Communication across lines of thought Johanna Tabin (Faculty)
Ernie Wolf raised interesting points about vocabulary and communication.
I am a bit addicted to Freud's preference for plainsong. That is, Strachey's Latinization of Ich, Uber-ich and Das Es was a very different message from I, Above-me and It (as in: "It just came over me"). (I know that Freud did not use "mich," but to say Above-I in English is as silly as the Latinizations.)
I enjoy the professional shorthand vocabulary that removes us a little from the intensity of patients' unconsciouses; and is wonderful for generalizing with others in the field who are like-minded. It gives zip our mutual understanding. And surely it sharpens our understanding of the shared experience we garner with our patients. Personally, however, I do not tend to think in that kind of collegial terminology with a patient. I wonder: Did it not appeal to everyone else, too, that the most technical thought that seems to occur mentally to Meichenbaum with patients is "Socratic questioning?"
It seems to me that the vocabulary of everyday speech is also the best to use in our interchanges here, so that we have the best possibility of really understanding each other. My interest in our interchanges comes from respect for the work of those espousing various theories. I learned years ago at the workshops of the American Academy of Psychotherapists that everyone likely has the experience of a new patient who complains of lack of success with former therapists who approached things differently. Conversely, recognizing the successes of those who operate from different theories than mine is challenging. I try to understand these successes in terms of my accustomed way of looking at personality. When I cannot, I stand to learn.
In the case of Gary, I did not mean to say that Jim was helpful solely as a good father figure with whom to identify. That is why I mentioned the apparent value of Gary's developing a cognitive structure which strengthened him in facing former triggers of his fears.
Jim's last remarks on Gary seemed to emphasize Gary's successive involvements in therapy over the years. We can take it for granted that Gary gained enough from his initial work with Jim to continue his hope for further gains each time he returned.
With this example, we can ponder over goals in treatment: Helping people over humps, expecting that the momentum of a more integrated personality carries the person into further gains. Or, finding it preferable to see people through crises with the intention to make it acceptable for them to return for further work as internal pressures seem to require it. Or, believing that sticking through a deep therapeutic process eventually proves to be the most advantageous and economical method for enabling growth.
Psychoanalysis (by almost any of the flourishing different schools now extant) is the prime example of the third goal. And in almost any of these, analysis of the transference--or catching in the patient's behavior with the therapist repetitious patterns which are deleterious to the patient--is the hallmark of the method. I was surprised, therefore, to read Jessica Broitman's dispensing with transference interpretation, even though she represents one of the most vital new approaches in psychoanalysis, Control Mastery Theory. I was glad to find out about the study by Fretter, et al. on which she based her statement. Interlibrary loan has still not gotten me copies of the references, so I am waiting to read the details.
Maybe the issue will turn out to be in what way the transference interpretations were handled. If such interpretations were made before giving attention to whatever the patient was already aware of, then they would not have had much chance for becoming useful. Do we not agree that any stable constructive changes in a personality include reordering of ways of relating to people? Isn't the obvious sample for this the relationship between patient and therapist? Doesn't this give the patient the freshest data against which to compare earlier (and other, present) relationships?