Judith Fingert Chused

The Evocative Power of Enactments

The inevitability of analytic enactments, defined as symbolic interactions between patient and analyst, is discussed. Clinical material from the psychoanalysis of a latency-age child is presented to illustrate the role of enactments and to demonstrate their usefulness in furthering the analytic work.

The Therapeutic Action of Psychoanalysis: Abstinence and Informative Experiences

In recent years a number of analytic concepts have been subject to scrutiny, with the value of interpretations, the usefulness of abstinence, the possibility of neutrality, all questioned. One reason for the skepticism about interpretations, in particular, is that before a patient can use an interpretation for psychic change, his perceptual frame must change, a process that is rarely initiated by the verbal content of an interpretation alone. Instead, alterations in perception usually require experiences which are discordant with expectations. In this paper the author demonstrates how the nonverbal elements of an intervention, the action communications, provide informative experiences, creating the dissonance between expectation and eventuality which makes psychic cnange possible. Case vignettes are presented to illustrate this point as well as to support the idea that when nonverbal experiences contribute to lasting change within a patient, the therapeutic benefit does not accrue primarily from the gratification provided by the experience, but from how the experience informs the patient about his mode of thinking, perceiving, and reacting.

The analyst's mistakes.

The analysts mistakes are an inevitable aspect of his conduct of psychoanalysis. They result from the inherent uncertainties and ambiguities of the analytic process itself, and from the continuing effect upon analytic technique of the analysts unresolved conflicts, as manifested in countertransference attitudes and enactments. Variables of clinical experience, skill, and the vicissitudes of the analysts life also contribute to the susceptibility to error. When the analysts mistakes result from his active engagement in the psychoanalytic process, they yield important clues for understanding clinical material as well as present potential obstacles to analytic progress.

Transference Across Gender Lines

Four clinical examples of oedipal-based transference across gender lines are presented with the aim of illustrating (1) its existence, (2) the defenses against its emergence, and (3) the use of the analysts gender as both an organizer of and resistance to certain transference manifestations. Factors that contribute to the availability for analysis of cross-gender transference are discussed, as are the resistances and other obstacles to its actualization.

The patient's perception of the analyst : the hidden transference

Just as the person of the analyst becomes a nidus for the manifestations of transference, so does the analysts technique. When the patient misperceives person and technique, identifying the transference is not difficult. More complicated are those situations in which the patients perception of the analyst and of his or her technique is congruent with the analysts self-representation, or when the patient uses reality aspects of the analysis and the analyst as a resistance. Clinical material from the analysis of three patients is used to illustrate this.

Neutrality in the analysis of action-prone adolescents

An adolescent patients action during analysis reflects both neurotic conflicts and the developmentally determined task of establishing an integrated self-representation. Concern for the consequences of the action often provokes the analyst to respond, covertly, with interventions intended to change the action through influence rather than understanding. This can lead to a distortion of the analytic process which, in itself, may be an enactment of the developmental conflict. Examination of such interventions reveals a lack of analytic neutrality and an unconscious participation in the patients neurotic and developmental conflicts. Clinical material from the analyses of two fourteen-year-old girls and a sixteen-year-old boy is presented to illustrate and support this hypothesis.

Idealization of the Analyst by the Young Adult

Idealization is an intrapsychic process that serves many functions. In addition to its use defensively and for gratification of libidinal and aggressive drive derivatives, it can contribute to developmental progression, particularly during late adolescence and young adulthood. During an analysis, it is important to recognize all the determinants of idealization, including those related to the reworking of developmental conflicts. If an analyst understands idealization solely as a manifestation of pathology, he may interfere with his patients use of it for the development of autonomous functioning.

Little Hans analyzed in the twenty-first century

Freuds monograph on the analysis of Little Hans is examined from a perspective aimed at highlighting elements of current thinking that would be considered mutative from those originally emphasized at the time it was written, and with a specific focus on the relative importance of verbal versus nonverbal interventions.Freuds monograph on the analysis of Little Hans is examined from a perspective aimed at highlighting elements of current thinking that would be considered mutative from those originally emphasized at the time it was written, and with a specific focus on the relative importance of verbal versus nonverbal interventions.

Nonverbal Communication in Psychoanalysis: Commentary On Harrison and Tronick

I n the beautiful clinical material presented in this paper, we see Alexandra Harrison create an action-dialogue with her young patient Kate, containing and thereby transforming the fear-f illed consequences of her patient’s trauma. Harrison and her coauthor, Edward Tronick, use the material to illustrate their “dyadic expansion of consciousness model,” a model for understanding the cognitive and emotional growth and understanding that can develop when a child’s inner world becomes altered and meaning gets made, not just uncovered, through the interaction with a sensitive, empathically attuned other. The session presented here has significance as a model for understanding what can transpire, nonverbally, in analytic treatment, not only with children but also with adults. Harrison demonstrates how what is communicated implicitly by our words and actions, as the communication takes shape in the back-and-forth movement between patient and analyst, may have more mutative power than an explicit communication. What I would add is that in some instances such implicit communications lose their power to alter a patient’s inner world if they are made explicit. Harrison’s first moves were directed toward engaging her patient, Kate, who had begun treatment for panic attacks, stammering, significant separation anxiety, and a sleep disturbance, all of which developed after she witnessed the televised attack on the World Trade Center. Her mother was not available during this frightening event because she had ja p a

AN ANALYST'S UNCERTAINTY AND FEAR

The motivations for choosing psychoanalysis as a profession are many and differ depending on the psychology of the analyst. However, common to most psychoanalysts is the desire to forge a helpful relationship with the individuals with whom they work therapeutically. This article presents an example of what happens when an analyst is confronted by a patient for whom being in a relationship and being helped are intolerable.