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Emphasizing that psychoanalysis is a psychology of unconscious mental conflict, resulting in compromise formations, where wishes, unpleasure, defense, moral imperatives, and realistic considerations are all represented in varying degrees, Jacob Arlow and Charles Brenner (Arlow and Brenner 1964, Brenner 1982) saw the utility of free association within the psychoanalytic situation to help determine the specific contribution made by each of the components of the conflict. An example of their (Arlow and Brenner 1966) approach are three suggestions to severely obsessional patients: If the patient experiences great turmoil in speaking freely, they recommend helping the patient become aware of his guardedness in revealing his thoughts. Then, while not requiring the patient to follow the fundamental rule, they explore the patient's reasons and motives for the resistance. Last, they demonstrate that the same resistance stems from the very conflicts that bring the patient to analysis, and that these conflicts interfere with the progress of the analysis just as they interfere with the patient's life. This development eventually ushered in what came to be called the Modern Conflict Theory. Another trend was a further exploration of defenses, ego functions and ego functioning, upholding the view that repressions and other specific defenses are not compromise formations (Blum 1985). The ego not only effects compromise, but it could decide between alternatives (Rangell 1963). This development led to what became known as Contemporary Ego Psychology . Arguing that while Arlow and Brenner wrote of the need to analyze resistances, their clinical examples tend to stress overcoming resistances, rather than analyzing them, Gray (1994, 2005), Busch (1992, 1993, 1994,1995, 1999), Paniagua (2008) and Sugarman (1994) further developed defense analysis within the analytic method of free association. Among the original integrations of Ego psychology and object relations , those of Hans Loewald (1961, 1978) and Otto Kernberg (1975, 1983) are most relevant to free associations. Since the latter part of the 20 th century , with the ongoing advances of psychoanalytic theory and a broader application of the psychoanalytic technique to a ‘widened scope’ of patients, the primacy of free associations has been under reconsideration in all regions and psychoanalytic orientations. Two trends emerged, as to the relative centrality versus periphery of free association, echoing the historical Freud-Ferenczi controversy. In North America, Contemporary Structural thinkers (Ego Psychologists and Conflict theorists) Anton Kris (1982), Paul Gray (1982, 1994), Fred Busch (1997) and Axel Hoffer (2006), are among those who uphold the value of the free association as a tool for in depth understanding of the patient’s internal world and all its ramifications. Post-Bionian theorist Thomas Ogden (1996) and Relationist Irwin Hoffman (2006) are among those who see free associations as diminishing patients’ personal agency and stifling their privacy. Many contemporary analysts, like Harold Blum (2019) and Otto Kernberg (2020) consider both ego operations and object relations, resorting to modified or qualified use of free association, as per individualized assessment. While these trends may have wide inter-regional relevance, each region may have formulated them somewhat differently, as will be noted below.
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