When interpretations are not enough: Interactions between the analytic pair, an intersubjective approach

Psychoanalysis today is increasingly turning its sights on narcissistic and borderline states, in which archaic forms of defense predominate and accordingly burden the analytic setting. Mental function suffers, and psychic pain cannot be experienced as a mental emotional experience. As a result, the whole situation tends towards the direction of enactment. In such cases, interpretations are not enough, at least on a primary level. Instead, there should be a possibly lengthy period of containment of this archaic nonverbal communication within the psychic space of the analyst in order give it meaning and subsequently remit it into the potential space between the analyst and the analysand in the analytic setting. It has been increasingly accepted by the psychoanalytic community that the analyst's response towards the analysand's transference is likely to contain elements that come from the analyst's own mental and affective processes. Such a holistic view of countertransference is open to acknowledging, and even embracing, the subjectivity of the analyst in the analytic process. The analyst's affective reaction toward and involvement with his patients, which is absent from the classic description of countertransference, turns the latter concept into a valuable and reliable tool for understanding severe pathology within an intersubjective frame of interaction. This paper presents the clinical case of a middle-aged man with narcissistic disorder and an incapacity to mourn. It describes the course of the interaction within the analytic pair that, in a setting of intersubjectivity, worked toward reconstructing the patient's sense of loss and absence.