Psychoanalytic Listening—With Special Reference to the Views of Langs

LISTENING TO A PATIENT HAS BECOME immensely more complicated and controversial since the days of Freud. His original conception was that the therapist listened with "free floating attention" and attempted to attune himself like a receiver to the transmitting unconscious of the patient as it revealed itself through derivatives in the free associations (Freud, 1962). As these derivatives or disguised presentations of the patient's unconscious conflicts and wishes presented themselves in dreams, transference material, and free associations, the therapist gradually formed hypotheses about the patient's unconscious thoughts and presented these back to the patient. This is a fairly clear-cut and time tested procedure, requiring the proper training on the part of the therapist and above all a minimum of countertransference interference with the therapist's capacity to assess the patient's data and to formulate meaningful and well timed interpretations and communicate them to the patient (Chessick, 1969), (1971), (1974), (1977a), (1977b), (1980a).

There are since Freud's time a number of extremely important additional and complementary conceptualizations which greatly help us in the understanding of patient material. All of these are controversial and in some of their theoretical preconceptions they contradict each other. However, they are quite useful in lending additional perspective to the patient's data and in helping us to form additional hypotheses about where the patient is at. Most of these assume that therapists are well trained and free of serious countertransference difficulties; that therapists are not suffering from a "core psychosis"; and that they are capable of making interventions which are not primarily a manifestation of their own needs.