Radmila Zygouris: In connection with the discussion of empathy, a very controversial term here in France, I’d like to note that Freud’s concept of Einfühlung does not entail reciprocity. It involves the mother’s ability to sense something about her child even before the child can speak. If there were no maternal Einfühlung she would not be able to interpret her child’s crying and its different movements.
Juan-David Nasio: It’s true that “empathy” is not part of our usual vocabulary, but it’s interesting to consider whether what this word designates corresponds to anything in French clinical practice. According to Dr. Ornstein, empathy is vicarious introspection, feeling and thinking oneself into the inner life of the other. This corresponds to a state that I experience when I work with certain patients and that precedes the emergence of the interpretation. I wouldn’t say “feeling and thinking myself,” since these aren’t terms we use. I want to use the term “fantasy.” First the analyst perceives the fantasy in the analysand, then he identifies with one of the figures in it, and—this isn’t always the case—he may be able to name or say what that figure would have said.
Janine Chasseguet-Smirgel: Even non-Lacanians get angry at the idea of considering the analytic situation to be a symmetrical one between patient and analyst. It is profoundly asymmetrical; the entire setting, the entire frame, is in effect a product of asymmetry. We try to plunge the patient into a kind of regression, and the invisible analyst, the recumbent analysand, the fixed sessions (not always the rule in Lacanian practice), all promote a regression on the part of the patient and not on the part of the analyst.
As far as the idealizing transference is concerned, I think self psychologists may emphasize something that seems to me—and to a French author like Bela Grunberger—to be entirely natural and indispensable to the very constituting of the analytic relationship and to taking the plunge into the analytic situation. And it is very close to the distinction Freud made between narcissistic neurosis (his original name for psychosis) and transference neurosis. When beginning treatment an analysand projects a hope onto the analyst, which leads to his projecting his narcissism, his ego ideal, onto him. This situation must of course not continue to the end of the analysis, but it is indispensable for getting the process underway.
Jacques Hassoun: Dr. Kouretas raised the issue of whether Kohut’s theory isn’t that shadow zone that is a kind of protest against the delimitation of two structures: neurosis and psychosis. But isn’t Lacanian theory, which pays no special attention to borderlines, also able to open up such a gray area?
With regard to empathy, the question arises as to the place from which the analyst speaks, from which he intervenes, when he invokes the concept of empathy, since there has to be a third place in order for there to be an interpretation. If empathy means engulfing the other, then there is no analysis but instead a psychotization of the analytic setting. Although we come from different theoretical orientations we have all explored the issue of the third space, the space from which the analyst intervenes and that must be there in order for analysis to take place.
(French Analyst): I’d like to hear a bit more about the theory of psychic conflict, since this seems to be missing in what both sides are saying. For example, you have been emphasizing the value of empathy, but what do we do when we can’t stand a patient, when we want to hurt him?
Paul Ornstein: Let me first say that I deeply appreciate Professor Monique David Ménard’s immersion in the paper I presented and her having come up with a complex discussion, some of which I feel understood me and some of which passed me by. I’d first like to say something about how to listen to clinical presentations done from another perspective. I came to Paris determined to enter the field, absolutely unknown to me, of Lacanian analysis, which in the past I had unfortunately dismissed as something that didn’t touch my analytic work.
Since I have been here, I really feel rewarded in having opened myself to looking at it from the inside. Now, we can’t completely enter another perspective; that is impossible. We bring our baggage with us, and that limits our capacity. It is the same with empathy: empathy is a universal capacity in us, but given our personal experiences, training, and so on we have only a narrow band of capacity which needs to be broadened and widened—through further experiences with patients who are dissimilar to us, through encountering other cultures, or by coming to Paris and learning about Lacan. And this is what allows us to enter more successfully into these other perspectives. Vicarious introspection, as I think both Dr. Nasio and Dr. Hassoun seem to understand, allows us to try to enter the inner world imaginatively. We can’t penetrate; we can’t be accurate. It is in the dialogue that our empathic capacity, or its limit, evolves. We cannot say, “Ah! I empathized, I understood!” Until the patient feels understood, what we may claim is of no great significance in the analytic process.
I was particularly appreciative of Dr. Janine Chasseguet-Smirgel’s comment about idealization, because I had the feeling that there is a contact point which I knew about between us, and Bela Grunberger, and your work on idealization. Idealization is an absolute necessity, but, as you said, it needs to get transmuted and changed in the course of the analytic process so that it doesn’t remain as archaic as at the beginning. As far as asymmetry is concerned, in the past we accepted a great deal of asymmetry—“analyst here/patient here.” We have begun to feel, over the last decade or so, that the expert in the room about the patient’s inner world is the patient. We have to make the effort to listen in such a way that we can understand, and communicate that understanding to the patient. Now, if we have a blueprint of the unconscious, or theories about conflicts or the stages of drives, we think we are the expert, but we are not. On what level do we feel that the patient has, in a sense, the last word about his or her own inner experience? That will determine how we conduct the analysis.