Second Thoughts About the

Practice of Psychoanalysis Based on

My Personal Experience

D A V I D Z I M E R M A N , M.D.

The main goal of this paper is to share the changes that have been oc-
curring in the theory, technique, and practice of psychoanalysis, and
how they have had a very significant repercussion on my personal way
of thinking, disseminating and daily practicing psychoanalysis.

I WAS BORN IN 1930 IN THE CITY OF PORTO ALEGRE, IN SOUTHERN

Brazil, where I live and practice professionally as a psychoanalyst.
I graduated from medical school in 1954. At first I dedicated myself
to pediatrics, then finished my training in dynamic psychiatry at the
Clínica Pinel in Porto Alegre, where I attained the position of clinical
director. From 1960 onward, I began my psychoanalytic training at
the local psychoanalytic institute, where I graduated as an associate
member, and later a full member. I was invited to work as a training
analyst, to teach theoretical and clinical seminars, and act as an offi-
cial supervisor of training candidates, performing collective super-
visions. Because of my age, I no longer work at the institute, but I still
keep up my routine clinical activity, coordinate study groups on psy-
choanalytic themes, supervise colleagues who seek me out privately,

David Zimerman, M.D. is Full Member and Training Analyst, Sociedade Psi-
canalítica de Porto Alegre; Supervisor, Ad Hoc Member of Candidates, Instituto da
Sociedade Psicanalítica, Pelotas, Rio Grande do Sul, Brazil.
689
690 DAVID ZIMERMAN

write books on psychoanalysis, and accept invitations to give talks at

different venues in Brazil and sometimes abroad.
All my training as a psychiatrist residing within a psychiatric
clinic gave me the privilege of having close contact with psychotic
patients. We made intensive use of group dynamics, and I therefore
wished to learn more about group analytic therapies and their man-
agement. Thus, I was officially acknowledged as a group therapist,
and up to the present, psychoanalytic group therapy is what I teach,
lecture, write, and practice at my private office. It was because of my
interest in learning more about psychotics and group dynamics that I
came into contact with the work of Bion. This led to profound
changes in my way of understanding and practicing psychoanalysis,
besides having produced major changes in me as a person.
Another aspect that I consider relevant in my training is that, as a
candidate, I attended a customary course at the institute of my psy-
choanalytic society; however, in those days, although the teaching–
learning method was carried out following the classical texts by
Freud, psychoanalytic training emphasized above all the theoretical
concepts and technical postulates of Melanie Klein.
After some time in a more advanced stage of training, I began to
feel bored. It seemed that although all clinical papers presented by my
colleagues were very good, they sounded strictly the same—and
strictly Kleinian. The only thing that varied was the presentation of
the personal characteristics of the patient—but it was easy to antici-
pate how the psychoanalytic dynamics would be understood (the in-
evitable rise of envy in the patient, with the respective sadistic-
destructive hatred, followed by persecution guilt, with the necessary
provision of repair, etc.)—and the technical management by the psy-
choanalyst. I felt a worrisome emptiness, a feeling of someone who is
running in place, something already very familiar, saturated with the
same knowledge, so that I felt as though I were moving in circles.
Therefore I promised myself that the mandatory clinical work that I
would soon have to present to become an associate member could not
be along the same lines that were tiring and bothering me internally.
On my own, as discretely as possible, I began to move away from the
clinical discussion activities at our psychoanalytic institute and, in-
stead of continuing to study only the texts of Kleinian authors, I took
a sort of leave of absence lasting two years, a period during which I
worked alone and dedicated myself to reading authors from different
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 691

lines of thinking—whose work until then had been practically un-

known to me—such as Bion, Winnicott, the ego psychologists, Kohut
and Lacan.
I discovered the obvious: I had the right not to be completely faith-
ful to Klein or Freud; to be able to accept, internalize, and practice
many of their ideas (a conduct that I maintain until the present); and to
allow myself to question and even to refute another series of recom-
mendations and impositions that the lines that followed these two ge-
niuses of psychoanalysis imposed (and that did not always harmonize
with my experience in clinical practice, and especially with my true
“way of being”). Thus I slowly built my own identity as a psychoana-
lyst based on the belief that rather than being blindly faithful to my
teachers and to the commandments that then emanated from the Inter-
national Psychoanalytic Association (IPA), my greatest commitment
should be faithfulness to the patients and to myself. It was no longer
as important to be a Freudian, a Kleinian, or a Bionian, et cetera. In-
stead, I picked up and introjected those postulates from different au-
thors who were harmoniously in tune with my condition and personal
way of practicing as a clinical psychoanalyst.
Another personal discovery of mine—also obvious although it
cost me much time and suffering until I realized it clearly and harmo-
niously—was that my attitude of a sort of “rebellion” was not exactly
a gesture of hostility against my institution or colleagues; rather, it
was meant to rid myself of a “psychoanalytic superego” oppressor
(represented by the myth of a sacred Freud, by the dogmatic autoc-
racy of some sectors of IPA, and continued by some teachers, super-
visors, etc.) that asphyxiated spontaneity and creativity, not only
mine, but, I believe, that of a large majority of my contemporaries.
I managed to harmonize the following two aspects: first, the right
to face the ideology and practice of psychoanalysis in a fashion that
was somewhat different from the leading group, and therefore from
the significant majority of the colleagues of our institution; second,
as my mind was no longer saturated by aggressive and competitive, or
guilty and fearful feelings, something opened up inside me, I felt
lighter and more encouraged to put an old wish of mine into practice,
that is, to write a book that would contain psychoanalytic fundamen-
tals, mainly those concerning clinical practice, not so much those
fundamentals that are religiously advocated in public speeches, in
written papers, in supervisions, and so forth, but in fact those that the
692 DAVID ZIMERMAN

vast majority of analysts practice daily, sometimes in a clear contrast

between what they propagate and what they practice!
Thus, as I entered my 60s, encouraged by students who made up
my study groups, I began to write books on the different aspects of
psychoanalysis. Since they have been well received by the public—
there have been seven books so far—I keep on writing.
Accompanying the profound changes throughout the world—so-
cial, economic, cultural, geographic, ethical, scientific, how families
are composed, and changes in each one’s role, the constant frights
that we are submitted to by growing urban violence, a new philoso-
phy of life, the globalization of the modern world, the new computer-
related technologies, and a fantastic instantaneous communications
network via satellite, and so forth—psychoanalysis too presents sig-
nificant changes. Thus, in the present article, I have decided to adopt
a scheme of writing in which I separately and synthetically discrimi-
nate the main transformations—comparing the present of psycho-
analysis to past periods—listing the changes in the profile of the
patient who seeks psychoanalytic treatment. These changes are eas-
ily visible and recognized in the profile of the contemporary psycho-
analyst and the changes that doubtlessly continue to occur in the
process of daily analytic practice.

Transformations in Psychoanalysis

Considering the profound transformations that come with the evolu-

tion of humankind, it could be no different: psychoanalytic science
also has been going through major changes in theory, technique, and
practical applicability. Here we will focus separately on the changes
in the patient, the analyst, and the analytic process. And we will also
say a few words about quo vadis (i.e., “whither goes”) psychoanalysis.

The Patient

As for the patient, it should be said that in the pioneering days of Freud
and his immediate followers care was provided almost exclusively to
patients who presented a clear picture of symptoms typical of some
type of neurosis. Thus, at the beginning of Freud’s discoveries, all of
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 693

his clinical practice was constituted by young, hysterical women; later,

care was extended to patients who had phobic symptoms (the case of
the boy, Hans), obsessive symptoms (the case of the Rat Man), and
other related cases, such as Wolf Man, “Schreber” (paranoia), and
“Dora” (hysteria). Slowly, psychoanalysis stopped being limited to
symptom removal and began to prioritize patients who had some de-
gree of character disorder. Beginning with the Kleinian contributions,
psychoanalysis extended its action to much more regressive patients,
such as psychotics, and also opened its doors to child analysis.
It is actually a well-known fact that there has been a significant in-
crease in the number of children who, motivated by better informed
parents, teachers, and physicians, seek analytic therapy. The same
goes for children reaching puberty, adolescents, and also for men
who are now coming for analysis more spontaneously and with less
prejudice.
Currently, people who seek analytic treatment do so mainly with
complaints about problems relating to some identity feelings disor-
der, and there is also a high proportion of patients with low self-es-
teem, which escalates into the onset of pictures of depression and also
people who feel stress, with a high degree of free anxiety (the high in-
cidence of panic disorder may be a good example of this). Other dis-
orders that prevail today concern personalities of the “false self”
type; narcissist disorders; regressive pathologies, such as psychoses,
borderline cases, perverseness, somatizing, eating disorders (e.g.,
bulimia, anorexia nervosa), drug addictions above all in young peo-
ple, perversions, and psychopathies, and significantly, those patients
who fit into what contemporary psychoanalysis calls the “emptiness
pathology.”
It is more clearly recognized in emptiness pathology that the pa-
tients’ demand for our offices does not so much result from a mental
state in which the subject feels like a sinner as a result of forbidden de-
sires and feelings that suffer repressive action and induce some
movement of flight, which is promoted by many different defense
mechanisms. What we find today is that the initial complaint of pa-
tients requesting this type of analysis often falls into existential anxi-
ety as to the meaning of why and wherefore they are still living, that
is, as to the validity of existence itself.
In the patients who suffer from the emptiness pathology, the axis of
distress does not so much turn around the classical conflicts resulting
694 DAVID ZIMERMAN

from the clash between drives and defenses, or between complicated

object relations and anguishing unconscious fantasies and very primi-
tive defenses; it really turns mainly around the lacks, resulting from the
faults and failures that were installed during the initial stages of primi-
tive emotional development and determined the formation of voids in
the ego, real “black holes” waiting to be filled by the figure of the psy-
choanalyst, which may be achieved by means of his psychoanalytic
function.
Furthermore, patients currently seeking some form of psychoana-
lytic treatment present a clear tendency to seek speedier solutions
and, alleging economic reasons that are real—because it is undeni-
able that purchasing power is generally much diminished—they in-
sist that they want fewer weekly sessions and a shorter duration of
analysis. All of this, together with the success of antidepressants and
the negative arguments of some sectors of the press against psycho-
analysis, leads many patients to present a dangerous preference for
alternative methods that promise rapid, sometimes miracle cures.

The Psychoanalyst

As for the psychoanalyst, a very modified profile now prevails. Thus,

during the time of both orthodox and classical psychoanalysis, the at-
tributes that were most valued in the person were their ability to de-
code the latent conflicts that appeared indirectly in vestiges of
manifest contents expressed in parapraxes and lapses, dreams, symp-
toms, and in the folds of the “free association of ideas.” Equally, a
good psychoanalyst is supposed to remain completely faithful to the
rules of abstinence, neutrality, and anonymity so as to keep a distance
(which I was about to describe as “aseptic”) from the patient.
Above all, however, the exclusive use of performing brilliant in-
terpretations—insofar as they discovered a symbolic meaning in ev-
erything that was narrated by the patient—constituted a quality of the
psychoanalyst related to that of a deity. Beginning with the Kleinian
influence, the seal of legitimacy that conferred the status of an excel-
lent analyst reposed in his skill at systematically performing “trans-
ferential” interpretations that, independent of everything said by the
patient, was usually converted in a reductionist form to the person of
the therapist, using the classical old saw that everything the patient
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 695

brought should be interpreted based on “It is here with me now, as

there and then.” At the height of the aegis of Kleinianism—the 1960s
and 1970s—it was a basic requirement that the interpretations be
guided toward the “internal, partial objects,” that is, the analyst per-
ceived by the patient as partially a breast (or penis), good, bad,
idealized, persecuting, or a total object composed by these last four
elements.
Equally, in a way that was practically accepted by everyone, anal-
ysis was performed unilaterally: on the one side, lying on a couch was
a suffering patient whose role was limited to performing free associa-
tions to present his “material,” while on the other side, behind the
couch, relaxing in a comfortable easy chair, was the analyst, with his
attitude as a “subject supposed to know.”
In contemporary psychoanalysis, which results from a combina-
tion of contributions by different authors from different psychoana-
lytic schools, the psychoanalyst’s profile has undergone significant
changes. Thus, in the past few decades, mainly and more markedly
since Bion, the analyst is considered no more than a person, well-
trained and prepared, who, with the other person—the patient—con-
stitutes the analytic field, that is, a mutual and permanent interaction
in which each person influences and is influenced by the other. Thus,
the evidence that the analytic relationship creates a bond signifi-
cantly changed the profile of the contemporary analyst. I believe that
the following characteristics deserve to be mentioned:

1. The analyst has come down from his plinth; he has changed his
home, because he no longer resides on the Olympus of the sacred
gods, so that he can no longer show off his pompous Sujet Supposé
Savoir emblem, that is, the therapist who when interpreting believes
that he is dictating the definitive truth. Today the analytic therapist
feels more like an ordinary person, like all persons; what prevails in
him is the acceptance of an attitude of uncertainty, so that this latter
aspect favors the formation of a necessary interrogative state of mind
that begins with uncertainties and healthy curiosity.
2. In this way, the emphasis of analysis is on the analytic bond that
unifies two people, the patient and the analyst, so that although a neces-
sary asymmetry is maintained between the roles, places, positions, and
functions that each of them is to perform, there is greater symmetry re-
garding the condition of being human, and therefore subject to the
696 DAVID ZIMERMAN

same anxieties and existential doubts. Thus, although the analyst pre-
serves the required distance from the patient, he is more spontaneous,
informal, and has an affect that can be more easily modulated. A signif-
icant proportion of current analysts is already accepting the inclusion
of a few parameters, such as the use of medication concurrently with
analysis, some reduction in the number of weekly sessions, answering
certain questions asked by the patient, being able to make a few recom-
mendations (like the need for medical services), respecting the pa-
tient’s freedom to use the couch or not use it, and so forth.
3. As a result, although the contemporary analyst continues to
value the transferential movements of the patient, he does not present
himself in a systematic and reductionist way, as being the only center
of the universe in the analysand’s life. This analytic attitude has
transformed the analyst into a simpler person, with a more open atti-
tude to listening to the multiple dimensions that are enclosed in the
patient’s narratives.
4. Thus, in our times, an old controversy is growing: whether in
the analytic situation the psychoanalyst appears to be simply a trans-
ferential screen for the multiple and diverse objects that inhabit the
interior of the patient’s psyche or, going well beyond this, whether he
also decisively influences the fate of analysis because of his status as
a real person, as I particularly believe.
5. If we accept the legitimacy of the latter hypothesis, the impor-
tance of the analyst’s attributes as a real person grows, as in the case
of his code of values (moral, cultural, ethical, etc.), his psychoana-
lytic referentials, his intrinsic capacities as a container, empathy,
intuition, and so on.
6. Based on the possibility that the importance of the “real person
who is the analyst” is valid, another aspect gains relevance, what some
North American psychoanalysts call a match, that is, a “meeting” of the
characteristics of a given patient with those of a given analyst, so that
the analysis of one patient by two analysts of equal competence and be-
longing to the same psychoanalytic line may develop well with one and
badly with the other, and vice versa.
7. As to the internal psychoanalytic attitude of the therapist, in con-
temporary psychoanalysis the rational position of the analyst who clas-
sically seeks logical and consequent connections between causes and
effects has been giving place to what is not formally logic, such as what
is present in the “principle of negativity,” that is, in the contradictions,
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 697

the paradoxes, the concomitance of the opposites of what the patient

brings us, sometimes in a chaotic form, unconsciously expecting the
analyst to be able to perform an integration.
8. Consequently, the contemporary analyst no longer feels under
the obligation to fanatically obey the concepts that emanate from au-
thorities above him, as being the holy scriptures of psychoanalysis,
so that he values what he has learned but has begun to have greater re-
spect for his rational, affective, and intuitive consensus when facing
each patient separately in daily practice.
9. The recommendation that the analyst should hold to a given
school, under the argument that he would thus avoid becoming dis-
persed in a diluting and thus impoverishing “eclecticism,” is being re-
placed by the valuing of a multiple formation, that is, the advantage of
having the analyst know the contributions of different authors, differ-
ent psychoanalytic lines, to freely construct his true identity as a
psychoanalyst, respecting his personal style.
10. Economic and cultural changes, as well as the competition that
alternative methods—especially those of modern psychopharmacol-
ogy is imposing on psychoanalysis—lead to worrisome empty spaces
in the office schedules of many analysts, including many of those who
are acknowledged as veteran and competent. This is in flagrant con-
trast with a recent previous era, when it was usual to find a long waiting
list for some psychoanalyst of renown. Especially among candidates
and young analysts, there is an undisguisable fear of losing patients, a
fact that somehow influences the development of analysis.
11. Another fact that characterizes a change in the analyst’s pro-
file compared to the past is that, in keeping with the movement of
change in the very ideology of psychoanalysis, the therapist of today
is trying to perform a broader and more solid integration of psycho-
analysis with the other disciplines of human knowledge.
12. I believe that it is useful to reflect on the fact that changes are
sometimes cyclical. Thus, since before the common era, there was no
strict discrimination between the notions of organic–psychogenic,
sacred–profane, material–spiritual, objective–subjective, real–imagi-
nary, or conventional–mystical. Based on the Cartesian rationalism of
Descartes, the respective distinctions began to be imposed on philoso-
phy and on the incipient scientific movements. However, now that a
few centuries have gone by, the current scientific trend is to go back
to integrating the manifestly opposing and apparently contradictory
698 DAVID ZIMERMAN

aspects in a single unit, without the radical distinction that formerly

existed.

The Analytic Process

Here is an extremely synthetic list of some of the factors that have

contributed to the changes in the way I now think about and practice
psychoanalysis.

1. The multiplicity of psychoanalytic lines. At the beginning of

my psychoanalytic training—in the early 1960s—the referentials
that constituted the teaching–learning of candidates to the local psy-
choanalytic society were practically all based on the metapsychol-
ogy, theory, and technique of Freud and Klein, with scarce references
to pioneering authors of the ego psychology school, such as Hart-
mann. Actually, what predominated in those days was the foundation
of the Kleinian school, which we dissected to exhaustion. Currently,
the psychoanalytic institutes open their doors to the other psychoana-
lytic schools that were formed based on the roots and the great main
stem of Freud. In this way, the candidates take up contact with the
main contributions from the seven schools of psychoanalysis: Freud,
Klein, ego psychology, self psychology, Lacanian structuralism,
Winnicott, and Bion.
2. New paradigms of psychoanalysis. For decades, the paradigm
prevailing in psychoanalysis was the Freudian model that we might
call drive repression (the clash between drives, especially the forbid-
den libidinal desires, and the ego defense mechanisms).
Around the early 1960s, Klein and Fairbairn separately developed
the second paradigm, the theory of object relations, which gained a
hugely important space, especially in the British and Latin American
Cone societies. This second model of a paradigm may be called ob-
ject-phantasmic because there was such great emphasis on the uncon-
scious fantasies linked to internalized part objects.
The third paradigm, based on the work of Bion, I propose to call
bonding-dialectical. It bases analytic work on intrasubjective and
intersubjective bonds, so that the analyst must be in permanent dia-
lectical interaction with his patient—that is, to the thesis presented by
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 699

the patient (his psychic reality), the analyst proposes his antithesis
(through interpretative activity), from which a synthesis (insights) re-
sults, which in turn functions as a new thesis, and so on, in an ascend-
ing, expansive spiral movement promoting mental growth.
At present, a fourth paradigm, which refers to deficits-emptiness,
is highly valued. That is, the formation of real psychic “black holes”
resulting from the primordial defects in the course of primitive emo-
tional development, from which many patients who have what we call
an emptiness pathology suffer and who, above all, are waiting for the
analyst to fill.
It is clear that these four paradigms are not mutually exclusive; on
the contrary, they are complementary, although each of them is more
applicable according to the uniqueness of the psychopathology in a
given clinical situation.
3. Psychoanalysis and psychotherapy. At the time when I began
my psychoanalytic training, a great distance was imposed between
psychoanalysis and analytic psychotherapies, to the point that if a
therapist who did not have official psychoanalytic training “dared”
perform a transferential interpretation, even though it were obviously
necessary, he ran a great risk of being said to be “acting.” This situa-
tion has been changing substantially, although there are still strong
groups of psychoanalysts who insist on maintaining a Manichean po-
sition, using the old resource of denigration by saying the cruel
words, “This is not psychoanalysis,” regarding everything that does
not lie within the framework of their assumptions.
As to this, the predominant position in current psychoanalysis is
summarized in the well-known metaphor that emphasizes the un-
equivocal existence of complete differences between what character-
izes day and night; yet, there are the states of dawn and dusk, where
differences disappear, since in these cases night and day interpen-
etrate and meld together. Well, the same occurs with a few obvious
differences that exist between psychoanalysis and psychotherapy;
however, it is undeniable that increasingly the confluence zone of a
dusk or a dawn between both is clearly expanding.
In this way, the external criteria that are commonly used to define
what is “true psychoanalysis” (a minimum of four sessions a week,
compulsory use of the couch, systematic use of transferential interpre-
tations, etc.) are losing their legitimacy and being replaced by intrinsic
700 DAVID ZIMERMAN

criteria, such as those of greater accessibility given by the patient to the

analyst (and to himself) of getting to know his unconscious, and espe-
cially whether true psychic changes are occurring or not.
4. Analytic field. A number of elements and psychic phenomena—
such as the setting, resistance and counterresistance, transference and
countertransference, communication, interpretation, actings, identifi-
cations, insight, working through and cure—constitute the analytic
field, in a permanent, interactive two-way direction between the pa-
tient and analyst. This is not the place to go into details about each of
the aspects mentioned. I will refer only briefly to each of them, con-
cerning what, in my opinion, basically looks like a significant trans-
formation from the past to the present.

Setting. Going well beyond the meaning that alludes to the neces-
sary combination of rules, arrangements, and combinations that favor
the development of an analysis, I currently consider insight the cre-
ation of a new space—single, rare, and unique—in which the patient
will once again experience, with his analyst, old emotional experi-
ences that were ill-resolved in the past by his environmental sur-
roundings and, consequently, by himself as a child.
Thus faced with a new model of empathy and continence that he
experiences with his analyst in an emotional atmosphere that he did
not yet know, the patient promotes resignifications and deidenti-
fications, followed by new meanings for past facts and fantasies, and
new healthy identifications in place of those that are pathogenic.
The use of the technical rules recommended by Freud, which con-
stitute a basic pillar of the setting, has also undergone rather signifi-
cant changes. Within this conception, it may be stated that the setting
in itself constitutes a major psychoanalytic therapeutic factor, espe-
cially if we take into account that the simple presence of the real per-
son who is the analyst significantly contributes to the “atmosphere”
of the analytic field and to the institution of “new identification
models” for the patient, not so much by what the analyst interprets
verbally, but mainly by how the analysand introjects what his psy-
choanalyst in fact is.
As to the previously mentioned technical rules that are part of the
setting, I maintain the essence of what Freud recommended to us so
emphatically, but I significantly changed the radicalism of the mean-
ing of each of the aforementioned rules. Thus, the first of them, the
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 701

one Freud considered the golden rule, the fundamental rule, the “rule
of free association of ideas” that we know today was not all that
“free.” This includes the fact that Freud (1912) recommended that the
analyst impose on the “patient the obligation of saying everything
that came to his mind, whether he considered it important or not.”
Nowadays I understand that the patient should be free to speak or not
(among other reasons because he may “speak” a lot and “say” little or
nothing; on the other hand, he may speak little, sometimes even re-
main silent, and “say” a lot through other forms of nonverbal lan-
guage). Moreover, today I consider the “rule of abstinence” very
relative and apply it much more flexibly, so that I allow myself to an-
swer certain questions from the patients, indicate certain books or
films, recommend certain competent professionals, and so forth.
Now, as to the third rule, that of “fluctuating attention,” I consider it
fully in force and highly important, especially if we add a few contri-
butions made by Bion to this rule—for which he gives full credit to
Freud. Bion’s contribution is that in the analytic situation the “ana-
lyst’s mind cannot be saturated with memories, desires, anxiety about
understanding and preconceptions.” The fourth technical rule be-
queathed by Freud—that of “neutrality”—is the one that has under-
gone the greatest changes. I believe that supported by this technique,
many analysts maintain strict neutrality and anonymity, which ac-
quires a tone of coldness, almost indifference and asepsis, and may be
in the service of a certain phobia concerning a more intimate relation-
ship with their patient. In fact, I think the analyst should indeed be-
come affectively involved with his patient, as long as he does not
remain involved with him and never loses the preservation of the set-
ting that has been instituted, with the respective places, roles, and
functions occupied by each person in the analytic dyad.

Resistance. Until recently, the (inevitable) onset of some type of

resistance in the patient during the course of analysis was considered
an obstructive factor that was to be overcome, as a priority factor. In
current psychoanalysis, although it is quite clear to us that there re-
ally are obstructive resistances that are sometimes deleterious to the
free course of an analysis, in the vast majority of analytic situations,
resistances constitute an excellent sampling (like the budding of the
first fruits shows which is the original fruit tree) of how the patient
has constructed his inner world, and how, from there, he acts in the
702 DAVID ZIMERMAN

external world. Therefore, I usually summarize the beneficial impor-

tance of the resistances with the phrase, “Tell me how you resist, and
I’ll tell you who you are.” The traditional form of interpreting the pa-
tient’s resistances gave the impression that the analyst was criticiz-
ing, or even condemning, the patient (and thus reinforcing an already
existing punitive superego), to make it seem that using resistances
could be a voluntary, deliberate, conscious act on his part, and not so
much a conjunction of unconscious defenses against the threat of the
onset of terrible threats to his ego. I now do a lot of work with the
resistances that oppose a growth in the quality of life of the patient
himself. These are different modalities of pathological organiza-
tions—to which I propose to give the generic name of counterego
(Zimerman, 2004), which, acting within the ego itself, like an “enemy
in the trenches,” resists changes and, by means of unconscious
boycotts, especially sabotages the possibilities that would make the
patient grow.

Counterresistance. It is useful to highlight the difference the ther-

apist of today should make between the resistance that comes from
the analyst himself and the resistance that is aroused in the analyst by
the patient. The important aspect to be recorded is the possibility that
unconscious conspiracies will arise in the analytic dyad, such as that
of a “reciprocal narcissist fascination” (Zimerman, 2004), in which
analyst and patient idealize each other mutually, so that no space is
left to analyze the possible onset of any aspect of aggressiveness, and
both maintain a permanent complicity of stagnation in analysis, in a
“conspiracy of accommodation” (Zimerman, 2004).

Transference. The phenomenon of transference was considered by

Freud one of the phenomena of a compulsory need for repetition. Now-
adays it is considered basically the opposite—that is, a repetition of
needs that have been badly resolved, awaiting a new chance that the pa-
tient gives the present analyst (differently from what may have hap-
pened in his past relationship with his parents or possible girlfriends or
boyfriends, spouses, and past analysts) to be understood, contained,
and filled in on his basic defects. This exemplifies that many of the
concepts—the way of dealing with the onset of the transferential phe-
nomenon—are rather changed. At the time when I trained, the term
negative transference led to an immediate assumption that there was
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 703

something wrong in the relationship between the patient and his ana-
lyst; currently, I believe that once the negative transference has been
well understood and managed, it may be a highly positive experience
from the viewpoint of evolution of the psychoanalytic situation, since
the manifest aggressiveness of the patient may mean that he is gaining
greater confidence in himself, in his analyst, and in the bond between
them, so that he allows himself to reexperience old emotions and ver-
balizations that used to be forbidden to him.
Another practical aspect that refers to the connection between
transference and interpretation is that there is transference in every-
thing, but that not everything is transference to be worked on in the
analytic situation. In many cases the analyst is interpreting correctly
from the standpoint of content, but insisting on the “here now with
me,” while the patient “couldn’t care less,” so that in these cases the
analyst needs to dedicate himself to “constructing the transference”
(Zimerman, 2004). In my function as official supervisor of psychoan-
alytic training candidates, I valued removing from the candidate the
obligation of systematically taking on the role of “transference
hunter.”

Countertransference. This phenomenon is indissociable from trans-

ference. In the early days of psychoanalysis, countertransference re-
ceived credit neither from Freud nor Klein, but today it is considered
as a probable primitive channel of communication, and also as a po-
tential instrument of empathy with the patient. Just as was said about
contraresistance, here too it is the task of the current analyst to dis-
criminate when his feelings that emerge in the sessions, which are
sometimes very difficult, are his responsibility only, or when the
emotional reaction emerges in him, because the patient somehow
“puts it inside him,” the analyst, through the phenomenon known as
projective counteridentification.

Communication. Communication is no longer just the patient’s

verbal statements; nonverbal communication, in its different modali-
ties, has become highly relevant in the current technique. It is known
that the “greatest evil of humankind is the problem of misunderstand-
ings in communication”; this is basically caused by disorders of the
three main component factors of communication: emission, recep-
tion, and channels of communication. The content of the message that
704 DAVID ZIMERMAN

is being emitted, either by the patient or by the analyst, is not enough:

one must value the tone of voice, the attitude (arrogant? excessively
timid?) As to the reception of messages, in the analytic situation, the
form of listening is of essence, especially listening how each person
in the analytic dyad was listened to by the other. As to the channels of
communication, besides the classic verbal one, nowadays the multi-
ple nonverbal modalities should be greatly valued, such as somatiza-
tions, actings, and countertransferential effects.
A particularly relevant aspect of contemporary psychoanalysis re-
fers to the form of primitive communication that is expressed by im-
ages or by means of ideograms, holograms, and photograms that
erupt into the analyst’s mind, aroused by “something” contained in
the patient’s narrative.

Interpretation. The analyst’s art of interpreting is undergoing a

profound change. Our interpretative activity once involved a system-
atic symbolical decoding—and transference—of everything the pa-
tient said. The same exaggeration, still quite persistent in some
sectors, is the systematic interpretation reduced to “It is here and now
with me,” thus running the risk of not taking sufficiently into account
the significance of that special moment when the patient spoke. Cur-
rently, it appears that things are changing a lot: the analyst now real-
izes that his interpretation is not a categorical sentence, a final truth,
but that his interpretation is really no more than a hypothesis that may
be accepted or refuted by the patient. Presently, interpretation still
plays a fundamental role in the analytic process, but there is a grow-
ing conviction that many other factors “beyond interpretation” also
have an important function.
Nowadays, I also establish a difference between formulating an
“interpretation proper” and practicing a permanent “interpretative
activity,” which consists of clearing up points, showing contradic-
tions, paradoxes, and, above all, asking questions of the patient. I ask
questions to collect data or to cross-examine the patient as the defen-
dant, and I as the prosecutor. The questions that I refer to are, by far,
those that instigate the patient to exert his capacity to think.

Mapping the psyche. The human psyche never behaves like a mas-
sive block with a single voice; on the contrary, it is compartmented
and looks more like the map of the world, in which the different
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 705

regions of the earth are highlighted. Any subject has very different
“parts,” so that in the same space of the psyche the “childish” part
lives together with the adult part, the psychotic part of the personality
with the nonpsychotic one, the conscious with the unconscious, the id
with the ego and the superego, and so on. Although all these elements
of the psyche separately maintain a certain autonomy and differentia-
tion of their functions, they allow several combined arrangements
among themselves and are always interacting. The analyst must pay
real attention to the fact that the human mind also is constituted by
different zones, with specific characteristics and functions that oper-
ate distinctly, sometimes harmoniously, but most of them configure
contradictory aspects. We can extract at least two important applica-
tions for psychoanalytic practice: the first is that the analyst always
works with a multifocal view. That is, at the same time he keeps his
eye on a certain more manifest aspect of the patient at a given moment
of the analytic situation, and looks on other aspects that may be the
complete opposite of those that he first perceived. The second practi-
cal application consists of satisfactory mapping of his patient’s psy-
che; if not performed, analyst and patient run the serious risk of feeling
lost, confused, ambiguous, and contrary, with a high probability of act-
ing out and being inconstant persons.

Functions of the conscious ego. Psychoanalysis used to almost ex-

clusively value the unconscious aspects, but nowadays it is indis-
pensable to also analyze the conscious ego—that is, the functions of
perceiving, communicating, getting to know (or not wanting to
know), knowing how to think, critical judgment, and so forth. More-
over, it is essential that the patient take conscious responsibility for
what he says, thinks, and does so that, rather than simply accessing
the conscious of what is hidden in his unconscious, he acquires the ca-
pacity to release transit of communication, in a two-way direction,
between the conscious and the unconscious.

Actings. At present, actings are no longer considered “dirty words”

and may be used as an excellent means of showing how the patient is
communicating—in a nonverbal mode—aspects with which he cannot
yet get in touch. This difficulty promotes actings, such as those in
which the patient acts anguished feelings he cannot recall, know, think,
verbalize, and contain.
706 DAVID ZIMERMAN

The script of the theater of the psyche. One of the most impor-
tant aspects of contemporary psychoanalysis is the value attributed
to the old inscriptions (a conceptual term used by Freud) that re-
mained imprinted on the mind, with the respective significants (a
term of Lacan’s) constituting in the form of a network, true plots
with a given story and different characters acting on a stage to-
gether, under a director, all taking place in the theater of the mind,
which maintains its essence even if the play is reproduced for de-
cades or centuries and only the actors change. Equally, the archive
of the inner psyche consists of a few theater plays, which may be re-
produced endlessly in the outer world. An example may be the repe-
tition of a play that deals with a “suffering love,” which, against all
the logic of the very person who is a prisoner of this unwholesome
situation, goes on endlessly, amidst painful humiliations. This is
different from the classical concept of masochism. Another exam-
ple refers to a type of bond of love that is configured by the repeti-
tion of situations of abandonment, so that when an adult provokes
his own abandonment by another person (a very frequent situation),
they may be reproducing the script, under the same previous condi-
tions in which they sought their mother in a mixture of feelings of
helpless anguish, accompanied by some form and degree of excite-
ment and enjoyment. In such cases, there is a compulsive need for
the subject to repeat the play that could be called An Interminable
Meeting with One’s Own Failure to Meet.

Insight, working through, cure. There are different types of in-

sight. Currently, cognitive insight (very different from intellective in-
sight) is being greatly valued. As to the “working through” of the
partial insights, the analyst of today assigns great importance to the
patient’s developing the capacity to “learn from the experiences”—
of life and of the analytic act—the good and the bad.
The analytic “cure” is never complete, according to Freud’s cele-
brated concept that “we can resolve neurotic miseries, but never the
misfortunes of life.” The important thing is that the patient has had
significant mental growth, a strengthening of the ego, and that he is
sufficiently equipped to face the natural vicissitudes of life, in addi-
tion to arousing a feeling of freedom, acquisition of latent capacities,
creativity, and fruition of pleasure and leisure.
SECOND THOUGHTS ABOUT PSYCHOANALYTIC PRACTICE 707

REFERENCE

Zimerman, D. Z. (2004), Manual de Técnica Psicanalítica [Psychoanalytic technical

manual]. Porto Alegre: Artmed

Rua Comendador Caminha 286/404

90430-030 Porto Alegre, RS, Brazil
dgzimer@terra.com.br