Psychoanalytic Collisions (Book Review)

Author:  Slochower, Joyce Anne
Publisher: The Analytic Press
Reviewed By: Christine C. Kieffer, PhD, ABPP, Fall 2008, XXVIII, No. 4, pp. 45-46

Psychoanalytic Collisions, a thoughtful and profound book by Joyce Slochower, examines the ongoing dissonance between the analyst’s hopes—professional and personal—and their realization, or the “collision” between illusion and reality, the ideal and the actual. The author, who divides her book into two sections—Part I, which explores the analyst’s “personal/professional” struggles, and Part II, which examines how these struggles impact the clinical encounter—expands her views of the Winnicottian (1965) concept of “holding” which she first developed in an earlier book written in 1996. Throughout, Slochower depicts one of the most complicated dialectics that beset practitioners of our “impossible profession”: that of the tension that the analyst must hold between her professional ideals and her imperfect attainment of those ideals, collisions that Slochower demonstrates are often rooted in the individual analyst’s—and the profession’s—own illusions. Another thread that unites the chapters in the book is the myriad ways in which both analyst and patient co-construct a set of ideals about the analyst herself as well as the nature of treatment—leading to Slochower’s extended meditation on the meaning of these both necessary and countertherapeutic illusions.

The first two chapters in Part I summarize and reflect upon psychoanalytic literature on these topics, but one of the most original and intriguing chapters in this section is the one that takes up the question of how psychoanalytic writing mirrors the dialectic between professional ideals and illusions, with the analyst inevitable falling short in fulfilling them. Moreover, the topic of writing highlights the ways in which this very public act “collides” with the group ideals of a profession. Until recently, few analysts have written about the experience of writing, and Slochower provides us with a beacon of clarity and honesty that few of our colleagues have matched. The author believes that gender plays a role in bringing about inhibition in writing about one’s work. That is, writerly ambitions may exacerbate an ongoing tension between the maternal expectation of focusing completely upon others and the inherently solitary and self-focused act of immersing oneself in the act of writing. Slochower also makes some very cogent observations about the kinds of anxieties that interfere with writing, first noting that writing is in itself an inherently relational act. That is, there is an ongoing dialectical tension between recognition and its breakdown in the act of being read. Slochower observes that the author must be able to both “locate her own voice and be able to tolerate the inevitable ‘misreadings’ that occur in communication between subjects” (p. 45). The author identifies two major sources of anxiety in the writer: that of collisions between “doing” and “being.” She links Winnicott’s notions about these two key analytic functions to inhibitions in writing. Writerly anxieties that relate to “doing” refer to concerns about committing one’s thoughts to the page and thus exposing oneself to criticism, while anxieties about “being” interfere with the very capacity to think and thus inhibit creativity. Slochower maintains that the successful writer is able to create a transitional space between these two forms of anxiety. This is a chapter that should be assigned to all students in psychoanalytic training programs (who often falter in writing up case reports, even if they do not engage in scholarly work); and perhaps an adapted version should be written for students of all kinds. I know that I plan to recommend it to the students that I teach at my institute.

The fourth chapter in this section, “The Analyst’s Secret Delinquencies,” in which Slochower examines the phenomenon of “misdemeanors”—that is, breaches of professional conduct that include eating meals or reading magazines during sessions, polishing one’s nails or answering the telephone. She contrasts these kinds of breaches with analysts’ “felonies,” which would include sexual boundary violations, dual relationships or stealing, that is, misconduct that would result in malpractice suits. Most of the misdemeanors that Slochower describes—virtually all are learned about through confessions made by supervisees or colleagues—are sins of omission of a sort, that is, acts that are performed to satisfy personal needs and which “steal” time and attention from the patient. This is a work that has evoked much controversy and discussion at recent analytic meetings. Having attended presentations at which Slochower presented earlier versions of this paper, I can attest to the amount of frisson that this work provoked in listeners. As the author notes, psychoanalytic colleagues often react with intense disapproval—even outrage—when they learn of these misdemeanors, a response that Slochower surmises may reflect a desire to distance themselves from identification with the perpetrators that she describes. The author, while acknowledging her surprise and dismay in learning of these breeches, adopts an attitude of inquiry into the underlying circumstances that have given rise to them, in an attempt to help supervisees understand how the intersubjective dimension of the clinical encounter might have influenced the analyst’s behavior. Slochower, however, reaches a perhaps surprising conclusion, given that she resides firmly in the relational camp. She concludes that the various delinquencies described in the book tend to come about as a result of analysts not having sufficiently attended to their own needs, “stealing” time and attention from the patient whom they may either resent or simply tune out as a result of inadequate self-care. Slochower contrasts the conditions that give rise to these delinquencies with those of psychoanalytic “felonies,” noting that analysts who appropriate patients’ time for themselves tend to do so during quiet periods in treatment—or periods that are less demanding of relational engagement. She believes that this phenomenon in fact bolsters the argument that these analysts’ misdemeanors occur when the self is being insufficiently nourished. Slochower asserts that these kinds of delinquencies occur across theoretical camps, and cannot be explained away as simply arising from a contemporary trend towards the blurring of patient-analyst boundaries, a charge that has been hurled with particular force at the relational movement.

The second part of Slochower’s book addresses emotional collisions between the ideal and the actual as they pertain to the clinical encounter. The author displays great skill in employing intricate, highly sensitive clinical vignettes to make her ideas come alive. In her chapter entitled simply, “Emotional Collisions,” Slochower provides us with one of the most delicately rendered and deeply reflective papers on erotic transference and countertransference that I have read, revealing the intersubjective co-construction of the “collision” between patient and analyst. Throughout this chapter, the author examines the dialectic tension between affective resonance (n.b., this does not necessarily imply a pleasant experience; even an experience of horror need not involve a sense of affective clash) and the collision that is created when the experience between analyst and patient is affectively dissonant. She cites Josephs’ (1995) critique of analysts who approach experiences in countertransference with naïve realism—precluding a more complex investigation of sources of these affective responses. Slochower asserts that this poses a particular problem in working with erotic transference. She writes movingly of the “pain of finding oneself feeling what seems therapeutically destructive” (p.105), which can lead to a sense of impasse, helplessness and withdrawal on the part of the analyst. Slochower provides us with a frank and detailed depiction of the vicissitudes of her feelings about “Emily,” eventually developing a capacity for holding the feelings of both herself and her patient as she encouraged an exploration of what lay beneath what seemed to be Emily’s oppressively expressed erotic feelings. The impasse seemed to begin to abate when the author finally told her patient that “there seemed to be no good way of responding to Emily’s question (about whether she reciprocated her desire) without either rejecting or seducing her” (p. 111), making a plea that the patient join her in understanding rather than taking such wishes as a given. Together they discovered that Emily’s “vulnerability to scrutiny and penetration (in response to her mother’s aggression) had become assimilated, reversed and had reenacted these dynamics” (p. 115) in the analytic encounter. Slochower helped her patient to become aware that her eroticization and idealization in a maternal attachment had protected her from what would have been an unbearable awareness of her mother’s aggression. This is an example of psychoanalysis at its best.

In her chapter entitled, “Asymmetric and Colliding Idealization,” Slochower first traces the history of this concept in the psychoanalytic literature, noting its lingering negative connotations in many branches of psychoanalytic theorizing and making a case that permitting the patient’s idealization of the analyst is not necessarily, and not merely, defensive but may instead provide both support and fill in developmental deficits. (Here, she tends to valorize Winnicott at the expense of Kohut [1977], but that is a small quibble.) On the collision between idealization and recognition often cited by relational writers, Slochower asserts that both experiences are not mutually exclusive and often co-exist. She notes that the analyst’s unconscious rebellion against idealization can lead to the “secret delinquencies” that she writes about in Chapter 4. She also notes that idealization may reflect an unconscious bargain in the psychoanalytic couple: “I’ll love you if you love me” (p. 131), a stance which can serve both a defensive as well as restitutive purpose. A particularly interesting aspect of Slochower’s contribution to this topic is the insightful section on the analyst’s need to idealize the patient. She concludes this chapter by telling us, “idealization does not so much as dissolve as become complicated by mutuality” (p. 137), a state that Benjamin (1995) has characterized as being one of mutual recognition.

In summary, Slochower has made another significant contribution to our theoretical as well as clinical literature and I recommend this book highly. In fact, I plan to assign it as an essential text to the candidates that I teach at my Institute.

Christine Kieffer

Benjamin, J. (1995) Like subjects, love objects. New Haven: Yale University Press.
Josephs, L. (1995) Countertransference as the expression of the analyst’s narrative strategies, Contemporary Psychoanalysis, 31, 345-379.
Kohut, H.H. (1977) The restoration of the self. New York: International Universities Press.
Slochower, J.A. (1996) Holding and psychoanalysis: A relational perspective. Hillsdale, N.J.: The Analytic Press.
Winnicott, D.W. (1965) Maturational processes and the facilitating environment. New York: International Universities Press.

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