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It seems to be intrinsic to the nature of our work that we try to build up a coherent picture of the patient’s history. It is always our picture, of course, and it will evolve in the course of the analysis. In this chapter I want to consider some of the difficulties relating to our interventions, our attempts to restore and clarify the patient’s incomplete or forgotten history, and to the mechanisms of psychic change.
I believe we are still under the influence – to a greater or lesser degree – of the model that suggests that it is the recovery of the repressed memories themselves that carries therapeutic force. The analysis of the transference, according to this model, is primarily used as a route by which we gain access to the history.
Far less attention is usually given to the exploration of the process between the patient and the analyst, out of which a different historical perspective may emerge. In this chapter I argue that the patient’s history is embodied in his internal object relationships and is manifested and expressed in the transference–countertransference relationship. It is primarily through the experience and understanding of these relationships that we can hope to bring about internal changes. Such changes involve the properties of, and relationships between, the patient’s internal objects that result from dynamic shifts in the patient’s use of projective and introjective mechanisms.
In 1912, Freud addressed the difficult task the analyst has in ‘keeping in mind all the innumerable names, dates, detailed memories and pathological products which each patient communicates in the course of months and years of treatment’ (Freud 1912b: 111). In fact, he suggests that as soon as the analyst tries deliberately to concentrate his attention on a particular theme:
Page 72He begins to select from the material before him; one point will be fixed in his mind with particular clearness and some other will be correspondingly disregarded, and in making this selection he wil