Irwin Z Hoffman | Search PubMed

PubMed2006

Forging difference out of similarity: the multiplicity of corrective experience.

In the context of work with an adult survivor of childhood sexual abuse, the interplay of multiple forms of engagement contributing to therapeutic action is explored. The compulsion to repeat old patterns is seen to be gradually overcome by new corrective experience in which the whole of the patient's sense of the analyst as a person is greater than the sum of its parts. Interpretation of enactments--often involving patterns of dominance and submission--is complemented by a range of "helpful" actions that must be detoxified. That process entails the progressive differentiation of coercion and influence, on the one hand, and of compliance and responsiveness, on the other In the end, autonomy and creative responsiveness emerge as integral to each other rather than as mutually exclusive. This development requires that the patient gradually relinquish an "essentialist" view of self and other in favor of a "constructivist" view, in which the ambiguity of experience offers opportunities for new forms of relational engagement and understanding.

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PubMed2006

The myths of free association and the potentials of the analytic relationship.

The author challenges the traditional and still prevalent view of 'free association', arguing that it entails three forms of denial (also formulated in terms of corresponding myths): 1) denial of the patient's free agency; 2) denial of the patient's and the analyst's interpersonal influence; and 3) denial of the patient's share of responsibility for co-constructing the analytic relationship. That responsibility includes some degree of consideration of the analyst's needs. Sometimes, the patient's good judgment to that end may be reflected in what is automatically and mistakenly reduced to a form of 'resistance'. Attention to the patient's responsibility must be balanced against the effort to provide a uniquely safe environment for the patient's revealing of shame and anxiety-ridden feelings and attitudes. But the therapeutic action of psychoanalysis, ideally, includes the cultivation, through lived experience, of the dialectical interplay of self-expression, on the one hand, and caring relational engagement, on the other. Recognition of the patient's free agency does not preclude exploration of constraining structures laid down in the past. On the contrary, it deepens such exploration. At the same time, it opens the door to the possibility of explicit recognition, via challenge, criticism, or affirmation, of the patient's contributions to the analytic work.

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PubMed2004

Miss A.

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