Some Little-Described Elements of the Psychoanalytical Relationship and their Therapeutic Implications

The most neglected feature of the psychoanalytic relationship still seems to me to be that is it a relationship: a very peculiar relationship, but a definite one. Patient and analyst need one another. The patient comes to the analyst because of internal conflicts that prevent him from enjoying life and he begins to use the analyst not only to resolve them, but increasingly as a receptacle for his pent-up feelings. But the analyst also needs the patient in order to crystallize and communicate his own thoughts, including some of his inmost thoughts on intimate human problems which can only grow organically in the context of this relationship. They cannot be shared and experienced in the same immediate way with a colleague, or even with a husband or wife. It is also in his relationship with his patients that the analyst refreshes his own analysis. It is from this mutual participation in analytic understanding that the patient derives the substantial part of his cure, and the analyst his deepest confidence and satisfaction.

The evolution of the theory of technique might be thought of as a gradual victory, but only a partial victory, for the recognition of the relationship. This clearly had its reasons as it was liable to get out of hand in the early days when wild analysis was a danger, as it still does occasionally today. And the technique of interpreting unconscious impulse aggravated resistance, resulting in the sort of sexual battle that Freud described in 1915 in his 'Observations on Transference Love'. In his last clinical paper (Freud, 1937) he was still struggling with the analogous problem of the negative transference, protesting that the hostility of a former pupil was nowhere to be seen at the time of his analysis. The path to an approach which is less threatened by the patient's feelings was opened gradually between 1928 and 1950 by Wilhelm Reich (1928), (1950), Anna Freud (1937), Melanie Klein (1948), with her concentration on the interplay of obj