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Articles- Part XXIX


Two Different Methods of Analyzing Defense
Monroe Pray, M.D.

INTRODUCTION

Until Paul Gray's recent, detailed, still evolving examination of ego analysis in a series of papers (1973, 1982, 1986, 1987, 1988, 1990, 1992), there were no clearer descriptions of the ways in which defenses work than in the writings of Anna Freud and Charles Brenner. If we add Fenichel's systematic contributions on analyzing defense, we have the guiding influences in the fifty-year development of ego-analytic technique.
      Looking back, we see that the technique for analyzing defense branched in the middle 1930s, one branch becoming trunklike, while the other, Anna Freud's, did not begin to grow into importance until much later when Gray (1973, 1982) described the ego's capacity for viewing moments of intrapsychic conflict. Not widely recognized today, but standing out as truly original, is the method she described in The Ego and the Mechanisms of Defense (1936) of doing defense analysis by focusing "microscopically" on moments of conflict and defense occurring at the conscious surface.
     Mainstream analytic thinking at that time did not incorporate Anna Freud's method, although her close attention to details at the surface was adopted briefly by a few theorists such as Rapaport (1944-1948) and Hartmann and Kris (1945). Open interest in the method essentially disappeared from the literature, including Anna Freud's own writing. Then, starting in the early 1970s, Gray described using what he has come to call "close process defense analysis." While Anna Freud did not write more about the technique, she did not change her mind about the existence of this "window" on the unconscious. We shall see that she became even clearer and firmer in her assertions concerning conflict at the surface in her Hampstead Clinic conversations with Joseph Sandler (1980-1984, 1985) when they "revisited" The Ego and the Mechanisms of Defense. She did not expand on her methodology. The purpose of this paper is to do that.
     We all know that Freud's (1923, 1926) structural propositions had offered new possibilities for seeing and representing conflict more clearly than before. His structural model made it possible to demonstrate analytic premises about patients' conflicts in more understandable form. Theorists saw new hope for technical progress. In the 1930s the ego's strength grew relative to the id, and the importance of defenses to the understanding of neurotic symptoms and character traits grew apace. Fenichel said everyone was talking now about analyzing defenses but no one was saying how to do it--a job he himself proceeded to tackle with enormous skill and tenacity. His systematic approach held the center ground in classic technical thinking and is the base on which traditional defense analysis stands today, as exemplified by Brenner's writings on technique.
     Fenichel was vitally concerned with trying to reduce the magnitude of suggestive influence in psychoanalytic work, where a weak and passive ego is vulnerable to an authority imbued with magical powers (1944a). He said that the patient's critical, evaluative capacities have to be safeguarded to combat his natural longing for "magical protection" and "participation in omnipotence." This means that what the analyst presents to the patient's perception and judgment should be demonstrably close to awareness and not require submission to the authority of the analyst for him to "believe in" the analyst's interpretations (1941, 1944b).
     At approximately the same time that Anna Freud proposed her "conscious conflict" perspective, Fenichel, with his interest in reducing "hypnotic" influence in technique, advocated moving the aim of interpretation closer to the surface--as close as one could get: "it makes no sense to give `deep interpretations' (however correct they might be as to content) as long as superficial matters are in the way" (1934, p. 334). He went on to say that the analyst "directs the patient's attention to something preconscious which he had not noticed (and to a 'something more')" (p. 342).
     While this may sound as if Fenichel is very near Anna Freud's conscious surface, he is not. He says that manifestly what the patient says disguises unconscious conflict. "Psychoanalysis is a psychology that strips disguises" (p. 320). We "deduce what the patient actually means" and tell it to him in the form of what we call "interpretation" (1935, p. 322). What the words of the patient actually allude to requires "an intense empathy with the personality of the patient--the tool of the analyst is his own unconscious" (p. 324). "The forces which at one time opposed each other are now wasted in the useless and hardened defensive attitudes of his ego; the conflict has become latent" (1940, p. 190). "Dynamic interpretation" means finding things not mentioned by the patient spontaneously--though they are "shown involuntarily"--finding where the "decisive conflicts are located." Fenichel focused the analyst's interest on the ways unconscious conflict is pervasively influential on manifest behavior and on "hardened defensive attitudes of his ego." Fenichel did not find Anna Freud's formulation helpful. He felt that the analyst had to "break through to the rejected instinct" (p. 189), stripping the disguise concocted by the defending ego. Anna Freud's manifest surface point of view was either not seen clearly or, if understood, was not deemed useful.

THE GOALS OF THIS CHAPTER: WHY IS A COMPARISON PERTINENT?

This chapter compares Anna Freud's 1936 ideas on analyzing defense with mainstream traditional psychoanalytic thinking, represented here by Charles Brenner's views in The Mind in Conflict (1982) and other writings, as well as the views of other analysts consistent with his point of view. Anna Freud and Charles Brenner agree with Ernst Kris (1938) that "psychoanalysis is human behavior viewed as conflict," but they differ fundamentally about how to recognize intrapsychic conflict and how to show their conflicts to patients.
      First, we will compare their observational stances and compare the ways each would choose to intervene. Second, we will use a detailed clinical example by Martin Silverman (1987) for comparison, which was first published in Psychoanalytic Inquiry. Third, we will discuss more about the differences between the two approaches and why Anna Freud's approach caught the eye of so few analysts. Ultimately, the purpose is to begin a discussion that will lead to an evaluation of the analytic validity and research potential of the two points of view.
     We will see especially clearly in her conversations with Joseph Sandler that Anna Freud's views about conflict at the conscious surface seem (to him) to deny the advantages that modern structural theory has provided for understanding the ubiquity of unconscious influences and compromise formations. She responds that modern theory may say what he says it does, but that it thereby contributes to the loss of a sense of immediacy in analyzing, to overlooking the experience of powerful clashes within one's personality, and to a dwindling interest in the ways thought processes actually work. She felt hers was the "classical" viewpoint and that modern theory erred in neglecting topographic considerations.
     In her 1972-1973 Hampstead Clinic Conference discussions with Sandler (1980-1984,1985) about The Ego and the Mechanisms of Defense, Freud tried to make it clear that she used topographic concepts to detect conflict. Growing up with the topographical theory as she did, she said that she had incorporated structural concepts only gradually: "I definitely belong to the people who feel free to fall back on topographical aspects whenever convenient.... By the way, this bad habit of mine of living between the two frames of reference--the topographical and structural--is much to be recommended because it simplifies thinking enormously and simplifies description when necessary" (pp. 31-33). Once she had learned to be comfortable with structural theory she used both concepts as tools: "To think of unconscious, preconscious, and conscious as qualities now instead of as topical areas did not seem to give them second place; on the contrary, these qualitative factors seem to offer the only real explanation for the struggle between the parts of the mind being such a muddle" (A. Freud's letter to Lawrence Kubie, 1955, quoted by Young-Bruehl, 1988, p. 162). She indicates that the ego only cares about a threatening impulse when it becomes conscious.

THE TWO BRANCHES: CONSCIOUS CONFLICT AND UNCONSCIOUS CONFLICT

The following short clinical excerpt from Silverman's (1987) long example to come (see pp. 105-109) will be useful in beginning to illustrate the differences between the two points of view:

Friday
The rain woke me up early this morning. It was beating down on my air conditioner so loudly it woke me up. I looked at the clock. It was 5:30. I thought in an hour I have to come here. 1 didn't want to come today. I've been mad at you all week. It's not that I'm mad at you. I wanted to stay away from all this stuff I think I feel here. I also got angry at R. [her roommate] yesterday. In the bathroom, she takes two towel bars and a hook. And I just have one towel bar. I didn't say anything for a long time. I finally got up the courage and told her we have to change the arrangements in the bathroom. It sounds so silly. I get so worked up over such things. I get so angry. [p. 151]

     "Only for a few moments at a time," Anna Freud said (1936; see also Sandler with Anna Freud, 1985), "can the analyst observe 'fresh conflict.'" The analyst observes an instinctual impulse, a drive derivative expressed and then opposed. The analyst can observe the clash, the dynamic opposition, in the ego's inhibiting, defensive effort to reduce uneasiness aroused by that instinctual expression.

"I've been mad at you all week. --- It's not that I'm mad at you."
"I finally got up the courage and told her we have to change the arrangements in the bathroom. --- It sounds so silly. I get so worked up over such little things."

     If the defensive effort is successful, she said, a compromise formation is achieved: "Peace reigns once more in the psyche--a situation most unfruitful for our observation" (1936, p. 10). This statement draws the line clearly between the two positions on defense analysis.
      Charles Brenner (1982) says that the analyst can look at conflict from Anna Freud's moment-to-moment viewpoint but that it "gives too limited a picture of the psychic phenomena one is trying to describe and to understand" (p. 111). For example, rather than attending closely to what he hears at the patient's conscious surface, he might perceive the patient's anger and indignation as serving defensively to prevent awareness of sexual interest in the analyst, and to push away the idea of missing him when he is on his upcoming vacation. He says that the id, ego, and superego are involved in extremely complex unconscious, conflictual interactions. There are varying proportions of expression, satisfaction, and restriction, and different degrees of unpleasure. produced. The "guiding principle is: as much satisfaction and as little unpleasure as it is possible to attain" (p. 111). Brenner centers analytic interest on the compromise formations that are outcomes of unconscious psychic conflict of infantile origin.

ANNA FREUD'S VIEW OF CONFLICT AT THE SURFACE IN MORE DETAIL

In 1936, Anna Freud introduced four new ideas. The first, as we have indicated, was that the analyst can observe moments of intrapsychic conflict at the conscious surface, when repressed elements surface and the ego then opposes them. In discussion with Sandler (1985), she said:

Of course the whole of psychoanalytic therapy is based on the fact that the reconciliation between opposing tendencies can happen only when they are lifted into consciousness. Why should we try so hard to make them conscious if they could be brought into harmony while they are unconscious? One of our basic presuppositions in analytic therapy is that conflict exists only in the conscious ego. [p. 301]

    The second idea was that these small pieces of clinical material can be used to great effect in the technical process of gradually and systematically uncovering the vast realm of unconscious contents. When these moments of conflict are analyzed, she said, it is discovered not only that a repressed impulse has surfaced but that the patient falls back on old modes of defensive functioning. These moments provide opportunities for studying the transference of defense. The motives for the defenses, the defensive rationale, and the defensive repertoire light up the past. Her third idea was that analyzing conflict solutions (compromise formations) was not helpful for seeing the ego's defensive functioning.
      The fourth departure from prevalent thinking was that the analyst's observational stance required very sharp attention to moment-to-moment variations in what the patient actually says, not a matter of free-floating attention or listening with the third ear. She apparently believed at the time that there was nothing new in her interest in the superficial layers of the mind, but later she said to Sandler (1985):

I was interested to hear how very strong the reaction of older analysts was at the time, when the value of an analyst was thought by many people to be measured by the distance from the surface of the area he was exploring. So the idea that I advocated at the time, that the analyst's position should be equidistant from the id and the ego, from the depth and the surface, was not a popular attitude at all, at a time when the whole tendency was to go deeper and deeper into the unconscious. From the beginning I felt that this was maligning analysis, because analysis was always the exploration of conflict, the examination of the defense neurosis.... The depths alone could never produce a neurosis. This can only happen in interaction with the surface. [p. 523]

     On the other hand, she was aware that her idea that these very small pieces of clinical material could transferentially light up the past was new. She said that the concept of transference of defense "was for some reason not generally recognized at the time" (Sandler with A. Freud, 1985, p. 41).
      To go back for a moment to the clinical vignette, Anna Freud "listened" for intrapsychic conflict first by catching a drive derivative being expressed and then by watching for the collision of forces as the ego "objects" to the drive.

"I finally got up the courage and told her we have to change the arrangements in the bathroom. --- It sounds so silly. I get so worked up over such little things."

     In this example, the patient speaks up actively and aggressively for a moment, and then a second "voice" (after arrow---) stops (controls) the impulse with self-ridicule. These two voices represent parts of the mind relatively closer on the one hand to the id and on the other to the ego/superego.      Anna Freud sees this internal dialogue as the way "normal" associative thinking and expression work. For the purpose of identifying conflict, she tries to make the distinctions between the parts of mind, the "id" and "ego" voices, easily recognizable and familiar. The id-like part is bent on wish fulfillment at any price without regard for consequences. It is self-centered, impassioned, wants what it wants "now." The ego she describes has "an innate disposition against the drives." She says, "This is what the ego was meant to do from the beginning. That is why it was set up at all, to control, to impede the id" (Sandler with A. Freud, 1985, p. 61). It is able to rein in, frustrate, and guide the instinctual impulses in directions that avoid "danger" at that moment, with relative gratification later as its goal.
      Interpersonal considerations are vitally important to the ego and not the job of the id. Evolving personal "rules," a map or chart of what it is safe or dangerous to say or do or to "think" (when thought leads immediately to action) is a critical task for the developing ego as it deals with both environmental "dangers" and "dangers" from within [drives]. Using trial-and-error methods, the child, like an experimental scientist, creates charts that he or she will come to depend on more and more, gradually making these charts the basis of automatic interpersonal adaptive adjustments and defensive efforts. The outcome, inevitably, is that there are repeated, uniquely personal tendencies in "conflict [and conflict-solving] within each person, as the aims, ideas and ideals battle with the drives to keep the individual within a civilized community" (A. Freud, 1974, letter to J. C. Hill as quoted by Young-Bruehl, 1988, p. 457).
     A map, however, is only dependable within its borders. Anna Freud recalled one of Freud's comments about how we bring up children--supplying them with maps of the Italian lakes and sending them off as adults to the North Pole (Sandler with A. Freud, 1985, p. 343). In analysis, our study of the ego's "map" is all-important. Rapaport (1960) wrote:

Human beings in dealing with each other repeat the patterns they have developed in their relations to 'significant others," and these patterns of relationships ultimately go back to those which the individual has developed toward the earliest "significant others": father, mother, siblings, nurses, etc. Such repetitions of relationship patterns are the empirical referents of the transference concept. Transferences are ubiquitous in everyday life, but so far the psychoanalytic methods are the only ones for observing them systematically and for tracing their genetic roots. [p. 125]

     She admitted that simplifying the picture of the "parts" of mind was too much for some people's comfort, but she herself embraced personification. Her simplifying was consistent with a major purpose of Freud's when he proposed the new structural model as a replacement for the topographic model; it puts life into the description of mental conflict that fits the ways people experience opposing parts of their minds--"struggling." Her viewpoint suits "everyday" observation if we recall what Grossman and Simon (1969) write about the interior dialogue we all engage in. They write of the "natural language of introspection" and the usefulness of "anthropomorphism." People naturally experience inner conflict in terms of oppositional `voices."
      Freud (1983 [1932]) wrote: "We are warned by a proverb against serving two masters at the same time. The poor ego has things even worse: it serves three severe masters and does what it can to bring their claims and demands into harmony with one another. These claims are always divergent and often seem incompatible. No wonder that the ego so often fails in its task. Its three tyrannical masters are the external world, the super-ego, and the id. When we follow the ego's efforts to satisfy them simultaneously--or rather, to obey them simultaneously--we cannot feel any regret at having personified this ego and having set it up as a separate organism. It feels hemmed in on three sides, threatened by three kinds of danger, to which, if it is hard pressed, it reacts by generating anxiety ... " (p. 77).
     In the following two clinical examples (Silverman 1987, Dahl et al. 1988) we hear an "id-like" voice and then a more reasoned, balanced, "ego-like" comment that controls the first voice and changes the perspective:

1. "--I thought of saying `thanks for asking' to him because I was so grateful he'd asked, ---but I decided not to say it. Because I'd have been calling attention to her never asking." [Silverman, p. 152, emphasis added]
2. "--And, and he just didn't say anything, except sort of mutter under his breath. And so I got furious at him and ---[sniff] I imagine I'm doing--in a way--the same kind of thing that my father always is doing" [her father whom she had described as weak and childish]. [Dahl et al., p. 21, emphasis added]

     Anna Freud takes the structural model and aims at making things so clear and logical that anyone can understand--including patients when their psychodynamics are identified for them. She personified and concretized the parts of mind. The id and ego, she said, "are not only at cross-purposes with each other but also speak different languages and act out their intentions in a totally different medium" (from her letter to Lawrence Kubie, January 1, 1955, quoted by Young-Bruehl, 1988, pp. 161-162).
      She makes manifest consciousness an operational "stage," visualizing the parts of mind as actors who speak and clash. In her conflict model, the ego is innately predisposed to oppose, supervise, and regulate the id. An impulse being expressed may be thought of as "consciousness-syntonic" (but not ego-syntonic) for varying amounts of time. Watching for conflict, she prefers not to think of an impulse as "egosyntonic" because she wants to keep in mind that the two agencies, the ego and id, pursue entirely different aims (Sandler with A. Freud, 1985, p. 48). Of course, the other way around, during times when compromise has been achieved, when conflict is not evident, she sees that the ego shapes and guides the id's impulses toward "safe" satisfaction. She writes:

On the one hand, the ego is of enormous help to the instincts. By knowing the outside world, it can guide the instincts towards fulfillment and particularly towards safe fulfillment. The ego takes regard of reality. It is not any more owned by the pleasure principle. But, on the other hand, by interposing these thought processes and by insisting on safety, reality, and good sense, it holds up and inhibits wish fulfillment. So while on the one hand the ego is the friend of the id, on the other it seems to be the enemy of the id. [1952, p. 34]

     In advocating her observational stance, she would not agree with Fenichel (1940, 1941) who says that to ferret out the unconscious id and defensive ego we "need first of all an ally accessible to us, the reasonable ego, which must be separated from the defending element" (1940, p. 189). Watching manifest expression of previously unconscious-bits as she does, Anna Freud does not need to ally one way or the other. (Here is the basis of her famous dictum that the analyst should analyze from a position "equidistant" from the id and ego: he waits until both are evident at the surface.) Watching intently, she sees the ego's efforts to get the id under control. She sides neither with the rational ego against "unreasonable" defenses, nor with the superego to gain leverage in confronting infantile impulses (as Freud suggested at one point). We will see the use of such "leverage" in the long clinical example to come.
      Technically, Anna Freud is reconstructing conscious--or recently conscious--sequences of thought, not really interpreting unconscious contents at all. Rather than interpreting she points out conflict (1936, p. 15).

CHARLES BRENNER: CONFLICT SOLUTIONS/ COMPROMISE FORMATIONS

As opposed to an interest in moments of "fresh conflict," primary attention is paid to unconscious infantile conflict; the analyst observes compromises, multifaceted conflictual outcomes. He infers and interprets the unconscious forces and tendencies of id, ego, and superego. The task involves interpretively dissecting these compromises.

It is compromise formation one observes when one studies psychic functioning. Compromise formations are the data of observation when one applies the psychoanalytic method and observes and/or infers a patient's wishes, fantasies, moods, plans, dreams, and symptoms. Each of these is a compromise formation, as are, indeed, the entire range of psychic phenomena subsumed under the heading of material for analysis. [Brenner 1982, p. 109]
      All psychic activity, including neurotic symptoms and character traits, is a compromise among drive derivatives, anxiety and depressive affect, defense and superego. One cannot ask, therefore, "Is this defense? Has this to do with castration or loss of love? Is this gratifying? Is this selfpunitive?" The answer will always be "Yes" to each question. What one wants to know is the answer to the question, "Which determinant of the compromise formation is it most useful to interpret to this patient at this time?". [Brenner 1987, p. 167]

ANNA FREUD AND BRENNER'S ANALYTIC "LISTENING" IN PRACTICE

Hypothesis: Brenner tries to recognize (relatively enduring, persisting) defensive postures that bar threatening contents from access to the patient's awareness, while Anna Freud tries to observe conflict in process at the manifest surface.

Analyzing "postures"

About analyzing "postures," Brenner (1976) writes:

To put the matter succinctly, a defense is not a thing, it is a posture, specifically a mental posture. To ask, "What happens to defenses in analysis? Do they disappear? Do they go away?" is like asking, "What happens to your lap when you stand up?" "A lap" is not a thing any more than a defense is. Both are useful concepts that refer to a posture, the one to a physical posture, the other to a mental one. Thighs are thighs, whether they are vertical or horizontal. Their function, however, is (or can be) different, depending on their posture, and "a lap" refers to one of their possible functions when they are horizontal. The same is true for ego functions. When they serve one purpose, they are executants of drive derivatives. When they serve another, they are defenses against them. [pp. 77-78]

     An analyst can analyze the mind in its "sitting posture" to identify and explain a part or parts of the compromise formation: instinctual elements, superego influences, defensive efforts, and considerations of reality as it is perceived.

Analyzing changes in posture--that is, analyzing "process"

In the technical model Anna Freud describes, the analyst might ask the patient to look back, to recall "standing" just moments before, to try to look into what was going on right there when she sat down. Recalling that, the patient might be able to recognize clearly and feel again a sense of annoyance that had become uncomfortable.

Patient: "I've been mad at you all week. --- It's not that I'm mad at you."

(A. F. might comment: You are saying you don't feel that way now, but the feeling was there a moment ago--did some discomfort stop your saying more about it?) Clinical material in this "process" model might find the patient "standing" and "sitting," again and again, as drive derivatives surface, become conflicted, and get resolved. These operations occur rapidly and repeatedly.

THE DEFENSES THEMSELVES

Brenner (1982) indicates: "Defense is an aspect of mental functioning which is definable only in terms of its consequence: the reduction of anxiety and/or depressive affect associated with a drive derivative or with superego functioning" (p. 73).
      "There are no special ego functions used for defense and for defense alone. There are no specialized defense mechanisms" (pp. 74-75). The twists and turns, the augmenting, diminishing, or silencing of attention, perception, thinking, memory, and affect, that is, plainly and simply the usual ego functions, perform defense. The ego can use "anything that comes under the heading of normal functioning or development", (p. 75).
     All defenses have in common that they "oppose." In defense, by definition, there is "an element of denial or negation, in the colloquial meaning of those words. Every defense against a drive derivative arousing anxiety and/or depressive affect is a way of saying, `No,' to some aspect of it" (pp. 75-76). "Every defense denies something" (p. 78).
     Anna Freud (1980b) writes that because "dangerous impulses ... are more difficult for the child to combat when they are perceived, acknowledged, and remembered.... defense turns not only directly against the id derivatives themselves but simultaneously ... puts the relevant ego functions at least partially out of action" (p. 143, emphasis added). She implies that we will see a patient's sharp, direct, incisive observations become softened, or blurred, or contradicted when the ego objects to the "sharpness" or "aggressiveness" of the observation (the drive derivative). But, in addition, when such an impulse is opposed, defense includes "impairment" of the ego function that might recognize the impulse--self-perception is blocked. Such ego functions as perception, attention, memory, reason, and reality testing get impaired as part of the control effort.
      While Brenner does not appear to use his operational definition of defense for studying regularly recurring fluctuations in the associative process, his descriptions of defensive operations are compatible with analysis of moment-tomoment conflict and defense-the technique Anna Freud proposed. A patient's shift from present to past tense, or vice versa, can restore a sense of balance that had seemed precarious moments before (i.e., "I've wondered if you understand me. I think that less than I used to"). Changes in the scope or direction of the patient's attention avert "danger." All the subtle changes of tone, emphasis, attribution, and so on, that move uncomfortable thoughts out of awareness help in regaining a "sense" of safety. By means of simple variations in what the patient is attending to from moment to moment, the ego reduces conflictual anxiety.
      Brenner indicates that id derivatives can break through to the surface under certain conditions that encourage the return of the repressed. But in Anna Freud's listening, break-throughs "naturally" occur over and over again and while they are conscious they run into opposition by the ego.

AN ILLUSTRATION OF MOMENT-TO-MOMENT LISTENING FOR CONFLICT

The following are excerpts from the fully transcribed fifth hour of an audiorecorded analysis (Dahl et al. 1988). Defensive "shifts" are indicated by arrows: ---.

1-At the beginning of the hour:
[3-minute silence, occasional stomach rumbles] Something that's been on my mind today is the relationship I have with the girl who is my assistant this year and was last year. And [sigh] well, it took me quite a while to get used to her last year and I imagine it was a variety of reasons, ---. But at the beginning of this year things were going quite nicely and I was quite pleased with the kind of things she can do and not feeling at all annoyed by her, which was part of the trouble I had last year, although at times she's a, a type of person that I don't feel completely sympathetic with. --- I guess. And uhm, because of the other assistant having left, she's having to fulfill both of the functions to an extent and, and both of the teachers, myself and the other teacher, are to make adjustments too, so that she can help us both out. [p. 16, emphasis added to indicate moments when the ego opposes an impulse being expressed.]

2-Because I, I [chuckle] was just thinking I probably do the same thing with David. Last night in particular, I was talking with him about ---I don't know. I just seemed to be in a funny mood by the time he got home. He got home sort of late, and it wasn't that he was late, because I knew he would be. But I guess he didn't immediately respond to me in the way I wanted him to or---I don't know what it was, because I imagine that somehow I was already in some kind of a mood.-I was upset about something I'd done and I didn't want him just to listen to me say it. I wanted him to actually react to it, and either suggest another course of action or, or approval that well, I guess that in the circumstances that wasn't that bad a thing to do. And, and he just didn't say anything, except sort of mutter under his breath. And so I got furious at him and --- [sniff] I imagine in a way it's the same kind of thing that my father always is doing [i.e., that she, like her father, is weak--"always asking for reassurance"] [Pause, stomach rumble]. [pp. 20-21, emphasis added]

3-[Analyst comments] Is there any connection? Does it follow perhaps that uh you [stomach rumble] have some criticisms of me that have occurred to you?

[Pause] I think if I had, I would have [nervous chuckle] suppressed them too much to admit them. [Clears throat, sniff, pause] Uh, perhaps one. I'm starting with one that's less [nervous chuckle] personal, one that I'm sure still is occurring to me at times. --- although I don't think it functions as much in my thinking now as it might have-is uhm, sometimes wondering if all this really does get anywhere, and [sniff] you know, if it isn't some sort of a hoax. --- But that's partly because I was brought up to think of it as being something that really didn't do any good for anybody and just costs a lot of money. --- I don't think that occurs to me as much now. [p. 25, emphasis added]

BRENNER'S LISTENING

Brenner writes, "The balance between defense and drive gratification is a mobile one, not a static one. For example, in a revery, a dream, or a slip of the tongue, a drive derivative often emerges into conscious awareness or is given verbal expression only to be forgotten, repudiated, or ignored moments later" (1982, p. 110).
      While he indicates that one may analyze moments of impulse expression and defense, he sees a bigger picture that is far more important for analysis. His perception of the relationship of repressed drives to manifest mental operations is that the repressed "regularly gains access to consciousness and influences conscious mental life and behavior while it is repressed." As Brenner listens to clinical material, ubiquitously there are profound influences on that material from unconscious, deep, long-standing infantile conflicts. These are the targets of his analytic work.

The phenomena of our daily mental life, our fantasies, our thoughts, our plans, and our actions, are compromises among the forces and tendencies of id and ego and, later, of the superego as well. The parts of the id Freud called the repressed are among the determinants of the phenomena of daily psychic life--not true only for those relatively atypical phenomena called neurotic symptoms. ... They constantly influence every patient's thoughts enough so that they can be inferred with some certainty by the listening analyst. [p. 114, emphasis added]

     The analyst holds the compromise formation model in mind as he infers wishes, fears, fantasies, moods, and plans. Brenner (1976) writes, "It [may be] obvious, for example, that a patient is bending every effort to remain unaware that he is so angry that he wants to kill everyone in the world" (p. 60). At another point, he draws on a clinical example of defense , analysis in which the "patient regularly blamed himself and was angry with himself in order to avoid knowing he was angry at someone who offended him" (pp. 54-57). He indicated that while "the main emphasis in each interpretation was on the fact that the patient was blaming and criticizing himself in order to divert his attention from his critical and angry thoughts about someone other than himself, the fact is that each interpretation contained some reference to the drive derivative being warded off as well as to the defense employed for that purpose" (pp. 60-61).
      Thus, Brenner describes one patient who is "bending every effort to remain unaware" and another who is "angry with himself to avoid knowing." In the second instance, Brenner essentially interprets to the patient what is "unthinkable," beyond his awareness, disguised within his defensive posture: "Which determinant of the compromise formation is it most useful to interpret to this patient at this time?" (Brenner 1987, p. 167). Brenner emphasizes the importance of considering what the patient has been talking about in that hour and previous ones, particularly the importance of an overall understanding of the patient's dynamics and most important conflicts. He says:

Having understood what these conflicts are as best we can on the basis of the patient's history, current symptomatology, and analytic material, including various transference reactions, we interpret whichever components of the conflicts are both important and accessible as determinants of a patient's current associations and behavior in analysis. Our framework, so to speak, is our knowledge of the patient's conflicts. Our focus within that framework is what the patient says and does in a particular analytic session. [p. 169]

In 1990, Arlow and Brenner wrote:

The analyst determines the specific contribution made by each of the components of the patient's conflicts. Wish, unpleasure, defense, moral imperatives, and realistic considerations are represented in varying degrees. The analyst's interventions serve to clarify for the patient the interplay of these various components, to indicate the purpose each serves, and to trace their origins to their sources.
      What the analyst communicates to the analysand serves to destabilize the equilibrium of forces in conflict within the patient's mind [which]--leads to growing awareness of the nature of their conflicts and facilitates the emergence of additional material--and so forth. [pp. 679-680]

     In summary, Brenner (with Arlow) describes interventions that name components of the compromise formations that make up thoughts, plans, attitudes, fantasies, and emotions. He judiciously selects elements of the "postures" he sees before him. The element he names is not conscious at that moment to the patient, nor was it conscious moments before, as is true of the data addressed by Anna Freud's reconstructions. Naming contents that are at a greater depth, Brenner "sees through" the defense into the compromise, rather than catching the defense in the act as Anna Freud does.

ANNA FREUD'S "TECHNICAL TASKS"

Anna Freud's (1936) first technical task is to recognize the drive derivative and then, the moment that it meets resistance. The next task is to undo what has been done by the defense-revive the impulse in its most recent context by reconstructing the sequence. The third task is to investigate the resistance encountered by the impulse (p. 14). The fourth is to focus on the linkage between that id derivative and that specific defense, to study the repetitive defensive methods of the ego (p. 20). She says, "Not only do we fill in a gap in the patient's memory of his instinctual life as we ... do when interpreting the first, simple [id] type of transference, but we acquire information which completes and fills in the gaps in the history of his ego development or, to put it another way, the history of the transformations through which his instincts have passed" (p. 21). Hartmann and Kris (1945) wrote a paper particularly relevant to Anna Freud's model ("The Genetic Approach in Psychoanalysis"). They describe a two-step technical sequence of first recognizing a conflict and then moving to analyze the epigenetic-adaptive history of that specific conflict and defensive outcome.
      Brenner uses his total experience with the patient to study what initially appears to be a far more complex, largely unconscious picture. In a sense, Anna Freud is trying, with William Blake, "to see a world in a grain of sand." Brenner, deductively, comes to know on the basis of his broad experience what the patient's world contains, and by naming its components in a timely way helps the patient see what is there. His patient can associatively confirm and expand his understanding.
     In "The Genetic Approach in Psychoanalysis," Hartmann and Kris (1945) elaborated their clinical understanding of the dynamic investigation followed by analysis of the causal (genetic) factors. In an example, they write of "the man who tends to drop his effort whenever an immediate competitor appears." (We can imagine how that can become manifestly apparent as the patient associates.) The analyst, they say, will take the opportunity "to establish a causal relationship between the individual's retreat pattern in conflict situations and [in] earlier experiences, in which the pattern was gradually formed" (p. 12). Learning theory applies. The analyst "will inquire when retreat from competition was learned or adopted as a solution; why, when the competitors were father or sibling, that conflict was solved by retreat; and what experiences ... in which different behavior was attempted ... failed in response to parental disapproval or feelings of guilt. The pattern was learned through failure (and via alternative defensive/adaptive success." Dynamic propositions "are concerned with the interaction and the conflicts of forces within the individual and with their reaction to the external world, at any given time or during brief time spans." The genetic propositions are "concerned with the explanation of these behaviors by an investigation of their origins, how any condition under observation has grown out of an individual's past, and extended throughout his total life span" (pp. 11-12).

CLINICAL EXAMPLE

Neither Anna Freud nor Brenner offers us specific, detailed clinical material. There is help in trying to understand Brenner's clinical thinking, however, in his paper, "A Structural Theory Perspective" (1987), written as a critique of Martin A. Silverman's (1987) meticulously recorded clinical paper.
      We will assess Silverman's (and Brenner's) method from two standpoints: (1) How might an analyst listen to develop inferences about impulses, defenses, and superego influences from compromise formations? (2) When the analyst forms a conjecture about something that a patient is not permitting himself to think, how is it possible to demonstrate that picture to the patient in a way which is both understandable and tolerable to him? With each question, I will speculate about the ways that applying Anna Freud's technical point of view to the study of conflict and defense would change the picture.

FROM "CLINICAL MATERIAL" (SILVERMAN, 1987)

Miss K., 25 years old, was referred for analysis by a psychiatrist with whom she had been in psychotherapy in college in another location. She showed sexual and social inhibitions, masochistic tendencies, as well as chronic, neurotic depression. Throughout her childhood and adolescence, she indicated, she had been unhappy, restricted in her self-expression, and a homebody who clung to her family. She had always felt unappreciated and mistreated, both at home and outside of it. The details which she presented amounted to a litany of complaints and grudges over injuries and slights she could neither forget nor forgive. Her parents had gone away together on frequent business trips each year during her childhood, including her birthday, which still infuriated her. Her father and older brother always had had a special, intellectual relationship with one another, centering largely on word games and word play, from which she had been excluded, since she was too young to keep up with them. She had always considered herself "dumb," even though she hail been an excellent student in elementary school.
      Her father was an emotionally restrained man with a quiet but quick temper. He had a way of explaining things unclearly but was impatient with her and intolerant when she failed to understand him. She had developed a kind of pseudostupidity with him so that she found herself incapable of answering even his simplest questions and ended up in tears. She had looked up to and loved her father, with whom she had subjected herself to repeated disappointments and pain. She described her parents as angry people who compensated for resentments, insecurities, and low self-esteem, stemming from unhappy childhoods, by derogating and disparaging other people, whom they perceived as their inferiors. Miss K. described her older brother as a pampered, favored child who in her parents' eyes could do no wrong. He was condescending and disparaging with her, when he paid her any attention at all. Miss K. had always loved, revered, and hated her older brother.
     She always had clung to her mother while complaining bitterly about her favoritism toward her older brother. She repeatedly expressed hurt and disappointment at her mother's dependence upon her father and her failure to appreciate herself as a woman. [pp. 147-148]

     Silverman describes the analytic work as it progressed from the beginning of analysis, and then expands on the year of analysis that leads up to the "Sample Sessions" presented in full detail. He begins with the Friday session. Thoughts which occur to him and his verbalizations to the patient are in parentheses and observations about the patient's affect or about background data are in brackets.

Friday
The rain woke me up early this morning. It was beating down on my air conditioner so loudly it woke me up. I looked at the clock. It was 5:30. I thought in an hour I have to come here. I didn't want to come today. I've been mad at you all week. It's not that I'm mad at you. I wanted to stay away from all this stuff I think I feel here. I also got angry at R. [her roommate] yesterday. In the bathroom, she takes two towel bars and a hook. And I just have one towel bar. I didn't say anything for a long time. I finally got up the courage and told her we have to change the arrangements in the bathroom. It sounds so silly. I get so worked up over such little things. I get so angry. She was talking about being all worked up because someone called her for a date. She hardly listened to what I was saying. She's so self-centered. Her boyfriend came, and he was there two minutes and he asked about my cousin. She never asks about my cousin. She only thinks of herself. I thought of saying "thanks for asking" to him because I was so grateful he'd asked, but I decided not to say it. Because I'd have been calling attention to her never asking. I get so mad at her. I thought about something else in the car on the way here. I went to have my hair cut and it was to be cut at seven o'clock. But I had to wait and wait till nine o'clock. I got angrier and angrier. I told the girl when I paid (she'll get a bill from me in a few days, and it's the end of the week and she has to wait two days to see me again on Monday--like the two hrs. for the hairdresser--and in two weeks I leave for vacation, and she'll have to wait a month for me) that I was angry. I told her that I can go to someone else to get my hair cut--or I can wait for him. I don't like either alternative. I don't even know why I go there. I don't fit in. They're mostly older women. But I didn't say anything to him. I'm intimidated by him the way I'm intimidated by M. [the tennis pro]. I don't know why. He's not big and tall like M. He's good-looking, but he's not my type. He's married and has children (so does her father). He has their pictures up. With M., I think it has something to do with my knowing nothing about tennis and his knowing so much about it. And I couldn't understand when he was telling me what to do. "Hold it this way" and "turn that way," and I couldn't understand anything he said. It was just like with my father all my life. He thinks he gives such good directions and clear explanations, as I said yesterday, but he doesn't. I get intimidated with men. I always feel that they know they have the knowledge. They have the brains, and I'm dumb. And I always feel like I don't know anything and I can't understand and I get intimidated. It's the same thing here, I keep feeling like asking, you, "What does it mean?" I always feel like you know. I feel like asking you now. I know you've told me you don't know anything until I've told it to you, but I don't feel that way. I feel you're always a step ahead of me. You know, because you're smarter than I am and all the training and experience you have. (I speak: I don't think that's what it is. I think you feel I know because I'm a man, that as a woman you don't have the brains.) I get intimidated by men. [anxiously] Do you think I signal it to them and that drives them away? So they think, "Who wants her!" I think it started in a way when my father said to me, "Every man is going to want the same thing from you." I got so angry. Why? Why would he expect that of me? What right does he have? I heard R. and her boyfriend kissing just outside the door. She likes it! When my father said what he did, first I was mad at them for wanting sex eventually, and then I got mad if I thought they wanted to kiss on the first date. Then I started getting mad that they'd ever want to kiss. I got so angry. I'm such an angry person. (I speak: As you've said, you get mad to push away other feelings.) With A. [the young man she had met on a singles weekend trip, at which she had relaxed her usual guarded stiffness and had danced and smiled and joked, and who had become interested in her and arranged to come in from out of town to spend two days with her, only to stand her up when she went to meet him] I told him when he said he would come down here that he could stay at my apartment. And he got all excited about it and eager to come. And then I got frightened about what I'd said to him, and I said, "Wait a minute," and I made it clear to him I meant he could sleep over at my apartment--on the couch--not with me. [with emotion] Do you think that's why he didn't show up? Did l chase him away? Men intimidate me. It's like with my father. It's a mixture of excitement and pain and hurt and fear. But wait a minute. It's not only men who intimidate me, I get intimidated about money. Paying and tipping intimidates me. I avoid it if I can. Until lately, when I've been thinking about it here and trying not to avoid the things I tend to avoid. When I left the hairdresser's I looked for the girl who'd shampooed my hair to give her a dollar. But I'd have avoided it if I could. If they had a can with tips in it I would've put it in there. I was too intimidated by the hairdresser who cut my hair and I was intimidated about tipping the girl who shampooed my hair. Why? [slight pause] I can't figure it out. There's no rhyme or reason. I don't understand it. (I speak: So long as you take that attitude, so long as you don't think it out and find out the rhyme and reason ...) Well, he cut my hair. He cut me. But she just put her fingers into my hair. I don't understand. (I speak: He stuck scissors into your hair and she stuck fingers into your hair. You were talking before that about avoiding sexual excitement. Scissors and fingers into your hair sounds sexual. You turn away and avoid the excitement, pain, and hurt with men, and when you turn away from men altogether and turn toward a woman you get scared all over again.) Yes. But there's something that doesn't fit. I had no problem about tipping the woman who gave me the manicure. And she massaged my fingers. And didn't get me anxious. I like it. It's relaxing. I thought of something. I told you about it a long time ago and then dropped it and avoided it. It's a masturbation fantasy. [Now her voice changes, becomes more hollow, tending toward a chilled monotone, drained of all emotion. She speaks this way for much of the remainder of the session, constantly pausing between words. I found her slow, start-and-stop delivery agonizing, and have tried to convey it on the page by the use of dashes to indicate her briefer pauses, reserving the word pause, in brackets, for the longer ones.] There's--a doctor--a mad scientist--and his nurse and--he ties me down to--do things to me. I don't know what this has to do with being intimidated by the hairdresser and feeling inhibited tipping the girl who washes my hair but not the manicurist. It makes no sense [pause] (I speak: You've blocked yourself from hearing the answer you gave: the hairdresser sticking scissors in your hair and cutting you; the young woman preparing you for the haircut; they're the mad scientist doctor and his nurse.) The fantasy had to do with--something--it had to do with getting bigger breasts. It's foolish--I feel sheepish [pause] It's so silly [pause] (I speak: There's nothing silly about it; you mobilize those feelings to push away and avoid looking into the fantasy and the feelings.) I'd try not to think the fantasy. I didn't want to dig into it. You're right. I feel sheepish to push it away. (I ask: And what happens to sheep?) They get sheared, their hair is cut off. (I say: And so do "fallen women.") In old times, they did. I know about that. The hairdresser was cutting my hair off. Maybe it was my "crowning glory." And sheep certainly get their hair cut off. When I was in New Zealand, I saw the sheep getting sheared. There was one brown one I remember. They held it and sheared it, and piled the wool, and all that. (The emotion's gone from her voice; she's shearing the sheep to pull the wool over our eyes.) (I speak: You're getting away to avoid uncomfortable feelings.) You're right. That fantasy makes me very uncomfortable. The mad scientist would do something to give me bigger breasts. I wanted bigger breasts very much [pause]. (I speak: Notice you're interrupting yourself, stopping yourself ?) I don't want to talk about it, think about it: I'm afraid you'll think I'm foolish. I had to submit to the mad scientist, like I was his slave and he was my master. When I'm intimidated by men, it's like I have to put up with anything. [pp. 151-1551

WHAT CAN THE ANALYST LISTEN FOR TO DEVELOP INFERENCES ABOUT UNCONSCIOUS CONFLICTS UNDERLYING COMPROMISE FORMATIONS?

Sometimes material that is manifestly concerned with others in the patient's life contains recognizable, logically connectable, apparently "unconscious" allusions and references to important objects (the analyst, her father, etc.). Analytic theory sees this in terms of unconscious displacements that operate to keep her from knowing about her impulses, feelings, or fantasies (at root), or knowing that they are intended for her analyst or important others.

Example 1: But I had to wait and wait till nine o'clock. I got angrier and angrier. I told the girl when I paid (she'll get a bill from me in a few days, and it's the end of the week and she has to wait two days to see me again on Monday like the two hrs. for the hairdresser and in two weeks I leave for vacation, and she'll have to wait a month for me).
Example 2: He's married and has children (so does her father).
Example 3: I don't know what this has to do with being intimidated by the hairdresser and feeling inhibited tipping the girl who washes my hair but not the manicurist. It makes no sense. [pause]

Analyst: You've blocked yourself from hearing the answer you gave: the hairdresser sticking scissors in your hair and cutting you; the young woman preparing you for the haircut; they're the mad scientist doctor and his nurse.
Patient: The fantasy had to do with--something--it had to do with getting bigger breasts. It's foolish--I feel sheepish. [pause]
Analyst: There's nothing silly about it; you mobilize those feelings to push away and avoid looking into the fantasy and the feelings.
Patient: I'd try not to think the fantasy. I didn't want to dig into it. You're right. I feel sheepish to push it away.
Analyst: And what happens to sheep?
Patient: They get sheared, their hair is cut off.
Analyst: And so do "fallen women." [Silverman 1987, pp. 151-155, emphasis added]

     In other instances there is manifest clinical material in which she denies knowledge of something Silverman understands--her underlying impulses, wishes, and fantasies. Her negation is manifestly evident in the form of reaction formation, denial, blocking, ignoring, naivete, and getting mad.

Example 1: I keep feeling like asking you, "What does it mean?" I always feel like you know. I feel like asking you now. I know you've told me you don't know anything until I've told it to you, but I don't feel that way. I feel you're always a step ahead of me. You know, because you're smarter than I am and all the training and experience you have.

Analyst: I don't think that's what it is. I think you feel I know because I'm a man, that as a woman you don't have the brains.

Example 2: I got so angry. I'm such an angry person.

Analyst: As you've said, you get mad to push away other feelings.

Example 3:
Patient: With A. [the young man she had met on a singles weekend trip, with whom she had relaxed her usual guarded stiffness and had danced and smiled and joked, and who had become interested in her and arranged to come in from out of town to spend two days with her only to stand her up when she went to meet him] I told him when he said he would come down here that he could stay at my apartment. And he got all excited about it and eager to come. And then I got frightened about what I'd said to him, and I said, "Wait a minute," and I made it clear to him I meant he could sleep over at my apartment--on the couch--not with me. [with emotion]

Example 4: Why? [slight pause] I can't figure it out. There's no rhyme or reason. I don't understand it.

Analyst: So long as you take that attitude, so long as you don't think it out and find out the rhyme and reason....
Patient: Well, he cut my hair. He cut me. But she just put her fingers into my hair. I don't understand.
Analyst: He stuck scissors into your hair and she stuck fingers into your hair. You were talking before that about avoiding sexual excitement. Scissors and fingers into your hair sounds sexual. You turn away and avoid the excitement, pain, and hurt with men, and when you turn away from men altogether and turn toward a woman you get scared all over again. [Silverman 1987, pp. 151-155, emphasis added]

TECHNICAL SCHEME--ANALYZING COMPROMISE FORMATIONS

Brenner (1987) writes:

Silverman and I function as analysts in essentially the same way. We try to understand a patient's symptoms and characterological problems as compromise formations ... [that], we believe, originated in childhood and have persisted throughout the patient's life in various forms right up to the present time. [p. 169]
      As I read the protocol, [the] patient is a sexually inhibited, masochistic woman who, at the time of the report, wished to stay in the same sort of relationship to Silverman that she'd had for years with her father: one which was unconsciously gratifying in a masochistic, submissive way ("You teach me; you tell me what to do.") and at the same time was not consciously sexually exciting. To that end, Silverman tells us, she avoided any contact with suitable and available men or, when she made contact with one, arranged to push him away in a fashion that enabled her to feel rejected by the man, righteously indignant at him, hopelessly unattractive, and ready to give up on men forevermore and to hate them all. In particular her anger, we are told, served an important defensive function. In addition, Silverman believes that his impending departure on vacation played an important role as a determinant of his patient's emotions and associations at the time reported: she would miss him and was angry with him for leaving her, both feelings she energetically warded off. [p. 168]

     Silverman and Brenner see two principal currently obvious themes underlying this clinical material: (1) the patient was unconsciously angry about the analyst's impending vacation but prohibited herself from being aware of that fact, and (2) she had active unconscious sexual impulses and interests in men, including the analyst, that she energetically defended against knowing about. These conflicted underpinnings, including "unconscious gratification" of some aspect of the wishes involved in the conflicts, are beyond surface recognition.

FORMING CONJECTURES ABOUT THE COMPONENTS OF COMPROMISES

Silverman's knowledge of his patient's typical conflicts and defenses allows inferences into the patient's compromise formations in which displacement and negation effectively defend her (1) against experience (and awareness) of her unacceptable impulses; (2) against knowledge of the defensive maneuvers she employs; (3) against the nature of her "moral" prohibitions (superego) that operate against knowledge of, or expression of, those impulses; and (4) against the ways in which she experiences "reality" as a consideration in her behavior. One assumption is that her impulses are being "unconsciously gratified." The patient "wished to stay in the same sort of relationship to Silverman that she'd had for years with her father: one which was unconsciously gratifying in a masochistic, submissive way ('You teach me; you tell me what to do.') and at the same time was not consciously sexually exciting."
      By tradition, to infer or "tease out" psychic conflict and defensive activity, an analyst asks himself three questions: (1) What is the patient's hidden wish? (2) Of what is she afraid when she wishes that? and (3) When she is afraid, what does she do to reduce the 'danger'? "What the patient does when she is afraid" is a compromise formation that has a defensive purpose and effect. For instance, Brenner (1976) describes a patient who "regularly blamed himself and was angry with himself in order to avoid knowing he was angry at someone who offended him" (p. 60).
     Silverman looks at her struggling in terms of hidden, "unthinkable" sexual conflict. Her displays of ineptitude, refusals to "think," momentary aggressive disagreements, and eventual submission, are all assumed to be part of a sadomasochistically gratifying enactment.

Why? [slight pause] I can't figure it out. There's no rhyme or reason. I don't understand it.

Analyst: So long as you take that attitude, so long as you don't think it out and find out the rhyme and reason....
Patient: Well, he cut my hair. He cut me. But she just put her fingers into my hair. I don't understand.
Analyst: He stuck scissors into your hair and she stuck fingers into your hair. You were talking before that about avoiding sexual excitement. Scissors and fingers into your hair sounds sexual. You turn away and avoid the excitement, pain, and hurt with men, and when you turn away from men altogether and turn toward a woman you get scared all over again.

I don't know what this has to do with being intimidated by the hairdresser and feeling inhibited tipping the girl who washes my hair but not the manicurist. It makes no sense. [pause]

Analyst: You've blocked yourself from hearing the answer you gave: the hairdresser sticking scissors in your hair and cutting you; the young woman preparing you for the haircut; they're the mad scientist doctor and his nurse.
Patient: The fantasy had to do with--something--it had to do with getting bigger breasts. It's foolish--I feel sheepish [pause]....

--They held it and sheared it, and piled the wool, and all that. (The emotion's gone from her voice; she's shearing the sheep to pull the wool over our eyes.) [Silverman 1987, pp. 151-155, emphasis added]

ANNA FREUD'S TECHNICAL SCHEME

Here is the beginning of the clinical material again, looked at from Anna Freud's point of view. We see drive derivatives expressed for a few moments and then "counterattacked"--via defensive efforts that reduce conflictual danger (bold-face; arrows indicate defensive "shifts"):

Friday
Patient:
The rain woke me up early this morning. It was beating down on my air conditioner so loudly it woke me up. I looked at the clock. It was 5:30. I thought in an hour I have to come here. I didn't want to come today. I've been mad at you all week. ---It's not that I'm mad at you. I wanted to stay away from all this stuff I think I feel here. --- I also got angry at R. [her roommate] yesterday. In the bathroom, she takes two towel bars and a hook. And I just have one towel bar. ---I didn't say anything for a long time. I finally got up the courage and told her we have to change the arrangements in the bath­room. --- It sounds so silly. I get so worked up over such little things.

     Simple defenses in the forms of negation and displacement in person and time are evident in these examples of conscious drive/defense contiguity. She says, "I've been mad at you all week," and, immediately, "I'm not mad--." One "voice" and then another, a drive-controlling, anxiety­ reducing, "quieter" one. She complains more openly about R. (a displacement away from the analyst as her target), but then says, "I didn't say anything--" (she uses her memory defensively--by recalling holding back her criticism in the recent past, reassuring herself and the analyst about her "control" of her anger, she reduces anxiety) Then she becomes freer, for a moment, to renew her complaint, but quickly labels her feelings "silly" and overdone.
      The material further along in the hour, gives us the opportunity to watch moment-to-moment editions of a kind of "aggressive expression --- masochistic submission." She brakes her active aggressive comments by turning to self­observation and criticism.

--and I said, "Wait a minute," and I made it clear to him I meant he could sleep over at my apartment--on the couch--not with me. [with emotion] --- Do you think that's why he didn't show up? Did I chase him away? Men intimidate me­--

--I always feel like you know. I feel like asking you now.--- I know you've told me you don't know anything until I've told it to you,--

--then I got mad if I thought they wanted to kiss on the first date. Then I started getting mad that they'd ever want to kiss. I got so angry. ---I'm such an angry person.--[In this example, she shifts from active anger at "them," to deprecating herself.]

     In this clinical material we are looking primarily at aggressive drive derivatives encountering conflict. There are also libidinal conflicts, though not at the same frequency. For instance, she describes a man's interest in her and, moments later, she stops that presentation of herself [as if stifling any display of her "sexual, competitive" urges.].
--Her boyfriend came, and he was there two minutes and he asked about my cousin. --- She never asks about my cousin. She only thinks of herself. I thought of saying "thanks for asking" to him because I was so grateful he'd asked,---but I decided not to say it. Because I'd have been calling attention to her never asking. [Competitive impulses become conflicted--a triangle in which she gives way to her friend.]

     Anna Freud might intervene after the patient has regained her equilibrium via the defensive effort. She observes where the patient stands at the current moment, 'just as the conflictual anxiety has been reduced."

--I always feel like you know. I feel like asking you now.
--I know you've told me you don't know anything until I've told it to you,­-

     What if Anna Freud said, "You're thinking of how I might comment--Are you getting control of your urge to ask me by answering for me? What if you were to let your question stand? continue with it?--whatever! Can you sense a risk right there?"
      Speculatively, if that kind of conflict had been worked on before, the patient might say that she notices again ["now"] that she is feeling uncomfortable. As she recalls saying, "I feel like asking you now!" she says that she feels again very uneasy! She feels frustrated with him but imagines the analyst ridiculing her for not thinking things through. There is a range of fantasies we might imagine the patient sensing or noticing that involve the analyst's "reacting" to her being more aggressively demanding--his reproach, even disdain, or "teasing" her, or his judgments about her lack of self­reliance, and so on. One advantage in looking at this as fresh conflict is that both the analyst and patient can see directly how she gained control over her impulse to demand an answer--an impulse that was conscious, became dangerous, and can be recalled immediately. By mobilizing the fantasy of her analyst disapproving of her question, she controlled the impulse and reduced her "anxiety." Submitting, she is on safe ground.
     Anna Freud points out "in-situ" moments of conflict and conflict resolution. She invites the patient to look back at the moment when the impulse became dangerous and asks the patient, by implication, to hold herself there in that precarious position again--to see what she, the patient, notices looking her impulse right "in the eye" to experience the sense of danger--to sense whatever she can in her imagination, feelings, and memory that are linked to that danger.
     Repeated conflict occurring on a small scale with a short time span is the focus. Conflictual anxiety is related to the "danger" of the drive derivative remaining conscious for a moment more. Her approach deals with very small quanta of resistance which can be sharply experienced, and confronted in ways that drive derivatives can "grow" to whatever size the patient can tolerate.
     If we examine closely the ways in which conflicts arise and are "solved," we can demonstrate to her this tendency to be submissive in order to stop an aggressive impulse--her "masochistic" solution. We can still assume that there are unconscious gratifications within observed compromises, but in this model the "evidence" might not support the observation that she "wished to stay in the same sort of relationship to Silverman that she'd had for years with her father: one which was unconsciously gratifying in a masochistic, submissive way." Instead, we seem to observe over and over again, for moments at a time, that she is attempting different behaviors.
     This segmented, incremental, or "fractal" picture of tendencies, attitudes, character traits, and symptoms is consistent with what Hartmann and Kris (1945) and Rapaport (1944-1948,1951) describe.? "Fractals," in this context, are self-similar repetitions that occur on the same as well as larger and smaller scales of magnitude. The theory is that changes produced in manageable "bits" result in large effects. A symptom or trait will be altered by systematically "interfering," with the "normal" sequence of events (with conflict solving that is currently automatic). A character trait seen up close seems to be made up of repeated conflicts and their solutions. For moments at a time, the patient demonstrates active aggressive behaviors and then controls them in her characteristic fashion. If we were to help the patient study these moments of conflict, we would invite her to look into the "dangers" experienced at those moments (before restraint), to look into why her aggression needs restraining, how she tames it, the rationale for handling it the way she does, when she learned to do that, with whom in childhood some attempted behaviors failed while others worked. In what ways did her solutions represent the most adaptive outcome? (Hartmann and Kris, 1945).
     Two contrasting hypotheses (of many): (1) Conflict and conflict-solving (regulation) are going on simultaneously at every moment. "Effective regulation" is the rule and moments at which we glimpse imbalance are rare. (2) Thought is advanced in tiny increments. Conflict and conflict­solving is an "event" that occurs incrementally over and over again. (One could use as a metaphor the description of the way the brain works neurochemically, the recurring activation and inhibition that occur at the neural cleft.) As listeners, we are only aware of impulses that are relatively less "controlled" or "balanced," and that will vary clinically with diagnostic type and developmental level, as well as all sorts of factors like fatigue, illness, "permission," "seduction." etc.--described by Arlow and Brenner (1964).
     As the Friday hour continues, the patient's "denial" is interpreted by Silverman in a variety of contexts. She finds her disagreements with him more and more dangerous. Her "defensive" efforts grow--this is marked by relatively small capitulations initially, but she gradually moves toward a larger­scale regressive masochistic submission. This is manifestly evident in her recalling her slave-master fantasies. The clinical material quoted in this paper stops with the beginning of this regressive slide, before its full degree is demonstrated.

DISCUSSION

In Ernst Kris's review of The Ego and Mechanisms of Defense for The International Journal of Psycho-Analysis (Vol. 19, 1938), Anna Freud's "method of observation" caught his attention. He wrote that innovations, in analytic circles, "are generally received with proper skepticism.... Great misunderstandings dictated by resistance often proceed from efforts to modify its technique." In this instance, however, he said, "I am much more inclined to think that the opposite danger exists: the change in the mode of observation might pass unnoticed." He went on, "There is no need to insist what an advance it represents if we follow Anna Freud's lead in the technique of interpretation, first revealing the whole extent of a type of behavior, the activity of the ego, and only then penetrating into the deeper layers. This method promises to bring us decisively nearer our therapeutic goal ... but--and I say this simply to prevent misunderstanding--it is only one step in interpretation." He adds, "It is desirable to emphasize what insight acquired in this way must mean for the theory of psychoanalysis, for psychoanalysis as psychology: the superficial layers of the mind, those functions of the psychic apparatus that are bound up with ego, have for long remained beyond the reach of psychoanalytic psychology" (pp. 347­348). Kris's comment here showed that he did see the extent to which Anna Freud's technique avoided the need to "penetrate" to the deeper layers (by restricting attention to what keeps coming from the depths to the surface).
      Both Otto Fenichel and Ernest Jones also contributed reviews of her 1936 book to the 1938 International Journal. Neither indicated that he saw how different the "change in the mode of observation" really was.
     Based on watching very closely what the patient actually says, Anna Freud's method of observation did not follow the suggestions of Freud, and others, including Fenichel, that one's attention should be "evenly suspended" or "hovering" or that one's unconscious is his tool. She indicated that when derivatives surface they come right up to the observer. (She says that we have less trouble observing others' ids--"dangers" external to ourselves--because it is adaptively useful for survival. Observing inner "dangers," our own impulses, is a different matter; for example, the child's perceiving and remembering her own aggressive impulses makes control more difficult and "peace of mind" unlikely [A. Freud, 1980a,b]). Anna Freud then watches the ego's reaction to the expressed impulse very closely. How much will be expressed? How long will it go on before the ego takes action?
     Her concentrated attention on what the patient actually says was something even her close colleagues found difficult to grasp. We can look again at what she said in her 1972 to 1973 Hampstead discussions with Sandler (1980-1984, 1985). She tries to make it clear. In the following quoted transcription, the controversial portion, in italics for emphasis here, was omitted when the discussions were published in book form in 1985, in The Analysis of Defense: The Ego and the Mechanisms of Defense Revisited.

Anna Freud: Of course the whole of psychoanalytic therapy is based on the fact that the reconciliation between opposing tendencies can happen only when they are lifted into consciousness. Why should we try so hard to make them conscious if they could be brought into harmony while they are unconscious? One of our basic presuppositions in analytic therapy is that conflict exists only in the conscious ego.
Sandler: Not in the unconscious ego? [1985, p. 301].
Anna Freud: No, the conflict only arises there. The opposing elements are in the id, but they don't conflict with each other--they simply exist as opposites.
Sandler: I think we are running into some difficulties, Miss Freud.... Don't you think it a great mistake to equate all that is unconscious with the id?
[Sandler with Anna Freud 1980-1984, 1982, p. 311].
Anna Freud: Yes, you are right. The better way would be to say that in primary process functioning there is no conflict, but with secondary process functioning there is. Then it becomes a secondary question of whether the conflict is in full consciousness, or is preconscious.... [1985, pp. 301-302]
      By contrast, if the analyst focuses on unconscious conflict, he is freer to listen with his unconscious, to listen for allusions, to interpret deductively, to be guided by empathy or intuition or to use countertransference as a guide.
     The two methods also define resistance differently. Anna Freud (1936) says that we see "resistance" when "defense mechanisms intervene in the flow of associations." Resistance is defined as an event occurring for only moments at a time. In the compromise formation model, resistance is large scale and virtually ubiquitous. It refers to a panoply of forces that keep infantile conflicts and their solutions out of awareness.
     In the clinical example that follows, Anna Freud would consider the patient's disagreements with the analyst as "not­resistance." In contrast to a view that the patient's objections represent "resistance," Anna Freud might say that resistance appears only after the patient becomes "anxious" about contradicting the analyst, speaking of pleasure at the hands of a woman. Identifiable resistance occurs when she stops disagreeing, becoming painfully self-critical, and regresses.
     There are indications that Silverman may need to employ more "authority" or "influence" to overcome resistance because his technique requires interpreting unconscious conflicts and their resultant compromises. A degree of "insistence" appears to be necessary. The "resistance" to awareness of unconscious contents is considerably greater than to the conscious or barely preconscious contents Anna Freud addresses. On the basis of our limited material, it is not possible to assess how much the "authority" of the analyst is necessary to get the patient to consider his interpretations. Brenner and Silverman would want to analyze thoroughly any behavior in which a patient deferred masochistically. But it is possible, ironically, that when Silverman analyzes something the patient cannot see or evaluate directly, he introduces a dilemma for the patient in which submitting to his "authoritative suggestion" may be unavoidable.

When I left the hairdresser's I looked for the girl who'd shampooed my hair to give her a dollar.... I was too intimidated by the hairdresser who cut my hair and I was intimidated about tipping the girl who shampooed my hair. Why? [slight pause] I can't figure it out. There's no rhyme or reason. I don't understand it.

Analyst: So long as you take that attitude, so long as you don't think it out and find out the rhyme and reason....
Patient: Well, he cut my hair. He cut me. But she just put her fingers into my hair. I don't understand.
Analyst: He stuck scissors into your hair and she stuck fingers into your hair. You were talking before that about avoiding sexual excitement. Scissors and fingers into your hair sounds sexual. You turn away and avoid the excitement, pain, and hurt with men, and when you turn away from men altogether and turn toward a woman you get scared all over again.
Patient: Yes. But there's something that doesn't fit. I had no problem about tipping the woman who gave me the manicure. And she massaged my fingers. And didn't get me anxious. I like it. It's relaxing. ---I thought of something. I told you about it a long time ago and then dropped it and avoided it. It's a masturbation fantasy. [Now her voice changes, becomes more hollow, tending toward a chilled monotone, drained of all emotion.]

     The two techniques have different goals. Brenner's interventions (and, even more clearly stated, Arlow's [1985]) aim at "destabilizing the equilibrium of forces in conflict within the patient's mind" for the purpose of healthier restabilization (Brenner, 1976, chapter"Defense Analysis"; Arlow and Brenner, 1990, pp. 679-680). A desirable result might include reports of various new conflict solutions evident in the form of compromises. In the hour itself, new attitudes and access to new memories and fantasies would be good signs. "It is the compromise formation that changes, not this or that defense" (Brenner, 1976, p. 74). Insight into and familiarity with the mechanics of thought processes, of conflicts and defenses, of the "voices" representing the ego, id, and super­ego as entities would not be likely--nor important. It might develop as a side-product but is not required for good results.
      Anna Freud (1980a) was convinced about the curative importance of insight: "It is the knowledge of the unknown inner life that cures" (p. 161). All the rest--the relationship to the analyst, transference, etc.--are adjuncts to that aim. "Insight" is defined as "the extent of the individual's' knowledge of his own psychic processes, especially the communication between the ego and the id" (p. 139). Her technique objectifies whatever is being called impulse and defense. The patient can see, and is invited to look into whatever the analyst is considering "evidence." Whenever the analyst hypothesizes conflict and defense, it is immediately subject to the patient's critique. She aims at the patient's being able to hold her ego and id apart in order to get a clearer look at their interaction--and in an attempt, as well, to postpone and inspect those id-regulating strategies of the ego that involve pain and personality restriction. This perspective helps the ego "face" more and more intense drive derivatives. It is clear that the ego, including the "rational" ego, is never expected to give up its fundamental guidance of impulse expression--its basic interest in regulating impulses.
     These are dramatically different techniques. Yet we know, as Kris warned, that the major differences were not really noticed. Anna Freud analyzed manifestly expressed dynamic interactions of id and ego. In his conversation with her, Sandler (1985) reacts to her comment that it is possible for an analyst to directly "hear" the id speak! (Not possible if we only "hear" compromises). In favorable cases the ego does not object to the intruder but puts its own energies at the other's disposal and confines itself to perceiving; it notes the onset of the instinctual impulse, the heightening of tension and the feelings of unpleasure by which this is accompanied and, finally, the relief from tension when gratification is experienced.... The ego, if it assents to the impulse, does not enter into the picture at all" (A. Freud, 1936, pp. 6-7). In the transcript (1980­1984), Sandler appears at first to have "misheard" what she said (in the following, the portion italicized is, again, not included in their 1985 book):

Sandler: I was intrigued by the fact that one can think of the ego in terms of depth, in terms of distance from consciousness, and that the deeper strata of the ego can be seen as being the location of earlier modes of functioning. It does seem to be worth noting, Miss Freud, that the "deeper" functions of the ego were regarded by you as those which relate to an earlier time in the life of the child. [1985, p. 29]
      In considering this chapter we come up against a question which we have discussed before, namely the role of the ego in relation to instinctual impulses. We agreed last time that to say that the ego stands aside or is silent is simply a way of speaking and in fact no derivatives of the id can come through without the collaboration of the ego. In this regard, perhaps it could be that the id and its derivatives come to the surface with the collaboration of a deeper or more infantile part of the, ego, in the form, for example, of a slip. Would that be correct?
Anna Freud: I want to emphasize that I meant in our discussion last time, that even though the ego may lend itself to the instinctual wish and its fulfillment, and by lending itself lend its particular way of functioning this does not help the observation of psychic structures. When what goes on is unified and harmonious, then we do not know in our observations what belongs to the id and what belongs to the ego. It is only when the two clash that their different modes of functioning become obvious. I wanted to clarify this and it is also related to your question.
Sandler: I think you have made it very clear that it is conflict that shows us the psychic institutions, or rather enables us to conceptualize things in terms of the psychic institutions. Nevertheless statements of the sort we discussed last time, such as "the ego standing aside and allowing the id to act" would, I think, be phrased differently now.
[1980-1984, p. 8, emphasis added]
I should like to go straight to a point on which I would very much like to hear your comments, a point relating to the role of the unconscious ego. If I am correct, with the introduction of the structural theory, the replacement of the unconscious dynamic system by the id represented an attempt to deal with problems that had been confronting Freud in regard to the topographic model.... [p. 8; 1985, p. 29]

     While Anna Freud might agree that her description of the id acting without the ego's participation "would be phrased differently now (by many analysts)," would she agree with him that they should "be phrased differently"? I believe that is very doubtful.
      Sandler seems to insist on a compromise-formation model. Anna Freud views the ego as initially permitting expression of a drive derivative, and then objecting and acting to stop this expression. She puts a spotlight on the ego first and then goes back to the id. She is "simplifying," studying them individually, trying to describe their activities in ways that are highly focused.
     Gray (1982) generalizes the problem analysts have had with understanding her point of view. He attributes it to a "developmental lag" inherent in the prodigious difficulty we all have in trying to observe and understand the ego's functioning--including our own.
     There is another possibility. These two different ways of viewing intrapsychic conflict are scientifically and philosophically different worlds, with very different theoretical and technical languages. They are not easily reconciled.
     Why didn't her point of view attract more attention--other than that of Kris, Hartmann, and Rapaport? Was one of the problems (!) with her approach that it was radically better for appreciating dynamics in an analytic situation and cast into virtual irrelevance the investigation of dynamics using the other method? The appearance of being able to understand conflict that is out of sight, at some distance in time, was being taken for a reality. Analysts don't (and apparently can't) recognize that they are using such an awkward instrument for analyzing dynamics. As soon as she made her position clear, did it render the prevailing view obsolete?
     In trying to stimulate discussion of ways to measure the usefulness of these two clinical approaches to conflict, I suggest that it might hang on which way of organizing the clinical data "works better" scientifically. Does Anna Freud's approach seem to be more consistent with current scientific theory and research methodology?
     Hers is a style of thinking we can associate with modern science. First, she sees that the fundamental problems in psychoanalysis cannot be understood unless they are epistemically sound; particularly so with respect to the meanings of "dynamics" and "intrapsychic conflict." Second, the way she views conflict puts it on the level of perceived "reality"--it fits with natural introspection (Grossman and Simon, 1969)--she does not put it beyond or behind sense experience. And third,, her method of observing conflict is described in terms of its usefulness as an "instrument": she says to Sandler, "I want to emphasize that I meant, in our discussion last time, that even though the ego may lend itself to the instinctual wish and its fulfillment, and by lending itself lend its particular way of functioning, this does not help the observation of psychic structures" In other words, she says, "you can hold, if you wish, to the model of unconscious conflict and compromise formation, but then you won't be able to `see' the id and ego as separate! You won't see the struggle between the parts of the mind, between voices speaking different languages and acting out their intentions in a totally different medium."' Scientific models have limited domains of validity and their value is measured by their utility. It is fundamental to understanding the use of such models that "scientific truth" is not possible to establish.
     The essential differences described between the two approaches to analyzing defense involve: (1) the analysis of "fresh" moments of conflict (characterologically determined) versus analysis of compromise formations ("infantile" conflict-solutions); (2) the use of very short time-span reconstructions versus interpretation of components of compromise; (3) the supposition that analysis-created insight into the relations between the id and ego will be "curative" versus a belief in the fundamental importance of stimulating new compromise formations--often, without "insight" as a factor; and (4) the comparative ease or difficulty each method presents as to demonstrability, analytic utility, and research potential.
     One of the astonishing aspects of Anna Freud's thinking about conflict is the consistency of her outlook over the years after her 1936 revelation. She drew a line as clearly as one can be drawn and remained convinced about her side of it, wondering still in 1980 what had become of the idea that insight was the vehicle of cure. Her side offers possibilities for treatment and research that were not really noticed until Gray marked it out in 1973.

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