Meetings of the New York Psychoanalytic Society

February 12, 1957. REMARKS ON SOME VARIATIONS IN PSYCHOANALYTIC TECHNIQUE. Rudolph M. Loewenstein, M.D.

The author makes a distinction between modifications of psychoanalytic technique which are distinct deviations from the classic technique and those which are minor variations within the framework of the standard technique. An example of the latter (the subject of this paper) concerns the rule of abstinence which in some cases of homosexuality should not be imposed because it may provoke intolerable castration anxiety (Anna Freud). Such variations are usually employed intuitively. The goal is to make any variation in technique theoretically comprehensible by fitting it into a definitive conceptual framework. The rule of abstinence in the transference should rarely be transgressed. To a 'borderline' patient, the analyst's acceptance of a gift meant that she was a worthwhile person and his deviation from this rule of abstinence facilitated the analysis of her very seriously disturbed object relationships. A 'parameter' (Kurt Eissler) is any action of the analyst which is not an interpretation. Dr. Loewenstein prefers the term 'intervention' because it is more neutral and thus points more clearly to the need for succinct differentiations with respect to such variations in technique. Some authors have defined certain interventions that are not interpretations as 'confrontation' (Devereux), 'suggestion', 'manipulation', and 'clarification' (Bibring). Other interventions aim at the creation of initial rapport by listening, understanding, and giving hope of relief from suffering. The recumbent position is an intervention designed, among other things, to help the patient follow the fundamental rule and to facilitate reality testing. It may at times be necessary temporarily to abandon this position and let the patient face the analyst. The purpose is to give the patient a chance to distinguish transference fantasies from fact, and to appraise the analyst as a r