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1 Patients with borderline or narcissistic personality disturbances have made it increasingly clear that adequate treatment by the analyst does not consist solely in interpretations. Attention has thus shifted to certain aspects of technique which, when they are used correctly, provide something similar to what Winnicott has called “a support environment” (Gedo 1979).
When dealing with such patients, sudden interruptions in the analytic dialogue often occur, followed by states of tension which are not easy to understand. For example, it can happen that after an apparently ordinary interpretation the patient falls into a deep sleep, or on the other hand appears forced to sit upright and look around. Another possibility is that at the beginning of a session he is unable to break a long silence, which suggests that something about the analyst's studio or appearance may have disturbed his imagination during his journey to the couch …
Until recently, these and other similar situations of tension were believed to be inevitable and were attributed to the reactivation of the