Psychoanalysis as theory has to do with conflicting psychological forces -- or, put another way, conflicting motivations -- acting largely unconsciously within a person's mind. When it accumulates data, psychoanalysis, like any other discipline, sets up its own operational frame encompassing a limited range of phenomena to be studied. When it does this it tends to make a variety of simplifying assumptions about the rest of the world and therefore about other disciplines (Wallerstein, 1973). What is referred to here are operations rather than intellectual content. Of course, it is possible for the intellectual aspect to be subverted by the operational aspect, but this fallacy like its opposite, can be avoided.

Thus, psychoanalysis is a theory about the events within the mind of an individual and it leans toward a view of the external world as more or less constant. Examples include the concepts of the "average expectable environment" of Hartmann (1958) or the "good enough mother" of Winnicott (1960). Psychoanalysis also tends to make simplifying assumptions in the other direction, so to speak: about the role of constitution in determining mental life. In any event, the constancy, regularity, sensory deprivations and fundamental rule of the psycho-analytic situation also turn attention toward the inner world.

But if psychoanalytic theory at a high level of abstraction inclines us toward the idea of the individual mind as a closed system, the inclination does not do away with the obvious: It almost goes without saying that psychoanalysis concerns itself with the mind as an open system in interaction with other minds.

Freud's work is full of references to the mutual influences of internal and external worlds. The Principle of Multiple Function (Waelder, 1936), Hartmann's adaptational (1939) and Erikson's psycho-social points of view (1950) all take such influences for granted. The developmental concepts of Mahler (1975), Winnicott (1960) and Loewald (1971), while not exactly congruent, are based on the basic notion that individuality emerges as a center of forces within an interactional field. And our standard, or classical, clinical theory constantly refers to interpersonal interactions: the psychoanalytic situation itself (which after all is an object relationship, not merely a set of representations), object relations theories, internalization, externalization, projections, transference, countertransference, the role of psychoanalytic interaction as a vehicle for the transformations of shared unconscious fantasies -- not to speak of the multitude of studies of interpretations and their effects.

Many authors have tried to make the leap from individual psychology to communal, interactional psychology. Beginning with Freud's Interpretation of Dreams (1900), psychoanalysts and others have discussed the roles of shared fantasies leading to social forms: groups and leaders created out of common needs on the basis of shared identifications (Freud, 1921), works -- too many to list -- on anthropology, sociology, literature, religion, art, folklore, political science, economics, even history. Of particular usefulness have been the psycho-analytic contributions to the study of myth and metaphor (Arlow, 1961, 1979). Regarding the therapeutic interaction alone, Langs 1976, Vol. I) collected detailed abstracts by 360 authors (many with multiple contributions). He also constructed (1976) his own overview and synthesis, a synthesis which, in delineating the therapeutic situation, makes particular use of the words "frame" or "framework." This is not the place to criticize Langs' work, but it should be stated clearly that the "frame theory" used in the present paper is of a different sort, in origin and application, than the concepts used by Langs. The two approaches should not be confused inasmuch as they are not truly compatible, conceptually or clinically.

Despite all these papers, no general interactional theory, constructed from within the mainstream of psychoanalytic thought, has been inclusive and convincing so far. The "simplifying assumptions" have indeed been simplifying. Intrapsychic concepts have often been transposed too directly into the interactional field; interactional concepts have sometimes been smuggled into abstractions more appropriate to the inner world; and outmoded, unacknowledged philosphical assumptions about the nature of reality have been embedded in most works. As for theories developed outside the mainstream of psychoanalysis -- examples include Sullivan's interpersonal theory, the various "cultural" approaches, phenomenological and existential analysis, sociological theories, e.g. "role theory" -- they may be self-consistent but are fundamentally flawed: they are bereft of the concept of a dynamic unconscious.

This paper aims to apply to the classical psycho-analytic situation, and the theories deriving from it, certain views of social interaction developed in other realms of thought. These have to do with a relativistic view of social reality and the rules by which certain kinds of interaction, of which the psychoanalytic situation is one, are "framed," that is, spelled out and delimited from other kinds of social interactions. A clinical vignette illustrates some direct usefulness of this approach in the under-standing of the analyses of certain "difficult" patients. In the process, it suggests expanded ways of conceiving the ego and superego systems developmentally and functionally. But primarily, the intent is heuristic; it presents a way of looking at phenomena, a way of thinking. As such, it represents a step toward a compatible interactional theory.

REALITY

Sigmund Freud opened a way to a revolution when he forever redefined "reality," at least as far as psychology is concerned. He demonstrated a buried world, largely unconscious, which interacts with the world as it is consciously thought to be. As McLaughlin (1981) observes, however, that external world continued to be seen as tangible, and potentially explainable scientifically. But the "hard" sciences themselves have advanced, and new philosphical and artistic insights have accrued: the faiths of positivism or behaviorism can no longer be maintained. Even the dichotomy between what is scientific and what is artistic can no longer be thought reliable.

Gunther Stent (1975), a molecular biochemist, maintains that psychoanalysis itself represents one of the vanguards of a new twentieth century breakthrough in scientific thinking. Physics, of course, has long since abandoned the older assumptions about mechanical causality and material "reality." A structuralist approach has been applied to linguistics, anthropology, cognitive development, epistemology, history and sociology. General System Theory represents a (somewhat) similar way of thinking. Positivistic assumptions and the forms of thought utilized by analytic philosophies have been challenged by the neo-Kantians, such as Cassirer (1923, 1925, 1929) on the one side, and very different philosophers, such as Wittgenstein (1953) on the other. Psychoanalysis thus joins other disciplines in seeking to interpret the "surface structure" of events in terms of "deep structure." Only the so-called behavioral sciences cling to older concepts and methodologies following the rubric of nineteenth century science.

Despite its own theoretical thrust, and however eroded older concepts of reality may be, psychoanalysis continues to utilize them. References to what is psychologically real, what is rational, irrational, delusionary, realistic, the nature of reality testing, the supposed "real" relationship as opposed to the "transference" relationship, the sense of reality, what is or is not psychotic, distorted, appropriate, inappropriate, adaptive, maladaptive -- all of these judgmental references are to matters lying at the heart of our profession. Yet most of these references, while they remain for the most part operationally satisfactory, are no longer conceptually tenable; the philosophical position of "naive realism is obsolete.

The discussion to follow attempts to grapple with these issues.

RULES

In intrapsychic terms, it has been customary, following Freud, to speak of psychic structure. As Beres (1965) pointed out, there are many potential confusions in using the word, structure. Freud (1923), Hartmann (1939), Rapaport and Gill (1959) and Gill (1963) all ascribed slightly differing meanings to the term. But all recognize that psychological structures are inextricably related to functions. They are abstractions, not morphological entities. They do not have "contents," and should not be reified.

Both in intrapsychic and interactional psychology one can also speak of rule. For general discussions of rules, see Black (1962), Garver (1967), Rawls (1959) and Wittgenstein (1953). But to speak of rules, one must be prepared to present at least a rough sketch of what one means. Not all philosophers are happy with the vagueness of words like rule or structure. Rush Rhees (1974) remarks, "Rules were not made by the devil, but the word 'rule' was" (p. 42).

As distinguished from various other meanings (the reign of a king, a measuring device, etc.), rule here refers to "an established guide or regulation for action, conduct, method, arrangement, etc." (Webster's Unabridged Dictionary, 1979). Included in this sense are empirically discovered regularities (gravity is a stern, implacable teacher; if there is a "deep structure" of language there must be rules governing the transformations to "surface structure;" if the brain is constructed in such and such a way, there must thereby be rules according to which information is processed; etc.) and empirical limitations (if the brain is constructed in such and such a way, there are limited modes by which it can process information; without external interventions one will grow only so tall; there are absolute limits in the capacities to survive stress; etc.).

Piaget (1932) documented an epigenetic theory of cognition. He assumed the existence of rules, partly innately determined and partly the results of assimilations from the environment. Chomsky (1968) postulates rules governing transformational grammar. Wittgenstein (1953) spoke of "language games" governed, of course, by rules. More generally, a myriad of behavioral phenomena can be described as governed by shared, learned rules, without which culture and social life itself would be impossible. Most such rules are used effortlessly by all competent individuals. They are silent. They require no rewards or punishments because they are not disobeyed by sane or good people.

Our shared notions of social reality itself are governed by such silent, almost universally practiced rules (it would be less astonishing to see a murder committed than to see a twelve year old boy in a formal baseball game run to third base after getting a hit; we trust unknown drivers every time we venture on the highways; it would be strange indeed to see a diner exactly reverse his courses in a fine restaurant; one hardly ever sees tennis players wearing bathing suits on public courts; etc.). On the other hand, some socially undesirable behavior is too personally desirable; formal prohibitory laws and formal punishments are required; otherwise, too many violations would occur. And still other kinds of rules, perhaps as important as any other kind, are of an ad hoc nature, generated spontaneously by two or more persons to meet particular exigencies.

Although psychoanalysis needs to be cognizant of genetic rules, rules governing cognitive development, or the conceivability of transformational grammar, it is most preoccupied with hierarchies of shared, invented rules, social rules, acquired in the process of development. If rules are established guides or regulations for action or conduct, there obviously are many kinds of such rules: there are different ways of establishing different kinds of guides and regulations, and there are many, many kinds of actions.

Thus, there are rules at one end of the spectrum which are highly codified (as in a logical calculus, or in chess, or in drop-the-hand-kerchief), and rules at the other end of the spectrum which are clearly existent but which can be formulated only with great difficulty, if at all (no natural language has had all its rules explicated; spontaneous children's games clearly become structured but their evanescent nature makes them difficult to analyze; in studying primary process, it is easy to infer condensation, displacement, symbolization, etc. but hazardous to make more detailed inferences about when, how, etc.). While there is hardly any difficulty in formulating and invoking rules in artificial languages, there is a very great difficulty in discerning with clarity those rules which operate in social behavior, where they are constantly being invoked, usually silently, but hardly ever formulated.

It would be easy to imagine (but premature to try to achieve) a structured general theory of rules, to which psychoanalysis would contribute. It would be devoted to the general questions of rules -- how they come to be set up, how they change, what levels of constancy, what consequences if violated. Such a theory would encompass a series beginning with the foundation, built-in, instinctual rules for behavior (the orderings of primary process; perhaps the governances of deep grammatical structure); extending to the hierarchical sets of cognitive rules which Piaget demonstrated; extending further to what psychoanalysis can tell of the intrapsychic ego and superego origins and operations, development and function of ordinary social rules governing play, leisure, work, public and private behavior; and finally extending to new concepts of codified rules and laws of the state.

It is understandable that psychoanalysis would primarily concern itself with those intrapsychic acts and interpersonal actions having to do with bodily and intimate behavior -- relatively "instinctualized" behavior along with the relevant modulating and control activities that necessarily go with them. But anyone who has paid close attention to the in-home development of his children knows how important every new achievement of skill or language is to both parents and child; even the most "autonomous" behavior makes up part of the warm cloth of family life. And it is understandable that psychoanalysis would care about how more and more subtly detailed and made representations of self and object come about, and how structure is made out of internalization processes.

Thus, children acquire psychic structure not only as a result of separations which come about at approximately the right times, but also as a result of direct learning (for the most part eagerly) by example and by instruction as part of the astonishing, incessant educational activities of parents and siblings (these are the ways you deal with food; there are the things you must never touch; this is the way you go to the bathroom; here are things you can play with; you play with them in these ways; you don't say, "Me want...;" you say, "I want...;" etc.; etc.). Sometimes it seems to the outsider that developmental theorists too often address only limited ranges of phenomena in only limited locales. The place of fundamental development is in the home, not the nursery. And on that foundation many important things happen in the widening social worlds beyond the nursery.

One of the amazing consequences, after the sphincters have been consciously possessed and language come to life, is the fabrication of quite different sets of rules governing private, family and public behavior. And the consequences of being taught (and having needed to accept) the wrong rules, so to speak, rules which might work at home but not in the school, or rules which are taken to apply to other people but not one's self, are wide-ranging; inwardly, they refer to unfortunate developments in the ego and superego systems.

In summary, the study of the shared rules governing everyday social interactions, especially those of an intimate nature, opens one way to understand shared notions of reality. As mentioned, these rules may be divided into the prescriptive (how to do this or that; ritual; games; expectable social behavior) and proscriptive (the "limits of permissible behavior," a term suggested by Arden King (1979, 1980). Attention to the latter type, the limits of permissible behavior, can be particularly helpful in the attempt to understand complex game-like social interactions, for example, the analytic situation.

THE ANALYTIC SITUATION: THE ANALYTIC FRAME

The situation that develops between an ordinary analyst and an ordinary patient is indeed a social situation, but a most peculiar one. In this social situation, a number of usual rules governing two-party relationships are specifically abrogated -- in particular, the to-and-fro dance of organized, eye-to-eye, dialogue, the ubiquitous censorship of thoughts which might disrupt rational communication and interaction, and amenities of an (usually amiable) hypocritical nature. The analytic situation has a frame, if one thinks of a frame as referring to unchanging basic elements or principles of organization that define it as a specific social event, and distinguish it from other events.

The analytic frame is largely constructed consciously and unconsciously by the analyst. Parts include the office setting itself, the regular schedule of time-limited appointments, the fee, etc. More unconsciously derived parts include the analyst's particular stance, his manner, approach, etc. The analysand invariably joins with the analyst -- again, unconsciously for the most part -- in building and elaborating the frame. In other words, two or more persons follow more or less silent, cooperative interactions in constructing any ongoing dialogue (for similar ideas, see Bernfeld, 1941) . The two people come to share private expectations, agreements, disagreements, symbolic words, and metaphors.

The analytic frame is deliberately unbalanced. That is, analyst and patient play different roles, have different functions. But each must have a certain tenacity in order to accept and hold to the frame and the rules governing it. From the analyst's point of view, he has a strategy and evolves a set of tactics; having them, he has many more conscious options than the analysand. He decides when and when not to intervene, for example. On the other hand, the analysand's initial strategies and various tactics, on an unconscious level largely aimed toward the avoidance of pain, the maintenance of neurotic defenses, and the search for infantile gratification, are to a great extent frustrated. But gradually and almost imperceptibly, they come to resemble, at least in part, those of the analyst.

From the beginning of an analysis, the patient is set a seductive, but for any length of time, impossible task: to come as close to telling everything -- without self-criticism, tendentiousness, or censorship. We assume with him that he does not have freedom to convert his impulses into motor action during sessions, but he does have absolute freedom verbally; we overtly and covertly encourage that freedom. Then we wait for him to fail, as he surely will. Much of the work is involved in showing him how he fails to allow himself freedom, and discovering the reasons for keeping himself in bonds. At the same time, we take the "failures" themselves as part of the associations and seek meaning in them. Metaphorically, as Anna Freud (1936) put it, we ask the ego to remain silent and let the id have its say, simultaneously laying down the dictum that thoughts and feelings must be expressed in words only. We thus play a "double game with the instincts."

At the same time, we set ourselves a task which in certain respects is even more impossible; we play double games with not only our own id but our superego and ego as well. While we seek maximum freedom for our associations, we do not regularly permit ourselves freedom to even verbalize them, much less physically act on them. We totally abjure power and something paradoxical happens: in abjuring power we acquire it. In limiting our words they acquire weight. We acquire the weight of words. But we assume still another burden; we are forever having to decide whether to intervene or not, and if the decision is to interpret, how to couch the interpretation.

In an analysis, we enjoin ourselves to neither attend too closely, too rationally, to what the patient says, nor drift totally off into reveries or sleep (McLaughlin, 1975); neither think predominantly "linearly" nor "nonlinearly;" become fixed neither in objectivity nor subjectivity. We oscillate between observation and participation and we note these oscillations (although quite frequently we can’t immediately understand them very well). However, when the oscillations stop -- when our minds become frozen in one attitude or another, we know that something has gone awry within us. And the very fact that something has gone awry is a telling association of the analyst's -- of particular value if attention is paid to it. Evenly hovering attention is as hard to sustain as free association. We sit back and watch ourselves fail to remain in this steady state, and our movements away from it into alertness or into withdrawal become vitally important data. Recognizing such events, we step back to examine their meanings cognitively.

In essence, we take our private reactions, feelings, fantasies -- in short everything possible in our inner life -- as a series of commentaries upon the patient's material (Beres and Arlow, 1974). At times of maximum empathic contact, as these authors point out, we are apt to discover memories or fantasies or sensations which indicate to us shared unconscious fantasies of great importance. But the discovery of periods of minimal empathic contact may also lead to important insights.

We expect our patients to regress, develop resistances, transferences. We may discern transitory, similar reactions in ourselves, which we hope to analyze silently. We expect that from time to time on the stage within the analytic frame (Loewald, 1975) we "become" the patient's parents or other important people. Equally, we recognize that outside the analytic frame we are not parents, lovers, mirror images, parts or wished-for parts of the patients. While we experience ourselves -- temporarily, within the frame -- as taken to be, for example, parents, and our responses are authentic within the frame, we know that the analyst is an adult involved in a game which is sometimes quite playful but hardly ever trivial. Even within the frame we do not act like parents; we do not succor, ignore, reward, spank, cajole, argue with, instruct, bathe, forbid, etc., etc. Nor do we act like lovers, enemies, friends, siblings, or the patient himself or some part of him. We act like analysts -- a fact sometimes forgotten in the literature where one finds assertions that within the "alliance" the analyst is "really" being a better parent than the patient ever had. It is as disastrous for analysts to actually treat their patients like children as it is for analysts to treat their own children as patients.

Now in this situation a system of interactions develops consisting of information exchanged between the two parties, each with his own intrapsychic processes. As mentioned, the analytic frame is set up so that the interaction is unbalanced and quite unique. It is dramatically suitable as a medium in which the patient can enact and re-enact fantasies and feelings representing other frames of experience in his life, from the past, from the outside world. Opportunities to do this provide opportunities for unconscious changes in the balance of forces within the patient’s mind to take place.

Although the analyst sets up the outlines of the analytic situation in the first place, the common teamwork between the two, the shared, mostly unconscious areas of minds, and the rules and common fantasies governing communication about these areas, is a joint effort. Isakower (see Malcove, 1975) spoke of this as the "analyzing instrument." The workings of the analyzing instrument and the happenings in an analytic situation are framed by mostly silent proscriptive rules (the limits of permissible behavior), and regulated by embedded prescriptive rules. Analysis is like a game in the formal sense of game. The rules, of this game, generated by both analyst and patient, are existent and potentially understandable.

FRAME THEORY AND PSYCHOANALYSIS

There is nothing novel in comparing the happenings in an analysis to play regulated and codified in the form of games. Freud (1923) compared the opening and closing moves in a psychoanalytic situation to the opening and closing moves of chess; he pointed out that the technique in the middle phases of an analysis deals with matters too complex to be simply taught. Ella Freeman Sharpe (1930) also used the analogy, adding the elements of stage and drama.

"In play a child dramatizes the inner story. In adult analysis it has to be tracked through dramas, phantasies, memories, and linked with the staging of present-day life. In that relegating of roles, the infinite shifting, endless interchange of character -- intricacies of superego, ego and id -- the drama is being externalized and the patient learns what he is doing, rids himself of the fear not only of his wishes, but of the nemesis that his wishes postulate for him" (1950, p. 28).

Loewald (1976) similarly used the theater and drama as analogies and on occasion as specific metaphors for the analytic process.

There are at least two relatively new ways to think about social interactions which point beyond artistic approaches to these psychoanalytic questions. One is the use of von Neumann"s Game Theory (1944). Although Game Theory cannot mathematically explain complex games -- even simple parlor games have too many fluidly graded options to be analyzed mathematically -- at least Game Theory can summon possible models for psychoanalytic interactions. If the psychoanalytic frame and situations within it are seen in terms of an exceedingly complicated pair (or more than a pair) of games, we might come closer to the rules defining the games and their transformations into one another. Thus, the analyst and the analysand may work together using strategy and tactics designed to further the analysis of unconscious meanings (we win together, stalemate, or lose together), only to lapse often into zero-sum two person games in which there is conflict between the players (I win, you lose). The interdigitations of these games (and other possible games) might represent possible avenues to new insights.

Of more immediate utility to psychoanalysis is a general and less rigorously defined line of thought relating to the multiple realities of social interaction. It began with William James (1869), and was further developed by Alfred Schutz (1945), Gregory Bateson (1955) and Erving Goffman (1974). James approached the question of reality not by asking what reality is but by asking (and stressing) the question:

"Under what circumstances do we think things are real?"  

That is, there must be shared rules (again, usually totally outside ordinary awareness) for determining a situation which you and I, for example, would conclude to be "real." Schutz examined this question in more detail. In the search for the rules allowing us to generate any particular "world," he concluded that there are many worlds of reality and further that we experience a special kind of shock when we move from one to another. Some examples: moving from sleep into wakefulness, or from conversing quietly in a theater to the other world of the play when the curtain rises, or leaving an analytic session to confront the everyday world.

Bateson re-defined the "worlds" as "frames" -- defining frames as principles of organization governing social interactions. Observing the play of animals as opposed to their actual fighting, he saw that there could be levels of activity within the same frame which were in some respects the same, in others different.

Goffman took the same concepts and added the concept of "keys" to describe various levels of action within a particular frame. The key of the frame is analogous to the key of a musical composition. Change the key and meanings at one level of the frame become in part altered at another level. Take, for example, small talk between a man and a woman intended to be more or less meaningless in terms of content. Alter certain rules and that small talk can become communication between clandestine lovers full of meaning. A change of key results in a different version of something that remains essentially the same.

Goffman's brilliant Frame Analysis: An Essay on the Organization of Experience (1974) pursues these ideas with a subtlety and richness not possible to convey here. But I can illustrate them briefly without pursuing them systematically. Take two ten year old boys from the same culture. They are seriously fighting. Without consciously knowing or thinking about rules -- unless they are broken -- they observe quite complex standards and regulations during the fight. Rules covering beginnings, ritual ways to begin the actual hurting, prohibited forms of hurting, endings and epilogues. Take these same two boys again. This time they are playing as if they are fighting. Some, but not all of the earlier rules have been altered. Now expressions have changed, punches pulled, giggles emitted, and hurting and being hurt dramatized rather than actualized. It is well known how easily this second situation can, perhaps by miscalculation, be keyed down, and a serious fight erupt. But it is important to note that each situation, the serious fight and the play fight, is real in its own terms.

We can go further with our boys. The situation between them -- the frame -- can be further keyed upward. The two boys can play a game of checkers, again changing some but not all of the rules. Or they can play at playing checkers. Or they play the roles of two boys playing checkers in a school play. Or they can rehearse for that drama. All of these are "real", each in its own terms. Yet, different as the situations are, they remain in the same frame. In this example, they all remain within a frame defining a competitive struggle between peers.

Unfortunately, non-psychoanalytic interactional theories of the sort proposed by James, Schutz or Goffman operate at phenomenological levels which do not include either the perspective of multiple unconscious motivations or a historical perspective to every act. Goffman, for example, uses for his baselines ordinary, everyday experiences. In the example given, his baseline would have been two similarly acculturated boys in a fistfight. It is quite possible that Goffman would not agree with a psychoanalyst's speculations about the fight. The psychoanalyst, shrugging his shoulders, would assume that further changes of key could be made downward from the ordinary fight. For example the fight might be an elaboration of unconscious homosexual impulses which might in turn be keyed back to oedipal conflicts and wishes, sibling rivalries and pre-oedipal conflicts of various sorts.

Goffman would probably agree, however, that if our interpretations are correct, each of these unconscious levels has its own reality; one is not more real than the other. And he certainly would agree with the idea that when I see "Death of a Salesman" my feelings about Willie Loman are "real," and they are not made up of the whole cloth of imagination; there is an entity known as Willie Loman. I know also that the actor called Willie has another name; each name is valid in its context. From this point of view, the distinctions between "fact" and "illusion" become more complex: what is "fact" in one context becomes "illusion" in another, and vice versa.

Early on in an analysis, the patient takes what he knows of interpersonal relations as factual. The analyst knows better; he knows that these relationships, seen by the patient without the dimension of unconscious processes, are at least in part illusory. Conversely, the patient may intellectually know something about the unconscious, but cannot help but regard these ideas as theories without the emotional stamp of truth. But as the analysand progresses, he comes to know these more fundamental aspects of his experience as factual. Similarly, the patient may discover that transference phenomena taken as factual by him are in part illusions, based on repressed, childish wishes. At the same time, the analyst knows that the transference phenomena in part are factual.

There is nothing imaginary about the affective erotic and destructive swirls of currents in the consulting room. Each is real in its own sense, and it is a mistake to interpret them "away" as "really" concerning past figures. Nor is there anything more "factual" about the patient and analyst working together cognitively as an adult "team;" there are transferences there too. Following this view, questions like the real relationship -- and the transference relationship -- simply evaporate.

To summarize, the analytic frame is empirically constructed so that it facilitates both the recovery of "facts" and the recovery of "illusions:" it is constructed to allow for more and more fantastic (but nonetheless "real") changes of key "down" within a given frame enacted within the larger analytic frame (we term it regression), and some of the time keying upward in the opposite direction. In this way the analytic frame is uniquely suitable to allow the illusory dramatizations of other frames within it, as Loewald (1976) showed so beautifully: frames encompassing outside relationships, past relationships, fantasied relationships with one's own self, and the like.

A large part of an analyst's ordinary, minute-by-minute work is aimed at catalyzing changes of keys within the analytic frame up or down, thus demonstrating to the analysand his attempts to keep out of awareness the connections between the analytic frame and the multiple other frames dramatized within it. The analyst is a weaver; his analysand begins as a weaver or becomes a weaver. Else he is not analyzable. The analyst works -- in usually small and half thought-out ways -- to demonstrate to the analysand his neurotic need to maintain himself as though he were in fragments, to try to be half alive by clutching only to "facts" at the expense of "illusion," or to try to be half alive my mooning about in "illusion" at the expense of "fact," or to compartmentalize the present from the past, or the inside from the outside. In analyzable patients, whatever the pre-oedipal determinants, these neurotic distortions of the personality are invariably in the service of coping with uniquely unresolved but "frozen" oedipal fears and wishes. And if structural changes result, it is because the neurosis that began as the infantile neurosis comes to include the analyst in a situation which bears the most convincing stamp of reality of all -- in terms of feeling: the analyst becomes the object of the most infantile desires; he becomes the object of incest and murder.

Some analysands are able, for whatever reasons, to hold to the overt and covert rules which govern the analytic frame with little difficulty -- except, of course, to consistent adherence to the fundamental rule of free association. But failures of the latter sort help them to come to understand that resistances are resistances to themselves, and are as important -- temporarily more important -- to analyze as anything else. A recognition of resistance temporarily changes the key of the frame. Analysands of this sort are regarded as "good patients." The capacity to observe and stay within the limits of permissible behavior in the analytic situation is the most important element in the question of "analyzability."

Those patients who are not able to adhere to rules, who hold that certain rules are made only for other people, force the analyst to tend the frame, lest it be broached and the analysis fail. Or if it has already broken down, to repair it if he can. The analyst's aim is to maintain an analytic stance, interpreting resistances, avoiding, if possible, non-analytic interventions. Yet every analyst has his own limits. He will only go so long without being paid, for example.

Patients who persistently broach the analytic frame are regarded as "difficult" patients. Much of the work has to do with the reasons the patient has to "act out," perhaps refuse to pay the bill, miss sessions, force external events in ways that would be self-destructive or at least destroy the possibilities of analytic work. Sometimes the analyst has to temporarily abandon the analytic frame in order to preserve the possibilities of work; sometimes he has to resort to measures which are psychotherapeutic rather than psychoanalytic, with the hope that these departures from standard technique can be analyzed later. Some analysts label these patients "narcissistic" or "borderline;" sometimes they are said to have ego or character "defects;" sometimes they are thought to be developmentally blocked in certain ways. Other analysts simply call them the "sicker" and "sickest" patients. Too often, attention is focussed on "archaic" qualities of fixations and object relations. Yet, there are patients who seem quite "narcissistic" or "borderline" who do very well in analysis. They are able to maintain the analytic frame despite the supposedly primitive nature of their conflicts. Still other patients appear to have more ordinary psychoneurotic organizations and yet are analyzable only with difficulty, or not at all.

The problems comes to this: why can some people construct an analytic frame more or less spontaneously, and others not, or at least not without considerable work on the part of the analyst to help set up and maintain the frame? The answer is not merely an estimation of how primitive the conflicts are, or the postulation of very early developmental failures. Some of the answer would involve the effort to understand specific ego and superego functions having to do with social interactions. In most ordinary and successful psychoanalytic experiences, these functions may be taken for granted and are not subjects for inquiry. They "go without saying," so to speak. But some more "difficult" patients call attention to the rules discussed in earlier sections of the paper, the prescriptive rules governing ordinary social realities, and the proscriptive rules -- the limits of permissible behavior. And they call attention to how these rules come to be set up, or fail to be set up, during the course of development.

Logically, we would associate the prescriptive rules with ego functions, including ego values. And we would associate the proscriptive rules with the superego. Where there is no conflict, the ego and superego functions cannot be distinguished, of course. It follows that the concepts of the superego, in particular, need to be greatly expanded. The superego, as Freud indicated repeatedly, has not only to do with prohibitions and ideals. It has to do with the capacity to engage with the worlds of others. In fact, if it is successfully made, it is the representative of one's society and one's culture. At unconscious levels it is also what we mean by the metaphorical Phallic Father. It represents a world of reality including the genital world of parents and the separation of the generations in terms of erotic exchanges. It follows that the restructuring of the ego and superego organizations after the approximately adequate resolution of the oedipal dilemmas allows for a progression into the less intimate social worlds encountered in latency. The failure of oedipal resolution in these areas carries momentous consequences. While these issues are of great importance, they cannot be addressed further here, and will be discussed in a future paper.

A CLINICAL VIGNETTE

In the turbulent years of the late 1960's, I began to work with Dr. L., a young professor in one of the humanities. He was still not thirty. He dressed and acted as if he were a member of the "counter-culture," but was not. A slightly built man, he wore his hair in a sort of bush; he could have been a model for rock star or a bust of Beethoven. At that time, Dr. L. functioned professionally far below capacities and felt no sense of "really" being a professional. "Life seems to be slipping by," he said, "meaningless."

After the analysis began, it came out that he had smoked marijuana every day for years. He felt bad, and called that "chronic depression;" he knew close relationships seldom lasted and the responsibility was his, though he did not know how or why. A secret stance against all authorities was labeled "guerilla warfare" (when he felt expansive) or "just grumbling" (when he felt low). Prospects in the academic hierarchy seemed hopeless. Something was very wrong.

The analysis, though ultimately satisfactory, was long and difficult. Despite intellectual and artistic gifts, despite strong motivations, despite periods of fascinating associations, nothing much happened for over a year. The material seemed disorganized and vague; a passive negativism hung like smog. Spells of vicious hatred, when interpreted, led only to utter despair, and worse, to all sorts of acting out. Over and over, I doubted my analytic stance, whether I could maintain it -- or should. Interpretations were of no avail, either, in reducing the daily dependence on drugs.

Finally, I told him I would not continue unless he agreed to absolutely stop the use of drugs. Whether this "parameter" should (or could) have been used earlier remains a conundrum. In any event, he complied, but with rage that was unspeakable. During the following months, however, matters improved; associations were less vague; his manner was not so bland. But brief periods of apparently useful work would still be followed by long periods of resistance, in which the patient alternated between the manners of a wickedly provocative, haughty, impoverished nobleman and a clinging, whining, constipated little boy.

From the age of four, L.'s years were stormy. The first of a number of terrible separations came at five, when, without warning, both parents left him with relatives and vanished – at least as far as he knew. For two years he did not hear of his mother, except that she was alive. When he was seven, she returned and reclaimed him. She then had a new husband. L. detested the man from the first moment; he tried to kiss his "new daddy," only to be rebuffed as a sissy. The family made many abrupt moves subsequently, only jumps away from the bill-collectors.

A messy, truculent, contemptuous lad, he was always protected by his mother from the stepfather's hand. She indulged him in every way she could. Except with her, the boy was forever the "outsider," living by his wits. He hated sports, but from an early age read constantly, voraciously. He had intellectual friends but no playmates; later there were sexual encounters but no authentic partners. By late adolescence he possessed a fine ability to pick up information by listening, but had lost the pleasure of reading. Beyond the bare minimum, he rarely was willing to read the literature of his profession. He loved the music but hated the theoreticians and critics. Yet, he could speak as if he were learned indeed. Ashamed of the fraudulent erudition, he was nevertheless proud that he could get away with it. Dr. L. was a witty conversationalist, and had an entertaining and complex sense of humor. Many people liked him, but the liking could never be reciprocated very long. Attachments often had a kind of fierce intensity, but they almost always broke down. Mordant and crafty jibes, usually aimed toward men, antagonized or intimidated them. He looked for fathers; he had to demolish fathers.

One day, about a year and a half into the analysis, he related a dream.

He was in his car, at night. He had been having reveries -- dreams within the dream which he could not remember; suddenly he "awoke" to discover that his car was parked on the median ground of a boulevard down which trolley car tracks ran. He was shocked: he could have been killed by a streetcar. He peered down the tunnel of trees; sure enough, far away, one was coming. Then, somehow, he was outside the automobile. He noticed a policeman taking his prized new car away. He felt outraged; after all, he had intended to move it himself. Across the boulevard, in the middle of a residential neighborhood, was "Irwin Sander's Bar." He went inside. There were prostitutes upstairs. He was attempting to explain to an older man what had been happening. The man clearly did not like him. "You'd better call the police," the man said, "they'll diagnose you -- I think you're a paranoid schizophrenic." This was very upsetting and the dreamer kept following the man around. "You don't understand. I'm not a schizophrenic. I'm a professor!" He awoke with anxiety.

As he finished the account of the dream, Dr. L. chuckled ironically at the last part. He knew that I recognized his contempt for professors. But instead of commenting on making himself the butt of the humor, he remarked that he knew the exact location of the dream. The car had been on the streetcar tracks by a stop nearest the apartment where the family had lived when he was twelve or thirteen. (He told me where, and I automatically knew two things; the location was far up the boulevard in an area which would have had no bars, and it had large, expensive homes and some rather modest apartment buildings. To have lived in one of these apartment buildings would imply a much lower social status than to live in a house.)

As a boy, on Sunday mornings before daylight, he would wait at this same streetcar stop; he was an altar boy in a church some distance away (one, I knew, that could not rival the Catholic church attended by the town's elite and which was, in fact, within easy walking distance from the apartment). The last car to get to Mass on time came at 5:30. He remembered what it was like to look down the long dark tunnel of trees and see the headlight of the trolley car appear, far away, trembling in the soft pre-dawn air of New Orleans. Listening, it seemed to me I knew what he felt as a twelve or thirteen year old, despite the superficial differences of our generational, geographic and religious backgrounds.)

Dr. L. did not pause, but went on to mention that he did know an Erwin Sanders, but the first name was spelled with an "E", unlike the name of the bar, which was spelled with an "I". That brought to mind a painful memory from the age of seventeen: the first girl he had loved (after his fashion) had written that she had to break off the relationship at her wealthy parents' insistence. The young couple had been surprised en flagrante. (He told me the details, seeming not to remember that he had told them all before. I did not comment.) After receiving the letter, in distress, he insisted to his mother that he go away for several days to stay with friends. She had not protested.

But he did not go to the home of a friend. He went, instead, to the French Quarter, at the other end of the streetcar line. In a bar, he met two older men; one was a stranger; the other, Erwin Sanders, thirtyish, was a librarian of a small museum. Both seemed healthy, athletic and "intellectual." Both seemed to like the boy, and they drank beer all afternoon, found something to eat, walked around. Sanders eventually suggested that L. stay overnight in his apartment nearby; he could sleep on the couch, and the other man had something else to do. But once there, why sleep on the couch, the man asked, why not share the bed? And in the bed the touches began, tentative at first, unmistakable later. The boy felt consciously shocked. Could he be wrong about what the man was doing? What was he doing there? And he felt excruciatingly embarrassed. He just wasn't interested, he said, apologetically. He liked Sanders, but didn't want to do things like that.

The man finally desisted, and L. hugged the edge of his side of the bed, and thought he must have slept the whole night that way. He also remembered that he was aware that his buttocks were turned to Sanders. In the morning, when they got up, the displaced lover -- it was obvious by then -- returned. The three went out for breakfast. It was as if nothing had happened. (Again, as I listened, the boy and his dilemmas seemed particularly "real"; and I thought I had a fairly clear understanding of the unconscious origins of those dilemmas.)

Still without pausing, Dr. L. returned to how "Erwin" had got changed to "Irwin". Or maybe it was "Irvin"? Then, he had heard of another local psychoanalyst named Irwin, a man he had never met or known about in other ways but had learned of his excellent reputation. This analyst, older, might have more prestige, skill and wisdom; perhaps he would have been better. And, though it made him feel awkward (so he said), he had to add that the other analyst might be more masculine than I am. "'E' replaced by 'I' -- what the hell is that? Oh, 'I' for 'me'? I don't know what do do with that." Then he thought of the bar, with its prostitutes, as opposed to the homosexuals in the French Quarter.

Without knowing quite why, I asked if there might have been something that happened recently to connect these thoughts. Suddenly he almost sat up on the couch. "Oh my God," he said. He remembered that a friend had mentioned that F., an acquaintance, was also an analysand of mine. L. had spoken in earlier sessions of intense rivalry with F. What had startled him was that one of F.'s names also happened to be connected to the material (in a way I cannot specify, for reasons of confidentiality). He hated F. for his good looks and socially proper manner; as an eligible young man he was much more likely to meet attractive women. I remained silent.

Spontaneously and gradually, Dr. L. shifted into another mode or style of communication. He reported, with no trace of excitement, a fierce argument with the woman he was living with. Afterward, he had spent some time with an old sexual partner -- one he degraded -- and had considered going to bed with her again. As he talked, L. seemed more and more bored. I thought he was going to drift off into rather flat, detail-ridden ruminations, a characteristic form of resistance. I mentioned that he seemed bored, and added that he had apparently given up on the dream. (I did not mention that the defensive departure also was a disguised reference to it.) Dr. L. admitted that he hadn't understood anything about the dream.

Almost dutifully, he returned to it, speaking about feelings of separation (girlfriend, mother, current lover), and the fact that he had wound up in bed with a homosexual so "naively". Then he connected, quite blandly, his memory of his buttocks turned toward the man while he was asleep, and the streetcar bearing down on him as he was lost in the dream of being in a reverie. Hoping to thicken this rarified air of what I took to be intellectualization, I asked, "But what do you think all these things have to do with your relationship with me? For example, you haven't said anything about my middle name." (For a moment, distrusting my contact with my own unconscious life, I thought asking this question might be a mistake: after all, I rarely use my middle name, Erwin, and was not certain my patient knew it.). He reacted with visible shock.

"What? What is your middle name? 'E' -- God -- it's Erwin. I looked your name up in the directory a long time ago. (I don't believe he had ever told me this.) Dr. L. seemed stunned. Impressed. Awakened. But by then we had used up the session.

Dr. L. was quite late for the next appointment. The work was dreadfully dull. Interpretations relating the resistance to the happenings the day before at first were met with blankness -- he couldn't remember anything about the session. Then he did remember, and remembered being excited. But "deadness" had descended again like a blanket, and he had spent most of the day procrastinating.

The following session, however, he was able to experience as "real" an intense need to destroy me in a "real" way, and a bit more work could be done. 

CLINICAL DISCUSSION 

I did not believe the session represented a "good hour," only a good dream. Knowing the history, it was fairly easy to understand that the latent content had to do with the activation in the transference of negative oedipal yearnings and defenses against intense castration and separation anxieties. Knowing it, it would have been possible to interpret the dynamic complexities of this intricately constructed dream in a variety of ways. And the patient might even have "accepted" these interpretations. But I had been down blind alleys before. I chose only to interpret the resistance in ostensibly moving away from the dream (as he came to a closer awareness of homosexual wishes and flew off into a dead account of promiscuous heterosexual displacements), and the obvious, warded off dilemmas relating to the most intimate possible relationships with me. I knew that it not only would have been a waste of time to refer to the relations with his sexual partners as transference displacements, it would at that point have been distracting.

In one way, I regarded the dream as an unconscious play, documenting the course of the analysis up until that time: reference to the use of drugs (the reveries within the dream), the various transference representations (the policeman taking his car away, doing his work for him, later to return and diagnose him as hopelessly ill, bad and helpless -- ignoring his ironic joke; the unfriendly man who diagnosed him as not only psychotic but a criminal as well; the homosexual librarian; and then there was the streetcar imagery: the streetcar emerging from the tunnel of trees which would take the lonely thirteen year old to salvation, the seventeen year old to the actualization of sexual fantasies, the streetcar that might be blocked by the sleeping man's car or that might be an unstoppable, intrusive, destructive force).

The subsequent examination of this clinical "strip" showed three noticeable spontaneous affective expressions during the session, the two sets of memories from adolescence, with their poignant appeal, and the sudden panic and chagrin that he might have been run over by a streetcar while indulging in reveries. My interpretations touched off two other affective expressions, both guilty, startle reactions (condensations, I believe -- in terms of later material -- of memories of infantile traumata, including responses to the primal scene). It was as if I had caught him playing with my name in his sleep -- putting an "I" in it -- replacing me with a more gratifying and masculine analyst, and fearing that he would in turn be replaced by a more appealing rival.

Partly on the basis of earlier material, but partly on the basis of the dream itself and the associations to it, I believe the dream represented on different levels, an ambivalent presentation, a gift, a homosexual invitation, a masochistic provocation, and an attempt to have the work done for him, served up to him to be intellectually but not affectively received, more likely contemptuously denied. And it had to do with murder. But it was also a creation for the analysis: an interpretable dream. My dilemma at the time was obvious. Flooded with material, my Scylla would have been too much intervention, my Charybdis too much reliance on affective expression. While I could extract a great deal of meaning from the material, and while the patient could have extracted all sorts of intellectualized understandings, there were only brief encounters of shared, immediate meanings.

In most ways, most of the time, the patient had been merely feigning being in analysis.¹ He was frozen in only one position: the only way he could see me was as actual enemy. It was not that the other transference representations did not exist; it was that he had no affective access to them on any level near consciousness. And it was not that he had an inherent difficulty "testing" reality; it was that his dynamic needs left no possibilities for challenges to certain conscious "realities." He could not mutually constitute such realities. When I "caught" him, he did not respond with relief, or more material, or more insight. He responded as though he were literally in danger. The stamp of "reality" was placed on this version of his relationship, which was not influenced at all by his "rational" conceptions of "reality." "Rational reality," for that matter, did not feel "real" to Dr. L. While a transference neurosis might be fairly assumed, its negative aspects, and its deeper positive aspects, were not analyzable at that time.

But there was something representing a potentiality, at least, for future shared analytic work. My inner responses to the adolescent memories represented the one area of effortless "shared play" -- not a part of an unconscious feigning or duping -- that might provide a connection with the patient, an access to a transferential reliving. And so it proved to be. It was, in retrospect, the beginning of a workable analytic situation, as opposed to one that was in some respects a spurious one. If there were space I could document this thesis.

INTERACTIONAL THEORY

The preceding remarks about reality suggest the relevance of attending to the rules governing the analytic frame and the enactment of other frames of experience (the current life, the transference, the past). It has already been mentioned that ordinary psychoneurotic analytic patients are able, without major difficulties, to set up and follow the almost completely silent rules governing the dialogue and the limits of permissible behavior with the analyst. Their outside lives are also governed by reliably shared and generated rules with others. That is, their outside behavior is not to a significant or dangerous degree "acting out." Resistances are not so impenetrable; in clearer periods such analysands are able to reenact frames of past experiences, transference experiences, and extra-analytic contemporary experiences, and connect them in affectively alive ways. Perhaps spontaneously, or responding to the analyst's interventions, they are able to subtly change the keys of these frames both "down," regressively, and "up" to various levels of secondary process thought. Achieving new insights, they come to understand the historical nature of their psychic acts, ultimately to freely connect multiple realities into a sense of the wholeness of the personality. The analyst can function more truly as a catalyst -- not as a reagent. In a practical sense -- though not in a theoretical sense -- frame theory is irrelevant to the work with such "good" patients. The interaction "goes without saying," so to speak.

But Dr. L. was not able to function like such "good" analysands, for dynamically valid psychological reasons. At least for a long time he could not. I believe early experiences (the loss and lack of replacement of the father; the loss and tenuous recovery of the mother) favored a distorted oedipal compromise. Concomitantly, there was a lack of structuralization of certain ego and superego rules governing ordinary interactions with others in intimate relationships. Some rules were not "made" for him -- in fact, some rules ordinarily shared with others did not exist for him in intimate situations. Material from the analysis as a whole provided further understandings of the intrapsychic structures and functions, and their developmental origins, which accounted for the patient's inability to place the "stamp of reality" on many social interactions and their various "worlds." But the remainder of this paper will attend only to an interactional analysis.

In terms of frame theory, the patient assumed one set of rules governing ordinary behavior while the analyst assumed another. There was little mutuality in the framing; he had one set of realities and I had another. In terms of enacting and re-enacting other frames of experience in the encompassing shared frame of analysis, all his past experiences led him to assume the hatred of me and the fear of any positive contacts were factually based. He could not discover that some "facts" were illusory and some "illusions" were factual. Nor could he utilize the historically active positive and negative oedipal events, and pre-oedipal precursors, as part of the whole of his life. The patient had a severe limitation in the scope of his worlds of realities. He expressed this in the unremembered dreams within the transference dream.

For a long time, Dr. L. was not able to "willingly suspend disbelief." He could not experience various transferences as "alive" or immanent. This was true on one level because of the unneutralized qualities of the hateful and homosexual conflicts, which had to be warded off by any defensive means. On another level, it was true because he was unable to engage in a cooperative situation with another man whereby he could allow free play for his imagination – in which he could place the accent of reality on the re-enactments in the transference of memories of the past and continuing unconscious fantasies. Intrapsychically and interactionally, he was caught in the rut of one dimension of inner reality, and thus, outer reality. He could not connect with other dimensions.

It was useful to examine in more detail the shifts of enacted frames which occurred spontaneously, as well as those triggered by my interventions. The first enactment was one of sleeping, broken by the intrusion of the recognition of dangers (actual and archaic) of continuing to sleep. The second represented the scene at the bar (based on memories of his experiences in the French Quarter, in which he attempted to find in action some solution of the oedipal dilemma; based also on his own versions of the analytic situation). He "awoke" with a jolt.

His associations moved to the adolescent memories, and from there, back to the transference and envy and rivalry in relation to the acquaintance, F. But anxiety mounted, and when I failed to intervene he altered the key of this frame "up. The analogy to musical keys is limited. Musical keys function along one dimension. The changes of social keys would have to be thought to exist in lateral dimensions as well to an affectless account of his battles with his lover, along with a bland reference to defensive promiscuity, ostensibly leaving the dream behind. At this point, I did say something, but inadvertently triggered a change of key even further "up," to more or less empty intellectualizations (however accurate his interpretations might have been on a strictly cognitive level). Again I intervened, this time more effectively, interpreting the resistance in one -- and only one -- of its aspects. The change of key "down" brought forth a sharp awakening to the intensity of his transference feelings, partially understood in both their hateful and homosexual meanings. For a brief moment, he seemed to understand that the dream was part of a complex whole, that his life was a complex whole. Momentarily the analysis "came alive."

As the months and years went by, such moments came more frequently. As they did, Dr. L. altered his external life; more and more he became able to have social experiences that felt "real" to him. First in the transference relationship, then in others, he could feel involved not only with play but with work. Intimacy became reliable. And the analysis slowly came to be like other analyses.

Such patients are often misdiagnosed, I believe, as "borderline." Although the technical difficulties may be expressed in terms of setting up and maintaining the analytic frame -- holding an analytic stance -- in the face of the analysand's continuing subtle and gross efforts to evade it or broach its limits, such difficulties are not necessarily traceable to "archaic" traumata, conflicts or developmental blocks. There is no one-to-one relationship between the severity of pathology (as we assess it) and "primitive" developmental problems. I was never able to document or reconstruct a history of pre-oedipal catastrophes with this patient, although there obviously were pre-oedipal determinants, particularly of an anal nature. The patient instead had catastrophes during the oedipal period, and afterwards, leading to inadequate structuralization of those superego and ego functions necessary if one is to operate according to internalized rules governing the limits and possibilities of social behavior, necessary to be able to generate "ad hoc" mutual rules governing ordinary behavior, and the capacity for mutual play. It is not a great interest of mine to diagnose patients according to descriptive nosologies. But I believe this man was an unusual sort of obsessional neurotic.

__________________________________________________________________

ENDNOTES

1. "Feigning" is a slippery word. Dr. L. was not dishonest. But more than most analyzable patients, he was, for a long time, simply unable to consciously conceive parts of the analytic relationship, much less commit himself emotionally to them. 

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