The Management of Aggression in Modern Psychoanalytic Treatment*

Human life is driven by two great forces: love and hate. As psychoanalysts, we must be concerned with both these forces—even though some of us may have a predilection for one or the other. Freud himself, though he eventually accorded aggression as much theoretical importance as the libidinal drive, never fully integrated the concept of aggression into his theory of analytic treatment, nor did he give it adequate recognition in his account of the severe psychopathologies he referred to as the narcissistic neuroses. The modern psychoanalytic movement begun over 30 years ago by Hyman Spotnitz, has attempted, among other things, to correct this imbalance. At a time when the schizophrenic patient was seen as suffering from excess anxiety and overmuch self love, Spotnitz recognized the central role of aggression and defenses against aggression in the treatment of such narcissistic disorders. The emphasis on aggression has been necessary because most people don't like being on the receiving end of aggression, nor is it easy to acknowledge it in ourselves. But it should be pointed out that modern analysts are not interested only in hate and aggression; they try to help patients feel, tolerate, and verbally express all of their feelings and impulses, including loving ones.

While different analytic schools disagree about the sources of human aggression, there is general agreement that it has both constructive and destructive aspects, and can be manifested either as destructive hatred or as self assertion.