title: Helplessness and the exercise of power in the analytic session.
abstract: This paper describes a clinical situation in which the analyst may be provoked to become overactive if he feels that his attempts to reach his patient are frustrated. Lack of tolerance for feelings of helplessness may leave him unable to sustain a receptive stance, and he may be drawn into enactments which lead to a power struggle with his patient. I will try to describe situations where such enactments were compelling. I will also consider what enabled me to extricate myself from the activity, at least intermittently, to re-establish an analytic attitude in which understanding and containment were priorities. From time to time I was able to recognize and accept my helplessness and relinquish my attempts to reach the patient. These moments of recognition led to a shift of atmosphere in which a feeling of sadness replaced the more familiar confrontational mood. In these sadder moods the patient felt I was more available, and he too seemed more able to contemplate loss. Theoretical ideas that enabled me to recognize some of the mechanisms at play included an understanding of narcissistic mechanisms, a recognition of previous ideas of power and dominance such as Freud's Bemächtigungstrieb, and the role of dominance in the resolution of the Oedipus complex. My previous work on the dread of humiliation allowed me to be sensitive to the way helplessness can come to be associated with being looked down on and humiliated.
authors.affiliation: john@jsteiner.co.uk
authors.forename: John
authors.initials: J
authors.lastname: Steiner
mesh_terms: D006801:Humans; D009289:Narcissism; D009813:Oedipus Complex; D011209:Power, Psychological; D011369:Professional-Patient Relations; D011575:Psychoanalytic Therapy