Bulletin of the Menninger Clinic. XLII, 1978: The Conceptualization of the Therapeutic Action of Psychoanalysis: The Action of the Holding Environment. Arnold Modell. Pp. 493-504.

Because of the increase in frequency of the analyses of narcissistic disorders, Modell has drawn attention to the development of the actual object relationship to the analyst as the locus of the therapeutic action in these cases. In this interplay the analyst can be said to be symbolically "holding" the patient. This is analogous to holding a child who is having a temper tantrum or communicating to an adult that he cannot destroy the analyst with his sadism. It provides a measure of actual gratification, especially during the early phases of the analysis of certain narcissistic character disorders when there exists a persistent state of affective nonrelatedness. For these patients the analytic setting and procedure themselves become the focus of their conflicts. The lack of a full sense of separateness from others causes these patients to accept empathic interpretations only if they support the illusion of fusion with the analyst, not for their content. The illusion of merging with an impotent analyst needs to be analyzed in order to touch the core of the neurosis. The holding environment thus represents an actual object tie between the analyst and the patient and grows out of the work that the