Comments on the Case of Raquel

“Traduttore, traditore.”… to translate is to betray

Psychoanalysts speak differently to themselves than to their colleagues, but also differently to their patients. This has sustained a problematic series of contradictions among our theories about how we help our patients and what we actually say to our patients. This confusion has been prominently visible in our polemical discussions about technique. It becomes a topic for focused discussion now in a richly detailed case presentation by Dr. Adriana Yankelevich. Her gifted navigation of a variety of initial obstacles led ultimately to a viable working alliance with her challenging patient. Her discussion gives rise to many possible paths for consideration. I was especially interested in the orienting questions for possible discussion posed by Dr. Bronstein about the possibility of recognizing shifts in the technique employed by Dr. Yankelevich when he invited me to comment about this case report. The questions we are thinking about are something like: Do you see shifts in the analyst's technique in these sessions? If so, why do you think they occur; are they, for example, the result of a temporary collapse in the analytical stance, or the analyst's necessary adaptations to the patient's needs? What effect do you think they had; for example, were they a risk to the analytic process or did they bring the patient and analyst close together?

I was most interested in the suggested possibility for discussion because I do not customarily think in terms of “shifts” in technique. In fact I have usually felt that during some periods what I should do or say (hardly an adequate definition of “technique”) was self-evident until inevitably some event required me to re-think what was going on. And that re-thinking about shifts in technique is what I wish to do in this discussion. My first problem was that I did not know how to address these questions about technical shifts. Like so many terms in our lexicon, “tec