Some Implications of Conducting Psychoanalysis as a Talking Cure*

Hyman Spotnitz's Modern Psychoanalytic approach, through which psychoanalysis is conducted as a “talking cure,” has profoundly influenced my understanding of how to function therapeutically with patients. Ultimately patients are helped to address and verbalize whatever is on their minds, including the full range of what they experience vis-à-vis the analyst and the analysis, especially experiences of negative impact. To this end, inquiry is favored over interpretation. Patients with implosive defenses are especially resistant to experiencing the therapist as the agent of fault—as the caregiving object who fails and disappoints. Instead, anger and hate are turned against the self. When such a patient feels safe enough to place the analyst in the position of “the object not protected,” the angry and hateful feelings that are unleashed may severely test the analyst's emotional resilience. Management of such “bad-analyst-feelings,” with clinical examples, is discussed. Also discussed are how a patient's transference predispositions are dealt with in the Modern Psychoanalytic approach; the use of the couch and how it favors an analysis that is conducted as a talking cure; and the problematic consequences that might ensue from the analyst's self-disclosure.