The analyst's act of freedom as agent of therapeutic change.

In this paper I intend to explore a phenomenon with which all analysts are familiar. I will first describe it and then examine what its implications are for theory. I shall refer to it as the 'x-phenomenon'. I shall start with some clinical examples. I was charging Miss M a little more than half what my other patients were paying. She had been a clinic patient and I used to sigh to myself and say inwardly, 'Poor Miss M, £X is the most that I can charge her'. I did not in fact articulate it so clearly as that. In my mind it was like an acknowledged fact that everyone knows, like the unreliability of the English weather. It was part of the furniture of my mind and I had resigned myself to it in the same way as I reluctantly resign myself to the English weather. So the analysis went on and on with that assumption as its unquestioned concomitant until one day a startling thought occurred to me: 'Why can't Miss M pay the same as all my other patients? ' Then I remembered the resentment she frequently expressed towards her boss who always called her 'Little Mary'. A certainty began to grow in me that I was the prisoner of an illusion about the patient's capacities. I had been lassoed into the patient's self-perception and I was just beginning to extricate myself from it. I then brought up the question of her fee and in the course of a discussion she said, 'If I had to pay more then I know I would'. She had now clearly told me that she had the capacity in her to pay more and that this could be mobilized if I changed my inner attitude towards her. A few sessions later I said to her, 'I have been thinking over our discussion about the fee. I charge most of my other patients £X and in our discussion I have not heard anything that makes me think that I should not charge you the same'. For two sessions she cried rather pitifully but then became resolved that she would meet the challenge. Soon she found a job that paid her one third more than her previous salary. In moving job she extricated herself from the patronizing tutelage of the boss who called her 'Little Mary'. She had been able to do this because she had first been freed from the patronizing attitude of her analyst. Shortly after this she finally gave the push to a parasitic boyfriend. Again I think she had been able to do this because she had been able to give the push to a parasitic analyst. These two events were soon followed by other favourable developments. I think the source of these beneficial changes was in that moment of inner freedom when I had the unexpected thought: 'Why can't Miss M pay the same as my other patients? ' I am calling this act of inner freedom the 'x-phenomenon'. Now I want to take another example. This patient was an obsessional man who used to hesitate sometimes in the middle of telling me something, usually as he was about to tell me some thought he had had since the previous session. As he had often expressed his apprehension that I would think him pathetic I would say to him something like, 'I think you are afraid that if you tell me about the incident in your mind I shall think you are pathetic'. Of course I was thereby clearly inferring that I would not think him pathetic. With this assurance he would then obligingly tell me the thought in his mind. Then one day I was reading the following passage from 'Four Discussions with W. R. Biori: