Prologue

THIS ISSUE OF PSYCHOANALYTIC INQUIRY is concerned with the problem of compliance in clinical psychoanalysis. To assist us in exploring it, we have asked four prominent analysts of different theoretical orientations—from the British Kleinian (Feldman) to object relations influenced conflict theory (Rizzuto) to social constructivism (Levine) to Self Psychologically influenced intersubjectivist (Lichtenberg)—to illustrate and address how they view and work with compliance in the clinical setting. Their contributions are then discussed by two equally prominent analysts close to the mainstream of contemporary North American psychoanalytic theory and practice (Fogel and Reed).

Compliance is not, of course, a theoretical concept. It is a description of a behavior on a patient's part that impedes the analytic process as that process is seen from the perspective of the practicing analyst. Compliant behavior must consist of clinically manifest action of some kind, yet the criteria for identifying that behavior are variable and unclear. While differences in theoretical perspective may account for some of this variability, agreement on a theoretical perspective does not make it easier to identify clinical criteria.

Within the framework of modern conflict theory, for instance, compliance can be conceptualized as a part of a person's character, to be analyzed when it interferes with adequate functioning, as one would any maladaptive character trait. It can also be seen as a more specific defense appearing at a given moment in an analysis. There the interpretation of the unconscious wish motivating the defense would render it less necessary. Yet even within this agreed upon theoretical framework, neither of these definitions specifies what criteria to use to identify the existence of compliant behavior, let alone the type.

Within theories that emphasize developmental arrest, there naturally arises a question about whether compliant behavior on the