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The role of analytic neutrality in the use of the child analyst as a new object
Abstract
The analyses of two children and one adolescent were presented to illustrate the concept that the neutrality of the analyst can be used not only to (a) establish a working, analyzing, and observing alliance, (b) permit the development, recognition, and working through of the transference neurosis, but also to (c) develop a sense of autonomy and self-esteem which had been contaminated by the neediness and lack of true empathy of the primary objects during the practicing and rapprochement phases of separation-individuation. For the patients discussed above, many ego functions which should have had a degree of secondary autonomy were either inhibited, enmeshed in conflict, or experienced as nongenuine, part of a "false self." It was as if the experience with the neutral analyst permitted an "autonomous practicing" that had not been possible during the period of separation-individuation.
... Neutrality defined as being open to everything within them. I think that Judith Chused (1982) defined it that way. A certain frame that's not punishing, depriving, defensive, or used as a way to establish authority or to hide from certain things that happen that make you anxious. ...
... This created both fear and anger at separation from those close to her as well as an intense need for a relationship in the present that could both substitute for what she needed from her mother and that would allow her to attempt to understand what she had lost. In this way, I became, in a limited way, both a new object as well as a transference object (Chused 1982;Loewald 1960). In addition to "real" relationships with people important to her, Grace was also able to utilize fantasies to maintain connections to important others, including a fantasied connection to me. ...
The author presents an in-depth exploration of her work with Grace, an 11-year-old girl dying of liver failure. The experience of terminal illness in childhood is discussed with attention to the ability to cope with multiple losses (e.g., body image, body functions, important objects, a healthy future), the impact of the denial of impending death on the child and her family, the child’s use of fantasy as a means to obtain comfort and reduce feelings of loneliness, and the difficulties in the perception of self and other that result from the overwhelming stress of serious illness. Although the author was a pediatric resident at the time, the ability to work therapeutically at the patient’s bedside is illustrated, and unique aspects related to interacting with the ill body are discussed. The therapist’s ability to enter the experience of dying with the child, to understand both verbal and nonverbal forms of communication, to openly discuss loss and death and to allow the child to elaborate and address fears and fantasies regarding the child’s rapidly changing physical self in a developmentally appropriate way are illustrated. The experience of caring for a dying child is explored with a discussion of the range of affects evoked by this work and the centrality of the relationship as a way of both processing and defending against loss for both patient and therapist.
... Relational scholars emphasize that exposure to subjective otherness is essential for the foundation of the self (Aron, 1996;Benjamin, 1988) and view therapist self-disclosure as a form of intersubjective inquiry, which is part and parcel of every treatment. This mutual in-1 Over the years, the concept of equanimity has been constructed and widely referred to and discussed in the psychoanalytic literature as "neutrality" (e.g., Chused, 1982;Franklin, 1990 ;Glover, 1928;Hoffer, 1985;Schachter, 1994). Kallner (2002) points out that, although Freud himself never employed the term "neutrality," it gained currency due to James Strachey's use of it to render the German indifferenz. ...
This article advances an integrative conceptualization of therapist self-disclosure. The first section reviews various theoretical positions regarding self-disclosure and then proceeds to examine research and theory concerning the impact of self-disclosure on patients' perception of the therapist, its efficacy as evaluated by both patient and therapist, and its impact on the therapeutic outcome. It is proposed that the power of therapist self-disclosure derives from its integration of various therapeutic dimensions, enabling it to simultaneously strengthen the therapeutic relationship and advance diverse dimensions of therapeutic change. Illustrating this claim clinically, it is suggested that an integrative conceptualization of self-disclosure supplements previously discussed approaches to psychotherapy integration. (PsycINFO Database Record (c) 2013 APA, all rights reserved)
... One of the prime areas of analytic concern to which this consideration of the role of the alliance arises is child analysis. The alliance has certainly found application in the analyses of children (Chused, 1982;Chused and Tyson in Panel, 2003;Evans, 1976;Franch, 1996;Frankl & Hellman, 1962;Geleerd, 1962;Osofsky, 2003;Otte, 1999;Tyson, 2002), 15 and adolescents (Schimel, 1974;Schowalter, 1976;Shapiro, Shapiro, Zinner, & Berkowitz, 1977), and in working with parents (Badoni, 2002;Obershneider, 2002). As Yanof (2005) observed in her recent review of technique in child analysis: ...
The therapeutic alliance is often misconceived, misunderstood, or ignored in conceptualizing the therapeutic process and the therapeutic relation in analysis and other forms of therapy. Conversely, I will argue that the alliance is indispensable in all forms of therapy. After briefly outlining the nature of the alliance, I discuss some of the empirical findings regarding its utility in various therapeutic contexts. I then consider its role and function in various therapeutic settings other than adult analysis and psychotherapy, including child analysis, treating various forms of psychopathology, and related contexts like supervision, forensic psychiatry, and hospital and medical treatment. The alliance plays a definite but analogous role in all of these, with differences according to context. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
... There have been many disclaimers from psychoanalysts that the "blank screen" reflects the actuality of the analyst in the analytic situation (e.g., Chused, 1982;Franklin, 1990;Gill, 1983;Greenson & Wexler, 1969;Hoffman, 1983;Poland, 1984;Schafer, 1983;Shapiro, 1984), yet psychoanalysts from the relational school (e.g., Greenberg, 1981Greenberg, , 1986Mitchell, 1988) have written as if none of this exists. ...
I maintain that the proponents of the relational school of psychoanalysis underestimate the role of interpersonal relations in Freud's theory and in contemporary Freudian theory, thereby overestimating the nature of their contribution to psychoanalytic theory. This polarization only contributes to the fragmentation in psychoanalytic theory today. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
I maintain that the proponents of the relational school of psychoanalysis underestimate the role of interpersonal relations in Freud's theory and in contemporary Freudian theory, thereby overestimating the nature of their contribution to psychoanalytic theory. This polarization only contributes to the fragmentation in psychoanalytic theory today.
A term increasingly used in psychoanalysis when referring to the analyst's role is developmental object. However, it is often used descriptively and the meaning remains unclear. The history of the concept and an understanding of its current meaning are traced. Analytic material is presented as an illustration.
Analysts have interpreted the concept of neutrality in a variety of ways, beginning with Strachey's use of that word to translate Freud's (1915) term, Indifferenz. In this paper, neutrality is linked to Freud's notions of free association and evenly suspended attention. A history of psychoanalytic attempts to clarify the concept are presented, with special attention to issues of ambiguity and the patient's role in the determination of neutrality. Neutrality is further elaborated in relation to the bipersonal field as described by the Barangers and contemporary field theorists. Understood in terms of the field, neutrality becomes a transpersonal concept, here conceived in terms of alpha-function and a dreaming dyad. Two clinical examples cast in the light of a Bionian perspective are discussed to suggest an alternative understanding of analytic impasses and their relation to alpha-function and neutrality.
Neutrality, anonymity and abstinence are three important aspects of psychoanalysis and psychoanalytic psychotherapy. This paper examines the varying ideas inherent in these principles with particular reference to the influence upon the therapeutic process of extraordinary situations in the lives of therapists: a serious, life threatening illness and a notorious situation. Treatment dilemmas, problems of transference and countertransference are illustrated by case studies. The discussion reiterates the importance of neutrality in the psychotherapeutic encounter, with guidelines for therapeutic interventions.
The analytic state of consciousness is a particular regressive altered state in the patient characterized by an increased sensitivity and reactivity to impressions arising from both the inner world and the analyst, a heightened sense of dependence and vulnerability, a permeability of boundaries in regard to the analyst, and a shift toward functioning on the basis of omnipotent fantasy in the analytic relationship. These changes are accompanied by a feeling of realness of one's psychic reality, but without any true loss of reality testing. Based on an analysis of the structure of play, this state can itself be understood as a kind of play; it serves as a foundational transference underlying more specific transference manifestations; and it is central to the analytic process. Over time, in response to physical aspects of the analytic setting, its safety, the analyst's emotional accompaniment, and a generally restrained analytic stance (an issue I discuss in some detail), it emerges in a more developed form that promotes symbolization and ownership of aspects of self, greater emotional presence, and a deeper sense of meaning in one's experience. Additionally, the concept of the analytic state of consciousness provides a new look at the role of abstinence and frustration in analytic process.
La presente tesis revisa, en su primera parte, las aportaciones teóricas sobre el concepto de transferencia desde Freud, pasando por las aportaciones teórica sy técnicas de las psicoterapia con niños y adelescentes. Así como las investigaciones realizadas sobre la transferencia en sus diferentes modalidades. La segunda parte es un estudio clínico, realizado en un Servicio de Salud Mental, con pacientes en tratamiento psicoterapéutico. El objetivo de la investigación es el análisis del patrón transferencial con el METODO DEL CONFLICTO CENTRAL EN LA RELACION (CCRT) de Luborsky. El análisis de los resultados, partiendo del material de las sesiones, se realiza un dos niveles: individual y global. El análisis individual especifica el patrón transferencial de cada paciente con sus características particulares. El análisis global estudia las características comunes y las diferencias del patrón en función de la edad, el género, las conotaciones positivas y negativas del afecto, las relaciones significativas de los pacientes, los síntomas somáticos y la configuración del conflicto edípico.
An adolescent patient's action during analysis reflects both neurotic conflicts and the developmentally determined task of establishing an integrated self-representation. Concern for the consequences of the action often provokes the analyst to respond, covertly, with interventions intended to change the action through influence rather than understanding. This can lead to a distortion of the analytic process which, in itself, may be an enactment of the developmental conflict. Examination of such interventions reveals a lack of analytic neutrality and an unconscious participation in the patient's neurotic and developmental conflicts. Clinical material from the analyses of two fourteen-year-old girls and a sixteen-year-old boy is presented to illustrate and support this hypothesis.
Four clinical examples of oedipal-based transference across gender lines are presented with the aim of illustrating (1) its existence, (2) the defenses against its emergence, and (3) the use of the analyst's gender as both an organizer of and resistance to certain transference manifestations. Factors that contribute to the availability for analysis of cross-gender transference are discussed, as are the resistances and other obstacles to its actualization.
Idealization is an intrapsychic process that serves many functions. In addition to its use defensively and for gratification of libidinal and aggressive drive derivatives, it can contribute to developmental progression, particularly during late adolescence and young adulthood. During an analysis, it is important to recognize all the determinants of idealization, including those related to the reworking of developmental conflicts. If an analyst understands idealization solely as a manifestation of pathology, he may interfere with his patient's use of it for the development of autonomous functioning.
The word and concept of neutrality play an important but confusing role in the history of psychoanalysis. Does neutrality imply indifference? The origin of this ambiguity is traced to the fact that Freud himself never used the word "neutrality" (Neutralitaet) in his own writings. (His term Indifferenz was translated as "neutrality" by Strachey.) The essence of the controversy that has simmered in the psychoanalytic literature ever since is contained in the question: "Is remaining true to the concept of neutrality somehow antithetical to the analyst's genuine involvement with the patient?" In this paper, I examine the feeling and power aspects of the word and suggest that the concept of neutrality becomes clinically useful when the analyst asks himself the question, "Neutral to what?" The analyst's awareness of his motives for recognizing and addressing certain conflicts and for overlooking others is heightened. With three clinical vignettes as illustrations, I explore the role of the concept of neutrality in deepening our understanding of (1) the analytic relationship; (2) The influence, on the conduct of the treatment, of the analyst's goals and theoretical persuasion regarding how the goals are to be achieved. As examples, I use the current debates over the relative value of the analyst's focusing his attention on: (a) the patient's mind in the hour rather than his life outside the hour and, (b) transference over nontransference interpretation. Finally, I emphasize the far-reaching implications of adding an explicit concept of "external reality" to A. Freud's exclusively intrapsychic definition of the "objective" analyst's position of neutrality as equidistant from id, ego, and superego. The addition of this fourth point to the analyst's "compass" widens the analytic field toward which the analyst is neutral. The concept of neutrality with respect to specifiable conflicts is thereby also broadened to include (a) interpersonal conflict within the psychoanalytic relationship and (b) conflict within the analyst. With these explicit additions, the concept of neutrality with respect to conflict becomes congruent with the current emphasis on the nonauthoritarian two-persons aspects of the psychoanalytic relationship, without detracting from the primary analytic goal of deeper understanding of intrapsychic conflict.
In spite of the increasing number of foster children who have had pathological relationships with their biological parents, there are relatively few reports of intensive therapy with these children. This paper focuses on the psychoanalytic psychotherapy of two young foster children whose treatment began shortly after placement. The paper describes the children's developmental problems, their conflicts and defenses, and the therapeutic process utilized to enable them to resume progressive development. The children were helped to mourn their past objects and to form more appropriate attachments to their foster parents.
Concepts of neutrality and abstinence are discussed in terms of the variant opinions about them, pro and con, with particular reference to efforts to dispense with them based on the unavoidable role of the analyst's personal influence and subjectivity in the analytic process. Stereotypes of both neutrality and abstinence are examined, and the therapeutic alliance established as the most appropriate context within which to articulate the essential and constructive role of effective analytic neutrality and abstinence. The alliance is not possible without the persistent exercise of both neutrality and abstinence; conversely, other components of the alliance are intended to facilitate and preserve neutrality and abstinence on the part of both analyst and analysand. These elements are essential factors in effective analytic practice.
This paper will attempt to explain certain dimensions of the child analyst's role as a developmental object in an effort to better clarify the nature of that function as well as demonstrate that it is an important part of most child analyses. A review of the literature reveals a bias toward differentiating this function from that of promoting insight with the belief that these two functions determine different treatment modalities. Therefore, many authors suggest that being a developmental object is necessary only in the treatment of seriously disturbed children and/or those whose familial histories require a departure from a "genuinely" analytic stance. A case of a prelatency boy is presented to demonstrate the child analyst's need to serve as a developmental object in regard to setting limits in order to promote affect regulation. Closer scrutiny of these interventions raises the possibility that they may simply have been transference of defense interpretations at a concrete level commensurate with the child's level of cognitive development. This possibility is highlighted as an area for further study.
In the past three decades, neutrality has come under increasing criticism. The idea that a psychoanalyst can leave himself out of the therapeutic exchange has come to be seen as either an impossible dream or a myth. We propose that examining neutrality through the lens of curiosity allows for a new appreciation of the ongoing and vital importance of this psychoanalytic attitude. Our hypothesis is that curiosity and neutrality are linked, and that to maintain a neutral stance, the analyst must be able to direct a relatively conflict-free curiosity toward the workings of the analysand's mind as well as his own.
Examination of the clinical evidence offered by proponents for the concepts of therapeutic and working alliance leads the author to conclude that neither concept is justifiable. Both refer to aspects of the transference that neither deserve a special name nor require special treatment. The related topic of frustration/gratification as necessarily inherent in the analytic situation is also considered.
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