Disclosure, Countertransference, and the Promotion of Usability

Analytic therapy in its most effective form provides the patient with the opportunity to reengage contact with derailed development and to rework the traumata emerging from failures in the earliest relationships. It is a treatment that is unique because it takes place within a dyad and enables the patient to establish connections with needed others and with the core of his creative and affective self. Informed by the humanism implicit in selfobject and object relations theories and by the two-party intersecting systems notions of the social constructivists, the contemporary therapist approaches his patient with a willingness to be informed and directed by that patient's needs. However beguiling as this situation sounds, the route to a new beginning or ultimate usability can often resemble an obstacle course strewn with blockades, misunderstandings, and frustrations.

This chapter addresses the dilemma of, in Mitchell's (1988) words, “the delicate balance,” that is, the problem of distinguishing genuine self experiences that have been sequestered and protected in the hope that a new and usable object will present itself and self experiences in which hope for a second chance has been lost, replaced by defensive structures that attempt to control a basically hostile environment. Beginning with Winnicott's (1960) depiction of the facilitating environment, one in which the mother appears to be under the infant's omnipotent control, I will briefly trace development through its transitional stages to the establishment of a core self, emphasizing the concept of usability. Application of these concepts to the clinical setting will conclude the chapter.

While we may have cleared our heads of the cramping restrictions and paralyzing dicta of the classic tradition, we quickly learn that most of our patients are quite chary about our preferments of a new available and usable object.