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Abrams, S. (1988). The Psychoanalytic Process in Adults and Children. Psychoanal. St. Child, 43:245-261.

(1988). Psychoanalytic Study of the Child, 43:245-261

Clinical Contributions

The Psychoanalytic Process in Adults and Children

Samuel Abrams, M.D.


In describing aspects of the analyses of an adult and a child, I focused on the clinically demonstrable observations, suggesting with annotated comments how the psychoanalytic process, the infrastructure of the treatment situation, informed the empirical data. I tried to show that Jessica used Rhino to cultivate experiences that took her back to her past, whereas Leslie also used Mr. Beary to actualize experiences which served as the nidus for a newly emerging developmental organization. The case descriptions do, of course, lend themselves to other theoretical discussions, e.g., the study of character development, or the origins of the sense of gender, or the meanings of transitional phenomena. It has taken some effort to avoid the temptation vigorously to pursue these areas. But the effort seems justified. The customary clamor about technique or dynamics or structure too often interferes with the focus upon the silent shaping process; and, after all, what distinguishes psychoanalysis from other therapies resides within the view of that process.

These are the main points of the summary:

1. It is useful to distinguish between the conceptualization of the psychoanalytic process and the operations necessary to introduce and sustain it. The process itself belongs to the conceptual realm of psychoanalysis, not its empirical realm.

2. The psychoanalytic process may be viewed as that sequence of steps which appears within the mind of the patient as the treatment proceeds. The steps are more often overlapping or interweaving than they are sharply delineated.

3. For adults and children the steps include characteristic modes of relating, a transference consolidation, the revival of earlier pathogens, and the effects of knowing. Children also use the setting for new experiences in the service of emerging developmental organizations. This

causes what is at times bewildering cross-currents, forward and backward.

4. The psychoanalytic process is the vehicle for therapeutic action.

5. The impetus for such action arises from the ego's integrative capacities in adults and children and is further fueled in children by the pull forward of developmental organizations.

6. All patients also use the analytic situation to experiment with new identifications, to mourn lost objects, and to overcome areas of inhibited development. While these are valuable and often necessary treatment actions, they are not specific to psychoanalysis.

7. These views of the process are useful for clinical work since they underscore the tasks of both participants in the setting. The patient introduces the potential for the treatment by being who he is. The analyst, the guardian of the process, confronts the distinctiveness of that presentation so that the process may be activated. As the sequence evolves, both share in the responsibility for sustaining its direction by committing themselves to the essential dialecticresistance and interpretation.

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