Psychoanalysis: Practice and Technique

I suspect that international readers will find this a very North American issue of JAPA. Despite the enormous influence of Klein and Bion on the West Coast, the many reviews here of Kleinian books show mostly an appreciative, wide-eyed fascination—a stranger's hospitality—rather than a family entanglement (see Margulies's review of Mitrani). An issue on another topic—epistemology, theory of the mind, therapeutic action—might have had a more cosmopolitan flavor, and tapped a more worldwide concern.

Have practice and technique, then, become especially problematic for North Americans? Such a generalization is hardly warranted. Analysts everywhere contribute to all our discussions. But few would deny that North Americans as a whole are peculiarly unsettled on the question of the analyst's place. American analysts often seem as puzzled by their own role as they are by their patients' transferences. Colleagues abroad wonder why Americans can't just take the analytic set-up for granted and get on with the work. As though they were building analysis all over again, Americans wonder about neutrality … enactment … goals and who gets to set them … negotiations between analyst and patient … compliance, etc.—the topics that predominate in this issue of JAPA.

Why are so many North Americans obsessed in this way? Of course, the “widening scope” challenges settled customs (see Waugaman's review of Giovacchini), but this cannot be the root of American concern, for North Americans are not foremost in the theorizing about difficult patients, and, in any case, illness shows no evident demography.

Much of the answer is surely the inspiration and challenge offered by home-grown interpersonal and relational schools and their offshoots, as amply illustrated in the following pages (see Slochower's review of Frankel). And the lack of a deeply rooted intellectualistic tradition makes Americans more skeptical about theorizing, less proud of analytic interpretations, less enamored of language. Sha