Otto F. Kernberg, M.D.

The Psychoanalytic Situation, published thirty-four years ago, was a path-breaking, systematic exploration of the analyst's attitude vis-à-vis the patient in the course of psychoanalytic work. It appeared in the context of what retrospectively may be described as the nineteen fifties conventional interpretation of Freud's basic recommendations regarding the principles of abstinence, the surgeon as model, and the analyst as “mirror.” Those principles of abstinence, in Stone's view, while generally agreed upon as essential to permit the transference to develop as a discrete and “uncontaminated” phenomenon, also contributed, in the way in which they tended to be carried out at the time he wrote his book, to a perceptual and emotional “vacuum” that may have had deleterious effects on the psychoanalytic process.

This vacuum, Dr. Stone proposed, was brought about by the combination of several factors: the analyst's nonvisibility during the hours, the relative confinement of his responses to interpretation, clarification, or other “neutral” maneuvers, the stereotype of schedule and fees, the relative lack of even conventional emotional responses to the patient's personality and career. There were also the lack of intervention in the patient's everyday life, the general “blanketing” of the analyst's personality, actively and passively, except as it appeared inevitably or inadvertently. On the part of the patient, there was the formally childlike role of the analysand derived from the abrogation of any “right” to suppress verbalization, the generally extreme one-sidedness of communication, the supine position of the patient, the lack of gratification in terms of ordinary exchange of feeling, or experience of demonstrable affective influence on another person.

Stone also suggested that “a nuance of the analyst's attitude” can determine the difference between a lonely vacuum and a controlled but warm human situation which does offer the gratification of security and support, the