You do not currently have permission to view the full text for this document. Please sign in to an account with an active subscription or contact support.
The belief that gratifying patients inevitably diverts analytic couples from deeper exploration or attainment of insight is in need of examination and revision. The psychoanalytic endeavor is inescapably replete with provisions, as there are many universal therapeutic behaviors—listening and understanding, for example—that gratify our patients. Further, patient requests for provision, explicit or otherwise, can contain expectations of refusal. A therapist’s lack of spontaneous response may not necessarily be experienced as “neutral”; rather, it may activate an old traumatic pattern where the expectancy of non-response is confirmed. Responding more directly can be a serious challenge to a patient’s dysfunctional relational template—where actually receiving what is being requested registers as a decidedly foreign event, and the patient finds that he or she has “no place to put it.” Here the patient’s relational assumptions have been unbalanced by the presentation of an alternate form of relating. A clinical case is used to illustrate how therapeutic provision can activate disavowed affects, evoke forgotten memories, create disruptions, and eventually lead to deepened insight and therapeutic change. Contrary to what many of us have been taught, gratification did not shut down enquiry, but instead functioned to facilitate it. This new view of provision encourages expansion of our therapeutic repertoire, to help establish new relational expectancies and capacities in our patients.