Chapter 5 Words and Working Through

This paper discusses communication, its modes and its changes, between analyst and patient, and, more particularly, within the patient himself in the course of a psychoanalysis. In the form of spoken dialogue, communication has always been at the centre of the psychoanalytic method and there have always been puzzles and complexities about it.

A patient’s talk is not simple. It is multiple in function as Freud showed when he differentiated three related processes – repeating, remembering, and working through (Freud 1914). Nor is an analyst’s talk a simple conveying of information. James Strachey, in his classic paper ‘The nature of the therapeutic action of psycho-analysis’ (Strachey 1934) was among the first to review the work on, and himself notably advance the problem of, what a therapeutic interpretation is. An interpretation becomes the agency of change, according to Strachey, when it is specific about the point of urgency in the transference, i.e., the patient’s impulses and anxieties at that moment active towards the analyst. Then it is a mutative interpretation, as Strachey called it, which enables the patient to change his archaic internal figures by introjecting the interpreting analyst.

Since Strachey’s time there has been a vast discussion about analysts’ interpretations and patients’ communications. The investigations and the controversies in the literature have recently been summarised and reviewed by Langs (1976). From Langs’s two volumes it emerges that, while some analysts endorse active, non-interpretive techniques for special pathology or situations of impasse, currently there is still agreement that interpretations play the key role, and that a mutative interpretation is a verbalisation of the immediate emotional transference. Analysts still agree, too, that their patients’

communications involve Freud’s basic three of remembering, repeating and working through.

Over the past 50 years, however, psychoanalysts have changed their view of their own me