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Wilson, E., Jr. (1992). Revue Française De Psychanalyse. XLIX, 1985: The Recalcitrance of the Clinical. Fixation on Technique or Questioning Theory? Variations on a Major Theme. Jean Bergeret. Pp. 525-550.. Psychoanal Q., 61:148-149.
Psychoanalytic Electronic Publishing: Revue Française De Psychanalyse. XLIX, 1985: The Recalcitrance of the Clinical. Fixation on Technique or Questioning Theory? Variations on a Major Theme. Jean Bergeret. Pp. 525-550.
Various aspects of technique have at some time or other been controversial, for example, the number of sessions and the length of sessions. This paper highlights the evolution of technical thinking on these and other issues, to delineate the reasons for the focus on technique, as well as the clinical bias toward oedipal material. Bergeret reviews Freud's comments on technique and shows the development of Freud's thought from the six sessions a week he wrote of in 1913 to his modifications in the 1920's. Bergeret also discusses some of Freud's limitations when confronted with those areas that have today become of interest to us—borderline and psychotic patients, as well as neurotics who do not exemplify classical treatment cases. He links the question of frequency of sessions and duration of treatment to the focus on the neurotic aspects of psychopathology (genital, triadic, and oedipal themes). The length of treatment seemed to increase as problems other than these were faced, with the mean length changing from six months in 1922, to two years in 1927, and then to four years at various institutes by 1947. Bergeret criticizes the "neurotocentrism"
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of analysts, while at the same time emphasizing the centrality of the oedipal conflict in psychological development. He argues that Freudian theory rests on a specific metaspsychology, which cannot be questioned without risk of serious deviation. On the other hand, the models for the understanding of psychological development have evolved considerably and need to be integrated.
Freud had a theoretical bias perhaps more than he had clinical gifts; his treatment cases were hardly successful, as he himself knew. In his clinical, as opposed to his technical papers he shows a preoccupation with the deeper theoretical mechanisms on which he was concentrating at the moment. However, clinical work cannot be reduced to theoretical interests, even when these interests are scientifically respectable. It is inappropriate to oppose therapeutic concerns to epistemological ones. Bergeret points out the narcissistic, self-validating elements involved in attempting to make theoretical discoveries in the course of clinical work, and in trying thus to inherit the mantle of the master. In the give-and-take between patient and analyst on an object-relational level, as well as on a narcissistic level, technical inventiveness may simply hide a lack of spontaneous affective interchanges. When a block occurs because of such a failure in communication, some analysts resort to technical manipulations, while others adhere even more slavishly to the rules which alone establish the conceptual framework. The only justification for technical manipulation is the necessity of finding and maintaining a frame favoring the conscious recovery of transference movements and their "archeological" elaboration. Bergeret argues that we must not confuse the analytic framework with analytic technique. The framework is indispensable for analysis and permits the functioning of the fundamental rule, whereas analytic technique is to facilitate the rule. He sees the couch, regular hours, fixed length, reserve, and neutrality as constitutive of the analytic framework.
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Wilson, E., Jr. (1992). Revue Française De Psychanalyse. XLIX, 1985. Psychoanal. Q., 61:148-149