On the Analyst's Noninterpretive Activities in the Clinical Situation

In recent years psychoanalytic practice has expanded to include the routine treatment of deficiencies in ego development. This has brought an enhanced interest in the analyst's noninterpretive activities because failures in child-hood relationships are among the analyzable causes of ego deficiencies and the analytic relationship is a model for understanding childhood relationships. But attempts to bring the analytic relationship into theoretical prominence have led to uncertainty within the analytic community regarding the effects of the analyst's activities on the analysis of intrapsychic conflict. There is a concern that excessive attention to the therapeutic interaction may support the analysand's or the analyst's defenses against observing unconscious drive derivatives. Frequently, analysts who have recognized the need for expanding psychoanalytic clinical theory to include an interactional point of view have pulled back from recognizing the full implications of that step.

The theories of psychoanalytic technique that focus on psychopathology, as if it is best understood as defined by problems of ego deficiency, propose that there is a current insufficiency in self-regulating psychological structure and that the analyst must play an active role in helping the analysand compensate for the insufficiency (Terman, 1984–1985) In these models of psychoanalytic therapy, the past is seen as a model for understanding current needs, whereas, in classical theory, the past is seen as currently active and represented by repressed unconscious fantasies. In these models of deficiency, cure comes from the reconstruction of failures in current relationships and from the internalization of the therapeutic relationship. In the clinical situation, when viewed from the perspective of structural deficiency,