Unintended Consequences of Psychoanalytic Training1

IN AN ANALYTIC CONTROL SEMINAR a psychotherapist with nearly 20 years of clinical experience is presenting a case. The patient previously had been in twice weekly psychotherapy with the same therapist but the presentation is about her first analytic hour on the couch. As the protocol is reported, one has the clear impression that the patient is getting increasingly anxious about her sense of abandonment in this new circumstance. While other themes can be discerned, the assessment of both the analyst and the members of the seminar is that the patient is becoming panicky about the apparent differences between this new way of working and the old. As her anxiety mounts, the analyst makes a comment that conveys to the patient a sense that, despite the changed circumstances, she is still with her in the room. The analyst's comment has a palpable effect and the patient settles down and discusses, in what appears to be a genuine and reflective way, her decision to undertake analysis at this point and what she hopes from it.

In the seminar there is much discussion about this intervention. There is a strong consensus that it very effectively helped the patient feel less abandoned and fearful. At some point in the discussion, someone asks whether this would be considered a psychotherapeutic intervention or an "analytic" one. As it is suggested by the seminar leader, an analytic intervention would have maintained a more inquiring stance about the patient's experience of abandonment and panic and would have been less directly reassuring