Discussion: Some Aspects of Compliance in Psychoanalytic Treatment

THERE IS A TRADITION IN PSYCHOANALYSIS of revisiting old concepts in the light of new theoretical developments. The authors who contribute to this special issue on changing notions of the compliant patient represent a range of important points of view in our contemporary pluralistic psychoanalytic climate—ego-psychological, object-relational, and self-psychological. Their ideas arise at a time of paradigm shift in psychoanalysis. Where once we assumed we could view the patient objectively or through a neutral lens, we now mostly agree that the analyst's subjectivity is inevitable—that both analyst and patient are participant observers in an intersubjective and interpersonal field. Additionally, in clinical analysis there are two persons mutually affecting and influencing each other, reflecting an underlying two-person rather than a one-person psychological field. Every author reflects this conceptual shift to a greater or lesser extent. All, for example, routinely reveal their personal thoughts and feelings, and utilize these to discern what is happening in the analytic process.

But despite this shared context, I cannot discern that clear themes or lines of convergence and divergence arise from this collection of articles. Synthesis does not seem possible. Each contributor has a piece of the elephant and I cannot make out the whole. I do see at least