Dialectical thinking and therapeutic action in the psychoanalytic process

The therapeutic action of the psychoanalytic process depends upon a special kind of power with which the analyst is invested by the patient and by society, a power that is enhanced by adherence to psychoanalytic rituals, including the asymmetrical aspects of the arrangement. It is important, however, that the analyst also engage with the patient in a way that is sufficiently self-expressive and spontaneous so that a bond of mutual identification can develop between the participants. At the core of the generic "good object" is an element of uncertainty as the analyst struggles to find an optimal position relative to this dialetic between formal psychoanalytic authority and personal responsivity and self-expression. At the core of the generic "bad object" is an uncritical commitment to one side of the dialetic at the expense of the other. An extended clinical vignette illustrates how the analyst's struggle with this dialetic has great therapeutic potential.