Procedures, enactment and clinical validation in psychoanalytical psychotherapy and psychoanalysis

摘要

INTRODUCTION: Procedures used in psychoanalysis and psychoanalytic psychotherapies are presented, emphasizing those that show failures in the analyst's capacity, indicating the need to validate the procedures. For this purpose, differences between Psychoanalysis and Psychoanalytic Psychotherapy are shown as to procedures and objectives. The enactment model is presented and its value in the clinical validation process is discussed as related to the treatment objectives. OBJECTIVES: The objectives of the paper are to describe and discuss ways to validate procedures in psychoanalysis clinically and relate them to the objectives of Psychoanalysis and Psychoanalytic Psychotherapy. METHOD: Clinical-psychoanalytical, illustrated with a patient with OCD. RESULTS-CLINICAL MATERIAL: The dynamics involved in parts of two analytical sessions is presented. It shows that the analyst's failure turned out to be productive when its effect was evaluated (clinical validation), resulting in extending the patient's thinking capacity, the theoretical model used. DISCUSSION: Two items are discussed. 1. Validation, enactment and countertransference: showing the need for the analyst to be part of the scene and use the derivatives of his/her countertransference to understand the enactment. 2. Psychoanalysis and Psychoanalytic Psychotherapy: showing how clear objectives are a condition for their proper validation. CONCLUSIONS: Because psychoanalysis and psychoanalytic psychotherapy deal with complex variables, which are impossible to isolate and control, they need continuous intra-clinical validation, and clear objectives are essential. The enactment model associated with the Bion thinking theory is demonstrated as a basis for this validation.