Ritual and Spontaneity in the
Northwestern Dental School
240 E. Huron Rm 3380
Presenter: Irwin Hoffman
(Chapter 9 in Hoffman, I.Z. (In press; expected December 1998) Ritual and Spontaneity in the Psychoanalytic Process: A Dialectical-Constructivist View. Hillsdale, NJ: The Analytic Press)
This paper brings together several themes developed in the author's earlier work and integrates them with a view of the analyst's affirmation of the patient as pitted against the "dark side" of the analytic frame and, at the same time, the dark side of the human condition. With respect to the former, the analyst could be viewed as exploitative, playing upon the patient's neediness from a position of power. With respect to the latter, life itself can be viewed as a seduction which is followed by disillusionment, abandonment, and death -- in other words, as a cruel deception. The love of parental figures in critical periods of childhood helps to buffer the impact of reflective human consciousness, particularly as it comes up against the terror of mortality. When the injuries of childhood are sufficiently traumatizing, the added insults of the human condition can be unbearable. The analyst is in a position to counter these assaults on the patient's sense of worth through a powerful kind of affirmation, one that is born out of the dialectic of psychoanalytic ritual and personal spontaneity. The interplay of the two can triumph over cynicism and despair and cultivate the patient's capacity for expansive and committed living.
Among the new concepts introduced here is the notion of liminal space, a transitional zone, identified by the anthropologist Victor Turner, between structured, hierarchical, role-related ways of being and spontaneous, relatively unstructured, egalitarian ways of being. Many experiences occur in that liminal zone, which is "neither here nor there." An example within the analytic situation is the time period between the moment the analyst says it's time to stop and the moment the patient leaves the office. At such a moment the sense of analytic ritual is suspended, and the analyst and the patient are together more simply as fellow human beings. Nevertheless, even then the sense of the power of the ritual is in the background so that the liminal interaction has a special kind of charge.
This paper includes a detailed and extended clinical illustration. A key liminal moment demonstrates the co-creation by analyst and analysand of a quality of relatedness that is new and generative even as the specter of potentially destructive forms of enactment is evoked. The case affords an especially poignant look at the interplay of neurotic and existential anxiety. The patient's primary symptom, a kind of vertigo, could be viewed as rational, whereas the usual sense of balance and confidence that people maintain in their everyday lives could be viewed as illusory, grounded essentially in denial. The case also offers the opportunity to explore the relationship between "drive" and "deficit," with particular attention to the issues highlighted by self psychology and classical theory. The two perspectives in this case play themselves out in a special manner in that the patient had an interest in self psychology which he seemed, at times, to use defensively. The paper closes with a series of dreams bearing on the termination of the analysis, ending finally with an account of the last hour in which analyst and analysand try to co-construct a "good-enough ending" for that hour and for the analysis.
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