Chapter 4 Notes on the Contribution of the Analyst's Self-Awareness to Optimal Responsiveness

While the subject matter of responsiveness, provision, gratification and restraint—what the analyst does—is located in the psychoanalytic situation, moment to moment clinical decisions are critically related to the larger question—why she does what she does and how beneficial change occurs. What is the optimal way to respond so that change will occur? Morton and Estelle Shane's useful review of the optimal responsiveness literature thus bridges two levels of discourse. One level refers to that which is “observable” or empathically accessible in the clinical situation. The other is “inferential” and refers to mental processes presumed to mediate the clinical events. Although for heuristic purposes we can describe these levels, they are not easily separable in practice, as what the analyst does ought to be shaped by her understanding about what produces change.

In reviewing the contributions of Bacal (1985), Terman (1988), and Lindon (1994), the Shanes focus largely on the clinical level of discourse, addressing themselves to clinical moments when the analyst must decide how to respond. Their ecumenical approach utilizes complementary theories of development and pathology to guide the practitioner's responsiveness (Basch, 1988; Lichtenberg, 1989; Goldberg, 1995). All such technical suggestions imply assumptions on another level about