IPA Inter-Regional Encyclopedic Dictionary of Psychoanalysis

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Nowadays the frequency of the sessions is a polemic issue. For some analysts, the number of sessions is irrelevant, for others, it is important. The former consider that what matters are the attitude and the analytical function of the analyst or the “internal setting”. Other analysts think that, in order to develop the analytic function and an adequate internal setting with respect to a specific patient, an intense relationship is necessary, and the high frequency of sessions is an essential factor. They also consider this as essential for the patient, in order to be able to explore his mind through free associations on the deepest levels and, above all, to work through the analyst's interpretations. With regard to the frequency of sessions, Freud said: “I work with my patients every day except on Sundays and public holidays—that is, as a rule, six days a week. For slight cases or the continuation of a treatment, which is already well advanced, three days a week will be enough. Any restrictions of time beyond this bring no advantage either to the doctor or the patient […]. When the hours of work are less frequent, there is a risk of not being able to keep pace with the patient's real life and of the treatment losing contact with the present and being forced into by-paths”. (Freud 1913 SE: 12, p. 127). Although the high frequency of sessions is not a sufficient condition, for many analysts it is a necessary factor. However, this must be accompanied by other elements of the psychoanalytic method: attention to transference and countertransference, including the primitive and psychotic levels in both patient and analyst, along with the analyst’s interpretation . Other external conditions . The analyst’s office has specific characteristics (furniture, decoration, room climate etc.) showing something of the personality of the analyst. The analyst’s body is also part of the setting. Enid Balint (1973) writing about the analysis of women by a woman analyst, suggested that for the patient, at an unconscious level, the analyst’s room takes on the meaning of the mother’s body. Lemma (2014), following Bleger’s idea, has developed the conceptualization of the “embodied setting”, particularly in patients with a symbiotic transference. She pointed out how the analyst’s physical appearance acts as a powerful stimulus in the patient’s internal world and any change in the analyst’s body is felt as profoundly destabilizing. Other components of the "contract", such as fees and holiday periods should also be included as parts of the external setting. As regards fees, and especially nowadays, the patient may need financial support from some organizations, which inevitably implies the presence of a third party, an element that must be considered in the initial contract. This third party varies according to different countries: it may be the National Health Service, a Health insurance, or the Psychoanalytic Clinic of an Institute, in the case of candidates.


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