Molnos, A. (1998): A psychotherapist's harvest

ABSTINENCE

The rule of abstinence is a typically psychoanalytic notion. According to this rule the analyst "should refuse in principle to satisfy the patient's demands and to fulfil the roles which the patient tends to impose upon him." (Laplanche et al., p. 1973, p. 2). To illustrate this let us think of the patient arriving for his first appointment. He attempts to cover up his initial anxiety and to take charge of the situation by making pleasant remarks and asking socially acceptable questions: "This is a very nice building. When was it built?" Or a bit more intrusively: "You must have a fabulous view from here. Have you lived here for long?" According to the rules of abstinence the therapist should not respond to such pleasantries and should not answer such questions. In short, she should not socialise with the patient. Her task is to focus on the patient's problems and help him to resolve them.

Although the above definition seems simple enough, its implications are complex and subject to debate. It is, for instance, a moot point whether the therapist should or should not apologise for her mistakes. Nowadays an analytic psychotherapist would apologise, for instance, even for a couple of minutes lateness on her part, while some decades ago a classically trained psychoanalyst probably would not have done so. The rationale behind not apologising is that the event becomes more "grist to the mill" when subsequently the patient's feelings and response to it are analysed.

Also it is questionable whether all emotional demands should be frustrated as a matter of principle. There can be circumstances in which it is therapeutic to acknowledge the achievements or good qualities of a patient starved of recognition or to show care for him in a psychological, non-material sense. This can be a corrective emotional experience especially for a patient who suffers from low self-esteem. Thus, in certain cases, the principle of the corrective emotional experience can overrule that of abstinence.

The concept of suspended action is simpler, clearer and more easily applicable than "abstinence". Both imply that it is paramount to abstain from any physical or sexual contact between the therapist and the patient.

See also index: CORRECTIVE EMOTIONAL EXPERIENCE, NO SELF-DISCLOSURE, PSYCHOANALYSIS, SEX & SEXUAL CONTACT, SUSPENDED ACTION, VALUES.