IPA Inter-Regional Encyclopedic Dictionary of Psychoanalysis

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V. Cd. Psychoanalytic P rocess and S ymbolization When the patient’s symbolizing function is preserved, it is possible to conduct Freud’s classical analysis in order to bring the unconscious to consciousness, i.e., through the via regia of the “Interpretation of Dreams” (Freud 1900). It is noteworthy that, according to Freud, the interpretation of a patient’s dream was made using the key of symbolization chosen by the analyst. By doing this and using what occurred to him instantly, the analyst used to put his own mind at the disposal of his patients. Today, this procedure may seem highly intellectualized, but this is how Freud worked to transform the unconscious to consciousness. Currently, for this type of patient to whom "conflict" prevails, the analyst interprets based on the Transference – and in some cases relying on the Countertransference – and resorts to constructions and reconstructions to help his patient historicize. However, there are patients who do not follow the model of classical neuroses, and very often, they show important flaws in their symbolization processes. These patients have been described according to different models as psychosomatic patients (Paris school of psychosomatics), patients of deficit (Killingmo 1989), from “The Work of the Negative” (Green 1972), with narcissistic identity suffering (Roussillon 1999). As presented before, these authors have highlighted the need for conducting the analysis with them in a different way. Roussillon (2015) describes these patients’ preconception of finding a person who can help and understand him/her: the notion of "Subjective Object Analyst" accounts for the expectation of an encounter with a person who welcomes the need to be received (in a broad sense). The desire to be heard and the unconscious inscriptions of acute suffering are inscribed in the analyst's unconscious, who gives body and voice to this preconception, generating a subjectivizing response. For Roussillon, analyzing patients with compromised symbolization requires an analyst and therapeutic devices with a disposition for a free encounter, in an immediate and safe setting. The quality of analytical listening needs to be expanded to the non-verbal and oneiric communication. It is compulsory to individuate the dominant relational configuration (the nuclear problem) which concerns the psychic suffering that has led the subject to ask for help. The way in which this pattern unfolds in transference and relationships is analysed by the dyad. Last but not least, Villarreal (1998/99) and Jordán-Quintero (2015, 2016) note that it is usual for child analysts to make themselves available "in an extended way" to their patients. Not only as a person but also in the physical space of the office, furniture, objects, and toys, as well as schedules, continuity, and rhythm, so that the child can build the concepts of space and time, essential for psychic development. Both children and adults with these characteristics require an analyst in a more comprehensive sense. This, in their view, is the only way to reach the symbolizing function of verbal communication.

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