The 'Tricky Intimacy' of Psychoanalysis

By Atkinson, Roland | Clinical Psychiatry News, April 2004 | Go to article overview

The 'Tricky Intimacy' of Psychoanalysis


Atkinson, Roland, Clinical Psychiatry News


In the film "Empathy," both documentary and fictional approaches are used to examine what director Amie Siegel terms the "tricky intimacy" that exists between psychoanalysts and their patients. "Empathy" is far from being a mainstream film, but the ingenious, probing manner in which the filmmaker approaches her subject makes the film an important one to see for psychotherapists of every stripe.

Ms. Siegel, who also wrote the screenplay, is a poet and visual artist who is interested in spectatorship and its reciprocal, how people represent themselves to others. The psychoanalytic situation is rich soil for examining these interests, since both analyst and patient typically, perhaps always, represent themselves in special ways, subject to special constraints and modes of withholding. They role-play.

Classical psychoanalysts tend to adhere to Freud's technique of minimizing disclosure of personal information, in order to facilitate the development of the transference. The down side of this approach is that by withholding personal responses, the analyst may appear to be uncaring, callous, dismissive, or unreal. Appearing as a "blank slate" may even do harm when patients need a psychotherapist to be a real person, one who engages them with more spontaneity and candor. Contemporary psychoanalysts are often inclined to work in a more interactive, give-and-take manner. The analyst is also a privileged spectator, given a front-row seat from which to scrutinize the patient's most intimate feelings and thoughts. Patients, for their part, may consciously or unconsciously falsify or withhold information about themselves and their relationships for any number of reasons: fears of embarrassment, humiliation, rejection, punishment, guilt or loss of control, among others. These are the issues that Ms. Siegel takes up in "Empathy."

To examine these matters, Ms. Siegel intermixes footage of four sorts: interviews with psychoanalysts; a dramatization of psychoanalytic treatment; the process of making this film; and a segment about the relationship of psychoanalysis to modernism, focusing on architecture and the Eames lounge chair, said to be a favorite among analysts.

The film opens with the camera on a huge, empty, red leather upholstered chair--not an Eames. We hear a man's voice off screen and infer that a psychoanalyst is on the phone, reassuring an anxious patient. The call ends; the analyst walks into the picture and slouches in the chair before us. He is one of four psychoanalysts interviewed by Ms. Siegel during the film. Two are identified by name, including Dr. David Solomon, who also counsels a fictional patient. The other two psychoanalysts declined to be named in the film.

Ms. Siegel, off camera, poses these questions to each analyst: Do patients lie to you? Do you ever lie to them? Is there an element of performance in your conduct as an analyst? Do patients also role-play in treatment? Given the fact that one party pays for a relationship with another in analysis, are there analogous transactions? Is analysis in this sense like prostitution? Does the analyst's own voyeurism motivate interest in his work? Is empathy a spontaneous response by the analyst, or a more measured, calculated substitute? Do psychoanalysts find more meaning in relationships with their patients than in the world outside the office? Have you ever had sex with a patient? What are the limits of confidentiality? The responses the analysts give to such questions are far ranging and, for the most part, convincingly candid.

Interspersed with segments from these interviews is the fictional drama in which a depressed woman, Lia (played by actress Gigi Buffington), an aspiring actress, seeks help from a psychoanalyst (played by Dr. Solomon). We see Lia in several settings: at work as a reader for an audiobook, having dinner with her sister, lap swimming, and during several analytic sessions.

In Dr. …

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