Dialectical Thinking and Therapeutic Action in the Psychoanalytic Process

Abstract

The therapeutic action of the psychoanalytic process depends upon a special kind of power with which the analyst is invested by the patient and by society, a power that is enhanced by adherence to psychoanalytic rituals, including the asymmetrical aspects of the arrangement. It is important, however, that the analyst also engage with the patient in a way that is sufficiently self-expressive and spontaneous so that a bond of mutual identification can develop between the participants. At the core of the generic "good object" is an element of uncertainty as the analyst struggles to find an optimal position relative to this dialetic between formal psychoanalytic authority and personal responsivity and self-expression. At the core of the generic "bad object" is an uncritical commitment to one side of the dialetic at the expense of the other. An extended clinical vignette illustrates how the analyst's struggle with this dialetic has great therapeutic potential.

The Search for Identity When Clinicians Become Clients

“…Thus, rather than threatening the potency of the therapeutic dyad, exposure of the therapist's humanness enriches the connection. At the same time, the therapist's subjectivity can be problematic if it takes over the relationship; the client can experience this self-disclosure and ''use of self'' as narcissistic, exhibitionistic, and self-indulgent (Hoffman 1994).The therapist's subjectivity is thus a complex, double-edged force.…”

“…Although Ferenczi did not consider the experiment a success, he was impressed with how well the patient could identify his blind spots. Similarly, Hoffman (1994) speaks about highly perceptive patients who ''do not let me get away with the party line or tone. Instead, they challenge me to think things through in a fresh way' ' (p. 191).…”

“…This rests on a delicate interplay between the ''principle of asymmetry,'' where the therapist is perceived as a person with superior wisdom or power, and the ''principle of mutuality,'' where the therapist is perceived as a person like me (Hoffman 1994).The dialectic tension between role-determined behavior (''analytic discipline'') and authority, on the one hand, and natural responsiveness (''personal emotional presence'') or authenticity, on the other hand, is a pull that both client and clinician can feel (Hoffman 1994, p. 196). This tension is not necessarily a problem to be solved, however, but a source of creativity and growth, supported by the structure of the therapeutic relationship.…”

Repensando a ação terapêutica

“…Num veio similar, Hoffman 27 enfatizou que a ação terapêutica é inerente à tensão dialética entre jogar fora o livro ou reavê-lo.…”

Presentness

“…There is no knowledge that is transparent to itself, and there is no one correct framework of reference or therapeutic stance. Hoffman (24) refers to the dialectic between spontaneous personal responsiveness and the maintenance of a formal therapeutic setting. The very attempt to adhere to any schema seems to him as the functioning of a bad object, owing to the fact that it conforms to a technical position with no deviation or deflection (24, pp.191-92).…”