Back to the Future

Abstract

Significant components of psychoanalytic technique, and the theory that underlies it, seem to remain buried in our past, but are central to the growth of psychoanalysis as a treatment method based on understanding a patient's mind. By updating technique based on a theory of mind with structure, the author views the increasing freedom of the patient's mind as central to the curative process, and takes the position that in interpretive work, the analyst needs to pay more attention to the patient's capacity to meaningfully receive and integrate the analyst's interventions.

The psychoanalytic process and Freud’s concepts of transference and transference neurosis.

“…Already some 25 years ago Levenson (1984; see also Gann, 1984, p. 798) stated: “The sine qua non of psychoanalysis is… the psychoanalytic process” (p. 187, italics omitted). Similar statements were made throughout the following years (e.g., Andrade, 2003; Arlow & Brenner, 1990; Busch, 2003; Pulver, 1995). To what extent an existing psychoanalytic process justifies treatments as being psychoanalytic is addressed in Vaughan, Spitzer, Davies, and Roose’s (1997) statement that if a psychoanalytic process “does not develop, a ‘real’ analysis has not taken place regardless of the benefit to the patient” (p. 959).…”

The superego in observing ego functioning.

“…Gray (1973, 1986/1994) initiated a call for close-process monitoring of the patient’s associations, so that the patient could “see” his or her own conflicts at the moments that they were being expressed and hence experienced; this technique could then be identified with and assimilated over time as an integral part of the analytic process, enlarging the patient’s ego capacity related to self-observation. Busch has amplified this approach, emphasizing interpretations within a free-associative method that are experience-near—“in the neighborhood” (Busch, 1993, p. 204)—and ultimately “based on the ego’s capacity for observation ” (Busch, 2003). Although this mode of working does not expand on the observing ego as a functioning structure per se, it does intend to show how to recruit and establish an analysand’s ability to observe his or her thoughts and then think about them; the ability to distinguish between fantasy and reality as part of a transference resistance becomes central “at the moment,” and also as an active part of the patient’s domain.…”