Alan Roland: What do Psychoanalysts do?
What is psychoanalysis implies how does psychoanalysis work. To my mind, psychoanalysis works by simultaneously combining in different variations two broad ways of working with two very different kinds of emotional problems or psychopathology. The first is the traditional making the unconscious conscious. Or in more significant current terms, working with the internalization of problematic familial relations into the self that interferes with current day relationships. The earlier in childhood this occurs, usually the more severe is the psychopathology. Theoretically, this encompasses both traditional psychoanalysis and object relations theory.
The second vector is when the childhood of the patient is missing important aspects in familial relations that help develop self-esteem and self-cohesion, such as empathic attunement, idealized objects, and those who work with the child on various tasks. Theoretically, this falls within the domain of self-psychology.
Both the problematic internalizations and the missing aspects of what has been needed for the self are manifested in the transference and sometimes the unconsciously induced countertransference. Thus, the analyst must note what is being unconsciously repeated with himself or herself and other persons, as well as what has been missing that is now resurfacing in the transference in the therapeutic relationship. With different patients, as well as with the same patient at different phases of the analysis, the transference may vary, or both can even occur simultaneously. An example is sometimes a strong idealization of the analyst that simultaneously can be a defensive reaction against rage and the need for a missing idealized person. This work with both of these vectors is in the theoretical domain of different variations of intersubjectivity.
To my mind, psychoanalysis is a complex therapy that must encompass both of these continua within the therapeutic relationship. My view is thus a multi model view of working with the transference and countertransference.