Defense Generated Impasse: the Patient's Experience of the Analyst's
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Defense Generated Impasse: The Patient’s Experience of the Analyst’s Defensiveness1 Cheryl Chenot, Psy.D., MFT Institute of Contemporary Psychoanalysis Los Angeles, California 2000, 2012 ∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞∞ Any or all of this document may not be reproduced without the consent of the author. 1 This paper is about healthy and dysfunctional conversation. This paper emerged thanks to rich conversations with people who contributed thoughts and perceptions, and who helped me to clarify my ideas over the four year evolution of this paper. Their voices are to be found throughout the paper. Many thanks to Gary Sattler, Lolita Sapriel and William Coburn for their conceptual contributions, and to Elizabeth Altman and Carol Fahy for their thoughtful suggestions about form and structure. I also wish to express my gratitude to the many people who encouraged me in diverse ways, who are too numerous to mention in an exhaustive list, and too important to risk omitting accidentally from such a list. Special gratitude goes to Lynne Jacobs, who has a unique gift for cultivating my embryonic thoughts, for her generosity with her time. While their contributions have been invaluable, I am solely responsible for the contents of this paper. Introduction When .... therapist's and patient's primary vulnerabilities have been activated and intersect problematically, patient and therapist have become entangled in a relational knot to which both have contributed and from which they cannot extricate themselves. Like a Chinese puzzle, the knot becomes tighter the harder they try to loosen it. They each become dangerous to the other and increasingly defensive. Their perspectives on what is occurring differ and collide. Fearful of losing their perspective, and thus jeopardizing their hold on reality, they cannot tolerate hearing the other's point of view. Anger and anxiety escalate (Elkind, 1995, p. 333). It is commonly accepted that disruptions are an ongoing part of the psychoanalytic process. However, if not adequately or optimally resolved, they may sooner or later lead to impasse, painful termination and the patient’s (or, for that matter, the analyst’s) perception of being damaged. I propose that disruptions which are not adequately or optimally resolved frequently entail analysts being unable to acknowledge or to manage their defensiveness.i I have experienced firsthand this type of devastating situation as an analysand. I begin my exploration of these issues by offering a vignette from one of my analytic attempts, as the situation is paradigmatic of the issues I discuss in this paper. The following session, a particularly distressing one, occurred right before I terminated my four year, five days a week analysis. Much of it is taken verbatim from a journal I was keeping at the time. I have added present day comments in brackets for the reader’s clarification. For three months, my analyst and I had been locked in a downward spiral of painful interactions that were increasingly heated. I experienced her as frequently defensive and covertly hostile, while she did not experience these states in herself. She experienced me as attacking and abusive, while I experienced myself as angry and terrified at the prospect of losing my analyst. I was furious at her for “transforming” into someone I did not recognize after four years together and for being unable to guide us out of this horrible mess. I also felt utterly desperate to salvage the situation. She had flatly refused to seek consultation, which sent me into a furious panic, since I felt powerless to influence her in a helpful way myself. The whole experience was shocking and devastating to me, all the more so since animosity had not characterized our relationship (to the contrary, we had had quite a close relationship, and my analysis felt like one of the few safe relationships I had in my life). Over the first month since the initial disruption, my panic had evolved into anger and then provocative hostility in reaction to a palpable tension in my analyst that remained unacknowledged and unarticulated. I was asking, entreating, begging her to recognize that she was having feelings that were disruptive to me (subsequent to the initial disruption), but she could not or would not acknowledge them. By the time we hit this point in the disruption, both of us were so tense and angry that we could barely be civil. 16 January, Thursday session: I went in and sat down, feeling great waves of tension {over the way things had been going between us} and anger {at my analyst for not responding in a helpful way and for refusing to seek consultation}. She was completely silent {which was highly unusual}, and I thought I detected some hostility on her face. I began to speak, but then I lost my nerve, sinking into myself - imploding with hopelessness. After at least five minutes {it was also highly unusual that she would let the silence go so long, as she knew this was disruptive to me}, she finally said, “Is it hard to tell me what you’re feeling?” which sounded more benign than what I felt emanating from her. I said I thought I needed to hear from her first, how she has taken yesterday’s session {in which I became very angry}, what she has made of it, what thoughts she has had... She said she needed to hear from me, adding, “It’s your analysis, not mine.” Her comment felt hostile to me, which made me even more cautious. I told her that it seemed to me that she was upset already, so I did not want to tell her what I felt. She said she felt that I was very angry yesterday and the session ended on an angry note, and that she thought we have to work it out, and talk about it more. I said those were observations, they did not tell me anything about what she has been thinking and reflecting on, and I needed to know that she is doing that. I actually thought I was keeping a pretty good lid on my anger up to that point, though I could feel it escalating inside me. Somewhere in there, she could not contain her anger anymore and began to rage at me about how I devalue everything she does and criticize everything she says, and I have pushed her to her limit and really made her mad yesterday. I said it seems like she is mad right now. She repeated that she was mad yesterday. I said more heatedly, “You’re not mad right now?!” She repeated several times that she was mad yesterday . but was eventually able to admit that yes, she is mad right now, too - that I have pushed her beyond her limit. I do nothing but attack her, etc, etc. … …. She launched in again and did not let up for some time. I was yelling back at her part of the time, but was no match for her. Or maybe I was just so appalled and taken aback at how ludicrous the whole scene was. She railed at me for a few more minutes and then tapered off. I expressed my displeasure at her “lowering herself to my level” and then she was off again, repeating herself, raging at me. In desperation, I finally yelled at her to “Shut up!” and her response was a loud, angry, “No, YOU shut up!!” When she started up yet again - out of sheer desperation, and in lieu of walking out - I plugged my ears and lowered my head into my lap. She finally stopped. Then she calmed down and began to lecture me stiffly about how, “yes, this is part of analysis too,” and “we just have to work it through” and “maybe we have to find another way to talk to each other” which I heard as “YOU have to find another way to talk to ME, because I cannot tolerate your angry expression of anything about me.” She told me that she and her analyst had gotten angry with each other too, to illustrate that “it’s just part of the process.” And then later, “You’re abusing me and I can’t let you do that.” …. I ended up in tears of complete despair again, and she finally softened her voice and spoke to me gently. I felt a renewed surge of impotent rage in response.ii In this paper, I attempt to explore a particular slice of countertransference - the experience of defensiveness in the analytic dyad, largely from the patient’s perspective.iii I define defensiveness to include certain subtle, nuanced interactions that may not typically be thought of as defensive. I use the term specifically to describe a wide range of behaviors, reactions, and attitudes to which any person may resort in order to protect her sense of self at the expense of the other person’s efforts to articulate his reality. I contend that, while self-protection can be exercised in this defensive manner, it need not be. I believe that self-protection is an intrinsic aspect of self-regulation, and that the capacity to self-protect nondefensively is an asset to any relationship. Both of these assertions hold special significance in the analytic dyad. In this paper, I endeavor to examine the painful complications that result when the patient experiences the analyst as self-protecting in a defensive manner. Sue Elkind (1994) has conducted research which documents that unfortunate situations such as the one described in the above vignette are not as infrequent as we would like to think. “I have found that experiences of serious impasses, wounding, and rupture are more common than we acknowledge.