Reply to a critic of a unifying nomenclature for clinical psychoanalysis

Sunday, January 3, 2016
Santa Barbara, California

Dear Lovely Readers of this Blog,

Thanks you, Robbie, for generally acknowledging the ideas I presented initially regarding ways to organize clinical psychoanalysis. And thanks also to you, Diane, for adding those crucial ideas about how psychoanalysts must create a safe environment for their patients. I agree that this is a crucial component of their bringing their presence to their work.

I recently had a version of these ideas criticized by an editor of a psychoanalytic journal. He wrote that:

“theoretical differences inform practice and technique. Classical approaches have emphasized neutrality and interpretation; ego psychology—defenses, adaptation, and reality testing; Jungianism—archetypal symbols and individuation; attachment theory and object relations—the role of early development, internalization processes, and self/object representations; self psychology—mirroring and empathic attunement; modern conflict theory—compromise formation; Lacanian approaches—speech acts and techniques at disrupting the unconscious; and interpersonal/relational—the dyadic relationship and analyst self-disclosure.”

I found his commentary a helpful, concise summary of psychoanalytic approaches. I do not see how his ideas detract from my original thesis. As I noted in my first posting, all psychoanalysts frame their professional relationships, bring their presence to their patients, and engage them in various types of dialogue, conscious and unconscious, verbal and nonverbal, etc. These methods all serve to alter patients’ internalization processes, namely their unconscious structures or schemas. Using this critic’s words and phrases as a guide, such interventions as interpretation, neutrality, techniques of disrupting the unconscious and analyst self-disclosure would all be variations of how psychoanalysts engage their patients. His use of words or phrases like empathic attunement and mirroring would represent ways of being present with patients.

Where I most take issue with this particular critic is his failure to mention the significant impact of psychoanalysts’ beings on their work. We psychoanalysts bring our unique personality styles, our sociocultural features, our historicities, and other more ephemeral elements of our personal styles to our work. In my view, these ultimately trump whatever theoretical metaphors we use or methods of engagement we employ. I have perhaps been most influenced by Szasz, and end this posting with this particularly wonderful quote of his from 1988 in which he recommended that psychoanalytic relationships be:

as natural, spontaneous, and unrehearsed as is the relationship between

other persons who respect (and perhaps are fond of) each other.

Accordingly, from such a perspective there is – there can be – no such

thing as a psychoanalytic technique or psychotherapeutic method… a

therapist’s… relationship with his client cannot be, and cannot be reduced

to, a technique – just as a person’s relationship with members of his

family or friends cannot be reduced to a technique. (p. xiii).

Thanks again, so much, for reading this blog. I look forward to your comments and plan on responding every week. I wish you all the best for 2015.

With affection,



Szasz, T. (1988). The ethics of psychoanalysis. Syracuse: Syracuse University Press.

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