On Coming to an Agreement about the Nature of Treatment

In the last few decades psychoanalytic technique has exploded in complexity and sophistication Although welcome, this development has brought with it a measure of confusion which is often masked by facile references to “standard” or “classical” technique. It is becoming clear, however, that there is no longer any such thing as standard technique (if there ever was), and that many principles that some of us consider basic are no longer universally taken for granted. One such principle is that psychoanalytic treatment is a collaboration in which the collaborators need to start with an understanding about what they are working on, and how their work is to proceed.

I believe that reaching such an agreement makes treatment easier; that failing to do so introduces unnecessary problems, and that, in some cases, the attempt to reach to reach an agreement about the nature of treatment may itself become the most fruitful treatment.

This is not to say that education is an alternative to interpretive work rather, the patient must be shown that interpretive work makes sense in order to undertake it optimally We may sometimes get away with “trial interpretations” from which the patient may infer the nature of the work; but nothing is gained by making our patients guess at what we are doing, and in many cases much may be lost

My understanding of psychoanalysis is that it is a technique for relieving suffering by helping the patient to an awareness of his or her own contribution to that suffering Historically, analysts have sought to identify what was uniquely analytic in order to distinguish our work from other therapies This has led to an emphasis on certain