Chapter 1
An overview of technique and interpretation
Technique in Analytical Psychology
Before delving into interpretation, it is necessary to locate interpretation within the broader context of analytic therapy and training in analytic therapy. In most psychoanalytic institutes the training focuses on two areas, theory and technique, whereas in Jungian institutes the training focus includes theory, technique, and the study of archetypal content. However, the emphasis given to these areas differs significantly between psychoanalytic institutes and Jungian institutes. Psychoanalytic institutes give significantly greater weight to the technique of analysis, while Jungian institutes place significant emphasis on archetypal content such as fairytales, myths, religion, and alchemy. The technique of dream analysis1 is emphasized in Jungian institutes, but the techniques associated with the ebb and flow of the interaction between analyst and analysand receive comparatively little attention.
As I mentioned in the Introduction, technique refers to the methods or processes by which the analytic interaction takes place. That is, how the analyst listens, begins and ends an analysis, establishes the analytic frame,2 develops a therapeutic alliance,3 works within the transferenceâcountertransference matrix, engages the patientâs defenses and resistance, interprets patientâs dreams, and interprets the analytic interaction. These fundamental areas of technique were initially outlined by Freud (Ellman, 1991) but have been elucidated and expanded upon within the psychoanalytic world by Fenichel (1941), Stone (1961), Greenson (1967), Auld and Hyman (1991), and Etchegoyen (2005), among many others. The psychoanalytic literature also includes numerous texts focused on specific areas of analytic technique. Technique provides the underlying structure of the analytic process â the unseen but necessary support for the art of analysis. The integration of technique facilitates an understanding of why analytic therapy requires the unique shape it does and assists in cultivating a birdâs-eye overview of the analytic process. However, each analysis unfolds in its own unique way despite relying on a common underlying structure of technique that serves to maximize the engagement of unconscious processes. Connolly (2008) highlights the intimate relationship between technique, theory, and the creative art of analysis:
(p. 482)
In this regard, the structuring and creative aspects of analysis intermingle in the same manner as in jazz improvisation. The minimal but necessary form provided by the underlying chord structure, tempo, and rhythm serves to shape the musical exchange between soloists in the jazz setting (Barrett, 2000; Knoblauch, 2000). Barrett describes the improvisational process as follows:
(pp. 232, 233, 238)
The structure is sufficiently minimal that significant variation of expression is encouraged, yet it provides a sufficient organizing influence to prevent disintegration into musical chaos. Enactments, acting out, and âwild analysisâ (Freud, 1910) could be considered the equivalent of chaos in the analytic setting.
In contrast to the psychoanalytic literature, there is a relative scarcity of Jungian literature on analytic technique, with only a handful of books focused on the technique of Jungian analysis.4 Most of the emphasis on technique in Analytical Psychology is on dream interpretation rather than the techniques associated with establishing and maintaining the analytic interaction when dream analysis is not occurring. Dozens, perhaps hundreds, of Jungian volumes have been written that focus on dream interpretation, but there is little Jungian literature on technique and the processes that occur during analytic sessions. The technique associated with analytic interaction receives the least attention during the training of Jungian analytic candidates. Informal surveys, conducted during seminars I have taught, revealed that most Jungian candidates had not had a seminar specifically focused on interpretation. During my own training, I did not have any courses specifically focused on analytic interpretation, but I was fortunate to have a few mentors who emphasized and modeled the importance of interpretation and technique. In contrast, psychoanalytic institutes typically have multiple courses on technique; often during each year of their curriculum.
The general avoidance of technique within the Jungian world can largely be traced back to Jungâs attitude towards technique which carried over to many in the generations that followed him. Adler (1967) summarizes the traditional Jungian position as follows:
(p. 23)
Typologically, Jung was an intuitive (like many who have been drawn to his ideas) who had an aversion to methodological approaches. Dehing (1992, p. 42) indicates that Jung detested any sort of systemization. Jung also established his position as a reaction against elements of Freudâs theory and technique (Zinkin, 1969). Additionally, Jung felt that the pursuit of Analytical Psychology was so unique to the individual personality of the practitioner that he did not believe one should provide specific guidelines as to the practice of Analytical Psychology. While Jungâs adoption of an anti-methodological position may have been useful in differentiating Analytical Psychology from Freudian psychoanalysis, I propose that he also discarded an important element of the transformative process.
According to Fordham (1998), the lack of focus on technique had a detrimental effect on the development of well-rounded analysts, âThe methods used by Jung, and more so by his followers, were not applicable often in the rough and tumble of everyday psychotherapy when the careful analysis of sexuality and childhood was often needed but neglectedâ (pp. 56â57). Fordham is alluding to the reality that many patients presenting for therapy or analysis are not initially well suited for a classical Jungian or archetypally focused analysis. Such a situation arises with patients who arrive for therapy not yet functioning at a symbolic level and still needing to address areas of immature psychological development, deficits in identity and self-structure, or experiencing difficulty with affectiveâbehavioral regulation.
Kirsch (2000) captures the essence these two primary attitudes towards technique in Analytical Psychology:
(p. 247)
Zinkin (1969) argues that, âboth models are essential and complementaryâ (p. 131). I maintain that the divide between these two positions can be diminished and that a greater emphasis on technique can be assimilated by Analytical Psychology without losing the analytic values so central to Jungâs opus. With that perspective in mind, we can now turn our attention to a synopsis of interpretation.
What is an interpretation?
The origins of psychoanalytic interpretation can be traced back to a twelfth-century Latin term, interpretati, which means to explain, expound, or understand (Blue & Harrang, 2016). Interpretation is also connected to the field of hermeneutics, âthe study of the methodological principles of interpretationâ (Merriam-Webster, n.d.), often in reference to the textual analysis of literature, scripture, and alchemy as well as art and history. In analytic therapy, at the most fundamental level, âInterpretation seeks to make conscious the unconsciousâ (Etchegoyen, 2005, p. 386).
Contrary to some perceptions, a psychoanalytic interpretation is not everything that is spoken to the patient in a session. It is a specific type of verbal interaction set apart from other types of therapeutic utterances â such as asking questions, reframing patient statements, affective mirroring, empathic statements, or reassurance. As Oremland (1991) points out, while all of these interventions may contribute to the progress of an analysis, only interpretation is specifically intended to facilitate the engagement and understanding of the patientâs unconscious:
(p. 10)
In general, interventions that focus on reassurance, advice-giving, problem-solving, encouragement, consolidation of self-esteem, prevention of regression, maintenance of existing defense mechanisms, and maintenance of reality orientation are considered to be supportive interventions (Klerman et al., 1984; Werman, 1984). While these interventions support the patientâs conscious perception of the relationship as helpful, accepting, understanding, and supportive, they are not intended or expected to increase the patientâs insight, engage unconscious patterns, or facilitate the transformation of psychological structures. All types of psychotherapy or counseling include supportive inventions to some degree, and some forms of therapy focus almost exclusively on supportive interventions. In contrast, analytic therapies seek to minimize the utilization of supportive or suggestive interventions while emphasizing interventions, such as interpretation, that engage unconscious processes, increase insight and consciousness, and carry the potential for psychic transformation (Auld & Hyman, 1991). Auld and Hyman indicate, âPsychoanalytic therapy is interpretive rather than suggestive. . . . Principally, the therapist helps through making interpretationsâ (p. 19), and that, âThe warm relationship is the necessary context for the interpretive actions of the therapist, because interpretations necessarily involve some narcissistic affront to the patientâ (p. 35). Vivona (2013) offers a fuller explication of the interaction between the analytic relationship and the interpretive process:
(p. 1131)
Jung (1954b), like Auld and Hyman, cautions against the use of suggestion in analytic therapy:
(para. 315)
In any analytic therapy, a balance is necessary between the supportive and interpretive aspects based on the needs, psychological makeup, and presenting problem of the patient. The greater the severity of the patientâs psychological state and the lower the patientâs resources, the greater the supportive element may need to be. There is rarely an optimal analytic hour in which only interpretive interventions are utilized; there is always an approximation and balancing of these therapeutic characteristics. In addition, within every session, there is a need for flexibility of technique that allows for moment-to-moment shifts to meet the needs of the situation. The goal is awareness of the continuum between supportive and analytic interventions with an ongoing intention of moving closer to the interpretive end of the continuum (see Figure 1.1).
The following exchange is an example of an intervention that could have remained primarily supportive but shifted to an interpretive intervention as the exchange progressed. The exchange takes place at the conclusion of a session. The patient, John, was a student in his late thirties. He manifested sociopathic tendencies and a previous history of drug and alcohol abuse. John had lived a marginal existence for much of his life but seemed to have arrived at a frame of mind where he could begin focusing on lasting transformation. In the session, we had been focused on Johnâs anxiety regarding interactions with his mother. He had recently received a letter and check from his mother and was experiencing anxiety and ambivalence about feeling he should write her back. I made an observation about the level of anxiety she constellated in him and made reference to something he had said, during our previous session, about having to drink two beers before returning a call to his mother. The patient responded, âOh you remembered.â John was moved that I remembered what he had said in the previous session. From a supportive perspective, I could have concluded the session, or I could have said âOf course, I remembered,â but neither of those interventional options would have helped John know anything about himself or how he utilizes me. Instead, I choose to continue with an observation of his surprise:
A: | You seem surprised that I remembered. |
P: | I didnât mean any offense. I just meant that none of my therapists before have ever remembered what Iâve said from week to week. |
A: | I didnât think you ... |