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Dr Kenneth Winarick, training and supervising analyst of the American Institute for Psychoanalysis, presented an investigation of how “suggestions” may actually further insight if the inevitable transference enactments induced by suggestion are examined. Winarick presented excerpts from the transcripts of two treatments to show that apparent violations of neutrality may actually permit the adumbration of a core conflict and thus play a beneficial role in interpretation.
Winarick described Freud's initial use of explicit (hypnotic) suggestion as the means of cure, successful because it utilized the patient's “positive transference” or idealization of the doctor. But because the results were impermanent and limited, Freud then adopted the exploration of “unconscious objective genetic determinants” of a patient's neurosis as his method. By 1905, Freud believed that the two approaches were antithetical, though he later tempered his repudiation of the suggestive cure, commenting that for some patients it might well be necessary to alloy analysis with “hypnotic influence.”
Some questions raised by Winarick were: Is the distinction between analysis and suggestion so clear? Do we “protest too much” that our work relies upon analysis untainted by suggestion, because we suspect that suggestive influence will always operate within the realm of transference? Is it possible that suggestion might play a positive role within analysis? According to Winarick suggestion is not only inevitable, but also be a useful tool within analytic exploration, so long as it is brought into awareness and analyzed, to avoid the impermanence of the transference cure.
In expanding our awareness of suggestion, we consider the influence of the patient's transference and that of the explicit and implicit suggestions contained in the analyst's interpretations. Winarick questioned whether analysis can be conducted without occurring even subtle forms of suggestion. He cited analysts who have observed that it