A Conversation with Theodore Jacobs

Interviewers: How do you feel about being perceived by some relationalists — lewis Aron, for example — as a Freudian interactionist? And what exactly does that mean to you?

Jacobs: Well, I'm never sure exactly what that means. The term is new to me. But, generally speaking, I think it's a fair description. My training has been in the classical tradition. All my supervisors, teachers, and analysts were in that tradition and it's very much a part of my thinking, and my way of working. At the same time, I think it's extremely important to recognize the intersubjective or interactive aspects of our work, and to add that to our intrapsychic perspective. Because if we don't, I think we miss crucial material that helps us to understand the patient in depth. I don't see them as competing schemes, but rather as a way of understanding the patient in depth, through different modalities. So if that's what's meant by “Interactionist Freudian,” I'm happy with the term.

Interviewers: Is there an interactionist group or movement among Freudians — including people like Boesky, Renik, Poland, yourself, and perhaps others?

Jacobs: None of those people would consider this to be a group or a movement. But we share a point of view that has evolved slowly among not necessarily young, but somewhat younger, analysts. We have tried to account for certain experiences, phenomena, that do not seem well accounted for by a totally intrapsychic point of view. Many classical analysts are coming to realize that to understand a patient in depth, we sometimes (frequently, in fact) have to understand the kinds of overt and covert communications taking place in the analytic situation.

Interviewers: How widely accepted is this position among classical analysts?

Jacobs: I don't think that it is, as yet, fully accepted. But over the last, I would say, five to seven years, it is increasingly so. For example, at the New York Institute, the perspective which I and others talk about has just been put into our curriculum — granted, as an elective, but still it is part of the curriculum. Whereas five years ago it wasn't there. Even in the most traditional institutes there is a recognition of this dimension of our work, except among certain older colleagues, who were trained years before we were and still follow the method they've used over the decades. From their perspective, what happens in the analyst is secondary. And countertransference, although sometimes seen as a clue to what is happening in the patient, is more often seen as an interference. Their perspective is, I would say, fading. It's not as prominent or as dominant as it was before, but it is still there.

Interviewers: It seems a striking change. Is it the Zeitgeist?

Jacobs: Well, I think that it is in the air these days. But as some people, especially some of our revered senior analysts, often say, this perspective, in one form or another, was there years ago. For example, Isakower, one of the great classical analysts, speaks all the time about communication between analyst and patient and about the analytic instrument as a joint creation of the patient and the analyst. Careful reading of his work shows how much he was an intersubjectivist, in his real understanding of what happens. The same is true, to a great extent, of Jack Arlow, who was working on the sharing of unconscious fantasy long before this so-called movement started. Although developed more in recent years, the nascent ideas have been there for a long time.

Interviewers: Would you say then that these writings might be part of your lineage? Whereas the relationalist line of descent may be drawn from Ferenczi?

Jacobs: Yes, I think that's true. I am much more familiar with those people, say, Isakower, or one of my teachers, Lillian Malkov. She had the ability to tune in to what a patient was experiencing through what she was experiencing, to understand through the affects and feelings that arose as she listened to the material. I came to my ideas partly through their influence, and partly through my own experience with patients, but less in response to the ideas of Ferenczi, Sullivan, or people of that particular group, because I was not so familiar with them.

Interviewers: In your work, do you disclose your countertransference to your patients?

Jacobs: It's a question I cannot answer simply, because here I think we are really finding our way. I think we're really on a kind of frontier with regard to technique, self-revelation, and the acknowledgment of certain aspects of what the patient may pick up. I find it's a matter of judgment in each particular circumstance. Often I will follow the more traditional mode. But there are other times, for example, in which I think that it's important to share with a patient a particular set of feelings or reactions. But we haven't yet quite understood how to use this. Right now, it tends to be done more in times of difficulty or impasse — or, for me, at a point at which I have used more traditional ways of working and something more needs to be done.

Interviewers: That's one of the criticisms, that while classical thinking is expanding, these techniques are still being adopted as parameters, limited for use with certain types of patient.

Jacobs: There is really room here for much to be learned and explored — and understood. The problem, essentially, is that we're still interested in finding out what the patient has created of us. I don't want to cut off that possibility, and there's the difficulty. At the same time, if you double-bind a patient by seeming to deny his or her perceptions, or by not acknowledging the accuracy of those perceptions, the patient may feel threatened and have to deny what he or she has seen. You may also prevent a patient from having an important experience — one that not only confirms certain unconscious expectations but, by doing so and by creating a novel situation, fosters the exploration of the fantasies underlying such expectations.

I think that it is sometimes useful to share with the patient certain errors that we make, certain feelings that we have, certain fantasies. If we take seriously the idea that the analyst, when well attuned to the patient, will have inner experiences that resonate significantly with those of the patient, then judicious sharing

of some of the analysts experiences, rather than shutting off exploration of the patient's fantasies and imaginings, may actually enhance his or her understanding of them and of the way they are embedded in unconscious communications.

Interviewers: What do you think of gratification in the analytic situation? The Freudians are sometimes criticized for maintaining nongratifying and abstaining positions, underworking the interpretational aspects of the treatment, while relationalists are criticized for a tendency toward overgratification or confrontation, overworking the concept of mutuality.

Jacobs: Well, it seems to me that the whole idea of analysis being carried out in a state of abstinence was based on the early Freudian idea about drive theory, really, and the need to create an abstinent environment, in order to allow some of those strangulated affects to appear, to rise to the surface. If gratification came in, the tiger would go back to sleep, having been fed. But that idea really is a very old one. And even at the time in which I trained, the early sixties, there was not much adherence to that notion. Already it had begun to change. So that the idea really was much more that one had to find the correct balance between a certain amount of deprivation, which provided some kind of motor force for the analysis, and gratification, so that the patient wouldn't feel as though in a vacuum.

Certainly Leo Stone was an important force in recognizing that analysis has to be carried out in what one thinks to be an optimal atmosphere. And for some patients, that's more on the side of providing certain kinds of — I don't even like the word—gratification to the patient, answering certain needs that the patient has. And meeting certain needs may be very important. For other patients, who may carry the ball more themselves, it may not be necessary. They work better when there isn't as much interference on the part of the analyst, through interventions, or through providing a certain amount of support and so on. But even in the most classical condition, gratification always plays a role. Because it's one of the most gratifying things to come four or five times a week and have someone make every effort to understand you. The primordial transference that Stone speaks about is based to some extent on providing very important nutrients to the patient. So, it's a caricature to say that classical analysis doesn't gratify. It does gratify. But increasingly, as we look at different kinds of patients, it's important to find the correct mix, and not to be led by theory, before you deal with the individual. But to find that mix is sort of an art. It's more an art than it is a science. You're running a Sunoco station, and you have to find if your mix is 190, 220, or 240.

Interviewers: What place does regression have in the analytic setting? Some wonder if this concept is underemphasized by interpersonalists and some who work in a relational model.

Jacobs: I do agree with that. I think the capacity to regress in the sense of being in touch with earlier modes of thinking — to some extent memories, to some extent bodily experiences or fantasies that have been transformed over the years — is important. To be in touch with those requires the patient to have enough space and enough silence, and enough sense of working as an artist works, to get in touch with some of those experiences. There's no writer who can write when he's concentrating on the television, or on a conversation. He has to have the solitude. He has to be in touch with the inner world of experiences. And the same is true of the painter. Being able to create something does require a regressive movement in the sense of being in touch with these earlier experiences in fantasy. So the analytic situation, I think, is set up in order to allow for that possibility. The problem comes, I think, when you have patients who, even under those circumstances, lack the capacity for such regression. And then the question is, Are we dealing with somebody who really cannot enter into a full analytic process? And sometimes that is really the case. But under other circumstances, it seems to me that what looks like the inability to allow this regression to occur is the patient's not yet being able to trust the analyst or him- or herself—the fear of what will emerge.

Interviewers: Among the many names you have been called, have you ever been called a dissident?

Jacobs: Well, yes. I think so. I think with the more traditional group, yes, I think so. A little bit less in the last couple of years than maybe eight or ten years ago. I think this reflects a whole change that's going on in our field. I think there was a time when the thinking I've expressed, in the words of some people, was not that of a real analyst but tended to lean more toward the object relations perspective, which was not considered in-depth analysis. So, from that point of view, and still today, for those who hold to the older Freudian views, I would not be considered one of their core analysts.

Interviewers: Why wouldn't someone with an object relations perspective be considered a true analyst?

Jacobs: Well, because the tradition, which is partly a scientific one, partly a reflection of the history of analysis, and partly political, led many of the older, more traditional analysts to feel that some of the core ideas that distinguish analysis from other forms of analytic psychotherapy lay in the recognition of the importance of drives as human motivations, along with the importance of infantile sexuality and unconscious fantasy. These things became the cornerstones of what was considered true or real analysis. The object relations perspective seemed to work on another level, closer to the interactional or interpersonal, often, they felt, omitting or overlooking the importance of drives, deeper unconscious fantasies, and infantile sexuality. I think there is a place where the relational modes and the instinctual modes are coming together — particularly through the work of Loewald and in some of the infant research work, where there is a great emphasis on object relatedness from early on, as well as a recognition that the baby is full of instinctual urges. The idea that the aim of instinct is the object and that instincts and objects are fused was spoken about by Loewald. He anticipated some of the most interesting current views. In the olden days the people who stressed object relations were seen as not believing in instinctual theory — they didn't believe in what was thought to be essential. And that has a whole history to it — of Rado and Horney, among others, breaking away from the New York Institute — and anyone on that axis was considered to be in that camp.

Interviewers: Much of your writing is focused on the analyst's awareness of self-experience. Do you have any plans to write about self-analysis?

Jacobs: Well, I try to include that not only in my writing, but in my thinking, and in my work with myself. But I'm not sure that the word self-analysis is exactly right. I feel there's such a difference when analysis is done with another person. Because there are such limitations, no matter how dedicated we are to the project, within ourselves, that to have another mind, another heart, another view, is a different experience from trying to do it all by oneself. So I'm not even sure that we should use the word. But some introspection, self-reflection, ideas like that, I think, are very important.