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In this sensitive exploration of modern analytic technique, Jacobs turns the sometimes patronizing notion of the ‘unanalyzable patient’ upside down by suggesting that ‘an inflexible attitude (on the analyst's part) with regard to questions of neutrality and abstinence may lead to unbreachable impasses and to disruptions of treatment’ (p. 216).
Jacobs advocates the creative and judicious use of the forbidden: support, empathy, and the reduction of anxiety in clinical situations where interpretation is experienced by the patient as nothing but a rewounding and pointless repetition of prior painful experience. He describes the familiar moment when patients are caught in a time-warp, ‘past and present, perception and memory were entangled and confused’, making ‘effective analysis of transference distortions not feasible’ (p. 221). Although he does not use the language and formulations of analytical psychology, I believe he is describing the clinical phenomenon of identification with the deep archetypal core of a repetition compulsion. Jacobs suggests that at such moments it is only involvement and affirmation by the analyst which result in the achievement of a truly functional, rather than merely technical, neutrality.
Implicit in Jacob's sensibility is the differentiation between a therapeutic negative transference and a negative therapeutic reaction. In the latter, patients become more rather than less symptomatic in response to interpretation of transference dynamics. In this regard, ‘unless certain needs of these patients were temporarily met and certain defences supported for a time, no progress in analysis could be achieved’ (p. 218). Without feeling deeply understood by the analyst's affective responsiveness, without support and even vindication of various self-representations, analysis will grind to a halt in certain cases.
Jung was onto this (as are all creative analysts) at the very beginning, when he insisted that the patient must always be met initially exactly