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Grand, S. (2002). Action in the Psychoanalytic Situation: Reflections on Its Relation to Internal and External Reality. Psychoanal. Psychol., 19(2):254-280.

(2002). Psychoanalytic Psychology, 19(2):254-280

Action in the Psychoanalytic Situation: Reflections on Its Relation to Internal and External Reality

Stanley Grand, Ph.D.

Contemporary sensitivity to the importance of the relationship in psychoanalytic work has led, in some instances, to an over-estimation of “real” elements in the patient-analyst interaction and an underestimation of the fantasy aspects of the transference-countertransference relationship. This emphasis on external reality overshadows the internal reality of the patient and analyst's experience, shifting the treatment focus from intra-psychic to interpersonal aspects of the relationship, and it tends to bias technique toward the provision of restorative internal-izations in place of new understandings. The present article considers enactive behavior from the perspective of compromise formations, which make dangerous impulses less dangerous and ego-syntonic. The article also highlights some issues that arise when internalization mechanisms are assumed to underlie clinical outcome.

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