The Patient's Experience of the Analyst's Subjectivity

Lewis Aron, PHD, author; 243 West End Avenue, Apt. 310
New York, N.Y. 10023
This article highlights the analysis of
the patient's experience of the analyst's subjectivity in the
psychoanalytic situation. Just as psychoanalytic theory has
focused on the mother exclusively as the object of the
infant's needs while ignoring the subjectivity of the mother,
so, too, psychoanalysis has considered the analyst only as
an object while neglecting the subjectivity of the analyst as
the analyst is experienced by the patient. The analyst's
subjectivity is an important element in the analytic situation,
and the patient's experience of the analyst's subjectivity
needs to be made conscious.
Patients seek to connect to their analysts, to know them, to
probe beneath their professional facade, and to reach their
psychic centers much in the same way that children seek to
connect to and penetrate their parents' inner worlds. The
exploration of the patient's experience of the analyst's
subjectivity represents one underemphasized aspect of the
analysis of transference, and it is an essential aspect of a
detailed and thorough explication and articulation of the
therapeutic relationship. The paper explores controversies
regarding the analyst's self- disclosure and
countertransference.
The purpose of this paper is to highlight the clinical centrality
of examining the patient's experience of the analyst's
subjectivity in the psychoanalytic situation. Although many
cultural, social, and scientific developments have contributed
to a relational view of the psychoanalytic process, I believe
that the shift to an intersubjective perspective has emerged
predominantly out of our accumulated clinical experience in
psychoanalytic work with patients. I would like to begin by
noting some developments in two areas not directly related
to clinical psychoanalysis:
feminist thought and infancy research. My purpose is not to
base clinical theory on the grounds of laboratory research
nor to rest it on the movement to rectify social inequities;
rather, because the implications of an intersubjective view
are being clearly spelled out in these areas, they provide an
illustration of what I mean by intersubjectivity.
Only with the recent development of feminist psychoanalytic
criticism has it become apparent that psychology and
psychoanalysis have contributed to and perpetuated a
distorted view of motherhood (Dinnerstein, 1973; Chodorow,
1978; Balbus, 1982; Benjamin, 1988). In all of our theories of
development, the mother has been portrayed as the object of
the infant's drives and as the fulfiller of the baby's needs. We
have been slow to recognize or acknowledge the mother as
a subject in her own right. In discussing the prevalent
psychological descriptions of motherhood, Benjamin (1988)
recently wrote:
The mother is the baby's first object of attachment, and later,
the object of desire. She is provider, interlocutor, caregiver,
contingent reinforcer, significant other, empathic
understander, mirror. She is also a secure presence to walk
away from, a setter of limits, an optimal frustrator, a
shockingly real outside otherness. She is external reality—
but she is rarely regarded as another subject with a purpose
apart from her existence for her child [p. 24].
Benjamin has argued that the child must come to recognize
the mother as a separate other who has her own inner world
and her own experiences and who is her own center of
initiative and an agent of her own desire. This expanding
capacity on the part of the child represents an important, and
previously unrecognized, developmental achievement.
Benjamin has proposed that the capacity for recognition and
intersubjective relatedness is an achievement that is best
conceptualized in terms of a separate developmental line,
and she has begun to articulate the complex vicissitudes
involved in this advance. This developmental achievement is
radically different from that which has previously been
described in the literature. The traditional notion of “object
constancy” is limited to the recognition of the mother as a
separate “object.” What is being emphasized from an
intersubjective perspective is the child's need to recognize
mother as a separate subject, a need that is a
developmental advance beyond viewing mother only as a
separate object. Dinnerstein (1976) anticipated this when
she wrote, “Every ‘I’ first emerges in relation to an ‘It’ which
is not at all clearly an ‘I.’ The separate ‘I’ness of the other
person is a discovery, an insight achieved over time” (p.
106).
Intersubjectivity refers to the developmentally achieved
capacity to recognize another person as a separate center of
subjective experience. Stern's (1985) description of the
developmental progression of the sense of self has begun to
draw attention to the domain of intersubjective relatedness in
which the nature of relatedness expands to include the
recognition of subjective mental states in the other as well as
in oneself. Recent theorizing about the construction of
internal representations of self and others (Lichtenberg,
1983; Beebe and Lachmann, 1988a; Stern, 1989) has just
begun to consider the child's emerging ability to attribute
subjectivity or internal states to others and to explore the
ways in which these internal states can be interpersonally
communicated.
Winnicott (1954-1955) anticipated the importance of an
intersubjective perspective and provided a preliminary
hypothesis regarding the establishment of intersubjectivity.
He expanded Klein's depressive position to include the
development of the capacity for “ruth” (p. 265), which he
contrasts to the state of “ruthlessness” that exists prior to the
development of the capacity to recognize the other as a
separate person. Winnicott (1969) elaborates a theory of
“object usage” that describes the process by which the infant
destroys the object, finds that the object survives destruction,
and therefore is able to surrender omnipotence and
recognize the other as a separate person. Other theorists
who have been examining the nature and development of
intersubjectivity include Stern, 1985; Ogden, 1986; Kernberg,
1987; Stolorow, Brandchaft, and Atwood, 1987; and Bollas,
1989. It was perhaps Lacan (Miller, 1988) who, in his
seminars of the mid-1950s, first discussed the implications of
intersubjectivity within the psychoanalytic situation. I will not
elaborate here on the developmental aspects of
intersubjectivity since my present aim is to discuss
intersubjective psychology as it is related to clinical
psychoanalysis.
The theory of intersubjectivity has profound implications for
psychoanalytic practice and technique as well as for theory.
(It should be noted that in my understanding of
intersubjectivity I have been influenced by Benjamin [1988]
and that my approach to psychoanalytic technique is quite
distinct from that being developed by Stolorow, Brandchaft,
and Atwood [1987].) Just as psychoanalytic theory has
focused on the mother exclusively as the object of the
infant's needs while ignoring the subjectivity of the mother,
so, too, psychoanalysis has considered analysts only as
objects while neglecting the subjectivity of analysts as they
are experienced by the patient.
The traditional model of the analytic situation maintained the
notion of neurotic patients who brought their irrational
childhood wishes, defenses, and conflicts into the analysis to
be analyzed by relatively mature, healthy, and well-analyzed
analysts who would study the patients with scientific
objectivity and technical neutrality. The health, rationality,
maturity, neutrality, and objectivity of the analyst were
idealized, and thus countertransference was viewed as an
unfortunate, but hopefully rare, lapse. Within the
psychoanalytic situation, this bias, which regarded the
patient as sick and the analyst as possessing the cure
(Racker, 1968), led to the assumption that it was only the
patient who had transferences. Furthermore, it was as if only
the patient possessed a “psychic reality” (see McLaughlin,
1981) and the analyst was left as the representative of
objective reality. In sum, if the analyst was to be a rational,
relatively distant, neutral, anonymous scientist-observer, an
“analytic instrument” (Isakower, 1963), then there was little
room in the model for the analyst's psychic reality or
subjectivity, except as pathological, intrusive
countertransference.
As is well known, it is only in the most recent decades that
countertransference has been viewed as a topic worthy of
study and as potentially valuable in the clinical situation. For
Freud (1910), countertransference reflected a specific
disturbance in the analyst elicited in response to the patient's
transference and necessitating further analysis of the
analyst. Contemporary theorists are more inclined to take a
“totalistic” (Kernberg, 1965) approach to countertransference
and view it as reflecting all of the analyst's emotional
responses to the patient and therefore useful as a clinical
tool. Rather than viewing countertransference as a hindrance
to the analytic work that should be kept in check or
overcome and that should, in any event, be kept to a
minimum, most analysts today recognize the ubiquity of
analysts' feelings and fantasies regarding patients and hope
to utilize their own reactions as a means to understand their
patients better. Psychoanalysis has thus broadened its data
base to include the subjectivity of the analyst. It has not yet,
however, sufficiently considered the patient's experience of
the analyst's subjectivity.
In my view, referring to the analyst's total responsiveness
with the term countertransference is a serious mistake
because it perpetuates defining the analyst's experience in
terms of the subjectivity of the patient. Thinking of the
analyst's experience as “counter” or responsive to the
patient's transference encourages the belief that the
analyst's experience is reactive rather than subjective,
emanating from the center of the analyst's psychic self
(McLaughlin, 1981; Wolstein, 1983). It is not that analysts
are never responsive to the pressures that the patients put
on them; of course, the analyst does counterrespond to the
impact of the patient's behavior. The term
countertransference, though, obscures the recognition that
the analyst is often the initiator of the interactional
sequences, and therefore the term minimizes the impact of
the analyst's behavior on the transference.
The relational approach that I am advocating views the
patient-analyst relationship as continually established and
reestablished through ongoing mutual influence in which
both patient and analyst systematically affect, and are
affected by, each other. A communication process is
established between patient and analyst in which influence
flows in both directions. This approach implies a “two-person
psychology” or a regulatory-systems conceptualization of the
analytic process (Aron, 1990). The terms transference and
countertransference too easily lend themselves to a model
that implies a one-way influence in which the analyst
responds in reaction to the patient. The fact that the
influence between patient and analyst is not equal does not
mean that it is not mutual. Mutual influence does not imply
equal influence, and the analytic relationship may be mutual
without being symmetrical. This model of the therapeutic
relationship has been strongly influenced by the recent
conceptualizations of mother-infant mutual influence
proposed by Beebe and Lachmann (1988b).
Others have also suggested that we abandon the term
countertransference. Olinick (1969) suggested the
alternative eccentric responses in the “psychology of the
analyst,” but I see no advantage to the pejorative term
eccentric. Bird (1972) broadened the meaning of the term
transference and sees it as the basis for all human
relationships. He then suggests referring simply to “the
analyst's transferences.” This strategy, however, leads to
terminological confusion, such as in Loewald's (1986, p.
2801981) convincingly argues for abandoning the term
countertransference. He writes, “The term
countertransference particularly cannot accommodate the
intrapsychic range and fullness of the analyst's experiences
vis-à-vis his patient” (p. 656).
In a seminal paper, Hoffman (1983) draws together the work
of theorists from a wide variety of psychoanalytic schools.
These theorists share a radical social and perspectival
concept of psychoanalysis that recognizes that patients
make plausible inferences regarding aspects of their
analysts' experience. Hoffman advances a view of
psychoanalytic technique that makes central the analysis of
the patient's interpretations of the analyst's experience. In
many respects the present paper may be seen as my efforts
to grapple with and elaborate on the implications of
Hoffman's contribution. While Hoffman entitles his paper
“The Patient as Interpreter of the Analyst's Experience,” he
continues to refer to the patient's interpretation of the
analyst's countertransference. Because of my objections to
the implications of the term countertransference, I prefer to
describe the focus of this paper in terms of the patient's
experience of the analyst's subjectivity.
Racker (1968) was one of the first to make the technical
recommendation that “analysis of the patient's fantasies
about countertransference, which in the widest sense
constitute the causes and consequences of the transference,
is an essential part of the analysis of the transferences” (p.
131). Gill (1983) puts it simply and directly, although in my
view this point has not received nearly the attention it
deserves: “A consequence of the analyst's perspective on
himself as a participant in a relationship is that he will devote
attention not only to the patient's attitude toward the analyst
but also to the patient's view of the analyst's attitude toward
the patient” (p. 112).
Since, from a classical perspective, the analyst was viewed
as participating with the patient in only a minimal way (Gill,
1983), very little attention was given to the impact of the
individual analyst and the impact of the analyst's character.
Analysts did not consider that patients would inevitably and
persistently seek to connect with their analysts by exploring
their own observations and inferences about their analyst's
behavior and inner experience.
Wolstein (1983) has pointed out that resistances are
defensive efforts by patients to cope with a particular analyst
and that these resistances must therefore be patterned by
the patient to accommodate to some aspect of the analyst's
unconscious psychology. The point is that the patient could
find a specific defense or resistance to be effective only if in
some way it was designed to match the personality of the
patient's particular analyst. Therefore, the ultimate outcome
of successfully analyzing resistances is that patients would
learn more not only about their own psychologies but also
about the psychology of others in their lives, particularly
about the psychology of their analysts. Wolstein (1988)
writes:
Nothing was more natural than for patients to turn the
strength of this new awareness and reconstruction toward
the psychology of their immediately environing others—
especially their psychoanalysts—and describe the perceived
aspects of countertransference against which they thought
they had gone into resistance [p. 9].
Of course, it is often argued that patients can and do
fantasize about the analyst's psychology and that therefore
the successful result of analysis of these fantasies is that
patients learn more about their own psychology than about
that of their analyst. My point here is that these fantasies are
not endogenously determined, drive-determined, autistic
creations of patients, nor are they purely the result of
expectations derived from past interpersonal experiences.
Rather, these fantasies may additionally be seen as patients'
attempts to grapple with and grasp, in their own unique and
idiosyncratic way, the complex and ambiguous reality of their
individual analyst (see Levenson, 1989). Ultimately, an
analysis of these fantasies must contribute to a clearer
understanding of both the patient's and the analyst's
psychologies.
I believe that patients, even very disturbed, withdrawn, or
narcissistic patients, are always accommodating to the
interpersonal reality of the analyst's character and of the
analytic relationship. Patients tune in, consciously and
unconsciously, to the analyst's attitudes and feelings toward
them, but inasmuch as they believe that these observations
touch on sensitive aspects of the analyst's character,
patients are likely to communicate these observations only
indirectly through allusions to others, as displacements, or
through descriptions of these characteristics as aspects of
themselves, as identifications (Lipton, 1977; Gill, 1982;
Hoffman, 1983). An important aspect of making the
unconsciousconscious is to bring into awareness and
articulate the patient's denied observations, repressed
fantasies, and unformulated experiences of the analyst
(Racker, 1968; Levenson, 1972, 1983; Hoffman, 1983).
All children observe and study their parents' personalities.
They attempt to make contact with their parents by reaching
into their parents' inner worlds. The Kleinians have
emphasized this point vividly through concrete metaphors of
the infant's seeking literally to climb inside and explore the
mother's body and to discover all of the objects contained
inside. Children imagine with what and with whom their
mothers are preoccupied. They have some sense, although
they may have never thought about it, as to how their
mothers related to their own mothers. There is now empirical
research that documents that a mother's internal working
model of her relationship with her own motheraffects her
child's attachment to her (Main, Kaplan, and Cassidy, 1985).
The child acquires some sense of the characters who inhabit
the mother's and father's inner worlds and of the nature of
the relations among these inner objects. Most important,
children formulate plausible interpretations of their parents'
attitudes and feelings toward the children themselves.
Children are powerfully motivated to penetrate to the center
of their parents' selves. Pick (1985) states this idea in
Kleinian language: “If there is a mouth that seeks a breast as
an inborn potential, there is, I believe, a psychological
equivalent, i.e. a state of mind which seeks another state of
mind” (p. 157).
If, as McDougall (1980) asserts, “a baby's earliest reality is
his mother's unconscious” (p. 251), then patients' psychic
reality may be said to implicate their analyst's unconscious.
Patients have conscious and unconscious beliefs about the
analyst's inner world. Patients make use of their
observations of their analyst, which are plentiful no matter
how anonymous the analyst may attempt to be, to construct
a picture of their analyst's characterstructure. Patients probe,
more or less subtly, in an attempt to penetrate the analyst's
professional calm and reserve. They do this probing not only
because they want to turn the tables on their analyst
defensively or angrily but also, like all people, because they
want to and need to connect with others, and they want to
connect with others where they live emotionally, where they
are authentic and fully present, and so they search for
information about the other's inner world. An analytic focus
on the patient's experience of the analyst's subjectivity opens
the door to further explorations of the patient's childhood
experiences of the parents' inner world and
characterstructure. Similarly, patients begin to attend to their
observations about the characters of others in their lives.
This development is an inevitable and essential part of how
patients begin to think more psychologically in their
analyses. The analytic stance being described considers
fantasies and memories not just as carriers of infantile
wishes and defenses against these wishes, but as plausible
interpretations and representations of the patient's
experiences with significant others (Hoffman, 1983). This
point was anticipated by Loewald (1970), who wrote, “The
analysand in this respect can be compared to the child—who
if he can allow himself that freedom— scrutinizes with his
unconscious antennae the parent's motivations and moods
and in this way may contribute—if the parent or analyst
allows himself that freedom—to the latter's self awareness”
(p. 280).
In the clinical situation I often ask patients to describe
anything that they have observed or noticed about me that
may shed light on aspects of our relationship. When, for
example, patients say that they think that I am angry at them
or jealous of them or acting seductively toward them, I ask
them to describe whatever it is that they have noticed that
led them to this belief. I find that it is critical for me to ask the
question with the genuine belief that I may find out
something about myself that I did not previously recognize.
Otherwise, it is too easy to dismiss the patients' observations
as distortions. Patients are often all too willing and eager to
believe that they have projected or displaced these feelings
onto their analyst, and they can then go back to viewing their
analyst as objective, neutral, or benignly empathic. I
encourage patients to tell me anything that they have
observed an insist that there must have been some basis in
my behavior for their conclusions. I often ask patients to
speculate or fantasize about what is going on inside of me,
and in particular I focus on what patients have noticed about
my internal conflicts.
For instance, a patient said that when he heard my chair
move slightly, he thought for a moment that I was going to
strike him. I asked the patient to elaborate on what he
thought I was feeling, what he thought was the quality and
nature of my anger, what he had noticed about me that led
him to believe that I was angry in this particular way, and
how he imagined that I typically dealt with my anger and
frustration. I asked the patient what he thought it was like for
me to be so enraged at him and not to be able to express
that anger directly, according to his understanding of the
“rules” of psychoanalysis and professional decorum. I asked
him how he thought I felt about his noticing and confronting
me with my disguised anger.
I choose first to explore the patient's most subtle
observations of me, which reflect my attitudes toward the
patient as well as my character and personal conflicts, in
preference to examining either the patient's own projected
anger or the displaced anger of others in the patient's current
or past life. All of this anger ultimately needs to be explored,
but following Gill's (1983) recommendations, I begin with an
analysis of the transference in the here and now, focusing on
the plausible basis for the patient's reactions. It is important
to note that I proceed in this way whether or not I am aware
of feeling angry at that point. I assume that the patient may
very well have noticed my anger, jealousy, excitement, or
whatever before I recognize it in myself.
Inquiry into the patient's experience of the analyst's
subjectivity represents one underemphasized aspect of a
complex psychoanalytic approach to the analysis of
transference.
A balance needs to be maintained between focusing on the
interpersonal and the intrapsychic, between internal object
relations and external object relations. While at times
exploring patients' perceptions of the analyst serves to
deepen the work, at other times this focus is used
defensively, by patient and analyst, to avoid the patient's
painful inner experience (see Jacobs, 1986, p. 304
While asking direct questions about the patient's
observations of the analyst is often necessary and
productive, the most useful way to elicit the patient's
thoughts and feelings about the analyst's attitudes is to
analyze the defenses and resistances that make these
thoughts and feelings so difficult to verbalize. Asking patients
direct questions about their experience of the therapeutic
relationship entails the disadvantage that it may appeal to
more surface and conscious levels of discourse. The analyst
needs to listen to all of the patient's associations for clues as
to the patient's experience. Often the patient fears offending
the analyst and provoking the analyst's anger by confronting
the analyst with aspects of the analyst's character that have
been avoided. Patients fear that they are being too personal,
crossing over the boundary of what the analyst is willing to
let them explore. Patients are especially likely to fear that if
they expose the analyst's weaknesses and character flaws,
the analyst will retaliate, become depressed, withdrawn, or
crumble (Gill, 1982). Implicit in this fear are not only the
patient's hostility, projected fears, or simply the need to
idealize the analyst but also the patient's perception of the
analyst's grandiosity, which would be shattered by the
revelation of a flaw. The patient's expectations of the analyst
are related to the ways in which the patient's parents actually
responded to their children's observations and perceptions of
them. How did their parents feel about their children's really
getting to know who they were, where they truly lived
emotionally? How far were the parents able to let their
children penetrate into their inner worlds? Was the
grandiosity of the parents such that they could not let their
children uncover their weaknesses and vulnerabilities? To
return to the rich Kleinian imagery of the infant's attempts in
unconscious phantasy to enter into the mother's body, we
may wonder whether the violent, destructive phantasies
encountered are due only to innate greed and envy or
whether they are not also the result of the frustration of being
denied access to the core of the parents. Could these
phantasies be an accurate reflection of the child's
perceptions of the parents' fears of being intimately
penetrated and known?
What enables patients to describe their fantasies and
perceptions of the analyst is the analyst's openness and
intense curiosity about patients' experience of the analyst's
subjectivity. The patient will benefit from this process only if
the analyst is truly open to the possibility that patients will
communicate something new about the analyst, something
that the patient has picked up about the analyst that the
analyst was not aware of before. If, on the other hand, the
analyst listens to the patient with the expectation of hearing a
transferencedistortion and is not open to the likelihood and
necessity of learning something new about himself or
herself, then the analysis is more likely to become derailed
or to continue on the basis of compliance and submission to
authority.
The recognition of the analyst's subjectivity within the
analytic situation raises the problem of the analyst's self-
disclosure. The issues involved by the analyst's self-
revelations are enormously complex and can only be
touched on here. There are, however, a few comments that
should be made because they are directly raised by the line
of inquiry advocated in this paper.
When patients are encouraged to verbalize their experiences
of the analyst's subjectivity, it is most likely that they will put
increased pressure on the analyst to verify or refute their
perceptions. It is extremely difficult and frustrating for
patients to be encouraged to examine their perceptions of
the analyst's subjectivity and then to have their analyst
remain relatively “anonymous.” Once analysts express
interest in the patient's perceptions of their subjectivity, they
have tantalized the patient (Little, 1951) and will surely be
pressured to disclose more of what is going on inside
themselves. Furthermore, the ways in which analysts pursue
the inquiry into the patient's perceptions of themselves are
inevitably self-revealing. I assume that one reason that
analysts have traditionally avoided direct inquiry into the
patient's experience of the analyst's subjectivity is that they
recognized that pursuing this line of inquiry would
unavoidably result in self-disclosure.
Self-revelation is not an option; it is an inevitability. Patients
accurately and intuitively read into their analyst's
interpretations the analyst's hidden communications (Jacobs,
1986). In unmasking the myth of analytic anonymity, Singer
(1977) pointed out that the analyst's interpretations were first
and foremost self-revealing remarks. It cannot be otherwise
since the only way we can truly gaininsight into another is
through our own self-knowledge, and our patients know that
fact.
Hoffman (1983) emphasized that patients know that the
psychology of the analyst is no less complex than that of
themselves. He challenged what he termed “the naive
patient fallacy,” the notion that the patient accepts at face
value the analyst's words and behavior. For analysts simply
and directly to say what they are experiencing and feeling
may encourage the assumption that they are fully aware of
their own motivations and meanings. The analyst's
revelations and confessions may tend to close off further
exploration of the patient's observations and perceptions.
Furthermore, we can never be aware in advance of just what
it is that we are revealing about ourselves, and when we
think we are deliberately revealing something about
ourselves, we may very well be communicating something
else altogether. Is it not possible that our patients'
perceptions of us are as plausible an interpretation of our
behavior as the interpretations we give ourselves? If so, then
it is presumptuous for the analyst to expect the patient to
take at face value the analyst's self-revelations. Pontalis
(cited in Limentani, 1989) asks, “What is more paradoxical
than the presupposition that: I see my blind spots, I hear
what I am deaf to ... and (furthermore) I am fully conscious of
my unconscious” (p. 258).
We hope that we, as analysts, have had the benefit of an
intensive analysis of our own, but this in no way ensures that
we have easy access to our unconscious or that we are
immune from subtly enacting all sorts of pathological
interactions with our patients. This recognition has led to our
contemporary acceptance of the inevitability of
countertransference. Whereas in the past idealized, well-
analyzed analysts were thought to have no
countertransference problem, today's idealized analysts are
thought to be so well analyzed that they have immediate and
direct access to their unconscious. It is well to keep in mind
that the trouble with self-analysis is in the
countertransference! When analysis is viewed as a
coparticipation (Wolstein, 1983) between two people who are
both subjects and objects to each other, then the analyst can
read the patient's associations for references to the patient's
perceptions of the analyst's attitudes toward the patient. This
method provides additional data with which analysts can
supplement their own self-analysis. In this way the analyst
and patient coparticipate in elucidating the nature of the
relationship that the two of them have mutually integrated.
Bollas (1989) advocates that analysts need to establish
themselves as subjects in the bipersonal analytic field.
Bollas encourages analysts to reveal more of their internal
analytic process to their patients, for example, describing to
a patient how the analyst arrived at a particular interpretation
or sharing with the patient the analyst's associations to a
patient's dream. He argues that if the analyst's self-
disclosure is congruent with who the analyst really is as a
person, then the disclosure is unlikely to be taken as a
seduction. In establishing themselves as subjects in the
analytic situation, analysts make available to the patient
some of their own associations and inner processes for the
patient to use and analyze. It is important to note that
Bollas's revelations have a highly playful and tentative
quality in that he does not take his associations or “musings”
as containing absolute truth but rather puts them into the
analytic field and is prepared to have them used or
destroyed by the patient. Furthermore, Bollas is reserved
and cautious in his approach because of his awareness that
an incessant flow of the analyst's associations could be
intrusive, resulting in “a subtle takeover of the analysand's
psychic life with the analyst's” (p. 69). Bollas's clinical
contributions are enormous, but while I agree that analysts
should be available to the patient as a separate subject, the
danger with any approach that focuses on analysts'
subjectivity is that analysts may insist on asserting their own
subjectivity. In the need to establish themselves as separate
subjects, analysts may impose this on the patient, thus
forcing the patient to assume the role of object. Analyst's
imposition of their own subjectivity onto their patients is not
“intersubjectivity” it is simply an instrumental relationship in
which the subject-object polarities have been reversed.
In my view self-revelations are often useful, particularly those
closely tied to the analytic process rather than those relating
to details of the analyst's private life outside of the analysis.
Personal revelations are, in any event, inevitable, and they
are simply enormously complicated and require analysis of
how they are experienced by the patient. We as analysts
benefit enormously from the analytic efforts of our patients,
but we can help them as analysts only if we can discipline
ourselves enough to put their analytic interests ahead of our
own, at least temporarily.
The major problem for analysts in establishing themselves
as subjects in the analytic situation is that because of their
own conflicts they may abandon traditional anonymity only to
substitute imposing their subjectivity on patients and thus
deprive patients of the opportunity to search out, uncover,
and find the analyst as a separate subject, in their own way
and at their own rate. While a focus on the patient's
experience of the analyst needs to be central at certain
phases of an analysis, there are other times, and perhaps
long intervals, when focusing on perceptions of the analyst is
intrusive and disruptive. Focusing exclusively on the
presence of the analyst does not permit the patient
temporarily to put the analyst into the background and
indulge in the experience of being left alone in the presence
of the analyst. Analysts' continuous interpretations of all
material in terms of the patient-analyst relationship, as well
as analysts' deliberate efforts to establish themselves as
separate subjects, may be rightfully experienced as an
impingement stemming from the analysts' own narcissistic
needs. To some degree this outcome is inevitable, and it can
be beneficial for a patient to articulate it when it happens.
Winnicott (1971) has suggested that psychoanalysis occurs
in an intermediate state, a transitional space, transitional
between the patient's narcissistic withdrawal and full
interaction with reality, between self-absorption and object
usage, between introspection and attunement to the other,
and between relations to a subjective-object and relations to
an object, objectively perceived, transitional between fantasy
and reality. In my own clinical work I attempt to maintain an
optimal balance between the necessary recognition and
confirmation of the patient's experience and the necessary
distance to preserve an analytic space that allows the patient
to play with interpersonal ambiguity and to struggle with the
ongoing lack of closure and resolution. A dynamic tension
needs to be preserved between responsiveness and
participation on the one hand and nonintrusiveness and
space on the other, intermediate between the analyst's
presence and absence. My manner of achieving this tension
is different with each patient and varies even in the analysis
of a single analysand. I believe that each analyst-patient pair
needs to work out a unique way of managing this precarious
balance. The analysis itself must come to include the self-
reflexive examination of the ways in which this procedure
becomes established and modified. Analysis, from this
perspective, is mutual but asymmetrical, with both patient
and analyst functioning as subject and object, as
coparticipants, and with the analyst and patient working on
the very edge of intimacy. The question of the degree and
nature of the analyst's deliberate self-revelation is left open
to be resolved within the context of each unique
psychoanalytic situation.
In my initial attempts to present these thoughts to varying
groups of colleagues and students, I was struck by the
overwhelming tendency on the part of my listeners to focus
the discussion on the issue of the analyst's self-revelations. I
wondered why analysts were so eager to discuss self-
revelation when it was not the main point of the paper. In my
view, what is important is not the analyst's deliberate self-
disclosure but rather the analysis of the patient's experience
of the analyst's subjectivity. The very expression by patients
of their perceptions of the analyst leads to the establishment
of the analyst as a separate subject in the mind of the
patient. So why do analytic audiences focus on self-
revelation?
I believe that people who are drawn to analysis as a
profession have particularly strong conflicts regarding their
desire to be known by another, that is, conflicts concerning
intimacy. In more traditional terms these are narcissistic
conflicts over voyeurism and exhibitionism. Why else would
people choose a profession in which they spend their lives
listening and looking into the lives of others while they
themselves remain relatively silent and hidden? The
recognition that analysts, even those who attempt to be
anonymous, are never invisible and, furthermore, the insight
that patients seek to “know” their analysts raise profound
anxieties for analysts who are struggling with their own
longings to be known and defensive temptations to hide.
How is it that psychoanalysis, which is so concerned with
individual subjective experience and with the development of
the child's experience of the other, for so long neglected the
exploration of intersubjectivity? Why has it taken so long for
us to recognize that we must develop a conception of the
other not only as an object but as a separate subject, as a
separate psychic self, as a separate center of experience?
For most of its history psychoanalysis has been dominated
by the metapsychology of drive theory. Freud conceived of
mind as a closed energy system fueled by biological drives
pressing for discharge. This model of mind is based on the
notion that there are drives striving for gratification and that
the ego regulates, channels, and defends against these
drives while attempting to find objects suitable to meet their
fulfillment. Within this theoretical framework the other person
is “objectified”—seen as the “object” of the drive. Because
the focus of the theory is on the vicissitudes of the drives, the
role of the other is reduced to that of the object of the drives,
and the only relevant variable is whether the person is
gratifying or frustrating the drive. The dimension of
gratification-frustration becomes the central if not the
exclusive characteristic of the object since the object's
individual subjectivity is of no relevance in as much as they
are an object. Only with the shift in psychoanalysis away
from drive theory and toward a relational theory of the
development of the self and of “object relations” (that is, of
interpersonal relations —conscious and unconscious, real
and fantasied, external and internal [Greenberg and Mitchell,
1983]) could psychoanalysis begin to study the other not as
an object but as a separate subject (Chodorow, 1989).
Adopting a “two-person psychology” or a relational
perspective opens up the possibility for the investigation not
only of subject-object relations but of subject-subject
relations. As Mitchell (1988a) has recently stated, “If the
analytic situation is not regarded as one subjectivity and one
objectivity, or one subjectivity and one facilitating
environment, but two subjectivities—the participation in and
inquiry into this interpersonal dialectic becomes a central
focus of the work” (p. 38).
It should be clear that it is not only the classical
drive/structuremetapsychology that narrows our view of
people, deprives them of subjectivity, and reduces them to
objects. This limitation is true of any asocial, “one-person”
psychology. (For a discussion of asocial paradigms, see
Hoffman, 1983; for a discussion of one-person psychologies,
see Aron, in press). For example, Kohutian self psychology
provides an important contribution to clinical psychoanalysis
in its emphasis on the need for the analyst to be responsive
and empathic and in its recognition of the vital experience of
emotional attunement in the analytic process. Self
psychology, however, maintains the classical view that who
the analyst is as a unique character is irrelevant to the
process of the analysis. Kohut (1977) wrote that the patient's
transferences were defined by “pre-analytically established
internal factors in the analysand's personalitystructure” (p.
217). The analyst's contribution to the process was limited to
making “correct” interpretations on the basis of empathy with
the patient. Similarly, Goldberg (1980) has stated:
Self psychology struggles hard not to be an interpersonal
psychology ... because it wishes to minimize the input of the
analyst into the mix ... It is based on the idea of a
developmental program (one that may be innate or pre-wired
if you wish) that will reconstitute itself under certain
conditions [p. 387].
Similar objections could be raised regarding the clinical
stance taken by psychoanalysts of the British object-
relational school and of the American interpersonal school.
The metaphors of the analyst as “good enough mother” and
“holder” (Winnicott, 1986) or as “container” (Bion, 1970) and
“metabolizer” of the patient's pathological contents have
been extremely useful inasmuch as they have drawn
attention to nonverbal and subtle exchanges and to the ways
in which the analyst needs to respond to these “primitive
communications.” The danger with these metaphors,
however, is not only that the patient may be infantilized and
deprived of a richer and more complex adult kind of intimacy,
as Mitchell (1988b) rightly points out, but that the analyst is
similarly instrumentalized and denied subjective existence.
Instead of being seen as subjects, the mother and the
analyst are transformed into the baby's and the patient's
“thinking apparatus” (Bion, 1970). The blank screen has
simply been replaced with an empty container, free of the
analyst's psychological insides (Hoffman, 1983; Levenson,
1983; Hirsch, 1987). In parallel to this view, Chodorow
(1989, p. 253
While contemporary interpersonal analysts (Levenson, 1972;
1983; Wolstein, 1983) emphasize the analyst's personal
contributions to the patient's transferences, this emphasis
was not true of Sullivan's clinical position. Sullivan saw the
therapist as an “expert” on interpersonal relations who would
function as a “participant-observer” in conducting the analytic
inquiry, and as an expert he assumed that the therapist
could avoid being pulled into the patient's interpersonal
entanglements (see Hirsch, 1987). Sullivan's interpersonal
theory, while interpersonal in its examination of the patient's
life, was asocial inasmuch as it neglected the subjectivity of
the therapist as inevitably participating in the analytic
interaction. Sullivan's description of the principle of
participant-observation soon brought attention to the
analyst's subjective experience and the patient's perceptions
of the analyst's experience, which became the focus of
attention for later interpersonal analysts. Historically, Hirsch
attributes the contemporary interpersonal focus on the
participation of the analyst to the influence of Fromm. I see
this clinical movement, which emphasizes the contribution of
the analyst's subjectivity, as deriving more from the influence
of Thompson in the United States and Balint in England,
both of whom were deeply influenced by and attempted to
extend the later contributions of Ferenczi. Ferenczi was the
first analyst seriously to consider the impact of the analyst's
subjectivity within the analytic situation (see Dupont, 1988),
and the origins of relational theory and practice can be
traced back to the conflict between Freud and Ferenczi.
I will conclude by highlighting eight clinical points:
1. The analytic situation is constituted by the mutual
regulation of communication between patient and analyst in
which both patient and analyst affect and are affected by
each other. The relationship is mutual but asymmetrical.
2. The analyst's subjectivity is an important element in the
analytic situation, and the patient's experience of the
analyst's subjectivity needs to be made conscious.
3. Patients seek to connect to their analysts, to know them,
to probe beneath their professional facade, and to reach
their psychic centers much in the way that children seek to
connect to and penetrate their parents' inner worlds. This
aggressive probing may be mistaken for hostile attempts at
destruction.
4. Self-revelation is not a choice for the analyst; it is an
inevitable and continuous aspect of the analytic process. As
patients resolve their resistances to acknowledging what
they perceive interpersonally they inevitably turn their gaze
toward their analysts, who need to help them acknowledge
their interpersonal experience.
5. Establishing one's own subjectivity in the analytic situation
is essential and yet problematic. Deliberate or surplus self-
revelations are always highly ambiguous and are
enormously complicated. Our own psychologies are as
complicated as those of our patients, and our unconsciouses
are no less deep. We need to recognize that our own self-
awareness is limited and that we are not in a position to
judge the accuracy of our patients' perceptions of us. Thus,
the idea that we might
“validate” or “confirm” our patients' perceptions of us is
presumptuous. Furthermore, direct self-revelation cannot
provide a shortcut to, and may even interfere with, the
development of the patient's capacity to recognize the
analyst's subjectivity.
6. It is often useful to ask patients directly what they have
noticed about the analyst, what they think the analyst is
feeling or doing, what they think is going on in the analyst, or
with what conflict they feel the analyst is struggling. The
major way to reach this material, however, is through
analysis of the defenses and resistances that inhibit the
expression of each patient's experience of the analyst.
7. Focusing exclusively on the presence of the analyst and
on establishing the analyst's subjectivity does not permit the
patient temporarily to put the analyst into the background
and indulge in the experience of being left alone in the
presence of the analyst. This focus may be experienced by
patients as an impingement that disrupts their encounter with
their own subjective experiences. Instead of leading to an
intersubjective exchange, analysts' insistence on asserting
their own subjectivity creates an instrumental relationship in
which the subject- object polarities have simply been
reversed.
8. The exploration of the patient's experience of the analyst's
subjectivity represents only one aspect of the analysis of
transference. It needs to be seen as one underemphasized
component of a detailed and thorough explication and
articulation of the therapeutic relationship in all of its aspects.
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