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Reading Theodore Saretsky's Resolving Treatment Impasses: The Difficult Patient, left me with a strong impression of what's right about
psychoanalysis, an impression rendered all the more powerful by simultaneous reading of Janet Malcolm's brilliant study of classical psychoanalysis, in Psychoanalysis: The Impossible Profession.
Saretsky's book is academic and intellectually demanding and is directed to the practicing professional. Malcolm's book, which was originally published in The New Yorker magazine, is meant for the lay reader and consists largely of material gathered during a series of interviews with a practicing New York City analyst. It is a personal and often touching account of the internal and external life of a psychoanalyst.
These, however, are only the surface differences. More important differences are those that represent the heart of the divergencies in thinking of contemporary psychoanalysis.
Disagreements over application of technique or even over the correctness of theory are not new. They are part of the history of Freud's relations with his disciples. Breaches in thinking resulted in the rupture of several long-term and important relations to Freud. Disagreements are hardly less bitter today.
Melanie Klein's interest in the very early years of life marked a departure from Freud's emphasis on the developmentally late oedipal conflict. Her example inspired analysts to take increasing liberties in broadening theory and technique. Saretsky's chapter, “The Imperfect Container,” gives a clear and thoughtful elucidation of the history and implications of these changes. Lang's “bipersonal field” is referred to; Sullivan's construct of participant observer; Searles' provocative idea of the curative process being bi-directional—the patient cures the analyst as well as the analyst curing the patient.
Saretsky observes that: 1) Interpretation, without a prior establishment of trust and feeling, can be experienced by the patient as a “persecutory assault.” 2