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Abstinence (psychoanalysis)

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Abstinence or the rule of abstinence is the principle of analytic reticence and/or frustration within a clinical situation. It is a central feature of psychoanalytic theory – relating especially to the handling of the transference in analysis.

As Sigmund Freud wrote in 1914:

The cure must be carried through in abstinence. I mean by that not physical self-denial alone, nor the denial of every desire....But I want to state the principle that one must permit neediness and yearning to remain as forces favoring work and change.[1]

Later formulations

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The validity of the abstinence principle has been rediscovered and reaffirmed in a variety of subsequent analytic traditions.

  • Jacques Lacan re-formulated the principle via the concept of 'analytic bridge' – the analyst necessarily playing the part of the unresponding dummy to bring the patient's unconscious motivations out into the open.[2]
  • Eric Berne saw analytic frustration as a means of avoiding playing a part in the patient's life script.[3]
  • R. D. Laing, in the context of the false self saw analytic abstinence operating in opposition to false self collusion: "It is in terms of basic frustration of the self's search for a collusive complement for false identity that Freud's dictum that analysis should be conducted under conditions of maximal frustration takes on its most cogent meaning".[4]
  • D. W. Winnicott in the context of his notion of 'holding' the patient emphasised that understanding through verbal interpretation gave a deeper sense of holding than the physical act, use of which by the therapist could blur the symbolic nature of the analytic space.[5]

Debates

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The rule of abstinence has come under increasing challenge by Interpersonal and Intersubjective psychoanalysis,[6] concerned about the inflexibility of the rule, and the way its relentless application may provoke unnecessary hostility, even an iatrogenic transference neurosis.[7]

Defenders of the rule, against the practice of the warm supportive analyst, argue against the easy seductiveness of being overly 'helpful' in a self-defeating way already sketched out by Freud himself.[8] The concept of optimal responsiveness – balancing frustration and gratification from moment to moment – offers some mediation in the dispute.[9]

See also

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References

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  1. ^ Quoted in P. Gay, Freud (1989) p. 302-3
  2. ^ Lacan, Jacques (1997). Ecrits. Routledge. pp. 229–30. ISBN 9780415043236.
  3. ^ Eric Berne, What Do You Say After You Say Hello? (1974) p. 352
  4. ^ Laing, R. D. (1969). Self and Others. Pantheon Books. p. 123. ISBN 9780422731607.
  5. ^ P. Casement, Further Learning from the Patient (1990) p. 96-7
  6. ^ A. Fayek, The Crisis in Psychoanalysis (2009) p. 37
  7. ^ R. Stolorow et al eds., The Intersubjective Perspective (1994) p. xi and p. 146
  8. ^ Janet Malcolm, Psychoanalysis: The Impossible Profession (1988) p. 124 and p. 77
  9. ^ S. Akhtar, Comprehensive Dictionary of Psychoanalysis (2009) A and O

Further reading

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  • S. Freud, 'Observations on Transference Love' Standard Edition XII
  • J. Lindon, 'Gratification and provision in psychoanalysis: Should we get rid of 'the rule of abstinence'?' Psychoanal. Dialogues (1994) 4:549-582
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