Chapter 5 On Boundaries and Intimacy in Psychoanalysis

For many years, psychoanalytic technique reflected a general consensus about the relative positions of the analyst and analysand. The analysand came seeking insight about problems and difficulties that were brought into the analytic consulting room and presented to the analyst. The analyst attempted to maintain a position of some distance in the effort to remain “objective” about whatever was presented. This attempt to maintain some objectivity about it all seemed very important so that the analyst's skill and knowledge could be fruitfully brought to bear. This model of doctor and patient seemed impeccably rational, and deviance from it to any significant degree was usually understood to signal a difficulty on the part of the doctor—the doctor was too influenced or involved for some reason, and this was not good for the process, which required a steady hand on the rudder. Too much feeling of any type could cause a loss or disturbance of perspective and interfere with the steadiness of the doctor's focus on the inner workings of the mind of his patient. It was understood that the mind operated according to a set of principles that were generally accepted, and the patient was relying for her cure on the doctor's ability to apply these principles most effectively in order to throw light on the presumably distorted aspects of the workings of her mind. Certainly the relationship between the analyst and analysand was an issue, but primarily through one central venue: the patient carried within her a set of unconscious ideas, patterns of experience, and associated feelings from the past, which were experienced in the context of the