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SETTING, (THE PSYCHOANALYTIC) Tri-Regional Entry Inter-Regional Editorial Board: Joan Schachter (Europe), Jon Tabakin (North America), Thais Blucher (Latin America) Inter-Regional Coordinating Co-Chair: Arne Jemstedt (Europe)
I. DEFINITION
The stable conditions necessary to carry out the investigation and transformation of psychic phenomena, particularly those concerned with the unconscious, in a specific therapeutic environment . The concept of the psychoanalytic setting has been implicit from the beginning of Freud’s development of psychoanalysis as a method of research and treatment, as outlined in his papers on Technique (1912, 1913). Whilst there have been, for various reasons, modifications to the external setting proposed by Freud (6 sessions per week at the same hour every day), development and elaboration of the concept has predominantly occurred in relation to the unconscious meanings of the setting for the analyst and patient; particularly in work with borderline and difficult to reach patients and in relation to the analyst’s internal setting, also referred to as the analyst’s analytic attitude (Schafer 1993). When discussing the “analytic setting”, this should mean the specific, exclusive work conditions necessary to carry out an analytic process. Other treatments, including psychoanalytic psychotherapy, have their own setting, although they may use some elements from the analytic setting. The setting will include both external and internal conditions. The former are established within a framework of time and space, while the latter concern the state of mind needed to carry out the analytic work, which basically consists of keeping an open mind: in the patient, through the rule of free association, and in the analyst, through evenly- suspended attention and the maintenance of an attitude of neutrality and abstinence. Although the internal setting is usually associated with the analyst, it could also be applied to the patient. This “internal setting” of the patient may not be initially apparent and may need to be developed during the consultation process. As for the external setting, some analysts talk of a “pact” or rather “contract”, between analyst and patient (Etchegoyen, 1991). Patient and analyst have corresponding but asymmetric roles, attitudes and tasks both in the external and in the internal setting. It is important to point out that the two aspects of the setting will influence each other. The patient will have to accept the conditions of the setting and be willing to collaborate as best he can to fulfil them. The analyst will also have to agree to comply with these conditions. Any failure by the patient to comply will be subject to
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