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This dialogue meeting was based upon the papers read by Betty Joseph (this issue) and Leo Rangell (this issue) which served to illustrate their different approaches in practice and theory of psychoanalytic treatment by representative case material, to elucidate the role of affects, especially anxiety, in the clinical situation and their handling according to the different conceptions, in the 'Kleinian' and traditional 'Freudian' way.
Betty Joseph elaborated her approach describing some ways the analyst is sometimes used by the patient not only to contain his anxieties but to join in the patient's defence system. The patient can arrive at this by unconsciously provoking certain countertransference reactions which fit in his defence. Starting from the understanding of interactions between transference and countertransference, Betty Joseph demonstrated how to get in touch and work with deep anxieties underlying the defence and the more superficial manifestations of anxiety.
Her patient A. tried to live out a sadomasochistic relationship in the transference, in order to ward off anxiety by provoking critical and even hostile interpretations from the analyst. Thus he protected himself against the experience of guilt feelings and anxiety resulting from ambivalence conflicts.
Another patient, B., who behaved in a very calm and cool manner to demonstrate that he was not anxious at all, had a dream which provided in a very impressive way an opportunity to understand how he dealt with affects and succeeded in avoiding anxiety. For certain reasons he had to miss some sessions and he did not show any real emotional concern about this. In the manifest dream he met a woman who looked like someone he used to know. In the dream he knew that this woman paranoid; she was also linked with someone grandiose. Her name in the dream was 'Mrs Hours'. This dream showed that he was extremely afraid of women. This anxiety was characterized by Betty Joseph as being very deep-rooted paran