title: Cultural function and psychological transformation in psychoanalysis and psychoanalytic psychotherapy.
abstract: Cultural experience of silence and individual vicissitudes between talking and being silent influence the way individuals form an alliance and pursue the analytic process. This is of relevance both for the patient and for the psychoanalyst/therapist. The author describes a patient, whose silent phase occurred in the fifth and sixth year of intensive psychoanalytic psychotherapy. She suggests that a) the silence functioned as a protection of a space for the core self and promoted inner transformation and psychological development; b) the silence involved a transference-countertransference matrix with projective identifications of the patient's internalized mother- and father-related objects that caused a tenuous balance between maintaining and erasing the relationship between the patient and the author; c) the silence phase was highly influenced by the author's own cultural background and what she brought into the relationship of tolerance of being silent in the presence of another, and understanding of the many complex functions of silence. During the silent phase the patient moved from simply describing and naming her affects and inner experiences or expressing them as somatic processes, to being able to internally access and verbally convey her own affects and experiences in the therapeutic alliance. This process involved both affect desomatization, affect differentiation, and affect verbalization.
authors.affiliation: Harvard Medical School, McLean Hospital, Belmont, MA 02478, USA. ronningstam@email.com
authors.forename: Elsa
authors.initials: E
authors.lastname: Ronningstam
mesh_terms: D000328:Adult; D000339:Affect; D003142:Communication; D003379:Countertransference; D003431:Cross-Cultural Comparison; D005260:Female; D006801:Humans; D009289:Narcissism; D010553:Personality Development; D011369:Professional-Patient Relations; D011572:Psychoanalysis; D011573:Psychoanalytic Interpretation; D011575:Psychoanalytic Therapy; D014167:Transference, Psychology