change, to their perception of the analytic role. This would be akin to what we mean when we speak of internalizing the analytic function.
EHRENBERG’S “INTIMATE EDGE”
Like Renik and Hoffman, Darlene Ehrenberg (1992) argues that
to the patient regarding her own affects and opinions. These she
regards as a means to maintain a therapeutic focus on the “intimate
edge”-the ever evolving subjective experience of the interaction
for both parties. At times Ehrenberg uses self-revelation to convey
the patient’s impact. Once, to a patient threatening suicide if not helped immediately, she said simply that she didn’t like to be threat ened (p. 8). At other moments Ehrenberg initiates discussion of her feelings with patients, actively expressing them as she does so.
Ehrenberg’s technique might easily be dismissed or trivialized as wild analysis. But she articulates a clinical theory within which such interventions are understandable. That is, for Ehrenberg the role definition of analyst is constructed in a way that includes self disclosure, for the greater goal of vividly drawing the patient’s atten tion to the immediate experience of the interaction. This brings us to a new question: When do we reach the limits of what can still be called the analytic role? Ehrenberg’s activities may violate several of the role components I have cited. She seems to place on her own
experience a focus equal to-at times even greater than-that she
places on the patient’s. \/Vhen she acts out of her own affect, she is
probably no longer neutral-at least within the clinical mo
ment-and may be allowing automatic responsiveness. On the other hand, Ehrenberg’s position raises questions about the inclusiveness of my list of role characteristics. She builds on Freud’s emphasis on transference interpretation to make central the immediate analytic relationship. Perhaps we need to add, as a role component, awareness of emotional immediacy. This, combined with forthrightness, curiosity, and attentiveness, would qualify Ehrenberg’s style as a proper mani festion of the analytic role. Alternatively, we can take her position as a more idiosyncratic one, a manifestation of her individual tempera ment. Then, of course, it would come into question as a technique for others, unless they have a similar capacity for comfortable selfexpression to patients. ,
Reading Ehrenberg’s vignettes, one sees that the more dramatic aspects of her technique are used sparingly, predominantly with
more difficult patients who resist by externalizing conflict onto the relationship and the analyst. Seen in this light, self-disclosure is a
tactic-one Ehrenberg seems comfortable with-for enacting the
analytic role. Self-disclosure and affective expressiveness are dra matic ways of engaging the patient’s attention and disrupting power ful, externalizing transference resistances. Ehrenberg is arguing that
such variations in the analytic role may be useful, especially in diffi cult treatments. She reminds us that the definition of what is “ana lytic” remains in need of more precise description, categorization, and measurement.
CONCLUSION
The concept of analytic role has helped place each of these recent contributions to clinical theory (or theory of mutative action) within a broader framework. What appear to be radical views of analytic process (as including corrective emotional experience, for example) or radical technique (self-disclosure) are thereby put into perspec tive. This should not be taken as minimizing the importance of these views, which contribute to an enlarged discussion of process. But analytic theory tends to evolve in a dialectic. Too often positions
harden, as new ideas, and sometimes even old ones, are deemed
inconsistent with existing theory. They are then lost or become ex iles. We are only now, some sixty years later, rediscovering Ferenczi’s experiments with self-revelation (Haynal and Falzeder, 1993). Given the variety of personalities among patients and analysts, and the
range of fit in analytic dyads, we need a clinical theory that is varie gated, not monochromatic. Analysts are generally more familiar with models that view action as originating from “within” the individual. Consideration of the complexity of the analytic situation, including
the fact that the players are not “free” from social rules in their
associations or actions, must include the ways in which roles condi tion the expression of the intrapsychic.
I have deliberately not discussed the patient’s role here, to avoid confusion and complexity. But it is probably as important as the
analytic role. That is, the patient, too, comes with varying amounts of preparation for his or her role, and then learns further of a range of behaviors and guidelines in the analytic situation (the fundamen tal rule is an example). Together, the analytic and patient roles make possible a special sort of interaction, one that opens up thoughts
more precisely how the clinical situation of psychoanalysis evolves. Analytic role mediates among theory, analytic institutions, training, and the individual analyst and patient at work. Understanding its functions will be part of a more realistic apprehension of analytic process.
REFERENCES
BIDDLE, B.]. (|986). Recent developments in role theory. Annual Rev. Sociology, 12:67-92.
DAv|soN, W.T.; PRAY, M.; & BR|sTo|_, C. (I990). Mutative interpretation and close process monitoring in a study of psychoanalytic process. Psychoanal. Q., 59:599-628.
EHRENBERG, D. (|992). The Intimate Edge. New York: Norton.
ER||<soN, E. (|968). Identity: Youth and Crisis. New York: Norton.
FREUD, A. (I966). The Ego and the Mechanisms of Dqense. Rev. ed. New York: Int. Univ. Press.
FREUD. S. (|9I0). The future prospects of psycho-analytic therapy. S.E.,
11:141-151.
-1 (I9|2). Recommendations to physicians practising psycho-analysis. S.E.,
12:111-120.
-T (I9|5). Observations on transference-love. S.E., 12:159-171.
GOLDBERG, S. (|99|). Patents’ theories of pathogenesis. Psychoanal. Q., 60: 245-275.
GRAY, P. (|986). On helping analysands observe intrapsychic activity. In Psycho analysis, the Science of Mental Conflict: Essays in Honor of Charles Brenner; ed. A.D. Richards 8a M.S. Willick. Hillsdale, Nj: Analytic Press, pp. 245-262. HAYNAL, A. & FALZEDER, E. (l993). Empathy, psychoanalytic practice in the 1920s,
and Ferenczi’s Clinical Diary. Amer. Acad. Psychoanal., 21:605-622. HEIMANN, P. (|950). On counter-transference. Int. Psychoanal., 31:81-84. HOFFMAN. |.Z. (I983). The patient as interpreter of the analyst’s experience.
Contemp. Psychoanal., 19:389-422.
-- (|992). Expressive participation and psychoanalytic discipline. Contemp.
Psychoanal., 28:1-14.
KANTROWITZ. _|. (|992). The analyst’s style and its impact on the analytic process:
overcoming a patient-analyst stalement, Amer. Psychoanal. Assn.,
40:169-194.
KOHUT, H. (|97l). The Analysis of the Se# New York: Int. Univ. Press.
LEVINE, H. (I994). The analyst’s participation in the analytic process. Int. Psy choanal., 75:665-676.
MAHLEP., M.; PINE, F.; & BERGMAN, A. (|975). The Psychological Birth of the Human
Infant. New York: Basic Books.
RACKER, H. (|972). The meanings and uses of countertransference. Psychoanal. Q., 41:487-506.
RENIK, O. (|993a). Analytic interaction: conceptualizing technique in light of the analyst’s irreducible subjectivity. Psychoanal. Q., 62:553-571.
-i (l993b). Countertransference enactment and the psychoanalytic process.
In Psychic Structure and Psychic Change: Essays in Honor of Robert Wallerstein, M.D., ed. M.]. Horowitz, O.F. Kernberg & E.M. Weinshel. Madison, CT: Int. Univ. Press, pp. 135-158.
SANDLER, (I976). Countertransference and role responsiveness. Internat. Rev. Psychoanal., 3:43-47.
SARBIN. T.R. (|968). Role: I. Psychological aspects. In The International Encyclopedia of the Social Sciences, ed. D. Sills. New York: Free Press.
SCHAFER, R. (I983). The Analytic Attitude. New York: Basic Books.
STERN, D. (|985). The Inteqbersonal World of the Infant. New York: Basic Books. SZASZ, T. (|956). On the experiences of the analyst in the psychoanalytic situation.
j Amer. Psychoanal. Assn., 4:197-223.
l- & HOLLENDER, M.H. (|956). A contribution to the philosophy of medicine: the basic models of the doctor-patient relationship. All/IA Archives Internal Med., 97:585-592.
TURNER, R.H. (|968). Role: II. Sociological aspects. In The International Encyclopedia of the Social Sciences, ed D. Sills. New York: Free Press.
WOLFF, K. (I950). The Sociology of Georg Simmel. New York: Free Press.
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