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Sonnenberg, S.M. (1995). Analytic Listening And The Analyst's Self-Analysis.


Int. J. Psycho-Anal., 76:335-342.

(1995). International Journal of Psycho-Analysis, 76:335-342


Analytic Listening And The Analyst's Self-Analysis

Stephen M. Sonnenberg
In recent decades analysts in North America have been writing about the challenge of listening to
clinical material in ways which take account of the two person psychoanalytic situation. In that mutually
regressive setting, self-analyticthinking on behalf of the analysand is essential for many analysts, because
in it the analyst often relies on thoughts and feelings about conflicted and painful personal experience
better to understand the analysand's inner experience. Effortful introspection allows some mastery, at least
for the moment, of conflict which might otherwise prevent the analyst from thinking about and
understanding what his inner experience may be telling him about his patient's mental life. In this essay the
author describes the way an humiliating memory from his own childhood, recalled in response to his
patient's dream, served as a cornerstone of his self-analytic effort on behalf of his patient. Coupled
with self-analysis concerning his recent neck surgery, the analyst's self-reflections allowed him to be
sensitive to a critical development in the analysis. This way of working complements the more traditional
way analysts develop ideas from direct observation of the analysand in the consulting room.
In recent decades psychoanalysts in North America have been writing about the challenge of listening to
analyticmaterial. One viewpoint which has emerged is that analysts need to listen and think clinically in
ways which incorporate effortful introspection. The analyst is seen as a part of a two person psychological
situation, and must therefore be prepared to use himself actively. In this paper I shall report on experiences
in the course of an analysis in which my own self-analysis, in the service of my analysand, proved
clinically valuable.

Clinical case material


Mr A was an engineer in his mid-thirties. His parents were divorced when he was 5 and his older brother
was 7, and he lived with his mother until he left for college. His mother was physically abusive to him,
losing her temper and hitting him regularly. She constantly complained about her ‘digestion’, and the
patient's bowel functions were also acause for her concerns: she told him he had a ‘weak digestive track’
and, like his father, a ‘weak character’.
The patient recalls that as a child he believed his anal sphincter was ‘weak’, and feared that he could not
retain his stools between visits to the bathroom. During the early years in school he often uncontrollably
produced small, hard pieces of stool, and he would manage to let these pass down his leg, within his pants,
and drop to the floor unobtrusively in a corner of the classroom. This was apparently a regular occurrence.
There was otherwise no historyof loss of sphincter control in childhood and none of receiving enemas.
—————————————
An earlier version of this paper was presented at the Congress of the International Psychoanalytical
Association in Amsterdam.
(MS. received December 1994)
Copyright © Institute of Psycho-Analysis, London, 1995

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(MS. received December 1994)
Copyright © Institute of Psycho-Analysis, London, 1995

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The patient came for analysis after a particularly disturbing event involving his bowel. He had been
travelling abroad alone, by bus, and one day he found himself fearing that he was going to lose sphincter
control, and defaecate explosively all over the inside of the vehicle, at a time when he could not get off and
find a bathroom. He became very anxious and, because these fears continued for several weeks, he sought
my consultation at the end of his travels.
Analysis was recommended and, as it progressed, much was learned about this man's thoughts and feelings
about his bowels and their function. His fears of explosive bowel movements were found to be reflections
of profound fears ofloss of control, fears of committing acts of violence against his mother, father,
girlfriend, and me. We also learned that he desired anal penetration as a way of obtaining closeness with
his father, and empowerment through the deposit in his colon of father's ejaculate. Constipation, we came
to understand, was experienced as protection against the eruption of diarrhoea and anger, and the
emergence of behaviour which might include his being receptive to analpenetration and self-castration, the
latter so he could become a little girl better to obtain his father's attention and love. We saw, too, that in his
most masculine collegiate and postgraduate athletic achievements his secret wish was that he would be
noticed by his father, who would present himself to the patient for the first time in many years,
offering loveand support.
Now I shall offer material from two analytic hours. These occurred during the fourth year of this
man's analysis, shortly after he had experienced another episode of anxiety about the loss of sphincter
control.
Hour I
First Association of the Patient. The patient began his hour reporting a dream. He was in a toilet, shit was
all over his face, and he began to vomit shit.
First Association of the Analyst. As the patient reported this dream I remembered an unpleasant experience
from my own childhood. I was in the first grade, and I had been in a stall in a school bathroom when
a group of boys from an older class had entered the room in a rowdy frame of mind. They jumped in the air
to look at me over the stall door, shouted at me, and threw water at me from the space under the stall door.
In fact, I recalled, they threw so much water that they soaked my pants and underwear, which I then did not
wish to pull up. So I sat there on the toilet, after these boys left, feeling humiliated, hurt, enraged and
wanting revenge, powerless, and unable to return to class in my soaked lower garments. I wondered about
why I had this memory, and believed that my personal recollection of my humiliating childhood experience
was an effort at trial identification. This memory and thought, elaborate though they were, lasted a split
second.
Second Association of the Analyst. I next recalled a dream my patient had reported several months
earlier. He was in a bathroom stall at college, having defaecated in his sweatpants while on the athletic
field. He was covered with shit. Within the stall he tried to get out of his sweatpants and undergarments,
and clean them and himself, so as not to be noticed by his team-mates when he exited and threw his used
sweats in the laundry bin. I assumed that my recollection of this dream was my attempt to place the current
one in a context over time within the analysis. Thisassociation and thought again took a split second.
First Intervention of the Analyst and a Reaction to it by the Analyst. After my patient reported his dream,
almost at once I commented that this dream was not the first in which he was in a toilet covered with shit.
My comment, I noticed, came after the shortest of pauses—just a couple of seconds—and was made with
what was for me unusualspontaneity. I hadn't thought through my intervention before I voiced it, as I
usually do. But I promptly forgot about that characteristic of my response.
The Patient's Response and the Analyst's Reaction. My patient then commented that my memory was
incorrect, that I was remembering his report of a real event, which we had discussed a few months earlier.
When he told me that the event I recalled as dream material had really taken place, I remembered our prior
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discussion at once, and knew that my memory had played a trick on me. But I quickly forgot about
the error.
The Patient's Next Association. Next, my patient associated to his dream of the night before, noting that he
believed shit on his face and shit coming out of his mouth indicated his unease with his sexual and
aggressive desires, including his sado-masochistic masturbatory fantasies (in which he humiliated women
during sexual acts) and homosexual thoughts, his fear of the discovery of all this by me and his girlfriend,
and his chronic feelings of rage atmother, father, girlfriends, and me.
The Analyst's Inner Reaction. As I heard this discussion of the dream I focused on the patient's references
to shit: they represented his negative assessment of his sexual desires and his rage. I more or less ignored
his expression of fear of discovery.
The Patient's Next Association, the Analyst's Responsive Intervention, and the Patient's Reply. Then he
associated to a dream he had reported the day before, of a skull sitting atop an otherwise regular body. I
asked for his thoughts about that image, and he associated to neck surgery, and he wondered if
his dreams reflected his belief that he needs such surgery to rid himself of his vomiting of faeces.
He went on to say that in that dream there was a woman who observed his neck condition, and now he
wondered how she’d feel if he stopped vomiting shit without surgery. Would she believe it was possible to
control the condition without an operation?
The Analyst's Association. While he spoke of neck surgery I associated to my own recent neck surgery, a
cervical discectomy, of which this patient was aware. I remembered that before my surgery he had talked
of never wanting such surgery, despite a neck condition of his own. I again believed my memory about
myself was an effort at trialidentification, and that in his thoughts about neck surgery I was hearing
his superego and castration anxiety related to his sexual and aggressive wishes.
The Analyst's Observation and the Patient's Response. I noted to the patient that in speaking of not having
surgery and the vomiting stopping anyway he had expressed a wish to rid himself of his unwanted sexual
and aggressive desires, while avoiding neck surgery: both previously expressed sentiments. I constructed
this comment to touch the analytic surface; I thought it was specifically intended to allow him to focus on
those wishes and his guilt and anxietyabout them. He agreed, though he added that yesterday he had
spoken as though he’d continue to need it and even have it. The session then ended. I assumed that
this association, to how he might need surgery anyway, indicated the depth of his guilt and anxiety.
Hour II
The Patient's First Association. The next day the patient began by reporting a third dream, which he
referred to as the third of a trilogy. He dreamt that his step-father ‘messed up’ on a home building project,
which involved carpentry, and he begged his mother to acknowledge that this was so and that he was
correct in saying it was so. He even threatened mother to get her to side with him, acknowledge his
brightness and his step-father's stupidity.
The Patient's Spontaneous Associations to his Dream. There were many to childhood, when step-
father ‘messed up’ sinking fence posts, and when the patient expressed desires for mother to side with him,
especially after step-fatherentered the picture five years after his parents’ divorce. The patient added that if
now mother didn't take his side he feared he’d ‘lose it’, and kill her, step-father, and himself, by slitting all
their throats. He said this despite having minimal contact with mother at the present time.
The Analyst's Inner Reactions. I felt attuned to the patient. Here, I thought, the oedipal constellation was
clearly spelled out; I was sure his dream of shit reflected his typically regressive shift, through which he
expressed oedipaldesire and guilt in anal terms, and that his neck surgery dream showed his solution
in castration. I thought he saw his step-father as regressed, as ‘messing up’, as not being the man he was, as
only capable of sinking phallic fence posts incorrectly. I thought that by giving conscious voice to his
homosexual and sadomasochistic wishes, and to his fantasies of

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castration, he was enabled consciously to describe his oedipal feelings and appreciate his current intense
rage, and its roots in his oedipal past. I also thought all this had allowed him to be appreciative of his
regressive defences. In sum, I felt confident of my understanding of this analysand at this time. I thought
things were clear, I do not believe I felt overconfident or self-satisfied, but momentarily, at least, I felt as
though the matters of concern in the analysis were unambiguous. And so, for the rest of the hour, I listened
silently as the patient worked analytically.
The Patient's Further Associations to the Dream. He noted that this dream demonstrates the timelessness of
his rage, its boundlessness. He noted that when he feared a loss of sphincter control on the bus abroad he
felt as he does now: he was enraged and feared an explosion of shit as an expression of rage, feelings
which he could now recognise had been present on the bus and throughout his life.
The Patient's Final Association. He ended his hour noting that his thoughts of shit were related to thoughts
of sexualactivity, including coprophilia, as well as feelings of rage.

The analyst's self-analysis


I have previously described the systematic use of the analyst's self-analysis in the service of the analysand
(Sonnenberg, 1991, 1993b). Now I will convey in far more specific clinical detail than before how I engage
in that process, by describing what I learned the evening after the second of the two sessions described
above. I consider the process of thinking I shall describe to be a part of my ongoing self-analysis; it is a
way of thinking in which I engage regularly and with self-discipline (see also Sonnenberg, 1990, 1993a).
That night I began to self-analyse by thinking about my day, and my associations were drawn to my
recollection of the day before of my humiliating experience in the toilet of my grade school. Many
questions came to my mind. Why had I had that memory? Was it a trial identification? If so, why was that
the form of my trial identification? And why did I experience a trial identification at that time, anyway?
What was I trying to tell myself? And why, I next wondered, had I mistakenly thought of the patient's
earlier report of a real event as if it had been a dream, and spoken so quickly in that way?
As I considered this I realised that I had not thought of my humiliation in many years, and that even now,
so many years later, its recollection caused me great pain. I next had the thought that my faulty recollection
as regards my patient had transformed a real humiliation into an experience which was ‘only a dream’. I
wondered if my goal, then, had been a different sort of identification, one in which I magically took on my
patients real experience of pain and, through a further magical act of mine, made his pain unreal, so that he
would not hurt, not be in pain. I was aware of such magical wishes in my relationships with those to whom
I feel closest, and that this mechanism was one I often observed in analysands when they thought of painful
experiences endured by their children. So, I wondered, was I relating to my analysand as if I were
his father, and he my son?
I next associated to my recent neck surgery. I recalled that I had told this patient of my surgery, because
my medical problems required me to wear a cervical collar before the operation, because there had been
some absences on short notice, and because I had scheduled my surgery quickly and at a time not during a
vacation. I recalled that my patient had spoken of his own bad neck, and his fear of neck surgery. I thought
about his associations to his dream: they suggested an upward displacement, that his neck represented
his penis, the source of his conflicted sexual desire. Yet I wondered if it could mean something else. Why,
in his associations, had he thought about the possibility that neck surgery wouldn't be necessary? Was it
just because he feared castration, or might there have been some other wish there? And why had he dreamt
about a skull, a bony head on a regular body, in the first place? Why had he chosen that symbol to
represent his genitals, if that's what he represented by that dream element? I wondered, what was he feeling
about me?
Then I recalled that my patient had expressed a particular thought about me, together

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with a similar thought about mother, father, and girlfriend. He had expressed concern that I would discover
and fully understand his homosexual desires, and though these had frequently been discussed, they had
actually been out of focus in the analysis for a long time. I also recalled that we had spoken a great deal of
step-father's errors as a carpenter and fence builder, and his desire for his mother to take his side when he
complained about it. He feared ‘losing it’ and slitting the throats of mother and step-father, as well as his
own. I realised that my patient knew that for my surgery my throat had been slit, and I was struck by the
fact that he was identifying with me in his associations to his own neck and his own surgery, and in his
thought of slitting his own throat. I also realised that perhaps in thinkingof slitting the throats
of father and mother he was suggesting an equality: in his current state of mind they and I were one and the
same.
Then I considered that my patient had often expressed during these last two sessions how angry he was,
and that it was known that his timeless and boundless anger included me. I thought again about what I had
tried to tell myself with my identification with my patient in a toilet, covered with shit, and I realised that
for me, way back then, the person I would have wanted to help me was my father, and that perhaps I knew
that my patient was desperately conflicted about telling me something that had to do with feelings about
me as a kind of father. Then I recalled that prior to my surgery this patient, of all my patients, he had been
most fearful that I would die.
So I constructed an hypothesis. I wondered if my self-analytically emerging feelings and ideas about my
patient reflected my preconscious awareness that there were very powerful messages he was sending me:
he loved me; he wanted my physical vulnerability, as indicated by my recent need for dangerous surgery,
to be ‘only a dream’; he wanted to be penetrated by me and to be one with me; he feared I would abandon
him through death; he feared I would reject him because of his homosexual desires, and in that way
humiliate him; and he was furious with me because I had abandoned him and scared the hell out of him by
requiring surgery which he knew was very serious. I also recognised that the way his father had
humiliatingly abandoned him when his parents separated made these feelings that much more intense, and
the way his mother had humiliatingly abandoned him when she remarried did the same.
At this point there were two hypotheses which I had in mind. One, more grounded in direct observations of
my patient's associations within analytic hours, suggested a primarily positive oedipal formulation, though
there were also negative oedipal, pre-oedipal, and regressive anal components of importance. The other,
based more on a process of self-analytic self-reflection, necessitated by my conflicts over thinking about
my painful childhood experience and my frightening surgical experience, suggested that primarily on this
patient's mind was his negative oedipal love of hisfather and his loss of his father, and his feelings
of love and loss with respect to me. The original experience was traumatic, and it shaped the way he grew
from the age of 5. It had left him unprotected, and vulnerable to his often brutal mother.
I wondered about what I would hear when I next met my patient. Would he speak in terms
of castration anxiety and positive oedipal desire? Would he express his love for me, his experience of
recent loss, and his fear of future loss? Would he speak of both? Would what he spoke of represent
a defence against another set of concerns? Or would he actually move away from what he had been talking
about, to a subject which for some reason of defence, or wish, or both had moved on to centre stage?

More clinical case material


The Next Hour
The First Associations of the Patient. The next day the patient started his hour by reporting yet
another dream. He was lying on his back, on the ground, and a small girl rose out of his body. She seemed
to rise out of his abdomen, though his skin was not broken. She played with an adult who was observing
what was happening. In his associations he said the

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observer was me and his father, and he was the small girl. He said that he was a very smart fellow and
would figure out what to do, and then do anything required to get his father's love, and mine, and that
included turning himself into a little girl, or a woman who gave birth to a baby.
The Analyst's Response to the Patient. I was struck that the patient seemed to be focusing on his negative
oedipal wish towards me, and his father, and that my self-analytic reflections had permitted me to
anticipate this direction in which he may have turned. I believed that at this point in the analysis that wish
was possibly being expressed more explicitly than ever before, and that perhaps for the first time it had
been connected to conscious fears of losing me. Yet I also considered that this wish might primarily
represent a defence against his regressive anal sadistic rage, and his fantasies of oedipal destructiveness
which were developmentally connected to that sadism. His destructive fantasies were of course very
familiar to me, and I recognised that throughout the week he had expressed rage which might be thought of
as oedipal in origin, or the product of a regression designed to avoid oedipal wishes, or both. I knew that
those wishes and that rage had been directed at me, among others. I also knew full well that negative
oedipal wishes were very often employed as defences against positive oedipal conflicts, by this man and
many others.
I decided to ask him to elaborate on what he thought about his dream, without specifying any particular
element. I was aware that I could easily influence the direction of his associations and, prepared as I was to
hear negative oedipal material, I tried to remain as neutral in that regard as I could.
The Patient's Response. At this point the patient spoke more clearly than ever before about his love for me,
and reiterated his great fear that when I had my surgery he would never see me again, that I would die. He
associated to his father, to happy moments when he would sit on father's lap, before his parents’ divorce,
and to his terrible sense of the loss of father when the divorce occurred. For the first time he expressed the
view that his father had left to save his own life, because mother was so controlling and cruel. He seemed
slightly less angry at father for leaving than ever before. On that note the session ended.
The Next Few Weeks
Over the next several weeks the patient continued to express his love and longing for me, his wish that I
could be thefather-advisor he had never had. His wish for anal penetration by me, and fantasies that if he
had been a little girl he could have kept his father at home by offsetting mother's cruelty with a kind of
feminine kindness, were both expressed. He understood, as well, the connection between these two ideas in
his feelings about me. On several occasions he cried as he expressed his longing that I could be with him
always, whereas before he had not shed tears in the analysis. He also expressed for the first time
the idea that as he got well the end of our relationship would come, and he was sad about that, too.
Subsequent Analysis
This analysis went on for two more years. The patient continued to express positive and negative oedipal
wishes and conflicts, as well as wishes and conflicts reflecting regressive anal impulses. But the overall
focus did shift to the negative oedipal complex and, as these issues were worked through, his view of me
shifted from a man with whom he could best relate when he psychologically castrated himself, turned
himself into a girl who invited me to anally penetrate ‘her’, to a man whom he wanted as a fatherly advisor,
and in the end to a man who had helped him grow emotionally, a man he would miss, but whom he no
longer needed.
In his outside life he made many changes. He became a generative teacher of younger colleagues, and met
a lovelywoman whom he married. Shortly before the analysis ended he became a father, an event which he
experienced with pride and joy. No longer did he feel the need to be a woman and bear his father's child to
recapture his lost father: rather, he could experience the birth of his daughter and

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his own fatherhood with confidence and comfort.

Discussion
I hope that I have accomplished what I set out to do, which was to demonstrate in detail how my effortful
introspection in the service of an analysand complements the traditional way I listen and think analytically.
In accordance with that traditional model, I have listened to my patients with evenly hovering attention,
and drawn conclusions based on observations made in the consulting room. With the greater interest
in self-analysis which has emerged in recent years, knowledge gained from introspective efforts outside the
consulting room has acquired an ever more important place in my clinical thinking, and in the
clinical thinking of many colleagues (Gardner, 1983;Jacobs, 1991; McLaughlin, 1981, 1988, 1993; Poland,
1993; Smith, 1993). This newer way of thinking recognises the challenge of constantly monitoring the
many uncertain aspects of the two person psychoanalytic process, in which both members of the dyad
experience regression. It takes account of what happens to analysts when they regress in that way.
I believe that when analysts allow themselves to regress in the service of their analysands, allow
themselves to be drawn in various role responsive ways into the worlds of their analysands so as to
understand their analysands’ experiences more vividly, inevitable errors will occur and blind spots will
effect their work. That is because when we analysts work in that way we often rely heavily on our own
experiences to understand those of our patients, and it is then inevitable that our own conflicts about our
experiences will stand in the way of our understanding what we are trying to tell ourselves about ourselves
and our patients.
I cannot say that I would have handled the material this patient presented in the hours I have described
differently without my selfanalytic efforts, yet I believe that my introspective activity in this case allowed
me to hear something I might otherwise have missed, and integrate that into my general understanding of
my patient. I think that I was betterable to work with my analysand during these and subsequent hours
without inappropriately influencing the emerging data, one way or the other, because of my awareness of
what might be coming into analytic focus. I emphasise the word ‘better’, because I am in no way claiming
perfection as an analytic listener.
I believe that my relatively more attuned awareness of the clinical situation was possible because my self-
analysisgave me an opportunity to think about a mistake I made in recollection of a clinical fact, as well as
a potential blind spot as regards my patient's current view of me. That blind spot existed because my
recollection of my own feelings of longing for the protection of my father, which provided an important
clue to what my patient was experiencing, was painful for me to consider. Self-analysis made that painful
consideration possible, even as it also illuminated my related error in remembering my patient's real
experience as if it were only a dream. Conflicts over thinking about my fears at the time of my neck
surgery, and conflicts over thinking about how much at that time I longed for the protection of an all
powerful father, complicated my efforts to understand what was going on in this analysis, and further
made self-analysis necessary.
In my view, self-analysis is a useful tool in the work of many analysts as they explore the journeys of
discovery they share with their analysands. Many personal experiences like the one described here have
sensitised me to my own need to engage in this activity regularly; many discussions with colleagues about
their clinical work have sensitised me to the similar needs of others to engage in some form of self-
analysis.

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Article Citation [Who Cited This?]


Sonnenberg, S.M. (1995). Analytic Listening And The Analyst's Self-Analysis. Int. J. Psycho-Anal.,
76:335-342
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