When interpretation derails the patient: the negative impact of certain misuses of the concept of the unconscious.
Alternatives to classical psychoanalytic theory and technique have existed in the form of various "deviant" schools, all of which have found that contemporary conflict theory fails to achieve good results with the patients they treat. While the principles of interpersonal, self-psychological, intersubjective and relational schools are reasonably well known through the psychoanalytic literature, the opportunity to examine detailed analytic accounts by classical analysts has only recently become possible. The publication of full case reports has recently become a feature of the traditionally based psychoanalytic journals. This paper makes use of a recent volume of the Psychoanalytic Quarterly to examine the interpretations made during a lengthy analysis of a male patient struggling with his ambivalence about marrying his fiancée. The analyst repeatedly attributes his patient's reluctance to marry and negative feelings about his fiancée as determined by his unconscious conflation of his mother and his fiancée. The author attempts to demonstrate the derailment of the patient by these interpretations. They prevent him from solidifying his own judgment and, in so doing, prevent him from taking suitable action. An alternative approach to the material of the case is presented, including very different interpretations that would, in the author's opinion, liberate the patient rather than derail him from achieving his life goals.
Friedman
Henry J
HJ
Harvard Medical School, MA, USA. Friedmanhj@aol.com