How the analytic process is captured and absorbed into the familiar, the feared, and the desired

Psychoanal Rev. 2012 Oct;99(5):717-41. doi: 10.1521/prev.2012.99.5.717.

Abstract

In their transference efforts to maintain psychic equilibrium (Joseph, 1989), some patients will do their best to convert their analysts into familiar, dreaded, or desired internal objects which they then react to or relate to. The interpersonal, interactional, and intrapsychic pull for the absorption and utilization of the analyst into a predesigned and pathologically limited figure creates countertransference struggles and phases of enactment that can go unnoticed, denied, or justified. Even when analysts maintain their analytic balance, the patient can manipulate, mishear, and transform words, actions, and intentions into very specific archaic objects or part objects. Case material is used to illustrate the way in which patients attempt to turn the analytic process and the therapeutic relationship into an acting out of wished for or painfully familiar self and object interactions. This method of subsuming the analytic method can be quite subtle, or it can be very obvious but still extremely difficult to shift, interpret, or recover from. Indeed, the analyst can easily be drawn into this perversion of analytic procedure and end up participating in various enactments. With such patients, the nature of the unconscious fantasies projected into the transference matrix and the intensity of the patient's object relational conflicts almost guarantee some degree of ongoing countertransference acting out. So, the ongoing and repetitive interpretive style needed with such patients is both helpful and healing as well as often becoming a contribution to the fundamental pathology the patient repeats in the clinical setting. Although the transference dynamic being examined could be understood from a number of theoretical perspectives, the author focuses on the Kleinian psychoanalytic method.

MeSH terms

  • Countertransference*
  • Fear
  • Humans
  • Motivation
  • Professional-Patient Relations
  • Psychoanalytic Therapy / methods*
  • Transference, Psychology*