A particular perspective on impasses in the clinical situation: further reflections on psychoanalytic listening

We tend to think of impasses as manifest, if often puzzling events, but they may also occur quietly, disguised. The analytic process may seem to be moving on course--yet, on further glance, there can be subtle evidence that some impasse, at times just emerging, may be, perhaps collusively, evaded. Often outside the patient's awareness, cues to its occurrence may be expressed in the vicissitudes of affect or state or shift in content. When such phenomena go unnoted as vital communications, ultimately, a more dramatic eruption may take place; or, perhaps more insidiously, some central conflictual feature of the patient's character continues unexamined, unabated. The author suggests an alteration in how we think about impasses--how pervasive they may be, even as we may believe we are seeing the ordinary ebbs and flows of resistances and defensive processes. Drawing upon four clinical examples, the effort is made to elucidate the link between our understanding and recognition of the presence of an impasse and our mode of analytic listening.