A century after its establishment, psychoanalysis remains a young field, with analysts grappling to solidify its theoretical, scientific, and clinical underpinnings while drawing lessons from their experiences and mistakes. This paper responds to Friedman's work, “The Problem with Psychoanalytic Anonymity: The Obstacles Created by The Persistence of Traditional Technique.” This paper will also examine how neutrality, abstinence, and anonymity relate to objectivity and the historical and contemporary scientific influences shaping psychoanalysis.
In his paper on neutrality, abstinence, and anonymity, Friedman delves into the insights of psychoanalytic pioneers, underscores critical theories, engages in the ongoing debate about whether psychoanalysis aligns more with a one-person or two-person psychology, discusses the nuances of Transference and countertransference, and scrutinizes the dynamics and controversies surrounding the Training Analyst system. Considering the vastness of the subject matter, Friedman's exposition is sometimes impressionistic, even lyrical. I aim to distill some of Friedman's primary arguments along with my commentary.
Concerning psychoanalytic technique, Friedman notes, “At the core of Freud's triad of technical suggestions (effectively demands) is the analyst's anonymity, neutrality devoid of judgmental responses, and abstinence from transference gratifications.” Analysts traditionally operated under the assumption that adherence to principles such as practice, neutrality, abstinence, and anonymity enabled them to serve as objective and privileged observers. This implied that the analyst's personality remained detached from the analytic process, and their interpretations
aimed to address patient conflicts through an accurate understanding of the patient's reality.
Friedman (2020) underscores the real and tangible presence of the analyst in any analysis within these interpersonal and intersubjective contexts. The central argument put forth by Friedman revolves around the notion that, despite claims of substantial deviations from Freud's instinct-Oedipus complex model of psychoanalysis, the disagreements between traditional and contemporary psychoanalytic schools primarily exist on a theoretical level. In practical terms, many contemporary psychoanalytic schools still adhere to some form of the traditional psychoanalytic approach involving neutrality, abstinence, and anonymity.
Harry Stack Sullivan and Clara Thompson asserted that an individual's developmental environment plays a significant role in shaping them, introducing the concept of interpersonal psychology. Within this framework, they acknowledged the vital role of enactments in life and the analytic setting. Interpersonal psychology, which laid the foundation for two-person psychology, highlighted the active participation of both individuals in a relationship. They acknowledged that the analyst is either an active participant or a participant observer, making pure objectivity unattainable.
Friedman contends that the “price of protecting the Transference from being invaded by the reality of the psychoanalyst's personal life and character is to keep the analysis a one-person endeavor. The apparent two-person nature achieved by allowing the analyst to utilize his countertransference responses represents a pseudo-two-person entity; it looks like two persons, but it is, in actuality, two unconscious entities interacting with the analyst claiming to himself and to the patient the accuracy of his interpretation of the patient's transference, as well as his correct reading of his own countertransference.”
In this context, Friedman asserts that within contemporary psychoanalysis, despite the analyst appearing to engage in a two-person dynamic by recognizing and incorporating countertransference responses, the analysis fundamentally operates as a pseudo-two-person entity. The essential argument is that, in practice, it sustains a one-person psychology framework. The analyst maintains a privileged position, interfacing with
the patient's unconscious, affirming the precision of interpretations, and simultaneously upholding a degree of neutrality, anonymity, and detachment from the patient.
Friedman highlights that while Freud's Oedipal theories center on the psychology of post-infant childhood, Melanie Klein introduced an extensive theoretical framework that broadened Freud's concepts to include the pre-verbal early years of life—a period explicitly excluded by Freud from the scope of psychoanalysis. Klein emphasized the mental development of infants during their first year, exploring the paranoid-schizoid and depressive phases. This expansion enabled Klein and her followers to engage in psychoanalytic speculations about major psychotic disorders. Despite these theoretical differences, Friedman notes that Kleinian psychology remained aligned with the technique prescribed by Freud.
Similarly, Brenner and Arlow, operating within the framework of Ego psychology, defined psychoanalysis as a scientifically grounded therapy. They focused on uncovering the causal factors of human development and emotional conflict, highlighting the significance of compromise formations (Arlow and Brenner, 1964; Brenner, 1994). However, according to Friedman, these advancements did not significantly impact the notions of the analyst's anonymity. Instead, they further solidified the concept of the anonymous, neutral “very silent psychoanalyst.”
According to Friedman, “External reality was widely seen as irrelevant or even more likely the enemy of a true analysis. Hence, patients in a crisis, acute or chronic, were seen as not suitable for a continuing analysis of intra-psychic conflict, the very thing, or the only thing that really allowed a patient to be an analysand in the true sense of the concept. Any analytic treatment where the reality of the patient's life issues didn't fade into the background could be seen as a failure of selection; the analyst had simply taken the wrong type of patient into analysis. If an analysis was working the patient's thoughts, wishes and drives would be focused on the analyst.”
The idea of an external reality suggests that there is also an internal reality. This distinction between the inner and outer world is acknowledged by many analysts, who recognize the differences between the intrapsychic and interpersonal domains. Throughout history, the distinction between
external and internal realities has been the subject of much philosophical debate and disagreement. One way to comprehend this distinction is to compare the philosophical perspectives of naive realism and indirect (active-observer-dependent) realism, two different approaches to understanding reality. Naive realists assert a clear separation between external and internal reality, while indirect realists question the feasibility of such a straightforward separation.
In this essay, Friedman implies that the analyst's unconscious grandiosity or the fear of an erotic transference or countertransference might explain the continued adherence to neutrality, abstinence, and anonymity in contemporary psychoanalysis. He suggests that psychoanalysts, believing in their inherent understanding of a patient's situation, maintain a conviction that they know the true nature of the analysis, regardless of the patient's disagreement with interpretations. Friedman points out that this attitude risks the analyst assuming “omnipotence” within the analytic setting.
Friedman explores the relationship between neutral, abstinent, and anonymous analysts and the dangers of self-disclosure leading to the risks of a “slippery slope” to an erotic transference or countertransference. Concern about enactments has been with psychoanalysis since its early days. In the early years of psychoanalysis, Ferenczi recommended that analysts help patients overcome early emotional deprivation by gratifying their craving for love and affection, including hugging and kissing them. Freud was concerned that this kissing technique would lead to further erotic escalation.
What remedies does Friedman recommend for the persistence of neutrality, abstinence, and anonymity in contemporary psychoanalysis?
Friedman suggests that contemporary psychoanalysts must embrace their uniqueness and creativity rather than adhere to rigid rules and scripts that limit their engagement with each patient. He supports his argument by quoting Gabbard, who draws on Bion's idea that “The analyst you become is you and you alone, you have to respect the uniqueness of your own personality—that is what you use, not all these interpretations (these theories that you use to combat the feeling that you are not really an analyst and do not know how to become one”).
Friedman also cites Gabbard and Ogden (2009), who state, “Each time we start an analysis, we have an obligation and responsibility to become an analyst whom we have never been before. This requires that we drop the script and enter into a conversation of a type we have never before experienced.”
However, Friedman acknowledges that this is easier said than done and that many analysts struggle to overcome and change ingrained habits and expectations. Friedman concludes, “But, a great deal is left unsaid as to what dropping the script and entering into a conversation that is unique to each patient will involve or look like. On the surface, Gabbard and Ogden are saying something profound that expresses exactly what I am aiming at in this paper but without spelling out how difficult it is for most analysts to overcome the rules that they were taught as essential to being a psychoanalyst. The past, to paraphrase Faulkner, isn't actually dead, it isn't even past.”
There are significant differences between traditional psychoanalysis with the assumption of a privileged observer and contemporary psychoanalysis with an active participant observer in two-person psychology. They mirror the conflicts between classical traditional science based on absolutes, objectivity, and Positivism and modern science based on relativity, active observer, and complementarity.
Freud's Weltanschauung, or worldview, comprised a single intellectual construction and an explanation of the universe. This all-encompassing ideal hypothesis provided a comprehensive and internally consistent solution to all facets of human existence, grounded in observed phenomena and research, while rejecting revelation or divination as part of its method (Freud, 1933, pp. 170–171).
Freud formulated psychoanalysis in an era dominated by Cartesian dualism and Positivism. Descartes , with his “method of doubt,” established a dualistic framework asserting that subjects could objectively measure external objects without influencing them. Comte's (1855) Positivism further emphasized that verified scientific propositions lead to objective truths. These notions, inherent in classical science, significantly influenced early psychoanalytic practitioners.
Not only was the scientific observer assumed to be objective, but Freud believed that the patient could also become an objective collaborator. Freud (1893) said,
“By explaining things to him [the patient], by giving him information about the marvelous world of psychical processes into which we ourselves only gained insight by such analyses, we make him himself into a collaborator, induce him to regard himself with the objective interest of an investigator, and thus push back his resistance.”
Furthermore, Freud's (1893) view was that patients can learn… and adopt an attitude of “completely objective observation” towards the psychical processes taking place in them.
Freud, guided by objectivity and Positivism, integrated the principles of neutrality, abstinence, and anonymity into the foundational fabric of psychoanalytic technique. Freud considered these concepts, derived from his overarching worldview and the scientific ethos of his time, as crucial for preserving a rigorous and impartial analytical process. The analyst aimed to maintain a neutral stance to prevent bias or influence on the patient's process. By abstaining from satisfying any transference wishes that might arise, the analyst avoided interfering with the patient's analysis and allowed the unconscious material to emerge. The analyst's anonymity also created a safe space for the patient to project freely without interference from the analyst's personal characteristics or opinions.
In response to these influences, psychoanalysts embraced analytic neutrality, embodying the notion of the blank-screen anonymous analyst. This view held that the analyst should function as a neutral canvas onto which the patient projects conflicts and transferences. Many analysts felt that an objective and neutral analyst was feasible, necessary, and desirable, asserting that professional relationships could remain insulated from personal influences. Due to the analyst's role demanding anonymity, early practitioners deemed it unwise to disclose any personal details. This perspective engendered a technical approach in psychoanalytic practices. Analysts, in their clarifications, interpretations, interventions, and even in matters like billing, payment, vacation, sickness, and gift policies, draped themselves in a veil of neutrality to preserve the metaphorical blank screen.
The sciences underwent revolutionary changes at the start of the twentieth century, rejecting the objective observer, certainty, and the notion of an independent reality. For example, Edelman (1992, pp. 66–68) pointed out that classical science assumes an objective “God's eye view” by denying the observer's mind, consciousness, and intentions. In contrast to the omniscient perspective of classical God's-eye views, modern science explicitly acknowledges that each observer, based on location and personality, holds a specific perspective. Therefore, contemporary generalizations do not result in absolute or universally applicable statements; they are qualified and restricted by specific observations, observational methods, and the observer.
Edelman argues that a scientist's apparatus arrangement affects their measurements and outcomes, leading to modern scientific principles that recognize the active observer's role. Edelman has developed a framework for modern science that considers the active observer's (scientist's) mind, consciousness, and intention.
This abandonment of objectivity mirrors the revolutionary modern science discoveries, such as the study of subatomic events. Heisenberg (1958, p. 50) recognized that, in the subatomic sphere, there is no neutral observer; the scientist invariably influences what he observes, and that exact determination is impossible. Heisenberg discovered that an inevitable and somewhat uncontrolled mutual interaction exists between the observer and the observed. The apparent object under observation is not revealed in its intrinsic state but rather as a combination of the object's properties influenced by the measurements conducted by the observer. Heisenberg's principle states that every observation involves the observer and the object, which are theoretically inseparable. Consequently, a direct and independent observation of a designated object is impossible.
Bohr and Einstein engaged in a disagreement initiated in 1927 at the fifth Solvay Conference among physicists, focusing on their contrasting perspectives regarding the nature of reality. Bohr advocated for the concept of complementarity, positing that particles display wave and particle characteristics based on observation. Bohr asserted that, at the quantum level, entities possess only probabilities until measured.
In contrast, Einstein adhered to scientific realism, asserting that confirmed scientific theories faithfully depict reality. Einstein argued for a deterministic worldview, positing that physical systems possess objective properties independently of observation. He famously stated, “God does not play dice,” to express his dissatisfaction with the probabilistic nature of quantum mechanics (Skibba, 2018).
The central dispute revolved around whether the quantum realm was fundamentally probabilistic, as per Bohr's proposal, or whether an independent reality existed, as Einstein believed. This debate held profound philosophical implications for our comprehension of reality, determinism, and the role of observation in shaping the physical world. Bohr's and Heisenberg's perspectives, emphasizing the active observer and embracing a probabilistic nature, have proven extraordinarily successful in elucidating the microscopic world.
There is skepticism towards a naive view of reality in Western and Eastern philosophical traditions. Berkeley, for instance, rejects the notion of material things being independent of the mind or existing as separate substances. Berkeley (Downing, 2021) posits that there are no such mind-independent entities; instead, he famously states that “esse est percipi (aut percipere)”—to be is to be perceived (or to perceive).
In his work “Critique of Pure Reason,” Kant (1781) posited that space and time are not inherent attributes of the physical world; instead, they constitute elements of the mental framework essential for our experience of the world. Consequently, objects in space and time rely on the mind for their existence. This concept aligns with Kant's notion of the “phenomenal” world, representing the world as it appears to our perception.
Sankara, a philosopher of the seventh century, formalized Vedanta philosophy by positing the concept of Maya, which is the Self projecting its own attributes onto the world (Grimes, 2004). The concept of Maya involves the idea that the world is real, but as a phenomenal reality that depends on the observer. Therefore, we can only experience the world through the veil of our Self-consciousness. This projection of the Self to the world involves concealment (Avarna) and misrepresentation (Viksepa). A typical example explaining Maya is the rope and the snake illusion. When a person sees a rope and mistakes it for a snake, one
Avarna hides the true nature of the rope, and Viksepa creates an illusory false image of the snake (Raju, 1953). However, the perception of illusory snakes has causal effects if the person believes in them. Maya implies that the world cannot be separated from the Self and is always a reflection of some part of the Self.
Einstein steadfastly adhered to the concept of an objective and independent reality, a perspective that persists in numerous disciplines. Similarly, some contemporary psychoanalysts continue to practice based on the belief in the analyst's objectivity and neutrality. Schwaber (2005), for instance, emphasized this perspective, stating, “I felt secure in the knowledge that I had set aside my personal feelings, preserving my analytic neutrality.”
The resistance to the complete application of the idea of an active participant observer does not apply to analysts such as Schwaber. However, as Friedman notes in this paper, it does apply to many contemporary analysts who profess two-person psychology and the active observer and persist in notions of neutrality. For example, Galatzer-Levy (1991) states, “Self-psychology largely continues in a mode of naïve realism about entities like self, self object, and mind despite careful commentary that suggests more sophisticated positions.”
Wisdom drawn from atomic sciences and the accumulated insights from decades of analytic work suggests that in psychoanalysis as well, the observer plays an active role. Therefore, analysts must overcome resistance to change and acknowledge their own influence on an analysis and that they are active observers. Friedman notes that despite these intellectual developments in psychoanalysis, there is a persistent utilization of the notion of objectivity and anonymity, which he believes conceals desires for omnipotence (see below) and privilege, which can harm the patient's well-being and personal development.
Friedman observes that although Merton Gill underscored the significance of Transference, he acknowledged that the patient's perception of the analyst has some basis in reality. Gill (1994a, p. 47) states that,
“My thesis is that the therapist should embrace the principle that whatever he does or does not do is an action that will have its interpersonal [and intrapsychic] meaning, that he has a major responsibility to search
for this meaning, and, in interpreting that meaning, to recognize that his response (and here silence is a response) is a stimulus to bring about a response on the analysand's part. And the analysand's response will not simply be an irrational reaction without any basis in the ongoing interaction.“
Gill, a prominent figure in modern analysis, highlights the influence of analyst actions, including silences, as possible triggers for the patient's transference reactions. He also furthered the idea of social constructivism within psychoanalysis. Although he stressed the analyst's role in shaping the therapeutic process, Gill (personal communication) affirmed the relevance of an objective reality. He warned against “anything goes” in some forms of contemporary psychoanalysis, expressing the worry that such an approach could be a “slippery slide into solipsism.”
Similarly, Goldberg (1994) noted that the analyst is not an objective observer; instead, the analyst actively engages with the patient's inner world, seeking to unveil the meaning within the psychoanalytic context. The analyst is a participant who employs subjectivity, encompassing empathy and biases, in listening to patients.
After carefully studying the psychoanalytic process, many contemporary analysts have abandoned classical ideas of analytic objectivity, neutrality, abstinence, and anonymity. Many analysts focus on intersubjectivity, broadly exploring the co-created constructs emerging from the patient and analyst's mutually interacting selves (Stolorow et al., 1994; Stolorow, 1997). Ogden (2004), influenced by Winnicott's (1960) notion that there is no such thing as an infant apart from the mother, emphasized that clinical psychoanalysis is fundamentally an intersubjective process, relying on the relationship between the subjective reality of the analysand, the subjective reality of the analyst, and the intersubjective reality (the analytic third) created by the interaction of the former two.
Friedman suggests that the traditional model of the neutral, abstinent, and anonymous analyst carried an assumption of privilege. This positioning granted the psychoanalyst the belief that they inherently knew the true nature of what was happening with a patient, “no matter how much the patient found an interpretation to be wrong, irrelevant or
harmful.” According to Friedman, this attitude was fraught with the danger of the analyst assuming “omnipotence” in the analytic setting.
The God's-eye view proposed by Edelman, coupled with the certainty accompanying such an assumption and the grandiosity suggested by Friedman, implies underlying unconscious inclinations inherent in the notions of objectivity. These concepts indicate a perspective transcending individual subjectivity, providing a comprehensive and assured vantage point. Edelman's idea of a God's-eye view implies omniscience and certainty, and Friedman's reference to grandiosity hints at an unconscious inflated sense of importance and privilege. These unconscious inclinations could involve a desire for certainty and a sense of superiority linked to the belief in an objective, all-encompassing viewpoint. Examining these psychological nuances becomes essential in understanding how deep-seated, unconscious motivations may influence the pursuit of objectivity in various disciplines.
Gill advocated starting the therapeutic focus with actual experiences and interactions in the present moment. This approach diverged from a strictly one-person psychology (focusing primarily on the patient's intrapsychic dynamics) and moved towards a two-person psychology, highlighting the importance of the patient-therapist relationship.
Gill (1984) argued for a new definition of Transference, according to which both the analyst and patient inevitably contribute to the Transference. Gill's view, implicating both the patient and analyst in the production of Transference, contrasts with Freud's and a traditionally held view that the Transference was a product of the patient alone.
For example, Gill (1994a), following his new definition of Transference, developed a constructivist paradigm for psychoanalysis, and stated, “Analyst and analysand are in a continuous mutual interaction, each participating in shaping the other, and that not only is the knowledge of each about the psychic reality of the other being constructed in the immediate interaction but the assessment of previous interactions is likewise a construction. Neither participant can be unequivocal about the psychic reality of the other. The understanding each has of the other is always partial, selective, and seen through his or her own psychic reality.
The implications for technique of such a view are far reaching. They involve an essential recasting of every significant psychoanalytic dimension [p. 199].
In contrast to the earlier generation of analysts who believed in the effectiveness of the blank-screen approach for ensuring neutrality, analysts began to encounter surprises when clinical phenomena linked to the analyst's unconscious emerged. Analysts started acknowledging and exploring their episodic countertransference reactions to patients. For example, Lucia Tower forgot about a patient's session altogether, leading to a lapse in calendar scheduling, and she subsequently authored a groundbreaking paper on countertransference. Winnicott discussed experiencing hate in the countertransference. Analysts recognized the limits of relying on the blank screen. The analyst's unconscious and private life could unexpectedly make their presence felt in the analysis. The analyst's countertransference was no longer a private secret, but a phenomenon intertwined with the patient's Transference.
A traditional analysis views the patient's Transference and the analyst's countertransference, when present, as related but distinct phenomena attributable to the patient or the analyst, respectively. When countertransference (narrow) is evident in traditional analysis, it is episodic and indicates pathology in the analyst that impairs the analysis and necessitates some analyst's action. However, if the analyst detects no countertransference, he assumes he is objective, neutral, and reasonably error-free, providing the patient with accurate interpretations. Under such analytic conditions, where the analyst does not recognize his countertransference, exploring an analyst's bias is moot.
An analyst's assumption of objectivity and neutrality may be a dangerous illusion; without overt, undeniable evidence, analysts can continue to believe that their observations are unbiased. Such an assumption is often associated with the analyst's power and privilege. An unconscious collaboration between the analyst and patient may make it difficult for any analyst's bias to be detected and rectified. An analyst may consciously or unconsciously desire the privilege and powers of being a person of authority; simultaneously, it may also be the patient's conscious or unconscious wish to place the analyst in such an exalted position. The
patient will likely be unaware of, or hesitate to, challenge a traditional psychoanalyst when this dynamic is present. Thus, there is an increased risk of patient compliance or agreement with the analyst. Because its detection relies on the analyst's self-awareness, in such circumstances, the risk in a traditional analysis is for the narrow countertransference to go undetected.
Contemporary analysts assume that analysts and patients mutually influence participants-observers. Thus, the patient's Transference and the analyst's countertransference are intertwined. Therefore, the analyst's broad countertransference is continuous, not episodic. This mutual influence on the countertransference can be summarized thus: Analysts experience specific memories, emotions, and anticipations evoked by their patient relationships and interactions; these responses, in turn, shape their assessments, interpretations, and actions. When an analyst employs the notion of broad countertransference, the analysts must continuously account for influences and uncertainties introduced by the active participant-observer analysts throughout the analysis. In contemporary treatments, the patient and analyst views help provide complementary perspectives. The patients' and analysts' perspectives may overlap or conflict in different areas. The patient and analyst, when feasible, collaboratively negotiate a shared understanding of a psychoanalytic event. Sometimes, they may agree to disagree, leaving the matter open for further resolution. The analyst cannot unilaterally decide its meaning.
Contradictions at times marked Freud's practical application of psychoanalysis as he sought to navigate a balance between rules he established for psychoanalytic technique and the foundational principles of analysis. While Freud articulated stringent rules governing psychoanalysis, he also presented numerous case examples grounded in psychoanalytic principles that, paradoxically, deviated from his own prescribed rules of technique. This tension reflects Freud's ongoing exploration and adaptation of his theoretical framework in response to the complexities of
I thank Neal Spira, M.D., for his valuable suggestions concerning the section on Psychoanalytic principles and the assessment of Wild analysis.
clinical reality. His followers faced a challenge: how to reconcile these two aspects of his legacy? If they focused on the rules, they would encounter a clash between technique and principles. They would honor his spirit of freedom if they accepted both or gave more weight to the principles and adjusted the rules of psychoanalytic technique to fit the case.
Freud described a rule of his practice, and then adjusted it as follows, “I work with my patients every day except on Sundays and public holidays—that is, as a rule, six days a week. For slight cases or the continuation of a treatment which is already well advanced, three days a week will be enough” p. 127. In the same paper, Freud cautioned against rigidly applying his rules, despite advocating for them, and wrote: “I think it is better to call these rules ‘suggestions’ and not demand any absolute adherence to them. The great variety of the psychic situations involved, the flexibility of all mental processes and the abundance of influencing factors resist any mechanization of the technique [italics mine]” p. 123.
Another aspect of the psychoanalytic technique involves the use of the couch. Freud (1912) revealed a personal motif for choosing a couch as the tool for psychoanalytic treatment: he did not like being gazed at by others for long periods. Analysts often attempt to adhere to the rules of psychoanalytic technique, such as frequency, couch, neutrality, abstinence, and anonymity. Eissler (1953) noted that a parameter, a necessary departure from the standard psychoanalytic technique, is introduced when the basic model technique proves insufficient. General criteria for introducing a psychoanalytic parameter include (1) its use only when the standard model falls short; (2) ensuring it never exceeds the necessary minimum; (3) using it only if it eventually self-eliminates, concluding the treatment with a parameter set to zero. 4) Retrospective interpretations are the optimal tools for removing the effects of using a parameter. The dictates of psychoanalytic techniques and parameters have contributed to the practice of psychoanalysis.
Arnold Goldberg (1990) argues that the traditional foundations of psychoanalysis are so restrictive and restricting that they theoretically, institutionally, and educationally imprison psychoanalysis and the analyst. The frequency of sessions and the extended use of the couch became established prerequisites for psychoanalysis. Consequently, many analysts considered a treatment that effectively delved into unconscious
and Transference processes but deviated from these technical norms as not genuinely reflective of psychoanalysis. Friedman's paper, addressing neutrality, abstinence, and anonymity, sheds light on another aspect of the pervasive and damaging results stemming from some psychoanalytic techniques.
The history of psychoanalysis reveals that the considerations of psychoanalytic technique determine deviations from the norm. The characterization of a “wild analysis” has often revolved around discussions of technique and parameters. At times, deeming an analysis as wild has involved dismissing a treatment due to its incorporation of interpersonal considerations rather than focusing solely on intrapsychic factors or including elements of psychotherapy.
What measures have analysts taken to address the prevalent overreliance on psychoanalytic techniques and their mechanization, which appears to have constrained them?
In keeping with the need for flexibility in psychoanalytic techniques, Freud was not always consistent with his rules for psychoanalysis. Freud displayed a sparkling freedom from his rules of psychoanalytic rules. For instance, Freud (1909) recounted the analysis of Little Hans, wherein the boy's father communicated with Freud and conducted the analysis. Despite meeting Little Hans only once, Freud labeled his efforts as an “analysis.”
Freud's “Wild analysis” discussion may point to another principled direction: a proper appreciation of psychoanalytic principles over preoccupation with psychoanalytic technique. Freud (1910) recounted the case of a divorced woman who had sought his opinion after being dissatisfied with the vulgar counsel of her regular physician, who had claimed to be applying psychoanalytic principles. The physician had suggested that the woman's anxiety would only be alleviated by either reconciling with her ex-husband, engaging in an affair, or resorting to masturbation.
The woman opposed the doctor's suggested cure because it required her to enter into a liaison or to masturbate, both of which were repugnant to her on moral and religious grounds. She was unwilling to return to her former husband.
Freud maintained that analytic interventions are wild unless the analyst meets two preconditions: Firstly, the analyst must have already conducted a sufficient preparatory analysis of resistance to bring the repressed material very close to consciousness. Secondly, the analysand must have already formed a transference attachment to the analyst, ensuring they do not flee from the analysis as the repressed material emerges.
In this example, Freud exposes the poor and erroneous use of psychoanalytic concepts by the woman's regular doctor. The doctor's recommendations are superficial and inadequate, failing to capture the complexity and richness of proper psychoanalytic practice. They also show a distorted and misinformed application of Freudian principles. This anecdote illustrates the kind of “wild psychoanalysis” that Freud denounced—cases where individuals, without a solid grasp of psychoanalytic theory, provide simplistic and potentially harmful interpretations and advice to those seeking psychological help. Furthermore, this illustration underscores Freud's recognition of the significance of the patient's perspective and its role in assigning value to a treatment. The analyst must include the patient's perspective in his assessment.
Freud's concepts regarding the criteria for determining “wildness” appear most relevant for guiding analytic thinking according to the principles of analysis rather than technical elements that may vary from one case to another. Freud's definition of “wildness” is not contingent on factors like the frequency of sessions, the use of the couch, neutrality, abstinence, or anonymity. Instead, it is grounded in considerations of unconscious processes, transference dynamics, and resistance factors.
Freud (1914, p. 16), stressing the principles of psychoanalysis, stated:
“It may thus be said that the theory of psychoanalysis is an attempt to account for two striking and unexpected facts of observation which emerge whenever an attempt is made to trace the symptoms of a neurotic back to their sources in his past life: the facts of Transference and resistance. Any line of investigation which recognizes these two facts and takes them as the starting point of its work may call itself psychoanalysis though it arrives at results other than my own.”
To emphasize the lasting value of these principles and the role of unconscious processes in guiding psychoanalysis rather than fixed rules of technique, I (Sripada, 2015) defined Essential Psychoanalysis as any line of treatment, theory, or science that recognizes unconscious, Transference, or resistance and takes them as the starting point of its work, regardless of its results.
This definition of psychoanalysis is limited to clinical analysis, which aims to understand and assist the patient. It does not address training analysis, which balances the candidate analysts' educational goals and the patient's clinical demands (either of the candidate as a patient or the candidate's patient).
There are many ways to conceptualize contemporary psychoanalysis; this is my version's summary. As participant-observers with different histories, perspectives, and interests, the patient and analyst co-create and contribute to the analysis's Unconscious, Transference, and Resistance processes. Analysts' actions frustrate or gratify patients to varying degrees. The analyst is aware that he authentically reveals himself through his presence and in every aspect of his attitudes and interactions. To alleviate patient suffering and enhance the patient's well-being and freedom, the analyst employs interpretations, containment, empathy, and judgment and learns from the analyst's prediction errors and feedback in the analytic relationship.
Unconscious, Transference, and Resistance are not categorical terms but represent the following dimensions: unconscious-preconscious-conscious, transference-countertransference, and resistance and facilitatory factors.
Practitioners from various schools of Psychoanalysis acknowledge the dimensions associated with the Unconscious, Transference, and Resistance processes. Therefore, there are instinctual, structural, Oedipal, metapsychological, relational, self-psychological, intersubjective, developmental, hermeneutic, and neuropsychoanalytic variants of Unconscious, Transference, and Resistance in contemporary psychoanalysis.
A contemporary analyst does not claim any advantage or authority from being “objective,” “neutral,” “impartial,” or seen as “the exalted ideal analyst.” The contemporary analyst's strength lies in providing interpretations and perspectives, which can help the patient gain insight, make better choices, and foresee outcomes that can reduce distress and symptoms, enhance relationships with others in the patient's life, and increase self-awareness.
A contemporary analyst refrains from presenting interpretations as conclusive or definitive statements regarding the patient's situation. Instead, these interpretations are provisional opinions—tentative perspectives that the patient is encouraged to explore, test, and assess for their practical value.
The active participant observer and intersubjectivity are core principles that guide the contemporary psychoanalyst's work. They allow him to exercise his freedom, autonomy, and discernment based on these values, regardless of the outcomes. (The analyst's demonstration of freedom in thought, imagination, emotion, and action within the present therapeutic relationship can serve as a live experience for the patient. This demonstration may incidentally offer models for patient identifications, potentially fostering an expansion of the patient's own freedoms.)
The analyst remains dedicated to the core principles of psychoanalysis, with the overarching goal of alleviating the patient's suffering and enhancing their well-being. The analyst understands that each therapeutic journey is unique and requires flexibility and adaptability. Therefore, they do not strictly follow traditional psychoanalytic norms but rather adjust them to the needs of each case. Instead, the analyst tailors the psychoanalytic approach to each patient's unique dynamics and needs, considering their current challenges.
Analysts can access their external and internal perceptions, thoughts, imaginations, emotions, possible actions, and evoked memories. An analyst using broad countertransference uses the analyst's own experiences for analytic understanding and to interpret the patient's inner world. The analyst's experiences might relate to the patient's experiences, thoughts, feelings, fantasies, actions, conflicts, stresses, self-image, and relationships. This broad countertransference is like a living laboratory that
gives clues to the analyst about some possible insight, empathy, interpretation, or action the pursuing of which may be beneficial to the patient. The analysts should freely use any such countertransference guidance to initiate preliminary actions. The analyst's action starts the negotiation process with the patient, which may result in a shared view. It may also result in rejection, or the idea may require further time for additional assessments. The analyst, ideally, should welcome the patient's rejection of an interpretation, for it signifies the opportunity for further evaluation and a reflection of the patient's freedom to disagree with the analyst. However, a contemporary analyst may also experience countertransference that is so intense or prolonged that it interferes with or disrupts the patient's analysis. When countertransference interferes with the treatment, it becomes necessary for the analyst to seek consultation, enter a personal analysis, or transfer the case to another analyst.
I (Sripada, 2022) recently published a memoir to clarify the two-person active participant observer concept and provide a clinical demonstration of the interconnected transference and countertransference phenomena. This narrative explores the treatment of a severely depressed patient, offering a comprehensive account from the perspective of a first-person analyst. The memoir illustrates the advantages, both for the patient and the analyst, of embracing a more liberated approach that departs from traditional rules of psychoanalytic technique while still adhering to the foundational principles of psychoanalysis, including the detailed clinical exploration of the unconscious, understanding transference, and addressing resistance.
The foundation of all psychoanalysis lies in the patient's free associations, the analyst's interpretations and actions, and the psychoanalytic principles of the Unconscious, Transference, and Resistance. Traditional psychoanalytic techniques rely heavily on an objective, neutral, abstinent, and anonymous analyst. In contrast, contemporary psychoanalysis embraces a participant-observer approach within a two-person psychology. Here, the analyst's manifest reality or unconscious or conscious active-participant-observations contribute to the analytic situation and the patient's transference. The analyst recognizes that their presence and actions can evoke varying degrees of frustration or gratification in
the patient. This contemporary perspective acknowledges that analysts reveal themselves through their very being and all actions in the analytic situation. A broad countertransference encompasses the analyst's perceptions, thoughts, imaginations, emotions, actions, and evoked memories. The broad countertransference serves as a dual indicator of the analyst's personality and a laboratory reflection of the patient's conflicts, stresses, Self, and other identifications.
The divergence between traditional and contemporary psychoanalysis rests on significant technical assumptions. Despite theoretical departures from traditional instinct-based Oedipal theory and ego psychology, Friedman argues that many contemporary analysts still adhere to psychoanalytic technical norms such as neutrality, abstinence, and anonymity. He notes a lack of a sufficiently robust active analyst technique within the framework of two-person psychology.
This paper, along with Friedman's, explores factors contributing to analysts' hesitation, including unconscious or conscious attachment to the idea of the analyst's objectivity, a preference for the certainty of a God's-eye perspective, a desire for idealization, issues of privilege, power, and grandiosity, fear of solipsism, and concerns about criticism or being labeled as a “wild” analyst or as practicing psychotherapy rather than analysis.
Those championing contemporary psychoanalysis and seeking transformative change are responsible for developing, articulating, and advocating for a new psychoanalytic technique—one that embraces the analyst's active participation as an observer within a two-person intersubjective framework. I strongly encourage all contemporary analysts who believe in both the analyst and patient as active participant observers to share comprehensive reports of their treatments.
These reports should delve into significant details highlighting the co-creative nature of the analytic space and events within the two-person dynamic. Additionally, analysts should provide in-depth descriptions of their broad countertransference experiences, which serve as a crucial laboratory for understanding tentative patient dynamics. Furthermore, patient-analyst differences and the analyst's prediction errors, whether identified through the analyst's self-diagnosis or pointed out by the
patient, represent crucial starting points for negotiations and learning from analytic errors. These errors warrant significant attention and should be prominent in analytic descriptions. Analysts are encouraged to articulate their active involvement in the analytic process, their contributions to the patient's experiences of frustration and gratification, and instances of self-revelation. A vital part of analytic communications is addressing such contributions throughout the treatment.
Whenever possible, analysts should transparently communicate the source of their countertransference so their peers can better understand their interpretations and interventions. Such detailed descriptions of collaborative patient-analyst interactions and negotiations will benefit future patients, contribute to the advancement of psychoanalysis, and provide valuable insights for a broader understanding of humanity.