For most psychoanalysts outside of the United States, free association remains the soul of psychoanalytic treatment. As the French psychoanalyst Jean-Luc Donnet (2001) has put it, “Thus in accordance with the project of an analytic cure, the method consists in carefully creating the conditions in which free association proves to be practical, interpretable, and beneficial.” As I noted in 2014, it is based upon the premise that all we need to know can be found in the patient’s use of free association. In this way, the analyst can find how unknown thoughts guide the patient, inhibit her, and destroy her. Sometimes a patient’s thoughts are in words, sometimes in the absence of words. Sometimes they are more like actions, designed to have us love, hate, believe, or suspect them. All of this comes in an order and sequence we cannot ask about because it follows the fabric of the patient’s unconscious or preconscious mind. Betty Joseph’s description of the “total transference” is based on this premise.
Joseph Schachter’s dismissal of free association in these pages is typical of much thinking in America. [See “Free Association: Is It Still Relevant?” TAP 50/3, page 10] He begins with a biased quote from Lewis Aron who suggested Freud, in touting free association, was looking for something other than hypnosis to claim as his own. In short Aron seemed to be claiming it was narcissism that led Freud to champion free association, rather than his understanding of mental functioning leading to the adaptation of the “talking cure” as labeled by Anna O in Breuer’s treatment of her.
Schachter’s two major complaints about free association seem to be: (1) that free associations are not free; and (2) the influence of the analyst on the patient’s associations are not considered. Regarding the first complaint, Freud recognized early that resistances to free associate were inevitable. He first tried overcoming them, but eventually realized analyzing them was the key to the process of working through (Fred Busch, 2014). However, as I noted in 1992, Freud himself, and most who followed, found it difficult to apply the new paradigm of analyzing resistances. It was not until Paul Gray’s (1982) classic paper that a method for analyzing resistances, especially unconscious resistances was developed (e.g., also see Busch, 1994, 2000, Gray, 1994, and Cecilio Paniagua, 1991, 2001, 2008).
There have been further developments in the understanding of free association, leading to greater emphasis on the process rather than the content alone, and that, in one form or another, everything that happens in an analytic session is a form of free association. An evasion is never just an evasion, what seems unrelated is never unrelated, and what seems boring is never boring. In broad brush strokes the patient is always communicating or doing something. Therefore, free association is not something the patient is supposed to do, but what they are doing. Anton Kris (1982) succinctly captured this when he said, “Psychoanalysis does not create free association in the treatment setting. It merely provides an alteration in the condition of ordinary association … It replaces silent soliloquy with spoken words.”
About Schachter’s criticism that free association doesn’t consider the analyst’s role in influencing the patient’s association, there is nothing inherent in the use of the method of free association that precludes taking this into account. Admittedly, it took some time for many analysts to recognize their role in the transference. However even Merton Gill (1984), an early champion of the co-created transference, eventually concluded, “One way of stating the changed view … is that the setting and the analyst’s behavior exert an influence, ranging from a minor one to a major one, on the
manifestations of the potential intra-psychically organized patterns of interpersonal interaction and in that sense, codetermine the transference.”
In response to Joan Lentz’s excellent commentary on Schachter’s article on free association, [See TAP 52/1, pages 23 and 24] Schachter questions Lentz’s use of the word “interaction,” stating if the analyst “had any emotional reaction to the patient clearly this wasn’t expressed.” Here Schachter is using a very limited definition of interaction (i.e., the analyst’s expressed emotions). From my perspective, he misunderstands the importance for the patient of the analyst containing and analyzing his feelings before acting on them via expression. From an analytic perspective, what good does it do for an analyst to tell his patient he’s feeling hatred, love, or sexually excited? It seems to me, it’s the analyst’s responsibility, after becoming aware of his feeling state, first sorting through as best he can via his own free associations, where this feeling comes from (e.g., a countertransference reaction that may prove insightful about something co-created and/or the patient’s dynamics, or an idiosyncratic reaction on the part of the analyst). At this point the analyst tries to find a way to express an intervention that can both be understood by the patient, and create a new representation, which is central to the curative process. This in no way precludes the analyst from reacting as a mensch, congratulating our patients on their achievements, telling them how sorry we are when tragedy strikes, empathizing with how good it must feel when their experience of themselves in the world changes for the better, or how frightening it can be when they are feeling confused or alienated from themselves. I think all of us have come a long way since the only thing an analyst was supposed to say was an interpretation.
References provided by the author upon request at .