The Conflict of Power in the Analytic Dyad

In recent years the development of agency has become an increasing focus of analytic therapy across theoretical perspectives. The common experience of seeing the patient unable to take a psychologically active role in making change despite insight into unconscious patterns has frustrated clinicians and undoubtedly given impetus to the introduction of agency as a primary therapeutic goal. Less discussed are the concrete clinical implications that may follow from conceptualizing therapeutic action as agency. This is all the more important given the fact that the means by which we attempt to achieve this goal are the same as those deployed when understanding was regarded as the only tool of analytic change. Very few analysts still believe that making repressed material conscious is sufficient, but a gap remains between this awareness and clinical technique.

The hallmark of analytic therapy has always been interpretation, but if the analytic process consists in the patient's receipt of the analyst's interpretations, the patient is in a consistently passive position, and one wonders how agency can develop under such conditions. Or, to put the point in the reverse: how is the patient to become agentic from the passive position of absorbing the analyst's interpretations, no matter how accurate they may be?

To be sure, some contemporary analysts include the role of the relationship in therapeutic action, rather than confining therapeutic movement solely to the interpretive process. However, the problem persists, because the provision of a relationship can promote passivity to the same degree as a sole focus on interpretation. When the emphasis is on what the therapist does to or for the patient, the conflict between therapeutic intervention and the goal of agency is present. So, the dilemma becomes: how can the analytic relationship, with its focus on depth understanding and relating, facilitate the development of the capacity to take ownership over one's life?

Jessica Benjami