(1994). Psychoanal. Q.

, (63):219-245

The Concept of Interpretive Action

Thomas Ogden M.D. 

ABSTRACT

Interpretive action is understood as the analyst's use of action (other than

verbally symbolic speech) to convey to the analysand specific aspects of the
analyst's understanding of the transference-countertransference which cannot
at that juncture in the analysis be conveyed by the semantic content of words
alone. An interpretation-in-action accrues its specific symbolic meaning from
the experiential context of the analytic intersubjectivity in which it is generated.
The understanding of the transference-countertransference conveyed by the
analyst's interpretive action must simultaneously be silently formulated in
words by the analyst. Three clinical vignettes are presented which illustrate
different forms of interpretation-in-action.

We say ourselves in syllables that rise From the floor, saying

ourselves in speech we do not speak.
WALLACE STEVENS (1947)

At this point in the development of psychoanalytic thought, it is generally

accepted that action (other than verbal symbolization) constitutes an important
medium through which the analysand communicates specific unconscious
meanings to the analyst, for example, through the actions mediating projective
identifications (Ogden, 1982); (Rosenfeld, 1971), "role responsiveness" (Sandler,
1976), "evocation by proxy" (Wangh, 1962), "enactments" (McLaughlin, 1991),
and so on. However, it has been very little recognized that many of the analyst's
most critical transference interpretations are conveyed to the analysand by
means of the analyst's actions. It is this aspect of the analytic

219

process, the analyst's "interpretive actions," that will be the focus of the present
paper.

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By "interpretive action" (or "interpretation-in-action") I mean the analyst's
communication of his or her understanding of an aspect of the transference-
countertransference to the analysand by means of activity other than that of
verbal symbolization.1 At times such activity is disconnected from words (e.g.,
the facial expression of the analyst as a patient lingers at the consulting room
door); at times the analyst's activity (as medium for interpretation) takes the
form of "verbal action," (e.g., the setting of the fee, the announcement of the
ending of the hour, or the insistence that the analysand put a stop to a given
form of acting in or acting out); at times interpretive action involves the voice,
but not words (e.g., the analyst's laughter).

The significance of interpretive action lies in its capacity to convey to the

analysand aspects of the analyst's understanding of unconscious transference-
countertransference meanings when they cannot be communicated to the
patient in the form of verbally symbolized interpretation alone. Of course, an
action in itself (in isolation from a matrix of intersubjectively generated
symbols) is without meaning; an interpretive action acquires specific meaning
from the way in which it is generated within the context of the experience of
analyst and analysand in the "intersubjective analytic third."

I have discussed my conception of "the intersubjective analytic third" (or "the

analytic third") in a recent series of papers (Ogden, 1992a), (1992b), (1994a),
(1994b). In brief, I view the analytic experience as a process in which a new
subjectivity is created. This new subjectivity (the intersubjective analytic third)
stands in dialectical tension with the individual subjectivities of analyst and
analysand, who are engaged in a mutually creating, negating, and preserving
form of relatedness. The analytic third

1In this paper, the notion of interpretation will be used to refer to a "procedure

[which] … brings out the latent meaning in what the subject says and does"
(Laplanche and Pontalis, 1967, p. 227).
220

is not conceived of as a static entity, but as an evolving experience that is in a

perpetual state of flux as the intersubjectivity of the analytic process evolves
and is transformed by the understandings (interpretations) generated by
analyst and analysand.

At the same time that the intersubjective analytic third is created by the
dialectical interplay of their two subjectivities, analyst and analysand (qua
analyst and analysand) are, in turn, created by the analytic third. In its absence,

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there is no analysis and therefore no analyst or analysand, merely two people
in a room together.

The analytic third is experienced through the individual subjectivities of analyst

and analysand; therefore, the experience is not identical for each. However, the
experience in and of the analytic third constitutes the intersubjective matrix of
meanings in which all analytic understanding is grounded.

In this paper I am focusing not on the conveying of affect or the creation of a

mutative emotional "climate" (Balint, 1968, p. 160) or "atmosphere" (Balint,
1968, p. 160) through the analyst's actions; rather, my focus is on the use of
action as an interpretive medium through which the analyst conveys specific
aspects of his or her understanding of unconscious transference-
countertransference meaning. There has been considerable discussion of the
analyst's actions (other than verbal interpretation) as agents for therapeutic
change (see, for example, Alexander and French, 1946); (Balint, 1968);
(Casement, 1982); (Coltart, 1986); (Ferenczi, 1920); (Klauber, 1976); (Little, 1960);
(Mitchell, 1993); (Rosenfeld, 1978); (Stewart, 1990); (Symington, 1983); and
(Winnicott, 1949). However, the idea of the analyst's actions as a medium for the
interpretation of the transference-countertransference has been very little
explored. Contributions by Coltart (1986), Rosenfeld (1978), and Stewart (1977),
(1987), (1990) have discussed the impact of the analyst's actions in ways that
overlap with my own conception of interpretive action. However, the emphasis
in these latter papers is on the use of the analyst's actions in the service of
(re-)establishing conditions in which analyst and analysand might reflect on the
events (often an acting out or

221

acting in) that have been occurring in the analysis. In contrast, my own focus is
on the analyst's actions as an interpretive vehicle for conveying to the patient
specific aspects of the analyst's understanding of unconscious transference-
countertransference meanings, an understanding derived from the analyst's
experience in and of the analytic third.

I shall attempt to frame the discussion of the concept of interpretation-in-action

in such a way that it does not fall prey to forms of reductionism that are
regularly so large a part of the discussion of the question of whether
interpretation or object relationship is the greater (or exclusive) therapeutic
agent in psychoanalysis. I take it for granted that interpretation is a form of
object relationship and that object relationship is a form of interpretation (in
the sense that every object relationship conveys an aspect of the subject's
understanding of the latent content of the interaction with the object).

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I shall attempt to illustrate the importance of the way in which aspects of the
interpretive process take the form of symbolic action, and the ways in which
these forms of interpretation are drawn from experiences in and of the analytic
third. To this end, I shall offer three clinical vignettes, each of which highlights a
different aspect of interpretive action. In selecting this clinical material, I have
made an effort to offer illustrations of the everyday and commonplace in
analytic practice. Interpretive action is not an exceptional analytic event, but
simply part of the fabric of ordinary interpretive work.

CLINICAL ILLUSTRATION I

Silence as Interpretation of a Perversion of Language and Thought

Dr. M, an English-born research scientist in her early forties, entered analysis

because she was experiencing overwhelming anxiety that she would lose her
job and "end up disgraced and in the gutter." She feared that it would be
discovered that for

222

years she had been getting by at work by "piecing together" bits of advice and
information gleaned from conversations with her colleagues. Her entire career
felt like a sham that was in imminent danger of unraveling.

In the years preceding the beginning of analysis, the patient had been twice
married (and twice divorced), both times to men who were from socially
prominent families and who she thought were extremely handsome. The
patient felt no arousal of her own during sexual activity, but took great pleasure
in the power she experienced in arousing her husband to a great pitch of
sexual excitement. Having succeeded in doing so, she would then consciously
imagine that she was stealing his erect penis in the act of intercourse. In this
fantasy, Dr. M silently observed the scene from a great psychological distance.
Proof of the intensity of her husband's sexual excitement was so critical a part
of intercourse for her that she would encourage her sexual partner to physical
extremes, once leading her second husband to accidentally fracture one of her
ribs.

In the initial year of the analysis, Dr. M, at the end of each meeting, would tell
me that she would see me the next day and name the specific time of our
meeting. This was done with the conscious intention of reminding me that we
had a meeting scheduled for the following day and what time that meeting was

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to begin. This "reminder" (an unspoken accusation that I might forget) served
as a powerful way of provoking anger in me. The patient held the conscious
conviction that causing me to become angry was one of the few ways she had
of eliciting interest in her, or even memory of her.

As the analysis proceeded, it became increasingly apparent that Dr. M did not
speak for the sake of reflecting on her internal life, or of commenting on
present or past experience. She seemed to have virtually no interest in anything
that she might think, feel, or say. The act of talking seemed to serve only one
function: to get me to talk. When I pointed this out to Dr. M, she, without
hesitation acknowledged that this was so. The patient felt that the only events
in the analysis that held any importance

223

for her were the interventions I made, whether they be confrontations,

interpretations, or clarifications. Even my questions were felt to be of value
because they reflected the way I thought and what I considered to be
important. The patient kept a journal in which she recorded the events of every
meeting. Years later, she told me that she wrote down only what she could
remember of what I had said, without a single reference to any of her own
thoughts or comments. I experienced Dr. M's ready confirmation of my
interpretations as maddening; her unswerving, unreflective matter-of-factness
served as still another manifestation of her exclusive interest in ferreting out
my thoughts and comments.

Over time, I was able to interpret that the patient felt it was impossible for her
to create anything of value and that this belief led her to behave as if the entire
worth of the analysis lay in me. Moreover, the patient's fantasy of the analytic
process involved a vision of her passively absorbing my internal strength
through the ideas and feelings that I conveyed to her. She readily concurred
that this was what she wanted and expected from analysis.

A history was presented in bits and pieces over several years. Dr. M told me
about childhood memories and fantasies in a way that suggested that the
information was being given to me in order for me to help her with her
difficulties while she remained utterly passive. In other words, these were not
memories upon which she reflected, or about which she experienced curiosity;
rather, they were data handed over to me for the purpose of my making sense
of them and interpreting them for her.

Dr. M reported having had conscious childhood fantasies in which her idealized
father (described at times as "wonderful" and at other times as depressed,

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withdrawn, and utterly dominated by his wife and his mother) was felt to be the
sole source of her value and strength. However, this strength was borrowed and
could only be held briefly, never becoming the patient's possession in any
permanent, integrated way. As a child, Dr. M developed a compulsively
repeated form of "play" in which slips

224

of paper, paper clips, bottle caps, etc., were distributed in hiding places around
the house and were used to represent "spells" that had been given to her by
her father. Each spell would provide her with a particular form of power, for
example, the ability to run fast in a given fantasized race, to act bravely in the
face of a specific danger, to demonstrate intelligence at a key moment, etc. The
temporary and unintegrated nature of the "internalization" was reflected by the
fact that the fragments of the father's power were named "spells," i.e., magical,
externally generated ego-dystonic forces.

Dr. M, the middle of three children, experienced her mother as hatefully

withholding love for her while generously bestowing it on her brother and
sister. The patient was thought to be mentally retarded by her first grade
teacher, who suggested to her parents that she undergo psychological testing.
Although the tests revealed that the patient was of superior intelligence, she
showed no signs of being able to read until she was in the third grade. (The
patient had in fact learned to read in the second grade, but took pleasure in
keeping this knowledge secret.)

For the sake of brevity, I shall describe what I came to understand in the course
of the succeeding several years of work with Dr. M, without providing a detailed
account of the analytic process within which this understanding developed. The
patient seemed to experience my interpretations (and everything else I said) as
"spells," magical acts through which idealized (and at the same time,
denigrated) internal contents were momentarily lent to her, only to be
immediately exhausted, leaving her as empty and impotent as before. Dr. M
attempted to conceal the joy and excitement with which she received an
interpretation in order to hide her feeling that she had succeeded in
deceptively extracting, stealing, wooing, seducing, it from me. She feared that if
I were to sense the quality of her satisfaction and excitement, I would
understand how desperately dependent on me she was, and would be either
revolted and frightened by the enormity of her greed, or would sadistically
torment her, holding her hostage forever while stealing her money (her life)
from her.

225

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At the same time, Dr. M resented the borrowed/stolen magical internal objects
acquired from me. She regarded me as hateful for tantalizing her with these
borrowed/stolen objects while remaining unwilling to release her from her
dependence on me. She experienced me as cruelly refusing to recognize her
strengths (e.g., a sense of humor) other than those borrowed from me. Dr. M's
angry attacks on the introjected parts of me (my interpretations) helped to
establish a vicious cycle in which she remained unable to learn or to make use
of anything I might say. (Each aspect of this form of relatedness and the
underlying fantasies were fully and repeatedly interpreted and received by the
patient in the way I have described.)

I came to view Dr. M's use of interpretation as a form of perversion in which she
compulsively and excitedly transformed each of my interpretations into an
eroticized magical spell. (Only much later in the analysis did the patient become
fully aware of the nature of the excitement she felt in receiving an
interpretation, which she described as being "like an electric charge through
me that makes my body tingle." Eventually, she recognized this feeling to be a
form of sexual excitement.)

I understood the patient's use of my interventions as an unconscious attempt

to create a sense of a living self from the borrowed/stolen contents of her
parents. Even interpretations concerning her use of interpretation (i.e.,
interpretation of the transference "in terms of total situations" [Klein, 1952); (see
also Joseph, 1985), (and Ogden, 1991]) were immediately incorporated into the
perverse drama. In other words, every attempt I made to interpret the patient's
use of my talk for the purpose of bringing herself to life was in turn
transformed by the patient into still another scene in the drama.

It took me quite some time to fully appreciate the extent to which this form of
relatedness prevented Dr. M from generating a single original thought in the
analytic discourse. I had underestimated the extent of the patient's paralysis of
thought. My blindness to this aspect of the therapeutic interaction resulted in
part from the fact that Dr. M described her experience in a way

226

that often gave the appearance of insight and self-reflection. She was extremely
attentive to certain kinds of detail about the analytic setting, for example,
noticing if the cushion on my office armchair was rumpled in a way that
suggested someone had been reclining in it in a manner she had not seen
before: "There must have been a new female patient 'lounging' seductively in
your chair." Such fantasies at first seemed rich, but over time it became clear
that the patient's fantasies were restricted to a single theme with slight

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variations: she imagined a continual party going on in my interpersonal life
(e.g., my amorous relationship with my wife, my romantic and intellectual
enjoyment of my patients, my flirtations and affairs with supervisees, etc.) and
in my internal life (the interesting and insightful thoughts I had and the
richness of my creativity).

In the course of the first five years of analysis, Dr. M made substantial progress
in several aspects of her life. For instance, she developed the capacity to learn
in an academic setting, thus allowing her for the first time to engage in
research activity that reflected her own ideas. She made great strides in
becoming a successful, creative, and respected member of her field. Her
capacity to make decisions and manage her life improved dramatically.
However, her capacity to develop relationships with both men and women
remained stunted. The satisfaction she derived from the interpersonal aspects
of her work made her aware in a new way of how unable she was to develop
either romantic relationships with men or close friendships with women.
Despite the fact that Dr. M had developed the capacity to experience sexual
excitement that she felt to be her own, and was able to experience orgasm for
the first time in her life, she was unable to have intimate, exciting relationships
with men whom she liked and respected.

Dr. M had become aware of her loneliness in a way that she described as
"agonizing." She could now more fully experience and observe aspects of the
central conflict constituting the transference-countertransference: she felt
unbearably lonely and desperately wanted to "let me in," but at the same time
felt so

227

enraged at me for my "unwillingness to help" her (i.e., to think for her) that she
vowed she would never allow herself to submit to me by treating me as a "real
person." At times she said she felt so furious at me that she was genuinely
surprised that none of my patients had yet murdered me.

Despite the psychological changes that had occurred in some areas of the
patient's life, perversion of the interpretive process continued in the analysis
and resulted in the foreclosure of a generative discourse of a sustained sort.
When such discourse would briefly take place, it was invariably followed by
weeks or months of withdrawal on the part of the patient into an intensified
attack on the analytic discourse through enactment of a now consciously
fantasied "arid" discourse/intercourse involving a tantalizing and ultimately
powerless father and an untouchable mother. Dr. M observed this lifeless
discourse/intercourse from afar in her role as excluded and excited child,

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pretending not to understand what she was seeing (her "pseudo mental
retardation").

In a meeting during this phase of work, I offered an interpretation concerning

this sequence of engagement and anxious withdrawal. Dr. M responded with a
series of questions about my interpretation: Did I feel this was something she
did every time she came into the room with me? How could she prevent herself
from withdrawing in the way that I described? Did I think she had done this
from the beginning of the analysis, or was I referring only to the current
meeting or perhaps to the last few meetings? At this point I felt an emotional
shift that led me to respond differently from the way I had previously. Instead
of experiencing anger, I felt sadness and a deep sense of despair. This
transference-countertransference shift contributed to my decision to embark
on a course of interpretation conveyed largely in the form of action.

I met each of the patient's questions with a form of silence that both the
patient and I experienced as having an unmistakably different quality from
previous instances of silence. The silences in the current hour were filled with
an intensity of feeling

228

which served as an interpretation that could not have been made in words
because of the perversion of language and thought that was being enacted in
the analysis. This new form of silence constituted an interpretive action, an
interpretation that was not comprised of words and therefore lay to some
degree outside the domain of the power of the perverse transformation of
language. In the transference-countertransference, the perversion involved my
playing the role of the idealized/impotent father while the patient
predominantly identified with the impenetrable mother and the hidden,
observing, envious, excluded, over-excited child.

The silences under discussion were intended to convey an understanding that

had been developed and presented to the patient many times in the course of
the analysis, but which until now had been immediately and systematically
transformed and rendered ineffectual as the patient incorporated them into the
next scene of the perverse drama. The meanings conveyed by my deliberate
silence (which meanings I articulated for myself) included the idea that the
patient knew full well that her questions were not offered as part of a discourse
in which she was attempting to develop greater self-understanding for
purposes of psychological growth; rather, her questions represented an angry
accusation that I was hatefully excluding her from the riches of my internal
world (in the maternal and paternal transference) which she wished to plunder

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and hoard, and, at the same time, enviously to attack and spoil. She also knew
that if I were to answer her questions, she would feel momentary relief in
possessing a part of me (one of my spells), but that relief would almost
immediately turn to fury. Her anger reflected her feeling that I was forcing her
to become enslaved to me by preventing her from developing the capacity to
create thoughts, feelings, and sensations that she could experience as her own.

Dr. M's initial response to my silence (interpretation) was to fire at me more and
more angry, provocative questions. She then shifted to a series of affectless
descriptions of current events in her life, as if attempting to comply with what
she felt

229

was a demand on her to conduct the analysis by herself without any help from
me. My sadness and despair continued, increasingly accompanied by a deep
sense of loneliness. I could feel the futility of the patient's frenzied thrashing
about. For the first time, I was not at all convinced I could help her.

Dr. M began the next hour by announcing that she was having great financial
difficulties and would have to diminish the frequency of our sessions from five
to four meetings per week. This represented a rather transparent provocation
in an effort to extract words (spells) from me. I felt that any effort that I might
make at interpreting her anger and feelings of isolation in conjunction with her
efforts at extracting spells from me would simply perpetuate the perverse
drama. Consequently, I chose to interpret with silence, despite the danger that I
might be exchanging one form of perverse drama for another, i.e., reversing
the roles in a sadomasochistic relationship and further intensifying the patient's
(and my own) feelings of isolation. I also for the first time considered the
possibility of the patient's committing suicide. Again, the silence was meant to
convey my sense that the patient could make an interpretation of the
transference for herself and that her not doing so reflected a form of
perversion of language and thought which was currently being enacted
between us. The value of the silence as interpretive action would be measured
by the degree to which it served to expand analytic space. In other words,
would the silence facilitate the capacity for symbolization of conscious and
unconscious experience (enrich the "dialectic of modes of generating
experience" [Ogden, 1989]), or would the silence foreclose the use of symbols,
reducing the analytic interaction to a series of reflexive evacuations of
unmediated experiences of isolation (that the patient was not yet capable of
experiencing as sadness)? Intermittently during this period, I told Dr. M that I
thought we both knew that my thinking for her would create the illusion of

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analytic work, but that nothing could come of repeatedly and endlessly
substituting my thoughts and feelings for what might become her own capacity
to think and feel. This was an idea that

230

I had discussed with her many times over the previous years. Nonetheless, I felt
that it was important that I continue to present to her my understanding of my
reasons for conducting myself in the analysis in the way that I was (Boyer,
1983).

A meeting several months later was unique, in that silence as interpretive

action became the principal context for, as well as the content of, the meeting.
Dr. M experienced in a much fuller and clearer way than she had at any
previous time in the analysis the elements of the internal conflict that to this
point had been given shape almost exclusively in the form of the perversion of
language and thought that has been discussed. Dr. M talked about events in
her current work life that were undergoing change for the better as a result of
her ability to experience herself as a person who had the right to speak and
behave as an authority, as someone who could think and speak her own
thoughts. She interrupted herself by saying, "Okay, I've wanted a response
from you at every moment today. I am curious about why I need to hear your
response to every single one of the sentences that I utter." (In a previous
meeting, I had asked Dr. M whether she had felt curious about her behavior in a
situation that she was describing.) After three minutes of silence, the patient
again protested that she could not think—she could sleep, but she could not
think. I was interested by her reference to sleep and (silently) wondered if she
had begun to be able to remember her dreams. She had reported very few
dreams to this point in the analysis, and those she had reported were
presented either with no associations at all or with mechanical imitations of
associations.

Dr. M went through her usual maneuvers in an effort to get me to talk, but
there was something subtly different about her that I could not name. In the
middle of the meeting, she looked around the office without turning on the
couch to look at me, and asked, "Have you changed your office?" I made no
reply. "It looks like it's been moving laterally. The cracks on the wall have gotten
bigger. What do you think?"

Despite the fact that half of her sentences were questions, she

231

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did not seem to expect or demand any response from me. More important,
there was something quite imaginative and humorously self-mocking in what
she was saying and in the way she was saying it. Her sense of the change in our
relationship was being described in the physical-sensory experience of change
in the analytic space—there was movement occurring in the present moment
that had the quality of a "lateral" movement (a pun on "literal" movement) in
the analytic space and of decrease in the density of the barriers to reflective
discourse (the widening cracks in the wall). To have offered my understanding
of the meaning of these comments would have usurped the beginning of Dr.
M's capacity for imaginative thought, and most likely would have caused her to
return to a perverse dependence on me as the source of all that is good and
valuable.

Dr. M began the following day's meeting by saying that she had had a dream
the previous night. When she awoke from it in the middle of the night she
considered writing it down, but felt that it was so vivid that she could not
possibly forget it. She said that she was now unable to remember anything of
the dream.

I said that it seemed she had begun to think in her sleep, but was anxious
about the prospect of thinking in my presence. She said she was certain that
the dream was about being unable to think, but did not know why she felt
convinced of this. Dr. M went on to say that she was losing weight and was
approaching a weight where she "loses her breasts." (I felt she was accusing me
of willfully shrinking my own breasts so that there would be no milk for her. I
imagined that she felt that both of us would rather starve to death—kill the
analysis—than give anything—or lose anything—to the other.) Dr. M added that
she was certain that I had not noticed her weight loss. The session was filled
with angry attempts to get me to give her interpretations. At one point she
demanded that I tell her how much time we had left in the hour despite the fact
that she was wearing a watch. I said that reading the time on her own watch
would not be the same as my telling her the time. She barked back, "No, that

232

wouldn't help me. I want to know your time. My time isn't of any help to me.
Your time is the only time that counts." (Dr. M had previously told me that she
never knows the correct time because she keeps every clock and watch she
owns at slightly different times.)

The session continued with more questions from the patient that were
"interpreted" to her with silence and to myself in words. (An important aspect
of interpretive action is the analyst's consistent, silent, verbal formulation of the

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evolving interpretation. In the absence of such efforts, the idea of interpretive
action can degenerate into the analyst's rationalization for impulsive,
unreflective acting out.)

Near the end of the meeting, Dr. M recounted having seen a homeless person
begging for money the previous evening as she and her parents were about to
enter a very elegant restaurant. (In my own mind I understood the scene as a
description of the patient's feeling of intense deprivation in her meeting with
me.) Dr. M then said she could now remember the dream that she had had the
previous night: a man in the elegant restaurant was pouring expensive
champagne into her glass; the champagne was glamorous and sparkling, but
went flat a moment after it entered the glass. She said she awoke from the
dream in a state of intense anxiety. Dr. M said, "That's how I feel with you, I feel
desperate, like a homeless person, and would kill you if I had the guts. When
you give me something, it feels flat almost immediately after you give it to me. I
must kill it in some way, but I don't know how I do it or why." (Although there
was remarkable vitality in the initial part of her statement, her latter comments
regarding her own role in attacking my interpretations seemed rote and
compliant.)

Dr. M did not immediately follow her comment with a question as she had
consistently done in the past, but after a short pause returned to asking me for
the time in a way that invited me to interpret the connection between this
demand, the imagery of her dream, and the account of the homeless person. I

233

again responded with silence that was intended to renew the interpretive
working through of the perversion of language and thought.

The analytic movement (experienced by the patient as the physical movement

of my office) continued in this phase of the work. Striking among the changes
occurring in the analytic process was the appearance for the first time of
several slips of the tongue in almost every meeting. The patient was not only
embarrassed by the slips, but also seemed to welcome them and to experience
interest in them. For instance, in talking about the incomparable pleasure she
derived from her feeling of power in succeeding to extract an interpretation
from me, Dr. M unconsciously substituted the world "powder" for "power." She
associated "powder" to the ashes resulting from cremation and the feeling of
deadness and extreme detachment that were inseparable, and at times
indistinguishable, from the sexual excitement connected with acquiring one of
my spells. Most important, there was a distinct sense in this exchange that
these thoughts were the patient's thoughts, although I made no comment

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about this in an effort not to change her thoughts into something other than
what she had created. It seemed that "despite herself," in these slips Dr. M was
unconsciously allowing herself to begin to experience and to create a voice for
aspects of herself that had been present, but to this point in the analysis, only
in a strangulated, stillborn form, i.e., in the form of the transference-
countertransference relationship organized around the perversion of language
and thought that has been discussed.

CLINICAL ILLUSTRATION II

Interpretive Action as an Early Stage of Interpretation

During the telephone call prior to our first meeting, Mr. P told me that his
marriage of eighteen years was in shambles, that he was in love with and
having an "intensely passionate" affair

234

with the wife of his best friend, and that his life was "in a downhill spiral." as the
patient entered my consulting room for the initial meeting, he had the look of a
broken man. The intensity of his desperateness and anxiety filled the room. Mr.
P handed me a sheaf of papers and explained that these were love poems he
had collected which he thought would help me to understand the feeling he
was having in relation to this woman. The abject surrender conveyed in the
patient's facial expression and bodily movements as he handed me the papers
had the effect of a plea: it felt as if it would be cruel and inhumane not to accept
his gesture. I was aware that there was something slightly effeminate about the
patient's appearance and manner of speech.

Immediately following these momentary initial impressions, but still within the
period of seconds during which the patient's hand was outstretched, I
developed a distinct sense that the patient was inviting me to engage in a type
of sadomasochistic homosexual scene. In this scene, I imagined that I would
either submit to him and have his "loving" contents (concretely represented by
the poems) forced into me, or I would be moved to sadistically refuse them and
thereby demonstrate my power over him (perhaps through a "forceful"
interpretation of the patient's wish to dump his destructive internal objects into
me).

On the basis of these extremely rapid (hardly apprehended) responses to what

was unfolding in the opening seconds of the analysis, I told Mr. P that it would

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take some time to understand something of what had just transpired between
us and suggested he keep the poems for the time being. In the minutes that
followed, I became increasingly aware that I had not even wanted to touch the
papers that he had offered me, and had felt an even stronger aversion to the
idea of touching his hand. It seemed to me that to have accepted the papers
would have been to have taken part in the particular form of sexual fantasy
that I sensed underlay what was being enacted in Mr. P's occupying the bed of
his best friend. I hypothesized in a highly condensed, hardly articulated way
that in having an affair with his best friend's wife, Mr. P had in unconscious
fantasy put his penis

235

where his best friend's/father's penis had been. In this way, he had had sex with
his father while avoiding conscious awareness of the homosexuality of this act
because the meeting of his father's penis and his own took place in his
mother's vagina.

I view my thoughts/hypotheses about the incestuous/homosexual meaning of

what had just occurred in the meeting as a form of "reverie" (Bion, 1962) that
reflected experience in (of) an intersubjective analytic third that was being
generated by Mr. P and myself in the course of his introducing himself to me. I
mention these thoughts for two reasons: first, they formed the basis for more
fully elaborated transference interpretations that were gradually discussed with
the patient later in the hour and in the succeeding several meetings regarding
the patient's anxiety about beginning analysis. The conscious level of the
patient's anxieties, which he discussed later in the hour, related to his fears of
breaches of confidentiality, the fantasy of meeting me in situations outside of
the analytic setting, and his already knowing things about me from my writing
that excited him and made him feel we could have a special relationship with
one another.

Secondly, I mention these reveries/hypotheses because I feel that these

thoughts and feelings would not have been discernible to me had I reflexively
acceded to Mr. P's offer of the poems in an "empathic" effort to accept his
expression of his need to be understood. Not accepting them allowed for the
creation of a psychological space in which the poems could be recognized (and
eventually understood) as an "analytic object" (Green, 1975); (Ogden, 1994a).
The intervention (the act of not accepting the poems, in conjunction with the
tone and content of my comments about my reasons for refusing them),
represented not simply an attempt to create "analytic space" (Ogden, 1986);
(Viderman, 1979), it also represented an early stage of interpretation which

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communicated the essential elements of what would eventually be offered as a
set of verbally symbolized interpretations. The interpretation-in-action
communicated my initial, tentative understanding of the following unconscious

236

transference-countertransference meanings: the intensity and desperateness

of the patient's need to put something into me (the papers into my hand, the
poetry into my mind and body) reflected his feeling that he could not bear to
live with the destructive, out-of-control passion and fear that he felt were
consuming him. It was imperative that the destructive passion be evacuated
into me so that he could be freed of it while remaining connected with it
through me. At the same time, I felt that Mr. P wished to make use of me as an
analyst in his effort to extricate himself from the web of painful internal and
external object relationships in which he felt hopelessly trapped. All of this was
discussed with the patient gradually over the course of the first few meetings,
in language very similar to that which I have used here.

To summarize, my rather prosaic statement that it would take some time to

understand something of what had transpired between Mr. P and myself, and
my suggestion that he keep his poems for the time being, represented more
than an effort to establish analytic space within which to think about what was
being enacted. As important, the statement represented a form of transference
interpretation in the form of action that emerged from my experience in (and
of) the intersubjective analytic third. This experience led me to formulate the
opening interaction of the analysis as the patient's enactment of unconscious
incestuous/homosexual fantasies by which he felt in danger of being
overwhelmed. His attempt to hand me the love poems was a highly specific
communication about his internal object world.

The semantic content of my refusal did not delineate my hypothesis concerning

the incestuous/homosexual nature of the unconscious fantasy in which I was
being invited to participate. To have offered this interpretation to the patient in
a verbally symbolized form at that point would have been to participate in the
fantasied sexual drama in the role of invasive homosexual partner.
Nonetheless, my refusal to accept the poems was more than a generic refusal
to engage in an acting-in with a patient;

237

it was a refusal to take part in the particular unconscious fantasy being

experienced in the analytic third (which experience I was formulating for myself
in words). As a result, my refusal carried meanings (tentative understandings of

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the transference-countertransference) that constituted an early stage of what
would later be offered to the patient as an explicit transference interpretation.
(The subsequent verbal elaboration of an understanding initially offered only in
the form of an interpretive action and the exploration of the analysand's
experience of the interpretive action are inextricable parts of this form of
interpretive intervention.)

CLINICAL ILLUSTRATION III

Interpretive Action in the Area of Transitional Phenomena

In the following example, interpretation-in-action was offered in the context of

a transference-countertransference field in which transitional phenomena
(Winnicott, 1953) were of central importance. Although the interpretation that
will be discussed was presented in the form of a question, the meaning of the
interpretation was carried as much by the experience of the intervention as a
transitional phenomenon as it was by the semantic content of the words.

Dr. L, an analyst in consultation with me, had presented a rather difficult case
over a period of years. The patient, Ms. D, an extremely intelligent woman in
her early thirties, had been so crippled by phobias (particularly claustrophobia)
and anxiety about her inability to think that she had never been able to work or
to pursue graduate-level education. (It had taken her eight years to complete
an undergraduate degree.) In addition to the phobic symptoms, the patient
engaged in compulsive masturbation in which the central fantasy involved
being sexually stimulated by several men against her will, usually while she was
bound or being threatened. Although the patient occasionally

238

entered into relationships with men, she had had no sexual experience other
than masturbation.

In her fourth year of analysis, Ms. D arrived at a session saying that a friend had
given her one of the analyst's published articles on psychoanalysis. The friend,
a graduate student in psychology, had not known the identity of Ms. D's
analyst, because for the patient it was a closely guarded (shameful) secret. Ms.
D said that she had not yet read the article because she wanted to discuss her
feelings about it, and to hear the analyst's thoughts with regard to her reading
it, before going ahead.

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The patient said that she would like to read the paper although she was afraid
that she would not understand it. The analyst was aware of feeling anxious
about the patient's viewing a discourse (between herself and her colleagues)
that felt private. Dr. L told me that she had had the fantasy that she would
never again be able to write once this private area had been invaded by the
patient. The analyst also had fantasies that the patient would recognize herself
in the article despite the fact that Dr. L had never written about her work with
Ms. D.

In the consultation in which Dr. L discussed this meeting with me, these
countertransference feelings were understood as a reflection of an
unconscious fantasy (on the part of Dr. L) that Ms. D had discovered Dr. L's
shameful secret of wishing to observe in an excited state her own parents'
intercourse. The result would be not only the punishment of being paralyzed in
her writing (the recording of her "insights"), but also being "found out" by the
patient.

Ms. D's feelings of shame about being in analysis had been tentatively
understood and interpreted over time as having roots in her unconsciously
fantasied equation of the analytic space and the parental bedroom into which
she felt she was secretly and excitedly entering. Although Ms. D discussed
elements of this understanding with considerable interest, it seemed to Dr. L
that the patient was "viewing the interpretations from the outside." In a
meeting some weeks after the patient had been given the journal article, Ms. D
said that she

239

had read the paper and had found it interesting to hear the analyst's voice in
this different form. Ms. D's excitement and her feelings of competitiveness,
envy, and guilt were discussed in some detail. The patient then said that there
were several terms and ideas she had not understood and that she would like
to know more about them. The analyst asked the patient, "What would you like
to know?" Dr. L became aware of the ambiguity of her question only after she
had posed it. Did she intend to answer any and all of the patient's questions, or
was she simply inquiring about the nature of the questions? Dr. L told me that
in the moment of asking this question she had created in her own mind the
imaginative possibility of directly answering the patient's questions, although
she had felt no pressure to make a decision about whether or not she would
actually do so.

Ms. D was startled by the analyst's question (responding to the same ambiguity
of which the analyst had become aware) and said that she did not know if the

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analyst really meant what she had said. (Ms. D had, during the course of the
analysis, repeatedly described the loneliness that she had felt during childhood
in not being able to talk to either of her parents or to her siblings about "What
the hell is going on?" "What did you mean by that?" "Why did he [her father] say
that?" etc. Ms. D went on to say that she felt that something important had
changed between Dr. L and herself as a result of Dr. L's response (which she had
not at all expected). The patient said that she no longer knew what to ask or
even if she wanted to ask anything. Ms. D paused and said that mostly what she
had wanted to know was whether the analyst would be willing to talk to her
about the things she was confused about and, surprisingly, the answers to the
questions no longer seemed to matter.

Dr. L understood the patient's response in terms of Ms. D's conflicted wish to be
curious about the private discourse (including the sexual intercourse) of her
parents without feeling consumed by it or entrapped in it. The patient was
struggling to create in the transference-countertransference an intersubjective

240

"potential space" (Winnicott, 1971); (see also Ogden, 1985) in which imagined
participation in the parental discourse/intercourse could take place in a
different way. In other words, Ms. D was attempting to be curious (to imagine
and think about the parental discourse/intercourse) without becoming caught
in a perverse, overstimulating psychological event which would have to be
either compulsively and excitedly repeated (as in the compulsive masturbation)
or fearfully warded off (e.g., by a paralysis of the capacity for thought).

Dr. L's response, "What would you like to know?," was spontaneous and highly
informed by her experience in the intersubjective analytic third. This
intervention stands in contrast to an inquiry into or interpretation of the nature
of the patient's conflicted unconscious wish to participate in the extra-analytic
(sexual) life of the analyst. Dr. L's response represented an interpretation-in-
action which was generated in a potential space between reality and fantasy.
Her response (interpretive action) conveyed understandings that could be
utilized by the patient in a way that had previously been impossible because the
response itself represented a form of transitional phenomenon, i.e., an
intersubjectively generated experience in which an emotionally important
paradox was created and maintained without having to be resolved. In this
instance the paradox related to the latent question (within Dr. L's manifest
question): "Do you 'really' want to participate in the private intercourse/
discourse of your parents/analyst?" The question in both its manifest and latent
content was re-created intersubjectively in such a way that both analyst and

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analysand came to experience and understand it as a question (more
accurately, a set of questions) for which no answer was required.

Under other circumstances, Dr. L's response/interpretive action might have

been heard as a frightening, overstimulating invitation to "break the law of the
father" (Lacan, 1958), i.e., to violate the prohibition against breaches of
personal boundaries that are at the foundation of the analytic relationship. The
fact

241

that Ms. D experienced the analyst's interpretive action/question as having the

qualities of a transitional phenomenon (an intersubjectively created paradox in
the form of a question that need not be answered) was reflected in Ms. D's
response to the intervention: she did not attempt to compulsively enact
voyeuristic fantasies or to actually enter further into the professional discourse
of the analyst (for example, by anxiously seeking out Dr. L's other writings).

In this instance, the analyst's silent verbal formulation of the interpretation

evolved over time. There was a spontaneous, unplanned quality to the
intervention/question, whose meanings the analyst began to recognize and
consciously and silently verbalize only after (or perhaps as) the question was
being posed. This type of interpretive action might be thought of as
representing "the spontaneous gesture of the analytic third." Dr. L's
understanding of her question as a type of transitional phenomenon which
generated paradoxical, imaginative possibilities became fully articulated for
herself only in the course of consultation.

To conclude, the interpretive action under discussion conveyed an

understanding of the patient's unconscious conflict (as experienced in and
through the intersubjective analytic third) and represented an experience in the
area of transitional phenomena. In this instance, it was necessary for the
experience of the interpretive action itself to occupy a transitional space wherein
new imaginative (as opposed to compulsively fantasied) possibilities could be
created intersubjectively. The question, "What would you like to know?,"
represented an interpretive action that conveyed an understanding of the
patient's leading unconscious conflict, resulting in a psychological shift in which
the primal scene (and the oedipal drama) could be safely (re-)created and
explored in an area between reality and fantasy. In that "third area of
experiencing" (Winnicott, 1953), neither Dr. L's nor the patient's (manifest and
latent) questions needed to be answered. In fact, conveying this understanding
(i.e., that the questions required no answer) constituted the interpretation.

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 242

SUMMARY

In this paper, the concept of interpretive action was understood as the analyst's
use of activity to reveal to the patient specific aspects of his or her
understanding of the transference-countertransference which cannot be
communicated at that juncture through symbolic speech alone. The
understanding of the transference-countertransference conveyed by an
interpretive action was derived from the experience of analyst and analysand in
the intersubjective analytic third. Although the analyst used action to
communicate aspects of this understanding to the analysand, the analyst
simultaneously and silently formulated the interpretation in words.

The three clinical illustrations of interpretive action that have been presented
were selected not because they represent remarkable or unusual
psychoanalytic events. Rather, they have been presented in an effort to
illustrate the way in which interpretation-in-action represents a fundamental,
and yet insufficiently explored aspect of the interpretive process.

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