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Internal and external aspects of psychoanalytic listening have been a central theme of the last two chapters. On a broader front, there are internal and external facets of clinical technique in general.
Take the question, for example, whether analysts should be the same with every patient or whether they need to be different with different patients. There are answers from either perspective. Certain aspects of clinical technique are constant. Analysts always attend to unconscious meaning in a patient’s associations, always take note of the transference and always seek to maintain analytic neutrality. Other aspects, such as the balance of emphasis between history and the here and now, how active or how silent the analyst is, and whether interpretations are focused and specific or open-ended and allusive, will vary according to the perception of a particular patient’s needs. This is an answer couched in terms of external aspects of clinical technique.
A different kind of response would be that analysts need to be authentically themselves with every patient, but will also need to express their emotional availability, or deploy the qualities of their analytic identity, in different ways with different patients. Such an answer again shows how an analyst is both the same and different with every patient, but this time with reference to internal aspects of the analyst’s technique.
External aspects of clinical technique comprise the ways that analysts behave, and what they say, or do not say, in response to what they hear from the patient. By internal aspects of technique, I mean all those elements that contribute to analysts’ ways of being with a patient—verbally, non-verbally, emotionally and in their bodily presence—that come about in response to what analysts hear from inside themselves.
It is accepted that an analyst’s external listening should be undirected and free of preconceived aims. Monitoring a patient’s material for particular themes is not free-floating attention.