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Frawley-O'Dea, M.G. (1998). What's an Analyst to Do: Shibboleths and “Actual Acts” in the Treatment Setting. Contemp. Psychoanal., 34(4):615-633.

(1998). Contemporary Psychoanalysis, 34(4):615-633

What's an Analyst to Do: Shibboleths and “Actual Acts” in the Treatment Setting

Mary Gail Frawley-O'Dea, Ph.D.

It is when we all play safe that we create a world of utmost insecurity.

—Dag Hammarksjold

For a long time, freud incorporated the laying on of hands into his analytic technique. Freud also loaned money to one patient and served a meal to another (Gay, 1988). Winnicott held a patient's head when she was in deep distress (Little, 1990) and allowed a little boy patient to live with him for a while (Grolnick, 1990). Cornelia Wilbur fed Sybil in the kitchen of her home and often held her during sessions (Schreiber, 1973). Robert Lindner (1954) pored over maps of his patient's delusional planetary system and visited a severely regressed bulimic patient at home. Joseph Newirth (1996) ate half of a patient's donut each session for years. Emmanuel Ghent (1995a) covered a female patient's lap and legs with a blanket.

As witnessed by the actions, or in Lindon's (1994) terms, provisions, encapsulated within this smattering of clinical lore, we as analysts have worked amidst a paradox since the inception of psychoanalysis. On the one hand, we and our patients are exhorted not to act. The whole idea is to put feelings, thoughts, fantasies into words rather than action. Greenberg (1996), in fact, points out that a primary psychoanalytic goal for Freud was to “move the patient beyond the act or repetition, which is a thing, to the memory, which is a word” (p. 198). We certainly know, however, that patients act in and act out, and it is further implied in the above examples that (rarely or sometimes or frequently) analysts act too, although, until recently, we have not wanted to talk about it much and have usually preferred to assume that the other guy does it or did it. Let me emphasize that I refer here to action with some motoric component.

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