From Technique to a Theory of Psychic Change

We have had a series of papers that focus on technical issues in relation to psychic change. To move from technique to theory, and to facilitate active discussion and perhaps controversy, I shall use my brief discussion time to make two rather expansive points. One will have to do with a theory of psychic change; the other with a theory of mind. I shall build my remarks upon two threads that I extract from the presented papers and also from the prepublished Congress papers in Volume 72, Part 1 of the International Journal of Psycho-Analysis. These two threads have to do with how we understand change and how we conceptualize pathology, but I shall follow these two threads well beyond the presented papers. To begin, then, with psychic change and some specific examples from the papers:

The instrumentality of psychic change that Betty Joseph (1992) calls to our attention and chooses to focus upon is the patient's coming to be able to take the analyst's perspective on his (the patient's) disorder without losing his own perspective. The place where this can generally be done best, she suggests, is in relation to the phenomena of the transference because, there, patient and analyst have a shared event to examine close-up. Alan Parkin (1991), in contrast, chooses to focus on what he refers to as the deconstruction of attitudes (characteristic traits that operate as resistances) by turning them into processes (of wish, conflict, defence, fantasy formation). But he also sees this happening most readily with respect to transference phenomena where the character traits can be seen in process—that is, at work to accomplish unconscious aims. Respect for the power of interpretation in the here and now of the transference is shared by most contemporary analysts. For the patient, it is where things are happening and, because of the emotionally powerful relation to the analyst, it is where they matter.

Yet we all know perfectly well that interpretation in the transference—or