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    7 views9 pages

    Kris A4

    Uploaded by

    KeisukeIto

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    © All Rights Reserved
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    n RUDOLPH M. LORWENSTEDN ‘4 sun, eas The Pochowayie Treatment of Chien, Landon: Tage Publing Gos eds so Thee ond ihe Mahone of Drfente. London Hoge Pee, ‘me: Cone Burton to Pychosasn. New Yok: Bai & Livi, 2 rregmentof «ae of Hyer. Ca, Papen HL SNe Upon Cae of Obsoal Ser Cl. Papers, 1. + = Papers on Meiepycoagy. ‘The Uneanacions Call: Paper, WV, Gap. VE Neral Sepa the They of Dame Ca 1 "Fe Interpretation of Dremt, Landon: George Allen & oe ve rin, LIN Zea Th yams of Tree, Ca ape ‘Paper om Tehnue, Recommendations for Pye om the ‘omlgic Mth of Trsinet Call ape T, Gaps XEN tii cme the atu of Pci, On The Dymo he Care Ca Pape Chop AE glean, Reptin end eking Thewgh Cale Fp Cp satins on Trnfrence ove, Cal. Papers My Gag. a Si, Ramin the Ws of Peele Pry. a ape, Te uno Ly dna. New Yrs WW, Norn Co 1 Eis Terminale ond Internal, In. J. Po, XVI, 9p contractions i Ana Ca Papers V Chap. XXXI. com, erin The Thre HP of rma Ip Ia artikel Apenprton, tt Ze aS Meal ns of fe Phlgy Teeuarm, XX, 4 emp ner: go chology and Interpretation in Prcheanate There. "Pe coum, 3 gp Poeteane : 2: woremenan, sine! Remarguer str le fect dane te technique se wc, eect hun pe ee si, Mate Theory of edo Now Yak sau, sali Cheater dale” New So: o rete dnalyn™ New Yor: Orgone Insite Prem 18. emmy sun: PrehomaytieIetetion of ine Group of Rewocs Ts guaran “hrs in the Beker 198 Pore EGO PSYCHOLOGY AND INTERPRETA~ TION IN PSYCHOANALYTIC THERAPY ‘py JRNST ERIS, PHD. (NEW YORK) “While during half a century ofits history the development of foanalyis has been comparatively litle influenced by simul- Pitsous discoveries in other fields of science, the various appli- ‘atons of psychoanalysis have almost continuously influenced Gach other. Its in this sense thatthe history of psychoanalysis ‘Gin be viewed as a progresive integration of hypotheses. The Glearese interrcationship exists between clinical observations Sand the development of both psychoanalytic technique and theory (29, 24). The development of the structural point of view in peychoanalysis, Le, the development of psychoanalytic ‘go psychology, can profitably be traced in terms of such an Enterdependence. Freud was at one point influenced by his col- laborators in Zirch who impelled him to an intensified interest {in the psychoses, This led him to formulate the concept of nar- tisssm and thus to approach the ego not a a series of isolated functions but a8 a psychic organization, ‘The second group of linical impressions that favored the development of a structural peychology was the observation by Freud of individuals mot ated by an unconscious sente of guilt, and of patients whose ‘response to treatment was a negative therapeutic reaction, These types of behavior reinforced his conception of the unconscious ‘nature of sefreproaches and autopunitive tendencies, and chus feontributed to the recognition of important characteristics of the superego. ‘There i lite doubt that other clinical impres- sions to which Freud relerred during these years were derived from what we would today describe as ‘character neuroses'—cases in whose analyses the unconscious natue of resistance and de: fense became particularly clear and which, therefore, facilitated ‘rscncd ate pane on Techni Impiatos of go Pycolgy atte miner mating oe Aer Poyesanate Asotin, NewYork, Deco mine Vom he Child Say Cntr, Yale Univer Schoo of Medine 6 a formulations of unconscious and preconscious functions of the ge. However, these events were not fortuitous. Nobody can be. lieve that the clinical impressions of which we speak reached Freud accidentally, Surely Freud did not turn to the study of psychoses merely 1 engage in polemics with Jung, or in response {osuggestions of Abraham; nor ean it be assumed that his inter ‘xt in character neuroses was due only to an increase in the inci dence of character neuroses among his patients during the carly gz0's, and hence to a ‘psychosocial’ event (27}—though it ia probable that such a change of frequency distribution occurred. Its obviously more sensible to assume that a readiness in the ‘observer and a change in the objects observed were interacting, Freud's readiness for new formulations ie perhaps best attested bby the fact chat the principles of ego psychology had been antic pated in his Papers On Technique (78). Most ofthese papers Were written contemporancously with his fist and never com. pleted attempt at a reformulation of theory, which was t0 be achieved in the Papers On Metapeychology ‘The precedence of technical over theoretical formulations extended throughout Freud's development. It was evident during the 1890's when in the Studies in Hysteria® Freud reserved for himself the sec tion on therapy and not that on theory. Several years later, ‘when his interes in dreams and neuroses was synthetized, and the importance of infantile sexuality gained ascendancy, he was first concerned with a modification of therapeutic procedure: the ‘concentration technique’ was replaced by the technique of free aswociation (2a). Similarly, Freud's papers on technique ‘during the second decade of the century anticipate by implies tion what a few years later he was to formulate in terms of ego psychology. His advice that analysis should start from the sur- face, and that resistance be analyzed before interpreting content implies principles basic in ego paychology. This accounts for Tred (ith Bowe Studs Bpteria. Trandate by A.A Beil New ‘York! Neots sod Metal Deen Monograph se a0 PSYCHOLOGY AND EVTERPRETATION ” che watus of Frew papers on technique in prychoanalyie the fru! they have retained a pivotal posicon and mow tes sare echnique have illasated or conSrmed rather than {8 fed his ae fundamental precepts fone wrens Fresd's ‘fas to the Pychoanalytc Congress in Ddapes in 1938 (+), She bene sve oh et hat many cee poles con SEising the variation of techniealpreceps in cera types Sey fellas the whole end ofthe development that apres ‘Br taes to link prchoanate therapy to pstehotherapy in the ridden sense, were accurately predicted by Freud. ‘The devlop- ete which he predicted became posible, however, through the ‘Boy wstan that ego prychology opened tothe earliest and prob- Ty bese systema modifeatons of Prychoanalyie tech- hen the development of child analy by Anna Freud, the Jnhoanalyis of delinquents by Aichhorn and later to ome of Efe varour modifications of technique in the poehoanalytc treatment of borderline eases and poychose : "Not only di ego paychology extensively enlarge the sopeo poychoanalyc therapy, but ie technique of prychonalye of The neuroses undervent finite changes wader i impact ‘These change ae part ofthe slow and st times almost imiper capable proces of development of peychosnalytictechniqae fioated changes which constitute this development ae dif {0 sudy because what one may describe as change can alo be Mined fre a iene i ies a Iyts who share approximately the sme fundamental views may te due to many factors, howeven if we study the trends of ‘hanging atiuds, we are in a more favorable position. ‘Neither all nor most of the changes in prychoanalyie ech nique are comeaquences ofthe developmen of some arp of Pychoanaltic theory. If we reread Freud's older case histori, Fe find, for example, that the conspicuous iellectalindoct Tntion ofthe Rar Man was soon replaced by a greater emphasis (on reliving inthe transference, a shift which bas no apparent iret relation to definite theoretical views. Similarly, better understanding and management of transference was probably ‘ot initially connected with any new theoretical insight Tt was 18 EaNsT RIS a proces of increasing skill, of improved ability, in which Freud and his early collaborators shared,‘ not dissimilar to that process ‘ofa gradual acquisition of assurance in therapy which character izes the formative decade in every analysts development. But ‘other changes in psychoanalytic therapy can, I believe, clearly bbe traced to the influence of theoretical insight Every new discovery in psychoanalysis is bound to influence to some extent therapeutic procedure. The value of clinical presentations is that in listening to them we are stimulated to Teview our ov ‘nial experiences, evise our methods, and to profit—in what we may have overlooked or underrated-—from the experience of ‘others. To assess this influence of ego psychology itis necessary to recall the ideas which developed synchronously with or sub- sequent to the new structural orientation: the psychoanalytic ‘theory of instinemal drives was extended to include aggression, and the series of ontogenetic experiences studied included in ever greater detail preclipal conflicts deriving from the unique- ness of the motherchild relation. A historical survey of the psychoanalytic literature would, I believe, confirm that these ‘new insighes were having reverberations in therapy, influencing, however, mainly the content of interpretation and not the tech nique of therapy in narrower sense. A gradual transformation ‘of technique came about largely through better understanding and improvement in the handling of resistances. In interpret ing resistance we not only refer to its existence and determine its cause, but seek also its method of operation which is then reviewed in the context of other similar types of behavior as part of the defensive activities of the ego. Resistance is no longer simply an ‘obstacle’ to analysis, but part of the ‘psychic smiths pee a ny os mc {fatdy Grp Hors sr repro ery ena weds se to Bama Gh "This mrp do aoe apply to all odvidunle, The ration of theo ‘ting to terapate pele rai rm nai to aoa a ee ino viene spon mic to tse tn pinion mv ho which tye of ean pina 1260 PSYCHOLOGY AND INTERPRETATION 19 Gace which fae be explored “The term resistance then see uplenant conntation of 4 patent ho rss seen wh any at he patient's opponion, This ws the pletion of a change it -wiat may be decribed the Bima of ana none of his lt papers Freud (12) defended analy iter: penta aging the reproach of atbarinesexpeclly etn with estan; be dese in tal teeters sexo ieesnich, by te patient's sulnequent reaction, comectnes 308 fnterpreaons can be veiied. in doing so he sreaer ea of codperation between soa and patient and imple: 2h cava agntdicatrialy impo interpreations™ "That {lot mean tate pout or dab saya 0 aed ee icon of Ue patent any interpretation, But means (eth tne development of ego pycology a umber of ‘Outer inthe technique of imuerpretation have come sbout— Set Sindow changes characterise othe wor of ome ala 1h not of others bat changes tae conaeate asc of ads sents of pychoamalgi technsqe o pychoanalye theory ILLUSTRATIONS “To clarify issues, I cite first a simplified version of an incident in the analysis ofa six year-old boy reported by Anna Freud (6, pig). The visit to the dentist had been painful. During his nalytic interview the litle boy displayed a significant set of ‘Symptomatic actions related to this experience. He damaged tr destroyed various objects belonging to the analyst, and finally repeatedly broke ofthe points and resharpened a set of pencils. How is this eype of behavior to be interpreted? ‘ee nthe ing of Wein Rec (27,29 and of Anna Fea (6 The ‘line ven ten ton. Rose pen only $y bad othe gunn eoance oe ner tlhe sorting of wh Seber iced by Haran By Sana Trend, esane al ena Wace py) has ter raed pol ‘The interpretation may point to retaliatory castration, may strest the turing ofa passive experience into an active one, or may demonstrate thatthe ttle boy was identifying himself with the dentist and his aggression, All three interpretations can naturally be related to the anxiety which he had experienced, ‘The choice between these and other posible interpretations will clearly depend on the phase ofthe alysis. The first interpreta. tion, an ‘id interpretation’, is directly aimed at the castration complex. The second and the third aim at mechanisms of defense. The second emphasizes that passviy is dificul to bear and that in assuming the active role danger is being mas. tered. ‘The third interpretation implements the second by ppointing out that identification can serve as a mechanism of defense. It might well prove to be a very general mechanism in the little boy's life. It may influence him not only to react aggressively but to achieve many goals and may be the motiva. tion of many aspects of his behavior, “The interpretation that stresses the mechanism of identification is, therefore, not only the broadest, but it may also open up the largest number of new avenues, and be the one interpretation which the litle boy can most easly apply in his selfobservation. He might learn to ‘experience certain of his own reactions a ‘not belonging’ (Le, a8 symptoms) and thus be led an important step on the way toward readiness for further psychoanalytic work, ‘We did not choote this example to demonstrate the poten: Walities of an interpretation aimed at making the use of a ‘mechanism of defense conscious, but rather in order to demon- strate that the situation allows for and ultimately requires all three interpretations. A relevant problem in technique consists in establishing the best way of communicating the full set of ‘meanings tothe patient. ‘The attempt to restrict the interpreta ton o the id aspect only represents the older procedure, the one ‘which we believe has on the whole been modified by the change fof which we speak. To restrict interpretation to the defense ‘mechanism only may be justifiable by the assumption that the sot dntyng Nii ith te ps oth peemer bt it hi apres’ patent is not yet ready—a valuable pice of caution, though it avis that there isa tendency among some analysts to exaggerate ‘Sch eaution at times. It may also happen that though we care- fly resrice the range of interpretation the patient reacts as if te had not done so, While our interpretation points to the Mectaniam by which he wards off danger (e., identification), the next set of associations canses the patient to react as if we had interpreted his femininiey. A sequence of this kind indi- ites norinal progres: the interpretation concerns the warding ‘of device, the reaction reveals the impulse warded off INo truly experimental conditions can be achieved in which the efects of alternative interpretations can be studied. Com- parisons of ‘similar eases’ or comparisons of patents’ reactions Jp ‘similar situations’ help us to reach some useful generaliza- tons. The occasional situation under which somewhat more ‘proce comparisons can be made is the study of patients who ave a second period of analysis with a different analyst. The peed fora second analysis ino disparagement ofthe frstanalyst, for does it imply thatthe frst course of treatment was unsuc fesiful_ In several instances of reanalysis in which I functioned fs second analyet, the first analysis had been undertaken at a time when the problems of ego psychology had not yet infu fenced analytic technique, or by a colleague who (at the time) {id not appreciate its importance. The initial teatment had produced considerable improvements, but the very same prob lems appeared in a new light, or new relationships, when intr pretations of a different kind, ‘loser to the surface’, were fingered’. Ina few of the cases in which these conditions ‘existed, a published record of the fist analysis was available nd furnished some reliable comparison, ‘At the time of his second analysis a patient, who was a young scientist in his early thirties, successfully filled respected aca + voter appaen doainsty or Jump in Tecan, o ea eget and no enor desea by what Haann ste plage of ple ese pacing yen, acne By whl Reh gy Sox Gp ane sont carom Names (aod Aland demic position without being able to advance to higher rank ‘because he was unable to publish any of his extensive researches ‘This, his chief complaint, led him to seek further analysis. He remembered with gratitude the previous treatment which had improved his potency, dituinished socal inhibitions, producing a marked change in his life, and he was anxious that his resurmp- tion of analysis should not come ta the notice of his previous analyst (a woman) lest she feel in any way hurt by his not return ing to her; but he was convinced that after a lapse of years he should now be analyzed by a man. Hie had learned in his fist analysis that fear and guile pre vented him from being productive, that he ‘always wanted to take, to steal, as he had done in puberty. He was under com- stant pressure of an impulse to use somebody ese’ ideas— frequently those of a distinguished young scholar, his intimate friend, whose office was adjacent to his own and with whom hhe engaged daily in long conversations. ‘Soon, a concrete plan for work and publication was about to iaterialize, when one day the patient reported he had. just dliscovered in the Hibrarya treatise published years ago in which ‘the same basic idea was developed. Te was a treatise with which he bad been familiar, since he had glanced at it some time ago, His paradoxical tone of satisfaction and excitement led me to inquire in very great detail about the text he was afraid «0 plagiarize, In a process of extended scrutiny it turned out chat ‘the old publication contained useful support of his thesis but no hint of the thesis itself. The patient had made the author say what he wanted to say himself, Once this clue was secured the whole problem of plagiarism appeared in anew light. The ‘eminent colleague, it transpired, had repeatedly taken the patients ideas, embellished and repeated them without acknowl- ‘edgment. The patient was under the impression he was hearing forthe frst time a productive idea without which he could not hope to master his own subject, an idea which he felt he could not use because it was his colleague's property ‘Among the factors determining the patient's inhibitions in his work, identification with his father played an important part. re the ganda, ingle cen, dhe father ad Vale tris mak in hs Bld of endeavor ‘The pens sae nd poo to bono Hes, ont nd tha hey sein notable cr oud ony be fog, epodaced we Ng uh ener veatonbip with bin txts "The poe con ro paternal grea Wo in par determined by the vn ae geat and neal ater (grader) In i hse ipl conc with the far wan represented a ae uch books were weaponsandcongured books were ae ering cua Thir neste he wih aor the Ears pois, Ie eould be este to deine snr sancy when aged fur and five, the le boy wat Be cea ters companion on bing eps "The Wish Fe ager tlhe sneory of exchanging and cooparng Rees teled ith many dst The tendeny 10 ake SG sal was cael tnvogh my rutin 3 se ing ney and adleeence wi could be pnd a ay the dechive placement wast det” Only IR sf owen were tly incre, only ts one cool weecisee the ling had to De engined. At thi pint of (a pcpretion {ms aig forthe patents action. The ‘sent alent and he ery eng of ie lence ada pea fmifences “Then, vif reporg 4 sudden ight, he mid BED noon, wen I eave here, Sore hth, ad ore ‘Eerting to my ae T walktrough X Set see well {now ff sll bt auracie seman snd Took athe ‘Norn he window. In one ofthe rsaurans asl Sd Ered teh ti Tris now pauble to compare che ow apes of aay ap percha eft anlpi the connection beeen or gg reno and te inibion in bis work ad been recognized ‘A pet who daring puberty had wceaonally sole, any nto bola reed inter certnalsaen o plage. Since to him scvey wav connec with nealing, aenic fulaver mio pagan, be cma ceape fom the Pare eae inpubes through a fnseahing nkibidon of ia ig and hs tlc venture” Go) "The poin which the 4 vst aus second analysis daca concerned the mechan wed in Inhibiting activity. ‘The seconds of merpetaioy, therfore, implemented the Sint by ho grentr eonreenen bythe fat that ie covered lange mimes of deals of beavor sod thee fore opened the way to linking present and past tut sy tomatslogy and infale fanany. The erucal pola, ower, war the exploration of the surtace. ‘The problem was to estab Ish how the fesing, Tm in danger of pngaing, comet Bout “The procedure di not aim at divc or rapid ace to thei earoug ncerpretation, there was eran inal exloatny period, using which various pec of havior wesc etal dic, ‘Thi study started on ¢deseplive level and proved ‘radually to ecablth pial paterns of behavior, pracnt and fos” Noved fret were his Gia and admiing wide of Uther peopl ideas then the relation ofthese the panes tovn dean intins At is pot the eompsrion between the patient's own productivity and that of thers ad to Be tree ingest del then the pare tha such eomparsons had Played in his carer development could be Care. Tialy the distortion of imputing to thers his own ideas could he analy athe mechanism of give and tae’ made const The eplontry doeripion is aimed, thereto: taialy 2 cncoverngs dlaue methanom and wet ata coon The Sox penne enon stl hein wen this dente aod the patients sean i seal, at pet hich in the present context wil not be dscuwed i ny Jal epeatedyaincanel by Bavardiing. Tus bs ee fea 2 Wit grt Sty ace Lg ames pa neat rpc ee Toon athe vege amu fates” the pees pres mete eh Caro eben (ones re argc repr opaer e Sea ah gee ee ae ene yi ae ‘ere ib 4 danger that we shall nees arrive at conte knowledge of the infil ter od he elt may well bean ect interpretation of te matrl 100 PSYCHOLOGY AND INTERPRETATION 25 po motor sepa in ei ana resemble those which Doe rT lcci ins aingy sar ease Fe ae Chee enaeny to pian is fn ak Srt“~*S”w———— SS rtrtrs—S—=

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