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Jacobs, T.J. (1996). On Therapeutic Interventions In The Analysis Of Certain "unanalyzable" Patients—lessons From Child And Adolescent Technique. Contemp. Psychoanal., 32:215.
(1996). Contemporary Psychoanalysis, 32:215
On Therapeutic Interventions In The Analysis Of Certain "unanalyzable" Patients—lessons From Child And Adolescent Technique
Theodore J. Jacobs, M.D.
WHEN THE WORK OF ANALYTIC CANDIDATES is being evaluated, it is not uncommon for a supervisor to remark of a particular student that he is too therapeutic in his approach. Such a comment is generally understood to mean that the student is too supportive, that he often seeks to reduce a patient's anxiety rather than to interpret it, and that when put under pressure by a patient's needs, demands, or critical attacks, he has difficulty maintaining an appropriately neutral and abstinent stance.
While a good many candidates encounter such difficulties, especially early in their training, the opposite problem occurs with equal, and perhaps greater, frequency. In this situation, despite clear indications that the treatment is not progressing well, that the patient experiences the analyst's neutrality and abstinence as insufficiently supportive or as actually threatening, and that, as a consequence, the patient is unable to reveal him- or herself in this kind of atmosphere, the student holds fast to his traditional analytic stance as though to the tree of life.
It is not difficult to understand why this may happen. From the earliest days of their training, students are taught not only to adopt an analytic stance in their clinical work, but to value it above all else. For a candidate working with a difficult and challenging case there can be few greater satisfactions than to be praised by his supervisor for his ability, despite encountering stormy weather and rough seas, to hold a steady course, keep a firm hand on the tiller, and maintain his analytic position.
In many situations, of course, this is just the right thing to do. In these cases it is precisely the analyst's ability to sustain his analytic stance that allows a patient to overcome critical resistances, to work through transference