The Patient and the Analyst: The Basis of the Psychoanalytic Process

258 Pages·1992·6.899 MB·English

by  Joseph Sandler, Alex Holder, Christopher Dare, Anna U. Dreher

THE PATIENT

AND THE ANALYST

T HE PATIENT

AND T HE ANALYST

The Basis of

the Psychoanalytic Process

BY
JOSEPH SANDLER

CHRISTOPHER DARE

ALEX HOLDER

Second edition

Revised and expanded by

Joseph Sandler and Anna Ursula Dreher

KARNAC
LONDON NEW YORK
First published in 1973 by George Allen & Unwin, Ltd.
Revised and enlarged edition published in 1992 by
H. Karnac (Books) Ltd,
118 Finchley Road,
London NW3 5HT
Reprinted 2002
Copyright © 1992 by J. Sandler
All rights reserved No part of this publication may be reproduced, stored in a
retrieval system, or transmitted, in any form or by any means, electronic, mechanical,
photocopying, recording, or otherwise, without the prior written permission of the
publisher.
British Library Cataloguing in Publication Data
A CLP. for this book is available from the British Library
ISBN: 978-1-85575-008-1
www.karnacbooks.com
CONTENTS
Preface to the First Edition vii

Preface to the Second Edition ix

CHAPTER ONE
Introduction 1

CHAPTER TWO
The analytic situation 13

CHAPTER THREE
The treatment alliance 23

CHAPTER FOUR
Transference 37

CHAPTER FIVE
Further varieties of transference 61

v
vi CONTENTS
CHAPTER SIX
Countertransference 81

CHAPTER SEVEN
Resistance 99

CHAPTER EIGHT
The negative therapeutic reaction 121

CHAPTER NINE
Acting out 133

CHAPTER TEN
Interpretations and other interventions 147

CHAPTER ELEVEN
Insight 165

CHAPTER TWELVE
Working through 175

References 187

Index 223
PREFACE TO THE FIRST EDITION
S
ome three years ago we began an intensive research
study on basic psychoanalytic concepts. This was felt to
be necessary because of the difficulties we had encountered
in teaching psychoanalytic theory to intelligent postgraduate
students of psychiatry—a difficulty that, we had realized, was
due in no small part to a lack of clarity in the concepts themselves.
Fortunately, the clarification of certain basic ideas was a research
task appropriate to our role in the Institute of Psychiatry. This
book presents the results of our work in a form which we hope
will make the basic clinical concepts of psychoanalysis clearer
in their meaning and development. We also believe that it may
provide the basis for the adequate and appropriate extension of
psychoanalytic concepts to related fields, such as those of psycho­
analytically orientated psychotherapy and casework. We hope
that this book can help to dispel some of the mystique still
surrounding psychoanalytic ideas. As students and teachers of
psychoanalysis we found, in the course of this work, that our own
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vii i PREFACE TO THE FIRST EDITION
thinking in this area had been substantially clarified and in many
respects modified. It is our hope that this book will be of particular
value to those training and teaching in psychoanalytic training
institutes.
We are indebted to Sir Denis Hill, Professor of Psychiatry at
the Institute of Psychiatry, for the special efforts which he made
to provide us with the opportunity and facilities to carry out
our work, and for his continued encouragement. Dr Eliot Slater
risked his reputation as Editor-in-Chief of The British Journal of
Psychiatry in accepting a series of ten papers (Sandler, Dare, &
Holder, 1970a, b, c, d, 1971; Sandler, Holder, & Dare, 1970a, b, c,
d, e; some additional material has been drawn from two other
papers: Sandler, 1968, 1969) containing much of the work
included in this book after seeing only the first two, and we are
grateful to him for this, as for his tolerant and good-humoured
support.
A number of colleagues—in particular Dr Max Hernandez,
Dr Robert L. Tyson, and Mrs Anne-Marie Sandler—read drafts
at various stages and helped us with their comments. Financial
support was provided by the Bethlem Royal Hospital and the
Maudsley Hospital Research Fund as well as the Foundation for
Research in Psychoanalysis, Los Angeles. We valued in particular
the personal interest shown by Mrs Lita Hazen and Dr Ralph R.
Greenson of the latter foundation. We gratefully acknowledge the
permission given to us by Sigmund Freud Copyrights Ltd, The
Institute of Psycho-Analysis, Mrs Alix Strachey, and The Hogarth
Press Ltd, for permission to quote from The Standard Edition of
the Complete Psychological Works of Sigmund Freud, revised and
edited by James Strachey.
London,
March, 1971
PREFACE TO THE SECOND EDITION
M
ore than twenty years have passed since the papers
that were drawn together to form The Patient and the
Analyst were first published. Since then there have
been a number of very significant developments in psychoanalytic
thought, a consequence in part of the awareness of the 'widening
scope of psychoanalysis' which began in the 1950s. In particular,
attention has been paid in recent years to the involvement of
the analyst as a partner in the analytic situation, and a move
has been made away from the classical metaphor of the analyst­
as-mirror. A greater understanding of the dimensions of transfer­
ence and countertransference has been reached, and indeed each
of the concepts treated in this book has undergone significant
extension of meaning over the past two decades.
As a consequence, a second edition of this book was more than
warranted, and we are grateful to the original authors for allow­
ing us to revise and extend a work that has become a classic in its
own right. The original text has been brought up to date, and
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