Thomas Ogden, “Comments on Transference and Countertransference in the Initial Analytic Meeting” (1992) (I)

In this article, which expands on a chapter from The Primitive Edge of Experience, Ogden argues that — with slight caveats and few exceptions — the first session should not differ from the subsequent “analysis.” Hence the analyst must vigilantly guard against temptations to view and conduct the “initial analytic meeting” as anything but psychoanalysis stricto sensu.

Yet in suggesting that “there is no difference between the analytic process in the first meeting and that in any other analytic meeting” (226), Ogden must commit himself to some conception of psychoanalysis generally. After all: which characteristic or characteristics, exactly, should the first meeting share with “any other analytic meeting”? How ought “any other analytic meeting” to look? For this reason, perhaps, Ogden allows that “the subject of the opening of the analytic drama…touches upon almost every aspect of psychoanalytic theory and technique” (226). 

Ogden’s unspoken premise is worth contemplating explicitly, since it may restrict the application of his reflections. For even if we accept this opening gambit — that the first session ought to resemble subsequent sessions in all or most respects, that analysis always begins in medias res — we may still reject his notions of psychoanalysis proper, or dispute which norms and techniques, precisely, ought to be honored starting from the very first interactions.

This preamble seemed necessary, because Ogden largely presupposes some consensus about proper psychoanalytic technique — as it happens, a rather “classical” version. The question he addresses is merely whether, and in what respects, this “uncontroversial” technique should be extended to the initial analytic meeting. But once again, we may agree that “the function of the first meeting centrally involves the initiation of the analytic process” (229) without much agreement about the nature of that process.

How, then, does psychoanalytic technique look for Ogden, and what sorts of behavior tend at the very beginning to interfere with the functioning of that technique? The selection of an appropriate analytic technique will depend, of course, on the aim of psychoanalysis. Consider the following: “Everything that the analyst does in the first face-to-face analytic session is intended as an invitation to the patient to consider the meaning of his experience” (226). In other words, “technique” for Ogden comprises all the analyst’s efforts to communicate this “invitation” — to encourage the patient’s reflection on the “meaning of his experience.”

But let us consider Ogden’s starting point: is psychoanalysis exclusively or predominantly dedicated to generating this sort of self-reflection? Traditionally, this aim is indisputable. For Freud and his disciples, the therapeutic value of analysis is inseparable from its epistemic yield: what finally diminishes neurotic suffering is “insight” into formerly obscure motivations, fantasies, and conflicts. This neurotic conflict is “unconscious,” not accidentally, but essentially; mental suffering — at least of the sort that interests psychoanalysis — is a function of this unconsciousness. Hence the resolution of this suffering must follow the path of self-knowledge, of making the unconscious conscious, or precisely, as Ogden writes, inducing “the patient to consider the meaning of his experience.” This is a process of de-familiarization: “All that has been most obvious to the patient will no longer be treated as self-evident; rather, the familiar is to be wondered about, to be puzzled over, to be newly created in the analytic setting” (226).

Yet is this the result at which analysis should aim, and around which all methodological decisions should be arranged? Must everything answer to this de-familiarizing quest for unconscious significations? The epistemic tilt of psychoanalysis indicated here has been an object of implicit and explicit criticism in the 20th century, especially in the interpersonal and relational movements. This critical attitude is represented in such a concept as “corrective emotional experience.” On this later view, in the first instance, the patient requires, not insight into unconscious motivation and conflict — hence a process of reflection on “significations” designed to promote that insight — but rather a certain affect-laden relationship (of whatever type the patient has lacked).

I make this point, not because I think Ogden’s premise is wrong, but because I think it is unspoken, and because I want to reiterate that we may accept the explicit thesis — that analysis begins at the first meeting — while wondering about the features Ogden ascribes to that analysis. To be sure, many of Ogden’s observations, suggestions, and warnings, especially in the early part of the article, seem broadly acceptable among psychoanalytic tendencies. For example, analysts must square the need to accept the patient, without judgment, with the mandate to help change that patient (226); to somehow immediately involve the patient in an analytic “project” that his or her neurosis in principle obstructs (226-27); to reckon with the anticipatory transferences and counter-transferences that inaugurate the analysis well before the first meeting (on the basis of such things as the referral, the phone call, generic and personal ideas about psychoanalysis, and of course the biographies of the participants) (227); and to accept or decline patients for subtle reasons related to these transferences and counter-transferences (229).

But I imagine that other pieces of Ogden’s argument will be less broadly acceptable among different analytic factions. Doctrinal differences concerning the objectives and concomitant techniques of psychoanalysis would be pertinent to any aspect of the first “meeting.” They are especially pertinent, though, to the major focus of the article: how best to address the inevitable anxiety that, in both analyst and patient, overshadows the beginning of analysis. Ogden treats this anxiety, not as one important element among others, but as the overriding consideration, one that confers meaning on everything else, and in deference to which all “technique” is organized.

“Everything that the analysand says (and does not say) in the first hours can be heard in the light of an unconscious warning to the analyst concerning the reasons why neither the analyst nor the patient should enter into this doomed and dangerous relationship” (235)

Once again, though, one may share this assumption of Ogden’s — that the patient’s initial communications, correctly observed, reflect “the leading edge of transference anxiety” (235) — while disagreeing about how best to address this leading edge. In particular, one may wonder: are there perhaps legitimate anxiety-reducing measures that an analyst may take? — measures that do not compromise the analytic value of the interaction but instead enhance it? Later, Ogden recounts (with a hint of pride) his habit of repelling the questions of patients, with scant exceptions, as “fairly undisguised statements of the patient’s phantasies about the specific ways in which I will fail to understand him” (242). But surely we may grant the aptness of these characterizations of the patient’s behavior, while questioning the wisdom of the response Ogden recommends, that is, an attitude of unyielding reserve and non-gratification that verges on the inhuman.