PATIENTS OFTEN APPEAR FOR TREATMENT when they feel powerless to resolve a life crisis, to relieve an unpleasant emotional state, to modify troublesome thoughts or feelings, to change their mate's behavior, to change their mate, or to feel good about being alive. They usually do not understand their difficulty in these terms, but most would acknowledge that, indeed, they feel powerless about something important. They come to an expert in these matters, someone, they assume, who has the power to do something about their problem.
Although individuals who come to see us may feel powerless, we know that they share power in any ongoing treatment relationship. We make rules that encourage the patient to feel and express power: to show up, talk, talk to us about us, free associate. Each session reveals power struggles within and between the participants: the patient's resistances versus the analyst's interpretations; impulses versus reality; the patient's projections versus the analyst's introjects. At times, the patient may act in a manner that the analyst experiences as “entitled,” avoiding power or asserting power quite counterproductively, producing particularly knotty resistances. Thus, paradoxically, whereas the patient may feel powerless, he or she may seem to control the flow of the session.
In this article I assume that dynamics of entitlement belong to the analyst as well as to the patient, and that they may be interactionally cocreated when the desires of the analysand and analyst conflict. As Freud (1916) candidly acknowledged, each of us harbors irrational entitlement: “We all demandreparation for early wounds to our narcissism, our self-love” (p. 315). Thus, entitlement exist in one's very character and is expressed in the countertransference, as well as in the transference. When either party feels thwarted and powerless, he or she is more
The author thanks Drs. Joseph Newirth and Charles Raps for their stimulating ideas and editorial guidance.
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