Owen Renik

Analytic Interaction: Conceptualizing Technique in Light of the Analyst’s Irreducible Subjectivity

Every aspect of an analysts clinical activity is determined in part by his or her personal psychology. The implications for our theory of technique of taking the analysts subjectivity fully into account--which we have tended not to do--are discussed.

The ideal of the anonymous analyst and the problem of self-disclosure.

The principle of analytic anonymity is critically reviewed. A connection between the technical stance of nondisclosure and idealization of the analyst is proposed. Some preliminary suggestions are offered concerning what kinds of information about the analyst are useful to communicate to a patient.

The perils of neutrality.

The concept of analytic neutrality is reviewed with respect to its utility as a technical guideline. Participation of an analysts personal judgments and affects in clinical work is discussed in relation to differing conceptions of how learning takes place in analysis. The question of what actually protects a patient from being exploited by an analyst is considered. A case example is provided as a basis for discussion.

Getting real in analysis.

: A detailed clinical example is used to illustrate how reality testing can create rather than foreclose opportunities for analytic investigation. It is proposed that effective analysis of transference within the treatment relationship requires close and explicit attention to considerations of reality. The author reconsiders certain conceptions of a special psychoanalytic reality, of regression in clinical analysis, and of the nature of free association, suggesting that they tend to discourage the realism necessary to productive psychoanalytic work. He underlines the importance of ongoing reference to therapeutic outcome as an aspect of reality.

Use of the analyst as a fetish

In some cases a gratifying transference fantasy is the subject of progressive analytic work, while in other cases the same type of fantasy eludes investigation, and its enactment causes treatment to become an unproductive endless task. One cause for the latter difficulty can be that the patient uses his or her analyst as a fetish, permitting the distinction between reality and fantasy to remain inconclusive, so that relinquishment of magical expectations does not take place. The particular form of thinking involved in use of the analyst as a fetish is described. The role of illusion, its various clinical manifestations, the countertransference reactions they can evoke, and the technical problems posed are discussed. Special attention is given to the crucial issue of termination. By considering extreme instances in which use of the analyst as a fetish predominates, the author hopes to call attention to a phenomenon that appears to some degree in many, if not all, analyses.

The biblical book of job : advice to clinicians

Study of the Book of Job clarifies the particular adaptation to trauma that underlies the suffering of certain difficult patients. In addition, the misdirected efforts of Jobs comforters in the Bible story help us understand why, with such patients, an analysts attempts to address unconscious guilt and defenses against it will prove counterproductive. A case example is presented.

Comments on the clinical analysis of anxiety and depressive affect

In listening to clinical material, the analyst frequently has to decide among several apparently valid avenues of investigation. The author examines an aspect of the way he chooses among technical alternatives. His perceptions of an analysands motivations are influenced by two complementary affect-defense configurations: inhibition in response to anxiety and enactment of wishful fantasy in response to depressive affect. These conceptualizations act as deep structures at the base of his clinical thinking and give direction to his analytic activity. A connection is suggested between the choice to analyze one or another specific affect-defense configuration and the sequential unfolding of tolerable frustrations and gratifications for the analysand.

Analysis of a woman's homosexual strivings by a male analyst

Clinical material is presented describing how analysis of the homosexual aspects of a woman patients transference to a male analyst unfolded. Comparison and contrast is made to previous case reports and discussions of the impact of the analysts actual gender on analytic work.

An example of disavowal involving the menstrual cycle.

The author presents clinical material that illustrates the confusion between reality and fantasy in disavowal, the tendency of some women in analysis to disavow menstrual events, and some technical considerations pertaining to the analysis of disavowal as a resistance.

INTERSUBJECTIVITY, THERAPEUTIC ACTION, AND ANALYTIC TECHNIQUE

The author defines the therapeutic action of psychoanalysis as the patient’s increased capacity to make changes in his/ her attitudes or behaviors in order to achieve greater well-being and satisfaction in life. Although most analytic theories generally agree about this, the author notes, they diverge in their specifications of the principles of analytic technique that will best accomplish this aim. The patient’s experience of benefit is the most accurate criterion for evaluating the success of the analysis and thus of the resultant therapeutic action, in the author’s belief. An extended clinical vignette is presented in which he illustrates how his technical decisions are guided by these principles.