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Notes on Changes in Analysis. Anna Gourevitch. Pp. 341-349.
Through a series of brief clinical vignettes Gourevitch illustrates her ideas on the process of change in analysis. She posits that there is a freeing of psychic energy in the individual after the discovery of some aspects of the mental apparatus which are unconscious and impede self-understanding. This, in turn, provides the impetus for the person to become more "objective." However, many of our patients, she contends, would prefer to change "reality" and not themselves. Some of the elements of this process leading to change are briefly delineated. A prerequisite for the development of self-knowledge is the sense of distance from oneself. transference thus becomes crucial "by offering relative security against the fear of distance." The distance is also conceptualized as involving the giving up of infantile fixations and aims and, in turn, achieving the ability to tolerate feelings of sadness and loss. This surrendering of neurotic magical expectations for genuine change also results from "actually living according to the insights acquired through analysis." Gourevitch suggests taht this new sense of mastery creates a new self-image and eventually a new perception of the world, changed by the new ability to open up to the outside.