The Analyst's Desire and the Problem of Narcissistic Resistances
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Wilson, M. (2003). The Analyst's Desire and the Problem of Narcissistic Resistances. J. Amer. Psychoanal. Assn., 51:71-99. (2003). Journal of the American Psychoanalytic Association, 51:71-99 The Analyst's Desire and the Problem of Narcissistic Resistances Mitchell Wilson The ways in which the analyst's desire for particular experiences with patients is inevitable and often leads to narcissistically based resistances are considered. Five propositions are examined: (1) that the analyst cannot help but have desires and want them recognized by the analysand; (2) that these desires frequently underwrite the analyst's theoretical beliefs and technical interventions; (3) that narcissistic desires and their influence are ubiquitous among practicing analysts; (4) that the patient is often on the lookout for the analyst's various agendas; and (5) that the patient often hopes the analyst will put his or her desire aside and listen so the patient can further his or her own interests. Lacan's concept of the “dual relation” is central to this discussion. The neo-Kleinian position on narcissistic resistances is explored, as is the idea of the “analytic third” as a potential solution to the problem they pose. An extended case description illustrates the main points. [S]ometimes it is only the mask of distance, of vanishing, that lets you speak, that gives you the freedom to say what you mean without immediately having to stake your life on every word. So much of the basement tapes are the purest of free speech: simple free speech, ordinary free speech, nonsensical free speech, not heroic free speech. —Greil Marcus Invisible Republic: Bob Dylan's Basement Tapes ————————————— The author gratefully acknowledges helpful comments and suggestions from the following colleagues: Jonathan Dunn, Sam Gerson, Lee Grossman, Charles Fisher, Stephen Purcell, Owen Renik, Mark Scott, Thomas Svolos, and the JAPA editorial readers. Submitted for publication April 12, 2001 WARNING! This text is printed for the personal use of the PEPWeb subscriber and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form. - 71 - Though the meanings of [my patient's] experience can be debated according to our theoretical preferences, and though there is a novel element in her recent contacts with me, gue that finally it is her meaning that she unfolds within this setting … a new self-redefinition as subject, a search wherein she attempts to hold together more of the many strands of her existence. —Lewis Kirshner (1999) Ten years ago (1993), at the American Psychoanalytic Association's annual meetingin San Francisco, Lawrence Friedman stated the following: “Professional wishes are no less wishes. Analysis is a real world activity. Analysts want to analyze. They like towatch patients in analysis. They want patients to accomplish analytic goals” (p. 19). Friedman, as the discussant to a panel presenting papers on Resistance: A Reevaluation, distilled the analyst's activity to its essence: the analyst wants things from the analysis, from the analysand, y, and from being an analyst; the practicing analyst is a desiring being every step of the way. The four panel participants described intimate engagements with their analysands—engagements that involved struggle, negotiation, subtle coercion and conflict, and resolution. One analyst desired that patients “work” effectively on their problems. Another wanted an experience in which the analysand felt “present-tense” to him; he wished for the patient to “come alive” in his experience of himself and his analyst. A third presenter was concerned with the patient's fantasy of the analyst's authority: this analyst believed that the proper focus of analytic investigation was the patient's assumption that a hierarchy existed between them. The fourth analyst (the one Friedman applauded most generously) was a candidate in search of a control case, and she grappled straightforwardly with her desire for the new analytic patient she needed. Friedman pointed out that she was up front with her struggle to accommodate her wish to have a patient in analysis with the reluctance of her current prospect. The other analysts, to Friedman's ear, were less aware of what they wanted from their patients. Resistance, Friedman asserted, was as much about the analyst as the analysand. Friedman saw that each of the first three presenters assumed that his desire for a particular analytic engagement and process was inherent in psychoanalysis itself, in the technical application of theoretical WARNING! This text is printed for the personal use of the PEPWeb subscriber and is copyright to the Journal in which it originally appeared. It is illegal to copy, distribute or circulate it in any form. - 72 -
Transcript of The Analyst's Desire and the Problem of Narcissistic Resistances
Wilson, M. (2003). The Analyst's Desire and the Problem of Narcissistic Resistances. J. Amer. Psychoanal. Assn., 51:71-99.
(2003). Journal of the American Psychoanalytic Association, 51:71-99
The Analyst's Desire and the Problem of Narcissistic ResistancesMitchell Wilson
The ways in which the analyst's desire for particular experiences with patients is inevitable and often leads tonarcissistically based resistances are considered. Five propositions are examined: (1) that the analyst cannot help buthave desires and want them recognized by the analysand; (2) that these desires frequently underwrite the analyst'stheoretical beliefs and technical interventions; (3) that narcissistic desires and their influence are ubiquitous amongpracticing analysts; (4) that the patient is often on the lookout for the analyst's various agendas; and (5) that thepatient often hopes the analyst will put his or her desire aside and listen so the patient can further his or her owninterests. Lacan's concept of the “dual relation” is central to this discussion. The neo-Kleinian position onnarcissistic resistances is explored, as is the idea of the “analytic third” as a potential solution to the problem theypose. An extended case description illustrates the main points.
[S]ometimes it is only the mask of distance, of vanishing, that lets you speak, that gives you the freedom to say whatyou mean without immediately having to stake your life on every word. So much of the basement tapes are the purestof free speech: simple free speech, ordinary free speech, nonsensical free speech, not heroic free speech.—Greil MarcusInvisible Republic: Bob Dylan's Basement Tapes
—————————————The author gratefully acknowledges helpful comments and suggestions from the following colleagues: Jonathan Dunn, Sam Gerson, LeeGrossman, Charles Fisher, Stephen Purcell, Owen Renik, Mark Scott, Thomas Svolos, and the JAPA editorial readers. Submitted for publicationApril 12, 2001
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Though the meanings of [my patient's] experience can be debated according to our theoretical preferences, and thoughthere is a novel element in her recent contacts with me, gue that finally it is her meaning that she unfolds within thissetting … a new self-redefinition as subject, a search wherein she attempts to hold together more of the many strands ofher existence.—Lewis Kirshner (1999)
Ten years ago (1993), at the American Psychoanalytic Association's annual meetingin San Francisco, Lawrence Friedman statedthe following: “Professional wishes are no less wishes. Analysis is a real world activity. Analysts want to analyze. They like towatchpatients in analysis. They want patients to accomplish analytic goals” (p. 19). Friedman, as the discussant to a panel presenting paperson Resistance: A Reevaluation, distilled the analyst's activity to its essence: the analyst wants things from the analysis, from theanalysand, y, and from being an analyst; the practicing analyst is a desiring being every step of the way.
The four panel participants described intimate engagements with their analysands—engagements that involved struggle,negotiation, subtle coercion and conflict, and resolution. One analyst desired that patients “work” effectively on their problems.Another wanted an experience in which the analysand felt “present-tense” to him; he wished for the patient to “come alive” in hisexperience of himself and his analyst. A third presenter was concerned with the patient's fantasy of the analyst's authority: this analystbelieved that the proper focus of analytic investigation was the patient's assumption that a hierarchy existed between them. The fourthanalyst (the one Friedman applauded most generously) was a candidate in search of a control case, and she grappled straightforwardlywith her desire for the new analytic patient she needed. Friedman pointed out that she was up front with her struggle to accommodateher wish to have a patient in analysis with the reluctance of her current prospect. The other analysts, to Friedman's ear, were less awareof what they wanted from their patients. Resistance, Friedman asserted, was as much about the analyst as the analysand.
Friedman saw that each of the first three presenters assumed that his desire for a particular analytic engagement and process wasinherent in psychoanalysis itself, in the technical application of theoretical
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principles, and in the goals of analysis (however defined. The analysts' deepl held and deeply personal desires for particularexperiences with their patients—working on problems, coming alive in the analytic relationship, realizing the inhibiting nature ofidealization—became clothed in essentialist notions of the psychoanalytic process. Human desire, Friedman tells us, is never absentfrom human endeavor. There is no such thing as “natural” work, devoid of human action and intention. As Friedman said in hissummary of the analytic engagements the panelists described: “There's a demand for work here … a bending of purpose, a conflict ofwills, a verdict of satisfactoriness. The analyst is not just a facilitator: he is a taskmaster and judge” (p. 13). Friedman, of course ismaking a larger point: the analyst's desire for particular kinds of experience with the analysand is constitutive of the clinicalphenomenon we call “resistance.”
In this paper I explore different yet related aspects of the analyst's desire, specifically as it connects to the ubiquitousphenomenon of narcissistic resistances. I will describe what I consider to be an important, and arguably neglected, aspect of theanalytic encounter. By no means am I pretending to paint a comprehensive picture of the psychoanalytic process. Running throughoutthis essay is my assertion of the narcissistic basis of the analyst's desire, a desire to which the analysand is more or less sensitive. Idiscuss how the analyst cannot help but wish for certain kinds of experiences in the analytic process. And I will explore some of theways in which the analyst's wish for particular experiences can lead to iatrogenic resistance that have a narcissistic basis.
I mean to add another point of view, overlapping to be sure, to the literature on the analyst's subjectivity. By reframing the idea ofthe analyst's subjectivity in terms of the analyst's desire, I wish to emphasize that the analyst does not simply have his or her own point—————————————
My use of the termb “analyst's desire,” though inspired by Lacan's (1981) theorization of “the desire of the analyst” (p. 231), is both similar toand different from it. In this paper I elaborate a picture of the analyst's subjectivized desire and the ways in which this desire participates, forgood and bad, in the analytic process. For Lacan, the desire of the analyst is desubjectivized and part of the structure of a properly conductedanalysis. Lacan equates the desire of the analyst with the “object a,” or “cause of [the analysand's] desire” (pp. 273-274). In this ideal analyticstructure, the analyst's desire is enigmatic and, so being, allows the analysand to articulate gradually his own desires and position as subject.While overly rigid and idealized, Lacan's “desire of the analyst” does suggest that there are analytically helpful desires and analyticallyunhelpful ones (a point I take up later in the paper). My overall emphasis here is how the analyst as desiring subject gets in the way of theanalysand's ongoing elaboration of his desire.
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of view (that is, his or her subjectivity) forever at play in the flow of clinical work; the analyst always wants something. I also intendthis paper to offer a rebalancing of our consideration of the problem of narcissistic resistances in light of the significant and farreaching contributions of the neo-Kleinian school. These contributions, by Joseph (1989), Feldman, Spillius, Steiner, and Britton (inSchafer 1997), and Maldonado (1999), among others, have elaborated the nuances and subtleties of transference/countertransferenceconfigurations as expressions of the analysand's unconscious fantasy and of a demand for the analyst to enact a certain role within thatfantasy. Yet, as I hope to demonstrate, these writers insufficiently emphasize the role of the analyst's desire as a constitutive factor inthese configurations. I discuss in some detail Lacan's concept of the dual relation and use it to show that the nature of the role of thetwo participants in transference/counter-transference enactments is at times impossible to read and easy for the analyst tomisrecognize. The analyst is not, as usually described, simply responding to the role the patient has unconsciously invited, him toplay (Sandler 1976). The analyst puts pressure on the patient to play certain roles as well. It is this pressure—at least in some of itsmore blatant forms—that Lacan's concept of dual or Imaginary relations lays bare.
The Particularity of the Analytic EndeavorContemporary psychoanalysts encounter certain questions again and again that ultimately we—each of us—must answer for
ourselves. Here are some examples: Should the analyst try to be “helpful,” and what constitutes help? Should we help patients focus ontheir problems and goals and allow the process to venture wherever it does in the service of those ends? Should we focus on the hereand now of the transference to the relative exclusion of the past or the patient's outside life? Is the purpose of analysis to helpanalysands understand how their minds work or how to fix their problems? How much self-disclosure, and what kind, if any, ishelpful? Are we there to help patients discover something old and repetitive that plagues them or to create something new through thetherapeutic relationship? Is the analyst's countertransference—————————————
See Lacan (1977b; 1988, pp. 241-258; 1992, pp. 292-301; 1993, pp. 92-97 and 235-244), and Muller (1995) for descriptions and elaborationof dual or Imaginary relations.
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experience ever unencumbered, or is it always a distortion of the patient based on the analyst's desires and conflicts? All thesequestions—and many others—relate to the impact of the analyst's desire in the analytic setting.
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Obviously, I have falsely polarized pairs of questions that often rest most meaningfully in a dialectical relation with each other.Quickly we see that the analytic enterpris is radically situation-specific. These questions can only be answered in the context of anindividual case or, more correctly, a specific analytic couple. If each party in the analytic situation is “irreducibly subjective” (Renik1993a), then certainly there is something irreducibly subjective about any particular analytic pair (Jones 2000). Our desire fortheoretical principles that are coherent and generalizable is inevitably frustrated by the odd peculiarities and mysteries of any particularhuman encounter. Along the nomothetic-idiographic continuum—that is, the axis on which a science of general laws meets a series ofindividual, “signature” experiences—psychoanalysis as a practical endeavor is almost entirely idiographic. Given the particularity ofthe analytic enterprise, the analyst's wishes continually underwrite his conscious theoretical commitments and technical choices.
Against this theoretically pluralistic, yet clinically particularistic backdrop, one can catch glimpses of the analyst's desire at work.By “desire” I refer to our unconscious and relatively totalizing way of structuring reality based on unconscious fantasies andidentifications. Desire is what drives our being intentional and involves our irreducible interest in preserving our view of our place inthe world. By “wish” I mean specific and identifiable manifestations of this more all-encompassing, and therefore all-the-more-hidden,desire. Wishes can be more or less fulfilled and more or less conscious; desire cannot be fulfilled and is unconscious. When I say theanalyst's desire can be seen or glimpsed against the pluralistic backdrop of our clinical theories, I mean simply that each of us choosesour profession, our theoretical persuasions, and the kinds of experiences we want to have with our patients for our own particularreasons. The analyst's specific wishes may be facilitative or harmful to a specific ongoing analytic process; this issue I will take uplater in the paper. Whether harmful or helpful, our desires are engaged every moment we do analytic work.
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The Narcissistic Basis of the Analyst's DesireOne might argue that the analyst's wishes for certain experiences represent unresolved neurotic conflict. My claim is that these
wishes are inevitable. Working has no basis unless one wants to get something from that work. And yet, more essential than thegratifications we might hope for in doing analytic work is the wishfulness inherent in our being thinking and feeling persons. Theirreducibility of the analyst's desire starts here. Opatow (1997) writes compellingly about the essential nature of the psychoanalyticview of the human subject (or the mind). The mind, never complete unto itself, is inherently wishful and seeks its own satisfaction.Opatow investigates this idea through Freud's concept of hallucinatory wish fulfillment. For Opatow, the metaphor of hallucinatorywish fulfillment is foundational for psychoanalytic theory; it is psychoanalysis's original scene. It is also the original scene of the mindas conceptualized psychoanalytically; that is, hallucinating a, gratifying image is the genesis of the desiring subject, the subject's originas subject. This scene, to summarize Freud, unfolds in the following way: in the absence of nourishment, the hungry infant attempts tosatisfy itself (or affirm itself) with an image (a memory) of feeding on the breast. Faced with pain induced by absence, the infantattempts to refind psychically the object of satisfaction. Opatow writes: “An unconscious wish strives to actualize a scene—to revive itas a conscious event” (p. 873).
Opatow's point is farther reaching because he argues that the psychoanalytic postulate that satisfaction can be hallucinated is notlimited to a theory of unconscious fantasy. A hallucinated satisfaction is the foundation of thinking itself. Thus Opatow writes: “What istransferred from unconscious to conscious in the movement up the ordered hierarchy of mind is affirmation per se” (p. 873). In otherwords, there is an inherently self-validating aspect to thinking and perceiving. There is no such thing as “neutral” thinking; thinking issuffused with a distinctly narcissistic, self-aggrandizing desire. I want to emphasize that I do not mean to imply somethingpathological in using the term—————————————
Though Opatow's contributions (see also 1989) are only the latest in a long line of theoretical statements regarding the psychoanalyticconception of mind, in the paper discussed here Opatow offers a stunning synthesis of these statements into a compelling theoretical whole.
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“narcissistic.” Thinking is a self-preservative function, and in that very important sense is always already self-serving.If thinking is always already self-serving, then we necessarily tend to see ourselves, or refind ourselves in what we see around us.
Pontalis (1981), in a trenchant discussion of the development of the concept of the self, offers a similar conclusion: “Narcissism is nota phase, nor a specific mode of cathexis, it is a position, an insurmountable and permanent component of the human being. Even themost intellectual functions (thinking), the most objective ones (perception of reality), and the forms of behavior which come closest toinstinct (eating) are marked by it” (p. 136). In addition to seeing ourselves in the physical and interpersonal surround of our lives, wealso have a natural tendency to want others to recognize our perspectives, ideas, and feelings. Scholars of diverse intellectualbackgrounds have reached a similar conclusion about our desire as human beings to have our desires recognized by others (Kojeve1947; Lacan 1977a; Fukuyama 1992). By “self-aggrandizing desire,” then, I do not mean simply a self-centered and solipsisticdesire; I have in mind also one's desire for the, other's recognition and love. J. H. Smith (1991) puts it well: “Anything anyone does,
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thinks, or feels is a manifestation of concern for one's being and being-with. Desire at one moment, anxiety at another, arise from awant of being and a want of the other” (p. 92).
Despite the significance of the analyst's desire as a constitutive element in the analyst's functioning, the role of narcissism inpsychoanalytic theorizing has had a troubled fate. The point of view I have articulated so far is but one side of a tense argument thatpsychoanalysis has had with itself over the course of its history. Psychoanalysts have at times struggled with recognizing the deeper,more difficult desires that motivate our analytic activity, although it should not surprise us to know that we also desire not to knowcertain things about ourselves. This struggle can be seen from the perspective of the history of the psychoanalytic theory of the ego andthe self, which reflects a tension between our living more fully with our being desiring subjects and our wishes for rationality, order,and objectivity. It is this opening up of our selfhood that we are after, to which this paper contributes. I would like to summarize brieflyimportant aspects of this debate to lend context and clarity to my argument.
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The Ego and the SelfMany have remarked (see Laplanche and Pontalis, 1973, pp. 130-143, for a detailed discussion) on the conceptual confusion of
Freud's idea of the ego. The details of this confusion go beyond the scope of this paper. For the present purposes, I think it is fair to saythat for Freud the ego stood for the “I” (or the self) as well as for a set of cognitive and regulatory functions that comprised a proto-neurological executive agency. In Freud's topographic model, the ego and self were essentially synonymous. As Freud' structuralmodel gained in prominence, the narcissistic basis of the ego was deemphasized. American ego psychologists (Hartmann, for one)tended to highlight the ego's rational capacities; in so doing, they insisted on a distinction between the ego and the self. With thistheoretical separation of the ego from the self, the ego was more or less cleansed of narcissistic needs and influences. The theoreticalstatus of the ego changed: it was now conceptualized as a set of functions that were relatively autonomous from the pressures of thedrives (sex and aggression).
Within American psychoanalysis, there has been a sea change from a preoccupation with the ego to the consideration of the self.One way to read the recent North American psychoanalytic literature on the analyst's subjectivity in all its forms (see Bader 1993,1995; Renik 1993a and 1993b; and Grossman 1996, 1999 ) is as an insistent argument against the ego psychological claim that thereis thinking devoid of narcissistic investment (that is, thinking devoid of a self); and an argument against the technical precepts such atheory, in its strictest form, implies—precepts like neutrality, abstinence, evenly hovering attention, and “rational” or logicalinterpretations aimed at the ego's self-observing capacities. In this form of Freudianism, the ego never gains independence from theself. The ego and self form an indelible narcissistic structure. The analyst's activity—underwritten by specific—————————————
Hartmann (1950) writes: “It therefore will be clarifying if we define narcissism as the libidinal cathexis not of the ego but of the self” (p. 85).
Bader describes cases that demonstrate his claim that the analyst makes choices to act certain ways with patients that are both strategic andauthentic. Further, Bader demonstrates that the analyst, whether he or she knows it or not, is continually making choices. Renik emphasizes thatthe analyst's interventions are often unwitting; if retrospectively examined, they can propel treatments forward. Grossman emphasizes theanalyst's necessarily limited ways of listening, his or her inherent uncertainty in the clinical situation, and the ways in which that uncertainty ishandled clinically.
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wishes—is imbued with, as J. H. Smith (1991) puts it, “a concern for one's being” (p.92).H. F. Smith (1999) tackles head-on the complexities of what might be called “clinical epistemology” (and does them intellectual
justice), and stresses that the analyst's actions are an admixture of forces, a compromise between sexual and aggressive urges. Whilethoughtful and wise, Smith's account does not capture adequately the narcis sistic basis that underlies all perception, cognition, andaction. Grossman (1999) describes well what I have in mind. In his paper, “What the Analyst Does Not Hear,” he writes: “But Isuspect that both our way of listening and our preference for theories are primarily consequences of our way of seeing ourselves” (p.95). Cooper (1996) offers a similar observation: “… I would suggest that the analyst's choices of how to formulate and conceptualizeand the technique that follows from these choices are themselves the most blatant expression of the analyst's subjectivity” (p. 265).What may seem to be the practice of a rational-technical method is in fact suffused with desire, manifested by the analyst's wishes forparticular experiences with their patients.
The Analyst's Desire for Particular ExperiencesHow does this view of the ubiquity of narcissistic forces in the mind contribute to the kinds of experiences analysts want that lie
beneath the surface of conscious intent? I start, again, with Opatow's treatment of Freud's idea of refinding the lost object. I believe the
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analyst desires to reexperience a particular kind of object relationship with analysands. This refinding of the object relationship can,and does, take diverse and complex forms. The analyst may attempt to repeat with patients moments of relating that remind him or herof pleasurable past relationships.
Alternatively, the analyst may wish to redress with patients a particularly painful past object relationship or persistent internalconflict (Renik 1993b; Jacobs 1991; McLaughlin 1991). For example, an analyst—————————————
As commonplace examples: the analyst who eschews any measure of therapeutic zeal (and, therefore, assumes a “neutral” position towards hisanalysand) is valuing that particular stance. The analyst who (1) presumes to be in a position of “not knowing,” (2) cherishes “surprise,” and (3)embraces the ubiquity of countertransference enactment is similarly involved and concerned with inhabiting that particular stance with patients.
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with an emotionally distant and unavailable parent may believe him or herself to have been the agent of that parent's behavior and mayworry, accordingly, about his or her own omnipotence and destructiveness; that analyst may hope to redress these worries by havingemotionally close and intimate relationships with patients. Sharpe (1950) made a related point long ago. There she writes of the analystwho suffers from excessive therapeutic zeal—a persistent desire to be helpful and altruistic—in order to manage his unconscioussadism. Such an analyst, uncomfortable with patients who keep their distance, may too quickly and urgently interpret their defensiveposture and simply exacerbate problematic aspects of the transference/countertransference engagement. Gabbard (2000) captures mypoint in his discussion of the “ungrateful” patient. He writes: “… I am suggesting that ungrateful patients, in particular, are likely tomake us aware of our unconscious background wish to enact a gratifying object relationship that motivates us to return to theconsulting room day after day” (p. 699).
Another important factor in the analyst's desire for particular experiences is the analyst's theory of mind and clinical process.Several analytic thinkers have noted the importance to the analyst of psychoanalytic theory as a “loved object”—that is, a refinding ofa love that has been lost but never given up completely, now reestablished in the analyst's identification with a theoretical model(Almond 1995; Caper 1997; Purcell 2001). The analyst's relationship to theory has many important consequences for his or herfunctioning, some of which are clearly necessary for good analytic work to proceed. The analyst's attachment to a theoreticalperspective may be the wellspring of one of the gratifications of doing analysis: the analyst may feel satisfied, good, or whole if he orshe is acting in accordance with a particular theory of mind or therapeutic process. The analyst may use theory as a way to maintain afeeling of independence from difficult internal experiences, including feelings that the patient is trying to “take over” the analyst'sthinking and functioning. In other cases, the analyst may identify less with a theory and more with a former analyst or supervisor, andmay wish to recreate certain loving or hating, soothing or exciting interactions and feelings he or she experienced as a patient orsupervisee (Grusky 2000).
The motivation to refind the lost object only partly answers the question of the analyst's desire. The analyst's assessment of aparticular patient's troubles, their probable causes, and the ways in which they
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manifest themselves in the day-to-day work of analysis are also related intimately to the analyst's wishes and satisfactions. The issue isnot simply what kinds of experiences the analyst seeks to re-create or redress by doing analytic work. The issue is how these desiredexperiences interact with the analyst's conception of the patient's problems, as well as with the patient's own goals and desires fortreatment. As I noted earlier, the analytic couple's idiosyncratically evolving interaction of desires, subtly negotiated over time,determines the tone and quality of clinical process and outcome.
Dual Relations: The Analyst's Desire and ResistanceThe analyst is always, in part, looking for the lost objects, trying to refind him- or herself in the patient and to see him- or herself
as an analyst in day-to-day clinical work. The crucial question is how these desires facilitate or hinder a successful analytic process.For resistance does not reside “in” the patient. Resistance is fundamentally an intersubjective phenomenon. Boesky (1990) asserts thatanalyst and analysand co-create resistant moments in the analysis. Boesky writes: “I am convinced that the transference as resistancein any specific case is unique and would never, and could never, have developed in the identical manner, form, or sequence with anyother analyst. In fact, the manifest form of a resistance is even sometimes unconsciously negotiated by both patient and analyst” (p.572). Boesky continues later in his discussion: “If there can be no analysis without resistance by the patient, then it is equally true thatthere can be no treatment conducted by any analyst without counterresistance or countertransference” (p. 573). Boesky's contributionsuggests that there are useful resistances. If the resistant interaction becomes an object for mutual consideration, analyst and patientcan understand the significance of this interaction in the service of the patient's growing understanding of his or her subject positionand the way he or she relates to his or her important objects.
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Though it is true that the analyst's desire cuts both ways and can facilitate as well as hinder the analytic process, I want to focus inthis part of the paper on investigating how the analyst's desire contributes—————————————
See Goldberg (1987), Pizer (1992), and Aron (1996) for trenchant discussions of how analyst and patient grapple with their conflictinginterests over the course of psychoanalytic treatment.
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to resistant moments that more seriously threaten that process. Analysts are tempted to see themselves in the analysand and overvaluetheir ideas about the patient. The analyst also wishes to have the patient recognize those ideas in some manner. The situation iscomplicated because the analysand often canvasses the analyst for signs of the analyst's desire, or defends against noticing thosesigns. Among the analysand's fundamental questions are: what makes my analyst tick? what does my analyst want from me? whatdoes my analyst know? All analysts, of course, inevitably reveal aspects of themselves that provide the analysand with partial answersto those questions.
Complications notwithstanding, the analyst's desire—as it is expressed through specific wishes and demands—engendersresistance when the patient feels forced to recognize it. Especially during moments of uncertainty or uncomfortable silence orinteraction (in which the analyst feels in his bones caught in an enactment with a patient), the analyst is tempted to fall back fordefensive purposes on certain cherished identifications with a theory, a supervisor, a colleague, or his or her analyst. Precisely when wefeel lost we want to re-find ourselves. My argument is that at these moments of refinding ourselves we often stop listening to thepatient, and wish the patient would stop expressing the part of him- or herself we are having difficulty tolerating (Caper 2001). Theseresistant moments result from what Ogden (1988), following Lacan, calls “misrecognition.” The analyst, according to Ogden, fearsuncertainty and not knowing. The analyst stops listening and fills the gap of uncertainty with his own thoughts, guesses, or surmises.As Grossman (1999) writes, “… the villain in the piece is the analyst's certainty—a character trait, not a technical device” (p. 95).Lacan (1993) offers a similarly skeptical critique of the analyst's capacity to understand: “The major progress in psychiatry since theintroduction of psychoanalysis has consisted … in restoring—————————————
Steiner (1993), for example, writes: “The patient is always listening for information about the analyst's state of mind, and whatever form ofinterpretation the analyst uses, verbal and nonverbal clues give the patient information about him” (p. 390).
Lacan (1993) called this way of thinking the “relation of understanding” (p. 6). The analyst looks for patterns or relations among elements ofthe patient's discourse. In order for the analyst to make sense of the clinical material, he must assume a “self-evident” starting point and thenlook for a change from that point. Lacan suggests that the starting point usually remains an unexamined assumption. Rabin (1998, 1999), aneconomist, amasses a substantial amount of data regarding how people use “judgment under uncertainty” that support Lacan's analysis that inmoments of uncertainty we tend to look for the familiar, to “find what we're looking for.” In cognitive psychology this is known as“confirmatory bias.”
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meaning to the chain of phenomena [produced by the analysand]. This is not false in itself. But what is false is to imagine that thesense in question is what we understand” (p. 6).
Some readers may feel that this clinical dynamic of the analyst's imposition of his or her desire (and the effects of this imposition)is a reassuringly local clinical problem. My sense is, on the contrary, that this dynamic runs farther and deeper than is typicallyrecognized, and manifests itself in countless subtle clinical interactions. The problem of the analyst's desire and its effects is oftentucked neatly under the issue of “compliance.” Different patients handle the dilemma of the analyst's desire in different ways. Somecomply by being seemingly agreeable (Joseph 2000); some rebel in subtle or not so subtle ways. As I have argued, the analyst's desirethoroughly underwrites the analyst's technique; therefore, any analytic intervention houses within it aspects of the analyst's desire—inthe form of specific wishes—for some kind of response and recognition.
Under the clinical circumstances in which analysts desire too strongly, or too unconsciously, to have specific kinds of experienceswith their patients, iatrogenic resistances can result. The patient is put in the alienated position of “needing to deal” with the analyst'sdesire. Though the analyst's commenting on the patient's response to an intervention may further the analytic dialogue, ofteninterpreting the interaction by calling the analysand's attention to it only feeds its reinforcement. In such difficult clinicalcircumstances, which are more common than is usually acknowledged, there can be no clear way out. A crucially important aspect ofthese narcissistically based resistances is that, from a logical point of view, the dynamics asserted to be going on in the patient can justas easily be asserted to be going on in the analyst. Lacan called this way of interacting a “dual relation.” Dual relations are inherentlyreversible. Both analyst and patient want the other to recognize their desire. When caught in a dual relationship, it is often difficult tofigure out what is what; confusion results.
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————————————— See the issue of Psychoanal. Inq., 1999, Vol. 19: No. 1, for considerations of this topic. Levine's contribution (pp. 40-60) in that volume
comes closest to the point of view articulated here. Of American psychoanalytic writers, Weiss et al. (1986, 1993) has grappled most seriouslywith the problem of compliance in the psychoanalytic process.
In this case “dual” can also be read as “duel” since the images of confrontation, standoff, and reversibility are essential aspects of Imaginaryor dual relations.
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Joseph (1971) describes an interaction with her patient, Mr. B, that illustrates the difficulties posed by the analyst's desire forspecific clinical experiences and the reversible nature of dual relations. Joseph's focus on the patient's emotional contact, or lackthereof, with the analyst is central to her clinical point of view. Her ideas on transference, specifically on the totality of transferencemanifestations in the clinical moment, have influenced more than one generation of analysts. Everything the patient says or does hasimmediate transference meaning. In my estimation, the role of the analyst's desire has no independent theoretical standing in Joseph'sconceptualization of the analytic encounter.
Joseph's focus on emotional contact and the totality of the transference leads her to consider patients' reactions to weekends andholidays—periods of time away from the analyst—as important topics for analytic consideration. In the complex case of Mr. B, Josephdescribes a man with a narcissistic character structure and baroque sexual practices. While I assume that, as with all published clinicalmaterial, the analyst's understanding of the case has a privileged status, I believe that the clinical information Joseph provides us offersitself to an alternative reading. Mr. B, well into his analysis, gets married over a summer holiday. Upon his return, a number ofcomplicated interactions ensue between him and his analyst, including, among other things, an elaborate dream. I want to focus on onespecific aspect of Joseph's discussion. Mr. B tells his analyst that he was frightened to let her know about his recent marriage. He wasworried that the analyst, as Joseph writes, “would feel angry and left out, as if he ought not to have put the marriage before theanalysis; almost as if he ought to have married the analyst. It becomes clear,” Joseph continues, “how much he has projected his ownleft-out infantile feelings about the holidays onto me, and feels me to be watching, left out and demanding” (p. 445). Joseph does notmake clear precisely what she said to Mr. B, but she strongly suggests that she interpreted to him his projection of his feeling ofdependency onto her.
Yet this is where things get tricky and where, I would argue, confusion can reign in the clinical moment. This is because Josephwants clearly for Mr. B to admit his having felt left out over the holiday break. He doesn't acknowledge this, and therefore, in a veryreal sense, he is not acting in the way she wants him to act. More precisely, Mr. B is not thinking the way his analyst would wish himto think, in that he
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is not using the analyst's interpretations to further his self-understanding. Mr. B, in other words, is not recognizing his analyst's desire.One cannot help but wonder whether the patient has accurately concluded that the analyst feels the patient should have missed her,and, therefore, has understandable concern about thwarting the analyst's wish that he acknowledge feeling “left out” and “watching.”In terms of the logic of the interaction, the assertion that the patient misses the analyst and uses omnipotent defenses to ward off hisfeeling of dependency could be made also about the analyst: the analyst is engaging in omnipotent thinking because she “knows” whatis going on with her patient. Further, she wants the patient to relate to her in a very particular way that he is not doing, and in that senseshe feels “left out,” yet she projects this feeling into him. All the assertions the analyst makes about the patient could be made aboutthe analyst. The issue is not whether this reading is correct. The issue is that in a dual relation there is always an alternative,symmetrical reading and that it is arguably impossible to know which of the two readings is correct.
I would like to compare Joseph's approach to that reported by Gabbard (2000). Gabbard's contribution is an example of casesreported with increasing frequency in our literature (see below) that describe the analyst's contribution to a narcissistically basedresistance. He also offers a partial solution to this clinical problem. Gabbard, in the case of Mr. F, wants Mr. F's recognition for his(Gabbard's) “dutiful and steadfast service” to him (p. 698). Gabbard's desire, grasped by his perspicacious patient, contributes to aresistance. Gabbard writes about his desire in this way: “[T]he child's desire for a long-denied gratitude may in adulthood take theform of a yearning to be appreciated by one's patients, even to the point of encouraging expressions of gratitude that are at odds withthe patient's best interests. In such a situation, the analyst's need for gratitude may become apparent to the patient, who then feels thatthe analytic setting is being subverted to address the analyst's needs” (p. 700).—————————————
The difficulty in figuring out “what is causing what” in a dual relation is similar to the epidemiological axiom “correlation is not causation.”Cause and validity always require a third term to structure the correlation and make it meaningful. A similar question arises in Joseph's mostrecent paper. She presents clinical material that suggests a reading like the one I have offered above (Joseph 2000). Also, the question of theanalyst's authority enters into the clinical picture here. I do not have adequate space to elaborate on this aspect of things here. The reader is
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referred to the entire issue of the Psychoanal. Q., “Knowledge and Authority in the Psychoanalytic Relationship,” Vol 65: 1-265, forfurther consideration of the matter.
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Gabbard then reflects on how his patient reacts to his analyst's desire for recognition: “Repeating the scenario that occurred withhis parents, he sensed that I wanted him to fall in line with my expectations, and he derived great pleasure from digging in his heelsand defeating me. I had failed to appreciate that he was trying to communicate to me that he was doing the analysis in the way he hadto do it, and that my failure fed his own developmental difficulties in feeling appreciative” (p. 705). Gabbard attributes the turnaroundin the case of Mr. F to three factors: (1) his resilience in the face of his patient's attacks; (2) his recognition of what he calls “the two-person nature of the problem. My awareness that my countertransference resentment was contributing to the impasse….” (p. 710); and(3) successful interpretation of the patient's internal conflict. No doubt Gabbard is correct. However, I would argue that the secondfactor, Gabbard's acknowledgment of his countertransference resentment, is what allowed the stalemate to yield because the battle, atthat point, was no longer joined. And with the battle no longer joined, there was, as Gabbard describes, space for both him and Mr. F toconsider Mr. F's conflicts and “symbolize his experience.” An additional point worth reiterating, and one that Gabbard acknowledgesthough in my estimation underemphasizes, is the fact that his desire for gratitude—not simply his resentment of his patient'singratitude—contributed to, and in important ways engendered, Mr. F's resistance, the digging in of his heels.
In light of this comparison between the clinical offerings of Joseph and Gabbard, I ask the following question: At the level of theresistance as experienced by the patient in the clinical moment, is there a difference between an analyst whose desire is expressedthrough a model of the mind and a clinical technique that emerges from that model (Joseph), and an analyst whose desire is manifestedin the wish for a gratifying object relationship based on an unresolved conflict from the analyst's past (Gabbard)? It seems to me ourconventional answer to this question is that the latter is much more suspect, because it implies that the analyst has more self-analyticwork to do. Yet I suggest that both analysts are searching for lost objects, just different ones. One could argue that the formercircumstance is more difficult for the analyst to perceive and self-analyze because the desire is both expressed and hidden by a clinicaltechnique that, at that particular clinical moment, is contributing to the resistance. At the level at which the resistance is joined, thepatient may experience both desires similarly—
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as the analyst's demand for the patient to respond in a particular way, a demand that puts the patient in an alienated position. This is avery important issue, and one that requires further investigation.
“Solutions” to the Problem of Narcissistic ResistancesAs I asserted above, the transference/countertransference dynamics engendered by the analyst's imposition of his desire onto the
patient are common, not uncommon, in day-to-day psychoanalytic work. Different models of clinical process use different words andconcepts to grapple with what are, in my view, similar phenomena. For neo-Kleinians, the centrality of projective identificationdescribes and accounts for the intersubjective—or dual-relation—resistances I have described above. For the self psychologist, the“empathic failure” is the central feature of analyst-engendered narcissistic resistances. For those oriented inter-subjectively, theanalyst's irreducible subjectivity and countertransference enacting are constitutive of resistance and also the stuff of successful analytictreatment. While there are certainly important differences among these ways of conceptualizing clinical process, I am arguing here thatsuch seemingly different conceptualizations are all attempts to deal with the ubiquity of narcissistic resistances in our work andanalysts' struggles with successfully negotiating them. Analysts struggle with narcissistic resistances precisely because we areintimately involved with our patients in their creation.
While I believe it is true that the different clinical perspectives I mentioned above are trying to tackle the same basic clinical issue,I also believe that they have very different solutions to a common problem. To consider adequately these different solutions wouldrequire another essay. However, I do think it furthers my current discussion for me to summarize one of them briefly.
The solution that carries the most theoretical weight is the concept of the analytic third. By now it is fair to say that there is asignificant psychoanalytic intellectual history behind this idea. I want to emphasize that this is a theoretical solution to a theoreticalproblem. This solution has clinical implications. Essentially, the solution to the problem of dual relations in the analytic setting is theestablishment of a third term. Conceptually, the notion of the analytic third is isomorphic with oedipal relations (triadic structures asopposed to dyadic structures).
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This tradition of the analytic third started, after Freud, with Winnicott's transitional object. Lacan's concepts of the Symbolic registerand the “big” Other (1988, pp. 235-258) were extensions of Winnicott's seminal idea. Green (1975) and Ogden (1994) have writtenextensively on the topic as well, incorporating Kleinian theory. Greenberg (1995) has contributed similar ideas from a more explicitlyinterpersonal psychoanalytic point of view. All of these analytic thinkers strive to find away out of the problem of the analyst's desire.Their collective answer to this problem is that if analyst and patient can find a way to talk about the patient such that their discoursefeels to both participants like a shared object rather than a contested one, then the analytic third is present. Lacan's solution was toavoid logical and “sense-building” interventions with the analysand. He emphasized punctuating that which is “other” to the patient'sconscious discourse, such as slips, repetitions, puns, forgetting, contradictions, and the like. These formations of the unconscious are,quite precisely, the analytic third.
The concept of the analytic third and the clinical processes it informs can falsely suggest that analyst and patient easily cooperatein their pursuit of analytic goals. Often this is not the case. As I said above, analytic discourse can be contested rather than shared. Thismay mean, of course, that there are times when the analyst must confront the patient with what he or she thinks is going on and notback down. That is, there are times when the analyst must impose his or her thinking, his or her desire, on the patient and speakstraightforwardly about the clinical situation at hand. This is an important clinical issue, a thorough discussion of which would take usbeyond the scope of this paper. It is important to note that Joseph herself has made compelling arguments in this connection, especiallywith respect to the clinical issue of how the analyst might deal with omnipotent defenses of narcissistic patients (see Maldonado 1999;Joseph 2000; Purcell 2001).
In spite of the clinical truth that, at times, the analyst must not back down from a particular point of view, it is fair to say thatmuch of our clinical literature offers, or describes, the opposite solution to the problem of narcissistic resistances. Numerous analyticwriters over—————————————
Lacan's theory of the Symbolic has several other sources besides Winnicott— most notably Levi-Strauss (1963)—but it is fair to say thatWinnicott's seminal idea of the transitional object has great kinship with Lacan's Symbolic and his privileging of triadic structures.
See Wilson (1998), Laplanche (2000), and Poland (2000) for similar examples of “otherness.”
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the past ten years or so have reported cases where the analysis has turned from various degrees of stalemate to demonstrable progresswhen the analyst has managed to analyze or otherwise maneuver him- or herself out of a mutually created narcissistic resistance byunderstanding his role in the problem. Through this understanding, the analyst backs down, thereby removing himself from the field ofcontest. That removal allows the patient a sense control and autonomy and an ability to think more flexibly.
For example, Steiner (1993) grapples with the to and fro of the dynamics of projective identification in his paper on analyst-centered and patient-centered interpretations. Using a different theoretical language—yet clearly struggling with the same set ofclinical issues described by Lacan—Steiner tries to find his way out of his and his patient's mutually projecting onto each other.Steiner's admittedly partial solution to this dilemma is, not unlike Gabbard's, to take more of the interpretive burden onto himself andto put the stress on his own experience and the patient's experience of him. This is in contrast to interpreting in a more objectivist modeby commenting on the workings of the patient's mind and on what the patient “is doing to the analyst.” Others who have offeredsimilar solutions to the same clinical problem include: Schwaber (1983, 1992); Viederman (1991); Renik (1993b); Hoffman (1983,1994); Kantrowitz (1993); Almond (1995); H. F. Smith (1995); Chused (1996); Weiss (1995); Coen (1998); Grossman (1999).
The point of debate here is whether the analyst's backing down facilitates for the patient a necessary (and salutary) separationfrom the analyst's pressure and desire or reinforces the patient's use of omnipotent fantasy and other manic defenses. It may, of course,do both. One's answer to whether this is a salutary step in the analysis would depend on many factors; one's theory of mind and clinicalprocess and what counts as clinical evidence are but the most salient of those factors. This debate, in any case, points to the dialecticalnature of clinical psychoanalytic work. In the natural history of a psychoanalytic treatment the analyst's stance shifts and changes.Addressing the interaction, backing away from the patient, confronting the patient, insisting or not on one's point of view—manythings happen over the course of—————————————
Pizer (1992) describes an aspect of what I have in mind: “[T]hose moments when the analyst stepped outside his or her accustomed position… have a quality of the analyst's yielding to some subtlety of being in the patient …” (p. 218; emphasis added).
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a treatment. As I said at the beginning of this paper, I am describing but an aspect of clinical process that often goes unrecognized.
Case Illustration
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This brief case summary is intended to illustrate some of the main points presented here. I hope it demonstrates how my ownnarcissistic issues and unresolved conflicts—in short, my desire—clothed in a conventional theory of technique, contributed toresistant periods in the analysis. In some ways, what I relate below goes without saying because I describe in quite traditional wayshow my countertrans-ference contributed to an enactment. Of course, I am asserting a more universal clinical dynamic that is notlimited simply to the particulars of this case.
Mr. R, a divorced man in his early forties, had struggled through the first year of his analysis. He came for treatment because ofperiods of crushing despair and hopelessness about the future. Though talented in a number of areas, he was convinced there wassomething drastically wrong with him. He worried he would be alone the rest of his life. He was terrified of planning assertively forthe future. He had difficulty thinking about his career and the next direction in which he wanted it to go. He desperately wanted toremarry but worried endlessly about being rejected. Like Hamlet or Prufrock, he could not make a decision or let a woman know heliked her. The youngest of five children, he came from a middle class family where emotions were hard to read and conflicts rarelyaddressed. Though close to his mother when a young child, he had long since viewed his parents with embarrassment and some shame:they seemed unhappy, scared, and depressed. These feelings drove him, decades ago now, to move far away from the family; hestruggled to call them or visit them, fearing the feelings of shame, anger, and sadness he often felt when around them. Mr. R oftenlamented: “My parents don't seem interested in my life, what I'm doing, or what I'm feeling.”
My approach to his problems during this first year was to examine his conflicts with him, specifically the imagined negativeconsequences of various actions, should he take them. We discussed his passivity and the safety he felt in keeping his distance from hisfriends and me. We touched on the gratification he got by complaining. We discussed his views of his parents as weak and depressedand his
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worries about surpassing them or moving “beyond” them. He felt his suffering was “special” and that he deserved special treatmentand attention by his family and friends. He felt bitterly resentful when they didn't attend to him in this way. We discussed how heexpressed his anger through the distance he maintained from people. When possible, I directed his attention to how these issuesmanifested themselves in the transference.
Though he gained much “insight” into his masochistic stance toward his life and the world, none of this got us very far. Inaddition, my approach exacerbated his masochistic sense of analysis; much of the time he felt it an onerous burden. However tactfullyand “open-mindedly” I directed Mr. R's attention to our interaction—and especially to the atmosphere of struggle often between us—he took my observations to be criticisms that he was not letting me help him.
In the terms I have used in this paper, much of the first year or so of analysis felt “contested.” What was my contribution to thiscontest? My subject position with respect to this patient—a perspective gained only in retrospect—could be described as follows: Iwas a newly graduated analyst looking to build up my analytic caseload; I decided to work with Mr. R for a markedly reduced fee; Iwas without supervision. All of these factors contributed to an exaggerated therapeutic zeal on my part. Within this particularprofessional context in which I found myself, I identified with the patient's struggles in a number of important ways that onlyexacerbated my desire to somehow change and “cure” him. For example: Mr. R regularly told himself to “mellow out” about things,especially about a woman he was dating. He told himself that it's not a big deal whether things work out or not. As a younger man Imyself had struggled with a similar way of thinking regarding a deeply held ambition of mine, and had realized my self-deception onlywhen it was too late. With Mr. R, I wanted to redress a conflict within myself (more accurately, a loss unsuccessfully mourned), withwhich I had struggled very much alone, and I did so by trying to assure my patient I was “there” for him and would help him avoid theself-deception from which I had suffered.
The ways in which Mr. R and I discussed this mode of thinking and the anxiety that lay behind it are too complex to characterizeadequately. The end result, however, is easy to describe: Mr. R felt that I was telling him to stop thinking this way. Rothstein'sdescription (1999, p. 544) of a “sado-narcissistic” enactment captures accurately
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Mr. R's and my interaction around this issue. No doubt, given his masochistic character structure, he unconsciously involved me inways that made him feel victimized. Yet, none of this awareness was available to him at that point in the analysis. What was availableto me was a feeling, a strong sense of “here we are again”: once he started his complaints of despair, or his needing to “mellow out andtake it slow,” I could already feel the enactment occurring, and most any intervention I made that addressed his discourse as defensive,as related to anxiety and worry, led inexorably to his feeling that I was telling him what to do or how to think. And a vitally importantpart of this feeling was my sense of guilt: I was contributing to a dynamic between us that, at this relatively early point in the analysis,felt contested, stuck, and in some ways damaging to him. I should emphasize that what I have just described was my subjectivesense of a particular way in which Mr. R and I struggled during this part of his analysis. For Mr. R's part, though he complained some,
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he voiced no concerns that the analysis was in some ways stuck or that I was contributing to the trouble. His attitude wascharacteristically passive: “this must be how analysis is.”
After a while, for reasons I could not fully explain to myself at the time, I decided not to interpret the defensive aspects of hispseudo-nonchalance or his complaints of despair. I simply asked Mr. R to tell me more about these feelings. Over the next severalsessions he did. And his way of speaking gradually came to have a different quality. He talked about his despair without massaging it.He had moments of genuinely questioning himself without demanding immediate answers from me or condemning himself for notknowing them. He found himself describing ways in which he orchestrated interpersonal situations so he would feel left out or“dissed.” At times, he realized, he “made up” scenarios so, as he said, “I can feel angry and bitter and resentful.”
My understanding of our interaction was that as I stopped interpreting the defensive and gratifying aspects of his complaints (fromthe point of view of compromise formation) he felt I was not implicitly telling him to stop feeling what he was feeling; it was nowokay for him to feel as bad as he wanted to feel and to complain about feeling it as—————————————
That Mr. R, like many masochistic patients, wanted me to feel guilty for “doing my job” (as a defense against his sadism towards me) isanother, complementary reading of the material I have presented here. However, to point this out to him would have, in my view, furtherexacerbated the dual relation resistance I am describing. And the idea of my simply “doing my job,” or “functioning analytically,” obscures thedesire that underwrites my “doing my job.”
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much as he wanted to complain. My sense was that his primary wish was to tell me how bad he felt without being thrown off by me—without my desire (or his perception of my desire) getting in the way. In this case my conscious wish was to help him look at the usesto which he put his despair. He was unable, at this point in the analysis, to examine our interaction and his feelings about the analysiswithout severe superego intrusion. In my estimation, there was no other way out of this infinite regress than for me to stop contributingto it. In keeping with what Gabbard (2000) and Steiner (1993) describe, when I removed myself from the field of contest, Mr. R feltmuch freer to think about himself. This showed in his ability, perhaps for the first time in our working together, to analyze himself. Ashe talked about the details of how bad he felt at times, he began to notice he was feeling better. He became more curious about his ownthoughts and spoke more freely. He felt more “in control” and less overwhelmed.
Soon after, for the first time in the analysis, he reported a dream: “I'm on some kind of raft with a couple of other people, offshore, not totally at sea, but I'm afraid the waves might overtake us. The raft was, made out of concrete, of all things. You'd think itwouldn't float but it floated just fine. We were out there for a purpose; we had a task to do or something. That's all I remember.” Hereported this dream in his typically halting manner. We discussed his discomfort in telling me the dream. He had few ideas why he wasfeeling uncomfortable; he just was. “This is how I've felt a lot in here, though not recently.” Deaf for the moment to his having saidthat, I said, “I wonder whether you are worried that if you let your thoughts go about the dream you would be swept out to sea.” Hethought about that briefly and said he didn't think so. “Though there was the possibility we might get taken out to sea,” he said in amore comfortable tone, “I wasn't all that worried about that.” He fell silent and became more halting, and after a while he said he hadno more thoughts about the dream. I then asked him about the piece of floating concrete. “Yeah, strange huh?” He was silent again fora bit. “It was about the size of this couch.” I said: “Sounds like the dream has something to do with your thoughts about being here.” Inresponse he got “realistic”: “Well, since I am lying on this thing it seems like it was just an easy source of comparison…. But I havebeen feeling stronger recently, more hopeful. Somehow the concrete is related to that feeling, which, I have to say, I'm suspicious of,because it's so foreign to me. Like the sea is my despair, and somehow
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I feel more confident that I can swim in my depression and handle it without getting swallowed up.” I then asked about the otherpeople who are also holding onto the concrete raft. “Well, I think it was only one other person, not two. It was a man. We were doingsomething out there. We were supposed to be there, on a task of some kind…. I guess,” he said with surprise, “the other guy soundslike you. It's hard for me to acknowledge that this might be helping me and it's feeling more like we're in this together.”
Friedman ReduxMr. R, obviously halting and tentative in this series of interactions with me, peers from behind his (sado) masochistic way of
being and begins to see and experience something else, some other, less masochistic way of being. His subject position—as thedefeated, helpless masochist—is beginning to change. Mr. R talks to me differently, in a way that is both more his own and more ourown. There is a sense of the third now, the dream and our talking, however tenuous and evanescent. When I set aside my consciousagenda, my technique, he begins to find his own faltering voice. I had wanted a certain experience with Mr. R that was underwritten bya theory of technique (defense analysis) and my own narcissistic concerns. I first caught onto my use of technique as an expression ofmy own defensiveness because I saw my approach was not working. Upon further reflection, I realized it was being driven
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predominantly by an old struggle of mine. Then I saw through my own defensiveness, a defensiveness that amounted to myunwillingness to listen to parts of his mind as reflected in his speech. Who was being defensive? Who was being resistant? We bothwere, though I was in a position to do something about it. What emerged was a clinical process less contested than shared: we weremore “in this together.” My desire shifted to a different one, more aligned to the patient's interests at the moment. And I would againwonder whether it made any difference to Mr. R, at the level at which he experienced the resistance, what factors drove mycontribution to it. If my unresolved conflict were not part of this particular clinical interaction, I still may have contributed just asmightily to the resistant atmosphere by my overall approach of interpreting anxiety and defense.
The gratification I felt from this series of interactions with Mr. R was substantial. As Friedman says, I had reached a “verdict ofsatisfactoriness.” Yet my feeling of satisfaction was not based on any conscious
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agreement or assent on the part of Mr. R. Nor did I ask him to reflect on why he was feeling more hopeful. It seemed to me that thatwould be another attempt on my part to claim some therapeutic territory for myself precisely when he was just starting to feel he had aright to some of his own. I felt good simply because I was able to get out of his way enough so he could begin to see himself.
There is no easy resting place in clinical psychoanalysis. With Mr. R, in subsequent months, my more open and inquiring stance—to which I had become quite attached—itself became a source of resistance. Mr. R had retreated again, though perhaps not as far as Ifeared. The hours had become labored and tiresome. I felt the need to address his retreating more directly, which I did. This time, asthough I had enough credit in the psychoanalytic bank, he was better able to talk about his fears of me and others to whom he is closewithout the degree of suffering that had accompanied such interactions previously. Although Mr. R was now less brittle, my focusingtoo frequently, no matter how tactfully, on his anxiety often led to a more contested atmosphere. In the end, my maintaining arelatively flexible stance and not being committed to any one way of being with Mr. R seemed to be the most important aspect of myworking successfully with him. As Kennedy (2000) writes in his illuminating essay on the emergence of subjectivity inpsychoanalysis: “I suggest that things take place in various shifting positions between analyst and patient, where the subject opens upor closes down. This shifting becomes the basis for human subjectivity. Becoming a subject involves some sort of opening up; but onecannot ignore the closing down” (p. 884). Clearly in the case of Mr. R, he and I both were emerging subjects. Any particular positionof mine, while possibly salutary at one point in time in contributing to an opening up of the process, could at another contribute to aclosing down, to stasis.
While Friedman (1993) is right to emphasize that in psychoanalysis there is a “demand for work … a bending of purpose, [and] aconflict of wills” (p. 13), we can also say that the analyst's recognition of his demands on the patient, his recognition of the desire andwill inherent in the endeavor of analyzing, is the first step towards moving beyond the dual relation. Such recognition is often crucialin creating a space for “something other” to emerge, a “third thing,” born of the analytic interaction but slightly separate from theindividual participants, a discourse less contested than shared.
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ReferencesALMOND, R. (1995). The analytic role. J. Amer. Psychoanal. Assn. 43: 469-494. ARON, L. (1996). A Meeting of Minds. Hillsdale: Analytic Press. BADER, M.J. (1993). The analyst's use of humor. Psychoanal. Q. 62: 23-51. BADER, M.J. (1995). Authenticity and the psychology of choice in the analyst. Psychoanal. Q. 64: 282-305. BOESKY, D. (1990). The psychoanalytic process and its components. Psychoanal. Q. 59: 550-584. CAPER, R. (1997). A mind of one's own. Int. J. Psycho-Anal. 78: 265-278. CAPER, R. (2001). The goals of clinical psychoanalysis: Notes on interpretation and psychological development. Psychoanal. Q. 70:
99-116. CHUSED, J. (1996). The therapeutic action of psychoanalysis: Abstinence and informative experience. J. Amer. Psychoanal. Assn. 44:
1047-1071. COEN, S. (1998). Perverse defenses in neurotic patients. J. Amer. Psychoanal. Assn. 46: 1169-1194. COOPER, S.H. (1996). Facts all come with a point of view. Int. J. Psycho-Anal. 77: 255-273. FRIEDMAN, L. (1993). Discussion, panel on resistance in clinical practice. American Psychoanalytic Association Annual Meeting,
San Francisco, May. FUKUYAMA, F. (1992). In the beginning, a battle to the death for pure prestige. In The End of History and the Last Man. New York:
Free Press, pp. 143-152.GABBARD, G.O. (2000). On gratitude and gratification. J. Amer. Psychoanal. Assn. 48: 697-716. GOLDBERG, A. (1987). Psychoanalysis and negotiation. Psychoanal. Q. 56: 109-129.
[→][→]
[→][→]
[→][→]
[→]
[→][→]
[→]
[→]
[→][→]
GREEN, A. (1975). The analyst, symbolization and absence in the analytic setting (On changes in analytic practice and analyticexperience)—In memory of D.W. Winnicott. Int. J. Psycho-Anal. 56: 1-22.
GREENBERG, J. (1995). Psychoanalytic technique and the interactive matrix. Psychoanal. Q. 64: 1-22. GROSSMAN, L. (1996). The analyst's influence. Psychoanal. Q. 65: 681-692. GROSSMAN, L. (1999). What the analyst does not hear. Psychoanal. Q. 68: 84-98. GRUSKY, Z. (1999). Conviction and conversion: The role of shared fantasies about analysis. Psychoanal. Q. 68: 401-430.
WARNING! This text is printed for the personal use of the PEPWeb subscriber and is copyright to the Journal in which it originally appeared. It isillegal to copy, distribute or circulate it in any form.
- 96 -
HARTMANN, H. (1950). Comments on the psychoanalytic theory of the ego. Psychoanal. St. Child 5: 74-96. HOFFMAN, I.Z. (1983). The patient as interpreter of the analyst's experience. Contemp. Psychoanal. 19: 389-422. HOFFMAN, I.Z. (1994). Dialectical thinking and therapeutic action in the psychoanalytic process. Psychoanal. Q. 63: 187-218. JACOBS, T.J. (1991). The Use of the Self: Countertransference and Communication in the Analytic Setting. New York: International
Universities Press.JONES, E.E. (2000). Therapeutic Action: A Guide to Psychoanalytic Therapy. Northvale, NJ: Aronson.JOSEPH, B. (1971). A clinical contribution to the analysis of perversion. Int. J. Psycho-Anal. 52: 441-449. JOSEPH, B. (1989). Psychic Equilibrium and Psychic Change: Selected Papers of Betty Joseph, ed. M. Feldman & E.B. Spillius.
London: Routledge. JOSEPH, B. (2000). Agreeableness as obstacle. Int. J. Psycho-Anal. 81: 641-649. KANTROWITZ, J.L. (1993). Impasses in psychoanalysis: Overcoming resistances in situations of stalemate. J. Amer. Psychoanal.
Assn. 41: 1021-1050. KENNEDY, R. (2000). Becoming a subject: Some theoretical and clinical issues. Int. J. Psycho-Anal. 81: 875-892. KIRSHNER, L.A. (1999). A postmodern realism for analysts. J. Amer. Psychoanal. Assn. 47: 445-463. KOJEVE, A. (1947). Introduction to the Reading of Hegel, transl. J.H. Nichols, Jr. New York: Basic Books, 1969.LACAN, J. (1977a). The function and field of speech and language in psychoanalysis. In Ecrits: A Selection, transl. A. Sheridan.
London: Tavistock, pp. 30-113.LACAN, J. (1977b). The mirror stage as the formative function of the I as it is revealed in psychoanalytic experience. In Ecrits: A
Selection, transl. A. Sheridan. New York: Norton, pp. 1-7.LACAN, J. (1981). The Four Fundamental Concepts of Psychoanalysis, ed. J-A Miller, transl. A. Sheridan. New York: Norton.LACAN, J. (1988). The Seminar of Jacques Lacan. Book II: The Ego in Freud's Theory and in the Technique of Psychoanalysis, ed. J-
A Miller, transl. S. Tomaselli. New York: Norton.LACAN, J. (1992). The Seminar of Jacques Lacan. Book VII: The Ethics of Psychoanalysis, 1959-1960, ed. J-A Miller, transl. D.
Porter. New York: Norton.LACAN, J. (1993). The Seminar of Jacques Lacan. Book III: The Psychoses, 1955-1956, ed. J-A Miller, transl. R. Grigg. New York:
Norton.LAPLANCHE, J. (2000). Essays on Otherness. London: Routledge.LAPLANCHE, J. & PONTALIS, J-B. (1973). The Language of Psychoanalysis, transl. D. Nicholson-Smith. New York: Norton.
WARNING! This text is printed for the personal use of the PEPWeb subscriber and is copyright to the Journal in which it originally appeared. It isillegal to copy, distribute or circulate it in any form.
- 97 -
LéVI-STRAUSS, C. (1958). Structural Anthropology, transl. C. Jacobson & B.G. Schoepf. New York: Basic Books, 1963.LEVINE, H.B., & REED, G.S., eds. (1999). Clinical Aspects of Compliance. Psychoanal. Inq. 19(1). MALDONADO, J.L. (1999). Narcissistic resistances in the analytic experience. Int. J. Psycho-Anal. 80: 1131-1146. MARCUS, G. (1998). Invisible Republic: Bob Dylan's Basement Tapes. New York: Henry Holt.MCLAUGHLIN, J.T. (1991). Clinical and theoretical aspects of enactment. J. Amer. Psychoanal. Assn. 39: 595-614. MULLER, J.P. (1995). The ego and mirroring in the dyad. In Beyond the Psychoanalytic Dyad: Developmental Semiotics in Freud,
Peirce, and Lacan. New York: Routledge, pp. 120-133.OGDEN, T.H. (1988). Misrecognitions and the fear of not knowing. Psychoanal. Q. 57: 643-666. OGDEN, T.H. (1994). The analytic third: Working intersubjectively with clinical facts. Int. J. Psycho-Anal. 75: 3-19. OPATOW, B. (1989). Drive theory and the metapsychology of experience. Int. J. Psycho-Anal. 70: 645-660. OPATOW, B. (1997). The real unconscious: Psychoanalysis as a theory of consciousness. J. Amer. Psychoanal. Assn. 45: 865-890. PIZER, S. (1992). The negotiation of paradox in the analytic process. Psychoanal. Dial. 2: 215-240. POLAND, W.S. (2000). The analyst's witnessing and otherness. J. Amer. Psychoanal. Assn. 48: 18-34. PONTALIS, J-B. (1977). The birth and recognition of the “self.” In Frontiers in Psychoanalysis: Between the Dream and Psychic Pain,
[→][→]
[→][→]
[→]
[→][→]
[→]
[→]
[→][→]
[→][→]
[→]
[→]
[→][→]
[→]
[→][→]
[→][→]
[→][→]
transl. C.P. Cullen. New York: International Universities Press, 1981, pp. 133-138.PURCELL, S. (2001). Counter transference and the analysis of narcissistic resistances: Effects of the analyst's theory. Unpublished
manuscript.RABIN, M. (1998). Psychology and economics. Journal of Economic Literature 36: 11-46.RABIN, M. (1999). First impressions matter: A model of confirmatory bias. Quarterly Journal of Economics 114: 37-82.RENIK, O. (1993a). Analytic interaction: Conceptualizing technique in light of the analyst's irreducible subjectivity. Psychoanal. Q.
62: 553-571. RENIK, O. (1993b). Countertransference enactment and the psychoanalytic process. In Psychic Structure and Psychic Change: Essays
in Honor of Robert Wallerstein, M.D., ed. M.J. Horowitz, O.F. Kernberg, & E.M. Weinshel. Madison, CT: InternationalUniversities Press, pp. 135-158.
WARNING! This text is printed for the personal use of the PEPWeb subscriber and is copyright to the Journal in which it originally appeared. It isillegal to copy, distribute or circulate it in any form.
- 98 -
RENIK, O. ED. (1996). Knowledge and Authority in the Psychoanalytic Relationship. Psychoanal. Q. 65(1). ROTHSTEIN, A. (1999). Some implications of the analyst feeling disturbed when working with disturbed patients. Psychoanal. Q. 68:
541-558. SANDLER, J. (1976). Countertransference and role-responsiveness. Int. Rev. Psycho-Anal. 3: 43-47. SCHAFER, R., ed. (1997). The Contemporary Kleinians of London. Madison, CT: International Universities Press. SCHWABER, E.A. (1983). Psychoanalytic listening and psychic reality. Int. Rev. Psycho-Anal. 10: 379-392. SCHWABER, E.A. (1992). Countertransference: The analyst's retreat from the patient's vantage point. Int. J. Psycho-Anal. 73: 349-
362. SHARPE, E.F. (1950). Collected Papers on Psychoanalysis. London: Hogarth Press.SMITH, H.F. (1995). Analytic listening and the experience of surprise. Int. J. Psycho-Anal. 76: 67-78. SMITH, H.F. (1999). Subjectivity and objectivity in analytic listening. J. Amer. Psychoanal. Assn. 47: 465-484. SMITH, J.H. (1991). Arguing with Lacan: Ego Psychology and Language. New Haven: Yale University Press. STEINER, J. (1993). Problems of psychoanalytic technique: Patient-centered and analyst-centered interpretations. In Psychic Retreats:
Pathological Organization in Psychotic, Neurotic and Borderline Patients. London: Routledge.VIEDERMAN, M. (1991). The real person of the analyst and his role in the process of psychoanalytic cure. J. Amer. Psychoanal.
Assn. 39: 451-489. WEISS, J. (1993). How Psychotherapy Works: Process and Technique. New York: Guilford Press.WEISS, J. (1995). Bernfeld's “The facts of observation in psychoanalysis”: A response from psychoanalytic research. Psychoanal. Q.
64: 699-716. WEISS, J., SAMPSON, H., & The Mount Zion Psychotherapy Research Group. (1986) The Psychoanalytic Process: Theory, Clinical
Observations and Empirical Research. New York: Guilford Press.WILSON, M. (1998). Otherness within: Aspects of insight in psychoanalysis. Psychoanal. Q. 67: 54-78.
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Article Citation [Who Cited This?]Wilson, M. (2003). The Analyst's Desire and the Problem of Narcissistic Resistances. J. Amer. Psychoanal. Assn., 51:71-99
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