Tuesday, January 10, 2012

Nancy McWilliams - The Maternal-Paternal Dimension and Analytic Technique

"The foregoing is intended to shed some light on our confusing literature on technique. A review of major writers about the psychoanalytic art will reveal that, from the earliest history of the psychoanalytic movement, theorists have tended to split along lines that can be construed as predominantly maternal or paternal. While not all areas of disagreement between analysts of different persuasion reduce to a motherly-fatherly tension, in the realm of technique, it seems frequently to be one of the covert lines of dispute.

Analysts that I would characterize as paternal are those who emphasize interpretation, confrontation, the systematic examination of defenses, and the inevitability of internal conflicts in the face of a difficult reality. Maternally oriented practitioners emphasize holding, the expression of understanding, affective resonance, and facilitation of grief. Paternal therapists are inclined to see patients as actors who keep on, by the operation of the repetition compulsion, recreating a dilemma of their own unconscious choosing. Maternal therapists have a propensity to see patients as reactors to parental failures to understand, who have been hurt and need attention to their wounds before they can move on developmentally in a natural, more or less unconflicted way. Paternal clinicians stress the importance of the analyst's boundaries, discipline, expertise, distance from contaminatory countertransference, denial of instinctual gratifications, and stimulation of ego development, while maternal ones stress flexibility of technique, intuition, the capacity for deep understanding via countertransference reactions, repair to developmental injuries, and the therapist's function as auxiliary ego.

If my deductions about the centrality of both motherly and fatherly processes in good psychotherapy are correct, then effective practitioners always ultimately combine elements of each parental position. Freud, for example, has tended to evoke in his readers (partly because of his stimulating, didactic tone, partly because of his stress on the father's position in the oedipal triangle, and doubtless for other subtle reasons as well) a preponderantly paternal image. He tended to educate his patients authoritatively, to confront them, to expose actively their defensive processes, to stress the inevitability of ordinary, nonneurotic suffering, and to disparage as regressive the yearning toward fusion with a fantasied omnipotent Other. Yet, the same Freud stressed the importance of flexibility and tact, and was recalled fondly by many patients for his attitude of sympathetic kindness (H. D., 1944; Blanton, 1971; Kardiner, 1977; Lipton, 1977). Similarly, the Ferenczi who is noted for his emphasis (e.g., 1928) on the more maternal processes of comforting, holding, encouraging, and maintaining sympathy and tact above all other considerations was the same man who had devised the "active technique" (1920) by which the analyst's deliberate prohibitions and injunctions would stimulate resistances, increase the severity of inner conflict, bring it to consciousness, and purportedly thereby shorten the treatment.

The psychoanalytic community nonetheless, and with some justification, seems to perceive different therapists at a preconscious level as either primarily maternal or basically paternal in style, and it is my contention that many of our debates about technique reflect a preoccupation with this hidden polarity. The Freud-Ferenczi arguments of the late 1920s can be seen as the first in a long line of parallel disagreements, not so much about the theory as about the art of psychoanalysis; specifically, whether it should manifest a more motherly or fatherly dynamism....

I could extrapolate further, but let me simply invite the reader to reflect on how dialectically the argument about appropriate psychoanalytic technique has evolved over the last decades, and how frequently the dialectic has contained maternal and paternal polarities. If my thesis that both attitudes are necessary is sound, it becomes clearer why our efforts to evaluate which position is ultimately "correct" have been doomed.

Returning to the question of what is effective therapy, let us consider instances of disappointment and failure in the analytic endeavor. When psychoanalyses fail, frequently it is because one of two types of things has gone wrong. Either the analyst has been experienced as disproportionately and unempathically paternal (distant, critical, challenging, depriving), or the converse, as disproportionately and unempathically maternal (indulgent, infantilizing, nonstimulating). With insufficient devotion, the patient feels a lack of love; with insufficient integrity, a lack of respect."

Nancy McWilliams (1991). Mothering and Fathering Processes in the Psychoanalytic Art, Psychoanalytic Review, Vol. 78, pp. 525-545.

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