The Negotiation of Affect

When I was in training—and I suspect the same is true for some Df you—an article that appeared over and over again on required reading lists was a piece by Edward Bibring, entitled “Psychoanalysis and the Dynamic Psychotherapies”.1 In it, he said that for the dynamic psychotherapies, that is, any psychotherapy drawing on the fundamental principles of psychoanalysis, there were only five basic therapeutic procedures—five things one could do in one's capacity as a therapist. He ordered them in a hierarchy, proceeding from the more suggestive and manipulative to the more essentially and strictly psychoanalytic. In order, the five were: suggestion, abreaction, manipulation, clarification, and, the place at the top was occupied by interpretation.

Interpretation is understood as interpretation of wishes, most especially unconscious wishes. To cast the therapist's role is this manner amounted to a restatement of the assumptions of drive theory, following the model of a dynamic unconscious. However, putting the matter in this way provides every therapist with the opportunity to observe directly the powerfully organizing function performed by the capacity to wish. There is never a time when one cannot discover some more relevant, more accurate reply to the question “What do you really want?”

As with everything Bibring wrote, the article was very thoughtful, conceptually tight and written in a highly dense, compacted manner. It was an extremely slow read for me, and it left a long and lasting impression. I am only now deciding that I don't think I entirely agree. Exactly why, may take another 25 years to sort out. The closest I can come is to say is that interpretation is simply not what I think of myself as doing. This is especially so when what seem to be the critical parts of the treatment process are taking place. I don't mean to say that I don't interpret. I do. Probably more than I should. I do it, often, when I don't know what else to do. But, more and more, interpretati