Is Psychoanalysis in Danger of Being Judged Unfit to be Practised?

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Returning to the issue of the transference, the most important aspect of an analysis is the unfolding of the patient’s transference relationship with the analyst. This is crucial and central to everything. It is as if we, as analysts, provide a small oasis in the middle of an otherwise vast, hostile and arid desert, in which we are approached by our prospective patient, who bears a delicate and mysterious seed from some far-off land which they wish to plant in the cooling shade provided by the analst within the surrounding barren desert. Neither of us has any idea what plant that seed might eventually produce. It is so tempting for the analyst to foster and try to nurture that seed; but for us to do so, rather than the patient, would only produce, at best, a grotesque and distorted plant or maybe nothing but bitter, poisonous, choking weeds; or even nothing at all. Instead, analysts find themselves largely useless, from any practical point of view, in the endeavour of the other to plant and cultivate their seed in that harsh wilderness that so often encroaches on and constitues the analytic scene. We must content ourselves, instead, with merely being at our patient’s side throughout and, at most, offering them the occasional watering can. Only by encouraging the patient with our consistent and non-intrusive presence can we, together with our patient, discover what, if anything, develops from their endeavours.

An analyst makes no promises and gives no undertakings or explanations about what will take place with their patient. It is merely an encounter between two people, where the patient knows almost nothing about their analyst, while the patient is the only one who knows anything at all about themselves. Only these conditions will foster the flowering of a transference that can have any capacity to be beneficial or therapeutic.

The transference is gradually projected by the patient onto the largely blank screen provided by the presence of the analyst. It is a relationship in which the patient will slowly attribute all manner of dispositions onto the analyst and in which, at times, they may identify with the analyst. This results in the creation of a situation in which the analyst comes to represent, for the patient, aspects of their early primary relationships; usually mother, father or siblings. This does not mean that the analyst attempts actively to enact those relationships or to replace or repair them. In reality, the analyst usually tries to adopt a non-intrusive and largely neutral position. It is the patient’s privilege alone to fantasise and create the transference relationship; whether for good or bad and whether for malign and defensive intransigence or, more hopefully, as a means of bringing about beneficial change. An outcome that is even worse than at the beginning of the analysis remains a possibility and it is not always feasible to predict the likelihood that this might happen.