Working Through as Metaphor and as a Modality of Treatment

Abstract

Although Freud encoded the idea of "working through" as a mere metaphor, it served the essential role of designating the necessary activities of analyst and analysand that go beyond the elucidation of mental contents through interpretation. From a neurobiological viewpoint, these processes involve the establishment of new neural networks through gradual habituation. From the vantage point of cognition, this necessarily slow process amounts to learning new skills in communication, the mastery of mounting unpleasure, and the expansion of "referential activity." These considerations imply that the crux of analytic work is changing those biological functions we call thought processes, thereby improving the person's ability to regulate behavior adaptively. Thus, the interpretation of mental content is a byproduct of the analytic work--a result of clearer thinking, facilitated by identifying areas of primitive mentation and assisting analysands to expand their repertory of psychological skills. Only these intrapsychic changes in functional capacity will enable patients to reach the insight necessary for continuous adaptation through self-inquiry.

From Termination to the Evolution of a Relationship: A New Understanding

“…Thus, he stresses that repeated experiences of verbal and nonverbal interaction with the therapist over time produce lasting changes in brain structure that underlie enhanced affect regulatory capacities. Gedo (1995) says this about working through: "From a neurological viewpoint, these processes involved he establishment of new neutral networks through habituation. From the vantage point of cognition, this necessarily slow process amounts to learning new skills in communication, the mastery of mounting unpleasure, and the expansion of 'referential activity'" (p. 339).…”

Psychoanalysis as a traditional form of knowledge: an inquiry into the methods of psychoanalysis

“…Gedo (Gedo et al, 1964;Gedo, 1997), while criticizing psychoanalysis for accepting Freud's use of neurosciences to ground his theories (and ignoring contemporary advances in biology), argues for restructuring psychoanalysis so that our theories are aligned with contemporary neurosciences. He presents examples of his ideas taking the concept of working through (Gedo, 1995). It would certainly provide a stamp of credibility if psychoanalysis was able to make predictions which were borne out in neurosciences, or if there could be an active collaboration with neurosciences that proved fruitful to both fields.…”

Gedo on Smith's `Creative Misreading`

“…Nothing could be farther from the truth. But it is easier if it is there (see Gedo 1984). It is precisely to transcend simplistic notions of treatment that we need a hierarchical model of the mind congruent with the hierarchical organization of the brain: the one I have developed (see Gedo 1996, Epilogue) requires that in adult patients we take into account the capacity for instantaneous shifts among all developmental levels previously traversed, and even the concurrent use of several levels.…”