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November 3, 1986. COUNTERTRANSFERENCE AND ANALYTIC PROCESS IN FIVE CLINICAL HOURS. Alan Z. Skolnikoff, M.D.
In a psychoanalysis, the patient is the insider, providing the raw data of the analysis, while the analyst is the outsider, with his interpretations serving as questions to be confirmed by the patient's response. Similarly, in supervision the supervisor's comments are confirmed or denied by the analyst from the raw data of the analysis. Dr. Skolnikoff conducted a "consensual analysis" to study his subjective reactions to a patient in analysis. He would provide Dr. Emanuel Windholz in advance with a copy of the process notes of an ongoing analysis. At weekly meetings with Dr. Windholz, Dr. Skolnikoff would present a monologue of his reactions to the patient during the week before. These sessions were taped so that at their conclusion, he could compare the process notes with his verbal impressions of the patient from the previous week. There was an attempt to reach a consensus on the meaning of the analytic process, with special emphasis on how Dr. Skolinkoff's reaction to the patient influenced his interventions. He looked closely at the "inside-outside" paradox," Dr. Skolnikoff being inside the analytic process and Dr. Windholz being outside. Only in reviewing the analysis of a patient after the passage of time could Dr. Skolnikoff attain a more dispassionate stance on how much his remarks during the analysis were influenced by his involvement with the patient. Although the case Dr. Skolnikoff presented had not been studied through the "consensual analysis" method, he felt it would be useful for the discussants and the audience to study the process notes to discover the analyst's subjective reactions to the patient.