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Revista de Psiquiatria do Rio Grande do Sul

Print version ISSN 0101-8108

Rev. psiquiatr. Rio Gd. Sul vol.26 no.2 Porto Alegre May/Aug. 2004

http://dx.doi.org/10.1590/S0101-81082004000200015 

BOOK REVIEW

 

Comments on David E. Zimerman's Manual de técnica psicanalítica: uma re-visão (A Guide to Psychoanalytic Technique: a re-vision)*

 

Comentario acerca del Manual de técnica psicanalítica: uma re-visão (Manual de técnica psicoanalítica: una re-visión), de David E. Zimerman

 

 

Nazur Aragonez de Vasconcellos

Psychiatrist, Member, Sociedade de Psiquiatria do Rio Grande do Sul; Instituto de Psicanálise da SPPA; professor and supervisor, Instituto Contemporâneo.

Correspondence

 

 

 

Without exaggeration, I consider David Zimerman to be a public figure. Not just because of the vast amount of his high-quality scientific work, but also because of his brilliant performance at lectures, conferences, theoretical seminars, courses, study groups, because of his participation in the media, and because of his work in private medicine and as a teacher and supervisor.

Throughout the multiple activities performed by David Zimerman, a specific characteristic is in evidence: ease of communication. Indeed, one of the factors differentiating this author from many others is his ability to express himself, both in writing and in public speaking.

An initial feature that one observes in the Manual de técnica psicanalítica: uma re-visão (A Guide to Psychoanalytic Technique: a re-vision) is the transparency of the author and his integration with his own work. To explain a little better: the fact that this text, filled with illustrative clinical vignettes, is not divided along theoretical-practical lines is evidence of the impossibility of disassociating the author from his work. The point is that at all times I perceive coherence between what David writes and does, and what he truly is — indeed, this suggestion to a young therapist was made by him: "if you wish to identify whether a teacher, conference guest, supervisor, analyst or, even you yourself, are authentic or false, try to observe whether there is coherence between what they say, do and, truly, are." (p. 455)

A certain amount of effort, therefore, is necessary to attempt to disassociate the author from his work, since, just as "the essence of the analyst imposes itself on their appearance," (p. 86) David's essence shines through his text.

Well then, the Manual de técnica psicanalítica: uma re-visão is extremely practical as a consultation "guide" for many clinical situations and themes related to technique. David Zimerman's style affords pleasant reading. The text is well written, with elegance, and gives the impression of a direct conversation between author and reader. The individual way in which he expounds his ideas — in depth, but without losing a didactic and simple mode of speaking and writing — is a particular characteristic that is also found in a majority of other texts written by the major master of psychoanalysis — recognizable in Freud's "Conferências introdutórias sobre psicanálise", in Artigos sobre técnica, and in Casos clínicos, just to mention just a few.

By way of preface there is "An initial conversation with the readers," explaining the subtitle "a re-vision." Zimerman notes that the text covers a range of general and specific terms from the analytic technique, adding a new "re-vision."

In other words, his four decades of practicing and studying psychoanalysis enable David Zimerman to write in an up-to-date fashion, with great propriety, on the evolution of psychoanalytic theory and technique and offer his own vision as a psychoanalyst. This vision implies that the concept of "plurality" as a positive value concept, since no patient entirely "fits" — if one can put it that way — a single psychoanalytical school or theory, but "between" them and, sometimes, "beyond" them. Since "(...) what is important is that everything that we know about psychoanalysis- theory or technique — comes from clinical practice, and everything that we are yet to learn and transform will necessarily come from clinical practice." (p. 8)

The book is divided into five parts and 41 chapters. Part 1 covers general features of the evolution of the psychoanalytical technique; chapter 3 — "How do analytical therapies work?" — encourages us to reflect, since it contains subtitles on extremely important themes, which are elaborated on in other chapters. Among the themes alluded to I would highlight "The real person of the analyst," "The analyst as a new model for identification" and "Pseudo changes." The "two technical axes: interpretation and 'internal psychoanalytical attitude'" that the author employs to illustrate therapeutic efficacy also appear highly creative to me.

Part II — "Phenomena in the field of the analytical relationship", in chapter 7, deals with "The real person of the analyst in the psychoanalytical process". Here the author invites the reader to debate two schools of thought: in the first, the raw materials of analysis, "are solely based on the vicissitudes and varying configurations of the transference-countertransference phenomenon," (p.85) while the second considers the real person of the analyst as an important contributing factor affecting the success or failure of analysis. Zimerman reveals himself to be in favor of the second of these schools, and further adds the role of the, "analyst as new model for identification." Equally interesting is the suggestion that, in some of the cases described by Freud, Klein and Bion, the main element responsible for analytic success was "(...) The internal psychoanalytical attitude — mirror of these analysts' condition as the real people that they were (...)" (p.94). Chapter 10, "The contra-ego: a vestigial pathological structure," in turn, is highly useful clinically. Here the author defines contra-ego as "an intra-ego substructure", and discusses concepts that are built-in to this term and that come to us from authors such as Freud, Abraham, R. Sterba, Fairbairn, Winnicott, Bion, Meltzer, Rosenfeld, B. Joseph, J. Steiner and Bollas — to himself he merely credits the originality of the term. The richness of this chapter is clear in its emphasis on day-to-day clinical practice (given prominence with six apt vignettes) and also in the systematic nature of the technical management proposed.

Part III covers the "Clinical characteristics and technical management of the many different psychopathologies," distributing them across 12 chapters. In a systematic manner, chapter 25 — "The treatment of emptiness" — presents the necessary technical modifications for each of these conditions. It is worth pointing out that there is little published on this theme — at least under this title — , since such conditions belong to contemporary psychoanalysis. This part closes with chapter 32 — "A pathological way of loving: the tantalizing relationship." In addition to covering those pathological forms of loving characterized by relationships of "domination", "possession", "seduction" and "tantalization", in which there is "an irreversible and repetitive cycle of promises, expectations and deceptions, in a perverse give and withhold (...)" (p.337), the author offers technical suggestions that, to my mind, are of great clinical value.

Part IV discusses "Special analytical therapies", and covers, in chapter 33, "Psychoanalysis with children," in 34, "Analytical therapy with pubescent and adolescent patients," in 35, "Therapy with couples and families," in 36, "Therapy with the family," and in chapter 37, "Psychoanalytical group therapy."

Part V deals with "Specific situations" in three chapters — "Relationships and relationship configurations," "Reflections on analytic supervision" and "Dreams: as technical management" — and also in a "Glossary of concepts and terms proposed by the author."

Ending the book in an informal and colloquial manner, David makes available all the baggage of his long experience of analytic practice in a beautiful, intimate letter to those readers who are starting out as "psychoanalytic" therapists.

Employing a didactic technique that makes reading the text easier, the author numbers each paragraph and maintains a relatively high degree of independence between the ideas presented in each one. Thus, over a total of 40 paragraphs we have, in my opinion, a text of unparalleled richness for analytic psychotherapy practitioners, whether newly initiated or at any of a most varied range of degrees of professional development. I believe that, as a minimum, it would be an interesting text to read (and reread) at the start, middle and end of courses training therapists.

 

 

Correspondence
Nazur Aragonez de Vasconcellos
Rua Iguassú,150/302
90470-430 — Porto Alegre — RS — Brazil
E-mail: nazurvas@terra.com.br

 

 

* Zimerman DE. Manual de técnica psicanalítica: uma re-visão. Porto Alegre: Artmed; 2003.

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