Diversity and Direction in Psychoanalytic Technique

Diversity and Direction in Psychoanalytic Technique

Fred Pine
Copyright Date: 1998
Published by: Yale University Press
Pages: 242
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  • Book Info
    Diversity and Direction in Psychoanalytic Technique
    Book Description:

    New diversity in psychoanalytic technique offers analysts and therapists a wide array of treatment options. But many of these techniques, says Dr. Fred Pine, can be viewed as additions to a clinician's approach rather than substitutes. Access to more treatment choices enables the clinician to better meet the multiple challenges encountered daily in a psychoanalytic practice. Dr. Pine urges clinicians to be flexible and integrative as they select, test, and then use or reject diverse treatment techniques, and he shows how this may be done. He warns that adhering too closely to a powerful theory of technique can prevent the therapist from doing the best for the patient.This book is both a highly personal statement by an experienced clinician and teacher and a concise discussion of selected issues that confront the practicing psychoanalyst today. Focusing specifically on technique, the volume is rich in clinical reasoning, clinical concepts, and clinical examples. The author establishes some of the sources of the current diversity in technique, then illustrates and evaluates some of the many pathways the clinician may choose. Practicing psychoanalysts and therapists will find enrichment in the intellectual searchings and open-minded approach of this valuable book.

    eISBN: 978-0-300-14706-3
    Subjects: Psychology

Table of Contents

  1. Front Matter
    (pp. i-vi)
  2. Table of Contents
    (pp. vii-viii)
  3. Introduction
    (pp. 1-4)

    The chapters in this book grow from my experiences as a psychoanalyst, a psychotherapist, and a developmental theorist, each set of experiences influenced by recent developments in psychoanalytic theories of mind and technique. Each chapter addresses an issue in contemporary psychoanalysis; together they represent widely varying entry points into that domain. This approach in fact reflects my first theme: diversity.

    Given the wide array of psychoanalytic theories that currently command respect among experienced clinicians and the proliferation of technical approaches to the patient, a thoughtful analyst has to struggle to find a way through the diversity. I have chosen to...

  4. Part I Diversity in Psychoanalysis
    • [Part I Introduction]
      (pp. 5-8)

      The chapters in this section are intended to develop a view of the diversity central to current psychoanalytic thought. Chapter 1 spells out the underpinnings of the evolution of diversity in technique. This discussion makes it clear that there is no room for orthodoxy in technique, from whichever theory it is derived. The psychoanalytic process is rich but problematic; though we know a great deal, we are often working in the dark in the individual instance. The review of issues underlying the evolution of diversity presented here is neither historical nor theoretical. Rather, it is built around the subtle and...

    • 1 Diversity in Technique: Six Discussions of the Backdrop
      (pp. 9-34)

      Diversity in technique is a fact of contemporary clinical practice in psychoanalysis. While it parallels the current diversity in psychoanalytic theory (described in the next chapter), both its sources and its expressions are probably far more extensive, stemming not only from theoretical innovations but also from highly individualized features of the analyst and the analytic process. It is my aim here to explore some of the intellectual backdrop to this diversity, simultaneously underscoring the considerations that present challenges to any orthodoxy regarding technique.

      It is both a source and a reflection of the diversity that no two psychoanalysts hear a...

    • 2 Diversity in Theory: One Psychoanalysis Composed of Many
      (pp. 35-58)

      Although Hartmann (1964) proposed that psychoanalysis be seen as a general psychology, that reach is perhaps too great. There are too many issues in the domains of perception, learning, development, and group process, for example, that are well beyond the attention and grasp of psychoanalysis—though psychoanalysis may contribute something to their understanding. But psychoanalysis must aspire to be a general psychology of the phenomena of the psychoanalytic situation, of the human mind as it is seen through the lens of the psychoanalytic process.

      That lens is subject to the coloration brought to it by the mind of the observer....

  5. Part II Direction in Psychoanalytic Technique
    • [Part II Introduction]
      (pp. 59-64)

      Having described the current diversity in psychoanalytic theory and some of the sources of a parallel diversity in technique, I intend in this section to consider specific details within the broad domain of psychoanalytic technique. In no way are my remarks here a general theory of technique; to attempt that would be inconsistent with what I have outlined thus far. Instead, I provide details, the complex considerations that support our general ways of working and our specific modes of intervention in a given clinical instance. What I give are building blocks—building blocks not for a general theory, but, rather,...

    • 3 Therapeutic Actions of Psychoanalysis: The Mix of Interpretation and Relationship
      (pp. 65-84)

      The title of this chapter follows from Strachey’s (1934) and Loewald’s (1960) papers on therapeutic action (except for the change to plural, therapeuticactions). Kohut (1984) used the more engaging title “How Does Analysis Cure?” for his treatment of this same subject. Each author approached the subject from his own conceptual vantage point, and I do the same. My vantage point is twofold: first, where I am now as an analyst, how my work has evolved and is evolving; and second, where the field of psychoanalysis is now, with all its intellectual multiplicity, uncertainty, and potentiality. The question of therapeutic...

    • 4 A Contribution to the Analysis of the Psychoanalytic Process
      (pp. 85-102)

      In a series of papers on the psychoanalytic process published in thePsychoanalytic Quarterlyin 1990, one of the major issues involved the question of how we are to conceive of the two-person interactional features inherently present in a psychoanalysis and the impact of this feature on our understanding of the core psychoanalytic process. In his own contribution to that discussion, Compton (1990) wrote: “Once the role of the analyst as participant observer (like that of all scientists, but far more integrally participatory) was recognized, however, the study of the patient by the analyst in the psychoanalytic situation inevitably had...

    • 5 The Ego in the Session
      (pp. 103-130)

      For some analysts ego psychology has a bad name, whether because of psychoanalytic politics (a wish to disavow the so-called classical position) or because it appears to leave the “depths” of the mind behind or because—as a nonexperiential concept—“ego” does not have the appeal of, say, sexual or aggressive urges, affects, repetitive object relationships, or subjective states. “Ego” is an indispensable concept, however, and central to all clinical work. At the very least, the concept helps us in any assessment of a person’s capacity to enter and participate in the analytic task. But much more is addressed by...

    • 6 Conflict, Defect, and Deficit
      (pp. 131-152)

      Among the phenomena that become important during any psychoanalytic treatment, conflict iseverywhere, but it is noteverything. In this chapter, I discuss two “things” that may become prominent in any particular analysis—defects and deficits—things that get involved in conflict.

      I advocate no either-or opposition with regard to conflict, on the one hand, and defects and deficits, on the other. But defects and deficits exist in the real world (and therefore in our patients) and have an impact on the course and the outcome of analyses; hence it is in our interest to conceptualize them clearly.

      I am...

    • 7 Clinical Considerations Regarding Interpretation in the Four Psychologies
      (pp. 153-194)

      Since 1985, when I published my first work on what I have come to call “the four psychologies of psychoanalysis,” I have often been asked how one decides which psychology is active at the moment. How does one decide what and how to interpret? What are the guidelines determining the “choice” of interpretation in terms of the issues represented by one psychology rather than another? My response to all such questions is always the same: it all depends; I have no systematic guidelines outside the domain of my clinical listening. It depends on one’s understanding of the patient in general...

    • 8 The Use of Developmental Perspectives in Adult Clinical Practice
      (pp. 195-214)

      My impression is that most analysts who work with both children and adults feel strongly that their work with children and, more broadly, a developmental point of view profoundly affect their clinical work with adults. In discussing this view with others, however, I sense that while the influence is generally implicit in the analyst’s thinking, it is difficult to make explicit. The last creatures that would discover water would be fish, and developmental thinkers and child analysts seem to be the fish in this case—that is, swimming in an environment (developmental thinking) so taken for granted that it becomes...

  6. Postscript
    (pp. 215-218)

    Early in this book I referred to Berman’s (1991) remark that psychoanalysis has multitudes of mini-theories of how mind works but just does not know how to put them all together. We also, I would now add, have multitudes of mini-theories of technique, and in this case I believe we are best off not devoting much effort to putting them all together. Each of us needs some guidelines, and free association, evenly suspended attention, neutrality, abstinence, and relative anonymity remain the salient ones for me. But I now see these as baselines to which I generally return rather than as...

  7. References
    (pp. 219-226)
  8. Index
    (pp. 227-234)