Prospective patients often regard analysis as an 'extremely painful procedure'. Bergler believes that the patient's 'suffering' in analysis is in most cases concomitant with a technical mistake on the part of the analyst. Three instances of alleged torture stand out: the positive transference, which, not being reciprocated, is felt as painful; the discrepancy between the patient's illusions about himself and the analytic explanations of the underlying reasons for them; and waiting for free associations that refuse to come. Most surprising is the fact that
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patients do not list a pleasant element: the narcissistic elation that comes from self-understanding. Since only affective and not intellectual understanding is effective therapeutically, some patients misconstrue understanding as 'suffering'.
Unrequited feelings, repeated in the transference to the analyst, are disagreeable, but this is true only so long as they are not understood. Analysis of the positive transference serves to remove the sting. But in some cases the positive transference is not analyzed; here the analyst's technical error is responsible. Bergler declares that most neurotics do not have a true Oedipal development; instead they have a 'rendezous with orality', and in the transference the orally regressed patient resorts to Oedipality as a defense. The analyst must see through and explain this defense, then 'the mirage of Oedipality evaporates' and the dynamically decisive oral-masochistic substructure can be analyzed. (Instead of putting it that the neurotic, handicapped by early fixations, comes to grief in handling the Oedipus situation and castrationanxiety, and then by way of defense regresses to the earlier fixation points, Bergler states that most neurotics defend themselves against their oral fixation by developing a kind of pseudo Oedipus complex which he compares to a palimpsest, a new writing on an old parchment which conceals an older writing.)
Bergler describes the development of the child as starting with a duality, the mother-child relation. The child 'rescues' itself from this situation by establishing the mother-father-child relation, which Bergler regards as 'merely the last of a series of rescues from the masochistic attachment to the mother'. He emphasizes that all later phases 'are but desperate rescue and survival attempts to escape from the oral-masochistic danger'. He regards the oral phase of development as 'basically a period of passivity with a few aggressive defenses'. Likewise, in the anal phase, 'the passivity of the oral phase is continued … [with] a few weak attempts at counteraction: retention of stools, aggressive fantasies connected with defecation'. In both phases, 'passive experiences and misconceptions dominate'. When the Oedipus complex develops, 'the boy borrows strength from the father—he wishes to play the father's role and to demote the "dangerous" mother to passivity—meaning, at bottom, to an image of his own self'. By reversal, then, the mother is now penetrated as he had been penetrated, orally and anally. The result, according to Bergler, is bitterness and a strengthening of passivity. In addition, the positive Oedipus complex acts as a screen to conceal the negative one, which thrives mightily as a result. He therefore speaks of the 'oedipal camouflage', a façade that hides the 'true' preoedipal picture, which persists in the negative Oedipus complex. Thus if the patient suffers in the transference, it is because this Oedipality is false and has not been recognized and interpreted to the patient as such.
In the negative transference, too, according to Bergler, the pseudo aggressions are frequently misjudged as real aggression, denoting repetitions of infantile fury toward frustrations. If the analyst lets this pseudo aggression pass for real aggression, he involuntarily strengthens the patient's neuroticdefense. Bergler complains that this point is still tragically misunderstood.
Bergler believes that the analytic decoding of the patient's unconscious motivations is by no means as painful for the patient as is supposed. The patient is often angry, but at the same time has the unconscious feeling that the inner truth
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has been revealed, and this gives a narcissistic pleasure, derived from the realization that one is less under the influence of the unconscious. He states that the oral masochism is inwardly accepted only by the diseased part of the personality.
At the start of analysis, the orally regressed group of neurotics are quite unable to use free association. Bergler here advises a modification: the analyst has to talk, because these neurotics ward off their deep masochistic attachment with pseudo aggression. When asked to give words, they refuse. The analyst must circumvent the patient's projecting of the cruel giantess of the nursery onto the analyst by making the projection as difficult as possible, and by giving words himself, because unconsciously these patients want to be given refusals, which contradicts their alleged wish to be treated with kindness. However, in talking and giving words, the analyst temporarily strengthens the patient's 'basic fallacy' ('If mother had acted differently, I would have reacted differently, too'), and later the analyst must resolve this basic fallacy.
At bottom, 'suffering' in analysis is the patient's untouched psychic masochism. To leave it untouched is a technical mistake.