Clinical choices and the relational matrix

Abstract

In this essay, I argue that it is in the very process of establishing a personal relationship to psychoanalytic theory and to the profession that one becomes a psychoanalyst. If our identities as psychoanalysts are established through our relationships to the psychoanalytic community, and to the values and ideals established by this society and embodied in its theories and practices, then psychoanalysis itself functions as the Third to analysts’ dyadic relationships with their patients. Although contemporary psychoanalysis emphasizes the subjective, the intersubjective, and the unique relational matrix, the view presented here of the psychoanalytic relationship as always existing within the context of the psychoanalytic community and its history provides a context that allows us to place some (relatively objective) constraints on what we mean by psychoanalysis, and these restrictions are imposed not only by the individuals directly involved (subjectively) but by a wider set of forces, including not only contemporary influences, but the voices of history and tradition as well. Idiosyncratic, personal, and subjective factors (the romantic vision of psychoanalysis) must be continually counterbalanced by more general, objective, and impersonal considerations (a classicist vision), and, among the analyst's many professional responsibilities, one is to manage the polar tension between these forces. The analyst's only hope in managing this tension comes from the very fact that he or she can rely on the sustaining background of professional allegiances to theory and community, psychoanalytic values and beliefs. The exploration of a clinical vignette from the perspective of three different supervisors illustrates how the theoretical and the technical form a complex system of mutual influence with the personal, the subjective, and the intersubjective and how, in the teaching and practice of psychoanalysis, these factors need to be considered together as functioning in complex and often elusive ways.