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CLINICAL NOTES
Bruce Fink (1999). ‘The Analytic Relationship,’ A Clinical Introduction to Lacanian
Psychoanalysis: Theory and Technique (Cambridge, MA; London, England), pp. 28-41.
What exactly constitutes the relationship between the analyst and the patient?
Different schools of analytic thought and practice will have different answers to this
question.
These clinical notes are an attempt to answer this question only with specific
reference to Lacanian psychoanalysis though anybody interested in the theory and
practice of psychoanalysis will find them useful from a comparative point of view.
These clinical notes summarize the main points that Bruce Fink invokes in an answer
to this question in a book that he published in the first instance in 1997.
My citations from Fink in these notes use the paperback edition of his book from
Harvard University Press that was published in 1999.
Bruce Fink argues that patients already know a lot about analysis before they even
meet the analyst. Their attitude towards the analyst and analysis depends on which
part of the world they find themselves in.
There are some cities like New York, Los Angeles, and Paris, for instance, which
have a culture of analysis. Analysts do not have to sell themselves, or their wares, in
these cities since there is wide-spread acceptance of the role that analysis can play in
the medical profession and as a problem-solving technique.
In many countries in Latin America, psychoanalysis is taught widely in schools and
colleges. There are more analysts in Latin America than anywhere else in the world
though this may not be well-known. Most soap operas in Spanish or Portuguese
depict characters who are already in analysis or would like to be in analysis.

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In cultures where there is a lot of exposure to analysis, the analyst will find it easier
to occupy the role of the sujet supposé savoir.
Patients in these cultures are more open to asking and receiving help from an
analyst.
This is where analysts have to be careful because the help that they offer should not
be in the form of suggestions.
Suggestions, in the context of hypnosis, have been tried in the early history of
analysis by Mesmer, Charcot, and Freud, but the difficulty with suggestions is that it
substitutes the desire of the analyst for the desire of the patient.
And, furthermore, the analyst finds himself repeatedly making suggestions since the
effects of post-hypnotic suggestion are short-lived.
It is also easy to get things wrong here and there is a possibility that hypnosis can be
misused to get the patient to do things which he would not have done otherwise of
his own volition.
Who will take responsibility for the patient or his behaviour? This is therefore not, as
analysts understood early enough, a viable method of psychotherapy.
Knowledge is also an important consideration in the analytic method.
The motor force of analysis is the patient’s belief that the analyst knows something
that he himself doesn’t.
If the patient does not attribute this knowledge to the symbolic Other, the analysis
will simply not get started or gain traction when it does.
Fink’s point is that it is the patient’s unconscious which has the requisite knowledge;
all that the analyst can do is to punctuate and give it grammatical form when it
emerges in the analytic situation.

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It is not – as Freud understood only too well – the analyst’s knowledge of the patient
that is therapeutic; it is the patient’s repressed knowledge of himself (that he both
knows and doesn’t know) that is therapeutic.
That is why it is important to make the unconscious conscious though this cannot be done
in its entirety.
When the patient supposes that the analyst is in the locus of the subject presumed to
know, he is merely attributing his own unconscious knowledge to the analyst.
There is some justification for this since it is only within the positive transference
that his unconscious manifests itself in the analytic situation.
The analyst takes the Socratic locus of the mid-wife in this process of revelation.
Lacan cites an instance from the Platonic dialogues where a student of Socrates
pointed out that he experienced an enormous sense of eloquence in the presence of
Socrates, but felt deflated when he left the room.
This is a specific instance of a performance that is transferentially-mediated.
The patient’s situation is analogous to this student in the presence of the analyst who
is in the locus of the subject supposé savoir.

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In order to occupy this locus, the analyst minimizes his communications to the
patient, and does not reveal any aspect of his life whatsoever.
This is to ensure that the analyst is in the locus of the symbolic Other (and who
therefore has no agenda apart from keeping the analysis going).
This will also ensure that the patient does not see the analyst as a ‘rival’ in the locus
of the imaginary Other.
It is not that the analyst does not have any feelings or affects towards the patient.
It is rather a case of not acting in haste in response to these urges lest he act-out
himself and attempt to seek a close friendship or relationship with the patient.
The patient sees the analyst mainly as somebody who can mediate his ‘symbolic
relations.’
What this means is that every patient will have difficulties in pursuing the object of
his desire because he has difficulty in constituting his ego ideal.
The different ways in which patients pursue or do not pursue their desire is a clue
then to the state of their analysis.
The main problem in the context of symbolic relations is castration anxiety. The
patient experiences fear of retribution from some significant Other.
Some patients experience this fear of retribution because they want to act on their
desire; others because they do not want to act on their desire.
In either case, they are a bit secretive in terms of how they relate their desire to the
symbolic Other.
They will either say too much or too little about what they really want.
It is not enough to situate the patient in the context of the symbolic Other; it is also
important to understand how susceptible he is to the imaginary Other.
In lay person’s terms, we might simplify a bit and say that symbolic relations pertain
to how the patient relates to his parents, and imaginary relations to how he relates to
his siblings and friends.
The main affective dimension in the imaginary emerges then as rivalry as
instantiated most commonly in forms of ‘sibling rivalry’ between brothers.

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The symbolic and imaginary dimensions of the patient’s life are not parallel
phenomena but work at cross-purposes, as Lacan depicts it, in his Schema L.
The usual depiction of the analytic trajectory is that the patient must learn to move
from the imaginary to the symbolic.
Resisting the ‘lure’ of the imaginary is the nearest that the patient can come to the
Lacanian equivalent of maturity.
The reason that Lacan does not use the term ‘maturity’ in the positive sense is
precisely because he felt that it is easy to regress to the imaginary.
The more convinced the patient is that he is mature, the more likely it is that he will do
something immature.
So there is a ‘performative contradiction’ that is structurally inherent to any self-
congratulatory claim about ‘maturity’ on the part of the patient or the analyst for
that matter.
The patient may also locate the analyst in the locus of a judge.
What this means is that he expects the analyst to look at the situation from his point
of view. This is a role that analysts should not play too early (if at all).
If they do, the analysis will run out of matter because the patient will stop himself
from free-associating.
If the patient is suffering from a negative affect, it is best to let him suffer that affect
if that will keep the analysis going.
What the patient really wants is for the analyst to tell him that he is right and that his
parents are wrong, and that for whatever reason they could not mediate his
symbolic relations in the way that would have made him better off.
And, finally, the analyst finds himself in the locus of the ‘cause of desire.’

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What this means is that the positive transference is firmly in place and that the
patient has started to internalize many aspects of the analyst. This is most commonly
manifest in dreams.
Patients usually say that the analyst figured in their dreams or that they had a
particular dream ‘for’ the analyst. Their entire psychic life seems to be related to the
persona of the analyst.
Lacan consider this moment to be the ‘Archimedean point of analysis.’ It is only if
the analysis gets to this point that the analyst will be able to ‘apply the lever that can
move the symptom.’
If the analysis does not get to this point, it could well be because the patient is
suffering from a negative transference and is not willing to make himself vulnerable
to the analyst.
Needless to say, once the analyst is in the locus of the sujet supposé savoir, he will be
subject to an endless number of projections.
Knowing how to manage projections is an important skill-set for analysts.
Fink points out that even though projections happen within the transference, the
analyst should only point to the ‘content’ of the projection rather than the ‘fact’ of the
projection.
This is where even experienced analysts are most likely to err because it is difficult to
resist the temptation of pointing out that the patient is projecting.
The analytic situation can then be formulated as follows:
Should the analyst confront the patient with his projections?
Should the analyst interpret the transference?
What would the consequences be if he were to do so?
These then are the main points in Bruce Fink’s attempt to delineate the ‘analytic
relationship.’

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While he addresses this relationship mainly from a Lacanian point of view,
psychotherapists belonging to different schools will find that these clinical notes will
help them to clarify their thoughts on the issues raised here.
SHIVA KUMAR SRINIVASAN