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Although aware of a lack of consensus in the literature about the exact nature of the relationship between psychoanalytic theory and the clinical process, the authors contend that the analyst's theory(ies) are inextricably intertwined with the treatment process. Two clinical case examples are presented to illustrate this and to highlight the authors' discussion of the empathic mode of listening and its role in self psychology, as well as the self-object transferences and the interpretive process in self psychology.

Although the term psychoanalytic process is frequently used, there is no consensual definition of its meaning. Some authors use it to designate a recognizable set of experiences within psychoanalysis. Others, a majority, use it as a synonym for the entire psychoanalytic experience, describing in detail what analysts do to achieve their goals. A range of views may be found between these extremes. A distinction is drawn here between the structure and content of the psychoanalytic process, which is regarded as a specific, definable entity--a red thread--within the psychoanalytic treatment experience as a whole, consisting of a microprocess and a macroprocess. The former is predominantly an amalgam of the patient's and the analyst's highly subjective experiences and entanglements, while the latter is predominantly an amalgam of the infantile and childhood origin of the patient's difficulties, as well as the analyst's conception of these difficulties based on a preferred theory. These ideas are used to formulate a definition of the psychoanalytic process based on clinical experience and are traced here primarily through lessons learned from a patient, Mr. K, over the course of a long and arduous analysis.

This article presents a self-psychological understanding and treatment of anger. Angry reactions are based on various types of injury to self-esteem, and on disappointments in those one holds in special esteem-such as early caretakers and later important others. When these injuries and disappointments are massive--traumatic--the ensuing angry reaction is especially intense and often destructive. Treatment addresses the patient's vulnerability, the soil on which all these forms of anger arise, through an empathic entry into the subjective inner world of the angry or enraged individual rather than through direct confrontations. Empathic entry leads the therapist to the sources of anger, often precipitated by inadvertent, unempathic responses in the therapeutic encounter. Accepting nonjudgmentally, understanding uncritically, and explaining patiently the meaning and origin of the anger may lead to the amelioration of the vulnerability that gives rise to the anger.