chapter  2
16 Pages

Activating the experience of the field

In his ‘Recommendations to Physicians Practising Psycho-analysis,’ Sigmund Freud gives advice which is as pertinent today as it was in 1912, although his optimism now seems almost quaint:

The first problem confronting an analyst who is treating more than one patient a day will seem to him the hardest. It is the task of keeping in mind all the innumerable names, dates, detailed memories and pathological products which each patient communicates in the course of months and years of treatment, and not confusing them with similar material produced by other patients…If one is required to analyze six, eight, or even more patients daily, the feat of memory involved in achieving this will provoke incredulity, astonishment… Curiosity will in any case be felt about the technique which makes it possible to master such an abundance of material…

The technique, however, is a very simple one…It rejects the use of any special expedient (even that of taking notes). It consists simply in not directing one’s notice to anything in particular and in maintaining the same ‘evenlysuspended attention’…in the face of all that one hears. In this way we spare ourselves a strain on our attention which could not in any case be kept up for several hours daily, and we avoid a danger which is inseparable from the exercise of deliberate attention. For as soon as anyone deliberately concentrates his attention to a certain degree, he begins to select from the material before him … This, however, is precisely what must not be done…

What is achieved in this manner will be sufficient for all requirements during the treatment. Those elements of the material which already form a connected context will be at the doctor’s conscious disposal; the rest, as yet unconnected and in chaotic disorder, seems at first to be submerged, but rises readily into recollection as soon as the patient brings something new to which it can be related…

(1958, 111-12)

Many clinicians have recognized that Freud’s advice is difficult to follow, for when areas of meaninglessness, emptiness, mindlessness or blankness, over whelming and fragmenting anxiety, intense despair, and envy are constellated, an ‘evenly suspended attention’ is nearly impossible to maintain. In other words, when the analysand’s psychotic parts are activated, the analyst’s capacity to maintain an even, free-floating attention is challenged to the utmost. An analyst might as well attempt to enter a deep, tranquil state of meditation in the New York subway system at rush hour.