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Betty Joseph's book, Psychic Equilibrium and Psychic Change is a collection of papers in which she addresses subtle technical problems. These problems arose with patients who came to analysis because consciously they wanted to change but seemed to be unwilling or unable to do so. This was the case, even though their feeling about analysis and the analyst was usually basically positive. Joseph found that patients who failed to improve were more than usually insistent on maintaining their psychic equilibrium. While they might appear to agree with interpretations, Joseph found that this was a form of accommodation, and that what took place in the session was being used to support the pre-existing state of balance and to avoid change. These are the observations made by the editors of the book, Michael Feldman and Elizabeth Bott Spillius.
This paper, ‘Agreeableness as obstacle’ examines the same area. The patient agrees with the interpretations and accepts all that the analyst suggests, keeping the treatment ongoing and peaceful. But in actuality it is semi-paralysed. In her summary, Joseph writes that she aims to show the various ways in which agreeableness is enacted in the relationship with the analyst, and then to explore the kind of anxieties that this defensive structure tries to ward off. Material from an adolescent patient called Jenny is used to describe the slow unravelling of powerful anxieties about being invaded and taken over by her object, anxieties that lead to her having no life and no mind of her own. It is suggested that such deeply paranoid anxieties may unconsciously be present in other patients of this compliant, ‘agreeable’ type.
Setting out her aims in a paper about child analysis Joseph writes, ‘The more that the stress is laid on our having really one basic aim in analytic work, that of gaining and giving understanding, the more we become aware of the significance of the constant interaction between psychotherapist and child - the way that the cou