The Quality of the Analyst's Attention

Compiled and edited from lectures on psychoanalytic technique given by the late Karen Horney at the American Institute for Psychoanalysis during the years 1946, 1950, 1951, and 1952. Further lectures in this series will appear in subsequent issues of the Journal.

The analyst's attention includes understanding and the taking in of observations. This is to be differentiated from the passive receiving of impressions. For the analyst, attention is directing himself—mind and body—to the whole being of the patient, with the purposeful view toward action (therapy). It is not only the application of intellectual energy. We are focusing on getting a feeling for the patient, for his uniqueness, so that his differentness no longer feels strange to us. This is of fundamental importance. There are three aspects to the quality of the analyst's attention—whole heartedness, comprehensiveness and productiveness.

The whole-hearted aspect of the analyst's attention involves observing with all one's capacities and faculties. Here we are listening, seeing, and feeling with our intuition, undivided interest, reason, curiosity, and specialized knowledge. This knowledge involves awareness of our own selves, generalized professional knowledge and experience, and all that we are aware of in the particular patient. We are focusing ourselves as fully as we can on all the patient's communications, verbal and non-verbal.

Whole-heartedness is an ideal state, an approximation of one's own personal equation. It is the faculty of not being distracted, either by our own deeper problems or by situations which have upset us acutely. The mind is the analyst's tool, as is the equation of our total personality, and we have the obligation to keep this tool in good shape if we are to do such concentrated work with it.

As an example, Horney spoke of feeling herself yawning and being terribly tired while seeing a patient upon her return from a vacation. Doing some quick self-analysis, she thought