Balancing Empathy and Interpretation

How does the therapist avoid the twin dangers of either being a bull in a china shop or of handling the patient with kid gloves? How can he or she balance empathy for the patient's subjective self-experience with the rigorous analysis of the patient's unconscious defensiveness? For decades these questions have been at the heart of debates about psychotherapeutic technique and the source of tremendous polarization in the field. In the early days of psychoanalysis, one analyzed character resistances either aggressively like Wilhelm Reich or more gently like Anna Freud. Today, one sides with Otto Kernberg and confrontatively treats borderline and narcissistic pathology or, following Heinz Kohut, works more empathically. Lawrence Josephs transcends the rigid polarities of competing schools and offers an innovative approach. He proposes that one can move back and forth between opposing psychoanalytic stances and that flexibility in clinical technique is the key to efficacy. According to Josephs, when we avoid remaining rigidly stuck in any one way of working, we can learn from all perspectives. Dr. Josephs's own point of view centers on one simple recommendation: to maintain a dynamic balance between empathy and analysis. It is an easy recommendation to make but difficult to implement. Through the re-examination of classic case studies from Freud to Kohut, the author demonstrates how one can balance the rigorous analysis of the patient's character resistances - the most narcissistically injurious aspect of psychoanalysis - with a deep empathy for the patient's subjective self-experience - the most healing aspect of psychoanalysis.