On focused association and the analytic surface: clinical opportunities in resolving analytic stalemate.

Focused association is a technique for exploring repetitive noncommunicative phenomena, especially those which occupy center stage during periods of analytic stalemate. This psychological content is studied by a two-part investigation of the particulars of the presenting "surface," involving (1) focusing and (2) association. The technique was originally devised by Freud to access the latent meanings of dreams. The effort departs from free association, calling upon more active analytic teamwork within a transference-countertransference context that is steadily considered and analyzed. The key "unverbal" material arising from this dyadic flux is descriptively preconscious, multimodal, widely variable in form, and not primarily lexical. A frequent finding is that these repeating ad hoc clinical phenomena, often categorized as resistance (especially transference resistance), are highly condensed and defensively rearranged compositions, like dreams, that have been internally structured by processes akin to dreamwork. Approached by focused association, such content yields unconscious derivatives that previously had been sequestered in repetitious, noncommunicative forms. This work allows the analyst to follow Freud's clinical maxim to "start with the surface" and provides relief for the analyst from the temptation to invoke global resistance interpretations when derivative communication and analytic movement have lapsed.