Taking the Transference, Reaching Towards Dreams

"One of the aims of this game is to reach to the child's ease and so to his fantasy and so to his dreams. What a lovely description of an easy interplay between two people, leading to the communication of, even the creation of, inner life. Winnicott was a theorist of the unnoticed obvious, as much in this statement about his squiggle game as in his recognition of the eternal phenomenon of transitional objects. But it is also a commonplace of clinical psychoanalytic practice that no sooner is inner life contacted, and a beginning link made to the external world, no sooner do both parties realize that the behavior that seemed so idiosyncratic actually has relational meaning, than something else happens: transference, and taking the transference becomes the new, vital and risky clinical problem. This book reports on clinical work in, and at the boundaries of, the intermediate space between patient and therapist, perhaps the space between reaching toward dreams and taking the transference. Though the clinical work to be described here was influenced quite deeply by the writing of Winnicott primarily and then of Lacan, it is meant to stand for itself as the record of--and a set of stories about--one therapist's experiences and learning. The chapters that follow take up a range of clinical conditions (hopelessness, self-destructiveness, psychosis), clinical phenomena (regression, impasse, trauma), technical issues (interpretation, transference, free association) and related topics (dreams, creativity, the analytic setting). Most of this work took place at the Austen Riggs Center, a small psychiatric hospital in Stockbridge, Massachusetts, in which quite troubled patients are offered intensive psychoanalytic psychotherapy in a completely open and voluntary therapeutic community setting.