Contemporary Psychoanalysis, 2005 (41) 159-181

THE PERSISTENCE OF LAYERING LOGIC:

DRIVE THEORY IN ANOTHER GUISE

ABSTRACT

Even those who reject drive theory have had their thinking shaped by its conception of walled-off content. This inevitably generates a one-person psychology, despite the belief that working from a two-person psychology is a matter of choice. Drive logic, with its conception of fixed layers, is so intuitively compelling that it has obscured the way the (misnamed) structural theory conclusively invalidated it by conceiving of defense and defended-against as reversible, even as “in motion.” The revision requires a continuing differential diagnosis to determine what is defense and what is defended-against at any given time, one that rests on the patient’s response and therefore is, of necessity, a two-person psychology.

My argument proceeds from early vignettes, followed by two contemporary case reports that can demonstrate the unrecognized continuing influence of layering logic in the understanding of dynamics and in inviting unyielding reliance on an interpretation despite a patient’s protests, the sine qua non of one-person analysis.

Psychoanalytic theory is known for incorporating rather than resolving contradictions. Perhaps the clearest example of this is Rapaport and Gill’s (1959) widely accepted proposal that the early model be represented side-by-side with revised model of the twenties as simply “points of view”—as complementary vantage points. Gill (with Apfelbaum 1989) later sharply diverged from this position, as also did Arlow and Brenner (1964) earlier, in their stated conviction that the original and the revised models “are neither compatible nor interchangeable" (see also Brenner, 1980). This accorded with Jones’ (l957) view that Freud, prior to his revisions in the twenties, saw his life work as complete and therefore “there was not the slightest reason to suspect that in another few years Freud would have produced some revolutionary conceptions which necessarily had the effect of extensively remodeling both the theory and the practice of psychoanalysis (p. 265).

As it now stands, despite Jones, et al., the consensus appears to be that Freud’s contributions in the twenties were additive rather than revisionary. The essential question here is how radically the structural conception of id, ego, and superego diverges from the original conception of an Unconscious with a conscious overlay. The revised conception appears merely additive—no more than another point of view—if it is seen as a redrawing of the mental map, an elaboration of the original psychic areas. What is truly radical that Jones, et al., were referring to is an abandonment of the concept of psychic areas. This was a move about which Freud himself had been ambivalent, and of course, id, ego, and superego do call up the vision of psychic sectors, each with its own unique contents. However, as Gill, and Arlow and Brenner have shown, there are no ideas or feelings unique to these three categories. Hartmann (1951, p. 148) referred to them as ”units of function,” meaning that any idea of feeling can take on an “id character,” an “ego character,” or a “superego character.” In the original model, drives were “in” the id. In the revised model nothing is “in” the id. Boesky (1988) put it this way: “The essence of the structural theory” is that “the id, ego, and superego . . . are not three boxes. Nothing can take place ‘in’ only one of the three major systems. Everything ‘in’ the three systems is everywhere” (p. 305).

What can be disconcerting about Boesky’s assertion, even some fifteen years later, is that we are accustomed to thinking of drives and their derivatives as in the id and guilt as in the superego. But if we think of id and superego as describing the function a mental content can take on, we mean, for example, that guilt can have an id function and drives can have a superego function, as in the form of a sadistic superego—when the superego is “in league with the id.” This means that when encountering a specific mental content, we cannot determine a priori whether it is functioning as drive or defense. This is a sharp departure from the original model, according to which drive and defense are categorically different.

The original conception of mental sectors with indigenous contents does have a commonsense appeal, as in sophomore psychology texts, in which the superego is equated with the conscience of commonsense experience (despite Freud’s effort to clearly distinguish between the two). Even in professional discussions there are references to “the Unconscious,” despite the well-established conception, first enunciated by Freud (which then required him to revise the original model), that no mental content is intrinsically conscious or unconscious—that these are characteristics (“qualities”) that may be true of any mental content. The very term “structure” reinforces these holdovers. Beres (1965, p. 62) commented that misunderstandings might have been avoided if the structural theory had instead been named the functional theory.

However, what may primarily be responsible for the persistence of the original conception of psychic territories is what could be called “drive logic.” In the original model drives were repressed and defense was an overlay. In Boesky’s terms, each was in its own box. This vision can be seen as influential, unquestionably among non-analytic therapists, but less obviously among analysts as well, most tellingly in the form of the layering paradigm—defensive ideas and affects confined to their own “box” above, defended-against ideas and affects confined to their own box below. The underlying content need not be a drive derivative, but what it will have in common with the drives of the original theory is the vision of a truth that the patient is unable to come to terms with. My purpose is to show how this conception, that is, drive logic, persists even among analysts who reject drive theory.

In a case to be discussed in detail below, the patient’s presenting symptom was an intense sexual aversion, an obsessive belief that he was disgusting to women. This aversion looked convincingly like a defense against a drive derivative, a defense that could be seen as constantly being broken through by vivid and omnipresent fantasies in which he was erotically involved with any women he met or saw. The revised model makes it possible to see the sexual fantasies, not only as threatening, but also as welcome when his aversion became a threat. The aversion was, after all, his symptom—an alien experience that made him feel incapable of a sexual relationship. When he was most disturbed by the aversion, his erotic fantasies had the meaning that he was a sexual being after all, and hence they could be reassuring rather than threatening. Thus, what would appear from the perspective of drive logic to be the breakthrough of a drive derivative could actually be a reversal of drive and defense. From the revised perspective the sexual fantasies could be understood as gaining their urgency from the patient’s need to ward off his aversion, making them especially vivid and hence creating the impression of a biological imperative. Similarly, their omnipresence could be explained in terms of the compulsion to overcome his aversion.

The paradox here is that what appears from the perspective of drive logic to be the breakdown of a defense may actually be the breakdown of the theory. In other words, when the simple defense/drive conception does not hold, this can be seen as requiring a more comprehensive theoretical explanation, one in which defense and drive are not discrete layers with fixed content, but can exchange functions. In the original model, drives came with their own meanings, obvious to the observer. In the revised model, drive could be in the position of defense: whatever the nature of the drive, it is relevant only in relation to other mental contents—what function it serves—which depends on its meaning to the patient in the moment.

What does determine whether a content is defense or wish is its relation to another content, as Gill (1963) elaborated, referencing Fenichel's (1941, p. 58) formulation that a content is in the position of defense relative to another content when it is "nearer the ego." It is being held (consciously or unconsciously) by the ego as a way to ward off another content. This requires a differential diagnosis, as it were, to determine what is defense and what is defended against in any given instance.

In another case to be discussed at length, the patient’s intense rage looked like a primary substrate—an underlying layer, but outside the context of the layering paradigm it could be seen as gaining its force from the necessity to overcome the shame it engendered. Discussion of these cases is preceded by five brief examples that serve to illustrate the layering perspective of unreconstructed drive theory.

HOW DRIVE-MODEL LOGIC OBSCURES DEFENSE

Drive theory, of course, at least in its original form, provided the prototype for the layering model. Defense was an impediment to analysis, a layer which might not yield to interpretation and therefore would have to be overcome or broken through. Although the early decades provide the best source, Gedo’s contributions make a pointed introduction, since he exposes the interpretive insufficiency of this approach while remaining committed to it, his solution being, as is well known, to go “beyond interpretation” (1979). In treating a grandiose patient who apparently would give a nod to interpretations, only to return to expressing his grandiose self conceptions, unaffected, Gedo (1995) finally told him that “dealing with him was like barking at the moon.” When even this comment was disregarded by the patient in his usual way, Gedo “began to respond to his obstinacy by imitating a dog that howls in distress.” The patient “finally got the point” (pp. 3-4), although we are not told what convinced Gedo of this (nor what point the patient would have gotten).

Gedo (1981) offered an especially crisp statement of the futility of drive-logic interpretations (referred to here with some asperity as “intellectual explanations”) in unresponsive patients who either cling to infantile gratification (the pleasure principle) or are driven by self-defeating aims (beyond the pleasure principle). Speaking of the latter, he argues that: “Whenever the behavior of the analysand lies ‘beyond the pleasure principle’, it cannot be dealt with through intellectual explanations alone” and consequently:

The emergencies I am trying to describe do not permit us to engage in the elucidation of fine points. As Napoleon remarked about ending the tryanny of the Paris mobs, “Give them a whiff of grapeshot!” [p. 169n]

That is, the analyst needs to be free to be an unambivalent authority with patients who are determined to resist, even ”tyrannically” determined. Aligning patients with the Paris mobs gets across the siege mentality of the analyst who is pitted against defense. A more neutral analyst would clearly end up on the guillotine.

In another context, Gedo (1997) reports that when he complained to his own analyst, Gitelson, about his habit of "puffing on stinky cigars while he worked," Gitelson "was wont to reply with something like, 'Why do you think you want to knock the cigar out of my mouth'?" (p. 7). This interpretation is of the form “When did you stop beating your wife?” and although it is only as Gedo recalls it many years later, subsequent examples are in the same vein. This ex cathedra delivery was not merely a style but was considered to be a necessary component of effective interpretations, being prized as an avoidance of collaboration with defense.

Although this hardly needs documentation, two citations convey the essence of this necessarily confrontational style (already “beyond interpretation,” as it were). Stone (Langs & Stone, 1980) commented that "to be 'tough' with a patient is regarded as all right. To be a little gentle with a patient is always suspect" (p. 9). Hamilton (1996) in her report of interviews with practicing American and British analysts done between 1988 and 1990, reported that an “elderly analyst of international standing,” when asked if he uses qualifiers in making an interpretation, such as, “I think...,” or “Is it possible that...?”, answered, “In general I avoid it. Sometimes, under certain circumstances, I might say something like, ‘It might be’” (p. 262). Although this style has fallen into disrepute in many quarters, its substance survives, in part because it is treated as only a style, even an indulgence in the exercise of authority, rather than as an outcome of the layering paradigm, that is, of drive logic.

Gitelson’s sally was of the sort that was expected to cut through defense to get to the heart of the matter. The concept of such a “direct” interpretation only makes sense when defense is seen as a barrier entirely separable from what is defended against. Gedo reports that in his experience with Gitelson such interpretations "tended to leave me speechless." If he ever did have an urge to knock the cigar out of the analyst’s mouth, as for example in response to this interpretation itself, he would not have felt encouraged to access or elaborate it. He was not even in a position to ask for clarification, as to say, “That actually was the farthest thing from my mind. What led you to that conclusion?” He might well have been suppressing his complaint for fear of offending (there is other evidence for this), but that would be considered merely the conscious content. Any deeper meaning of the complaint, such as a warded‑off feeling of being disregarded and of being expected to be the one who subordinates himself, was obviously destined to remain so. Gedo's speechless response also was destined to remain in that state. He could hardly have felt encouraged to recognize any complaints that were conceivably being screened by this one. How well can this model accommodate the effort to modify its one-sidedness by stylistic modifications or, for that matter, by invoking the working alliance concept?

Kohut (1971) wrote approvingly of a similarly bold stroke, recounting an anecdote that apparently circulated among Chicago analysts:

There are, of course, moments in the analysis of some narcissistic personalities when a forceful statement will not come amiss as a final move in persuading the patient that the gratifications obtained from the unmodified narcissistic fantasies are spurious. A skillful analyst of an older generation, for example, as asserted by local psychoanalytic lore, would make his point at a strategic juncture by silently handing over a crown and scepter to his unsuspecting analysand instead of confronting him with yet another verbal interpretation.

[p. 224]

The word "unsuspecting" conveys the satisfaction of making the patient an interpretation he couldn't refuse. Such an iconic anecdote served a bonding function among analysts who were fighting a losing battle with narcissistic patients. There is no consideration here of how humiliated the patient would have felt to be ridiculed by what amounts to a practical joke. The assumption of underlying drive gratification (id resistance) makes the patient seem so thick skinned that the analyst’s only thought is to find the “whiff of grapeshot” that will break through the defensive barrier.

Fromm (1991), who trained at the Berlin Institute in the late twenties, dramatized this embattled position by declaring that the work is not for the faint of heart.

Many students in seminars, when they are presenting a case and I suggest they tell something to the patient, will say: "Well, but I am afraid the patient cannot take it." My first response usually is: "The only one who cannot take it is you, because you are afraid of sticking your neck out telling something to the patient, to which the patient might react with anger, with disturbance." [p. 125]

Fenichel (1941), in a familiar passage, described a case presented by an early analyst who was courageous enough to stick his neck out, in the Fromm sense, but was floundering:

The patient could no longer speak at all in the analytic hour because he was full of aggressions. The analyst could clearly see that . . . aggression. . . was now directed against him in the transference. "What shall I do?" the analyst asked. “For weeks I have been telling him in every hour that he wants to kill me; but he does not accept the interpretation.” [p. 38]

Notice that in this rather farcical but instructive example the analyst was working from drive logic in that he assumed that being “full of aggressions” was bound to be frightening and hence would be the obvious cause of the patient’s inability to speak. His questionable technical assumption must have been that a “naming” interpretation would make the wish to kill the analyst more available to the patient and hence accessible to analysis. His belaboring this patient undoubtedly was based on the assumption that correct analysis of the warded-off content should dissipate defense. This is the assumption that makes the conception of direct interpretation possible. Alexander (1935/1961, p. 234) put this layering view of defense as epiphenomenal in a nutshell: “Mostly the verbalization of what the patient is resisting diminishes the resistance itself.” Clearly, as in Fenichel’s example, it could take a lot of verbalizing.

The most direct expression of the view of defense as a layer that can be broken through is the concept of a “deep” interpretation. It can even be an “action interpretation,” as in the Kohut anecdote and in the following illustration. Knight (1954) presented an example of the way that "deep verbal or action interpretations are appropriate as emergency measures for an acute neurotic disability" (that is, when there is no time to waste on Gedo’s “elucidation of fine points”). A concert singer presented in a panic regarding a sudden loss of voice, with a concert scheduled for that night. She was only able to whisper that her symptom appeared in the morning of the same day, following sex with a new lover. This led the practitioner, a reputable Chicago analyst of the time (Lionel Blitzsten), to “surmise that she had spent the night with a new lover and that their sexual play had probably included an abortive attempt at fellatio to which she had reacted with repulsion.” He

decided on an action interpretation which would in a professionally ethical way re‑enact the traumatic episode. He excused himself from the consulting room and went to the kitchen where he procured a frankfurter which, by good fortune, was available. He returned to the patient and approached her with the frankfurter, insisting that she take it into her mouth. She let out a clear mezzo-soprano whoop of protest and her voice was back. [p. 119]

(It is disconcerting to imagine what Knight envisioned the professionally unethical alternative to be.) The drive model, at least in this early form, was made more convincing by the cultural consensus, it seeming only natural for this woman to enjoy fellatio. This would leave no way to consider her symptom as representing an inability to say no, to refuse to perform that night on stage (suppose her parents had forced this career down her throat?) or, for that matter, in bed.

The patient could conceivably have been startled out of her voicelessness by such a radical departure from professional decorum. But to describe her reaction as a “whoop of protest” makes sense only from the analyst’s perspective. A cry of fright might better fit the patient’s experience of the analyst suddenly bearing down on her, demanding that she take this object into her mouth. However, the reported version might have been accepted uncritically at the time, not only because it fit the model (and perhaps satisfyingly got a woman to fit conventional role expectations), but because it could reassure the beleaguered drive-model analyst that if you had the courage to stick your neck out far enough, as Fromm put it, there would be a payoff.

Yet by the same token this intervention also revealed how precarious the drive-model analyst’s position could be. Suppose the opera singer, in the face of Blitzsten’s insistence, had in turn insisted that he explain what he thought he was doing with this frankfurter. Or suppose the patient in Kohut’s tale, rather than grasping the meaning that his fantasies were “spurious,” had simply wondered what the analyst was up to, perhaps even what he was doing with those toys (the crown and scepter). Or suppose that Gedo's patient had not gotten the point of his howling.

Gedo (1995, p. 4)) refers to “the ‘operatic’ style I advocate,” but his howling can be seen as a vivid expression of what drive-model analysts may often have felt when confronted with rigidly defended patients, given the assumption that these patients were simply in the grip of underlying imperatives and consequently had no incentive to change. In the perspective of the layering paradigm all talk of constructivism or hermeneutics or of the analyst’s subjectivity seems at best idle or at worst irresponsible. Drive logic makes it hard to see the patient’s point of view or even to think the patient has a point of view. The early analyst was required to muster a degree of certainty about the content of an interpretation that now would be difficult to duplicate.

Two case reports can serve to illustrate the continuing influence of drive logic on analysts who have rejected the drive model as such. What makes these cases of special relevance is that both analysts represent contemporary approaches. Reminiscent of Gedo’s experience, both felt the limits of interpretation had been reached and, after a prolonged period of internal struggle, relied on enactments (as did Gedo). In both cases it can be shown that interpretation had followed drive logic, the consequence being that defense was conceived of as an avoidance or aversion that had ultimately to be overcome in non-analytic ways—bypassed rather than interpreted. Both reports provide extensive clinical material, making it possible to suggest how, outside the context of drive logic, defense might have been interpretable.

HOW DRIVE LOGIC INTERPRETS CATASTROPHIC FANTASIES AS THE EXPRESSION OF WISHES

Lachmann (2000, pp. 173-190) offers an opportunity to illustrate the way an analyst who has rejected drive theory may nevertheless formulate a case in accordance with drive logic. Clara’s fantasies of rage and assaultiveness terrified her. The analyst treated the patient’s fantasies, much as she herself did, as the direct expression of warded-off wishes. As a consequence, he found it necessary to either put a positive spin on her fantasies or to avoid interpretation in favor of enactments in which he responded playfully to what he in actuality saw as her sadistic impulses.

These are presented as recommendations for interventions to be used in such cases. However, there is evidence in the report that Clara’s fantasies could be understood as catastrophic fears of her capacity for uncontrolled destructiveness. Despite this evidence and despite, as a self psychologist, the analyst’s rejection of drive theory, her fantasies were taken as drive equivalents. This may be seen to demonstrate the continuing influence of drive logic. The conclusion that patients’ fantasies are drive derivatives was, after all, what originally generated drive theory.

Clara “adamantly refused to lie on the couch,” declaring that the analyst was stupid not to be aware of the danger it presented were she to move to the couch, “since she could easily bite off my penis from that position.” It took her six years to sit at the foot of the couch and then, after more several months, “and several tests,” she did lie down. Her apprehension about being close enough to bite off the analyst’s penis is approached interpretively as a realistic fear. Thus, the analyst “told her that I was willing to take that risk since I felt confident in my ability to protect myself.” He even adds that, “Privately, I did not feel worried” (p. 180). Why would there be any question of his feeling worried about this far-fetched, even surreal, physical impossibility? Her fantastic worry was interpreted as a wish that could conceivably be acted on—endorsed as something she was capable of. Lachmann refers to it as her “fantasy of biting off my penis,” which he interprets in “the context of her conflicted relationship with her father.”

Drive logic can be seen here to preclude the reality that Clara is so far from being able to sink her teeth into the analyst, clothes and all, that she can’t even lie on the couch. Consider that this is a woman whose “attendance was impeccable,” and “even in her hostility, she was consistently responsive to me” (pp. 188-189). Further, she was so terrified of being alone with her neighbor's daughter that she required the presence of another person. “She feared that inadvertently she might do something, or neglect to do something, that could harm the child.” Lachmann refers to this as her “fantasy of . . . harming her neighbor's child” (p. 189). These desperate fears are seen as representing underlying wishes.

An alternative interpretation would be that she is so afraid she’ll stop at nothing that her wildest imaginings seem like live possibilities. This focus would be on how Clara was in fact unable to use the couch. This does not seem arbitrary given that after six years she was only able to sit on the end opposite the analyst and that to lie down took several more months and several test efforts.

Working from the structural model would prompt the analyst to question whether an impulse is in serving as a defense. Clara fear for the analyst’s safety would have been seen as a reversal: the analyst was stupid to not realize how vulnerable he would be if she were to lay on the couch—how dangerous it would be for him. If we are less primed to think of impulses surging upward against a defensive barrier, it is not difficult to think of Clara’s refusal as a defense against her vulnerability, as it would be experienced by lying on the couch. In this view her vulnerability would be likely to return, since her refusal could have made her feel all the more crazy. To overcome thinking of herself as crazy would require an even wilder attempt to justify the refusal. Then her problem becomes, not why she needs to refuse, but that she can’t (other than counterphobically)—or, in general, her fear of being crazy.

The analyst noticed that when Clara had a cough, she swallowed the phlegm. She explained that she was afraid to cough it up because it would disgust him. This was not interpreted as extreme scrupulosity and a highly constricting fear of causing offense, but as a warded-off wish. Thus:

Further inquiry [not reported] revealed that what she really [italics added; note this drive-logic key word that treats defense as hardly more than a pretense] wanted to do was to smear the phlegm on me. I told her that I would smear it right back on her. We spent the session with her telling me that she wanted to smear phlegm, then urine, and later feces, on me. I told her that I would smear it back on her. [p. 186]

The early analyst would likely have directly confronted Clara with, “You really want to smear the phlegm on me” or possibly, following Gitelson as reported by Gedo, “Why do you think you want to smear the phlegm on me?” The problem for drive logic in contemporary work is how to avoid such unempathic interpretations. Lachmann, as a self psychologist, especially sensitive to this risk, found a way to treat this presumed wish playfully, and in general his approach is reassuring, as here, once again, to assure her that he can protect himself from her.

He comments that “eruptions of rage, contempt, and disdain were ever-present,” and that “Clara made critical, devaluing comments about me and my treatment of her during more than six years of her eleven year analysis” (p. 174). The approach to interpretation was on “the circumstances in which her rage was organized in her developing years.” In response, she “became even more enraged, hopeless, and suicidal.” This apparently is presented as evidence of her refractoriness to interpretation and the consequent necessity to cast her hostility in a positive light. Thus, when she asked at the end of a session, "What would you do if I refused to get off the couch, if I just stayed here?" The analyst at first answered, "I don't know," but when she insisted on an answer, he replied, "I would interpret that you don't want to leave me."

In response “She shot up from the couch, looked around my office and said, ‘I feel like pulling all your books off the shelves and throwing them on the floor’." Although the analyst “thought of a toddler about to have a tantrum,” he sidestepped her rage, saying “I would interpret that as your wanting me to hold you" (pp. 186-187). His thought was that she needed containment, “like being embraced by a parent,” which gave him this way to bypass her rage.

But was this a patient who was at risk for being uncontrollably angry or was she unable to be angry and attacking in any but highly constricted ways? Clara’s threat to refuse to leave and to throw the books on the floor could be interpreted as a desperate effort to make a complaint. In the drive-logic perspective she was more than able to complain; she “made critical, devaluing comments” about the analyst and the treatment for six years—rage and disdain were “ever-present.” But she also was meek and compliant (impeccable attendance, consistent responsiveness). Alternatively, her depreciating comments could be repetitive and eruptive because she could never successfully complain. Despite the lengthy presentation of this case, we are not told what Clara’s critical and devaluing comments actually were, which suggests that they were apparently so ineffectual as to not bear reporting. Do toddlers having a tantrum just want to be held or could something really be bothering them that they have no other way to express?

HOW DRIVE LOGIC PRECLUDES RELATIONAL INTERPRETATIONS

It is difficult to find case reports that demonstrate how drive logic precludes relational interpretations, relationships being understood as the expression of wishes, rather than as the product of the reactions of the participants to one another. This is shown most clearly where the focus is on libido itself, but in case reports sexual issues are typically presented as subsumed by other content. One report (Davies 1994) stands out in this regard since libidinal drive was treated as central and since the analyst took an unequivocal position, both interpretively and in a bold enactment. Given that this is a relational analyst, drive logic can be seen as subtly but powerfully determinative of the work, since key relational issues were not considered, either in the genetic material or in the transference. Further, the analyst’s unyielding persistence in repeating her interpretation in the face of the patient’s anguished protests would seem to owe its credibility to the work of the early drive analysts.

The effect of drive logic is to create the implicit assumption that love is consummatory, that it springs to life at a touch—an urge looking for an outlet—not as comparatively dormant in the absence of intimate connection, that is, as interpersonal. The relation between love and sex has, of course, been endlessly debated, but the effect of the drive logic has been to equate the two. Thus, the case report that follows is titled “Love in the Afternoon,” yet the content focuses almost entirely on sexual fantasies, both the patient’s and the analyst’s.

Mr. M’s statement of the problem was that despite having a vivid and active sexual fantasy life, “I can't stand it when women respond to me sexually. I'm afraid that they will change suddenly and find me disgusting. And I can't take that risk. It's too humiliating.” He had an almost phobic avoidance, with anxiety to the point of nausea about approaching a woman, and was immobilized when one approached him.

As was true of his reactions to other women, both acquaintances and strangers, M also had vivid and elaborate sexual fantasies about the analyst. Thus, he presented shyly and had a “deadened mathematically abstract [he was a mathematician] persona,” but quickly developed

an intense and highly eroticized transference, complete with compelling, almost poetic descriptions of his sexual fantasies involving the two of us. I was for him, he claimed, "the perfect woman, warm, sensual, perhaps the only person who could lead him out of his life of sexual inhibition and loneliness." [p. 163]

Predictably, as soon as the analyst became active,

he would appear to implode upon himself slumping down in his chair, his voice whining and somewhat grating; he had no right to these feelings about me. Of course, it was impossible that I shared any of his sentiments, and therefore I must be secretly laughing at him, describing to my friends how paltry and pitiful he was. [p. 163-164]

The explanation for this feeling of repulsiveness that emerged seemed straightforward. He recalled that with his mother he had to be “careful not to respond too overtly to her intimate cuddlings.”

If he rubbed or cuddled too eagerly, or as he put it one day: “Even if I sighed too deeply or longingly, she would change, virtually transform before my very eyes. She would look at me in horror and disgust, as if I was the most hideous person in the world. It was like she knew how I felt about her, and she was revolted by me . . . revolted by the thought that I could have those feelings about her.” [p. 165]

It would be hard to avoid sharing this patient’s definition of the problem. It seems obvious that the frightening transformation this apparently borderline mother underwent would have exactly the effect M described. This interpretation was reinforced by the way he could develop sex fantasies about the analyst in the hours even while sitting up, and not haltingly or sheepishly, but at length and in some fully embodied, extraordinarily elaborate, almost poetic, and even compelling way—demonstrating a degree of freedom that few patients exhibit. It made it look as if M’s sexuality was essentially intact and that he only needed to work through the effect of his mother’s aversion. M’s aversion is seen as a barrier or layer.

HOW DRIVE LOGIC FREEZE-FRAMES DEFENSE AND DEFENDED AGAINST

Following this logic, Davies approached the patient’s fantasies as the expression of his sexuality, as if they made possible the free play of his wishes until he was reminded of her real presence, when his defense against these wishes would return. However, his fantasies can also be seen as a defense. His unusually active and apparently enjoyable fantasy life would be seen as, at times, warding off his aversion. The fantasies may even have been reactively intensified—made especially vivid—considering that they had to surmount his belief that the analyst was secretly laughing at him with her friends. This is what it means to say, as Boesky does above, “The essence of the structural theory is . . . [that] everything ‘in’ the three systems is everywhere,” and what (Apfelbaum and Gill, 1989) meant by proposing that there is no categorical distinction between defense and drive. Drive logic freezes contents in one position, overlooking how their positions can be reversed.

Relevant here is Sandler’s (1974, p. 58) decades-old observation that “in most discussions of the hierarchies and ‘layers’ of the mental apparatus the temporal, sequential, process element has been relatively neglected [emphasis in the original].” (For an extensive discussion of the clinical and theoretical implications of this point, see Apfelbaum, 2004).

Since for Davies the patient’s fantasies were simply the undefended expressions of his sexuality, she ultimately resorted to disclosing that she had been having sexual fantasies about him. This was not done lightly, and it is the point of her contribution that there are times when such a controversial enactment is called for. Her purpose was to convince the patient that his fantasies, far from being laughable, were natural. He could be attractive to women, just as he was in his fantasies. Before resorting to her disclosure she suggested that his mother’s aversion, like his, was a reaction to the natural sexual feelings she would have for him. The interpretation was

that perhaps his mother had been revolted by her own sexual urges toward her young son, during these most intimate times, that perhaps when he responded in particular ways, it was she who became more highly aroused, surpassing even her own threshold of denial. [p. 166]

Davies apparently made a number of attempts to convey this view, reporting that M “was never able to accept the interpretation.” He would become enraged, protesting that what she suggested was impossible since mothers weren't allowed to have sexual feelings for their children just as analysts were not allowed to have such feelings for their patients.

It almost goes without saying that Davies had no evidence for her proposition that M’s mother was aversive to her natural and expectable sexual feelings. It was ex cathedra in actuality, if not in spirit, and could not be otherwise since it derives from a conceptual given, the drive-logic assumption that symptoms are generated by the rejection of natural impulses. Otherwise, it is easy to conclude that his mother’s sexuality was abusive. What makes sex exploitive is obliviousness to the object. This seems to have radically been the case for M’s mother, since he reports that she required him to show no sign of a response to her “intimate cuddlings.” It could then be pointed out that M’s experience of his sexuality as, like his mother’s, requiring the analyst to be completely out of the picture (as soon as he was reminded of her presence he would “implode”) would reinforce a vision of sex as far from reciprocal. Thus, he could fear that to erotically arouse the analyst could cause her to blot him out—since this would be how he experienced sex—and hence to react in some out of control, incendiary way. This also could explain why M insisted that for the analyst or his mother to have sexual feelings for him should not be allowed.

This is one way to understand why the patient “was never able to accept the interpretation” that there was no basis for his (or his mother’s) sexual aversiveness. Davies reports that

such stuckness in the treatment defied all other interpretive avenues that felt "safer" to me. Feeling that there was no other honest alternative, I said to the patient one day, "But you know I have had sexual fantasies about you, many times, sometimes when we're together and sometimes when I'm alone." The patient began to look anxious and physically agitated. 1 added, "We certainly will not act on those feelings, but you seem so intent on denying that a woman could feel that way, that your mother might have felt that way, I couldn't think of a more direct way of letting you know that this simply isn't true." [p. 166]

The analyst’s assumption was that she was offering this man something positive, an affirmation of “the reality” that he was sexually attractive. Yet it is familiar, at least outside the consulting room, that such a declaration may be oppressive, just as a crush is not necessarily a compliment. Outside the perspective of drive logic, it could be argued that M learned about being sexually objectified at his mother’s knee, as it were. It would be expected as the nature of the transference. Further, this is a man who is especially likely to assume that if a woman is attracted to him that she must be relating to a figment of her imagination—hence his apprehension and immobilization.

LIBIDINAL “DRIVE” AS INHERENTLY OBJECTIFYING

Indeed, in this perspective the analyst’s responding to his fantasies by disclosing her own would not appear, at least on the face of it, to establish greater intimacy. It might have been more intimate if the patient had been enabled to articulate his experience of sex as mercilessly nonintimate, which could itself be an intensely intimate moment and a significant accomplishment for the analyst working from a focus on defense structure.

On his hearing this declaration of her own fantasies by the analyst:

The patient became enraged beyond a point that I had ever seen him. I was perverse, not only an unethical therapist, but probably a sick and perverted mother as well. He thought he needed to press charges, professional charges, maybe even child abuse charges; how could I help him when my own sexuality was so entirely out of control. He was literally beside himself. Unaware of what he was saying, he could only mutter, "You make me sick, I'm going to be sick. God, I'm going to throw up." [p. 166]

The analyst responded to this by again relying on persuasion, maintaining that, “I don't think that there's anything sick and disgusting about the sexual feelings that either of us have had in here.” Since defense was taken to be a simple and inappropriate aversion, this made it appear possible to bypass defense and as a final resort to simply confront or persuade. To persevere in her interpretation despite this patient’s vigorous and sustained protests would also appear to have its anlagen in the drive model, especially in its original application.

Davies’ struggle was truly heroic, as she finally overcame her own understandable reservations to, in effect, pursue the non-interpersonal premise of the drive model, even though working from the relational perspective. With considerable dedication she overcame the pretense of neutrality that has accompanied that model and that obscures its thrust. What makes this such a valuable contribution is not only that reports of analysts’ disclosures rarely concern positive countertransference, much less with sexual content, but that the rationale for interpretation is the focus of Davies’ report, offering an unusually straightforward example of the logic of the drive model. As is well known, Freud himself, much as he idealized neutrality, given drive logic, could hardly restrain himself from encouraging patients to accept their sexuality. Davies came to terms with this inconsistency, taking the assumptions underlying that model to their ultimate conclusion.

The key assumption is that sexuality, divisible into primal energies and aims, is an organismic given. This model took hold when Freud decided that the seduction traumas were actually fantasies generated by infantile drives. This is the non-interpersonal basis of drive logic. The early interpersonal context came to be considered largely a screen on which drive representations were projected. Under the influence of this interpretation analysts were among the last to grant the reality of sexual abuse and until they did so they were called upon as experts for the defense in incest cases. Thus it was not unusual for an early analyst to think of a woman as frigid, just as she thought of herself, even though she may have been unresponsive to a husband or lover because his sexual style was objectifying. There was no such concept at the time, of course, but under the influence of the drive model, analysts were reluctant to appreciate this interpersonal hazard in sex, believing that it undermined the very basis of their work. Put in modern terms, sex was taken to be inherently objectifying.

It should be noted that it is not unusual to speak, as Davies does, of asking a patient to take “a risk, to venture forth with a shared description of his physical states of desire, dread, and arousal.” (Hence, she argues, the analyst should also be willing to take risks, much as she did in this case.) This familiar locution, “taking a risk,” captures the view that ultimately the patient is required to bypass defense. What makes this view persuasive is that defense is seen, as in this case, as a conditioned aversion or anxiety that may remain after the possibilities of interpretation have been exhausted.

THE ULTIMATE IMPLICATION OF DRIVE LOGIC: DISOWNED AGENCY

AS THE UNDERLYING SUBSTRATE

Under the influence of drive logic, interpretations are inevitably couched in terms of what the patient gains from symptoms that otherwise are distressing. The basic assumption is that whatever the behavior, it must be satisfying. Despite patients’ denials, the questions in the analyst’s mind are, “What underlying desires or needs are being gratified? What wishes does the design of their lives reveal?” Conflict Theory, as a contemporary version of the drive model, makes clear that this is an assumption, even though its advocates state it as fact that the universal motive is to seek pleasure and avoid unpleasure; the theory simply takes the avoidance of unpleasure as the definition of a motive. Thus, Lachmann’s patient Clara could be seen as avoiding unpleasure by refusing to lie on the couch. This is an explanation that cannot be refuted but has no explanatory power.

This drive-model assumption that, at bottom, we are pleasure seeking, tempts the analyst to commit the fallacy of asserting the consequent. Recall the patient who so consistently tuned Gedo out. Gedo makes it vividly evident that he felt stubbornly rebuffed, which led to the interpretation that he was in fact being stubbornly rebuffed. What makes this interpretation come especially readily to hand is the assumption that the patient must want to act as he does.

The assumption that we must want to act as we do has also been taken to mean that we are responsible for our behavior, however unconsciously. This inference has had far-reaching implications, but the logic has been left F. As a consequence, there even was a widespread misunderstanding that being driven by unconscious forces meant just the opposite, that we are not responsible for our actions, with Sartre and others famously taking up the cudgels to refute this. However, for those working from the psychoanalytic canon, the ego may be the weak rider, but the horse goes where we really want to go while the ego looks the other way.

The guiding assumption that our lives are of our own design generates a focus on choice and makes assuming agency the ultimate treatment objective. By being able to take responsibility for unconscious choices the patient is enabled to make conscious choices. Defense in this frame simply means the denial of gratification and therefore of agency.

Schafer (1976) declared that, “Not . . . all of one's life is . . . unconsciously altered, arranged, and disclaimed, but psychoanalytic interpretation deals methodically and specifically with the large part of one's life that is one's own action” (p. 361). Reviewing his well-known discussion of “action language,” Schafer (1999) was at pains to make it clear that he had not proposed a revision of the strategy of interpretation, but only a refinement that would more directly represent its ultimate objective:

It is well known that patients often begin their analyses thinking of themselves solely as victims of unhappy childhoods, unfortunate current life eircumstances, bad brcaks, or unknown factors that make them be this way or that way, much to their own disadvantage; and that as the treatment goes on, they begin to see thcmsclves more and more as actively implicated in many of their difficulties. That is to say, they realize that they had been agents even during their formative development and have remained so in their present situations. Particularly is this true in their fantasy‑ridden interpretation of their life events.

I also became aware that regardless of the language the analyst uses when interpreting transference, dreams, memories, feelings, desires, or therapeutic change, the way the analyst interprets inevitably, even if subtly, helps the patient to view himself or herself as a contributing participant and not just as a passive party to all the difficulties of existence. It is generally accepted in traditional analytic thinking that the thrust of analytic interventions is to help the patient "interiorize" many of the difficulties that for defensive reasons the patient has wished to see as external and has felt free to feel exempt from responsibility as expressed in anxiety, shame, and guilt. [pp. 344-345]

Schafer found, to his chagrin, that, “Unfortunately, many readers of these works, among them those who published critical reviews of it, understood me to be advocating a new method.” In other words, if “the analyst interprets inevitably, even if subtly” to help patients realize that they have “felt free to feel exempt from responsibility,” warding it off with “anxiety, shame, and guilt,” this subtlety has even been missed by many analysts. Schafer explains that he had attempted to clarify and systematize “what analysts had traditionally done,” but adds that this may not be recognized because it is misrepresented “by the prevailing mechanistic, essentialistic language of psychoanalysis” (p. 346).

Rangell (1981) went a step beyond Schafer, asserting not only that recognizing disowned agency is the point of interpretations but that the patient cannot be expected to get the point. Interpretation must be followed by exhortation. He spoke of “the responsibility of insight,” arguing that, “After exposure and amelioration of the etiologic anxiety, the patient has an expanded choice.” Choice “does not take place automatically” (pp. 127-129):

The patient is ambivalent toward being assigned—and accepting—responsibility. Resistances to progress at this stage are as tenacious as to the original uncovering of the repressed drives—and are to be as vigorously analyzed to the end. [p. 132]

What does it mean to vigorously analyze a patient’s ambivalence about being “assigned” responsibility? It appears to mean impressing on the patient the idea that once an insight has been gained, he or she is responsible to act accordingly (see “taking a risk,” above). As we all have seen after interpretive efforts have been made, and as Rangell represents it, “Some patients ask explicitly, and all think subliminally, ‘So what? What happens now? How does anything change’?" (p. 417). Rangell’s reply is, “Nothing ‘happens’ by itself” (p. 421). It is “the responsibility of the patient whose life it is to live" (pp. 419-20).

Schafer’s many readers and reviewers who thought he must be advocating a new approach to interpretation were undoubtedly even less likely to recognize themselves in Rangell’s version. However, there are other ways of saying much the same thing, as in the proposition that the analytic objective is to unblock frozen choices. Although the patient is thought of as coming to spontaneously exercise this freedom of choice, the interpretive focus on choice is what Schafer wants to bring to the surface. Even if these analysts would balk at the contention that they expect their patients to take responsibility for their life choices, their focus on choice makes it easy to see them as “inevitably, even if subtly” moving the patient in the way that Rangell openly demands. They usually have in mind what the choices are that the patient should make.

Rangell boldly espouses what Schafer finds to be a subtext of interpretation, even one that may be unrecognized when he calls attention to it. This follows from Rangell’s unmodified and unquestioned employment of the layering paradigm. Thus, in the passage above he speaks of “the original uncovering of the repressed drives” (referring to the analytic phase of his work).

It goes without saying that Schafer’s and Rangell’s contributions are not merely theoretical speculations, but represent the conviction that comes from decades of analytic work. The way this can be understood from the present vantage is to think of the analyst working from drive logic as freeze-framing, as recognizing all the moments when the presumed drive or wish is functioning as such, that is, is ego alien, not recognizing all the moments when it is in the position of defense, as exemplified by the case of Mr. M. Looked at this way, a drive or wish interpretation is simply that, representing an analytic moment, one that apprehends a shifting reality, in which what is a drive or wish at one point is not at the next.

What most directly reveals the influence of drive logic is the assumption that what is defense and what is drive is immediately obvious to the observer or can become so through further inspection of the material. This one-person psychology is represented conceptually by the view that drive and defense are just as intrinsically different as the terms themselves imply. If what is visualized instead is that what is defense at one time in relation to a given wish may at another time become the wish defended against, then the distinction between the two requires a continuing differential diagnosis. This is of necessity a two-person psychology since it rests on discovering what the patient experiences in the moment as ego syntonic—what, in Fenichel’s terms is “nearer the ego” at the moment of interpretation.

REFERENCES

Alexander, F. (1935/1961). The problem of psychoanalytic technique. In: The Scope of Psychoanalysis; Selected Papers of Franz Alexander. New York: Basic Books, pp. 225-243.

Apfelbaum, B. (2004). Interpretive neutrality. Journal of the American Psychoanalytic Association, 52: in press.

Apfelbaum, B., & Gill, M. M. (1989). Ego analysis and the relativity of defense: Technical implications of the structural theory. Journal of the American Psychoanalytic Association, 37: 1071-1096.

Arlow, J. A. & Brenner, C. (1964). Psychoanalytic concepts and the structural theory. New York: International Universities Press.

Beres, D. (1965). Structure and function in psychoanalysis. International Journal of Psychoanalysis, 46:53-63.

Boesky, D. (1988). Comments on the structural theory of technique. International Journal of Psychoanalysis, 69:303-316.

Brenner, C. (1980). Metapsychology and psychoanalytic theory. Psychoanalytic Quarterly, 49:189-215.

Davies, J. M. (1994). Love in the afternoon. Psychoanalytic Dialogues, 4: 153-170.

Fenichel, O. (1941). Problems of psychoanalytic technique. New York: The Psychoanalytic Quarterly.

Fromm, E. (1991). The Art of Listening. New York: Continuum.

Gedo, J. E. (1979). Beyond Interpretation. Toward a Revised Theory for Psychoanalysis. New York: International Universities Press.

Gedo, J. E. (1981). Advances in clinical psychoanalysis. New York: International Universities Press.

Gedo, J. E. (1995). The pragmatics of empathy. The Annual Review of Psychoanalysis, 23:1-12.

Gedo, J. E. (1997). Spleen and nostalgia: A life and work in psychoanalysis. Northvale, NJ: Jason Aronson.

Gill, M. M. (1963). Topography and systems in psychoanalytic theory. New York: International Universities Press.

Hamilton, V. (1996). The analyst's preconscious. Hillsdale, NJ: Analytic Press

Hartmann, H. (1951). Technical implications of ego psychology. In Essays on ego psychology, New York: International Universities Press, 1964, 142-154.

Jones, E. (1957). The life and work of Sigmund Freud. Volume III. The last phase. New York: Basic Books.

Knight, R. & Friedman, C. (1954). Psychoanalytic Psychiatry and Psychology. Clinical and Theoretical Papers, New York: International Universities Press.

Kohut, H. (1971). The analysis of the self. A systematic approach to the psychoanalytic treatment of narcissistic personality disorders. New York: International Universities Press.

Lachmann, F. M. (2000). Transforming aggression: Psychotherapy with the difficult-to-treat patient. Northvale, NJ: Jason Aronson.

Langs, R. & Stone, L. (1980). The therapeutic experience and its setting. Northvale, NJ: Jason Aronson.

Rangell, L. (1981). From insight to change. Journal of the American Psychoanalytic Association, 29: 119-142.

Rangell, L. (1992). The psychoanalytic theory of change. International Journal of Psychoanalysis, 73: 415-428.

Rapaport, D., Gill, M. (1959). The points of view and assumptions of metapsychology. International Journal of Psychoanalysis, 40:153-162.

Sandler, J. (1974). Psychological conflict and the structural model: some clinical and theoretical implications. International Journal of Psychoanalysis, 55:53-62.

Schafer, R. (1976). A new language for psychoanalysis. New Haven: Yale University Press.

Schafer, R. (1999). Recentering psychoanalysis: from Heinz Hartmann to British Kleinians, Psychoanalytic. Psychology, 16:339-354.