Contemporary Trends in Psychoanalytic Methodology

Modern psychoanalytic methods progress from "one-person psychology" through "two-person psychology" to "three-person psychology." Freud's original one-person psychology treats unconscious intrapsychic conflicts by comprehending intrapsychic protective mechanisms that prevent free connection. Two-person psychology studies transference and countertransference. The modern intersubjective, interpersonal, and self psychology psychoanalytic schools believe that transference and countertransference are mutual since the analyst's reality components activate the transference. Constructivists believe the analyst cannot be objective outside the transference-countertransference limit. In contrast, the contemporary objectivist position, as represented by the Kleinian school's "three-person psychology" approaches, the French psychoanalytic mainstream, and significant segments of contemporary ego psychology, proposes that the analyst, influenced by transference and countertransference developments, must also maintain himself or herself outside this process as a "excluded third party" who symbolically provides an early tr Severe personality problems require this triangulation.

It is important to distinguish between "acting out," the replacement of self-awareness by frequently dramatic and occasionally violent action, and the "enactment" of pathogenic object relations from the past that have been internallyized in the form of both transference and countertransference developments. Patients with significant character pathology are prone to acting out, which can happen to both the patient and the analyst while under the effect of regression both inside and outside of sessions. Even while it depicts a fierce defensive effort and resistance, it also presents a chance for a very basic investigation of a prehistoric fight if handled by consistent interpretations in as much detail as feasible. As the typical experience of transference-countertransference expressions, acting out can also be seen as an excessive behavioral manifestation of enactment.

"Repetition compulsion" as id resistance is likely acting out to avoid emotional containment of a particularly unpleasant or traumatic experience. Psychoanalytic "working through" involves repeating an unconscious conflict. The analyst must be aware of hidden meanings and implications in what appears to be a never-ending transference fight. The patient's description of the difficulty presented by these recurring traits implies Winnicott's "holding" role (1965). It requires the analyst to withstand primitive transferences without retaliating, abandoning the patient, or giving up in a self-deprecating way and to maintain a working relationship (or "therapeutic alliance") that consistently addresses the patient's healthy part, even when it is controlled by his most conflicting behaviors. "Containing" is complementary to "holding" in that "holding" focuses on the analyst's affective disposition, while "containing" focuses on his cognitive capacity to maintain a concerned objectivity and focus on the "selected fact," allowing the analyst to integrate what the patient can only express in violently dispersed or split-off behavior patterns.

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