Reply to Dr Levenson

Dr Levenson's reaction to my paper on enactment gives me a chance to clarify my thinking, to correct some misunderstandings, and to register areas of agreement and disagreement between us. I begin with the premise that the psychoanalytic method, together with the analytic attitude which makes it possible, represents a unique opportunity to engage with another person, to explore the way their mind works, and to provide a setting in which the patient's mental capacities can grow and develop. This opportunity carries with it a responsibility to facilitate the special kind of attention which is peculiar to psychoanalysis, that is, one in which priority is given to understanding. Of course, this attitude has to be consistent with our duty to the patient and giving a primary place to understanding is only justified because of our belief that it is precisely this understanding which is of therapeutic value to the patient.

Freud's development of the psychoanalytic method, in particular the discovery of transference and resistance, helped us to recognize that the analyst has to become involved with his patient at a human level. His emotions have to be available and he has to be willing to observe and face uncomfortable truths about his patient, and also about himself. At the same time, my view is that the analyst has to keep his feelings under control; he must be involved and yet has also to stay separate; he has to fully engage in the relationship and also be able to observe and evaluate it.

Developments in our knowledge of projection, introjection and identification have further enhanced our understanding of the transference and have allowed us to view the patient-analyst relationship as truly interpersonal. Our interest and knowledge of the patient's mind, his internal world, the methods he uses to relate to people, his beliefs, feelings and thoughts is made possible by the fact that these are all externalized in the transference and affect the emotional reactions of the an