The analyst’s posture in analysis is supposed to be driven by three aims: neutrality, abstinence, and anonymity. I want to focus specifically on neutrality. Read any psychological textbook and one always happens upon the same critique that neutrality is impossible. Freud was not always neutral, which should come as no surprise considering his case studies are all stories of failure not success. Relational analysts have emphasized two-person psychology and critiqued Freud’s neutrality as being robotic and inhuman.
I want to talk about the importance of neutrality or indifference. People going into the mental health profession tend to have certain proclivities to be caring and empathic. Of course, these attributes are necessary and can help the psychotherapist greatly who is engaging in difficult work. I wish I could find the quote from Freud that goes something like this: “the worst thing you can do is care too much about the patient”. This might strike some as odd. Aren’t psychotherapists supposed to care about the well being of others since their work is driven by a sense of benevolence? To explain why caring too much can severely hinder therapy, I want to use Klein’s idea of projective identification. This is a controversial idea that combines a couple of different notions such as: projection, introjection, and identification.
I want to first focus on the idea of projection. Paranoia is one common manifestation of projection in which one locates one’s own feelings elsewhere. For example, “I don’t harbor violent, murderous feelings, rather I suspect that you are working with FBI to kill me”. Projection differs from projective identification because the projection doesn’t “stick” since they are manifestly psychotic. The key to projective identification is that the projection somehow “hooks” onto the therapist’s psyche. Let me try and sketch this out. For example, let’s say the client is unable to experience feelings of aggression so they completely split off (banish it from consciousness) these feelings and project it into the therapist. Next, the client acts in such a way so as to provoke aggression in the therapist. The client can then, from a distance, identify with the aggression that is too difficult to experience directly. The client then acts in such a way that therapist cannot help but respond to (i.e. introject) the very thing the client has projected.
What does this have to do with caring too much? Projective identification can help us make sense of why this posture is unhelpful, unlike neutrality. Let’s imagine the client is severely depressed and has a dependent relational style. The client likely finds it difficult to care for himself and tends to excessively rely on others for help. Perhaps the client has, on some level, learned to be helpless because he has found himself unable to make any changes. It is intolerable for the client to try and change and so he splits off all feelings of hope or agency. The therapist is then “activated” to become excessively caring and maternal. The therapist contains all feelings of hope and care for the client’s well being. We could imagine that the client acts increasingly helpless which puts pressure on the therapist to hold all feelings of hope and belief that the client can change. Notice how the projected feelings of hope or change hook onto the therapist’s natural tendency to want the client to change. Unfortunately, we now have a situation where the client refuses the therapist attempts to help him change which renders the therapist feelings hopeless and inefficacious (feelings that the client himself could not own). The client can then create distance from his own feelings of uselessness by creating a situation in which the therapist carries those intolerable feelings for him. Inevitably the therapist cares too much and tries to suggest strategies and techniques to help the client change. However, this situation will not promote growth or change because the locus of control is sill external, i.e. it does not reside in the client but elsewhere. Not to mention the client continues to depend on the therapist for answers. This situation is similar to Lacan’s idea that transference is always established whenever a subject exists that is supposed to know.
Psychotherapists need to be careful to avoid using their own caring instincts to get in the way of actual change. Therapists feel extraordinarily uncomfortable when we feel useless. However, this is a test. A test that only the neutral therapist can pass because she refuses to get involved in this projective identification that ultimately renders the client dependent on the therapist and unable to embrace his own sense of agency. Sometimes caring too much has more to do with the therapist’s own needs to be useful and much less to do with what would be most beneficial for the client.