Taking Risks From the Unconscious: A Psychoanalysis as Experienced From Both Sides of the Couch

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Marcus, Donald M. and “Hope” (2007) Lanham, MD: Jason Aronson Division of Rowman and Littlefield. ISBN 07657 0483 8. xi + 129 pp. Paperback. $24.95.This is a remarkable account of an analysis that in its frankness probably violates orthodoxy and ethical rules. The authors are to be commended for their openness in describing how they worked. Such truthful reports of what actually takes place in an analysis will allow us to make comparisons of a variety of techniques.The patient, herself an analyst, had previous psychotherapy in addition to a previous 10 year analysis. This joint report results from her commentary on Marcus's notes from the reanalysis 3 and a half years post termination. The reason for writing is to report the “unorthodox interventions” with a good result. As the title indicates there is an assumption of communication with each other's unconscious. “Most important, both authors believe that the unconscious has access to the truth about our experience and the experience of the world in which we live” (p. 8). This access occurs via projective identification, best understood as an interpersonal event in which one's unconscious processes coerce the other person into experiencing content resonating from the unconscious of the first person. There is thus an “emotional contact at an unconscious level.” What is unique here is the extent of disclosure by the analyst to get at previously warded off (defended against) aspects of the patient's unconscious. The analyst states, “By getting into a state of reverie, I find that I am open to receiving information that I call intuition” (p. 16).The initial encounter with his coauthor occurred when Marcus was presenting a clinical case conference. Shortly afterward she sought him out for individual supervision and a few weeks later she began her analysis with him. She felt that her previous training analysis failed because her “analyst seemed to be hiding his true self.” Her coauthor agrees with her “that an analysis could only be successful if both parties’ true selves made intimate emotional contact.” She explains further, “pretty much nothing was against the rules with Dr. Marcus so long as the relationship was focused on our finding the truth of our experience together” and “he often said that his emotional experiences with me usually began as physical sensation in his body. So the physical was admissible, as long as we did not act on our impulses” (p. 21).His first risk was to sing a song that had been going through his thoughts during a session. His unconscious knew what her unconscious was communicating. Additional risks included declarations of mutual love for each other, all emerging in the context of positive (idealizing?) transference and counter transference.It is important to emphasize that they did not act out physically. He describes 2 phases of this analysis. The first lasting 4 years and 2 months in getting to know each other and working out the stalemate of the previous analysis. Then came the termination phase of 3 months with dramatic new work. In the early phase she was “attacking” the analyst for not making interpretations. Later on she viewed her wish for interpretations as a defense against getting to deeper feelings. Meanwhile the analyst, who did not become bitter or unforgiving, and the patient were developing a strong bond.Cognizant of possible ethical and boundary violation issues, Marcus includes an initial chapter on “Ethical Considerations” citing Judy Kantrowitz's book Writing about Patients (2006), which was reviewed in this Journal (Schulz, 2007).

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