The therapeutic frame revisited: A contemporary perspective (original) (raw)
Related papers
Freud’s papers on technique and contemporary clinical practice
The International Journal of Psychoanalysis, 2019
has gifted us with an exciting new book, Freud's Papers on Technique and Contemporary Clinical Practice. The book is primarily a collection of Friedman's previously published papers, with the addition of a helpful introduction, three orienting prefaces, and a short end section. We have the privilege of following Friedman as he thinks through, with great rigour, depth, and insight, issues inherent to what Friedman sees as Freud's empirical discovery of the "strange" experience that is "the psychoanalytic experience … a novel state of unusual mental freedom" (1; all quotes in this review are from Friedman). The papers-now chapters-are beautifully written in prose that is non-technical, clear, and suffused with wit. However, they are not always easy reading. They require concentration and thought, as Friedman takes us into a question, leading us as he thinks it through, always considering and evaluating different alternatives that would challenge or modify his main point. Friedman tends to begin with a thesis, based on an aspect of the analytic stance. He develops it, and then moves to questioning it, often based on post-Freudian challenges. He then challenges the challenges, and ends with a conclusion that reaffirms the initial thesis (and Freud's thinking). The papers are masterful contributions, one after the other. Friedman's focus throughout is on how the analyst's "attitudes" (170) allow the psychoanalytic experience to unfold. He sees Freud's technical recommendations-abstinence, neutrality, and anonymity-as default positions for the analyst, "beacons" (142) within which he can establish and maintain the psychoanalytic phenomena that Freud discovered, and tolerate the necessary ambiguity and paradox that psychoanalysis demands. Friedman writes: "It bears repeating that most of those anti-analytic attitudes (the 'don't's) that Freud's Papers on Technique cautions against are normal social attitudes. It is the task of training to make what is perfectly normal feel inappropriate to analysts while they are at work" (224). Friedman stresses that Freud's technique papers are best understood as a whole. I will review Friedman's book in a similar way, looking at the whole book and his central argument as it develops through the various chapters. I will quote him frequently, so that the reader gets a feel for his writing. Friedman's first point is that Freud's Papers on Technique, as a whole, are a record of Freud's experience. "The technique is not deduced from a model of the mind" (4). Freud's recommendations of anonymity, abstinence, neutrality, etc. are not derived from his drive theory. Rather, Freud's book records "an experiment in the evocation of a certain state of mind; specifically, to see what brings about that particular state and what interferes with it" (3, original emphasis). Psychoanalysis was Freud's "discovery" (3) and the Papers on Technique record Freud's process of discovery. This is important because it allows us to think about Freud's technical recommendations empirically, as ideal positions that affect the unfolding of a psychoanalytic process. We can think, for example, of these recommendations as facilitating or interfering with a patient's capacity to "flirt" with a "virtual reality" (Chapter 9). We can also look at how different analysts balance or collapse the always ambiguous interplay of illusion and "reality," as a way of differentiating between analytic approaches, as Friedman does (150-151, 172-174, for example). Friedman uses Freud's Papers on Technique as the base of his discussion of the analytic stance, and the cornerstone of this base is Friedman's understanding of Freud's concept of working through. Friedman asserts, in three chapters offering close readings of Freud's papers, that Freud concluded that working through is the major mutative agent of psychoanalysis. Working through occurs "in a patient's private experience" (51). Working through is the
Keeping the Psychoanalytic Setting in Mind (2006)
My aim in this paper is primarily to present a view of the nature of the psychoanalytic setting. I shall begin by reviewing briefly the idea of the psychoanalytic setting as invented by Freud, which is largely unchanged in the current practice of psychoanalysis with adults; then I shall discuss in some detail an attempt by the Argentinian psychoanalyst José Bleger to elaborate this idea in his 1967 paper, and his use of concepts developed a few years earlier by his colleagues Willy & Madeleine Baranger; I shall then go on to consider the idea of the 'internal setting' in the mind of the analyst or therapist; finally, I want to try to open a discussion about the relevance of these ideas for child psychotherapy, by considering a case which has been described recently by Brian Truckle.
Trends in Psychiatry and Psychotherapy, 2013
Determining the indications and contraindications for psychoanalytic treatment seems crucial to achieve therapeutic success and improve treatment effectiveness. In reviewing the classic literature on the topic, aspects such as age, diagnosis, motivation for treatment, present moment in life, ability to gain insight, psychic suffering when seeking treatment, defensive behaviors, and frustration tolerance are clearly analyzed by therapists/ analysts when indicating psychoanalytic treatments. However, traditionally, most criteria underlying such indications date back to a time when the therapeutic relationship was viewed merely as a therapist treating a patient, with no regard to the therapeutic relationship itself. The goal of this article was to critically review the relevance and current adequacy of indications for psychoanalytic treatment, in view of advancements in knowledge on the analytic field. Considering cases that do not evolve as expected according to the indications, patients who are better suited to certain therapists, and therapist-patient pairs that modify their interaction over the course of treatment, the main question remains on how to identify the necessary elements in evaluating a candidate patient for psychoanalytic treatment, as well as the significant elements of therapeutic action.
Psychoanalysis and psychotherapy: A long and troubled relationship
International Journal of Psychoanalysis, 2005
The extended, inconclusive debate over distinguishing psychoanalysis and psychotherapy has been muddied by two underlying issues. The scientifi c identity that psychoanalysis claimed, leading it to affi rm that it was more than a treatment modality, was in confl ict with the actual therapeutic mission it assumed. Psychoanalysis was further hampered in those discussion by its internal confl icts over doctrinal purity; deviations for psychotherapeutic ends were vulnerable to the charge of dissidence. More recently, the debate has been clouded by the fact that newer candidates, by and large, can anticipate careers primarily as psychotherapists, driving a wedge between generations within institutes. The course of the debate and the problems encountered in it are affected by the formal relations between the psychoanalytic establishment and the health-care industry, including government agencies. In the long run, it appears to make little difference whether psychoanalysis is offi cially recognized as a mental-health treatment, as in Germany, or attempts to maintain its independence, as in the UK. Finally, as the debate appears to be winding down, the fate of dynamic psychotherapy is also in the balance. If in the past psychoanalysis seemed at risk of losing its specifi c identity, today dynamic psychotherapy is in danger as well.