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Spanning more than two decades, Paul Gray's collected papers chronicle the evolution of his single-minded, rich vision of the approach he calls “essential structural psychoanalysis” or “defense analysis using close process attention,” an approach which he sees as optimal for certain patients. Gray offers extended theoretical discussions and technical recommendations to the clinician for conceptualizing, implementing, and teaching essential psychoanalysis. He describes his basic framework thus:
my working hypothesis, on which my technique depends, is that consistent, detailed analysis of the forms and motivations of the ego's surface-near manifestations of resistance against specific drive derivatives will of itself allow gradual, analytically sufficient ego assimilation of the warded-off mental elements…. (p. 101)
In Gray's analysis of defense, “the essential task [is] observing and understanding intrapsychic conflict” (Panel, 1984, p. 140). The phenomena which attend the activation of such a conflict can be clearly perceived and demonstrated. Unlike the emergence of drive derivatives, however, these phenomena do not call attention to themselves; they do not press toward expression. Therefore, both analyst and patient have to learn how to listen for these diffident, unobtrusive signs, for these “changes in voice,” which exhibit the ego's defensive maneuvers. The aim of the therapeutic process is “to help the analysand gain full access to those habitual, unconscious, and outmoded ego activities that serve resistance” (p. 65); an important goal is that “optimally the patient should come to make a conscious use of the ego's capacity for perceiving what is on his mind in either a psychoanalytically inside or outside sense” (p. 21).
Gray distinguishes sharply between essential structural psychoanalysis and “wider scope” analysis, arguing that the former is grounded principally in the structural, and the latter in the topographical,