Excerpt

The following excerpt is from the chapter on the role of emotional communication in psychoanalytic technique.

Prior to the session to be described, the patient had appeared to be a timid, usually self-deprecating man who constantly found himself hiding in social situations. He initially ascribed this to a modesty that was inculcated into him when he was young. He was afraid of looking like an arrogant exhibitionist. He was terrified that he would be destroyed – or deeply humiliated – by his parents if he let himself shine in any way. They were also modest and extremely judgmental about the need to keep to yourself. He had been frustrated that he had not gotten much of what he had wanted out of his life – romantically, socially, or professionally. He’d never had a boyfriend, he didn’t have many friends, and he felt he could do much more in his work than he had accomplished. He thought – correctly, in the analyst’s eyes – that his deferential demeanor had contributed to his lack of success.

But in one session, his way of relating to the analyst has changed somewhat: he cautiously describes fantasies of wanting to stand out more. He’d like to talk more in meetings at work, to put forth some proposals. He’d like to approach men at a health club, and he’d like to call people and make plans. He saw a beautiful leather jacket that would look great with some new jeans he bought – a sharp departure from his usual khakis and pastels. As he describes these thoughts and feelings with the analyst, he sounds very anxious. He tentatively wonders whether the analyst ever experiences these feelings. The analyst asks which would be better – if he did have the same feelings or if he didn’t? The patient thinks it would be better if he did, but he can’t articulate why.

Obviously, there a number of ways to interpret this situation, but let’s suppose that the most relevant interpretation is as follows: the patient’s desires (impulses, needs) to show off and to be exhibitionistic have been severely inhibited as a result of his parent’s harsh condemnation of these desires and their consequent inability to provide him with the normal narcissistic mirroring he needed to be able to integrate them into his personality. This has led to a repetition characterized by a severe restriction in his ability to pursue his desires in the present. In the analysis, the patient does not allow himself to experience desires and impulses that he had previously suppressed or repressed. However, he is both (a) frightened that the analyst will disapprove; and (b) longing for the analyst to share these feelings so that he will know that they are acceptable and feel the narcissistic reinforcement that was missing from his childhood. Thus, there are elements of both object and narcissistic dimensions of the transference.
The analyst wants to make an intervention based on this understanding of the transference. Three rather different possibilities are described below:

1.  “Perhaps you are anxious because you are afraid I will be as disapproving as your parents were, and you are wondering if it is safe. And maybe you wish that I would share these feelings because then I would clearly be accepting of them and would give you the feeling of sharing them with you that your parents didn’t give you as a child.” This intervention, a classical interpretation, is basically a condensed version of the theoretical understanding of the transference. Its therapeutic leverage lies in the cognitive communication that the analyst conveys to the patient’s reasonable ego. The interpretation is an observation designed to help the patient understand his feeling, to have insight into the meaning and origin of his anxiety. This cognitive communication is accompanied by an emotional communication that supports it and designed to help the patient to make use of the cognitive communication. The tone is slightly warm and clearly interested, and it conveys mild empathy that the patient is saddled with this problem. Nevertheless, the emotional communication is not an emotional response to the feelings the patient has for an analyst. It is designed to gently shift the patient’s attention away from his actual feelings about the analyst and to observe and understand them in light of his past experience and the analyst’s interpretation.
    
2. “It sounds like it’s really hard for you to take the risk of telling me about these feelings. I can imagine that you might be afraid that I’d react the way your parents did – attacking or humiliating you for having feelings and desires that are completely natural and healthy. They didn’t understand that, and made you feel bad about stuff that was actually really good. It would have felt so much better if only they had those feelings, too.” In this intervention – an empathic interpretation informed by Self Psychology – both the cognitive and the emotional communications are viewed as being equally important. The cognitive communication, which is essentially the same message as the first intervention, is designed to convey self-understanding and insight to the patient and is addressed to the reasonable ego. However, the language is closer to the patient’s experience, and the emotional communication that accompanies it is more intense than in the first intervention. It is designed to do more than support the interpretation. The words, and even more the tone, are more explicitly empathic with the pain the patient feels and felt and are addressed to the afflicted ego. The emotional communication is a direct response to the patient’s current feelings about the analyst. As a whole, the intervention encourages him to view his current feelings in light of the past, but it also provides an experience of being emotionally understood in the present in a way that the patient did not get from his parents.
    
3. “Of course I have those feelings. Why, sometimes all I want to do is show off – sound smart, be seductive, and wear cool clothes. It’s really scary. You never know how people will react, but sometimes there is just nothing more wonderful than showing people your stuff – going after the world and getting it. That jacket sounds really great. Where did you see it? What kind of leather is it? It sounds like it would make a fabulous outfit.” In contrast to the first two interventions, this one is not designed to help the patient to observe or understand his feelings in light of the past. No communication is made to the reasonable ego. Rather, the analyst works to provide the afflicted ego in the present with the emotional experience that he did not have with his parents. Whereas the second intervention conveyed empathic understanding of the patient’s feeling, this intervention explicitly reflects and amplifies the patient’s nascent extroversion. The self-disclosure is designed to give the patient the feeling that he is with a twin, who meets a developmental need and solidifies his sense of self. He provides direct narcissistic mirroring and validation, which encourages the patient not just to accept his feelings but to embrace and enjoy them. He is trying to help the patient experience and tolerate higher levels of excitement and joy – positive affect – in his impulses than he has ever known. The emotional communication is the primary source of therapeutic leverage in this intervention, and the cognitive communication supports and amplifies it. Both the cognitive and the emotional communications are addressed to the afflicted ego.

Although each one of these three interventions is based on approximately the same interpretation of the case, each uses a different combination of cognitive and emotional communication, and each addresses the patient’s reasonable and afflicted ego in different ways.  We will go into greater depth about how these combinations should be conceptualized and what aspects of the patient’s experience they are designed to engage. But for the moment, let’s make a basic observation: there is a fundamental difference between classical interpretations, which address the reasonable ego primarily through cognitive communication, and other types of interventions (including other types of interpretations) that address the afflicted ego primarily through emotional communication. When the cognitive communication is of primary therapeutic importance, the analyst emotionally positions himself outside of the transference – outside of the way the patient emotionally experiences him; his communications take the form of observations about the transference. He attempts to modify the patient’s repetitions by helping him understand them. In interventions in which the emotional communication is granted equal or greater importance, on the other hand, the analyst positions himself inside the transference – on the basis of the way the patient experiences him, and the analyst’s communication directly engages with the feelings that characterize the repetition. The analyst attempts to modify the patient’s repetitions by using his own feelings to change the patient’s feelings.

(Reprinted with permission from Emotional Communication: Countertransference Analysis and the Use of Feeling in Psychoanalytic Technique, Paul Geltner, Routledge, 2012.)  

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