Listening for the Effects of Psychoanalytic Interventions

THE COMPLEXITY OF THE INTERACTIONS that take place in the analytic situation makes it difficult to elaborate the process in definitive terms. Dale Boesky argues (1990):

The psychoanalytic process cannot be defined exclusively in terms of outcome, nor can it be defined without reliance on highly abstract assumptions. … the singular term "process" should really be a plural term "processes" because the psychoanalytic process is actually an extremely complex hierarchy of sub-processes whose adequate description requires a diverse mixture of frames of references, levels of abstraction, theoretical assumptions, and descriptive observable phenomena (562–563).

None of us will deny the density of the psychoanalytic process. It should nonetheless be possible to bring a degree of coherence and clarity to Boesky's "complex hierarchy." I believe this can be best accomplished by comparing the distinctive features of various sub-processes, or approaches, which have been described in the psychoanalytic literature. A searching examination of their differences, as well as their similarities, should provide us with a means for looking at the psychoanalytic process in a more coherent manner. In this paper I will compare an approach which I frequently use in my own work with those described by Joseph Weiss and Arthur Sampson, and by Paul Gray.

I have described my own approach in my book, Childhood Dialogues and the Lifting of Repression(1991). In my view, the analyst looks for evidence that the analysand is attempting to make sense of and to use the analyst's interventions. I emphasize the importance for the analyst to be alert to his analysand's attitudes about engaging in the analytic work. Of course, the analyst pays attention and responds to the analytic material that suggests that the analysand is reluctant to become involved in the process. Yet, by remaining sensitive to the indications that the analysand is striving