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Wagner, P.S. (1963). The Second Analysis. Int. J. Psycho-Anal., 44:481-489.
(1963). International Journal of Psycho-Analysis, 44:481-489
The Second Analysis
Philip S. Wagner
Of twenty-two patients I considered six as primarily intellectually defended individuals whose involvement in any overt transference interreaction was negligible. Three of the six had had more than one prior analytic experience, and of these I learned that two in later years arranged for additional analytic work. These were all individuals of considerable attainment who returned to analysis at the insistence of their spouses with renewed feelings of depression and discouragement.
Four patients presented chaotic transference interaction, and all came for additional analysis out of feelings of desperation and isolation. Two of these arranged for additional therapy in later years. One required electroshock therapy shortly before his death at the age of 58.
Eight patients I considered as seeking to maintain an idealized static transference relationship, and succeeded pretty much in maintaining this façade through most of the second analysis. Most of their hostility was directed towards their former analyst. Of these four, three had been in psycho-analytic therapy more than once previously, and two went on for further work in later years. One of the latter patients who terminated with me after great protestations of appreciation and friendship, quite as she had terminated with her first analyst, later described me to her third analyst as also a hypocrite and scoundrel.
Four patients came with a preference for the type of hysteric involvement described in the cases of Helen and Mary. One of these wrote me in later years, after marriage and several children, for suggestions regarding further analytic work in a distant city. With these four patients I felt
more had been achieved in terms of emotional stability and growth, and a capacity for reciprocal honesty, than with the other eighteen.
Several colleagues have questioned the appropriateness of considering a second experience a 'second analysis'. A number of these patients could never become involved in an analytic situation where transference awareness is the primary learning experience. 'Psycho-analytic therapy' has been suggested as more descriptive of the technique required in these instances. Also, some patients seek a second analyst to understand and conclude their previous analytic experience. The analysis of the first psycho-analytic experience constitutes for some the main work of the second experience. But when in most cases there is a different beginning, a different course, and a different ending, I have felt that the rubric 'second analysis' was applicable.
I wish to emphasize that for most of these patients there was no justification for considering the first analysis a 'failure'. In most cases all that could be elicited through further transference involvement, through exploration of unconscious fantasies, and the essential genetic facts, had been uncovered in the first experience. An unusual degree of defensiveness, primarily denial, had made acceptance and consolidation of the prior experience impossible without a change in analysts.
I have suggested that in most of these patients the experience of transference was unacceptable, and that if any technical error existed it derived from the first therapist's insistence that the patient work 'analytically' and accept the reality of the transference. As one patient said in retrospect: 'The man was utterly unrealistic in demanding that I trust him. The prospect of abandoning myself to this degree of trust provoked in me a feeling of panic and I could only remain silent.'
In classical analysis a degree of trust and intimacy is required which may be beyond the capacity of some patients, and the analyst need not feel that his contribution and effort is thereby diluted or modified. Our primary goal is to assist the patient in finding relief from his symptoms and in lessening characterological rigidity. We cannot too resolutely insist that the patient fit into the familiar pattern of transferenceregression and resolution. We are only too familiar with patients who are 'well analysed' but are finally most comfortable with characterological traits and interpersonal safeguards which impress others as idiosyncratic or peculiar.
Finally I have referred to the occasional absence of real and meaningful relationships between patient and therapist even at the conclusion of a long therapeutic effort. Sometimes this is consequent on a patient's need to maintain distance even from the person in whom he has placed his greatest trust. But in some cases the analyst's conviction that the analyst is always an analyst, and that the patient is always a patient, deprives both therapist and patient of the basic enriching and gratifying experience—a meaningful human relationship, mutually shared, unencumbered by neurotic limitations or concerns. The final relationship should be real, genuine, and capable of enduring mutual criticism and acceptance. Perhaps the most appropriate comparison is to the maturation of a child-parent relationship. The child becomes the adult, independent, free to judge the parent objectively, and secure in the knowledge that the parent sets no conditions on such judgement or such freedom.
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