MODES OF THERAPEUTIC ACTION

The dialectic in psychoanalysis between theories about the mutative ef fects of interpretation and psychological knowledge and those concerni ng the effects of interpersonal interaction constitutes an important t ension for approaches to psychoanalytic technique. This essay briefly summarises the thinking around these alternative conceptualisations of therapeutic action, and introduces a new empirically derived model, t hat of 'repetitive interaction structure: which attempts to bridge the rapeutic action by insight and by relationship. Interaction structure is a way of formulating those aspects of the analytic process that hav e come to be termed intersubjectivity, transference-countertransferenc e enactments and role responsiveness. The concept operationalises impo rtant aspects of interpersonal interaction, and can help specify the t wo-person patterns that emerge in an analysis Patient and analyst inte ract in repetitive ways; these patterns of interaction, which are slow to change, probably reflect the psychological structure of both patie nt and analyst, whether psychic structure is conceptualised in terms o f object-representations or compromise formations and impulse-defence configurations. Therapeutic action is located in the experience, recog nition and understanding by patient and analyst of these repetitive in teractions. Interaction structures stress the importance of the intrap sychic as a basis for what becomes manifest in the interactive field. Clinical illustrations from a psychoanalysis are provided and research on repetitive interaction structures is described.