Hope and Hopelessness: A Technical Problem? Por: Mehler, Jacqueline, Amati, Argentieri, Simona, International Journal of Psycho-Analysis, 00207578, January 1, 1989, Vol. 70

Hoping and losing hope are two ways of thinking about the reality of times to come, ways of thinking that become intertwined and linked in each individual in a continuous and natural fluctuation throughout life. But in analysis this attitude towards hope is still more significant and rich in complex implications, since the fostering or losing of hope develops and becomes necessarily more articulated within the frame of the analytical relationship, involving as it does subtle transference and countertransference, conscious and unconscious issues.

Often our patients come to psychoanalytic treatment as their 'last chance', as a real sacrifice to the spes ultima dea. We must not forget, however, that one of the analyst's natural tasks is to strive for an alliance with the vital forces of hope in our patients, as an expression of our basic trust in the real therapeutic potential of analytical tools.

Obviously, this 'function' of general unspecific openness to hope should not be confused with specific expectations or with the conscious or unconscious wishes of the analyst regarding the patient. We should also consider that over the whole course of the analysis, and according to the vicissitudes of the analytical relationship, the 'level' of hope may undergo deep oscillations not only in the patient but also in the analyst. Often enough we can trace in ourselves an excessive omnipotent feeling of hope, and we must watch out for this, even if we know that sometimes a tiny bit of omnipotence may reveal itself precious if used in the service of therapy! At other times we may have a feeling of despairing impotence, accompanied by a sense of devaluation of ourselves, the patient or the analytic instrument.

Within this vast and complicated subject, however, the purpose of our paper concerns a limited and circumscribed area; we intend, in fact, to make a few remarks about certain particular clinical situations, in whichin our opinionthe statement of loss of hope on the part of the patient assumes a specific meaning of resistance, and imposes on the analyst not only the difficult task of understanding and interpreting it but also a strenuous and delicate technical problem.

We ought to start by saying that this paper is the outcome of a sort of 'two-voiced reflection'. As often happens among colleagues, we had been exchanging impressions about our clinical experience and especially about some particular situations we had encountered. Even though the cases were quite different they had caused us a similar series of difficulties in the analytic process, due to a long situation of stalemate common to both. We may briefly synthethize both situations by saying that, in an advanced phase of analysis and after long, intense and profitable work had been accomplished, the course of the analysis had become blocked by impressive monotonous communications such as: 'I just can't make it can't make it ' in one case, and 'I never felt so bad everything is useless for me' in another.

Naturally, all possible interpretive paths had been tried and experimented with, as we shall show in some detail later, until a moment came at which both analysts resorted to a rather atypical and unusual technical strategy, perhaps evenand here we come to the point of our paper on which we want chiefly to focusopen to criticism or at least not rigorously analytic.

In the first case what happened was that the patient, whom we shall call Y, continued to repeat in the session with particular painful intensity, 'I feel I'm always worse analysis can do nothing else for me it's all useless ', until the analyst at this point responded directly and explicitly: 'Maybe it's so'. In the other case, in similar conditions, the patient kept crying and saying, 'I can't help it', and the analyst said: 'I'm afraid I can't help it either'.

Both interventions undoubtedly represent something of an unusual statement in analysis. We feel however that in each case it was precisely the disruptive effect upon the transference dynamics that constituted the turning point of the analytic process in that it released the blockage and formed the starting point for the termination of analysis.

Before discussing the meaning and the implications of this technical choice, we would like to illustrate the clinical material that provided the basis for our work. We felt it was more appropriate to report in detail only one of the cases, that of X, limiting our description of the other one, Y, to a brief sketch.

Case I: Y

We shall merely say that after many years of hard though rewarding work, the patient's pain had crystallized into an apparently depressive symptomatology, with intellectual and affective life reduced to its lowest ebb and ruled by a perpetual lamentation about the grave and ineluctable situation she was in. 'I'm so miserable I'm always worse it's all useless!' was the leitmotiv at the beginning of every session, in which improvement and gains attained through the analytic work were systematically ignored or cancelled by the usual complaints.

There was apparently no overt aggressiveness towards the analyst; rather there was the patient's fear of having reached her own limits, a painful appeal for further help or for a word that would revive hope.

The analytic work had dealt all along with the exploration of genetic and transference vicissitudes, the tendency to confer totally upon the analyst the role of the rescuer; the need to defeat in the analyst the image of an idealized and envied mother; the patient's inability to allow herself some serenity and peace on account of cruel archaic superego attacks; the masochistic attempt to provoke sadistic attacks from the analyst on account of her inertia; the unconscious need to guarantee herself an eternal analysis on which to depend etc.

With a feeling of weariness, the analyst too analysed her own painful sense of frustration, impotence, exasperation and irritation; the sense of challenge launched by such overt despair and the desire to meet the challenge and to fight the destructiveness of inertia and failure; above all, the authentic sense of compassion for the patient and the wish to understand the sense of this stubborn mechanism.

During one of these monotonous sessions of plaintive and repetitive declarations about the ineluctability of her destiny, when Y said, 'I am afraid there's nothing else to do', the analyst decided to respond straightforwardly and explicitly, 'maybe it's so'.

The patient reacted to this brief statement with great emotion, 'as if she had been struck'Y said later. She kept silent for a long time, most unusual for her, and gave up at once her complaining, querulous tone of voice. She said later on that she had felt the analyst's words as very harsh, but also extremely real, as if for the first time she had actually realized that there was a genuine possibility that analysis could come to an end without her having made adequate use of it.

It is most significant that the analyst should suddenly have introduced the temporal dimensionthe passing of the years and the end of thingswhereas it is in this regard that the resistance appeared to aim at exactly the opposite result: to enchain life and the analysis in an eternal and interminable dimension, even at the price of pain and failure.

The following case, which we shall describe in more detail, is similar in many respects to that of Y and quite different in others, but, just as in Y's case, a crucial developmental organizationwhich had, throughout the patient's life, prevented any escape from the role of eternal and hopeless victim of destinyhad now been invested in the analytic situation and threatened to result in the same outcome.

Remarkable insight into transference issues involved in such an impasse did not keep the patient from clinging tenaciously to the conviction that she 'just couldn't make it'. Trapped in this technical paradox, the analyst, after quite a long period of immobility, responded beyond customary and classical transference interpretation (by now thoroughly elaborated) by making a statement to the patient about her intention to step out of a repetitive script which required an ever-present and thus unreal analyst-partner.

Case II: X

A clever, smart 35-year-old woman requested a second analysis because she was again feeling depressed, unsuccessful and rejected. She was unable to work, to understand who she really was and what she expected from life, other than constant reinforcement and gratification, which she anyhow felt was utterly insufficient. Even when she could obtain gratification, Miss X would often fail to acknowledge it, or else even manage to turn potentially rewarding situations against herself or the people she cared for. Her brother, who had been mother's favourite, had become seriously ill mentally, and the patient's sincere efforts to take care of him confronted her with her own feelings of inadequacy, deprivation and ambivalence, so she eventually decided to look for help again. Miss X had first gone into analysis several years earlier with another colleague, for about seven years, because she was then very unhappy with her sentimental life. She was very attached to a married man who was, in fact, also very tied to her. This long liaison still continued when she started her second analysis. In her relationship with her partner she alternatively felt either as her own mother had, generally depressed and neglected by father, or like one of several women with whom her father had had affairs.

Different triangular situationsenacted through different role identificationswere quite a central issue in her history and in her analysis, but the intrapsychic conflict behind them was not only or even mainly oedipal. The patient, however, described her experience in those terms, saying that she was always in search of 'paternal figures'.

According to X, her mother had never really loved her and was jealous of her daughter whom she considered a rival for her husband's attention. The mother instead worshipped the brother, who was always on her side and had been generally despised by his father. The father felt X to be more capable than her brother and it was she who followed her father's professional activities. When X identified with the neglected mother she would complain that her partner (she often said the same of close friends) didn't care enough for her; but it soon became clear to us that behind the role of a neglected adult woman, the voice of a plaintive deprived child could be heard. Constant admiration or acceptance was needed to support a faulty image of herself. She was quite arrogant, though, and if her natural generosity encountered even a minimal inattention or distraction this would rouse catastrophic, furious feelings of rejection and exploitation. Her mother had apparently never been satisfied with any of her performances and only father had partially gratified her need for approval. Rather than feeling jealous of her father's other women, this gave herthrough partial role identificationa sense of guilty triumph over mother. In relation to her partner she thus lived again several roles:

a child neglected by the father-partner who was not her exclusive possession (although at a much deeper level she yearned above all for the maternal aspects of her partner);

a neglected wife like her mother;

a mistress, second-best to a wife-mother who had every thing she missed: social status and a husband;

an accomplice to the father-partner and guilty towards the neglected, betrayed mother-wife figure.

In this way X would usually accomplish an alternating succession of enactments by splitting off a part of herself, and this enabled her to remain in the same situation in spite of her real misery and pain. It took a very long time and a lot of work for her to realize the enormous unconscious need to remain attached to the role of complaining victim, thus less guilty than her slanderers but unable to gratify the needs of the different part-roles which were in opposition to and in contrast with each other. In fact, the one time she succeeded in her requests for the partner to leave his wife and live with her, she was unable to bear this choice; she promptly started an affair with another man, for about a fortnight, just long enough for her to 'convince' her partner to abandon the project and go back home to his wife.

In analysis, during the first months, she was very surprised at the ease of the relationship and of how she was able to feel trust and hope. As her involvement increased she started to worry, feeling 'it couldn't last', something was bound to happen. X wasn't working and, as she felt slightly better, she told the analyst, 'I know it would please you if I went back to work'. When the analyst wondered what made her feel this way, X started to cry bitterly, saying that since her father had died she had nobody she could really talk to. It became quite clear that as long as she could feel the analyst as a father figure she was safe, and felt supported enough to comply with what she eventually felt were the analyst's expectations. She was strong enough to take care of her brother in spite of her resentment of his past privileges with mother, and some of her guilt was appeased. But hard times were to come Her material all along, but especially her dreams, had been dealing either with stealing jewels from other women or with possessing things that would turn out to be somebody else's belongings. Another level in fact started to appear in analysis, dealing with earlier experiences and issues related to her relationship with her mother which had not been worked out in the first analysis. Positive and negative aspects of envy, greed and competition, a faulty organization of the separation-individuation process; all these now showed the basis and foundations on which what at first sight seemed oedipal guilt and conflict had been built.

The question as to whether this material appeared now because X's second analyst was a woman and the first had been a man, or whether she had in her first analysis merely been able to work on a safer level, analysing oedipal material in relation to her sentimental problems, is an important one, but less relevant to our subject, so we shall not discuss it here.

X alternated in her attitude, both outside and inside analysis, between a provocative, contemptuous mood and a more submissive one in which she idealized the analyst and other women who were able to do or to be what she felt she never could be or do herself. She would talk in a childish, plaintive voice about everything. It seemed as if all of her improvements in her private and professional life were to be kept hidden; especially they were to be concealed from herself and the analyst. When it became more difficult to hide all this, she became physically vulnerable and accident-prone. It became increasingly clear that X had at all costs to appear impotent and weak; anything in fact but competitive or 'threatening' to the analyst.

In the meantime, her brother was deteriorating very rapidly and needed several hospitalizations. It was a very serious and trying situation and X was very upset; she would cry most of the sessions saying, 'it's too much, I cannot take it any longer'. X was generally most concerned, available and affectionate with her brother, although at the beginning with a rather controlling and omnipotent attitude. At times however, she would alternate with outbursts of frustration and intolerance at her brother's demandingness and would become harsh and furiously rejecting.

On one occasion in which her destructive, hostile part seemed to overpower her concerned, helping part, the analyst's comment was experienced by X as a concerned, protective attitude towards the brother (which was actually true). The patient however failed to recognize this, the analyst's preoccupation, as representing one of her own parts at play as well. The crucial and feared moment in which the smooth analytic relationship was to explode had finally come. X was absolutely furious and threatened to stop analysis. The analyst had become the persecutor who accused her of not caring well enough for her brother. X used abusive talk and left the session without saying goodbye. In the following session she said she had lost her hope and trust in the analyst and added, 'You don't realize how important your words are for me' 'You didn't measure them well' 'The problem is that I am ill and I need your help, so my only alternative is to continue and pretend nothing happened between us'. When the analyst suggested that perhaps another alternative was to analyse what had happened, X's response was 'I'm not as good at it as you are, but now I'll give you my interpretation you thought it wasn't good for me to have all your attention, so you showed yourself preoccupied with my brother Don't you realize you hurt me?'

X was provocative towards the analyst who, just like her mother, had been more concerned about the brother. She remembered having said that she was afraid of ruining her relationship with the analyst, whom she accused of falling into her trap by providing and enacting with her the bad relationship she had had with her mother. This promoted a good deal of work; her resentment for her mother came gradually into the foreground, her disappointment at being unable ever to satisfy her mother, who felt she was always wrong and her brother right. She talked about her loneliness, gradually becoming able to recognize her mother's distress and depression as well as her own guilt and her need to repair her mother's internal image. Whenever she bought herself a nice thing, a dress or some jewellery, she would tell people, 'it was mother's' or 'mother gave it to me'. Her mother had died many years before but at this point of the analysis X had various dreams that represented attempts to take care of her mother, to alleviate her sadness or give her presents.

On the other hand, X was also feeling the dangerous condition of being envied and attacked just as viciously as she would or actually did attack others, especially women. Her main defence in analysis was still to hide any improvement and to cry hopelessly, saying she would never be healthy and anyhow her destiny was quite dismal, not any better than that of a kept woman. All this in order to reassure the feared mother-analyst (felt as potentially retaliating) by showing herself incapable, inadequate and not enviable at all, merely neglected, poor and resentful. She soothed her guilt feelings towards the mother-wife of her partner as well, by remaining in the subordinate whining position of a neglected mistress. Just as the analysis was beginning to show clearly the way in which these internal roles were organized, and how this established, more or less a constant 'script' to be followed in the transference as well, X was confronted with a highly traumatic event: her brother committed suicide during a short absence of hers. Real grief, mourning and feelings about guilt, impotence and depression invaded her internal life and held sway there, often without neat boundaries between past and present, or between real living and lost objects. The conflict between her destructive and auto-destructive drives and an intense vital drive towards life, love and self-assertion became crucial and excruciating for about two years, and her extreme defence was the split between these two parts.

Her increasing success at work and the realization of the importance for herself and her partner of their relationship confronted X with the need to examine, behind the roles she was constantly staging, who she really was and what she really wanted. And this is the crucial point in relation to the technical problem we are discussing here.

The analyst was by now aware of improvement. X herself was finding such improvement hard to conceal or deny, but she still kept crying and saying 'I just can't make it'.

A lot of the work had dealt with X's attempt to demonstrate that nobody, not even the analyst, was capable of bringing the expected relief to her misery, just as she herself had been unable to prevent her mother's or brother's distress. Her intent was to show that, no matter what was done, it was just not the thing she needed. This was in fact inevitable and true to some extent, because X wanted nothing so badly as for her mother to be still alive and with her, as she wanted her to be, to love and be loved. The system she had organized, and which she refused to relinquish, allowed a part of herself to feel in eternal credit, and she tried to corner the analyst into becoming the impossible substitute for the lost objects and for all that she was unwilling to recognize as irreparably gone or spoilt for ever. Another part of herself, though, felt so guilty about her greed and envious resentments that she was unable to allow herself to enjoy any of the positive things at hand, many of them achieved thanks to her own efforts in spite of all her losses. Refusing thus to forsake the illusion of obtaining the impossible, she also managed to release aggression, depriving herself and tantalizing the unsuccessful analyst, or accusing others of neglect and deprivation. The high price she paid for this was the feeling of not participating in life, since not assuming all of her split parts or responsibility for them engaged her in a battle for survival, not for living.

All this had been analysed and X would say 'Why should I live this way' 'I know I'm not obliged to be like mother or to get ill as my brother, I know I couldn't save him, I'm not guilty but I still can't make it, I can't help it'. At this point the analyst, who had felt all along that she was being dragged towards a deadly abyss, told the patient about it saying, 'I'm afraid I can't help it either, I'm willing to walk with you up to the edge of the abyss and, as we have been doing all along, try to see things together, but I shall not jump down with you. I will be very sorry indeed if you do but I shall let you go by yourself this is your choice and I cannot prevent it. I can help you see and understand; everything has been said and I cannot really do any more about it, the rest is up to you.'

In spite of her shock and her attempts to try to convince the analyst that she still needed her, the realization that analysis could no longer be maintained in a dead-end, atemporal, immutable dimension became a turning point of X's analytic destiny as well.

We chose to describe these cases because they were our starting point. Further observations, however, indicate that the clinical situations can vary a great deal, as well as the history and the individual pathology of the patients. What is common, though, in the cases that we observed, is the technical problem caused by a particular plot of the analytic 'scenario', whereby the patient's condition is not transformable by transference interpretations, although paradoxically the problem lies precisely there, in the transference, so that its working through is essential in any case.

The problem, in our view, lies in the fact that certain patients either try to impose or succeed in imposing on the analyst a stereotyped role in accordance with a fixed, immutable internal figure that bypasses other mental representations and in this way comes closer to actual and factual reality. It is as ifaccording to the 'scenario' metaphora specific pre-established plot were imposed on us within the analytic relationship, ruled by a compulsion to repeat the modes in which past intrapsychic events have been registered and inscribed in the patient's structure.

The analysis and the analyst are invested with an unrealistic task, which consists in preserving the illusion that what is past or lost for ever can still be provided and restored. The perpetuation of this demand, accompanied by resentment about the lack of its fulfilment, is the extreme defence against the threat of separation; we could say, using the 'scenario' analogy again, that different patients 'organize' different plays in which they try to rehearse and practise their longings. The upshot, though, is a constant pattern, derived from the way in which the intrapsychic events were inscribed, confirming each time, with its repetitive deceiving outcome, both that there is no hope at all ('I just can't make it') and the hope that trying again may fulfil the illusion.

The paradox lies in the necessity to have both opposites coexist. There is no alternative intermediary space between how 'it was' and how 'it should be'; pathological hope cancels realistic hope and gives way to hopelessness. Real chances available in life are dismissed, or rather not recognized, because they do not fit the rigid model that illusion pretends to realize. Capacity to feel and experience oneself as occupying a dynamic spatial-temporal dimension, in relation to others too, enhances sufficient 'symbolictension' to make it possible to think, to discriminate fantasy from reality and personage from person and thus to organize the boundaries of mental representations linked with intrapsychic and interpersonal separation processes. What distinguishes the cases we observed instead is a situation in which a very tenuous ridge divides illusion from disillusion: experiences of painful separation cannot be denied but nor can they be accepted; there is an eternal present in which loss is furiously felt, but the 'drama' which has already irreparably happened is not recognized or realized as such. We could perhapsby analogyusefully recall here Winnicott's description, in 'Fear of breakdown' (1974), of an intense anxiety about some expected catastrophe to come, whereas what the patient ignores is that it has already occurred.

Both authentic hope and authentic despair need the temporal dimension; it is necessary to experience a future time within which, for better or for worse, change and transformation can occur, whereas the reiterative declarations of uselessness, failure and lack of hope made by our patients are placed in a non-temporal dimension in which the idea of failure is fictitious, since all energies are pathologically directed to a past that needs to be kept immobile and therefore incapable of becoming 'history'. There is the cult of an illusion which could be defined as a clandestine pathological hope of continuing to claim what is lost, or perhaps has never been really enjoyed in the primary relationship, as if, paradoxically, the displayed despair could be used unconsciously to perpetuate the resented refusal to give up illusion.

In therapy, the analyst may be invested with one or more roles in this hopeless/hopeful project. Successful transference working through may do away with such entanglements, even if it meets tenacious negative therapeutic reactions or other difficult defence mechanisms. But in the cases we observed this is not enough. If the analyst becomes one of the actors in this (internal) play, the paradox arises from the fact that, on one hand, such an event is an inherent property of transference phenomena, but, on the other hand, it is precisely this that eludes change and progress. The problem seems to lie in the incapacity to 'drop the curtain' because the play is never over, as if it were impossible to bridge the symbolic gap between being and playing a role. It is so realistically 'played' that even insight fails to promote access to a partial function of the spectator; or if this is reached (as in one of the cases), insight into the transference implications still doesn't provoke decision-making as to whether to continue being a spectator of the same performance again and again, or not. It is as if this situation were bound to cancel the creative and transformative quota thataccording to Winnicottspreads out of the transitional area and allows for the role-playing function of the analysis, whilst still conserving the capacity to discriminate between transference and reality.

Our specific cases confronted us with the need to verbalize to our patients that it was the analyst who was going 'to drop the curtain' and that, behind it, the patients were free to make choices according to their feelings, needs, wishes or possibilities. Analysis was equipped only to help the patient get insight into these issues, understand their inner roles, and their reciprocal internal relationship and interaction with reality. Once the script was disclosed and revealed, as in the second case, the analyst 'consigned' it to the patient, saying that the play they had agreed to work on together was bound to end. In the first case the analyst had also given the patient a clue as to the fact that not all the possible outcomes were in the analyst's power to govern. Actually both statements, once verbalized, placed the analyst as a real, whole person who would no longer allow her patients to make her play an omnipotent or impotent role. In fact it came down to having to state outright that neither analysis nor analyst were omnipotent rescuers, as the patients in their illusion needed to believe (X was always ready angrily to accuse the analyst of not living up to her expectations), but that neither were they as impotent as an interminable role would require.

In certain other cases we were able to detect the way in which a particular appeal to omnipotent collusion on our side could enhance the need to foster the illusion that analysis or the analyst were really the only chance, or that analysis or the analyst would be able concretely to fill the gaps and become the object that the analysand lacked, and so undo the past. By doing so, the chance to mobilize and reorganize the boundaries of mental representation, linked with intrapsychic and interpersonal separation processes, would again be hindered. In fact, we feel that if the analyst is caught in such a trap, then he eludes the only chance analysis can really offer to the patient of changing his internal organization and the interactions of past, present and future.

Most probably, many colleagues will identify with these situations and note various similarities with some of their own cases and the usual difficulties connected with our work. In fact, we feel that our patients are not at all exceptional; on the contrary, we are confronted here with quite familiar kinds of pathology and psychic pain and with resistances that we know are frequent. We have actually quite purposely simplified our case presentations, leaving out whatever might distract our attention from the main question.

The particular issue and common element in both cases described, however, is the peculiar manner in which (a) the resistance organized itself within the analytical relationship and (b) the specific technical choice that both analysts put to work at a certain point in the process.

A. We asked ourselves whether the clinical situations that we described could perhaps be considered as a variation of the wide range of Negative Therapeutic Reactions (NTR), and therefore related also to the question of interminable analysis. As we all know, this fundamental concept of Freud's has evoked considerable attention in recent years and has permitted not only the elucidation of further meanings of the most persistent and tenacious resistance, but also the reassessment of such concepts as primary destructiveness, death instinct, narcissism, masochism, etc., according to the latest theoretical development. At the same time, however, the original specificity of the concept risks being diluted; it seems now and then to assume a sort of general explanatory function for all clinical situations characterized by obstinate resistances or prevalent destructiveness. As far as our question above is concerned, as to whether our cases belong to the NTR or not, we feel that perhaps our clinical material could usefully be considered by turning to some of the classical conceptual models proposed by various authors:

unconscious guilt and superego sadism associated with ego masochism as Freud (1923), (1924) first described it, as well as the ineluctable compulsion to repeat connected with the death instinct, later discussed in 'Analysis terminable and interminable' (Freud, 1937);

rivalry and competition with the analyst associated with fear of retaliation and fears of being envied for one's own triumph, as Horney (1936) pointed out;

the difficulty of complying with the narcissistic demand for self-esteem and the consequent manic defence against depressive anxiety described by Riviere (1936).

B. Another question we feel ought to be discussed is whether such a technical device as that used by us could be defined as the analyst's 'acting out', due to countertransference problems. Certainly, in the transference display of our patients there was a strong unconscious though tangible pressure on the analyst actively to assume a role, either that of a rescuer who doesn't yield to despair and 'finances' hope over and over again, or that of an accuser, giving sadistic and guilt-provoking interpretations, thus risking either way inducing an interminable analysis. We do not feel that our intervention was impulsive or that its function was to discharge tension or to avoid mentalization processes, as typically occurs in acting out.

We felt rather that our intervention was in a way the last card we could play, and it followed several years of preliminary working through and reflection. We were quite aware of the risks involvedif not completely of their meaning, which, although partially understood, became available to more thorough analytical work afterwards, due to the way in which our patients reacted. The analyst's statements were an active and sudden rupture of the transference and therefore inevitably traumatic. We realized to what extent our patients felt rejected, attacked, accused, refused and suddenly banished from a containing relationship, and thus inevitably separated from the analyst.

Because of this we wonder whether this kind of technical strategy can be used early in the process, since the crucial and critical nucleus articulates itself within the frame of the analytic relationship, and therefore needs time to mature and present itself with all its 'evil' depth; all the more so, since it is our impression that the problems involved date back to very early preverbal levels, linked with concrete and archaic thought processes that need to develop, in order to be 'dramatized' and understood in the analytical relationship in a very specific way. This is why we should feel very uneasy if our paper were to convey the impression that we are proposing a technical device that can be successfully applied to or imported into the countless situations of immobility that we may encounter.

Sometimes the existence of these problems may be suspected from the very beginning, perhaps even during the first sessions, but we think that the patient ought to experience for a sufficient length of time and at different levels the soundness of the therapeutic rapport, the security of being understood, the benefit of a careful and thorough working through of the transference, and a relational structure that enables him or her to contain the comprehension and the elaboration of the disruption of the transference play.

We must add, though, to conclude, that our awareness of these mechanisms, and the fact that we have become quite sensitive to their early organization in the analytical process, is probably not without consequences. We cannot help wondering whether and how this may change our way of relatingeven technicallyin such circumstances. Perhaps, at least we hope so, we shall be able to understand this better in times to come.

REFERENCES

1 FREUD, S. 1923 The ego and the id S.E. 19 (SE.019.0001A)

2 FREUD, S. 1924 The problem of masochism S.E. 19 (SE.019.0155A)

3 FREUD, S. 1937 Analysis terminable and interminable S.E. 23 (SE.023.0209A)

4 HORNEY, K. 1936 The problems of the negative therapeutic reaction Psychoanal. Q. 5 :22-44 (PAQ.005.0029A)

5 JOSEPH, B. 1982 Addiction to near-death Int. J. Psychoanal. 63 :449-456 (IJP.063.0449A)

6 LIMENTANI, A. 1981 On some positive aspects of the negative therapeutic reaction Int. J. Psychoanal. 62 :379-390 (IJP.062.0379A)

7 RIVIERE, J. 1936 A contribution to the analysis of the negative therapeutic reaction Int. J. Psychoanal. 17 :304-320 (IJP.017.0304A)

8 ROSENFELD , H. 1975 Negative therapeutic reaction In Tactics and Techniques in Psychoanalytic Therapy Volume II ed. P. Giovacchini . New York: Jason Aronson , pp. 217-228

9 WINNICOTT , D. W. 1974 Fear of breakdown In The British School of Psychoanalysis: The Independent Traditioned. G. Kohon . London: Free Association Books , 1986

SUMMARY

The authors discuss a particular technical problem raised by two patients whose analysis seemed to be at a standstill. The analysands had been complaining for a long time, repeating with a monotonous, plaintive tone that there was no more hope for them. The statement of hopelessness assumed a specific meaning in the frame of their resistance within the analytic relationship. All possible interpretations had been tried until both analystsindependentlyresorted to a similar unusual technical strategy which is the issue of this paper.

The analyst is invested with the unrealistic task of preserving the illusion that unsatisfied needs or lost objects can be supplied and restituted. This illusion coexists with constant resentment of its lack of fulfilment. Hope alternates with hopelessness and the paradox lies in the necessity to have both coexist as an extreme defence against separation.

The resentment and the mournful complaint represented the last and unique possible tie with the primary object and giving this up would mean the definite downfall of illusion and admission that it is really, truly lost for ever.