Remembering Repeating and Working Though

Using Freud’s Classic Paper to Plan a Strategy for Psychoanalysis

(Chengdu Psychoanalytic Center, Sichuan University, Peoples' Republic of China, October 19, 2005)

In 1914 Freud wrote a series of important papers on technique, which remain valuable today.

His famous paper on Transference Love still serves as a useful reminder that the feelings evoked in psychoanalysis have a past, an important past which the psychoanalysis must attempt to discover. Doctor and patient may both be misled if they think that the feelings between them are based in the here and now. This applies to negative feelings as well as positive feelings of course. We may give our patients reasons to love us or to be angry with us, but professional discipline requires that we attempt to understand those feelings historically or developmentally.

Remembering, Repeating, and Working Through probably comes closest to identifying in a quick phrase the main task of psychoanalysis.

Freud tells us in this paper that people have a tendency to forget their past and to repeat it or to act it out in current situations. It is the task of psychoanalysis to help the patient or analysand remember the past. Working through is the task of analysis. The patient gets better when he or she sees what they have been repeating with the analyst and with other people. When the past is worked through, that is when the person knows what he or she is doing, that person will have the choice to do something different.

It is fairly easy to identify a pattern of repetitive behavior. It is fairly easy to identify what someone does over and over again. A man who becomes angry whenever he is slighted, but refrains from saying anything about it, is repeating a behavior pattern he learned in childhood. A woman who flirts with men who are unkind to her may be repeating patterns she learned in her relationship with her father.

Although patterns of repetitive behavior may be easy to identify, it is harder to see what makes them compulsive. What drives people to do the things they do over and over again even though they don’t work, even though they make people unhappy rather than happy.

The clue to understanding what makes the repetition-compulsion compulsive is the transference. We observe the way the patient treats us in the treatment. If a patient is very nice to us and deferential in the treatment, what is our first thought? (Perhaps that this is a nice person and that is what we deserve.) But we must always ask, what is this repeating, how much of this nice behavior comes from the transference?

If a patient is cross and angry with us and impatient with our comments, what is our first thought? Have be done something to make them cross? Have we failed to understand them? Perhaps. But perhaps their anger is being transferred, repeated. This is the work of analysis.

How do we sort out what is going on in the present and what is coming from the past? Here psychoanalysis is different from some sciences. The patient is not like the bug under the bell jar, a specimen that the scientist observes from a position of objectivity. The scientist in this case is also under the bell jar, observing himself observing his patient, observing his patient’s reaction to what is going on.

We come to understanding the patient’s transference by understanding our own countertransference. Sometimes countertransference is considered a bad thing. It is only a bad thing if we are unaware of it. It is the responsibility of the psychoanalyst to learn about himself or herself in one’s own personal analysis, so one doesn’t act out the countertransference in ways that might hurt the patient. Also on the good side of things, the feelings that patients stir up in us give us an opportunity to learn more about themselves: to re-work our own historical-developmental conflicts and issues.

From the standpoint of assessment for analysis, there are two important questions:

Does the person need psychoanalysis?

Can the person benefit from analysis?

In a developmental perspective, we would expect that the person with an Oedipal-level conflict would be more likely to be able to utilize the methods and insights of analysis. Someone with pre-Oedipal problems might need counseling or psychotherapy but might be less inclined to do the work of psychoanalysis or to be able to articulate their feelings in words.

Looking at development in various theoretical perspectives suggests reasons for this:

Freud Erik Erikson Margaret Mahler Pathology

Oral Trust v. Mistrust Dependencies

Anal Autonomy v. Shame, Separation individuation Obsessions

Doubt

Oedipal Initiative v. Guilt Neuroses

With the developmental perspective in mind and anticipating that a patient will tend to repeat in analysis or psychotherapy as in other areas of life, it should be possible to anticipate the kind of issue that will occur in the transference. And the transference thus becomes a way of understanding what the patient experienced in early life, the things that the repeat rather than remember. When the are able to remember their experience, the become freer to make new choices, rather than compulsively repeating the old.