Our job as analysts consists primarily of trying to undo the pathological eff ect on our patients’ personalities of their lifelong devotion to ‘curing’ themselves and their objects. What we see in the consulting room is the moment-to-moment confl ict between two methods of ‘cure’, ours and the patient’s. From the patient’s point of view, in fact, things are even more dramatic, as the analyst’s engagement in his version of the curative process involves not only off ering an alternative form of treatment, but a treatment that causes the ‘un-curing’ of the patient. Cure by psychoanalytic insight will only establish itself as a better method over cure by unconscious mechanisms of defence through the painstakingly acquired evidence that the analyst’s interpretations will provide both suffi cient relief from mental suff ering and a lesser price to pay in terms of damage to mental functioning; some degree of conviction will be required to justify the gradual abandoning of older methods. The rapidity of the establishment of a therapeutic alliance will depend on the fl exibility of the personality in allowing this negotiation between ‘methods’ to take place; a willingness to experiment with the new, and the existence somewhere of a good object that can be trusted and can therefore inform the positive transference, will be essential; but, by defi nition, all patients (including of course ourselves as patients) will also unconsciously engage throughout the analysis in serial mini negative therapeutic reactions aimed at undoing the eff ects of the ‘foreign’ method and re-establishing the old one again; but from the point of view of the
part of the personality that wants to re-establish the safe equilibrium of the previous status quo (Joseph 1989), these are of course ‘positive’ therapeutic reactions. 2
The diff erence of opinion between analyst and patient doesn’t concern solely the curative method; it is also about who needs curing. Patients are always actively involved in trying to change their analysts, rather than themselves. In a paranoid-schizoid state of mind, the belief is that if only the object could be transformed, the self would be OK (for instance, like a little oedipal child, ‘curing’ mother from her delusional belief that she should be married to father). And in a depressive position mode, as we know, we are constantly involved in trying to cure our objects from the damage we infl icted on them.