The Frame and the Lens

In the middle of the journey through my analytic training, I had a patient who wondered to the point of insisting why psychoanalysis couldn't be conducted en plain air, walking together in some shared landscape instead of him lying beneath my chair, in my office. I dutifully, perhaps breezily, certainly defensively, recited the accumulated thinking that had glacially gathered — even as our forebears practiced their craft through the disruptions of war, persecution, displacement, economic calamity, and exile — to forge the fearful asymmetries of the analytic frame: the chair and the couch, the purse and the pocket, the fastened, shortened “hour,” the analyst's space housing the patient's mind, in person, but at an angle — in order to delineate the analytic relationship from all those other kinds of being with-others on whom one must cling or rely, endure, respond, or relate. Those conditions, informed by the doctrine of abstinence from gratification which was considered so central to analysis in its early, randy days, were understood (by me) to foster, through their idiosyncrasy, transparency, and constancy, to allow the dyad to dispense with the semantic anguish of civilized life, and focus on the mental and internal experience of the patient, to the approximate exclusion of reality.

Convincing not even to myself, my patient — who was after something I couldn't yet apprehend — had no use for my reasons, and though he

grudgingly tolerated the rules of our engagement, the gauntlet was down, and, before long, he assayed various inspired infractions against the frame. With my half-hearted endorsement, and with my supervisors' eyes on me, the patient sat on the floor, then lay on the floor, then insisted we switch chairs; once he hung upside down. Later on, we played with time — shorter and longer sessions, floating appointments — which, to my relief, the patient found even less congenial than I did.

…we are learning new ways to work, ways that were proscribed by custom if not training, until made urgent by our and our patients' mutual need.

But really, why, apart from the anxiety of scrutinized inexperience that analytic training entails, should I have cared? As we came to understand together, all of this playing with the frame wasn't simply a matter of working out the nature of control in the relationship (though it was that), but the founding of the relationship itself. In wanting to know what could be changed about the place and the way we interacted, the patient was asking would this be a collaboration; could he count on our relationship to move with him and still be constant, and above all, could he get with me what he had come for, and be sure it was his and not mine?

In due course, I had to learn with this patient (for that was what was needed) to dispense with not a few of the rules I had learned: We opened and read his mail together in my room when the pile grew too large in the patient's mind; we spoke by phone when the effort of finding the office was too great; ultimately, we learned that much of what I had to tell the patient about himself according to the theories with which I prosecuted him was of far less use than what he had to show me about what it was to be him, and that it was work enough for a long time to bear witness to his mind, and his yearning to be both idiopathically himself and also acknowledged and cherished for his becoming. For it was in that witnessing, in our embroiled reaching and not being reached and yet still reaching, that he could feel himself somewhat known, fleetingly seen, provisionally less separate, less mediated.

Now, de golpe, psychoanalysis, so intrinsically concerned with the mediation of inner experience, must suddenly contend with the mediations of film, the Modernist twin with whom it has so long shared the frame. And now we all find ourselves with certain rules dispensed, rules that we might have been cautiously considering before, in terms (we'd tell ourselves) of what was effective, therapeutic, ethical, developmentally informed, in the patient's interest, but perhaps also a little defensively, fearful of some disintegration if how we are with patients were to become too estranged from our inheritance and self-conception. Trading face time for FaceTime, evacuating our offices (for many of us, the incarnation in space of our therapeutic identities), confronting the sudden disclosure, through barking and baking and other irruptions of our own humanity into an analytic frame newly mediated by the camera eye, we are learning new ways to work, ways that were proscribed by custom if not training, until made urgent by our and our patients' mutual need. And now, having abdicated so many of the familiar symbols, guardrails and first things of our practice, we are left to ponder, as my patient and I did long ago: How shall we find one another again, what is really required to witness the mind of another, and can our patients still use us to find out what they come to us for?

Several years further on into the treatment, I was inadvertently locked out of my office at just the time I was to meet with my patient, and I hastily arranged for a substitute space. The space was just a few minutes away, and so we walked there together. The initial moments, which were not unfamiliar from rides we had occasionally shared in the elevator, had an anxious and uncertain quality for both of us, but then we adjusted to the new situation, and we began to talk as we might in the office. It was not lost on either of us that we had accidentally finally realized the patient's early wish. As it turned out, my patient and I did have our walking analysis, and managed to find ourselves together again in the new frame.