On: The comments of Marita Torsti-Hagman

Dear Editors,

I thank Marita Torsti-Hagman for her comments on my paper and for this opportunity to highlight some important points that were not sufficiently emphasized in the paper. I will focus my reply on the two main arguments addressed in her letter. The first is the problem of defining supportive interventions. In my paper, I have

proposed a reformulated definition of support, centered on its relationship with the patient's nonsymbolic mental functioning. For me, supportive interventions are deliberate efforts “at improving a patient's mental functioning by using principally pragmatic or interactive aspects of communication to transform her or his patient's nonsymbolic in-session experiences” (Lecours, 2007, p. 897). They are interventions actively recruiting the nonspecific or relational effects of analysis, such as what Mari-ta is describing when she says that she is “tolerantly being present and listening carefully”, which implicitly means that she does things such as accepting emotional expression without retaliating or reciprocating. However, the providing of a holding function, or the use of a benevolent analytic attitude, is a rather discreet and passive use of support, and I have argued that analysts can use the same interactive processes actively and deliberately. I have added that supportive interventions are psychoanalytic interventions when they are used to work through nonsymbolic layers of the transference. Defined as such, supportive interventions are much more central to analysis than a mere preparatory phase to ‘truly’ analytic work. They are used in every analysis, but more often and with more necessity with patients who suffer at a nonsymbolic level.

This brings me to the second point I wished to underscore. The kind of patients I had in mind when I wrote my paper were severely disordered patients, either seen in psychoanalytic psychotherapy or presenting intense moments of regression in analysis. The overwhelming aspect of their experience