What are VitalSource eBooks? For Instructors Request Inspection Copy. In recent decades the relationship between psychoanalysis and psychotherapy has been a focal point for debate about the distinctiveness of analysis as a particular kind of therapeutic enterprise. In place of the commonly accepted triadic division among psychoanalysis, exploratory psychotherapy, and supportive psychotherapy, he proposes a new triad: Interactive psychotherapy, on the other hand, uses the transference selectively to ameliorate psychic stress.
Interpretation and Interaction is enriched by a concluding chapter from Merton Gill, a preeminent authority on the therapeutic process. Gill's critical appreciation of Oremland's proposals amounts to an illuminating refinement of his own position on the relationship between psychoanalysis and psychotherapy. Scholarly in conception, thoughtful in tone, and pragmatic in yield, Interpretation and Interaction is a clarifying addition to the psychoanalytic theory of psychotherapy.
It will have the practical consequence, in Gill's words, of "aiding clinicians in retaining their analytic identities and their analytic orientation across the spectrum of their therapeutic work. A Psychoanalytic Study of Creativity We provide complimentary e-inspection copies of primary textbooks to instructors considering our books for course adoption. Learn More about VitalSource Bookshelf. CPD consists of any educational activity which helps to maintain and develop knowledge, problem-solving, and technical skills with the aim to provide better health care through higher standards.
It could be through conference attendance, group discussion or directed reading to name just a few examples. We provide a free online form to document your learning and a certificate for your records. Already read this title? Please accept our apologies for any inconvenience this may cause. Exclusive web offer for individuals. Home Interpretation and Interaction: Add to Wish List. Gill, following upon Knight, had been clearest in the early fifties in his distinct delineation of psychoanalysis, expressive therapy, and supportive therapy, each with distinctive characteristics, different techniques, and different goals, and each differentially indicated for a different segment of the psychopathological spectrum.
The very radical shift that I detect in his views has followed - to my mind - as a direct consequence of his preoccupation over this same period with his evolving conception of the overriding primacy of the interpretation of the transference as the criterion of psychoanalysis and of what is psychoanalytic. These newer views on the nature and piace of transference interpretation include a distinction between resistance to the awareness of transference and to its resolution; an insistence on the earliest possible interpretation of the transference, including a searching out of all possible implicit transference allusions and making them explicit from the very start of the treatment; a focus on the here and now as against the genetic thrust in the transference interpretation; and the need to elaborate all the implications of the two-person as against the one-person view of the two participants' contributions to the transference.
All of this was presented in detail by Gill in a succession of publications , , ; Gill and Hoffman, ; Gill and Muslin, and is discussed by me elsewhere Wallerstein, Here I will pursue only the implications of these views for my present theme - Gill's now very significantly altered ideas on the nature and relationship of psychoanalysis and psychotherapy.
Interpretation and Interaction: Psychoanalysis or Psychotherapy?
These implications he made specific in his contribution to the symposium, published in a revised version in as " Psychoanalysis and Psychotherapy: Gill developed these new views with his customary logical precision, summarizing his paper in a single sentence: He then reviewed both the "intrinsic criteria" by which analysis is customarily defined - "the centrality of the analysis of transference, a neutral analyst, the induction of a regressive transference neurosis and the resolution of that neurosis by techniques of interpretation alone, or at least mainly by interpretation" p.
It was then that he came to his taking-off point:. After reviewing the sociocultural and economic difficulties that analysts face today in maintaining the external criteria of psychoanalysis, Gill went on:.
Rather, "I will argue that with the definition of analytic technique at which I will finally arrive, it should be taught to all psychotherapists and that how well it will be employed will depend on their training and natural talent for the work" p. And, "I mean that analytic technique as I will define it should be employed as much as possible even if the patient comes less frequently than is usual in psychoanalysis, uses the chair rather than the couch, is not necessarily committed to a treatment of relatively long duration, is sicker than the usually considered analyzable patient and even if the therapist is relatively inexperienced.
In other words, I will recommend that we sharply narrow the indications for psychoanalytic psychotherapy and primarily practice psychoanalysis as I shall define it instead" Gill, , p. What we see here, of course, is a proposal to assimilate to psychoanalysis what Gill in had taken such pains to demarcate as the related but nonetheless distinct arena of expressive psychotherapy - that "intermediate form of therapy" - or, in other words, to now blur, perhaps obliterate altogether, the differences he had once felt it so vital to maintain.
To me, this is in effect a revival of the position, held by Alexander and his followers, that Gill had once led the effort largely successful to reject. Gill clearly acknowledged the basis for these radically altered views: He then went on for ten pages. It is what distinguishes it from psychotherapy.
It remains for me to try to show that it can be maintained even in an expanded range of external cri teria" p. Gill then went on to develop his idea that even a necessary frequency or use of the couch may be dispensable in proper psychoanalytic work - depending on the patient and, implicitly, the patient-analyst dyad:. No universal meaning of any aspect of the analytic setting may be taken for granted. It follows that no universal prescription can be given for this or that type of case.
One may generalize that analytic work goes better with healthier patients lying down and sicker patients sitting up and with frequent sessions for both kinds of patients but a particular patient may not conform to the rule. The meaning of the setting must be analyzed in each instance. Nor is degree of pathology the only variable which determines a patients response to the analysis of transference. Apart from pathology, some take to it like a duck to water and can work despite infrequent sessions, while others never seem to find it congenial" Gill, , p.
Gill, then, dealt specifically with the impact of each of the usual external parameters of the psychoanalytic situation. But if greater frequency is frightening to a particular patient, frequent sessions may impede the work despite interpretation.
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One cannot simply assume that more is better. The optimal frequency may differ from patient to patient. We must not confuse optimal frequency with obligatory ritualized frequency" Gill, , p.
Discussions of this issue seem to gravitate to quantitative terms as though there are fewer stimuli if the patient cannot see the analyst. It may be that the patient facing the analyst is exposed to a wider range of stimuli but the patients response is to the quality not the quantity of stimuli" Gill, , p. It is that analysis is a kind of all-or-none proposition, yielding its positive results only if carried through to the end. It is this belief which may sustain patient and analyst through long periods of apparent stagnation and stalemate, but this belief is often a vain illusion.
Freud compared interrupting an analysis to the interruption of a surgical operation. I suggest, on the contrary, that in the changed way of conducting it which I am proposing, analysis may be a process with progressively cumulative benefits, interruptible at various points without necessary loss of what has been gained" Gill, , p.
Surely this characterization of the prevailing view of psychoanalysis as an all-or-nothing endeavor is something of a straw man, since analysis can assuredly rest or stop at all stages of incompleteness, quite aside from the understanding that in theory analysis is never competed in any but an asymptotic sense. None of this, however - and this is my point - is the same as assimilating every expressive-interpretive psychotherapy to psychoanalysis, as Gill has here proposed we do, his only stipulation being that the therapeutic thrust be focused unswervingly on interpretation of the transferences implicit as well as explicit in the here and now.
In this entire uncompromising statement of his radically altered perspective on the relation of dynamic psychotherapy to psychoanalysis, Gill made only one concession to the generally prevailing views he was challenging. At the very beginning of his article he had written,. Gill posed the question this way: He obviously felt that the answer to this query was yes, though he did say that "other things being equal, obviously an analysis conducted at lesser frequency cannot accomplish what otherwise could be" and that "there ought to be different names for an analysis carried through as fully as it could be and one which is partial and incomplete" p.
The only alteration of name that he proposed, however, was of "psychoanalytic psychotherapy," which he now said "should be reserved for a technique which does not deal with the transference in the way I have suggested is the essential criterion of analytic technique" p. In other words, "psychoanalytic psychotherapy" should be the designation for that therapeutic approach that is not psychoanalysis i. That is what Knight originally, and Gill after him, called in the s and s psychoanalytically oriented supportive psychotherapy.
And, in what can be considered a further retrograde step, there is more than a passing allusion to the idea that this psychotherapy that is not psychoanalysis rests fundamentally on "witting and unwitting suggestion" p. I have presented these perspectives on Gills early and late views within the context of an historical overview of the relation of psychotherapy to psychoanalysis that I published in and subsequently expanded in my book on that topic b.
Merton, in a letter to the editor of the journal in which my article appeared, took serious exception to my representation of his views. That initiated our public dialogue on our differing assessments of his new position, a dialogue we had already been privately engaged in over a considerable length of time. Gill's letter Gill and Wallerstein, began with the statement that my assessment of his views in my article, "however well intentioned, is a serious misrepresentation" p. My seeming misunderstanding became clearest to Gill when I compared his revised views to Alexander's.
He then granted that indeed there was a similarity to Alexander, in that both of them espoused a two-person view of the analytic situation, but insisted that there was also a significant difference, in that Alexander advocated the manipulation of the interaction the corrective emotional experience , while he, Gill, advocated interpreting the interaction as fully as possible. He then said that I had presented neither the similarity nor the difference correctly. The reason he gave for this putative misunderstanding was his feeling that I did not really appreciate the analytic situation to be interpersonal and interactional, despite the fact that I might say I do.
From there he went on to say that my view of the analytic situation remained essentially within the framework of a one-body psychology, and that though I might regard psychotherapy as interactional, I did not view psychoanalysis as such, however beset it might be by unavoidable countertransferences and "infiltrations. Asked by the editor to respond to Gill's letter, I began my response Gill and Wallerstein, with the statement,. Let me explain" Wallerstein, in Gill and Wallerstein, , p. I then said that I agreed fully with Gill's description of both the similarity and the very significant difference between his position and that of Alexander; where the latter would manipulate the interpersonal interaction in analysis, Gill would interpret it.
However, in my linking of Gill's current views with Alexander's, I had been referring neither to the particular similarity nor to the particular difference that Gill described in his letter. I was referring rather to the efforts of Alexander in the fifties and of Gill in completely contra to Gill in the fifties to array both expressive or exploratory psychotherapy and psychoanalysis proper along a continuum in which differences are merely quantitative and all distinctions based on the usual criteria for psychoanalysis are declared not critical.
Alexander had in fact called for the "unification" of psychoanalysis and dynamic psychotherapy see Wallerstein, , p. Gill's letter had clearly not convinced me that I had misread him. When I called his position on this issue a return to the position of Alexander, which in Gill had led the effort to counter, I had in no way tried to equate Gill's views with Alexander's on any other salient matter. Nor, incidentally, did I see any contradiction between this assessment of Gill's position and Alexander's - as blurring if not completely obliterating any distinction between expressive psychotherapy and psychoanalysis - and my other assessment that on the issue of the nature of supportive psychotherapy Gill had reverted to the early position of Freud and of Jones and Glover , viewing it essentially as nothing more than simple suggestion.
I also addressed Gill's claim that I viewed psychotherapy as interactional but stili adhered to a one-person view of transference that would render psychoanalysis itself non-interactional. My counterclaim was that I considered both modalities interactional and that that was not where I located their essential difference.
Rather, to quote my letter,. I see psychoanalytic psychotherapy varyingly supportive and expressive as resting partly, where possible, on an interpretive-analytic base, but also, in varying degrees, depending on the characteristics and needs of the particular patient, on many other kinds of supportive technical interventions-which I have adumbrated and illustrated at great length in my book, Forty-Two Lives in Treatment " Wallerstein, in Gill and Wallerstein, , p. That is, I view both psychoanalysis and analytic psychotherapy as interactional; I see the difference in the comprehensiveness of the effort to analyze i.
When Merton received my response to his letter, he wrote to the editor-and to me-asking the special dispensation that he be allowed to respond to my response, with the understanding that I would in turn be able to respond to that; at that point the exchange would come to a close, with no further effort on his side, and the four letters would then be published. This was agreed to. Gill began his second, briefer letter with the statement that the first exchange had indeed clarified where we agreed and disagreed.
He further expressed his satisfaction that I did adhere to "the centrality of the interpersonal aspect of the psychoanalytic situation" p. He also acknowledged that he was using the term suggestion far more broadly than 1, meaning by it " any interpersonal influence whether direct or indirect" p. Where he correctly thought we disagreed was in his feeling that he was sharpening the distinction between psychoanalysis and all other psychotherapy by insisting that it is always possible to readily and simply distinguish psychoanalysis and psychotherapy, as follows: If he is not it is psychotherapy" p.
He said my confusion in this matter lay in the idea that his "belief that psychoanalytic technique can be done at a lesser frequency and sitting up" necessarily allied him with Alexander. My equally brief response to this last letter agreed that indeed much had been clarified about our respective views.
After indicating the areas in which we were in full accord, on the centrality of the interpersonal aspects of the psychoanalytic situation, and on the fact that I never intended to impute to him Alexander's conception of the corrective emotional experience , I then stated the two main issues on which we agreed that we disagreed. The first was my feeling that he had indeed returned to Alexander's earlier efforts to assimilate expressive psychotherapy to psychoanalysis:.
Interpretation and Interaction: Psychoanalysis or Psychotherapy? (Electronic book text)
I believe that it can only be analysis if the conditions of treatment are such as to properly facilitate and enable a psychoanalytic: My other disagreement was with Gill's predilection for using the term suggestion more broadly than I considered useful. After these letters our subsequent and aborted exchange is doubtless anticlimactic.
It came in connection with a request from the Journal of the American Psychoanalytic Association that I review Gill's capstone book, Psychoanalysis in Transition: A Personal View In chapter 5 of this final book, "Psychoanalysis and Psychotherapy," Gill declared that the Psychotherapy Research Project that I headed at the Menninger Foundation my final clinical accounting was reported in Forty-Two Lives in Treatment buttressed his position that the erstwhile ideal of psychoanalysis as a therapy is unattainable and that interactive elements enter necessarily into every analysis.
But he then went on to claim that I had not given up the ideal in principle but had concluded only that it was unattainable in practice and that analysis therefore often "necessitated the introduction of interactive contaminants into the analytic situation" Gill, , p. Though Gill stated explicitly that contaminants was his word, not mine, he went on to argue the difference between his position and mine on the basis of my viewing interactive components of the analytic process only as necessary contaminants no longer identifying this as his word rather than as inherent, ubiquitous, and vital to the full understanding of the process.
While Gill and I do have significant differences on these issues - witness our exchange - I disagree with their characterization in Gill's final book. Rather, I see as a major thrust of the Menninger project and of Forty-Two Lives in Treatment the demonstration that there is an inevitable and inherent, not accidental or contaminating interpenetration of what had once been considered mainly psychotherapeutic components or modes into every psychoanalysis-and, incidentally, vice versa-and that this has made the once very distinct conceptual differentiations between the two modalities of psychoanalysis and psychoanalytic psychotherapy much more ambiguous in both theory and practice than they were in earlier years felt to be.
On this issue I consider myself fully in accord with Gill's position; I too view psychoanalysis as both a one- and a two-person situation, accepting all the implications of that position, including the fact that every analysis is inherently both interactive and interpretive. My actual differences with Gill on these issues, while substantial, are quite other. The main ones are two. It is a special sadness to me that I was informed of Merton Gill's death the very day I was finishing my review of his final work; my effort might have led to yet another friendly but critical exchange of views, as again we would try to clarify precisely how we understood each other, and where we agreed and disagreed.
I have devoted this essay to such a detailed exegesis of Merton Gills always formative impact on our continually evolving conceptions of the nature of psychoanalysis and the psychoanalytic psychotherapies, and of their ever altering relation to each other, because clearly it has been such a central concern of his as well as of mine, but also and most importantly, of our whole discipline as a purposeful clinical healing endeavor.
If in the s it seemed that a majority consensus was being formed regarding a definition of psychoanalysis and the range of psychoanalytically based psychotherapies, as well as an understanding of their similarities and differences, together with a promise of ever increasing clarification and specification as theory advanced and clinical experience accumulated, this was as much as any single persons the doing of Merton Gill.
And if in more recent decades this convergence of psychoanalytic perspectives has progressively unraveled and the once seemingly crystal clear conceptual boundaries and relatednesses have become less clear, more problematic, replaced now by a range of reconceptualizations responsive to the varying tenets of a psychoanalytic world now more relational, constructivist, and pluralistic, then it can be said of Merton Gill that he has been a leading influence in staking out one of the significant contending positions on these issues, though it is not mine.
But whatever our differing individual takes on these issues, we can all agree that Merton Gill's influence is writ large and will endure. Internet edition of chapters 2, 4, and The corrective emotional experience: On the history of the psycho-analytic movement. Standard Edition , Ego psychology and psychotherapy. Psychoanalysis and exploratory psychotherapy. International Universities Press Italian transl.: Il modello topico nella teoria psicoanalitica.
The analysis of the transference. The Analysis of Transference. Theory and Technique Psychological Issues, Monogr. Teoria e tecnica dell'analisi del transfert. The interpersonal paradigm and the degree of the therapist's involvement. Il paradigma interpersonale e la misura del coinvolgimento dell'analista. Psicoterapia e scienze umane , , XXIX, 3: Trattamenti in setting individuale. Franco Angeli, , pp. Early interpretation of transference.
Psychoanalysis and psychotherapy An exchange of letters to the editor. The analysis of transference: A matter of emphasis or of theory reformulation?
Robert R. Wallerstein, 'Merton Gill, Psychotherapy, and Psychoanalysis: A Personal Dialogue'
Forty-Two Lives in Treatment. Review of Merton Gill's "Psychoanalysis in Transition: This paper later appeared in D. Wolitzky, editors, Changing Conceptions of Psychoanalysis: The Legacy of Merton M. Gill , Hillsdale, NJ: The Analytic Press , , pp. We thank for the permission]. For suggestions or corrections, please e-mail to: