ABSTRACT
In the dramatic episodes of analysis the patient's fantasies come alive as it were, and get linked with the impulses that they mirror. Unconscious fantasy reflects instinctual wishes and impulses, and underlies conflict over such impulses. Conflicts over instinctual pressures at the crucial points of development give rise to anxiety, and the defences come into force as an attempt to deal with this anxiety. The recognition of the importance of unconscious fantasy is a central part of psychoanalytic discoveries. If these fantasies are directly related to conflict about impulses, a crucial aspect of technique is to make them live, in the sense of connecting with the impulses as well as becoming conscious. This can only be done effectively and safely within the transference. It is the awful isolation of such patients left alone with their fantasies that is the problem, and a creative illusion of some sort has to take place before reductive interpretations can be tolerated.
