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  • Title: [Importance of external reality on the psychoanalytic situation. Contribution to the problem of psychoanalytical setting].
    Author: Nerenz K.
    Journal: Z Psychosom Med Psychoanal; 1977; 23(2):152-69. PubMed ID: 868312.
    Abstract:
    This paper deals with the influence of the "external" arrangement of the psychoanalytic setting on transference/counter-transference. It is based upon a comparison between the classical psychoanalytic situation and that of the analytically orientated treatment in the hospital. Its theme is that the theory behind the psychoanalytic technique contains no concept for handling a variable external reality. Continuing Leo Stones study of the psychoanalytic situation, in this paper the "immanent suggestion" of the structure of the external arrangement is more closely investigated and defined as a primary and general valence of transference. A particular emphasis of this study lies in the discussion of that specific level of information exchange between analyst and patient which is dependent on setting and which is stimulated by the "positional structure" of the external arrangement. Positional structure is defined and described in detail. Further the following questions are discussed: to which forms of communication does the psychoanalytic setting per se give most support; which forms of transference and counter--transference follow "logically" from the external arrangement and are consciously or unconsciously allowed by analyst and patient in the selection of the classical psychoanalytic setting? The paper reaches the conclusion that the setting of the psychoanalytic situation reproduces primarily pre-oedipal conflicts and early experiences of separation in the mother-child-relationship. In contrast, the face-to-face situation reproduces primarily pre-oedipal conflicts and early experiences of bring into focus a priori oedipal conflicts. Both analyst and patient are subject to the influence of the setting on the unconscious. This study suggests further investigations of those transference and counter-transference valences which are dependent on setting and to take into consideration their technical implications.
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