Channels of Communication and the Analytic Setup

There is much to be said in favor of performing tasks of daunting complexity, including the conduct of psychoanalyses, within a reliable framework—a set of conventions that may be taken for granted—in order to reduce to a relatively manageable number the variables that the practitioner has to monitor. Winnicott (1954), in referring to the conventions generally accepted by large sections of our community, called the almost banal results produced by these traditions—our liturgy, if you will—the “psychoanalytic situation.” Unlike the rituals of religion, however, no aspect of these conventions of ours is actually sacred. In America; we do not shake hands before and after each session, we do not provide analysands with warm coverlets; and, for that matter, we do not demand that they pay us in cash; yet these are routine aspects of the psychoanalytic situation in certain milieux abroad.

Perhaps no component of the psychoanalytic situation is as widely practiced as the use of the couch. Although this convention was originally dictated by the requirements of Freud's preanalytic “pressure technique,” wherein he strove to overcome the obstacles to the recollection of repressed mental contents by taking hold of the patient's head, it was retained when he changed the technique of treatment to that of relying first on directed and later on free associations. Freud apparently rationalized his perpetuation of the arrangement on the