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analytic couple. Numerous extra-analytic influences are analogical to the daily residuum of dreams. Initial transference and countertransference, just as with an analyst’s theoretical and other biases, predilections and preferences, may be intuitively picked up by patients already from the time of the initial interview, from the analyst’s decoration of the office, books on the bookshelves, etc. The way an analyst pays selective attention to particular elements of a patient’s account of history or dreams influence the patients’ associations. Patients also react to the analyst’s silence, questions, demeanor etc. Patients withhold secrets until trust is established. Associations may become freer in later phases of analysis, with greater access to the unconscious, but the freedom of associations is always relative to vicissitudes of the transference – countertransference field, preconscious and unconscious communication, and interpersonal interaction. Dreams with relaxed censorship may be closest to free association, though similar problems arise with associations to dreams as with any other free associative processes. As neither psychic present nor psychic past are static organizations (Blum 2016), past and present traumas influence the associative flow. If the basic rule and prompt to unedited free associations is experienced as a command, it may invite pseudo-compliance or defiance, or bilateral concerns that a patient is unsuitable for analysis. The analytic alliance or pact may be initially tentative, and requires interpretation. Some patients with tenuous reality testing and object constancy do better in face-to-face treatment. Free association is also influenced by factors such as the frequency of sessions, whether the patient is in re-analysis or training analysis, and issues pertaining to various phases of life. Special problems arise if a family member of an analyst is in treatment with a colleague, if a treatment is provided in a clinic or hospital setting, or with a very low or high fee. ‘Free of charge’ may impede free association. A special limitation to the free associative processes, the pre-symbolic pre-linguistic data, going back to the earliest times when the infant was forming first attachments, limits free associations. They are inaccessible to the verbal associative flow. These may be inscribed and encoded rather than remembered, and can be communicated inter-subjectively via enactments, rather than via free associations. Overall, Blum contends that free association may be a historical relic if taken literally. However, he sees overriding continuous value in talking as freely as possible with curiosity and capacity for self-observation, reflection, and relatively minimal interference or intrusion from the analyst. III. Bab. Ego Functions and Ego Strength Today, ego operations are defined to include basic mental functions (autonomous ego functions), control and delay capacities (ego strength), and defenses. All of these mechanisms usually work outside of conscious awareness, either dynamically unconscious (Shulman & Reiser, 2004) or preconscious (Kubie, 1974).
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