Seduction, Surrender, and Transformation

Emotional Engagement in the Analytic Process

Karen J. Maroda

• Publisher: Routledge
• Year: 2013
• ISBN:
  9781135060848
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Seduction, Surrender, and Transformation demonstrates how interpersonal psychoanalysis obliges analysts to engage their patients with genuine emotional responsiveness, so that not only the patient but the analyst too is open to ongoing transformation through the analytic experience. In so doing, the analyst moves from the position of an "interpreting observer" to that of an "active participant and facilitator" whose affective communications enable the patient to acquire basic self-trust along with self-knowledge.

Drawing on the current literature on affect, Maroda argues that psychological change occurs through affect-laden interpersonal processes. Given that most patients in psychotherapy have problems with affect management, the completing of cycles of affective communication between therapist and patient becomes a vitally important aspect of the therapeutic enterprise. Through emotionally open responses to their patients and careful use of patient-prompted self-disclosures, analysts can facilitate affect regulation responsibly and constructively, with the emphasis always remaining on the patients' experience.Moments of mutual surrender - the honest emotional giving over of patient to analyst and analyst to patient - epitomize the emotionally intense interpersonal experiences that lead to enduring intrapsychic change. Maroda's work is profoundly personal. She does not hesitate to share with the reader how her own personality affects her thinking and her work. Indeed, she believes her theoretical and clinical preferences are emblematic of the way in which the analyst's subjectivity necessarily shapes theory choice and practice preferences in general. Seduction, Surrender, and Transfomation is not only a powerful brief for emotional honesty in the analytic relationship but also a model of the personal openness that, according to Maroda, psychoanalysis demands of all its practitioners.

Chapter 1
On Seduction, Intellectualization, and the Bad Mother

Underlying Assumptions in Psychoanalysis

After almost a century of discussing psychoanalytic theory and practice, I am consistently amazed at the many aspects of the analytic enterprise that are rarely mentioned. Our reluctance to admit what we actually do and say when we are working with our patients remains the norm. Worse than that, however, is the tendency to omit the mention of interventions that might be controversial. That is, even when clinicians are talking about what they actually do, they frequently fail to include a behavior that they fear being censored for, such as, taking a patient's hand, or disclosing their feelings. The absence of honest discussions of technique has naturally created a most unfertile ground for innovations.

Another largely ignored aspect of psychoanalysis involves examining the premises or assumptions that underlie the whole analytic endeavor, both in theory and practice. It seems to me that it is difficult to propose revising something that is not adequately defined in the first place. The two-person paradigm evolved from an encyclopedic amount of evidence suggesting that we were overlooking important aspects of the analytic relationship. After decades of accumulating clinical data and experience, we could no longer deny that the analyst's individual personality had as much to do with what happened in the treatment as did the patient's. Yet this fact was strictly denied for many years, followed by a long period of slow recognition of the analyst's impact on the patient.

Thus, the two-person paradigm is not a new invention, but rather an extremely critical recognition of something that has always existed. If this sounds like a diminution of the two-person position, let me assure you it is not. The willingness to recognize the reality of the two-person paradigm is vitally important to the development of analytic technique. It is the difference between a flat world and a round one. Armed with this new perspective, we are in a position to develop the tremendous potential of the analytic relationship.

Although I continue to share much of my colleagues' excitement over the developments in the two-person perspective, it seems to me that progress in developing new theory and techniques remains painstakingly slow. We are still reluctant to talk about technique, and there is a regrettable resistance to changing what we do to accommodate our new paradigm. Somehow we want everything to be new, yet we also want everything to stay the same. People are willing to accept a relational model if it doesn't mean changing the way they do treatment. But if reconceptualizing the analytic relationship doesn't translate into technical changes, how important can these theoretical changes be? I don't think we can have it both ways.

Even though accepting the two-person model and redefining the analytic situation accordingly may seem like more than enough to focus on, I think there are many other realities waiting to be discovered. What else have we overlooked within the treatment situation? Are there not dozens of assumptions that determine our behavior at every turn, even though they may be more unconscious than conscious? Laplanche (1973) discusses our reluctance to scrap Freudian psychoanalysis and start over, retaining what seems to work and tossing what does not. "The Freudian system is never criticised, put in doubt; no-one ever envisages rebuilding it on surer foundations. New concepts are simply added each time a new difficulty is perceived" (p. 2). Rather than simply adding more new concepts, perhaps Laplanche is right and we need to further deconstruct psychoanalysis in order to build something better. In this chapter I will present some of the assumptions and characteristics of the analytic situation that I believe have been overlooked, or given inadequate attention. I discuss these aspects of theory and/or practice for the purposes of defining the reality of the analytic situation and to provide a foundation for the chapters that follow.

The Overvaluing of Intellectualization

One might argue that the over-intellectualization of any body of knowledge is inevitable. That is why Foucault argues against theories and labels. Simmel (1984) preceded him in noting that once a set of laws or rules have been set down they tend to be self-perpetuating, resulting in stagnation. I could argue, in fact, that in the act of writing about theory I am only contributing to the mass of intellectualization that stifles creative acts in psychoanalysis. And no doubt this is true. No matter how much I might emphasize that theory is nothing more than a tool, and that each person must find the right tool for the job, I run the risk of people interpreting my clinical guidelines as "rules" or taking my clinical observations as facts. (On the other side, of course, I also run the risk of being ignored altogether on the basis of presenting material that is alienating.)

So how are we to make observations, name those observations in some meaningful way, and then attempt to generalize those observations into legitimate broader categories without simultaneously creating obstacles to new experience? The answer is that we cannot. But there is much we can do to minimize the reifying effects of our attempts to organize what we know and share it with others. We accomplish this through dialogue with each other and through consistent interaction between theory and practice. Ultimately this leads to throwing out any theoretical concept that cannot be used clinically. Deleuze (1977) says,

No theory can develop without eventually encountering a wall, and practice is necessary for piercing this wall ... a system of relays within a larger sphere, with a multiplicity of parts that are both theoretical and practical [p. 206].

Thought of this way, analytic theory and practice can join together to create a "living" entity, that is, one that is open-ended and sees change as vital to its continued relevance and existence rather than as a threat. Along the same lines, Orange (1995) encourages the concept of conversation increasing our "access to the whole" and of holding our theories "lightly" and in a "fallibilistic spirit." Although no one would argue with the idea that we need to work constantly to keep the lines of communication open, and to keep open minds, psychoanalysis is nonetheless known for its dogmatism.

In recent years there have been more attempts to maintain an open dialogue between divergent groups. Mitchell's innovation in the world of analytic writing, the creation of The Analytic Press's journal Psychoanalytic Dialogues, is a prime example of this concept in action. Subsequently adopted by other journals, the dialogue format presents different views simultaneously, stimulating the reader on multiple levels and precluding the passive acceptance, or rejection, of the work of a single person.

Over-intellectualization of the analytic process not only threatens us with stagnation, but also denies some of the basic realities of the analytic situation. For example, the early belief that interpretation was the chief instrument for facilitating the therapeutic process created a very narrow, and unworkable, prescription for clinical interventions. We have known for some time that most of what we do is not interpretation (Compton, 1975) and that the change process probably relies a great deal more on emotion than intellectualization. That is, the acquisition of insight depends on a unique emotional experience antecedent to that insight.

All of us know far too many people who have been analyzed for extensive periods and yet seem emotionally impermeable. They can rattle off their pathology with jargon-filled aplomb, and may even choose to discuss the intimate details of their personal history at dinner parties. What enables them to use their own painful experiences for the purposes of entertaining others or demonstrating their enviable degree of openness is really a perversion of the analytic ideal. They have achieved enormous intellectual insight without the benefit of emotional connection or integration. They represent the consummate caricature of psychoanalysis— the talking head. They can discuss what one would expect to be painful and feel no pain at all. It is as if they are talking about someone else. Chused (1996) addresses this same point.

All too many adult patients have gained intellectual understanding with little change in psychic structure or behavior, and many of the doubts about the therapeutic value of verbal interpretations and insight that have surfaced throughout the history of psychoanalysis are based on observation of these "interpretation resistant" patients [p. 1050].

Chused suggests that patients benefit more when they make their own interpretations, which is undoubtedly true. And she acknowledges that the patient makes these interpretations as the result of an emotional shift. In response to a moment of emotional dissonance, the patient necessarily creates a new experience to resolve the dissonance. Intellectual insight is the naming of this experience. Although a vitally important part of the process, intellectual awareness follows, rather than precedes, the emotional experience.

Most analysts would agree with the statement that emotional experience is at the heart of a good psychoanalysis. Yet most of what we talk about is intellectual, or intellectualized. The primacy of emotion in human experience, and therefore the analytic experience, has not been fully acknowledged and our techniques suffer accordingly. Orange (1995) says,

I think the failure of psychoanalysis to grant emotion a life of its own may account for the persistence of the widely accepted idea that we do not know how psychoanalysis heals. None of the official explanations provides an answer to why it works when it works, and why it does not when it does not [p. 98].

I agree with Orange that it is time to give the world of emotion its due. Certainly we can do so without fears of throwing out the valuable intellectually-based framework of analytic theory. Equally, we need not give up the acquisition of insight as a priority. Affect has recently become a popular topic in psychoanalysis, and deservedly so. But the step that we have yet to make is the one where we recognize that without intense affective experiences within the treatment, there is no deep and permanent change. More emphasis on facilitating affective experience, and the developing of responsible techniques for doing so, await the revolution in psychoanalysis.

Determining the importance of affect in the change process, and noting how the affective interplay between therapist and patient facilitates or hinders the analytic process, is a huge task. It is also a necessary one. For example, in my clinical experience I have observed that the patients who seem to change the most are those who are capable of deep grieving, that is, crying profusely or sobbing. Patients who achieve equal levels of insight without this profound affective experience do not change to the same degree. I have to admit that I do not understand why this might be true, yet I believe it is.

I also think that simple changes in the way we discuss cases, both orally and in the literature, could add greatly to our body of knowledge. For example, most clinicians do not say much about what they are feeling when giving a case example, unless they are specifically discussing countertransference. But now that we have accepted that our emotional responses to our patients are ongoing and unexceptional, I think we could learn a great deal by regularly including this information in our case discussions. As long as we continue to value what we think more than what we feel, we are in danger of excluding the information that is most important.

Mutual Seduction in Psychoanalysis

Another ignored aspect of the analytic situation is the mutual psychological seduction that occurs in every therapist-patient relationship. Friedman (1997) says that Freud did not so much design a form of treatment as he discovered one. And he defines the essence of Freud's discovery as the "power of psychological seduction." He says, "By seduction I mean an arrangement whereby the patient is led to expect love while the analyst, in Freud's words, plans to provide a substitute for it" (p. 26).

Friedman goes on to say that the analyst is deliberately ambiguous about how he feels about the patient, in hopes of avoiding the traumatic collision between the patient's fervent desire (to win the analyst) and the somewhat disappointing reality. Ideally, the patient experiences the rewards of the analytic endeavor and becomes so invested in this experience that he or she comes to tolerate the personal loss of the analyst as a love object. (Friedman does not address what the consequences are when the patient succeeds in becoming the analyst's love object.)

I agree with Friedman's assessment that Freud, and all of us who follow him in the work of psychoanalysis, are in the business of this seductive dance. And I also agree that Freud did not create this phenomenon. Rather, he seemed to deny the reality of mutual psychological seduction, claiming that the realm of seduction belonged only to the patient.

Gerson (1996) explains this as Freud's fear of his own desires, as well as reflecting the cultural values of the times. Fie offers an explanation of Freud's early admonitions to maintain a certain distance.

These first usages make clear that the concepts of neutrality and abstinence were designed as technical guards against male desire and fear in relation to their experience of the female patient as dangerously seductive and that these concepts have their roots in the misogyny of the times [p. 629].

Thus we see Freud as a man who understood the power of what he had observed in his consulting room, but also as a man who feared the power that patients could have over him. He feared the results of acknowledging his own buried needs and desires. As he proceeded to define the psychoanalytic situation, he noted one truth (that the patient seeks to "psychologically seduce" the analyst) while denying another (that the analyst also seeks to seduce the patient). Having denied this need to seduce, he naturally was kept from enlightening analysts about managing the countertransference, which arises from this basic relational need.

Forrester (1990), in his book, The Seductions of Psychoanalysis, severely criticizes classical psychoanalysis for its seductive maneuvers. He sees it as encouraging docility, and unnecessarily infantalizing the patient and denying his or her real experience with the analyst. He sees sexual feelings as being particularly prone to denial. "The indeterminacy of knowing whether it is past seductions by the parents or present seductions by the analyst is what is interesting—because unspoken—when it comes to these skeletons in the closet" (p. 254).

Only recently have analysts felt freer to admit to their sexual feelings for patients. Yet we do not discuss the more generic need to "psychologically seduce" the patient as part of the analytic process. As a result, we cannot discuss the inevitable phases of approach and withdrawal, satisfaction and disappointment, victory and defeat, neurotic fears of rejection and grandiose visions of importance that each member of the analytic pair experiences.

For example, how much can, or should, we be aware of our own seductive maneuvers? Certainly some patients need to be 'seduced' more than others.

Diane, a thirty-something woman who socially is completely isolated, has depended on the "kindness of strangers" to meet her interpersonal needs. What I mean by this is that she has relied on the company of therapists for most of her social interaction. I am her third long-term therapist, and she has been in multiple session-per-week treatment for the past twelve years.

To say that Diane is phobic about intimacy is an understatement. The product of a broken home with a psychotic, highly intrusive mother and remote father, she has been severely depressed since her mother abandoned her forever when she was fourteen. I have been treating Diane for three years and am on the verge of despair. I have tried psychologically to seduce her for this entire period, and to some extent I have succeeded. I know I am very important to her, yet she does nothing to indicate that I am, other than whining uncontrollably and telling me I am selfish when I schedule any time off.

To say that I am running on fumes is to say the least. I have never treated anyone who gave me so little gratification. She has made some progress—she is less negative and argumentative at work, she exercises regularly, and she at least attempts to make some social contact with her peers. Intellectually I understand that she is terrified of being controlled (which she consciously knows and admits) and would rather be alone than lose herself to a crazy, intrusive person again. But emotionally, it is increasingly difficult to spend any time with her (I see her three times a week).

She hates being alone, has been preoccupied with the notion of suicide for years, and begs me to help her out of her prison. I see Diane as someone who cannot engage in the mutual psychological seduction that Friedman discusses. She cannot do it with me, or with anyone else. Therefore, she is alone.

In this scenario one might ask whether this person is treatable. Can someone ultimately be treated who cannot go through the basic steps of forming a relationship, of trying to win someone, and letting that person win you? My goal in treating Diane is to help her trust enough to be able to engage emotionally with me. She will not give me anything, both because her mother gave her so little, and because she is deathly afraid of the very engagement I am talking about.

Although Diane has no memories of being molested, she manifests many of the symptoms of someone who has been, including telling me that I should feel free to take advantage of her sexually at any time—that she would not resist. When I asked her why she thought I would want to do that, she said she didn't understand the question. It was as if she believed that anyone would want to molest another person if she knew she could get away with it. When I asked her why she would want me to do such a thing, she sa...