Falling Off The Couch

Abstract

The patient's therapeutic regression intensifies certain unconscious meanings of the analytic couch. In addition to representing the analysis or the analyst in general, the couch can represent the unconscious, or it may lake on the symbolic significance of the analyst's or mother's arms, lap, breasts, or womb. When the genetic roots of the patient's transference include substantial experiences of disappointment, narcissistic injury, and mistrust, the theme of falling from the couch may emerge as a dream, an association, or even an enactment. This theme usually implies the presence of a deepening but mistrustful transference, based on earlier disappointments by the patient's primary objects. Falling off the couch may be associated with being dropped as an infant, rolling out of bed as a child, birth, miscarriage, castration, death, termination, defending against passive wishes, punishment for sexual or aggressive transgressions, escaping an attack, descending into the unconscious, or wanting to be picked up and comforted.

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References

Altman, L. L. (1975). The Dream in Psychoanalysis. New York: Int. Univ. Press.

Andresen, J. J. (1985). The motif of falling: falling and the loss of the mother. Psychoanal. Rev., 72:403–419.

Bressler, B. (1961). First dreams in analysis. Their relationship to early memories and the pre-oedipal mother. Psychoanal. & Psychoanal. Rev., 48:60–82.

Fenichel, O. (1953). From the terminal phase of an analysis. In The Collected Papers of Otto Fenichel. First Series. New York: Norton, pp. 27–31.

Ferenczi, S. (1914). Sensations of giddiness at the end of the psychoanalytic session. In Further Contributions to the Theory and Technique of Psychoanalysis. New York: Basic Books, 1960, pp. 239–241.

Freud, S. (1900). The interpretation of dreams. S. E., 4 & 5.

Freud, S. (1916-1917). Introductory lectures on psychoanalysis. S. E., 15.

Freud, S. (1917). A childhood recollection from Dichtung und Wahrheit. S. E., 17.

Freud, S. (1922). Dreams and telepathy. S. E., 18.

10.

Gedo, J. E. (1981). Advances in Clinical Psychoanalysis. New York: Int. Univ. Press.

11.

Kelman, H. (1954). The use of the couch. Amer. J. Psychoanal., 14:65–82.

12.

Petty, T. A. (1953). The tragedy of Humpty Dumpty. Psychoanal. Study Child, 8:404–412.

13.

Rosenbaum, S. (1967). Symbolic meaning and theoretical significance of the analytic couch. Sci. & Psychoanal., 11:182–201.

14.

Scott, W. C. M. (1952). Patients who sleep or look at the analyst during treatment—technical considerations. Int. J. Psychoanal., 33:465–469.

15.

Searles, H. F. (1976). Transitional phenomena and therapeutic symbiosis. In Countertransference and Related Subjects. New York: Int. Univ. Press, 1979, pp. 503–576.

16.

Socarides, C. W. (1978). Homosexuality. New York: Aronson.

17.

Socarides, C. W. (1980). Homosexuality and the rapprochement subphase crisis. In Rapprochement: The Critical Subphase of Separation-Individuation, ed. R. F. Lax , S. Bach , & J. A. Burland . New York: Aronson, pp. 331–352.

18.

Spitz, R. A. (1956). Transference: the analytical setting and its prototype. Int. J. Psychoanal., 37:380–385.

19.

Waugaman, R. M. (in press). Analytic time. The Yearbook of Psychoanalysis and Psychotherapy.

20.

Winnicott, D. W. (1954a). Withdrawal and regression. In Through Pediatrics to Psychoanalysis. New York: Basic Books, (1975), pp. 255–261.

21.

Winnicott, D. W. (1954b). Metapsychological and clinical aspects of regression within the psychoanalytic set-up. In Through Pediatrics to Psychoanalysis. New York: Basic Books, 1975, pp. 278–294.