Conflict and deficit: implications for technique.

One of the most challenging theoretical tasks today is to integrate the psychology of deficit with the traditional psychoanalytic conception of conflict. In this paper it is argued that such an integration should take place within a framework of structural organization. By means of the quality of the transference, the analyst has to decide whether an actual piece of clinical material is mainly to be seen as an expression of conflict or of deficit. The paper illustrates how derivatives of deficit may appear in the therapeutic dialogue. When these are about to dominate, the analyst has to switch his strategy from one of unveiling meaning to one of constitution--utilizing interventions of an affirmative type. As the structural level will fluctuate within one and the same patient from one point of time to another or from one area of the personality to another, the analyst has to be in a state of constant receptivity to oscillate between the two strategic positions. It is concluded that even if psychoanalysis has to extend both its conception of psychopathology and its therapeutic strategy, no change in the basic analytic attitude seems necessary.