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EDGAR A. LEVENSON, M.D.,
Beyond Countertransference:
Aspects of the Analyst's Desire
We think of the key. each in his prison, Thinking of the key. each conlirms a prison T ,S, Eliot Tile Waslt Land WHAT IS DESIRE? THE ANSWER IS NEITHER AS obvious nor as ca­
sual as one might think. Desire has vel'y specific implications and,
without understanding them, one cannot begin to grasp the nu­
ances of much of present psychoanalytic debate. To begin with,
"desire" is a totally un-American concept. It's not a word we really
use much, "What do you desire for lunch?", or, "I desire you
madly", sounds rather awkward to Americans. Rather, it's one of
those words, like "discourse." or "subtext" one tends to hear used
only in post-modernist criticism, feminist writings, or, as 1 shall
elaborate. some European psycho<tnalytic derivatives.
To understand tbe concept of desire, as it is used in contempo­
rary theory, one must first understand thai d~sire is not a cognate
01', and canllot be used intcn:hange~~ith.~':!!.:w.ilni~. or
s;uisfacti(~Desire. as a coneept, is derived directly from_!i!:gel. I
would love to teU you that I've read Hegel's Phenomenology oj Mind
in the ol'igillal German; or. even in English translatioll. But alas,
pre-medical indoetrination-at least in my day-seemed more di­
rected toward dissecting clams and nematodes than studying nine­
teemh-ceritury German philosollhers. At any rate, my sources are
all secondary. I Nevertheless, one must attempt to grapple with
Hegel's concept; since. to quote Wilden. "The Hegelian concepI For the following exegesis of Hegel. I am heavily indebted to several secondary
sources; namely. Anthony Wilden (1972). M, Guy Thompsoll (I985b). and Lacan
(l975).
Presented to the Manhattan Institute for Psychoanalysis :Feb. 4. 1994,
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EDGAR A, I.EVENSON. M,D.
lion of desire is what lies behind or explicates most modern COIl­
ceptio~s ofjnt~ntig.uality (Brentallo, ,Hu3serl), ~catt2~~s (Freu~),
of pn~eCl (Heldegger, Sartre) and Q!,goal-seeklEj; (non-mechanIs­
tic cybernetics) ... And, of course, as Lacan has pointed out, the
words translated as In,stinct' or 'drive' or 'instinctual impulse' (in
~'re~d, 'trieb') as~the concept ~T~~~!.~~st}-iH}(j wish­
{ulhllmelll, i:an all be sUOsume'd UI!,~~I~Jhegene[al cafegory of
desire, whicl11snroeciiSiiii'glilshed from instinctual need and
~dellla~(Wdaell, m72:p:-65}.fris lloi7Iiowevcr. an easy
concept to grasp, For an unwitting example of just how thor­
oughly recondite and incomprehensible this issue call be, let mc
quote K~jevc, explicating Hegel:
~at~,,~!:£tlu:an
!u~I.J)e.~E~,_~S,.~~IO~e,.,r},_t::t,!le
0,1 fis,',h
({>!D.ple­
t.ion ill the I;elllg of allot ler-IO
10" the Other. 'fhiS IS, oddl ellougTl,-a-:-il1iwiHlgfiIYIriTei:subjectiye.. ('OIH:ept. Oe­ sile_r~~!i_!!.~)t Ie - peni'f5il: ~~J:QC"!:ea~;i'ls 'I shall elahorate, be
eI dehned
a Wish to fmd
elOlaUy-kll-(;WIl
II, IS
'*
incompletel~,~s.
1
No wondcr Americans, pragmatists to the core, abjure Hegel. Yel for all the almost willful obscurity of this language, Hegel's lJll~erstallding of the ~l!'boly end existential inUUllpleu:ness ~ired hy Frellc.LLi!!.uL.Euglish,..;Hlalysts.aluugc-with ~ililk. Therefore, one must undersland whal is
meant hy desire as cQ.U1Qsted with "wallt". III Henderson, The Rain
King. Salll Bellow's novel, the archeiY'Pal AmeriGlII protagonist
cries inchoately, "I want! I want!" (Bellow, 1959). This very Amer­
ican vision, is, "Give me everything, because everything is possi­
ble,", Freud, as you kllow. despised AUleri~a. Ile teared that we
wOllld'Subvertru.; austere psychoanalysis,change i[ illt!!_~ cheap
fl{lJilIme nl"{[iVlCe-a "Shift h tlAI thetragic illlpl£lCai)llily of desire
to the candy-n'lOlIntain dreams of gratifying wants, He lIlay !lot
have been so rar wrong. Much of the cllrrenl criticism of Ameri­
Gill psychoanalysis centers on its \allure to recognize socio-hio!og­
ical limitations. ~d its blandly romantic propensity to act as
tflOugh everything were ~ychO(lyii~imlcany-(Jefet'rnl!ledalj(\-lhl!s
s!lbje~ion,
----,.,--"
"
BEYOND COUNTERTRANSFERENCE
desire cannot ever _be fu!!illed: it is al~_a priori, a function of ~g.>
"DesiretS'tllesearch for;,Csy1Ti1iiI1c repetiti!m...DLa... satisfaction
mtrose- completion has become impossible" (Thompson, 1985, p.
431-; "We do not deSire olijects we desire desire itself' (KOjeve,!
1969, p. 1-30) quoted by Wilden (191-2.... p. 23); ",Gen!!in<>:.desire is
•
acceptance. of
whereas neurosi5..J,·s_a",_.Y.ain attern.p.L!Q keep the delusion_of ultimate satisfaC!i<.)n,<!I.!y~, an at­
tempt to achieve ultimate certainty" (Thompson, 1985, p. 186).
-S-o desirclS sOllletlullg far more obscure than want. There is a
peculi;u:. paradox built into this wish to J1n...d completion, in the
rej@rd of the qther. Who I am, my self or my ego-as I under­
stand it-is a COlisequence of reflected appraisals of me. It makes
me an objet:! in my own perceptions and in the eyes of others
(Thompson, 1985, pp. 178-79). T~plicitiJl.LaC!!I1'.~_'pC!s!ula­
tion~ his "mirror stage" and is also simi~ to SulliJ'a.n's .version
of self, in as much as he believed that the~ ensconc,!':d con­
cee.!_~f cor_c:..E~I~Qnalil¥-..was illusory, &;lCfrom. thi~_iIDID.L.of.yiew,
is al~Y1 a~ obiectHica~.!!L and therefore always false. Winnicott's
insistence 011 a "true" and "false" self would seem a false dichot- )
2,my since there is no true sell'. Self is merely who I thi~k..L~m. To
have my deSire met-tfiaTis, to beacknowledged in my total sub­
jectivity-I musl be recognized for Wll~t I am not!. That is, I must
diswver myself to be not who I thought I was in relationship with
the other person. Isn't this, after all. tbe essence of true love~
•
,-- Untorlullalel}'...JnisJeads.JOJIlhaLHegelHcaUed the M~ve '\ ' \
dialect'iZ In order to obtain the desired recogniti.2n.-nne-p1Ust to­
-ratlylffisoro the other person to one's purposes. To quote Thomp­
Se)nagairl,"Wftat he [the Master] wanted was the recognition of
the mllollomous free agent who would recognize his desire as hu­
man, but what he ended up with was merely the servile, pathetic
recognition of the slave" (Thompson, 1985, p. I 79). Mel yet tru:_,­
slave has a more auth~.!l!k...~!lse of being than th~ Mas.teI:,,-the
slavDI1()ws who be is Ibrou.gh his task. TI.!r: Master is nothing
wliliout him. It is the power of.the submiuex:.rtfle masochist, who
is as much needed as ne~y.
are the imPliCations for the analyst for this very particular
conceplltalization of desire which takes us beyond countertra.!!.s­
ference which is- merely a par!icular therapist's idios I1cratic ar­
lktpmt
ar
ar patient, a Ig y specific conseque!!ce
or. 1 111 eractlOlI. But what 0 analysts more generically? To para­
~n
To desi.'e a desire is to WOIIIl to substiulle oneself for the value desired by thai desire, , , To desire Ihe desire of an olher is thus, in the las! anal­
ysis. 10 desire Ihal the value Ihat I am or lhal I 'represent' he the value desired hy Ihe olher (quoted by Wilden, 1972. p. fi6), ~JeSlre, as lie
1
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1)~)2
693
BEYOND COlJNTERTRANsn:RENCE
EDGAR A. LEVENSON. M.D.
phrase Freud's famous question, what, after all, do analysts want?
Analysts want to be good analysts, get referrals, buy a counLry
house, have a career, write a book, be esteemed, earn their fees,
help patiems-but help them to do what? Well, get heuer-what­
ever that is.
Ah, but what, if they desire anything at all, do analysts desire?
~ ,definition, it !!!U~~_to be~ome t~~ sul~i~ct ..~.~t~e patient's
d~lre: to fin!J.llteir..afl1t:mat1:min.the cure of the palient. If the
analyst seeks the patient to affirm his/her own meaning-then
what? Cure then becomes a version ()f the Ma:;tercSlay.c.dialectic
with the patient~lTIllliiigJ{;lh; tbe~pil>t, who Lacancalled "the
slililect:Wflo-is-supposed-tt:>':::~I1_qw" (Wilden, 1972, p. 21).
'Why d()-ai-iiifySiSre4ulre such a profound lullillment Irolll the
patient which surgeons, ror example, are perfectly comfortable
eschewing? Surgeons do not require th,1l they bewme the sul~ie(:t
of the patient's desire. They will sellie t()r removing the unending
organ and collecting their fee. Why do analysts desire more?
Analysts, unlike surgeons, are not following a prescribed method
with a predictable outcome. If the surgery fails, either it is had
Illck or bad technique. Blame is easily assignable,_;gl~ts:.on the
otl!~~and~einvolved in a process which is poo!,l)' ~~Ii!:!eated,
and su~j~~~~~ ~~l~·i!i=~§)L1tatio_f1.<:!lllOngbotl1its~)~pp()rters and
dett,!ctor~ .. Even within a single Training Institute, the poor be­
deviled student is proselytized by teachers of markedly different
persuasions, Moreover, we cannot assure our patients of success­
ful outcomes, even with Our most skillful efforts, and-what is
worse-even when patients do extremely well, we cannot be sure
that their improvement is directly due to our intervention; since
over Ihe long time involved, many other intercurrent events take
place in the patient's life, And even if their cure could be directly
attributed to therapy, we cannot be sure which of the many many
things we did and said made the difference. PsydlOanalysis is like
magic. One makes multiple and contiguous interventions and
hopes for the best. And, as the Indian chief in Little Big Man, T.
Berger's book, said. rather resignedly, "Well, sometimes the magic
doesn't work" (Berger, 1964).
Why, one might ask, wilh all these discouraging ambiguities
afoot, does anyone become an analyst? It is, of course. hardly an
entirely conscious choice. _AnalYSIS are w'IJally people who are
continuing a Iif~!!!!~....role'._1lieihiy.~ !)iten played'-ihe'Sage, the
--.---~,­
694
sane one, the healer, the arbitrator, or the peacel}laker. ill their
ral.~i1"~-:!l1fi~,avel L~'!:!:~.L~5~2...~!~c:.Lhave .!!..
serious il}v~st­
I!~~nt III their th~euuc relevance. I recall hearing !t,.Q. Lamg
talking puhlicly about his r~tionship with his mother who was,
h~id, at times ~)vertly psy~TioUc. At her WOrst, whetrShe was
lllute or raving, Laing said that he could enter her room and she
would have a perfectly straightforward and sane conversation
with him. He said that she never acted in the slightest way bizarre
with him. Well, this might well he a bit of hyperbole, but it was,
h)r him, emblematk of his effectiveness with psychot~~7t,!ple. In
orner words, 1- am suggesting that 6eing a psychoanalyst.!1S differ­
eI1lJt:OInQ!11~rJlli1fessjons in the eXlent to which it Jends itself to
t~J:.£.xige!!ri~~)L~!~l~~nd the master-slave dialeclic.
If you doubt this. just lookatmialysts 111 therr work with those
impolite, unpleasant patients. the so-called narcissistic character
disorders. They are excoriatingly angry people, never gratified,
and they manage 10 make most analysts feel like idiots. They can
(:all ol1l embarrassingly revealing bursts of coumerlransterence. I
wonder why it is that anyone treats them? What's in it for us? God
knows they don't meet out needs. But, in spite of the grandiosity
of their expectations, they hold out the promise of affirming our
desire. of making us into something wonderful through our experi­
ence with them-through our ability to cUl'e them. I recall one
woman who lIsed to say to me, "By the time I'm finished with you,
I'lItm:n you into a great analyst!" Then, it seemed to me a grandi­
ose and irreverent reversal of the procedure. After all, I was sup­
posed to <:tIre her. nut wouldn't that turn me into a great analyst?
I must have thought so. O.!.~er~~~~~hydid J persi~tin .~hefilEe of
her onslaught of abuse? AltJlOugh the ulltcmlle,-Ol:.therapy was
w:iiillYrather goQ(f.She left. as do many of tbese-paliel1ts-,-wilh a
J!!'ong sense of disappointment. She did 110t become who she was
not, and I, alas, never fulfilled her promise of my promise.
011 the olher hand, what does the patient want? Of course, to
get better-LO have things work, to be happy, to be able to love, to
be loved, perhaps in an unqualified way. Maybe to have the neu­
rosis perfected! What the patient is doing in life is not getting the
antidpated results, but perhaps the analyst knows away. or can
provide a mutative experience which will make it work.
W~oes the patient desir~?T!!~p..a1ie~I!!!t jn..rouch with
real <.iesll,e and its conse9uen~~",I)ich aJ'e always ~~.-P.Qil)tmenL
ve!i
--------...
---­
695
EUG,\R A. LEV.ENSON, M.D.
UEY()ND (;OlJNTERTRANSFEREN(;E
InJJl~..!!:!~ of Hegel's master-slave dialectic, the analyst wishes [0
thepaii'enlw~lnts-'lolie cured. The-j)atle'ilTwfshes to
view-a useful conceptualization of the patient's problems-that
be desired,
~
I
fiJtrmltil'ciff~iIysrsdeslre, out can-Orjl};I')rfer ~!!e-.aug[y _~.~l,>missi()J1
oCthe sl~e.5)rr~si~ lJ:I~pro~.s.?.," uy., thepassive-;J.ggLe)isiv.e.x.ehel­
lioil-()Ct'he- slave. Since love is not freely given, Ihe Master is not
valIdated. Tli-e-success of an analysisdepends q!l !h~ ,,~mty()f the
two participants to SUfffiOllllt thisbind: H~~Lilict....!19tJLeU~ve it
wa~p6~~@e~2\ifis.ychilliriiilfstS;'we:r)refer to believe there is a way
oY.LQf w,hat h~~!lsidITedaD,existential impasse.
If desire can never be fulfilled, then what? Here we collie to lhe
nucial point. When Elizabeth Zetzel went before the Admissions
Commiuee of the London Psychoanalytic Institute, Ern~Jl~nes
t!2~her that, "Wh~teyel' YQ!l,do!d~!1·tJeJLt.he1llJhi!~ 'you .':V'!Hl to
~elp i!!.fp~ent:'2 This advice is not as silly as it sounds-or as it
makes t Ie Admissions Commiuee sound. r~,f..J£!.~!llyst !nUSU{Q!L.J..1.Y­
i~~~~!..P~!i!:~!_~o~,~ut_Qf_r~,S.JH:CJ fQ[ lilepatienfs ·n~e{~ 1i:)I'
~o~J~!~_U)~~lS~_~r~_ i~i,~ JIlt: service,Q[ thunal)'Sl:s,-Own
~.'!!!<1...!!~~~~~.!'!._~~_"UJ1!\Kbk\'able. Tbe pC!!ient latHS( come
into
IOllcb_~~-.~-~-.
...;· ... -lesire which is aJife1on<r
/""'0­ s.tate.al-ld-~~c_
.~~P!~<l,~~_~~j~tial. No one is ever fullY_~,~~ied. If the analyst
holds out the promise or bein'g' the perfect parent or mate-of
knowing the patient-it is a seduction of the patient in the service
of the analyst's need to be affirmed by the patie!lLJ!L~ch()­
analysis, the therapist succeeds by failing the patient. This is aDSO­
I~o!n~!K...w~etl!"~_~Cili.e is_1!.,ct,-!SSI~[Fr~~di.~~I;' a-seJf-r~y-
~1.~!~~:f~ni~le~ini:I'iift~;~*~;i~S/~~~~a~~}~y;~:~~II::J~~ t~!~~t~$~~
series of incremental disappointments in th;--anafysrarjiJtb e anal­
y~. Even Kohut, one notes, said that cure results from an ade­
quately maintained understanding, an "echo of empathic reso­
nance," and the analyst's occasional failures, optimal frustrations
which lead to the building lip of self-structlll"e (Kohut, 1984, p.
'he was subvertmg.!! 1'0 repeat, one must have no Interest Incur­
.--Ihg 01 helplngr:t'iepatient. 'I:~is is not doing nothillg;it is nOIl­
doing. The Tao says, "'fhe sage goes ahout, doing n(~ It
ii'iaSound,nZalTe bilt Il IS, I helleve, the key urpsycti()analytic
c~llge. The patient earns two lings. u's,
at resolUilOiisand
gratifications are always incomplete. And, second. that it is possi­
ble to discover oneself-albeit imperfectly-in the regard of the
therapist. 1. cannot emphasize enou h that this is self-discovery, not reilecle ap ralsa s or msi IllS institute<
tIe t lerap~C' ThiS IS t e hardest thing for therapists to learn. The single most ~'i consistently undermining error that analysts make is the effort to do some­
thing wTilCh works! This can take the tormof a mutative interpreta­
'~ative interaction-doing something with the patient
which makes a difference. Listen to analysts' work. The patient
tclls his/her story. Does the analyst think, "What can I say about
this?" And does helshe then proceed to supply a meta-explana­
tion, an overview? As Masud Khan said, we ask the patient for his
truth so that we may supply him with the meta-truth (quoted in
Milncr. 1969). Or, the therapist thinks, how should I reactto this?
If I say this, the patient will hear thal. I f I say thal. will the patient
hear this? If I do X, will the patient hear me as doing Y? It is not
at all uncommon, at clinical presentations, to hear all<\lysts who
believe in relational participation, not neutrality, worrying about
the nature of their participation; like Hamlet, pondering their
choices-afraid of supplying the wrong response or, Heaven for­
fend, if it is effective, afraid that they have inadvertently provided
what I have referred to as the Dreaded Corrective Emotional Ex­
perience-one of psychoanalysis's cardinal sins" Behind all this is
the fervent wish to make a difference, to do something which will
.~
78).
But failing the patient is a very difficult thing to do or eve II
conceptualize. It sounds mean. ~Jlen Bion said thai one must
enter each session "without memory or desire"; !!.. is precisely this
n'ceiTor-un: dlel <I!list to he helpful, 10 be ahft: 10 offer ...an...,over­
-------------~--------~~------­
1I Told by Zelzel at a panel of the American Psychtlanal)'lic Association.
by L. M. Zabarenko (Zabarenko, 1993).
696
;\A
3
'-­
That quole oj Bion's is hum the opcning stanza of T. S. EliOl's Tht' Waste Lalld.
April is II... nudl'S! 1II01l1h, bl'cediliH
Lilil('S 0111 of (he dead land, mixing memory and desire, stirring dull
'.
with srl'iug rain (Eliot, 1930, p. 69) rOOls
697
E/)(;AR A. LEVENSON, M.D.
BEYOND COUNTERTRANSFERENCE
only another way of saying "helpful or not." Should I answer a
patient who asks me whether I live in the city or the suburbs? If I
customarily proceed according to a strictly maintained frame neu­
trality then I must not answer regardless of how benign the re­
quest seems. I may ask why the patient asks, what fantasies he/she
has, why now? If I believe more in
.
'ub'ective field, then
my emphasis must he not on what response would be most he pful
to the patient would "work" ~~ut I'ather on what -my experience
is of being asked. The~becomes, not what is good fouhe
- )atient, or even why he/she is askin ,but what I am feeling. Do I
'feel pressure to resPQnq? Do I not want to, for some reason? Or,
'IS this one of those occasions in which I /elt like volunteering the
information? Is the patient asking because I was ten minutes late
to the session? Was it because of traffic on the road? Should I
have left earlier? Did I, this morning, leave later than usual? Did I
. fantasize that the patient might be allgry? Is this patient rigidly ou
tillle? Never on time? Is he/she a forgiving sort? And so on ad
infinitum-well, not quite ad infinitum. One SlOpS at some reason­
able point simply because time does lJot allow. ,And yet, an entire
therapy might be done through an endless exaillilla~~this
one mCIdent, and its recursIons Ulto tfie hves of both participants.
"l'his self-srn.Triny1:Int:s not neceSSallry~re-gurre'"inIOl:un'iig the pa­
tient, although one might well do so. ,But it is a rich source of data
about the intersubjective field. Again, IfllllSI ~llIP-bqsi.u:,thaLLam.,_
not suggesting that the corfect '(ili-this case, mo~t al~~~~!!ti.~L!esponse to the patient IS cii.f'iii1ve. 1.ilii[iiiigge.siillg thaI it clears the
way-fOr'-nle patient to explore his/her own experience. Psycho­
analYSIS IS a bIt hke curlmg, thal lCe-&owlll.:.!L sport ~ wh~~~ the
5'ec(~d player rllns ahead of lhe(Jjsc~-swee[!ing the ice~ clearing
~
the' way.
~rs all this nihilism? Am I suggesting one go for training to all
~ \J...'tV,/ Ashram? l?~cally the idea is that psychoanalysis requires an an­
.; ".J\}\'
a~t in touch wilh desire and enough sense to not try to COllvert it
~C\J~t() wagl. Does tillS sound wildly radical? Let me present two
~ ~ •quotes, f()r which I am indebted to Ik Gerard Chrzanowski. The
first is from Freud:
t./
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~~\e#...
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. 0t
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698
Ilowever IlIIu:h the analyst may be lempled 10 act as (c.ldlCI·, Illodel and
ideal to other people and 10 make men in his own image, he should not
lorget thai Ihis is not his task ill the analytic relatiollsliip, and that in.
deed he will be disloyal to his task if he allows himself to be led 011 by his
iudiniltiolls. lie will !lnly he I " e = whm Ihey Hushed
rheir
(I~ kil\llc~.!lepcndell(·c
('hild' . hy <Inother (hl'nd I !l4!l, p. 67). Or, Ihis tlllole from Fromm's posthulllously published book:
",J
(J{"I
all this is possible only if the analyst experiellces within himself whitt
goes 011 in the patient am! does not approach him cerebrally .......oif he sees
and sees and sees, ~hinks as hllie as IS ilhsolutely Ileq;;ssary and,
furthermore, II he gives np the IUnsulII Ihat he IS "well" and Ihe palienl
is "side" ... The analyst has the patient'S genuine colltideuce onl if he
permits himself~ullleJ"ble.aml (toes 1I0t 11 e behind the role of a
prclieSSWmtl man who kllOWS Ihe answers because he is aid for knowmg
the answers.
IC aCI IS t 1<11
e all the patient are engaged in <I COIII;I~sk-the share(1 understanding of the l;Jtient's ex ericlu:e, .!!!u\
III<' allal 51's resl<mse 10 liS experlencc-Itol of Ihe p;Jlient's "problcm;"
I he p'llielll lutl 110 J~ili.. elll lUI il <I lierson SlI ffering from his way of
hdng(r:mmril,T!l!'12. p. 711).
)
JtJ2
If onc a~iures helping, what is left? One returns to the VI' tool, "
the silll' qua non of psychoanalysis, free-association or its modern
an,~l()gl~e, t!!e detailed inquiry, They both o~erat~ as a .way of ~11. ves Igalmg the holes, the maUenllons, what IS letl out III the dla­
clo~le. In the Kabbahstlc tradlllon, Rabbi LeVI Isaac said that the
truth of God lay in the white spaces arollnd the letters, the ab­
sences, of which, in the Messianic age, God would reveal the
meanings (Eceo, 1984, p. 155). The therapist eschews understa!!d­
in~, looks into the "white spaces;" simply inquires to deconstruct
the story. It is interesting how dose this comes to recapitulating
tFie premises of hermeneutics that, "events, gestures, things sud­
denly appear as a strange, inexplicable, intrusive evidence within
a context which is too weak to justify their presence. So the~ re­
, ve!ll that they are there to reveal something else: it .is ue.. to th~e
_readel' ttt- decide what it is" (Ecco, 1984, p. 157)..~n other words,
patients, inslead{)f' sirh ly talkin to us, be ins to listen to the ­
se ves ta 109 to .US, and discover that the are ot ler' thaI they
tlioug 1l t ley w~e.
IS IS as c ose as we get to true desire.'
/
. Let tiS Imagine a young woman III her early UIII'tles. She has
travelled to the Himalayas to consult a famous Holy Man. At her
first meeting, the Guru asks why she came. It is dear he has no
particular investment in her being there. lie did not ask her to
come. Moreover, he has curiosity, perhaps compassion, but no in­
vestment whatever in her life, her values or what matters to her.
1
\~
699
~
1\~:y()ND
ED(;AR A. LEVENSON. M,D,
She says, '" am not happy. I think I have a problem with inti­
macy." "What is intimacy?" asks the guru. "The ability 10 sustain a
close relationship with another person, spel:ifical/y my hoy­
friend." "Wbat is a close relationship?" "We should like the same
things, feel the same way. he should understand me." "What is it
to understand?". asks the Guru, curious. "He is a wonderful per­
son", says'the patient. "What is wonderful?" "He is a hlwyer. Jew­
ish, his parents are well-lo-do, he is-attractive. wants what I want."
"What is it you want?" "To have children, a Ilice house." "Where
i;tne house to be? What is it to be a lawyer?" ... And so forth.
A thirty-six year old woman lawyer, consulting with me because
, she was mexphcably depressed, IiJaking mmlt II-re-samepreserna­
ti~asaOove. saId, "I have everyinirig'~;-;::ll1id -COli ra-(1 csi'ie"'. -"'A
child,"? would ask' (he Guru, "What is it to he a child?" The
' - IS IlOt at.~11 interested in figllring~ffiilwr1<lt's wi\)!lg and how LO fix
, A ',I) it He iumlW~ciiFi~TlisaDI'nQ~,~~ie~Jj~~(,)~--~m_ri~W_~he~()fld
u}t looks to her, smce It clearly doesn dook iliat way to fiuilana,he
~,' I)
has-noreaf(iesire t()~five'~hei~JU:~: fSllggest that tllis IS 'highly
' (tV A.~ thcrapclllic. becausetliesupplicant ,discovers he,rSdf-tha~is to
~ ~
sa2'!~h~ "~~not-in tne-rircic~~~_of tfieilllerilli>iliessloquiry.
I
Her deSIre begins to emerge through her OWl! voice.
'
\,0'\9-"\
Parenthetically, I llaV'eas- oiie-'()riiiYliiinlc-memories an inci­
~
dent when I was in the Army as a medical otlicer.:_My Colonel,
"
l \'"
who was a perfectly nice guy. made an ()bserv'!.':~m· £\b(}ut_~ ([fie
\J~ Y'
negative implicat~ons of w~icfi I s~all wll??ofd), and it was on~f
~ ~. \
~I~ most formative expellel!fes In my Me. I thought. My God.
S)Q.)I•
he's right! Of course, as in all these epiphanies, it was what every­
~
one had been trying to get across to me for years. Why did_il
register this time? I think it was that he really didn't rare whether
I -tistenEd or not. He was not angry. hurt. OI'-ii11'ei1i:rea:""f1e-Was
juSt telling me something because he felt like saying it and, )
think, because he did like me. This is now forty-six years later and
I still feel grateful. ) am convinced it was his lack of intentionality
which was critical. My Colonel's desire was invested elsewhere,
Well. let us say that our patient returns dissatisfied frolll the
Himahlyas and goes to an analyst. Why are you here? he/she asks.
, am unhappy and I cannot establish an intimate relationship.
What happens? I start with a boyfriend, feel very dose and in­
volved and then after a while, it all falls apart. I begin to find
fault, pick fights. and finally he leaves me. You never leave first?
gm:u­
J-
~
ty"
p J0-'
v>t
-
700
(;OllNTER'I'J{ANSFERENCE
No. I think I am afraid of the risk of desenion. Tell me about your parents. My mother is very dose, but intrusive and rovoca­
tive. Every tini'e ,I get together WIth her we end up Ig ning. 1 used .'.~ my father's favorite, but whenJ hecame a teenager, we be­
gclll to fight like mad., Now he is distallt and morose. Any psycho­
therapIst, following thiS exchange, IS hUllding a precept. wonder­
ing what questions to ask. But a prohlem with intimacy has been
clCcepted as a given, and an auempt is heing made to make sense
of it-to put it into historical perspective. The method is that the
therapist is gathering data. making cOflllections and conceptualiz­
ing an overview, a blueprint. hased on his/her theoretical canons
which will, presllmably, provide the patient with a frame of ac­
lion.
Up to this pOilll, one is CII raged in a rational )s chotlleR''' > , in
the Mey lall or even,
. , . . . n. Psychoamllysis begios
~hen
e lllquiry begins 10 touch on the absenc~s" the scotomata
in thc narrative, which conceal the patienl's areas of anxiety. Instt;!d of getting clearer. the story hecomes "deconstructed,"
br~S' down, bel'OlIIes Ulconsislent mCijiIicahJe gaps and ,.ab­
t
¥
'~
sences appear.
'---where is transference and cOL1(ltenransfercw:e? First, the pa- "
tient. bemUling increasingly anxious and r~ve<llctl-;-rnobiJizes
against (hetheral>isl and works to IIlcoR'porate the;}[aeist into
the-defellsivnystem. We become the enemy. not t e elper. We
'!Jeanne the dr.rease we have set out to cure. l':rgo, resIstance and transference. Countertransference emerges from the failure of the therapist to rnailllain his/liet uWl.focus. wlieUleL.ddltlf:iIas neutrality, autlienltClty. o.Lempathy. In the course of attempting tne"inq~meclOings become less aud less apparent. The analyst loses his/her own moorings in neutrality as the inquil'y btooms.--ll becomes eVIdent that the analyst partiCIpates, bl illgs hiS/hef Self to the inquiry, by virtue of what is asked, reveals himselti'herself by virtue of the inquiry. The inquirer becomes part of tbe inquiry. It then becomes evident that the inquiry takes on the pattern of Wlat .~s eing inqUlre( mto
mor hism between content an mqlllry. This. agaill. docs lIot make things dearer. Garity is afways a parellthesis around events; a stopping of time, a time:ool. a breather m the flow <if events.lntie'lfreraplst "inter­ prets he/she maK:eS thmgs temporarily clear; hut the flow stops and the therapist finds himself/herself ahead of the patient, pull­
)
701
HEYOND COUNTERTRANSFERENCE
EDGAR A, LEVENSON. M,D,
ing the patient into darity. IfJ.lli:,.tll!;:,raRi~.~sistt,the te!nptatign
and simply continues the process of inquiry, he/sb~}Jnd§ himseif
'1ienifld the patient, f(5)Towmg thefl()w.ndingJlie~(TeS[ of~'le,._
eLI
'a.nd bem.used bY. the S.hiftS and turns which come unP1<l._I.ln~d a.fl.
unpredtc1eo:-tlltel pi dation ISllie'-ilistrument of understanding ~ariij-uhderstanding is emblematic of the Master- He Who Must Know. !.he analyst who is not consuming th~ 'patie_nt,~it~_~is/~er ow~ desIre wIll leave the patien~_~'o~~r:!.~~y)me !!UO tOllch ~!~h de-sll-e, not wanl.
.
~I want to present a clinical example which I have used before (Levenson. 1988. p. 193-194). This is a young woman who is tell­
ing her analyst-with some trepidation-her secr'et fantasy:
There's a doctor-a Mad S(·iemist-<lnd his nurSe --alld he lies me
down to do Ihings [() me, The fanlasy has to do with-sollledling-il has
to do Wilh gelling bigger breasls, , , . The Mad Sdemi'l would do some­
Ihing to give me bigger breasts. I wallie!! bigger breasts very mudl. I
had to submit to the Mad Scientist like I was his slave and he was my
master. ) try not 10 think ahout this fanlasy . , , I don't walll [0 dig illlo it
(Levenson, 1988b. p. 193),
She proceeds to talk about her Master/Slave feelings, but not
really telling the fantasy. The analyst interprets, "You want ~
be the Mad~cientist Doctor forcing and hurtingy()-tlandlilaking
~ii_nges~'3..J::.?u." She denies it. "No," she says, sounding injured,
"I want you to use your knowledge and your understanding to '
change me. I have LO reject that. I can't agree with you oI1ffiat"
(Silvemmn, 1987).
-
----'
Note that the patient tells (very guardedly) a f~l1ltasy. The thera­
pist interprets in terms of his understanding of resistance and
transference-to wit. he is the Mad Scientist. That is, she is con­
verting him to the Mad Scientist as a resistan~e agaillst e~in­
nin her intrapsychic fantasies:.J::!lis is a canonical Freudian i!!.!:er- .
pretation. s ill says, ..All resistance manifests itself by way of . '"
tr~nce" (Gill, 1982). The projection onto the analyst pro­
teas--ne-rttom hearing the mutative insight interpretation that
would confront the meaning of the fantasy, presumably her inces­
tuous and sadomasochistic dynamics. Insight is the goal, trans­
ference is a resIstance to Instgl'll, and interpretation is away from
the therapist and his alleged- participation, and back to her intra­
psychic processes. But note that the patient lIot only rejects his
702
interpretation, bllt treats him as sadistic by experiencing his inter­
vention as unfair-she is "hurt" by his interpretation. One hopes
the therapist maintains his "cool," his neutrality. But olle could
hardly blame him for a flash of countertransferential irritation;
thus enacting the very problem under inquit-y, It is my stpmg­
be~ the iAter,lt.lioli of the therapist and patient always en­
acts the probl~m.JlDdei'-itHJ1:riry. Interpretation qua inter retation
fails heGltIse it ',. 51 '
•
'.
_~. It i~ the allalysis of thjs enact ownl as a reitcrative I"epla):: or \ '
the problem which I believe, carries the thera eutic leve
'If
ut w at if one were, like the Guru. simply curious about the timtasy? :atl we gel her to tell us it? What exactly is a Mad Scien­
dentist if lie is giving her her heart's tist? How mcan IS t le
'~I":::"Big Breasts? Why should he want to? How will he do it?
Certainly, it is implied, agalllst her will, strappe,d to sOllleoevlhsh
device. Will it hurtt Probably. What is so mal'veious about hig --'
breasts? Why not just go to a<recollstnlctive surgeon (this was be­
'-['ore the lilsert scandals)? Why mllst it he (llmt ;lgainSI her wilhtrtd
by a Mad S c i e n t i s t ? - - - ­
-Well, that s t11e whole point. It is not simply a lll.llter of getting
bigger breasts, She wishes to be the object o{lhe Mad Scientist's desire! !t
would be too !itmple to have inserts installed by a surgeon. The
Mad Scientist. in defiance of the laws of God and Natlll-e, out of a
consuming passion to be the Creator (which is. after all. what all
Mad SCIentists are about), will give hel' real big breasts. the kind
one is born with-not someslluulacrum availahle to any woman.
"'wlth the necessary mOlley and incentive. And, having aCCOIll-1
plished that miracle, be will love her. his ci'eature-not. because
ne always wanted a woman with big breasts (jut because It IS
:
ttfrough her devotion that he IS realized. I rue, she Will navener
desinrt:unrut'1arge breasts, but that IS a smalI triumph compared
to her service t.o her Creator.
T~e goal of the fanlasy is LO be desired through her capacity
fulfill the sCientist's dream. After all, what greater passion was
there than between flOfessor Frankenstein and his creaturea.Cim
one doubt that this woman, in therapy, wishes to do anythin tu
He
pel-fecl patient, re eemmg ler alia yst () cuurse, she
W{)Il'O. How could he (hell flO( lovelier? What must he do to cure ~
her? lIe must, unlike the Mad Scientist, fail her~The Mad Sricn­
list becomes the Wizard of Oz. and the pmient. resigned to never
,I(
1f
-¥­
[()'k
,
~
703
EDGAR A. LEVENSON. M.D.
be~ng
the subject of such passion, begins to listen
BEYOND COUNTERTRANSFERENCE
lO
her
~l
vOIce.
Ail
J
this defines, as I see it, the difference between psychoanal­
ysis and .psychotherapx-psychoanalysis's favorite conundrum.
The latter is pra matic and goal oriented. One does whatever
- wor s to ac leve a de ine outcome-w 11ch is, after all, the thera­
pist's idea of what cure is. ~choanalysis works differently: it in­
tends to fail the patient'S hopCTon:nfiagfca\ cure, force hlm7her
tblaH back Oil his 01 hel own resources and oegin t()-arnveat his
or ner-OWIfLOfiSrructicin of thiEwoffi[Tdreadlhe-presefiIlrelld
. towards the climactic cure-abreaciTve amnesia recall, the search
for an event which will fulfill life. Even the present ecumenical
movement in psychoanalysis reflects this chimeric dream of final
understanding, clarity at last. Why must we all agree? Find a com­
mon pathway? What's wrong with disagreeing, living ill doubt, not
knowing whethei: one is. on the right trac~ or not? Psychoanalysis
snould not be a trade or even a craft. To 'luote Crapanzano:
A version of psychoanalysis as professional kindness, psychoanalysis reo
duced to empathy, or 10 a long 'process the denouement of which is
confirmation that the patient'S life was indeed ruined by his parents, was
quite foreign to Winnicott (Rodman, 1987).
Relationships between individuals. institutions. or disciplines which sur·
render Ihe agonislic approat:h 10 facile affirmations of harmony and ac·
cord are in danger (If losing the vigor. crilical reflection, and creativity
Ihal come with Ihe disquieting knowledge that the world Ill" .J!!~
appeal' differendy to those wiLh whom we t'ngage~ ven more disquiet­
iag-is lhe knowledge thaflJiere IS no knowledgeconiVlefinrl-arntor
itsetf;-bunmly-1l-ttrirrktrrg-wtriclr;fS.l~t,!~:~(~wing··(Crapa,lian(;;T992,
p. 154).
---~-.-
Many analysts see a caring, empathic, or "holding milieu" as
providing a powerfully restitutive experience for the patient, Am
I denigrating the analyst's genuine caring for the patient. Am I
promulgating detachment or indifference? It is a really difficult .
question. We must distinguish caring as a ~!ate oj' being, an a priori. \
instrument of trealTl!,ent, from canng as an emergent process be­
tween two people. Why am I caring? Because I am a caring per- .\
so~ou had better not threaten my perception of myself.
Am I caring as a prerequisite to curing someone? Then the pa­
tient will resist and cause me to fail, for who wishes 'to be cured b.)::
the submission to (he ministrations OJthe.<!!D.!'T Vc:r;;gll-no matter-how saiiliry:--.,----.-·-·--....-~---··
----.
"''Empathy is all equally diHicult concept. Surely we IIlllst distin­
guish it from sympathy. I can sympathize with someone else's ex­
perience, but I cannot empathize with it unless I can truly feel it, 704
and that, it seems to me, requires that I have had the experielH:e
or something very close. Empathy must also
..spunta­
neoys.-An arbitrary posruon 0 empathic understanding looks
. very much like a boundary diffusion-a failure of p':.~~.!~.!!!:;.~_~
absence....What a paradox! To be totally responsive may well be an
absence.
Since this is frequently misconstrued, il might be well to quote a
caveat:
X
J
I believe all this is very difficult to grasp and sounds somewhat
abstruse and possibly, if you will forgive a pun, "guru-some."
Since I am rather used to this happening, let me, as a sort of
codicil, predict a dialogue between two persons leaving this meet­
ing:
A-[Wearily} What the hell was he talking about? It sounds like
he said that psychoanalysis doesn't work, there is nothing the an­
alyst can do that is right; aud that everyth!!,!g.we've been t;!ugh. In
do either fosters the patient's subniisSU)on or mobilizes resislance
ai1alsffi-ereforeyrong. Desire-shmesirel I never could undel··
stand Laean and anyway what's wrong with wanting to be helpful,
even cure patients?
B-1 don't think he was saying the psychoamtlysis doesn't work;
rather, he was saying that psychoanalysis doesn't wOl·k in the sa!Ile
way as psychotherapy which works by providing the patient ~~a
coherenroverview, a blueprint for making Changes. fflhechanges
wort:;tney reinforce more change. PSyCflOanalysis works by fail¥
ing the patient's ex ectations of a'lnaster hel er. :[he patient is
I:
n ac on his/her own resources and discovers, to his/her \/)
a'tn-azenient, tbat there IS a flow of consciousness, a deep river gf W
aw.<ireness, which lie/she can tap into and use. By eschewing direc­
iion, organizing, helping, or otfermg~ctive experiences, the
therapist creates a vacuum into which the )atient moves, nOLre- ;41'­
praci.IT~~~~~~est!'5)ying the Master y I( entifX!Eg with him/her: but
in Wilden's words, making him/her irrell'tlanl.. ~-the pa­
uCl!t ~~~t know.~hat!~_e~l1alyst knows, whia~ is what the ~tient
has a~_.l-:nown" (Wilden, 1972. p. 30).
705
EDGAR A. LEVENSON. M.D.
The hlllctioJl of the detailed inquiry or the pH.~n of free­
'lssl?CilitTnu5.,..-rn--e-Bflls, falltasies, is not to acculllulate data to make
clear to the patient what is the problem as the analyst (he/she­
who-knows) sees it; but to fragmem, deconstruct (to use another
trendy term) the patient's stu[ which alwaysconsists ofreITiea
I'@rrauves w IC eave no room for novelty. NeuroSIS, It must be
said. is alwa s both anachronistic and chcheil'--­
. Of course, giving up the maste[-s ave Ia ectic ~lleans giving up
Itle d;:;;am-or a magical outc()me;-;:tnepipnany;aiJ insight or-'expe­
ri~lCe which permits one to bve fia~plly ever after-mature, re-;
h~ed, intimate and loving. As he saii, Frei.'i(]was-alraiirffiat psy­
choanalysis,lili'rinertca-;-would be bowdlerized into some facile
version of uplift. Americans don't like difficulties: Ihey want COIll­
f~,!~a.~ers.'1\l it ybe :-a.s-Met1>Fi)(>ks'l)iiCiI;~ti f'e'-51 iolrS! h~a riil
recognizing that is a prerequisile f()r living successfully.
A- YEf1, but Ihen he's been saying for years lital we have to
get away from the old idea of the analyst as neutr:al observer.
That, first, neutrality is not really possible alld sel.:ond that it cuts
out it lot of useful interactional data. But then he goes on-in my
mind-to contradict himself by first encouraging all awareness of
Ihe imeractional field (in which the therapist is an equal partici­
pant); and_.!hen to claim thaI the therapist must avoid lIsing the
interaction iri-any-'cTefiljEnite1y corl'ec:iive way. That is, he saysthar
t<, attempt t()Ciireihe patierlt througtia superiOl' experience with
the analytic helper is what he so archly calls the Dreaded Correc­
live Emotional Experience-an analytic No-No. I don't gel it.
~-W~J!!!i.!~~,_~~;~ tEyingto~ay-admiuedly in his usual
.1)roli'jC~nd confusing fashion-t~at the analyst'S meticulous mon­
'>
iu)ri~g
~.~,.~~~e.rac~ion .a.~~~.some
hiS/_h._~r=~~.':".[~..... J)~I:~~c.~.pa.l. ~1.1l ~." ~.I~~Cl0 \;,
penecl- file partlClpauon
way wluch Will he therapeutic; -;tr
.Of.. .
. ,.'
III
but~~e~the-alia~j~utortne-w;iy()Clh(tpailei 11 's-now'oCcon- \
sciousl1~~~. The palient's~awareness()rselfiSSTlape(lby- its j'ilterl~iC'e
wi'il1"ihe t~pist; that is, the security operations of the therapist
limit and define the patiellt as well as Ihe patient's own defenses.
The patient flows into the space created by the therapist'~_abilit~,to
dt;!!ne~Wrctco'nstrall1 filS/her own security 6j)er~llions, and it is ~lere
that the patient expands fns/fier OWn self-awarene!>s.
A-[Begrudgmgly] Well, J suppose that does help make it
clearer. Say, listen, have you been in supervision or therapy with
Levenson? You're beginning to sound just like hilll,
B-Well, we all have our shorlcpmings.
706