Blood, sweat, and tears: the effort of narrative change in psychoanalysis

Facilitating change in psychoanalysis requires the analyst and analysand to understand the narrative that the patient has constructed of his life and then activate certain attitudes and actions directed against the finished narrative. The analyst has to not accept the story in order to destabilize psychic organization while also providing a new kind of attachment that the patient can use to construct a new narrative. Co-constructing a new narrative promotes the developmental process by providing more flexible regulatory systems for emotional and cognitive development, facilitating innovative views of people and relationships, and assisting in the organization of emerging structures necessary for progressive development. An analysis of a young man in his twenties is used to demonstrate how narrative change is used to destabilize arrested adolescent development and promote a developmental transformation to early adulthood.