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In his thought-provoking paper, a former version of which was presented at the XVII Nordic Psychoanalytical Congress in Gothenburg , Martin Lotz sets out to investigate whether psychoanalysis should become more concerned about the future of the analysand than it, allegedly, has been to date. Should the analyst become more involved in “the next step” of the analysand? In Lotz' paper, this question is discussed in the clinical context of so-called “defect” pathology, i.e., patients suffering from structural deficits found in what some call personality disorders. In his discussion, which is in favour of such an enhanced involvement, Lotz asks what this means from the methodological point of view; i.e., if we are to be more involved in our work, how is this to be reflected in psychoanalytic technique with these patients?
In his review of the relevant literature, Lotz refers primarily to Nordic authors, i.e., to the works of Veikko Tähkä and Bjørn Killingmo. Lotz states that the former was the first in the Nordic countries to write on this subject, and builds his presentation of Tähkä's standpoint on a paper published in 1984.
This paper of Tähkä, no doubt, gives a sketch of its author's view of the theory of defect pathology as well as on his view of how one, in a psychoanalytic treatment, can revive the development (once interrupted) leading to a higher degree of structuralization. Tähkä's main discussion of this subject is, however, to be found in the book Mind and Its Treatment, published in 1993.
As the findings presented in this book seem to be quite unknown to Scandinavian readers outside Finland, and as many of them address the problems raised in Martin Lotz' paper, one might be motivated to discuss the issue of the latter from the perspective not only of Tähkä's early paper, but also from the subsequent book. Below I will do this, briefly.
Lotz starts out from the assumption, or finding, that the interpretation of unconscious material does not always help the patien