Davide Lopez
English version of two papers published in "gli argonauti", XIV, 1-9; 85-101, 1992
The perspective
of the persona
on the countertransference
Whereas on the meaning of transference there is clearness of views and
substantial agreement, at international level, among psychoanalysts, freudians
and new-freudians, kleinians and bionians, lacanians and kohutians, the same
can't be said about the countertransference. Everybody agrees on the concept
that transference is the reedition, more or less dramatized, of past's
fundamental relationships. The accent, the emphasis, among the analysts and
among the different clinical and theoretical trends to which they belong, may
vary as to the contents and the preeminences of the libidinal-emotional levels of
the transference. However, to be true, even in regard to the transference it is
essential a discrimination, that just recently begins to appear and gather
consents and polemics.
There has recently been a heated debate in the British Psycho-Analytical Society
around a paper of Harold Stewart. This analyst, towards whom I feel empathy, has
held the view that even extra-analytical transference's interpretations are
necessary and promoting the therapeutic action of psycho-analysis. Thus, he has
extended the concept of transference, including in it those intercourses,
external to the analytical relationship, where we can equally see the
transference of essential relations of the past.
I personally consider the position of Stewart very sound; and I invite the
psycho-analysts to answer this question: what could be the difference from the
point of view of the nature and significance of the transference, if the
instinctual drives and the emotions of the past are transferred to the analyst
or to another person? What is relevant, it is just the nature and the
significance of the transferred relationship!
How important could the transference be, if it is, only and indiscriminately, an
artificial creation of psycho-analysis?
In this last instance, the critics would be right in stating that psychoanalysis
is a totally artificial construction, that is, in short, an artefact! From
Grecian times it has been understood that transference has universal meaning and
potentiality. Freud himself, who has repeatedly insisted on
the essentiality of the transference, as product of the analytical relation,
recognized that transference shows itself even in those love's relations that
reach depth.
I was, certainly, pleased that a courageous psycho-analyst has presented a paper
on the indispensableness of extra-analytical transference's interpretations,
facing polemics and disputes, that since long time did not take place in the
British Psycho-Analytical Society. But, from another point of view, since the
time of my analytical training in England, it was for me a completely clear and
irreversible concept, essential part of my clinical and theoretical tools, that
the transference shows itself, indiscriminately, in the analytical relationship
and in the intense emotional intercourses of the reality, and that it has to be
interpreted just where it appears.
In spite of his merits, we owe Strachey at least two serious handicaps, that
have caused clinical and theoretical slackness: the accentuation, not to say the
scientist and positivistic, deformation of the writings of Freud. For those who
know German, the freudian style is less scientific, more akin to the language of
the human sciences, and certainly more charged of emotional nuances, than the
way Strachey has tried to hand it down to posterity. Besides, he has gathered
the attention and the interest of nearly all the analysts on transference's
centrality in the analytical relationship, to the detriment of the natural
development of it in the extra-analytical relationships, as in the analytical
one. I don't wish to dwell on the deformation of the natural evolution of the
analytical relationship, caused by who sultrily insis s on the necessity to
reduce every interpretation to the relation with the analyst. At length, I have
spoken of it in Italian books and pages.
I rather wish to linger over this problem: what is the substantial difference
between the transference towards the analyst and that towards the love object?
The answer seems obvious: the analyst differs from the love object, as he is
able to interpret the twofold transference's manifestations. The
clinical-theoretical training and the libidinal-emotional position of the
analyst in analysis favours and permits, not only the dramatization of the
transference, but above all the comprehension and the transformation of it. The
considerable resistance of some analyst to accept such an easy differentiation
is
probably due to the anxiety of losing a privileged position. To a careful
analysis this anxiety turns out groundless. It is certainly very strange,
contradictory and paradoxical, that just those psycho-analysts that cling to the
concept of a rigorous setting, simultaneously, clutch at a compulsive position
of emotional privilege, rather than choose the really privileged position of the
empathic awareness. Such a discrimination and differentiation of
clinical-theoretical positions regarding the displacement of the transference
does not notch, however, the universal comprehension and agreement of its
meaning.
Let me, now, dwell upon the problem of the countertransference. I shall avoid to
consider sistematically the history and the literature on countertransference. I
was rather surprised to read in a recent paper of Samuel Stein (International
Journal of Psycho-analysis, vol. 72, part 2, 1991) that this Australian
psycho-analyst, a psychiatrist and a colleague of mine in London's Friern
Hospital in 1954, and in that time a senior student of the British
Psycho-Analytical Institute, assign to Paula Heimann the motherhood of the
concept of countertransference.
I think that every analyst knows that, starting from 1910 in The future
Prospects of psycho-analytical Therapy, Freud has mentioned the
countertransference, and more extensively has written on it in Recommendations
to Physicians practising Psycho-analysis (1912) and in On beginning the
Treatment (Further Recommendations on the Technique of Psycho-analysis) (1913).
Naturally, in that epoch the meaning of countertransference, expecially as Freud
was concerned, was identified, nearly entirely, with the reactions of .the male
analyst to the erotic-emotional transference of the female patients. In those
papers Freud invites the psycho-analysts to adopt a balanced behaviour between
repression of interest, inattention and insensitiveness to the transference of
the patient, on one side, and involvement and fulfilment of it from the other.
Paula Heimann has undoubtedly had the great merit to enlarge the concept to
include all the emotions and feelings of the psycho-analyst towards the patient;
the two papers of her (1950 and 1960) are really enlightening. Her
clinical-theoretical position can be better explained by what she wrote in 1950
paper: "The emotions roused in the analyst will be of value to his patient, if
used as one more source of insight into the patient's unconscious conflicts and
defences;... ". I remember Paula Heimann as a very intelligent woman, highly
cultured, very artistically minded and, above all, courteous. I owe to Winnicott
and to her my acceptance, as student of the British Institute of PsychoAnalysis.
Her defection from the kleinians in the second half of the fifties was much
talked about, and she was welcomed with, open arms in the middle group. I
remember also that, as soon as she stopped speaking in the Wednesday's scientific
meetings, immediately Hanna Segal went to the platform to sustain the kleinian
point of view, so as to make vivacious the debate. Naturally, the Heimann's
papers on countertransference, I think, are the result, not only of her lasting
experience with patients, but also of the enormous tension that she must have
sustained in her personal analysis with Mrs. Klein, and in the relations with
her analyst and the colleagues of the kleinian group afterwards. Faced with the
"rigorous" scientific attitude of Melanie Klein, for whom had little meaning to
speak of countertransference's feelings of the analyst, just because the
analytical relationship was reduced for her to the play of the projective and
introjective identifichtions of the patients, Heimann pointed out and asserted
the omitted area of the psycho-analyst's emotions.
Her theoretical position and her emotional inclinations were certainly
courageous in those days, but at the same time cautious and well balanced. She
declares her preoccupation to have given rise with her 1950's paper to an outcry
among psycho-analysts, and she is afraid of having been misunderstood and
identified with the technic defended by Ferenczi, where the pupil of Freud
claims the urgency to reveal and to show to the patients the libidinal-emotional
feelings and involvements of the analyst. Heimann rightly maintains that such a
technic results in throwing on the patient a further dangerous burden, that
makes more painful and difficult his emancipation. To the degree to which the
analyst is able to contain instincts and emotions, he can utilize them to
further deepen the analysis and to enhance the awareness of the patient.
It seems to me that the major difficulty that we find in meeting the
countertransference's problems is due not only, as somebody has maintained, I
think Racker, to the fact that the analysis of the countertransference implies a
review of the personal analysis and of the positions of superiority of the
psycho-analyst, but also, and above all, to the generalized absence in
psycho-analysis of the concept of the persona. This concept "for long time keeps
itself in its concealing", to recall a typical expression of Heidegger. The
psycho-analysts understand the persona, as something different from what I
understand. Polanyi, who perhaps more than others has neared the deep meaning of
the persona in his very interesting bo Personal knowledge (Towards a
postcritical philosophy), does not envisage the leap of libidinal-emotional
level that the model of the persona implies in comparison with the humanism.
Especially in Anglo-American culture, the persona is immediately identified with
the individual. The highest level of understanding reaches the representation of
the unique and unrepeatable meaning of the individual. The identification of the
persona
with the individual means, nevertheless, absorbing with the uniqueness and
unrepeatableness also the idiosyncratic, transient, episodic, ephemeral, sides
that belong to the concept of the individual.
The historical-characterological defence of the individual, strictly connected
with the Reformation, as it emphasizes the positive rights of the individual, is
forced also to accept the idiosyncrasies and the stupidities, the cavils and the
whims, of it. This obnubilation of conceptual differences, this loss of
discrimination, whose result is an ineludible overlap of meanings between what
is sound and sacred of the individual, and what is atypical, insignificant,
monomaniacal, dangerous and decadent, is in my opinion the reason that explains
the conceptual obscurity related to the countertransference.
The ambivalent position of Winnicott towards madness, where it seems that the
limits of it border on geniality, is due to the absence in him of the concept of
persona. His vigorous defence of the sacred rights of freedom of the individual
and his idiosyncrasy, that I myself share, towards everything that is
institutionalized, conventional and devitalized, and that tastes mouldy, stale
and "as if', has pushed him towards a defence of the originality, that
conceptually he has not been able to differentiate from madness. This defence is
felt by Winnicott, at deep level, as dangerous, and I perceive in his writings a
diffuse, preconscious, reparative, movement that gleams through in his
insistence on the importance of socialization, on his clinging to reality.
The concept of the persona is for me resolutive; and when I have found myself to
sink in libidinal-emotional conflicts, and in difficult clinical-theoretical
problems, suddenly the model of the persona appeared in my mind to offer me the
solution and to enlighten the path.
I then question: if we reduce the persona to the individual, how is it possible
to discriminate what is personal from what is personalistic, namely
idiosyncratic? And this, I think, is the reason why many analysts,
preconsciously or consciously, consider the manifestations of themselves as
personae in a rather undesiderable, negative, light. What is personal is
immediately identified with what belongs to the private life of the individual,
together with idiosyncrasies, perversions and follies (everybody has a right to
his private paranoia, used to say Freud). From this double register, from this
ambivalence of feelings related to the vindication of the sacred rights of the
individual, derives, simultaneously, the overestimation and the underestimation
of the individual, but also the inevitable banishment of what belongs to the
personal structure of the analyst and of his personal behavior. This
explaination gives account of the diffuse attitude, coloured of negativeness, towards the countertransference. And when, instead,
there is a vindication of the countertransference, here we find that this
vindication is strictly connected with whimsical and exorbitant attitudes, as we
can see in the continuous provoking, but dangerous, insistence of Searles on the
incestuous, criminal, homicidal, wishes of the psycho-analyst, or in some
disconcerting statement of Winnicott.
These considerations, I think, clarify the deep motivations of the scrupulous
clinging of the psycho-analyst to the rigorousness, scientificity and
objectivity, namely to the reductive identification of himself with the
professional man and the scientist. And so it has been perpetrated the
progressive dishumanization of the model of the psycho-analyst, clasped at that
scientific objectivism that Polanyi has ridiculed, in all the sciences in which
it appears, in his book.
From the beginning, the countertransference has taken on a negative colouring,
to the degree to which it interfered with the concept of the clean and clear
mirror, which should reflect, objectively and scientifically, the transference's
manifestations of the patient. What is personal must be eliminated and, if it
appears, must be, soon and accurately, subjected to washing and disinfection,
namely to selfanalysis, as if we deal with the most contagious illness. And to
secure the definitive warranty against the dangerous countertransference's
infection, we can observe the care that the kleinians, expecially Grinberg, have
lavished at sterilizing the analytical relationship from the
countertransference's personal feelings of the analyst. For Grinberg, the
countertransference is, above all, the product, the creation, of the patient.
But there is a hidden aspect, not seen by Grinberg: if we push the model of the
projective counteridentification to the extreme consequences, we can't avoid the
conclusion that the psycho-analyst must be a subject particularly sensitive to
hypnosis or, at least, to hystero-mimetic identifications. As we know, the
analyst in Grinberg's views identifies himself, unconsciously but healthily,
with the projective identifications of internal objects, but also with the
projected emotional self-states of the patient. Such phenomenon is so old, as it
is the world, and it consists in the potentiality that human beings have,
through the universal psycho-physical constitution, to perceive the modalities
of feeling and thinking of the other beings.
The projective counteridentification is, therefore, a fundamental capability,
highly developed, of the psycho-analyst. The preconscious of the analyst
functions, empathically, both towards the external world and his inner one, and
it is in close connection with what the patient is and does, and with what he
wants to let us feel and do. If we want to connote this capability with the
definition - projective counteridentification -, let us call it so, on condition
that we deepen the meaning of it.
The projective counteridentification, as a function of the psychoanalyst, has an
active and passive aspect. It is essentially a preconscious capability, refined
with years, and therefore it is not only the passive result of the
psychopathology of the patient. It is a highly empathic function that, if
absorbed in the area of the awareness of the analyst, is essential to his work.
But, even here, it is necessary a fundamental discrimination, regarding the
modality of function of this capability. It is necessary to take into
consideration the capacity to be present and the quickness of the analyst's
awareness to acknowledge the phenomenon of the projective counteridentification.
And, here, it is still essential the freudian concept of signal, or of anxiety
as signal. An analyst that functions as a persona can feel the depressive
identification with his patient, but seldom he will become really depressed, to
the degree to which his permeability is elastic, but it is also highly
selective. Differing from Bion, I maintain that the analyst is certainly a
container but he is also a filter. The relation of the consciousness with the
preconscious is in the mature analyst free and fluent, just because there is a
filter, highly selective, that allows the usage of the "pathos of the distance"
(Nietzsche), so essential to the construction of all human relations, especially
those with the patients. The analyst-persona will, immediately, avoid the
extreme swings from identification to disidentification, will not fall in a
hypnotic state and in a hystero-mimetic identification.
As a result of this analysis, we can reach the conclusion: when the concept of
projective counteridentification is unduly idealized, it can become highly
defensive. We can express the meaning of this defence as follows: it is far
better to ascribe to the patient the responsibility of the countertransference,
so as to save the sanity of the psycho-analyst, rather than to accept his
libidinal-emotional participation in the analytical interaction.
From another point of view, as to draw attention to the paradoxical position of
Grinberg, it is interesting to show that the conception of Searles is exactly
poles a pait. I think I can epitomize Searles' conception as such: the
psycho-analyst's unconscious is more than often responsible for determining the
projective counteridentification of the patient, and even his acting out. If
Searles goes too far as a second Christ, to take on himself the
libidinal-emotional countertransference's responsibility, Grinberg in his turn
distinguishes himself for an excess of de-responsibility. Against the loss of
sound defences from one side, and against the erection of an exaggerated
defensive system from the other, the position of Paula Heimann acquires all its
equilibratory meaning.
Let us resume the reflection on the persona. The persona is not reducible to
unicity and unrepeatibility. Truly, it is this, but it is also totality,
coincidence of singularity and universality, of temporality and eternity; the
persona is an individual, who is representative of the gender. The persona is
the satisfactory solution of the antinomies, contraddictions and paradoxes of
the history, just because it is a melodious recomposition of all the
libidinal-emotional splits, included the divine and the human. I don't want to
dwell further on the definition of the persona, because I have at length spoken
of it in books and papers.
I shall try, now, to utilize the persona's model to clarify the
countertransference. How could the persona renounce to be himself or herself,
namely a realized and mature individual, synthesis of singularity and
universality, discretion and continuity, temporality and eternity, and reduce
herself or himself to an individual, where the totality is arbitrarily
compressed and coerced in the partiality, so as to become, just a professional
man, a psycho-analyst-scientist? To be a psycho-analyst is the specialization of
the persona, it is its specific social functioning.
The psycho-analyst-persona enters from the beginning into the analytical
relationship with all his meaning and essential being, with his
libidinal-emotional, mental and formal potentialities. His more conspicuous task
is that of leading another individual to become a persona. Every manifestation
of egoistic and narcissistic tendencies, every irruption of idiosyncrasies, of
introjective and projective compulsions, of personalistic ideologies,
disintegrates the persona's quality of the psycho-analyst, interferes heavily
and dangerously with the interactions with the patient, and must therefore be
considered manifestation of neurotic countertransference, that is of personal
immaturity and obnubilation of its essential task and meaning of persona.
The persona's theory shows, therefore, that the word countertransference needs a
qualification, a specifying determination. Everything the analyst says and does,
when he manifests himself in a mature way in analysis, is personal, is
exquisitely personal. And what else could it be? If it was not so, he would be a
machine, a scientific observer, a smoked mameluke. And we can speak of neurotic
countertransference, when the analytic relation deteriorates from the personal
level to the personalistic one. And when all that the analyst says and does is
no more personal, it becomes "ipso facto" idiosyncratic, subjective,
personalistic, egoistic, narcissistic and neurotic, just because his word, his
gesture, and his way of being, are no more personal, which means the analyst is
no more present as a total being in the "hic et nunc" situation. His being and
his manifestations have undergone a process of corruption and decay. The analyst
has turned away, in space and time, from that relational tension, from that
emotional breath, from that present awareness, that is characteristic of the
persona.
Naturally, the relational tension in its more comprehensive meaning signifies
that the analyst is able to contain instinctual drives, conflicts, ambivalence
of emotions, and to change them in personal manifestations, functional to the
preservation and intensification of himself or herself as a persona, and to the
construction of the patient as such. After all, we can speak of a personalistic
or neurotic countertransference, when the analyst reacts, whereas he should act
or not act. To act or not to act means that the analyst is able to contain his
own emotions and those of the patient, to preserve and develop the freedom of
the interpersonal relationship. As we know, there are patients who can put to
the test the preservation of the libidinalemotional persona's quality of the
analyst, and they can cause neurotic or personalistic countertransference's
reactions. As many analysts have shown, if such reactions appear and disturb the
psychoanalyst's mind, they are not to be considered in themselves negative. In
such emergencies, it is necessary that the analyst trusts his awareness: "To
change the negative in positive", used to say Freud; "What does not kill,
strengthens me", said Nietzsche. From a great conflictual relational tension,
the persona becomes ever more herself. The persona enters in the analytical
relationship, not as an extraordinary individual, or as a sterilized and
dishumanized professional man and scientist, but as that alive being who uses
his knowledge, his talent and his wisdom, and also his preconscious, namely his
living computer, his rehabilitated, revived, reconquerred animal functions, his
wild strength, his intuition and his empathy, his restored harmony among the
different levels of his libidinal-emotional organization, but also his
spontaneity, his candour, and even his failings and his stupidity. The persona
knows that the truth is not objective, static, irreducible and alienated, is not
Sphinx-verity, but personal and interpersonal truth.
It would be of little meaning in a paper of so general theoretical perspective
to report entirely individual cases. The theoretical problems that I have
underlined require rather a description of that exemplary, typical, situation
that becomes evident in a crucial phase of the analytical treatment, when, for
example, a woman that has previously had easy, degrading and promiscuous
relations, or who lives a deep relationship, but of decisively sado-masochistic
character, succeeds for the first time to reach in analysis a level of
awareness, which makes her able to renounce to such previous relationship.
Through the interpretations she starts to acquire self respect and to
problematize her way of being and her erotical-sentimental and social
relationships.
But the level's leap towards personal genitality takes place, just when she
starts to perceive the meaning of the analyst, as a persona, and to confront the
model of the persona with the various personages with whom she has, till now,
lived her disintegrating relations. The relationship with the analyst,
recognized as a persona, and not simply as a transference's object, becomes
privileged, and it is just that level that allows the patient to disinvest those
relationships, based on sadomasochistic double roles, where herself and the
other don't exist as personae, but as simultaneous projections and introjections
of symbiotic and schizoid roles. It is quite evident that in the symbiotic and
schizoid roles relationships never could be reciprocity, but destructive and
rejecting narcissism, reciprocal exploitation and emotional impossibility of
being simultaneously together.
The transformation that happens in this phase is a real libidinalemotional
overturn of perspectives, a true overturn of the patient on himself, or on
herself; it is the result of the relational tension, namely of the analyst's
capability to use his countertransference, as empathic resistance, against the
patient's attempts of resignation and submission to the disease, of regression
and loss of every auspicate hope of salvation, but also as resistance against
the patient's efforts to displace and bring him down from his position of agent
of his or her more real interests of health and maturity, as to involve him in
the whirls of the illness.
The analyst is understood as a persona who is regulated by the awareness,
available if the patient is available, free to choose and to privilege his own
libidinal-emotional investments, irreducible and unconquerable in face of
whatever erotic and affective seduction, where the seduction is nothing else
than appropriative and omnipotent narcissism. The patient sees the analyst as a
persona who knows how to hold out and to be steady, who is empathic and even
emotionally sympathetic, when he moves towards the genuine suffering of the
patient, and knows also how to humorize the situations (Viederman, 1991), when
it is necessary to free the patient of his tendency to obsessivity and
sultriness, and who is, above all, hiddenly and deeply, human. This is the model
that the patient ends to choose and integrate; and the patient, in her turn,
becomes inaccessible to those affective and social relationships, that would be
reductive and disruptive of her so laboriously conquered persona's quality and
meaning.
Similar considerations we can do for the analysis of the male heterosexual and
homosexual patients. With regard to the last ones, the turning point appears
when they change from promiscuous to a deep
relationship with a subject of the same sex, who represents a parental figure,
where the relation may raise, sometimes, to a personal level. A relationship of
this kind, that in some cases leads to the withdrawal of the erotical
investments and to a true friendship, is often in time made impossible by the
unavoidable inherent ambivalence of homosexuality, where the ambivalence is
sustained by the impossibility of really true reciprocal complementarity, due to
the gender's identity (Rubinstein). Usually, an homosexual relationship of this
kind is the intermediate phase and the prelude to a further transformation of
the homosexual and to the passage to the heterosexuality.
This last happy resolution is due to the integration and identification with the
model of the persona represented by the analyst, and it is fairly typical of the
psycho-analytical history of some homosexuals.
I have so described that libidinal-emotional psycho-analyst's
countertransference's position that I have defined genital-personal. In the
personal countertransference the analyst functions, simultaneously, as a global
persona and as psycho-analyst, being available and participating constructively
to the analytical relationship, even when he experiences feelings of irritation,
annoyance, boredom, and even contempt, namely when he disidentifies with the way
of being and behaving of the patient. I consider these emotions, too,
expressions of sound and mature, in one word, personal countertransference.
To emphasize to what degree the genital-personal psycho-analyst's
countertransference's position, his positive disposition and his constructive
participation to the analytical relationship could be put to a hard test by the
aggressive and involving transference of the patient, but also by the
character's problems and the conflicts of the psycho-analyst, where there is the
danger of losing the meaning and quality of personal countertransference and of
deteriorating towards true neurotic or psychotic countertransference, I will
refer a crucial phase of the analysis of a female patient.
The patient, to whom I have hinted in a previous paper - The empathic Resistance
of the Psycho-Analyst -, and who has towards me a nearly steady positive
disposition of therapeutic alliance and of optimal transferential involvement,
where the dependance freely accepted is not submission, starts the session
telling a dream. An acquaintance tells her that my birth's date is the same of
that of the patient and that another psycho-analyst, known to both, is born in
the same month of the patient, precisely, in the same day of her lover.
I tell her that there is a wish of fusional identity between me and her and
between her lover and the other analyst. In this way she kills two birds with
one stone. Following these words, the patient has a sudden reaction of rage, and
accuses me to be biased and rigid, to
impose my interpretations, to destroy the welfare feeling that the dream had
given her, and finally, that I want to see competition and jealousy that she
doesn't feel at all.
The unexpected irascible reaction and the determined refusal of an
interpretation that I thought adequate and clarifying contents that had been
partially accepted and worked through, recalled to my mind that situation that,
following Wilhelm Reich, I consider a "typical basic character reaction". In
fact, whereas the behaviour of this patient is nearly always receptive, at
times, unexpectedly, when she is facing conflicts that touch on a tender spot,
she reacts with impulses of rage and with an obstinate refusal of
interpretations that are enough plain and self-evident. Mind you, this patient
is gifted with considerable intelligence and with introspective capability, that
sometimes border on obsessivity.
I notice in myself the rising of an irritation that gleams through the tone with
which subsequent interpretations are formulated.
In the meantime, the patient is becoming more and more angry and challenging.
Finally I tell her that her rage seems excessive to me, and if she doesn't like
my interpretations she can certainly do without them, but that she can't
nevertheless pretend that I should give her only interpretations to her liking,
namely that I should function as a compliant mirror, limiting myself to confirm
her self-analysis. Since every attempt to try to solve the conflict with
interpretations that would appeal to her rational ego doesn't get any result,
apart that of increasing her rage, I feel that the patient wants more and more
involve me in an enervating sado-masochistic interaction, the model of which is
well represented by the interminable polemics that mark the negative phase of
the relation in a couple.
I therefore regain fairly rapidly the position of empathic neutrality, and since
the session is ended, I tell her that we will better understand the conflict in
the following one. The next day the patient arrives with partly accusing, partly
self-defeating attitude, stating that, starting with her father and then with
the men with whom she had had eroticaffective relations, relatively few, indeed,
and finally with the previous analyst in an analysis of more than four years,
they have all been disappointing. She adds also that the relation with me is not
different from the previous ones. It is therefore better to resign, because she
doesn't want to delude herself anymore, as not to be completely deceived. I tell
her that she can't keep me responsible of her previous frustrations and
deceptions.
This observation immediately provokes the same emotional reaction of rage and
manifest wish to involve me in a sterile polemic, as in the previous session. If
I insisted on the same interpretative line,
I would lose my positive disposition and therefore the effectiveness and the
usefulness of the interpretations would decrease. Evidently, my interpretations
are interpreted by the patient, from one side as self-defensive, and from the
other as a compliant precocious attempt to humorize, convince and bring her back
to a positive and constructive disposition, that she from the time being hasn't
any intention to have towards me and the analysis.
So, I go back with my mind to what has been a typical character reaction of
mine, namely a sort of intollerance and irritability towards emotional
aggressive reactions, expecially of women, when they lose the way of rationality
and indulge with considerable complaisance in illogical, spiteful and childish
reactions. Once I used to think that, when we attain deep, oedipal and
pre-oedipal levels in the relation with a woman, we unavoidably bump, in periods
of conflictual tension, against the hard clog of the basic incomprehension
between man and woman, namely that nuclear situation that Nietzsche defined -
deadly struggle between the sexes -. As years went by, I became persuaded that
soon or later it comes out the woman's folly, which is concealed even in the
most apparently rational and comprehensive among them.
I gradually ended by accepting the possibility that there are two types of logic
(and, of course, of folly), a rational Aristotelic and Apollonian one, more
typical of the man, and an emotional and Dionysiac one, more specific of the
woman. With the passing of time I have, more and more, accepted and integrated
the libidinal-emotional and Dionysiac aspects in the model of the persona. This
recovered comprehension has allowed me to smile and relax in the session.
Therefore, after a quick historical re-examination of my countertransference, I
resume a position of calm empathy and I tell her with a quiet tone that perhaps
she has been irritated by the logic of my interventions, and that she wishes
instead to provoke and involve me emotionally in a closer relation. The effect
of these words is immediate. She tells me that it is probably so, and adds that
in the previous session she didn't tell me that she saw my wife, whose sight
made her jealous and envious, thinking of our life together, even in our
profession, expecially when she saw her calling her own patient. Furthermore,
she thought she was pregnant.
My preconscious feels waves of positive emotionality, coming from the patient. I
tell her that, leaving aside a wish to obtain my love and my exclusive
preference that we have analyzed, she can't accuse me of not having kept for
most of the time an empathic comprehension of her problems: I haven't abandoned
her, as the men of her past had done, starting with her father, and I am near to
her, searching after new and more satisfactory solutions. Moreover, if past
relations, to
start with her mother, even before her father, failed, the relation with me,
where the oedipal emotions, and not only oedipal, have been repeated and
dramatized, is still alive, and here and now, all the relational potentialities
are still at her disposal, to the degree to which she can, here and now, give
up, and this depends from her and not only from me, her disillusioned and
self-defeating behaviour, strictly connected to her need to possess people, as
if they were her own objects. And I add that just the conflictual dramatization
of the relation between her and me allows her to see that her construction as a
persona does not depend by destiny, by a negative fortune, neither from any man,
nor from the father, nor from the mother, but here and now only from us. Such
consideration can free her from the feeling of the overwhelming of the past, and
of its effect supposedly ruinous upon her. And so, whatever philosophers have
said about it, psycho-analysis shows that the past can be undone. At the end of
the session I feel that the patient, though hited, has recovered confidence in
the analytical relationship.
I have tried to describe a short time crack of what I prefer to define personal
countertransference's position of empathic availability of the psycho-analyst,
rather than position of empathic neutrality. This crack could have led to a
gross breaking off of the analytic functions, and to a relational conflictual
involvement, but has, instead, through a selfanalysis of the
countertransference, strengthened the capability of containment and
comprehension of the transference's meaning of the conflictual problems of the
patient. It has, in short, favoured awareness that is, always and
simultaneously, open towards the emotional problems of the analyst, and those of
the patient. The awareness, differing from consciousness, is always open towards
two versants: the inner and the external one.
The positive meaning of the acting-in of the patient, namely of her attempt to
provoke and break the position of the analyst's empathic availability, has been
that of putting to a hard test the function and the quality of persona of the
analyst, as to gain a greater emotional participation in the analytical
relationship. This participation can, in the long run, increase the analyst's
awareness and disponibility, and thus the potentialities of the analytical
couple. The persona and the persona-persona relationship, through friction and
increase of relational tension, reach and meet themselves at a higher
maturational level.
The analyst, who is a persona on his or her own account, becomes dynamically so
in the specific analytical relation with an individual patient, often and
paradoxically, through the negative transference of the patient. This is
probably the hidden meaning and concealed
purpose of the occasional and temporary conflicts in a couple*: to renew, again
and again, the love relation between two personae.
But, beside these analytical relationships, where, as a reaction to the
patient's transference neurosis or transference psychosis, the analyst may
become involved with countertransference's feelings or manifestations, there are
shaded areas of boundary between the countertransference feelings and behaviours
that I have defined personal, identifiable with a permanent, empathic and
constructive emotional disponibility of the analyst and the sliding down towards
a way of feeling and behaving that is personalistic, namely idiosyncratic, rigid
and compulsive.
All of us use the multeplicity of our personal qualities, capacities and
potentialities in relationship with the patient. But one of these positive and
constructive qualities, capacities and potentialities could be stimulated
unilaterally and could try to prevail and dominate the totality of the persona.
And this may escape to our awareness. So we would have the reduction of the
persona, of her exquisitely individual and personal characteristics to an
idiosyncratic, ideological, individualistic and personalistic way of being
equivalent to a neurotic countertransference acting-out.
As Sandler has shown, very often the transference-countertransference
relationship becomes established on the basis of the interaction between the
roles that the patient wants to impose on the analyst, and the roles that the
analyst personally prefers. Sandler thinks that the "ideal" solution for the
analyst is a sound compromise. Indipendently from Sandler, I developped over the
years the concept that I have
defined the play of the double roles.
I believe that the patient-analyst interaction is reducible to three
possibilities:
1) the Sandler's compromise between the roles that the patient wants the analyst
to play and the analyst's inclination to play the roles that he prefers;
2) the convergence (that should not be confused with Racker's concept of
convergence), as syntonic convergence between the roles ,that the patient
transfers or projects on the analyst and the positive inclination of the analyst
to play just those roles; 3) the divergence between the transferred or projected
roles of the patient and the negative inclination of the analyst to assume them
upon himself. In other words the relational tension swings in the analyst
between identification and disidentification.
I will present few quick examples.
* See also Kernberg: Aggression and Love in the Relationship of the Couple.
A psychiatrist, gifted with considerable intelligence and with a well organized
personality on a familiar and social level, tries to project and identify me
with a conventional role, as to share a normal and somewhat pedantic way of
looking at life, a way that I would define wise, but rather devitalized and
devoid of humor. I feel a slight annoyance for this projection, and attribution
of a model that is not one to my liking. In a case like this, it is necessary to
make a compromise. Little by little, this model that does not suit me and that I
accept for sometimes becomes crumbled, without giving rise to a real crise, by
interpretations, but also by some witty remarks.
As a consequence of my interventions, comes to light the nucleous of the patient
character structure. He had been forced, since he was a little boy, to adapt to
the model of a good, tidy, methodical, but above all patient and
overunderstanding boy faced by a severely depressed and plaintive mother, who
was, from time to time, capable of explosive rage and self-damaging fits. Since
he was a child, he gave himself the task to help and cure his mother,
compensating for a father who cared only little'!-of, her. The professional
choice was certainly based on his need, born in his chilhood, to cure and save
his mother. There was, however, a deep less evident layer in his character's
defensive structuralization. His grandfather was an anticonformist and
pleasure-loving man who dilapidated nearly entirely the considerable family
estate. To be good meant, from one side to satisfy his need to be patient,
honest, sober and overunderstanding with his mother, and from another, to avoid
the danger of an identification with his grandfather. Another component was the
need to offer to himself and to the mother an alternative model to that of his
father. The deepening of the analysis of the patient's character structure has
been prevalently due to the egodystony I felt towards the role that the patient
projected on me, that has compelled me to avoid the extremes, either of the
compliant acceptation of the role or of its refusal. In this case, I have made a
sort of compromise.
The second patient, a psychologist undoubtely very clever, who has a
prevailingly masochistic character structure, organized around what I have
defined narcissistic-masochistic collusion, from the beginning of his analysis
stimulated my tendency to use witty remarks that I considered equivalent to
interpretations; rather, the interpretations were given in a humorous shape.
In time, I became aware that there was a reciprocally egosyntonic coming
together, between the pressure of the patient to make me play this role, even
perhaps to identify me with the ideal model of the humorist and my particular
predilection for such a role and such a model. I became aware of the necessity
to contain my tendency to play
the role that I preferred and that the patient wished that I played, to the
point of provoking his frequent and unrestrainable bursts of laughter. By
containing my tendency, I became more and more aware that the humorist role is
just the one that the patient has adopted towards himself, as his privileged
character defence (the basic character reaction of Wilhelm Reich), in face of
all those situations that gave him anxiety, inadequacy and inferiority, but that
could also cause him grief and rage. It was expecially his father who used
humor, as his own character modality in face of the problems and difficulties of
life and that he administered to the patient abundantly, partly sadically as a
true leg-pull, but more often to mitigate the moments of discouragement and pain
of the patient due to the ambivalent character of an epileptic mother and to
sometimes difficult school situations. My countertransference tendency to
humorize every situation as a manifestation of a personal aptitude of mine that
met the projection upon me of a transference role and model, could deteriorate
towards personalistic self-indulgent sadism that would prevent the comprehension
of the patient, if the awareness did not intervene to modulate my tendency and
to integrate it in the totality of the persona.
The third case is that of a psychologist, whose initial analytical problem was
the need to be able to trust the person in relation with whom he could abandon
himself, a person, namely, that knew how to welcome his need of dependance
without letting him suffer traumata, frustrations and humiliations.
Shortly afterwards, I noticed that my positive and constructive disposition
towards him showed itself as an accentuation of my personal interest for
quotations taken from oriental sages, philosophers and psycho-analysts of the
past. This countertransference modality had a sudden and rather unexpected
beneficial result, so as to loosen the patient's resistance and to let himself
go in the analytical relationship. I became aware that this countertransference
tendency of mine, stimulated by the patient, could have become one-sided and
narcissistically inflated, at the expense of the totality of my being as a
persona and of a greater empathic sobriety. So I asked him if in the past there
was a person with whom he shared a pleasurable interpersonal atmosphere. He
remembered the pleasure that he felt listening to the tales with a moral shade,
narrated by his grandfather, and he remembered also the feeling of acceptation
he felt with him.
In this case, there has been agreement and syntony between a transference
exigency of the patient and a countertransference "penchant", derived from one
of my personal characteristics.
With a synthetical analysis of the three cases that I have presented, we could reach the conclusion that, in the
first case there was the analyst's intollerance towards the role that the
patient transferred upon and with which he tried to identify me. If however, the
resistance of the analyst to be identified with the transferred role was not
taken on by the domination of the awareness, it could have deteriorated and
become idiosyncratic countertransference and could have lost the potentiality to
become empathic resistance.
In the other two cases there was accordance between the roles transferred upon
the analyst and my tendency to identify empathically with these roles, on the
basis of a predilection for them. There has been, therefore, convergence. But,
even in these two cases, if the convergence was accepted "sic et simpliciter"
without the intervention of awareness, it could decay and become reciprocal
compliance and idiosyncratic, narcissistic self-gratification of the analyst. In
all the situations, therefore, awareness has intervened to control and contain,
both the personalistic convergence and divergence of the analyst. Awareness has,
hence, modified the countertransference's tendency towards spontaneism (unsound
spontaneity). To these modifications we could give the name of "sound
compromise" in Sandler's meaning, or choose another definition, as for example:
modulation.
From another point of view, the three observed situations could, perhaps, be
identifiable with three countertransference's possibilities: positive, negative
and personal countertransference.
I have shown, once again, how the concept of the persona is clarifying and
resolutive; awareness is the "forma mentis" of the persona.
I will now utilize the paper of Stein to develop and further clarify the problem
of countertransference. In his paper of considerable interest, Stein formulates
a clinical-theoretical consideration, that as far as I know has never been put
so clearly in psycho-analytical writings. He maintains that the
countertransference is much more due to the personal clinical-theoretical
structure of the psycho-analyst, than to the emotions, based on internal object
relations, which the patient could cause him. To exemplify his way of thinking,
I will utilize his own words: "The clinical implications of this paper are clear.
The idea that analysts have emotional reactions that are the direct and
immediate result of patients' interventions, pure and unsullied by our
personalities and theories, is refuted. Countertransference experiences need to
be carefully checked against the form and the content of the patient material,
the quality of the interaction between patient and analyst and all other
information able, to decide whether or not the patient motivates the analyst's
experience. If the patient does play this part, the analyst explores how the
patient stimulates the countertransference and what this means. The analyst
needs to be ever
vigilant that the utilized theory may influence the analyst's
countertransference and affect clinical judgement" (cit. p. 333).
The paper of Stein is definitely critical, and even subtly ironical, towards the
kleinian theorists, expecially towards the contributions of Bion and Grinberg.
He is, however, also critical towards the opposite tendencies, those that
emphasize the emotional reactions of the analyst, his complexes and conflicts.
He points at what, for conscious or unconscious reasons, we don't usually think,
namely, at the personal theoretical structure of the analyst and at the
consequent clinical application of this structure, responsible for the
countertransference. Utilizing a series of cases, among which that of the famous
patient (D and his double analysis with Kohut, he shows the undoubtful influence
on the patient of the analyst's reactions, due to his theoretical orientation.
Certainly, the defence and ideological promulgation, even at unconscious level,
of the analyst's theoretical position, must be taken in serious consideration in
the psycho-analytic interactions. However, the theory, when is not ideologically
and compulsively defended, is an essential part of the psycho-analyst persona.
There would be, here, a far too large ground of discussion about what should be
considered primary foundation, privileged factor, in the personality of the
psycho-analyst: his emotions or his theories?
And again, in this debate, the concept of persona would be resolutive, since
this concept privileges the totality, namely the inherent coherence between
theories and emotions. The discussion, however, would remain open, to the degree
to which some contending groups would consider valid, only, emotions and
theories that to other groups would appear inadequate, wrong, or even unhealthy
and unwholesome.
I believe that we live in an era, in which the task of the International
Psycho-Analysis is that of investing its emotional and mental energies to reach
a modulate synthesis that will not leave out of consideration the rigorousness
of differentiated scientific positions, of those, whose formulations are greatly
personalized, and of those who are committed and gathered, prevalently, around
shared clinicaltheoretical formulations.
As far as I am concerned the criticism of Stein to those analysts who are
unaware of their rigid and compulsive theoretical formulations, responsible for
the prevailingly ideological countertransference, is partly valid and justified.
It is, however, my convinction that, apart from the more or less acceptable
definition of Grinberg's projective counteridentification, the capacity of
perceiving, feeling and internalizing, the most subtle, shaded, projective
identifications fall within the definition of empathy, which is a peculiar
characteristic of the animal, and, even perhaps, of the vegetable kingdom. All
of us, apart the relationship with the patients, if our preconscious antennae
have not been coerced and crippled, feel the way the other people value and
judge us, the way they love and hate us. But if we are not sufficiently present
to ourselves, if we haven't developped our awareness, we would unavoidably end
by feeling, automatically, hypnotically, hysterically, unrecognized, devaluated
and put aside, or hypervaluated, idealized and exalted, so as to feel depressed
or elated. All of us, if our wild nature is not atrophied, and if in time the
conscious-preconscious relationship has been refined, will feel the negative or
positive judgement, the love and the hate, the appreciation and the contempt,
often silent and not declared, of our partners, and we will in turn enjoy or
suffer, but we will not fracture and crush ourselves, we will not lose the unity
and integrity of the persona. On the other side, we should not disregard the
clinical-theoretical contributions of Searles, his researches on the projective
conscious and unconscious activity of the psycho-analyst towards his patient,
which could be responsible for what I permit myself to define: "the projective
counteridentification of the patient", and for his acting-out. And it is just
with our strengthened awareness, that we could define - free and fluent
conscious-preconscious relationship -, that we perceive and understand that
nuclear split in our patients that, when it becomes manifest in analysis, could
be called "the play of double roles". My conception of the "double roles" is
similar to that of Sandler. The simultaneity of projective and introjective
double roles has not instead been taken in consideration from the kleinians, who
have so much urged on unilateral, alternating and solipsistic projective and
introjective activities.
But, if it is true that the analyst's projective counteridentification is, at
least partially, the creation of the patient, and Stein should have been less
critical towards the researches of Bion and Grinberg, just because they too can
be utilized for a more extensive and deepened comprehension of
countertransference, it is also true that the rather indiscriminate and
uncritical formulation of the projective counteridentification's concept, would
push the analyst to take a dangerous position of irresponsibility: the patient
is psychotic, the analyst is sane; everything the analyst says and does, even
the most over-elaborated, intellectualistically absurde, interpretation, if
justified from the theory, is always right. This is a dangeroyus-4~athway, where
the analyst meets solipsism and omnipotent irresponsibility. If the patient
suffers, year after year, the torments of hell, as Stein has been able to see in
a seminar's presentation of a case, it does not matter, as the analyst was
convinced that the analysis was proceeding, conforming to the theory.
All the analyst's maturity, his libidinal-emotional health and his awareness,
are engaged in discriminating what is projection, namely creation of the patient,
and what is due to the analyst's own hypersensitivity and susceptibility, to his
own emotional and ideological reactions. The projective counteridentification,
provoked by the activity of the double roles of the patient, inscribed in his
character's structure, could be exalted by the particular emotional and mental
hypersensitivity of the analyst, and even by his ideology, as Stein has shown,
or mitigated or even repressed by the insensitivity, smoothness and stiffness of
the character structure of the analyst, by his absence of empathy.
The analytical intercourse, sometimes, could be a meeting between two monsters,
between who has decided, on principle, that everything the other says and does
is manifestation of madness, and he who tries to show, stubbornly, cost what it
may, cost even the sanity, that he has always been right. But more than often,
it is the intercourse between a persona, who wants to lead the other, amid every
kind of difficulties and perils, to live and think as a persona, and another who,
in spite of conscious and unconscious resistances, ambiguities and conflicts,
preconsciously, yearns for becoming a persona.
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