chapter  13
22 Pages

Reflections on the unconscious

I hope that readers of this book have been as impressed as I have been, over the years of my career, with how readily inner workings of systems of pathological accommodation, whose symptomatic expressions were always evident, become almost invisible in any treatment that insists upon an intrapsychic focus on the patient to the exclusion of contextual factors. Indeed, it was only with the advent of the empathic-introspective approach of Kohut that the patient’s experience began to be examined with sufficient attention paid to the context of the treatment, and to the analyst’s immanent role in it, that the details of such systems could begin to make their presence consistently felt. And it was only with the further elaboration of the intersubjective viewpoint that such systems, which when present constitute the nuclear pathology of the patient and the outstanding obstacle to true analytic transformation, could begin to come fully into view. This progression of understanding quite obviously has implications for our understanding of the unconscious and how it may best be approached in treatment. In this postscript, I propose to reflect more deeply on the means by which an expanded view has lately emerged of how unconscious memory may be accessed in treatment to the patient’s advantage.