CHAPTER THREE

 

 

From analytic dialogue
to published text

 

Henning Paikin

 

 

 

 

“Death and life are in the power of the tongue”.

Proverbs 18:21

To write and publish case histories is Just as important for psychoanalysis and its development as is doing analysis. However, all candidates and analysts have experienced how difficult it is to describe an analytic session in writing. Many misunderstandings among non-analysts concerning psychoanalysis are due to the fact that many case histories that are informative and inspiring for analysts appear as undocumented statements to the reader without psychoanalytic training or without personal experience of the psychoanalytic process. Due to the uniqueness of the analytic process, we can only with difficulty publish the so-called raw data, whatever they may be.

To report about the analytic experience in writing is still, after 100 years, a challenge for psychoanalysis. The analytic session cannot be told with all its details and nuances, any more than a dream can. And sometimes the details appear just as elusive (cf. Stein, 1988, p. 108; Olinick, 1980, pp. 38, 40).

At the beginning of the first of the Introductory Lectures, Freud (1916–17, p. 17) says:

Nothing takes place in a psycho-analytic treatment but an interchange of words between the patient and the analyst.

And a few sentences later:

Words were originally magic and to this day words have retained much of their ancient magical power. By words one person can make another blissfully happy or drive him to despair, by words the teacher conveys his knowledge to his pupils, by words the orator carries his audience with him and determines their judgements and decisions.

Taking into consideration Anna O's definition of the treatment, which was the beginning of psychoanalysis, as “the talking cure”, and the relevance of the spoken word to the psychoanalytic process, to psychoanalytic supervision, to seminars and conferences, it is surprising how relatively little has been written in the analytic literature, at least in the English language, about speech (exceptions are Spence, 1987; Olinick, 1984; Amati-Mehler, 1993). I dare claim that more is written about silence! How to communicate the psychoanalytic experience, or whether it can be communicated at all, has not received much attention in the analytic literature (Olinick, 1980, p. 37; Haynal, 1993, p. 2).

In this chapter, I will occupy myself mainly with the very limited part of these issues that has to do with the conflict between oral and written exposition. In other words, I will take Freud's words literally: that in the analytic treatment “… nothing takes place … but an interchange of words”, and I will look into the conflict between the spoken and the written word. (I make this choice only to limit the length of my chapter: I am certainly of the opinion that many things happen other than the exchange of words.) I can only hint at other important topics connected with publishing, such as the problems concerning confidentiality and the fact that the analyst, through publishing, places himself in a vulnerable position (see, e.g., Stein, 1988).

Why have analysts been so reluctant to write explicitly about the conflict between orality and literacy that is so central to analytic literature?

I can find two answers: one, that Freud had a unique and unsurpassed literary style, especially in his case histories, which, in an ingenious way, hid the conflict; the other might be that the problems are situated in the borderland between psychoanalysis and many other sciences, such as philology, rhetoric, literary criticism, to mention just a few.

The psychoanalytic dialogue

It is unnecessary to furnish analysts with a detailed description of the prime importance of dialogue in psychoanalytic practice and training. I will therefore only give two examples, as a reminder of the very central and comprehensive position of spoken language within psychoanalysis.

The psychoanalytic process is established by means of spoken communication between analysand and analyst. In analytic work, the analysand's verbal expression has high priority. Other forms of communication are certainly not neglected, but it is standard technique for the analyst to consider it usually (but not always) as his task to verbalize these other pieces of information, whether they are the analysand's gestures, attitudes, actions, affects, or silence! “[T]alking is the method of psychoanalysis”, as Fenichel puts it (1946, p. 577). However, talking is also a form of showing. Everything in analysis is both communication and demonstration (Schäfer, 1983, p. 222).

I believe that most of us consistently try to get the analysand to communicate with us in oral form. Should the analysand bring letters, diaries or other material, we will usually try to analyse this as resistance. Such material can only be brought into the analysis if the analysand refers to its contents or reads it aloud.

The analytic rationale for this attitude is that language, the spoken word, is a transitional space between psychic reality and physical reality. Most analysts will be of the opinion that language is a tool by means of which we are able to help our analysands. Some might be of the opinion that only carefully verbalized interpretations are helpful, but most analysts today will also take the relationship into consideration. On the other hand, there is hardly an analyst who will dismiss the importance of oral interaction. No analyst will offer analysis by correspondence, although Freud's correspondence with Fliess has been regarded as a kind of analytic process!

Let me emphasize once again that I am not of the opinion that the psychoanalytic process can be reduced to a linguistic interaction. The psychoanalytic process is much more complicated and therefore difficult to describe, especially in writing. This applies especially to those analysands whose difficulties are on a nonverbal, basic-fault level. (A further discussion of these “wordless” analysands would take us too far from the topic.)

The classical analytical setting aims to promote the analysand's oral and spontaneous communication with the analyst, and language is often considered an indifferent tool. Schäfer has criticized the opinion that analysands should be able to report their thoughts “freely”. Freud made language, especially the spoken language, an object of his analysis, but in his technical recommendations he appears to consider it a neutral tool (Schäfer, 1992, p. 148).

The dialogue between analysand and analyst is no doubt the primary tool of psychoanalysis. The psychoanalytic dialogue is described so precisely and beautifully by Schäfer (1992, p. 156) that I will allow myself a long quotation:

… out of Freud's genius issued an altogether new form of dialogue. He made it possible for therapists and patients to engage in consequential forms of transformational dialogue that have never existed before. He showed therapists how to do things with words to help revise radically their patients' hitherto fixed, unconsciously directed constructions of both subjective experience and action in the world: to use words to change lives in a thought-through, insightful manner. No one before him had done anything as profound, comprehensive, skilful, basically rational and effective. Freud's clinical dialogue alters in crucial ways the analysand's consciously narrated presentation of the self and its history among people.

However, the psychoanalytic dialogue is, as Eiguer (1993, p. 26) emphasizes, also “distinct from all other human dialogues because it is characterized by unpredictability. The analyst listens to the unspeakable, which shocks, indeed disturbs him … [one of the] reasons for this unpredictability [is that] the unconscious material is unknown to us”.

The psychoanalytic dialogue takes place in privacy but also in a private language, where certain phrases or expressions have a personal, almost metaphorical, meaning that the analyst learns along the way. The more the analysand is able to follow the so-called fundamental rule, the more will the analytic session assume some resemblance to dreams and, in principle, also be interpreted the same way.

The analyst is concerned both with form and content. In most analyses, an idiosyncratic language develops between analysand and analyst in a way similar to the way this happens in all families. The analysand who feels sufficiently safe will also resort to the language of childhood. Amati-Mehler, Argentieri, and Canestri (1993), in their monography on mother tongue and foreign languages, The Babel of the Unconscious, pointed out that, in a way, all human beings are polyglots. This means that the adult analysand has, in addition to his normal official daily language, several “languages” at his disposal, depending on the people he talks to—family, children, colleagues, and so on. They write: “every analyst knows how many translations' his words and those of his patient require before they become similar words and are able to convey shared meaning” (Amati-Mehler et al., 1993, p. 233). They continue with a quotation from George Steiner, a professor of English and comparative literature, in his major work on translations (Steiner, 1975, p. 47): “Thus, a human being performs an act of translation in the full sense of the word, when receiving a speech-message from any other human being.” Poland (1986, p. 257) expresses it in this way: “In trying to express unconscious matters, we use language to approach experience which cannot be exactly reduced to language…. Inner experience is not solely verbal. The patient's associations, even at their most free, are already translations. Interpretations, thus, are translations of translations….”

Even Schafer's “action language”, which he calls “the native tongue of psychoanalysis” (1976, p. 362), is not to be used directly in the dialogue with the analysand. It is rather ironic that it is still a theoretical language. I believe that the mother tongue of psychoanalysis can only be “heard” in the actual psychoanalytic dialogue between analyst and analysand.

The other example of the oral dialogue's extreme importance in psychoanalysis is supervision or collegiate consultation.

Freud and language

Freud was a master of the spoken and written tongue. “Freud's genius will” according to Kurt Eissler “have to center in his language….”. And Abram Kardiner, who also knew Freud, tells us: “Everything he said was practically fit for print, it was incisive, imaginative, filled with metaphors, analogies and stories, particularly Jewish ones, and it was not wordy. Freud talked like a book” (Mahony, 1982, pp. 3, 9).

Freud's literary style has been the object of detailed studies especially by Mahony (1982, 1984, 1993). In Freud as a Writer, Mahony has shown how Freud's certainly not logical style actually recreates much of the analytic situation for the reader. Freud's style is psychoanalytic to an outstanding degree, for it constantly enacts the drive-defence unit (p. 179). It is a unique mixture of primary and secondary processes, and we experience his conscious and unconscious presence (p. 188). His writings blur the boundary between orality and literacy.

It is of interest for our topic that Freud's first book was the neurological treatise On Aphasia (1891). Ana-Maria Rizzuto (1993, p. 113), among others, has pointed out that this paper is relevant to Freud's later theorizing and analytic technique. In this treatise, Freud attaches great importance to sound images (Amati-Mehler et al., 1993, p. 30) and in the early works, The Interpretation of Dreams (1900a), The Psychopathology of Everyday Life (1901b), and Jokes and Their Relation to the Unconscious (1905c), he makes use of a long series of rhetoric figures and sound associations in his interpretations: pun, alliteration, rhyme, etc. In other words, it was the spoken language that was the object of Freud's analysis. Words in themselves are disconnected and meaningless in the precon-scious. They are given coherence, meaning, and intention first by interpretation “In this way the whole domain of verbal wit is put at the disposal of the dreamwork. There is no need to be astonished at the part played by words in dream-formulation. Words, since they are the nodal points of numerous ideas, may be regarded as predestined to ambiguity …” (Freud, 1900a, p. 340).

It is amazing that neither Freud himself nor later analysts have, as far as I know, paid attention to the fact that the language Freud placed in the preconscious is the spoken language. Written language belongs to consciousness and is a secondary-process activity or, as can be shown, cultural in the historical sense: The spoken language and its distinctive character was “repressed” to the preconscious or unconscious when literacy became dominant. Freud “rediscovered” characteristics of the spoken language through dream interpretation.

Although Freud was a master of language, he was nonetheless

painfully aware of the limping nature of language as a completely reliable instrument for clinical description…. Freud came back again and again to the basic challenge psychic reality poses for exposition: Psychic events are over-determinated and draw simultaneously from various strata, whereas in verbal exposition these superimposed strata are flattened out into a verbal string; if linearity is the essence of language, superimposition is the keynote of psychic events. [Mahony, 1982, pp. 9, 10]

Freud was explicitly against verbatim reports, as is testified by the following quotations:

… it must be borne in mind that exact reports of analytic case histories are of less value than might be expected…. They are, as a rule, fatiguing to the reader and do not succeed in being a substitute for his actual presence at an analysis. [1912e, p. 114]

Exhaustive verbatim reports of the proceedings during the hours of analysis would certainly be of no help at all. [1918b, p. 13]

In a letter to Jung on 19 April 1908 (Freud/Jung Letters, 1974, p. 141), Freud wrote that a case history story “cannot be narrated but only described”. In German it reads: “ein wirklicher ganzer Fall lässt sich nicht erzählen, nur beschreiben” (Briefwechsel, 1974, p. 156).

I believe that we can easily agree with Freud, but the problem is that few if any have been able to describe the analytic process as he did.

“To my knowledge”, writes Mahony, “no current analyst writer of case histories has insisted as much as Freud on the impossibility of writing a case history” (1993, p. 1033). However, Freud then did the impossible.

A digression on orality

Characteristic conditions for the oral mode can be illustrated by looking at them from a developmental and cultural historical point of view.

The baby is linked to his parents through an actual audio-phonic communication system. The mother is able to differentiate the three-week-old baby's cries as expressions of hunger, anger, pain, and so on. The five-week-old baby can distinguish his mother's voice from other voices, though he cannot yet distinguish her face from other faces. It is on the basis of such facts that Anzieu (1979, p. 27) describes a “sound mirror” that exists before the visual mirroring described by Winnicott and Kohut. Anzieu draws attention to the importance of the auditive environments for the early development of the self. (He draws our attention to the fact that the problems of voice and audition have not been of much interest to Freud's commentators, and he calls for research in this area.) This very early prelinguistic root to interpersonal communication makes sense of the fact that the sound of the voice is often more important than the content of what is said. This is especially true when consolation, reassurance, and support are in question, but not only then. It is what Olinick (1982, p. 461) has called “phatic” speech, which has the sole aim of establishing contact. As analysts, we are also accustomed to listening with a “third ear” (Reik, 1951), which, as we all know, means listening to the hidden meanings, but also to the emotional, the unsaid, the unspeakable, or the unthinkable.

It would, of course, be relevant at this point to say something about the development of speech, but that would lead us too far from the topic, so I will not investigate the issue further.

Walter J. Ong, a Professor of Humanities in Psychiatry at Saint Louis University, Missouri, in an already classic work Orality and Literacy (1982), has described some primarily oral cultures—that is, cultures without any form of written language—and this is of interest to us. Among other things, Ong emphasizes that the language and the thinking in these cultures are concrete, situational rather than abstract, and that oral personalities, owing to the lack of abstract terms, cannot be introspective. As he puts it: It is hard to talk to yourself for hours on end (p. 34). “Primary orality fosters personality structures that in certain ways are more communal and externalized and less introspective than those common among literates. Oral communication unites people in groups. Writing and reading are solitary activities …” (p. 69). Speech unites, even when one speaker approaches a large audience!

In oral cultures, people do not say anything that has no meaning or actuality for the speaker and the listener; writing is a different instance since it preserves everything. Memory is short in oral cultures—one knows only what can be recalled: “… oral memory differs significantly from textual memory in that oral memory has a high somatic component…. The oral word … never exists in a simply verbal context, as the written word does. Spoken words are always modifications of a total, existential situation, which always engages the body” (Ong, 1982, p. 67).

This summary of some aspects of primitive oral cultures is no doubt akin to what we know from the psychoanalytic dialogue, which aims among other things at bringing the analysand into the oral universe by verbalizing his thoughts. The analytical dialogue is, like other oral dialogues, mutual, actual, infinite, and creates mutual experience and includes more than words (Ong, 1982, p. 101). Thus, it gives a special admission to the preconscious (and unconscious), which no written communication can do. Psychic change begins when, in the presence of the analyst, the analysand says aloud what he hardly dares to think.

Ong (1982, p. 71) mentions, as Fink also does (1993), some physical characteristics of sound. Sound tells us about the interior of things, whereas sight only registers the surface. The expression on the face of a human being tells us something about his inner life, but facial expression can be controlled much better than the voice. People who are in acoustic contact with each other know something about each other's interior. We are in the hands of one another as far as the oral sphere is concerned.

Fink describes it in this way: “A spoken word will only linger on for a fraction of a second before becoming past. It may stay consciously or unconsciously in the mind of the patient and analyst, but it will be subject to emotionally determined change and possible distortion. It will never again be the same as when it was spoken” (p. 15).

From dialogue to retelling

The other example of the importance of oral dialogue in psychoanalysis is, as mentioned, supervision.

Let me give two very short but typical vignettes:

A supervisee looked up from his notes and said: “I really don't know whether it was I or the patient who said this.”

Another supervisee, who had given an excellent report about a session, added with all the signs of guilt that the report was a “fake”, because it was continuous and meaningful, which she didn't think was the case in the session.

Both of these vignettes can be interpreted in many different ways, but I am sure they illustrate the discrepancy between the analyst's experience and the retelling. That the same applies for analysands was nicely illustrated to me once by an analysand who kept a diary of his analysis. The analysand realized that notes concerning “important insights” were not recognizable a few months later, and he could not understand why he had made these notes as they no longer appeared important to him.

Although the supervisee depends on his written notes, supervision is a dialogue in which the supervisee's spontaneous presentation is, with some approximation, used in a way similar or parallel to the analytic situation. Supervision can nowadays take place by telephone, but even then it is an oral dialogue.

Olinick has pointed out (1980, p. 39) that the psychoanalyst's skills are primarily developed through oral communication and its non-verbal concomitants. Auditory and introspective channels are emphasized. However, memory, fantasy, and imagination exist largely in visual terms. Consequently, the subjective recording and the objective reporting of intrapsychic and interpersonal events of the psychoanalytic situation are handicapped by the need to make use of modalities that are relatively unnatural and unfamiliar. By borrowing a phrase from Aldous Huxley, Olinick asks what is the “adequate verbal equivalent” for the affective quality of a patient's silence?

I am fully in agreement with Tuckett (1994, p. 1182), when he writes: “What is to be communicated seemed there to us at the time, but we will all have had the frustrating experience of trying to tell someone else about it and discovering that what we say sounds much less convincing than it felt in the session, when it was formulated. (Bion makes the interesting point … that even the notes we take … often seem baffling or unconvincing to us later.)”

We know from supervision how the so-called report of a single session attains a similarity to the telling of the manifest dream where the dreamer can continue to make additions and commentaries because the dream was so ambiguous (Stein, 1988, p. 112). The above two vignettes illustrate how the telling of a session is a process similar to the secondary revision of dreamwork. And as there is only one dreamer who is responsible for the dream, so there is only one analyst who is responsible for his version of the “manifest” analytical dialogue the “latent” meanings of which we can try to discover and discuss. Concerning this issue, Tuckett (1994, p. 1184) writes: “The central point of a psychoanalytic process is that it cannot rely on rational verbalization alone, and in his attempt to communicate, the analyst says more than he consciously knows. This is a strength, not a weakness …” (see also Spence, 1987, p. 174). A strength, yes, when the analyst speaks about the analytical process with one or several colleagues, because in an oral dialogue the participating listener will have the opportunity to make a trial identification with the reporting analyst and possibly point out countertransference elements.

Psychoanalysis is today a well-established, independent science that presents some technical difficulties, like other sciences, for instance history and mathematics (the examples are not chosen at random!). Historians must, Just like us, hear or read reports about events that have to be combined, interpreted, and retold in light of the historian's assumptions. What the historian publishes is his own version of the facts. The psychoanalytic story is a retelling of the analysand's telling: the amount of detail must be extremely reduced and condensed. We cannot and should not be more precise than the historians. If the details were not reduced, a hypothetlcally “complete” telling should contain the analysand's “whole” prehistory, everything the analysand said, thought, or might have thought and so on, and the same applies for the analyst. (See Haynal, 1993, p. 3, for similar viewpoints.) If I have understood Spence (1982) correctly, he originally suggested something of the kind, although he later changed his mind (Spence, 1987).

The use of the tape-recorder demands a more thorough discussion than can be given within the limits of this chapter. It is, however, obvious that a tape-recording can only reproduce the words—that is, a very limited part of the manifest material—but it describes neither the comprehensive unconscious communication between analysand and analyst nor, of course, the analyst's countertransference.

We need not have a different attitude towards the analyst's report of a session than to the report of the manifest dream: it is the starting point for our investigation. It is, after all, the “latent”—that is, the unconscious—coherence and meaning that is of importance.

One more digression: writing is a technology

Speech is a natural human potential, which develops as an integrated part of the child's maturation and development; writing, however, is a technology, which can only be taught at a much later time. Written language has in many ways a status other than speech as far as psychology and cognition are concerned: It is context-free, autonomous, and one of the preconditions for abstract thinking. Writing implies consciousness and also increases consciousness and internalization. In contrast to speech, writing is a lonely occupation. The process of writing implies, for better or for worse, a distance from the material. The written text attempts to be logical and precise and will therefore be somewhat circumstantial, whereas the spoken word is always part of a total situation and does not appear merely as words. In a text, the words stand alone. The living word becomes dead on paper if it is not, incidentally, written by a brilliant writer. As analysts, we can listen with the third ear, but we cannot write with a third hand!

Historically, the development has been such that written language has influenced spoken language to the extent that the oral tradition no longer exists, except within the precincts of psychoanalysis (also mentioned by Olinick, 1984, p. 614). Most often, we regard writing only as an assistance to memory, but in Plato's dialogue “Phaedros”, Socrates recounts a myth where the point is that the inventor of alphabetic writing is told that instead of being an aid to memory and wisdom, writing will be a tool for forgetfulness. As analysts, we know very well that this is true, and this is one of the reasons why we usually do not require notes about our analysands. We have experienced that we can recall what is analytically relevant, and we know our analysands better than our relatives, about whom we do not need notes! From supervisions, we know that what makes sense in a session will be remembered or will be recalled during the supervision. We also advise our analysands not to write down the manifest dream, because it will only be a “tertiary revision”, which will not ease admission to the latent dream-thoughts.

There are also aspects of writing that might be frightening and take on a superego quality. The written word is in the nature of an oracle: it is separated from its author, and the paradox is that although the written word is dead, it lives an “eternal” life of its own, because it will survive even if it is disproved! From this, it follows that the writer never knows how his text will be read by his colleagues. “The writer's audience is always a fiction” (Ong, 1982, p. 101).

These factors no doubt contribute to many analysts' reluctance to publish cases. Another factor I have already focused on is, of course, that the psychoanalytic process involves the analyst personally.

From retelling to text

Even the characterization of the analytic process gives rise to delicate questions: Is it to be understood as a report, a description, a story, a narration, a translation, or a transcription? Many more definitions can be considered, but these examples amply illustrate that the answer will depend on the analyst's meta-scientific point of view, artistic talent, choice of literary genre, and understanding of the difference between speech and writing.

The distance between psychoanalytic dialogue and analytic literature has always been great. I have already mentioned some of the reasons for this: It is difficult, perhaps impossible, to verbalize the regressive, ambiguous, non-verbal, emotional, and intimate character of the psychoanalytic process. This is also due to the fact that while the analyst is listening, he is also trying to register the process, the latent messages of the analysand and his own emotional reactions and fantasies, at one and the same time. Being difficult in itself, it is not possible to describe it as a dream or, in Fenichel's words, it: “… can only be reproduced in words inexactedly, always with the addition of ‘something like’ …” (Fenichel, 1939, p. 10). We can therefore well understand why many analysts in their case reports resort to abstract metapsychological concepts.

Sandler (1983, p. 35) has emphasized that the “official” or “public” formulation of psychoanalytical terms has multiple, context-dependent meanings. At the same time, he has indicated that the practising analyst has his private, preconscious, implicit theories, which function well in his daily work, even if there are possible self-contradictions. These two matters contribute considerably to the gulf between the living, multiple-layered psychoanalytic dialogue and the manner of its presentation for publication.

Consideration for the confidentiality of the analysand is often mentioned as the reason for the reluctance analysts have shown to publish their case histories. I will not delve any further into this problem, which is self-evident. Instead I will repeat that the written—that is, the published—word is somewhat frightening. It is out of the author's control, and it lives forever. It cannot be changed or annulled. Furthermore, there are superego-coloured fantasies about how the text will be read and interpreted by kind or not so kind colleagues. The problems concerning discretion are greater for the author than for the analysand, whose identity can be disguised. But any case history worth reading tells us quite a lot about the analyst, whether he wishes it or not: that is a price we have to pay.

No wonder, then, that so few have attempted to publish more comprehensive cases. The editors of The International Journal of Psycho-Analysis issued an invitation to send in such cases—an invitation that must have reached at least 7000 analysts worldwide. In reply, they received only 26 manuscripts (!), of which 15 were published (Tuckett, 1991, p. 377).

Conclusion

Notwithstanding the absolutely central position of oral dialogue in psychoanalysis, we cannot do without the published text; we need text, both for theorizing and for case histories. Without written sources, we would not be able to communicate and discuss internationally and over time. We would not even be able to think abstractly. And we also need to publish in order to communicate psychoanalysis to other professionals and interested lay people.

In this chapter, I have tried to focus on some of the difficulties and conflicts that occur in translating the analytic dialogue and process to public text. The question is whether, or how, these difficulties can be overcome. One tentative answer could be as follows.

As psychoanalysis is an interpretive and not an empirical science, every single case will have several different versions. Just as the manifest dream always has more than a single true interpretation, so the analytic session, too, has more than a single true version. Just as there is only one dreamer who is responsible for the dream, so there is only one narrator or writer who is responsible for his version of the analytic dialogue. There are always several possible versions: a tape-recording will present one version; the analysand will give another; and the analyst will certainly give a third version. Similarly, the analyst's published version, actually co-authored by the analysand, will be interpreted in various ways by different readers. The author's version is not the final one.

The difficulties involved in transforming the analytic dialogue into text are great, but may in principle not be so different from those encountered in transforming other similar, intense, emotional, and significant human experiences. What is the “adequate verbal equivalent of, let us say, falling in love? The answer is only to be found in poetry and literature. And although a case history is not fiction in the pedestrian meaning of the word, every case history is a narrative that can be interpreted and with which we can establish a dialogue. If we take an analytic attitude—that is, an interpretative attitude—both dialogue and narration are only starting points for our analytic activity. Put in a somewhat more provocative manner: the publishing analyst and his reader are perhaps in the same boat.

There are, of course, differences between the oral analytic dialogue and an imagined dialogue with a text. The most essential difference is, however, that the analysand can change, and so can the reader, but the text itself, in terms of printed matter, remains unaltered. Otherwise, the dialogue and the principles of interpretation are the same.

What I have focused on in this paper are some of the technical difficulties involved in communicating the analytic session and process. These difficulties certainly explain in part why so few analysts have published more comprehensive case histories. The difficulties are, however, only a relative hindrance for writing, since the text becomes in itself the object of the reader's interpretation. The dialogue and the process continue.

 

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An earlier version of this paper was read before the Fourteenth Nordic Psychoanalytic Congress, Mariehamn, Aland, Finland, August 1994. Previously published in The Scandinavian Psychoanalytic Review, Vol. 18 (1995).