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Excerpt
For those who have not been following the evolution of psychoanalytic theory of technique over the past 25 years, this book provides an excellent exposition of current thinking and practice. The 10-page introduction outlines an overview of the development of changes in psychoanalysis.
Since this book is the third in a series, the reader may feel he or she has come into the middle of a movie and cannot immediately grasp the plot. This is especially true if the reader has not previously encountered Dr. Joseph Lichtenberg’s elaboration of his proposed 5 motivational systems. “Each motivational system develops in response to an innate need and each involves caregiver’s responses. The 5 motivational systems self-organize and self-stabilize in response to the need for (1) regulation of physiological requirements; (2) attachment to individuals and affiliation to groups; (3) exploration and the assertion of preferences; (4) aversive reactions of antagonism and withdrawal; (5) sensual enjoyment and sexual excitement.” (pp. 11–12). If all of this is too unfamiliar, the reader is advised to consult previous publications by Lichtenberg listed in the bibliography.
The “spirit of inquiry” (“ a search for expansion of personal meaning”; p. 2) is a frame of reference that opens up the exploration of communication between analyst and patient and the ways they influence each other. By contrast, the authors state, “In retrospect, during a period when analyst-patient communication was based on relatively fixed formulations of intrapsychic structural conflict, the analyst ‘knew’ the unconscious determinants and a spirit of inquiry was often lacking” (p. 2). “Now we wish to emphasize that exploration as a search for novelty and efficacy is present in all motivational systems” (p. 7). In keeping with modern increasingly detailed infant observational research, the authors make explicit correlations of communication processes between infant and caregiver with analogous processes between patient and analyst. Communication includes verbal and nonverbal aspects with “exchanges of explicit and implicit information interpersonally and to one’s self” (p. 11).
The neonate brain is viewed as being highly plastic and “mostly the brain creates itself through a dynamic interaction with the environment” (p. 14). Videotape observations of two contrasting mother-infant pairs are described that illustrate the effects of interactional patterns producing, in the one, insecure attachment and, in the other, secure attachment.
Chapter 3 describes several sessions from an analysis that includes some of the analyst’s private thoughts and how these are interwoven in the verbal and nonverbal interactions and enactments. While this complicates the more traditional dialogue, it is persuasive in the way it captures an ongoing mutually influencing and evolving process that emphasizes the relational aspects as well as the insight dimension. Although this is the modern focus, the authors point out that Freud said it in 1916: “what turns the scale is not intellectual insight, but the relationship to the doctor” (p. 75).
This book contains several valuable summaries of changes in psychoanalytic technique including reference to the work of Ferenczi as well as more recent author’s contributions to the shift from a previously assumed position of objectivity to the recognition of the analyst as full participant in a mutuality involving analyst and patient in the psychoanalytic situation. These changes are best conveyed in the author’s own words: “At a period in analysis when insight and reconstructions were considered central, the release of memory from behind its transference shield was the benefit assumed to be obtained from conflict interpretation.
