Hope and Hopelessness: A Technical Problem?

Por: Mehler, Jacqueline,

Amati,

Argentieri,

Simona,

International

Journal

of

Psycho-Analysis,

00207578, January 1, 1989, Vol. 70

Hoping and losing hope are two ways of thinking about the reality of times
to come, ways of thinking that become intertwined and linked in each
individual in a continuous and natural fluctuation throughout life. But in
analysis this attitude towards hope is still more significant and rich in
complex implications, since the fostering or losing of hope develops and
becomes necessarily more articulated within the frame of the analytical
relationship,

involving

as

it

does

subtle

transference

and

countertransference, conscious and unconscious issues.

Often our patients come to psychoanalytic treatment as their 'last chance',
as a real sacrifice to the spes ultima dea. We must not forget, however, that
one of the analyst's natural tasks is to strive for an alliance with the vital
forces of hope in our patients, as an expression of our basic trust in the real
therapeutic potential of analytical tools.
Obviously, this 'function' of general unspecific openness to hope should not
be confused with specific expectations or with the conscious or unconscious
wishes of the analyst regarding the patient. We should also consider that
over the whole course of the analysis, and according to the vicissitudes of
the analytical relationship, the 'level' of hope may undergo deep oscillations
not only in the patient but also in the analyst. Often enough we can trace in
ourselves an excessive omnipotent feeling of hope, and we must watch out
for this, even if we know that sometimes a tiny bit of omnipotence may
reveal itself precious if used in the service of therapy! At other times we
may have a feeling of despairing impotence, accompanied by a sense of
devaluation of ourselves, the patient or the analytic instrument.
Within this vast and complicated subject, however, the purpose of our paper
concerns a limited and circumscribed area; we intend, in fact, to make a few
remarks about certain particular clinical situations, in whichin our opinion

the statement of loss of hope on the part of the patient assumes a specific
meaning of resistance, and imposes on the analyst not only the difficult task
of understanding and interpreting it but also a strenuous and delicate
technical problem.
We ought to start by saying that this paper is the outcome of a sort of 'twovoiced reflection'. As often happens among colleagues, we had been
exchanging impressions about our clinical experience and especially about
some particular situations we had encountered. Even though the cases were
quite different they had caused us a similar series of difficulties in the
analytic process, due to a long situation of stalemate common to both. We
may briefly synthethize both situations by saying that, in an advanced
phase of analysis and after long, intense and profitable work had been
accomplished, the course of the analysis had become blocked by impressive
monotonous communications such as: 'I just can't make it can't make it
' in one case, and 'I never felt so bad everything is useless for me' in
another.
Naturally, all possible interpretive paths had been tried and experimented
with, as we shall show in some detail later, until a moment came at which
both analysts resorted to a rather atypical and unusual technical strategy,
perhaps evenand here we come to the point of our paper on which we
want chiefly to focusopen to criticism or at least not rigorously analytic.
In the first case what happened was that the patient, whom we shall call Y,
continued to repeat in the session with particular painful intensity, 'I feel I'm
always worse analysis can do nothing else for me it's all useless ',
until the analyst at this point responded directly and explicitly: 'Maybe it's
so'. In the other case, in similar conditions, the patient kept crying and
saying, 'I can't help it', and the analyst said: 'I'm afraid I can't help it either'.
Both

interventions

undoubtedly

represent

something

of

an

unusual

statement in analysis. We feel however that in each case it was precisely

the disruptive effect upon the transference dynamics that constituted the
turning point of the analytic process in that it released the blockage and
formed the starting point for the termination of analysis.
Before discussing the meaning and the implications of this technical choice,
we would like to illustrate the clinical material that provided the basis for our

work. We felt it was more appropriate to report in detail only one of the
cases, that of X, limiting our description of the other one, Y, to a brief
sketch.
Case I: Y
We shall merely say that after many years of hard though rewarding work,
the

patient's

pain

had

crystallized

into

an

apparently

depressive

symptomatology, with intellectual and affective life reduced to its lowest

ebb and ruled by a perpetual lamentation about the grave and ineluctable
situation she was in. 'I'm so miserable I'm always worse it's all useless!'
was the leitmotiv at the beginning of every session, in which improvement
and gains attained through the analytic work were systematically ignored or
cancelled by the usual complaints.
There was apparently no overt aggressiveness towards the analyst; rather
there was the patient's fear of having reached her own limits, a painful
appeal for further help or for a word that would revive hope.
The analytic work had dealt all along with the exploration of genetic and
transference vicissitudes, the tendency to confer totally upon the analyst
the role of the rescuer; the need to defeat in the analyst the image of an
idealized and envied mother; the patient's inability to allow herself some
serenity and peace on account of cruel archaic superego attacks; the
masochistic attempt to provoke sadistic attacks from the analyst on account
of her inertia; the unconscious need to guarantee herself an eternal analysis
on which to depend etc.
With a feeling of weariness, the analyst too analysed her own painful sense
of frustration, impotence, exasperation and irritation; the sense of challenge
launched by such overt despair and the desire to meet the challenge and to
fight the destructiveness of inertia and failure; above all, the authentic
sense of compassion for the patient and the wish to understand the sense of
this stubborn mechanism.
During one of these monotonous sessions of plaintive and repetitive
declarations about the ineluctability of her destiny, when Y said, 'I am afraid
there's nothing else to do', the analyst decided to respond straightforwardly
and explicitly, 'maybe it's so'.

The patient reacted to this brief statement with great emotion, 'as if she had
been struck'Y said later. She kept silent for a long time, most unusual for
her, and gave up at once her complaining, querulous tone of voice. She said
later on that she had felt the analyst's words as very harsh, but also
extremely real, as if for the first time she had actually realized that there
was a genuine possibility that analysis could come to an end without her
having made adequate use of it.
It is most significant that the analyst should suddenly have introduced the
temporal dimensionthe passing of the years and the end of things
whereas it is in this regard that the resistance appeared to aim at exactly
the opposite result: to enchain life and the analysis in an eternal and
interminable dimension, even at the price of pain and failure.
The following case, which we shall describe in more detail, is similar in many
respects to that of Y and quite different in others, but, just as in Y's case, a
crucial developmental organizationwhich had, throughout the patient's
life, prevented any escape from the role of eternal and hopeless victim of
destinyhad now been invested in the analytic situation and threatened to
result in the same outcome.
Remarkable insight into transference issues involved in such an impasse did
not keep the patient from clinging tenaciously to the conviction that she
'just couldn't make it'. Trapped in this technical paradox, the analyst, after
quite a long period of immobility, responded beyond customary and
classical transference interpretation (by now thoroughly elaborated) by
making a statement to the patient about her intention to step out of a
repetitive script which required an ever-present and thus unreal analystpartner.
Case II: X
A clever, smart 35-year-old woman requested a second analysis because
she was again feeling depressed, unsuccessful and rejected. She was unable
to work, to understand who she really was and what she expected from life,
other than constant reinforcement and gratification, which she anyhow felt
was utterly insufficient. Even when she could obtain gratification, Miss X
would often fail to acknowledge it, or else even manage to turn potentially
rewarding situations against herself or the people she cared for. Her brother,

who had been mother's favourite, had become seriously ill mentally, and the
patient's sincere efforts to take care of him confronted her with her own
feelings of inadequacy, deprivation and ambivalence, so she eventually
decided to look for help again. Miss X had first gone into analysis several
years earlier with another colleague, for about seven years, because she
was then very unhappy with her sentimental life. She was very attached to a
married man who was, in fact, also very tied to her. This long liaison still
continued when she started her second analysis. In her relationship with her
partner she alternatively felt either as her own mother had, generally
depressed and neglected by father, or like one of several women with whom
her father had had affairs.
Different triangular situationsenacted through different role identifications
were quite a central issue in her history and in her analysis, but the
intrapsychic conflict behind them was not only or even mainly oedipal. The
patient, however, described her experience in those terms, saying that she
was always in search of 'paternal figures'.
According to X, her mother had never really loved her and was jealous of her
daughter whom she considered a rival for her husband's attention. The
mother instead worshipped the brother, who was always on her side and
had been generally despised by his father. The father felt X to be more
capable than her brother and it was she who followed her father's
professional activities. When X identified with the neglected mother she
would complain that her partner (she often said the same of close friends)
didn't care enough for her; but it soon became clear to us that behind the
role of a neglected adult woman, the voice of a plaintive deprived child
could be heard. Constant admiration or acceptance was needed to support a
faulty image of herself. She was quite arrogant, though, and if her natural
generosity encountered even a minimal inattention or distraction this would
rouse catastrophic, furious feelings of rejection and exploitation. Her mother
had apparently never been satisfied with any of her performances and only
father had partially gratified her need for approval. Rather than feeling
jealous of her father's other women, this gave herthrough partial role
identificationa sense of guilty triumph over mother. In relation to her
partner she thus lived again several roles:

a child neglected by the father-partner who was not her exclusive

possession (although at a much deeper level she yearned above all for the
maternal aspects of her partner);
a neglected wife like her mother;
a mistress, second-best to a wife-mother who had every thing she missed:
social status and a husband;
an accomplice to the father-partner and guilty towards the neglected,
betrayed mother-wife figure.
In this way X would usually accomplish an alternating succession of
enactments by splitting off a part of herself, and this enabled her to remain
in the same situation in spite of her real misery and pain. It took a very long
time and a lot of work for her to realize the enormous unconscious need to
remain attached to the role of complaining victim, thus less guilty than her
slanderers but unable to gratify the needs of the different part-roles which
were in opposition to and in contrast with each other. In fact, the one time
she succeeded in her requests for the partner to leave his wife and live with
her, she was unable to bear this choice; she promptly started an affair with
another man, for about a fortnight, just long enough for her to 'convince' her
partner to abandon the project and go back home to his wife.
In analysis, during the first months, she was very surprised at the ease of
the relationship and of how she was able to feel trust and hope. As her
involvement increased she started to worry, feeling 'it couldn't last',
something was bound to happen. X wasn't working and, as she felt slightly
better, she told the analyst, 'I know it would please you if I went back to
work'. When the analyst wondered what made her feel this way, X started to
cry bitterly, saying that since her father had died she had nobody she could
really talk to. It became quite clear that as long as she could feel the analyst
as a father figure she was safe, and felt supported enough to comply with
what she eventually felt were the analyst's expectations. She was strong
enough to take care of her brother in spite of her resentment of his past
privileges with mother, and some of her guilt was appeased. But hard times
were to come Her material all along, but especially her dreams, had been
dealing either with stealing jewels from other women or with possessing
things that would turn out to be somebody else's belongings. Another level

in fact started to appear in analysis, dealing with earlier experiences and

issues related to her relationship with her mother which had not been
worked out in the first analysis. Positive and negative aspects of envy, greed
and competition, a faulty organization of the separation-individuation
process; all these now showed the basis and foundations on which what at
first sight seemed oedipal guilt and conflict had been built.
The question as to whether this material appeared now because X's second
analyst was a woman and the first had been a man, or whether she had in
her first analysis merely been able to work on a safer level, analysing
oedipal material in relation to her sentimental problems, is an important
one, but less relevant to our subject, so we shall not discuss it here.
X alternated in her attitude, both outside and inside analysis, between a
provocative, contemptuous mood and a more submissive one in which she
idealized the analyst and other women who were able to do or to be what
she felt she never could be or do herself. She would talk in a childish,
plaintive voice about everything. It seemed as if all of her improvements in
her private and professional life were to be kept hidden; especially they
were to be concealed from herself and the analyst. When it became more
difficult to hide all this, she became physically vulnerable and accidentprone. It became increasingly clear that X had at all costs to appear
impotent and weak; anything in fact but competitive or 'threatening' to the
analyst.
In the meantime, her brother was deteriorating very rapidly and needed
several hospitalizations. It was a very serious and trying situation and X was
very upset; she would cry most of the sessions saying, 'it's too much, I
cannot take it any longer'. X was generally most concerned, available and
affectionate with her brother, although at the beginning with a rather
controlling and omnipotent attitude. At times however, she would alternate
with outbursts of frustration and intolerance at her brother's demandingness
and would become harsh and furiously rejecting.
On one occasion in which her destructive, hostile part seemed to overpower
her concerned, helping part, the analyst's comment was experienced by X
as a concerned, protective attitude towards the brother (which was actually
true).

The

patient

however

failed

to

recognize

this,

the

analyst's

preoccupation, as representing one of her own parts at play as well. The

crucial and feared moment in which the smooth analytic relationship was to
explode had finally come. X was absolutely furious and threatened to stop
analysis. The analyst had become the persecutor who accused her of not
caring well enough for her brother. X used abusive talk and left the session
without saying goodbye. In the following session she said she had lost her
hope and trust in the analyst and added, 'You don't realize how important
your words are for me' 'You didn't measure them well' 'The problem is
that I am ill and I need your help, so my only alternative is to continue and
pretend nothing happened between us'. When the analyst suggested that
perhaps another alternative was to analyse what had happened, X's
response was 'I'm not as good at it as you are, but now I'll give you my
interpretation you thought it wasn't good for me to have all your
attention, so you showed yourself preoccupied with my brother Don't you
realize you hurt me?'
X was provocative towards the analyst who, just like her mother, had been
more concerned about the brother. She remembered having said that she
was afraid of ruining her relationship with the analyst, whom she accused of
falling into her trap by providing and enacting with her the bad relationship
she had had with her mother. This promoted a good deal of work; her
resentment for her mother came gradually into the foreground, her
disappointment at being unable ever to satisfy her mother, who felt she was
always wrong and her brother right. She talked about her loneliness,
gradually becoming able to recognize her mother's distress and depression
as well as her own guilt and her need to repair her mother's internal image.
Whenever she bought herself a nice thing, a dress or some jewellery, she
would tell people, 'it was mother's' or 'mother gave it to me'. Her mother
had died many years before but at this point of the analysis X had various
dreams that represented attempts to take care of her mother, to alleviate
her sadness or give her presents.
On the other hand, X was also feeling the dangerous condition of being
envied and attacked just as viciously as she would or actually did attack
others, especially women. Her main defence in analysis was still to hide any
improvement and to cry hopelessly, saying she would never be healthy and
anyhow her destiny was quite dismal, not any better than that of a kept

woman. All this in order to reassure the feared mother-analyst (felt as

potentially retaliating) by showing herself incapable, inadequate and not
enviable at all, merely neglected, poor and resentful. She soothed her guilt
feelings towards the mother-wife of her partner as well, by remaining in the
subordinate whining position of a neglected mistress. Just as the analysis
was beginning to show clearly the way in which these internal roles were
organized, and how this established, more or less a constant 'script' to be
followed in the transference as well, X was confronted with a highly
traumatic event: her brother committed suicide during a short absence of
hers. Real grief, mourning and feelings about guilt, impotence and
depression invaded her internal life and held sway there, often without neat
boundaries between past and present, or between real living and lost
objects. The conflict between her destructive and auto-destructive drives
and an intense vital drive towards life, love and self-assertion became
crucial and excruciating for about two years, and her extreme defence was
the split between these two parts.
Her increasing success at work and the realization of the importance for
herself and her partner of their relationship confronted X with the need to
examine, behind the roles she was constantly staging, who she really was
and what she really wanted. And this is the crucial point in relation to the
technical problem we are discussing here.
The analyst was by now aware of improvement. X herself was finding such
improvement hard to conceal or deny, but she still kept crying and saying 'I
just can't make it'.
A lot of the work had dealt with X's attempt to demonstrate that nobody, not
even the analyst, was capable of bringing the expected relief to her misery,
just as she herself had been unable to prevent her mother's or brother's
distress. Her intent was to show that, no matter what was done, it was just
not the thing she needed. This was in fact inevitable and true to some
extent, because X wanted nothing so badly as for her mother to be still alive
and with her, as she wanted her to be, to love and be loved. The system she
had organized, and which she refused to relinquish, allowed a part of herself
to feel in eternal credit, and she tried to corner the analyst into becoming
the impossible substitute for the lost objects and for all that she was
unwilling to recognize as irreparably gone or spoilt for ever. Another part of

herself, though, felt so guilty about her greed and envious resentments that
she was unable to allow herself to enjoy any of the positive things at hand,
many of them achieved thanks to her own efforts in spite of all her losses.
Refusing thus to forsake the illusion of obtaining the impossible, she also
managed to release aggression, depriving herself and tantalizing the
unsuccessful analyst, or accusing others of neglect and deprivation. The
high price she paid for this was the feeling of not participating in life, since
not assuming all of her split parts or responsibility for them engaged her in a
battle for survival, not for living.
All this had been analysed and X would say 'Why should I live this way' 'I
know I'm not obliged to be like mother or to get ill as my brother, I know I
couldn't save him, I'm not guilty but I still can't make it, I can't help it'. At
this point the analyst, who had felt all along that she was being dragged
towards a deadly abyss, told the patient about it saying, 'I'm afraid I can't
help it either, I'm willing to walk with you up to the edge of the abyss and,
as we have been doing all along, try to see things together, but I shall not
jump down with you. I will be very sorry indeed if you do but I shall let
you go by yourself this is your choice and I cannot prevent it. I can help
you see and understand; everything has been said and I cannot really do
any more about it, the rest is up to you.'
In spite of her shock and her attempts to try to convince the analyst that
she still needed her, the realization that analysis could no longer be
maintained in a dead-end, atemporal, immutable dimension became a
turning point of X's analytic destiny as well.
We chose to describe these cases because they were our starting point.
Further observations, however, indicate that the clinical situations can vary
a great deal, as well as the history and the individual pathology of the
patients. What is common, though, in the cases that we observed, is the
technical problem caused by a particular plot of the analytic 'scenario',
whereby the patient's condition is not transformable by transference
interpretations, although paradoxically the problem lies precisely there, in
the transference, so that its working through is essential in any case.
The problem, in our view, lies in the fact that certain patients either try to
impose or succeed in imposing on the analyst a stereotyped role in

accordance with a fixed, immutable internal figure that bypasses other

mental representations and in this way comes closer to actual and factual
reality. It is as ifaccording to the 'scenario' metaphora specific preestablished plot were imposed on us within the analytic relationship, ruled
by a compulsion to repeat the modes in which past intrapsychic events have
been registered and inscribed in the patient's structure.
The analysis and the analyst are invested with an unrealistic task, which
consists in preserving the illusion that what is past or lost for ever can still
be provided and restored. The perpetuation of this demand, accompanied
by resentment about the lack of its fulfilment, is the extreme defence
against the threat of separation; we could say, using the 'scenario' analogy
again, that different patients 'organize' different plays in which they try to
rehearse and practise their longings. The upshot, though, is a constant
pattern, derived from the way in which the intrapsychic events were
inscribed, confirming each time, with its repetitive deceiving outcome, both
that there is no hope at all ('I just can't make it') and the hope that trying
again may fulfil the illusion.
The paradox lies in the necessity to have both opposites coexist. There is no
alternative intermediary space between how 'it was' and how 'it should be';
pathological hope cancels realistic hope and gives way to hopelessness.
Real chances available in life are dismissed, or rather not recognized,
because they do not fit the rigid model that illusion pretends to realize.
Capacity to feel and experience oneself as occupying a dynamic spatialtemporal

dimension,

in

relation

to

others

too,

enhances

sufficient

'symbolictension' to make it possible to think, to discriminate fantasy from

reality and personage from person and thus to organize the boundaries of
mental representations linked with intrapsychic and interpersonal separation
processes. What distinguishes the cases we observed instead is a situation
in which a very tenuous ridge divides illusion from disillusion: experiences of
painful separation cannot be denied but nor can they be accepted; there is
an eternal present in which loss is furiously felt, but the 'drama' which has
already irreparably happened is not recognized or realized as such. We could
perhapsby analogyusefully recall here Winnicott's description, in 'Fear of
breakdown' (1974), of an intense anxiety about some expected catastrophe
to come, whereas what the patient ignores is that it has already occurred.

Both authentic hope and authentic despair need the temporal dimension; it
is necessary to experience a future time within which, for better or for
worse, change and transformation can occur, whereas the reiterative
declarations of uselessness, failure and lack of hope made by our patients
are placed in a non-temporal dimension in which the idea of failure is
fictitious, since all energies are pathologically directed to a past that needs
to be kept immobile and therefore incapable of becoming 'history'. There is
the cult of an illusion which could be defined as a clandestine pathological
hope of continuing to claim what is lost, or perhaps has never been really
enjoyed in the primary relationship, as if, paradoxically, the displayed
despair could be used unconsciously to perpetuate the resented refusal to
give up illusion.
In therapy, the analyst may be invested with one or more roles in this
hopeless/hopeful project. Successful transference working through may do
away with such entanglements, even if it meets tenacious negative
therapeutic reactions or other difficult defence mechanisms. But in the
cases we observed this is not enough. If the analyst becomes one of the
actors in this (internal) play, the paradox arises from the fact that, on one
hand, such an event is an inherent property of transference phenomena,
but, on the other hand, it is precisely this that eludes change and progress.
The problem seems to lie in the incapacity to 'drop the curtain' because the
play is never over, as if it were impossible to bridge the symbolic gap
between being and playing a role. It is so realistically 'played' that even
insight fails to promote access to a partial function of the spectator; or if this
is reached (as in one of the cases), insight into the transference implications
still doesn't provoke decision-making as to whether to continue being a
spectator of the same performance again and again, or not. It is as if this
situation were bound to cancel the creative and transformative quota that
according to Winnicottspreads out of the transitional area and allows for
the role-playing function of the analysis, whilst still conserving the capacity
to discriminate between transference and reality.
Our specific cases confronted us with the need to verbalize to our patients
that it was the analyst who was going 'to drop the curtain' and that, behind
it, the patients were free to make choices according to their feelings, needs,
wishes or possibilities. Analysis was equipped only to help the patient get

insight into these issues, understand their inner roles, and their reciprocal
internal relationship and interaction with reality. Once the script was
disclosed and revealed, as in the second case, the analyst 'consigned' it to
the patient, saying that the play they had agreed to work on together was
bound to end. In the first case the analyst had also given the patient a clue
as to the fact that not all the possible outcomes were in the analyst's power
to govern. Actually both statements, once verbalized, placed the analyst as
a real, whole person who would no longer allow her patients to make her
play an omnipotent or impotent role. In fact it came down to having to state
outright that neither analysis nor analyst were omnipotent rescuers, as the
patients in their illusion needed to believe (X was always ready angrily to
accuse the analyst of not living up to her expectations), but that neither
were they as impotent as an interminable role would require.
In certain other cases we were able to detect the way in which a particular
appeal to omnipotent collusion on our side could enhance the need to foster
the illusion that analysis or the analyst were really the only chance, or that
analysis or the analyst would be able concretely to fill the gaps and become
the object that the analysand lacked, and so undo the past. By doing so, the
chance to mobilize and reorganize the boundaries of mental representation,
linked with intrapsychic and interpersonal separation processes, would again
be hindered. In fact, we feel that if the analyst is caught in such a trap, then
he eludes the only chance analysis can really offer to the patient of
changing his internal organization and the interactions of past, present and
future.
Most probably, many colleagues will identify with these situations and note
various similarities with some of their own cases and the usual difficulties
connected with our work. In fact, we feel that our patients are not at all
exceptional; on the contrary, we are confronted here with quite familiar
kinds of pathology and psychic pain and with resistances that we know are
frequent.

We

have

actually

quite

purposely

simplified

our

case

presentations, leaving out whatever might distract our attention from the
main question.
The particular issue and common element in both cases described, however,
is the peculiar manner in which (a) the resistance organized itself within the

analytical relationship and (b) the specific technical choice that both
analysts put to work at a certain point in the process.
A. We asked ourselves whether the clinical situations that we described
could perhaps be considered as a variation of the wide range of Negative
Therapeutic Reactions (NTR), and therefore related also to the question of
interminable analysis. As we all know, this fundamental concept of Freud's
has evoked considerable attention in recent years and has permitted not
only the elucidation of further meanings of the most persistent and
tenacious resistance, but also the reassessment of such concepts as primary
destructiveness, death instinct, narcissism, masochism, etc., according to
the latest theoretical development. At the same time, however, the original
specificity of the concept risks being diluted; it seems now and then to
assume a sort of general explanatory function for all clinical situations
characterized by obstinate resistances or prevalent destructiveness. As far
as our question above is concerned, as to whether our cases belong to the
NTR or not, we feel that perhaps our clinical material could usefully be
considered by turning to some of the classical conceptual models proposed
by various authors:
unconscious guilt and superego sadism associated with ego masochism as
Freud (1923), (1924) first described it, as well as the ineluctable compulsion
to repeat connected with the death instinct, later discussed in 'Analysis
terminable and interminable' (Freud, 1937);
rivalry and competition with the analyst associated with fear of retaliation
and fears of being envied for one's own triumph, as Horney (1936) pointed
out;
the difficulty of complying with the narcissistic demand for self-esteem
and the consequent manic defence against depressive anxiety described by
Riviere (1936).
B. Another question we feel ought to be discussed is whether such a
technical device as that used by us could be defined as the analyst's 'acting
out', due to countertransference problems. Certainly, in the transference
display of our patients there was a strong unconscious though tangible
pressure on the analyst actively to assume a role, either that of a rescuer
who doesn't yield to despair and 'finances' hope over and over again, or that

of an accuser, giving sadistic and guilt-provoking interpretations, thus

risking either way inducing an interminable analysis. We do not feel that our
intervention was impulsive or that its function was to discharge tension or to
avoid mentalization processes, as typically occurs in acting out.
We felt rather that our intervention was in a way the last card we could play,
and it followed several years of preliminary working through and reflection.
We were quite aware of the risks involvedif not completely of their
meaning, which, although partially understood, became available to more
thorough analytical work afterwards, due to the way in which our patients
reacted. The analyst's statements were an active and sudden rupture of the
transference and therefore inevitably traumatic. We realized to what extent
our patients felt rejected, attacked, accused, refused and suddenly banished
from a containing relationship, and thus inevitably separated from the
analyst.
Because of this we wonder whether this kind of technical strategy can be
used early in the process, since the crucial and critical nucleus articulates
itself within the frame of the analytic relationship, and therefore needs time
to mature and present itself with all its 'evil' depth; all the more so, since it
is our impression that the problems involved date back to very early
preverbal levels, linked with concrete and archaic thought processes that
need to develop, in order to be 'dramatized' and understood in the
analytical relationship in a very specific way. This is why we should feel very
uneasy if our paper were to convey the impression that we are proposing a
technical device that can be successfully applied to or imported into the
countless situations of immobility that we may encounter.
Sometimes the existence of these problems may be suspected from the
very beginning, perhaps even during the first sessions, but we think that the
patient ought to experience for a sufficient length of time and at different
levels the soundness of the therapeutic rapport, the security of being
understood, the benefit of a careful and thorough working through of the
transference, and a relational structure that enables him or her to contain
the comprehension and the elaboration of the disruption of the transference
play.

We must add, though, to conclude, that our awareness of

these

mechanisms, and the fact that we have become quite sensitive to their early
organization

in

the

analytical

process,

is

probably

not

without

consequences. We cannot help wondering whether and how this may

change our way of relatingeven technicallyin such circumstances.
Perhaps, at least we hope so, we shall be able to understand this better in
times to come.
REFERENCES
1 FREUD, S. 1923 The ego and the id S.E. 19 (SE.019.0001A)
2 FREUD, S. 1924 The problem of masochism S.E. 19 (SE.019.0155A)
3

FREUD,

S.

1937

Analysis

terminable

and

interminable

S.E.

23

(SE.023.0209A)
4 HORNEY, K. 1936 The problems of the negative therapeutic reaction
Psychoanal. Q. 5 :22-44 (PAQ.005.0029A)
5 JOSEPH, B. 1982 Addiction to near-death Int. J. Psychoanal. 63 :449-456
(IJP.063.0449A)
6 LIMENTANI, A. 1981 On some positive aspects of the negative therapeutic
reaction Int. J. Psychoanal. 62 :379-390 (IJP.062.0379A)
7 RIVIERE, J. 1936 A contribution to the analysis of the negative therapeutic
reaction Int. J. Psychoanal. 17 :304-320 (IJP.017.0304A)
8 ROSENFELD , H. 1975 Negative therapeutic reaction In Tactics and
Techniques in Psychoanalytic Therapy Volume II ed. P. Giovacchini . New
York: Jason Aronson , pp. 217-228
9 WINNICOTT , D. W. 1974 Fear of breakdown In The British School of
Psychoanalysis: The Independent Traditioned. G. Kohon . London: Free
Association Books , 1986
SUMMARY
The authors discuss a particular technical problem raised by two patients
whose analysis seemed to be at a standstill. The analysands had been
complaining for a long time, repeating with a monotonous, plaintive tone

that there was no more hope for them. The statement of hopelessness
assumed a specific meaning in the frame of their resistance within the
analytic relationship. All possible interpretations had been tried until both
analystsindependentlyresorted to a similar unusual technical strategy
which is the issue of this paper.
The analyst is invested with the unrealistic task of preserving the illusion
that unsatisfied needs or lost objects can be supplied and restituted. This
illusion coexists with constant resentment of its lack of fulfilment. Hope
alternates with hopelessness and the paradox lies in the necessity to have
both coexist as an extreme defence against separation.
The resentment and the mournful complaint represented the last and unique
possible tie with the primary object and giving this up would mean the
definite downfall of illusion and admission that it is really, truly lost for ever.