Joyce Anne Slochower

Is there a baby in the relational consulting room? How and when can/should we try to hold our patients? What happens to the analyst's subjectivity when she tries to hold? In Holding and Psychoanalysis: A Relational Perspective (second Edition), Joyce Slochower brings a contemporary relational framework to bear on Winnicott's notion of the holding environment. Revisiting the clinical impact and theoretical underpinnings of holding, Slochower explores its function in those moments when "ordinary" interpretive or interactive work cannot be tolerated. Slochower expands the holding construct beyond the needs of dependent patients by examining its therapeutic function across the clinical spectrum. Emphasizing holding’s coconstructed nature, Slochower explores the contribution of both patient and analyst the holding moment. This second Edition introduces new theoretical and clinical material, including four additional chapters. Two of these address holding’s impact on the patient’s capacity to access, articulate and process affect states; the third moves outside the consulting room to explore how holding functions in acts of memorial ritual across the lifespan. A final chapter presents Slochower’s latest ideas about holding’s clinical function in buffering shame states. Integrating Winnicott's seminal contributions with contemporary relational and feminist/psychoanalytic perspectives, Joyce Slochower addresses the therapeutic limitations of both interpretive and interactive clinical work. There are times, she argues, when patients cannot tolerate explicit evidence of the analyst's separate presence and instead need a holding experience. Slochower conceptualizes holding within a relational frame that includes both deliberate and enacted elements. In her view, the analyst does not hold alone; patient and analyst each participate in the establishment of a co-constructed holding space. Slochower pays particular attention to the analyst's experience during moments of holding, offering rich clinical vignettes that illustrate the complex struggle that holding entails. She also addresses the therapeutic limits of holding and invites the reader to consider the analyst’s contribution to these failures. Slochower locates the holding process within a broader clinical framework that involves the transition toward collaboration—a move away from holding and into an explicitly intersubjective therapeutic frame. Holding and Psychoanalysis offers a sophisticated integration of Winnicottian and relational thought that privileges the dynamic impact of holding moments on both patient and analyst. Thoroughly grounded in case examples, the book offers compelling clinical solutions to common therapeutic knots. Clearly written and carefully explicated, it will be an important addition to the libraries of psychoanalysts and psychoanalytic psychotherapists.

A Relational Perspective

Holding and Psychoanalysis, 2nd edition

In this beautiful work of reflection and self-reflection, Joyce Slochower wrestles with a seldom acknowledged dimension of being a psychoanalyst - the dialectic between illusions and less ideal realities that complicate the analyst's sense of who she is and of how best to meet her clinical obligations. Psychoanalytic Collisions details the various ways in which the analyst's wishes (both professional and personal) collide with the less-than-perfect actualities of everyday clinical work. The collisions in question are often rooted in the analyst's own illusions: illusions of therapeutic possibility in the face of ordinary human existence or illusions of therapeutic selflessness in the face of one's own "immutably self-centered humanity." Such collisions may complicate nonclinical professional activities such as writing, in which the analyst's desire to develop a personal idiom collides with self doubt and the imagined rebuff of teachers and colleagues. Other collisions coalesce dyadically in the consulting room. They may reflect sharp dissonance between what the patient needs the analyst to feel and what the latter actually feels, as in discrepant experiences of erotic desire. They may grow out of colliding idealizations of analyst and patient, each of the other. And they may arise in the wake of traumatizing life events that destroy the shared illusions on which treatment has rested. In finely wrought examinations of these eventualities, Slochower is guided by the belief that collisions are intrinsic both to forging an analytic identity and to practicing in a manner consonant with that identity. Psychoanalytic collisions, she enjoins, often cannot be resolved, but they can usually be productively engaged. And the very act of engagement - be it establishing new grounds for collaboration in the wake of real-world catastrophe, or wrestling with clinical impasse grounded in the radically divergent expectations of analyst and patient, or owning up to what Slochower terms "secret delinquencies" - can provide the basis for a vision of the "good enough" analyst in which therapeutic hopefulness coexists with acceptance of the analyst's all-to-human fallibility.

Psychoanalytic Collisions

Joyce A. Slochower

In Holding and Psychoanalysis: A Relational Perspective, Joyce Slochower brings a contemporary relational framework to bear on Winnicott's notion of the analytic holding environment. She presents a fresh, thought-provoking, and clinically useful integration of Winnicott's seminal insights with contemporary relational and feminist/psychoanalytic contributions. Seeking to broaden the concept of holding beyond work with severely regressed patients, she addresses holding in a variety of clinical contexts and focuses especially on holding processes in relation to issues of dependence, self-involvement, and hate. She also considers clinical work with patients "on the edge" - patients who seem deperately to need a holding experience that remains paradoxically elusive. Slochower begins her study by questioning the therapeutic limitations of an interactive style. There are times, she proposes, when certain patients simply cannot tolerate evidence of the analyst's separate subjective presence and instead need a holding experience. Though this holding function is essential to work with difficult patients, it enters into the treatment of all patients, whether as figure or ground. Slochower's relational understanding of holding leads her to consider the impact of holding on patient and analyst alike. Throughout, she emphasizes the analyst's and the patient's co-construction, during moments of holding, of an essential illusion of analytic attunement; this illusion serves to protect the patient from potentially disruptive aspects of the analyst's subjective presence. Slochower's case vignettes helpfully illuminate the intersubjective aspects of the holding process, including the clinical picture when a holding frame fails. She elaborates her thesis by considering the therapeutic function of holding in mourning. And she concludes her study with a cogent examination of the theoretical and clinical limitations of working with a holding process. A welcome reprise on an essential Winnicottian theme, Holding and Psychoanalysis broadens and deepens our understanding of the therapeutic role of the analyst's holding function.

Joyce Anne Slochower

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