Listening, understanding and interpreting: reflections on complexity.

Beginning with the premise that a contemporary approach to analytic exchanges has become far more complex and multi-faceted than in earlier times, the author addresses listening, understanding and interpreting. The opening section presents the basis and utility of a proposed theory of five motivational systems and identifies the need for a shift from conceptualising 'structures' to systems. The nature of communication during analysis is considered from several standpoints including listening for needs and intentions, the place of theory as a background to listening, an optimal state for analysand and analyst, and the significance of the distinction between inner monologue and spoken discourse. Differing views of free association and narrative, especially questions arising from findings of the 'adult attachment interview', are discussed. The patient's sensitivity to the presence and influence of the analyst and the analyst's recognition of non-verbal as well as verbal communications completes this section. In the final section a brief clinical example is presented to introduce a differentiated depiction of the variety of interventions that analysts employ. Throughout the paper, the author presents his view of listening, understanding and interpreting in dialectic contrast with the many other perspectives held by analysts in this period of theoretical pluralism.

General principles of self psychology: a position statement.

In the more than twenty-five years since Kohut formulated a psychology of the self, the basic theory has undergone many revisions and additions. In the course of broadening from a focus on narcissism and empathy into a general theory of normal and pathological development, self psychology has taken so many different directions that the question can be asked, Does self psychology remain essentially a single theory with different descriptors--a theory of a self-selfobject matrix, a theory of intersubjectivity, a theory of motivational systems, and so on? A concise statement of general principles is intended to contribute to a dialogue between advocates of the views presented here and those who hold different views of theory and practice, within and withoutself psychology.

A motivational systems approach to the clinical experience.

A conception of the self and five motivational systems is applied to clinical psychoanalysis. Each motivational system develops in infancy from innate and learned patterns in response to a basic need, and each involves particular affects. Each motivational system contributes patterns from which important transferences evolve. At any given moment, motives derived from one or another system dominate a person's experience, motives from the other system being subsidiary or dormant. We describe the manner in which these concepts contribute to an explanation of foreground-background relations during analysis, and how analysts and analysands construct model scenes to give meaning to information acquired by empathic listening. We conclude with a clinical vignette illustrating the application of these concepts to the patient's transference and the analyst's response in the intersubjective realm of an analytic enactment and verbal exchange.

How libido theory shaped technique (1911-1915).

Freud's papers on technique were written at a time when he could express supreme confidence in the psychoanalytic process, based on his theory of libido. Freud was far less sanguine about the practices of many contemporary analysts; consequently the papers contain far more don't's than do's. From the vantage point of today, these papers portray a transitional stage in psychoanalysis, an age of innocence, in comparison to the complexities of our current view of the interaction between analyst and analysand.

The fundamental rule: a study of current usage.

Members of the editorial boards of the Journal of the American Psychoanalytic Association, Psychoanalytic Quarterly, and Psychoanalytic Inquiry, plus selected analysts from Canada, France, and England, were asked how they presented the fundamental rule to their analysands and what considerations led to their choice of initial guidelines. Forty-nine of eight-three analysts responded to the survey. The respondents described diversity in phrasing of the fundamental rule, the time in analysis when the guidelines are given, and the reasons for the practice they follow. The method each chose appears to reflect the differing conceptions analysts have of the analytic process. Two major trends emerged: either our respondents emphasized delineating a work or functional framework or contract, or they emphasized establishing an attitude or spirit of cooperation, mutuality and work sharing. In each group respondents differed as to whether they favored minimal or more lengthy instructions. They also differed as to whether they followed a consistent approach or one tailored to the needs of the individual analysand. A source of tension lay in an inclination either to remain in the tradition set by Freud or to experiment with different phrasings and timings. The authors give their reasons for choosing to give explicit instructions, requesting associational material beyond thoughts and feelings, and describing resistance as inevitable and a potential source of insight.

Clinical application of the concept of a cohesive sense of self.

Recent psychoanalytic studies have contributed significantly to our understanding of how the formation of self-image groupings (the body self, the self experienced as individuated, and the grandiose self) integrate to form a cohesive sense of self. In addition to our increased knowledge of the normal development, we have a richer understanding of vulnerability to fragmentation of the sense of self. Knowledge of the development of the sense of a cohesive self and its vulnerability to fragmentation are applied to illnesses familiar to psychoanalysts. During normal adjustment reactions different aspects of the self predominate. In most such instances, images of the self can be balanced so that self-cohesion is retained. In the conflicts of the psychoneurotic, aspects of the self may be defensively segregated. Psychoanalysis must enable these aspects of the self to come into awareness and be blended into the general experiencing of the self; rarely does the threat of loss of self-cohesion present a special problem in working on this with a psychoneurotic patient. In contrast, the narcissistic personality and borderline personality disorders present specific problems centering on the potential of the patients to experience fragmentation of their sense of self. Clinical vignettes and theoretical formulations contrast these with the familiar problems that arise in the treatment of the psychoneuroses. The therapist's full empathic contact and a correct strategy of interventions arise from the appreciation of the presence or absence in the patient of threatened fragmentation of the cohesive sense of self.

Freud's Leonardo: psychobiography and autobiography of genius.

In his creation of a psychobiography of one genius and the hidden autobiographic analysis of another, Freud exemplifies what he described in the study: "Kindly nature has given the artist the ability to express his most secret mental impulses, which are hidden even from himself, by means of the works that he creates" (p. 107).