ABSTRACT
Common wisdom has it that psychoanalysis is composed of a number of discrete bodies of theoretical and technical thought, or "schools." I argue that psychoanalytic schools are not as different from one another as they are commonly supposed to be, particularly in matters of technique. In their daily practice, most analysts do not adhere strictly to the precepts of a specific school, even though they profess to be adherents of that school. Instead, they read widely and adopt those technical procedures and principles that fit their own personality and prove most efficacious with their patients, regardless of the school from which those ideas come. In short, they are eclectic. I present a case to illustrate this eclecticism in my own practice, discuss the widespread nature of such eclecticism among the professions in general, and briefly discuss the significance of eclecticism for psychoanalysis itself.
Subject(s)
Psychoanalytic Therapy , Therapeutics , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Depressive Disorder/psychology , Depressive Disorder/therapy , Drive , Ego , Humans , Male , Middle Aged , Object Attachment , Psychoanalytic Interpretation , Psychoanalytic TheoryABSTRACT
The phenomenon of psychic change has been a subject of interest since the beginning of psychoanalysis. The author presents clinical material from a four-year analysis of a 50-year-old man, including a verbatim session, which illuminates two questions raised about psychic change. (1) What criteria may be used to evaluate psychic change and how do those criteria relate to the concept of 'structural change'? (2) Is it insight or the effects of a new object relationship that is most responsible for the changes that a patient is able to achieve? The search for a single mechanism of psychic change is doomed to frustration. But the author argues that insight is crucial to psychoanalytic change, both for its own sake and for its role in maintaining an understanding relationship.
Subject(s)
Psychoanalytic Therapy , Transference, Psychology , Anxiety Disorders/psychology , Anxiety Disorders/therapy , Awareness , Depressive Disorder/psychology , Depressive Disorder/therapy , Dreams/psychology , Female , Humans , Interpersonal Relations , Male , Middle Aged , Object Attachment , Psychoanalytic InterpretationABSTRACT
Controversies about the value of the manifest dream in psychoanalysis are usually a matter of semantics. The author concludes that two clinically meaningful questions about the manifest dream can be asked: Is the patient's report of a dream useful in formulating an interpretation if no formal associations to the dream elements are given? Inasmuch as such reports always include some kind of associations, and the analyst always possesses considerable knowledge about the patient, the answer to this question would seem to be "Yes, at least at times." In what ways can the manifest dream contribute to our understanding of the dream and the dreamer? Both the literature and clinical experience indicate that there are many ways; these are summarized in an appendix. One approach, the direct decoding of manifest dream elements, is discussed in some detail. Several examples of the undisguised appearance of memories of childhood traumatic experiences in the manifest dream are presented.