Rohde-Dachser C
Z Psychosom Med Psychoanal. 1981 Oct-Dec;27(4):318-37.
The psychoanalytic situation is based on a dyadic concept where the relatives of the patient easily may be regarded as a disturbing element which should be eliminated as far as possible. In reality, however, there exist manifold interrelationships and feedback mechanisms among the psychoanalytic dyad and other significant relationships of a patient in psychoanalysis. The relational triangle of patient, partner and psychoanalyst is taken as an example to demonstrate within a sociological framework the process of competition of two primary one-to-one relationships mutually demanding exclusivity. Because of the inhibited communication between the analyst and the partner of the patient, this competition, however, cannot be settled obviously. It is rather shifted into the partner-relationship where it appears as a (originally iatrogenic) conflict of the couple which, then, easily may be misinterpreted by the psychoanalyst from a psychopathological point of view and not in terms of structural interrelations. In this process, a scapegoat function often is ascribed to the partner of the patient who is not able to disprove this interpretation and may react in a paranoid manner. The patient, on his part, in this situation often suffers from a loyalty conflict between his partner and his analyst which can be resolved in several modes. One pattern of solution is the splitting of the transference into a totally "good" and a totally "bad" relationship, the negative side generally ascribed to the partner-relationship. The different viewpoints of Kohut and Kernberg regarding these splitting phenomenons in the transference are discussed, and also the problem, whether a protracted narcissistic transference as required by Kohut for the treatment of narcissistic personalities must not lead to undue impairment of a concurrent real relationship of the patient. There is the question whether the present state of psychoanalytic technique can do justice to relational triangle as presented here from a sociological point of view, or whether they rather are denied (out of structural reasons, too) by a dyadic conception which does not correspond to the post-symbiotic reality of adult patients, even when a disturbance on the so-called prae-oedipal level is attested to them.