Time, Self, and Psychoanalysis (Book Review)

Title:  Time, Self, and Psychoanalysis
Author:  Meissner, William W.
Publisher:  Jason Aronson
Reviewed By:  Annie Lee Jones, Winter 2008 (Vol. XXVIII, No. 1) pp. 45-47

Taking The Time To Seriously Consider Time: A Psychoanalytic Exploration

When I received the book, Time, Self, and Psychoanalysis, by William W. Meissner, a Jesuit and psychoanalyst, I did not know what direction it would take me in my efforts to think through a problem that has preoccupied me for years-temporality in the psychoanalytic situation.

Grappling with issues of resistance related to scheduling new patients, negotiating fees intertwined with frequency of sessions required for the work to be psychoanalytically oriented, and major questions surrounding the chronically late or unscheduled absent patient, all prove vexing in the private practice of an urban clinician not in fulltime private practice. The management of time in the psychoanalytic situation is a major concern of mine, and I have often been left wanting when considering the question of time from a point of view solely focused on the treatment frame while duly noting the timelessness of the unconscious.

It is relevant for me to mention here that I started to develop my practice of psychoanalysis during the early days of managed care and co- payments, finding myself struggling with the corrupting effect outside monitors had on the way I approached new patients.

I worried about "giving" the extra 5 minutes to patients who insisted on using their insurance, since I knew that the insurance carrier only required a 45 minute "hour", contrasting with my usual practice of the 50 minute "hour". It also took me years to satisfactorily resolve my problems around the collecting of the "co-payment". Over the years, I managed to train myself and my patients to drop the "co-payment" check or cash in a wonderful woven basket that I trusted that has always held its place just to the left of the bookcase by the door to my office.

The evolution of my practice style has seemed to me like an accommodation that has always led me back to questions of temporality. Putting questions aside on the obvious countertransferential issues that I bring to the work as demonstrated by the way I introduced this review, along with my awareness of my own need to self analyze my blind spots or seek consultations in particularly paralyzing cases in my work , I have still found myself struggling with issues of maintaining the analytic situation when questions of frequency of sessions, fee negotiations for additional sessions beyond those covered by the insurance carrier, are compounded by the impact of the patient's experience of time on the treatment.

Noting that transference/counter transference issues were at play in many of my cases where these issues were prominent, I was always seeking opportunities to think through matters of time in the psychoanalytic situation. Therefore, I approached Time, Self, and Psychoanalysis eagerly seeking avenues to think through these and more problems of time in psychoanalysis, and the psychoanalytic situation in particular, and was not disappointed. Not only was I not disappointed, but I found that each chapter of this book led me further into my own reveries regarding each of my troubling cases, where time dynamics was most prominent. I struggled with the author’s theorizing around questions of mind/body developmental issues but once free of the first chapter, I easily followed his stream of thought around the relationship of the self to its past, and the nature of these experiences as they unfold in the presence of the analyst. Meissner states,

"Unavoidable questions within my mental horizon concern the operation of time in the psychoanalytic situation and process. The time parameters of analysis are complex enough in themselves, but when one adds in the role and function of the temporal dimension of the psychic realities of both patient and analyst, the prospects become rather interesting. Time is no longer just time as measured by the clock or calendar; it is transformed into something else that is overburdened with psychic meaning and involves levels of complex motivation on both the conscious and unconscious levels. How do these elements emerge within the analytic process, how do they affect the progress of the analysis, what problems and difficulties do they create in the analytic interaction." (p.viii)

He goes on to describe the limitations of this book, emphasizing that the case studies are presented to demonstrate the operation of only time related factors in the analytic situation, with salient process material meant to stimulate the reader to raise questions that may lead to further exploration of the relationship of time and the self within psychoanalysis.

This thoughtful disclaimer regarding the selective use of clinical case material was relieving given the recent commentary on Meissner's more detailed presentation of one of the book's case studies in a journal article. (See Meissner, 2006; Spero, 2008; Singer, 2008; Meissner, 2008)

Green (1986) introduced a collection of his most thought provoking writings by explaining why he avoided using clinical examples and case histories by commenting, “I do not think that presenting clinical observations constitutes proof of what an analyst advances from a theoretical point of view. Presentation of material can obviously be modulated to fit one’s demonstration, and the same material can be used to illustrate different if not opposing views, depending on the circumstances. No clinical observation has the validity to settle a theoretical debate. (Green, 1986, p.4) He goes further in stating that “a ‘theoretical’ paper is also clinical insomuch as it stimulates associations in an analyst reader, in connection with his own experience or that of his patients.” (Green, 1986, p.5)

With Green’s comments in mind, Meissner’s book can bring into strong relief the strengths and weaknesses of the use of detailed clinical material to demonstrate and support one's theoretical position. This in addition to the novel use of temporal graphs to bolster psychoanalytic interpretation (for an example see chart 8.1. Percentage of Scheduled Analytic Time Utilized in Monthly Intervals, p.146) , keeps the reader alert, while driving home the starkness of the reality of the analyst's action of taking note of time in the psychoanalytic situation.

The intersection of temporal factors in the conceptualization of the work by the analyst, the timelessness of the analysand's unconscious as it unfolds in the session, and the reality of the conscious experience of time by both participants in the analytic dyad are made clear in Meissner's writings.

To this end Meissner brings the reader into the realms of time, time as experienced in reality, in the phenomenological elements of development across the lifespan, and in the reliving and telling of life experiences in the presence of the analyst.

Beginning the book with the philosophical and psychoanalytic underpinnings of the meaning of time, Meissner explores the psychological elements of time on the mind and body. Questions of embodiment of psychological phenomena are explored in detailed inquiry from the perspective of the practicing analyst.

Meissner's chapters unfold to elaborate on the rich interplay of objective and subjective time on the physical self. He develops a theoretical thread that weaves from classical and contemporary thinking on questions of the meaning of time in human development to the intrasubjective experience of time in relation to one's own reality.
Meissner's rich and highly developed clinical cases bring to the forefront many classical psychoanalytic tenants, in particular, the dynamics of time between the unconscious and conscious experiences of the analysand.

Meissner surmises the following in his discussion of a particular dynamic in one of his case studies-The Late Lawyer, "Thus the role of unconscious motivational components became salient and determinative. It was as though the timelessness of the unconscious, one of its operative characteristics as described by Freud, came to overshadow other aspects of the temporal experience and create a fantasy or illusion of time out of time, time isolated from the demands and limitations of the objective time constraints of the real world". (p.140). This is one example of Meissner's use of the rich case material that flows throughout the book to bring in full relief the psychodynamics of time in the treatment frame and dyadic relationship.

Meissner also provides the reader with extensive notes that further illuminate the points made in each chapter, perhaps in the hopes of raising as many questions as he answers in this highly informative text which in addition to examining process dynamics of lateness on the treatment also explores temporal contributions to the analyst's sense of authority and autonomy, and the technical aspects that unfold during the termination process.

In discussing psychoanalytic discourse, Barnaby B. Barratt writes, "Although psychoanalytic discourse gradually moves forward, the patient and the psychoanalyst never now the truth of the moment they are at, nor do they know the truth of the moment ahead of them. In a certain sense, they experience but do not understand the present, and anticipate the future only bewilderingly. Such is the thoroughly historicized and vigorously mobile character of the discourse itself. However, the patient and psychoanalyst do know the untruth of the preceding moment, for the falsity of this preceding moment has been treated negatively, its untruth unmasked in the emergence of the present. It is in this sense that psychoanalytic discourse is dialectically truthful and transformative." (Barratt, 1984, p. 263)

Through Meissner's writings, and particularly through his in-depth exploration of what he knows and discovered in his work with his patients, psychoanalysts can reconsider problematic aspects of their own work while discovering new ways to think through the workings of time in the psychoanalytic process.

References

Barratt, B.B. (1984). Psychic realty and psychoanalytic knowing. Hillsdale: The Analytic Press.
Green, A. (1986). On private madness. London: The Hogarth Press and The Institute of Psycho-Analysis .
Meissner, W.W. (2006). Time on my hands: The dilemma of the chronically late patient. Psychoanalytic Psychology, 23, 619-643.
Meissner, W. W. (2008). Reply to Singer commentary. Psychoanalytic Psychology, 25, 186-188.
Meissner, W.W. (2008). Reply to commentary by M.H. Spero. Psychoanalytic Psychology, 25, 197-199.
Singer, M.C. (2008). How anti-gay bias comprised a treatment: A commentary on Meissner (2006). Psychoanalytic Psychology, 25, 181-185.
Spero, M.H. (2008). Screen time: Clinical notes regarding Meissner's (2006) Chronically late patient. Psychoanalytic Psychology, 25, 189-196.

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