Neuropsychoanalysis has an influence on psychoanalytic technique but not on the psychoanalytic method

Abstract

The psychoanalytic method requires, on the analyst’s part, a core psychoanalytic stance, where the patient can be reached in a conjoint working-through process, allowing a gradual understanding of the feelings present in the consulting room. Clinical neuropsychoanalysis originated with the presumption that this sort of treatment is valuable for patients suffering from brain lesions. Arising from the practice of clinical neuropsychoanalysis, and responding to critiques of the implications of neuropsychoanalysis in general, the author proposes that neuroscience can positively impact psychoanalysis, but within limits. Specifically, neuroscience provides useful information and conceptual tools that may affect the parameters of treatment – psychoanalytic technique – but can only help indirectly to understand the inner world as the patient subjectively conceives it; in other words, it does not fundamentally impact the basic analytic method. This basic stance, kindled in the analyst by controlled identification with the patient (as exemplified by countertransference-based interpretations), is enhanced by the intrinsic capacity for empathy and introspection, on the part of the psychotherapist and progressively, it is hoped, the patient, even those with neurological impairments. Technique (whether derived from neuroscientific notions or from psychoanalytic theory) can only help to facilitate change in circumstances in which this core psychoanalytic stance is in place. A corollary to this is that, in certain circumstances, theory (be it neurological or psychoanalytic in origin) may even inhibit this crucial psychoanalytic process. This view is supported by revisiting Joseph Sandler’s ideas on the “theory of technique” in psychoanalysis and by examples taken from clinical practice with patients with brain injuries

Does interpersonal behavior of psychotherapy trainees differ in private and professional relationships?

“…Attendants of a cognitive behavioral therapy (CBT) training rated support as the most important attitude and adjustment as the main curative factor for their therapeutic work, whereas for trainees in PA, Psychodynamic (PD), and Psychotherapy insight was the most relevant curative factor and neutrality the most important therapeutic stance. According to Clarici (2015) therapeutic stance bases on the individual’s private and professional roles and is defined by his/her strategies to deal with mentally challenging material. Hence, the preferred stance, as therapeutic technique of choice, is not necessarily stable over time, but can be redefined to some extent, when the therapist realizes that he/she has to modify his/her chosen method to make it more suitable to the patient’s problem ( Sandler, 1992 ).…”