Psychoanalytic psychotherapy and the analytic attitude : a cross-cultural case study approach

Abstract

The relevance of individual psychoanalytic psychotherapy in the context of post-apartheid South Africa is a contentious issue. The western-centric universalist bias of this treatment approach has been criticised for not being applicable to Black South African individuals. With these criticisms in mind the appropriacy and efficacy of psychoanalytic psychotherapy was examined by focusing on three Black English-speaking South African women between the ages of 25 and 35 from the urban Western Cape. A collective case study design situated within a postmodern framework of enquiry was chosen for its capacity to incorporate both the therapist’s and the participant’s experience of the therapeutic process over time. This study focused on the analytic attitude, which comprises the basic template through which psychoanalytic psychotherapy is practised. The model used was that described by Ivey (1999) which includes five elements: generative uncertainty, abstinence, neutrality, countertransference receptivity, resoluteness and three related concepts: the task process and setting. The therapeutic dyad comprised the principal unit of analysis; by examining the interactive responses within this dyad in terms of the eight sub-units of the analytic attitude it was possible to evaluate the effectiveness of this modality. The findings showed that this model was successful with an emerging group of individuals who simultaneously hold traditional collective values and western values of individuation and self-determination. Some adjustments to abstinence and neutrality were necessary and a high degree of vigilance and self-reflection on the part of the therapist was required. It was revealed that western ideals of individualism, subject/object dualities, and taken-for-granted assumptions tend to obscure the practice of psychoanalytic psychotherapy across culture. The relational two-person model was able to accommodate cultural difference to good effect, opening the way for universalistic assumptions to be challenged and re-thought. This attitude was effective both as a treatment model and as a research tool. The participants in this study represent an emerging class of Black South Africans who are seeking different pathways for psychological concerns. The findings of this study can be generalised to a body of knowledge concerning the use of the analytic attitude in specific cross-cultural contexts in South Africa.