Back to Table of Contents
(corresponding to Kohut’s selfobject). It is as if there is no one behind the hapless patient to protect, to help, and to organize him/her. For borderline patients close to the psychotic spectrum, in whom the neurotic and psychotic personalities may co-exist, Grotstein (1986, 1989) stresses a dual-track approach for the verbal and preverbal (nonverbal) domains of the borderline psychotic's existence: “Whereas the nonpsychotic personality seems able to communicate to the therapist in free associations which are appropriately encoded as symbolic derivatives, the psychotic personality seems to speak either in loose, disorganized, encoded associations or in nonverbal projective identifications which the therapist may be able to detect in his or her own projective counteridentifications…” (Grotstein 1989, p. 270). Overall, the analyst listens to “the text of associations from the patient's unconscious, for which the patient's conscious speech (free associations) is merely the channel” (Grotstein 1995, p. 398). Another North American Post-Bionian author, Lawrence Brown (2012), further elaborates on the Bionian concept of ‘Transformations’, as it applies to free association in the clinical process: “Through listening solely to the patient’s free associations and extracting unconscious meaning, the analyst assists the analysand to achieve a transformation in K that affords the patient knowledge about himself…” (Brown 2012, p. 1209, original italics). In the next phase of bringing about mutative structural changes in the patient’s unconscious, the analyst identifies with (becomes) those aspects of the patient revealed in free associations which the patient disowns. If the analyst can contain these ‘pre- psychic’ contents, he can help the patient to transform the intellectual knowing into intimate emotional experience, thus effectively facilitating the patient’s internalizing the analyst’s ‘alpha function’, which made this transformation possible in the first place. III. Cd. Other Developmental and Dynamic Approaches Minimizing Free Associations Research on “mentalization” of Fonagy and Target (2003) is sometimes viewed as the obverse of free association. In mentalization-based therapy (MBT), people are encouraged to consciously think about their thoughts to mobilize self-observing capacity (“observing ego”). It has been used with patients who are overwhelmed by eruption of too much primary process into consciousness, or, those who appear rigid, concrete and obsessional, with no or minimal access to primary process. Robert Langs’ (2005) “guided associations” employs the process similar to Freud’s early technique of asking people in treatment to associate to parts of their dreams, memories and other experiences (as did Jung and the Zurich School in their modified Wund’s Word Association Test). In various dynamic psychotherapies in North America, which may be structured around specific focal problems and conflicts, not using the fundamental rule at all (Knight, 1953) may coexist with employing free associations in a limited scope within a
399
Made with FlippingBook - professional solution for displaying marketing and sales documents online