UNUSUAL INTERVENTIONS UNUSUAL INTERVENTIONS Alterations of the Frame, Method, and Relationship in Psychotherapy and Psychoanalysis Edited by Salman Akhtar First published in 2011 by Karnac Books Ltd 118 Finchley Road London NW3 5HT Copyright © 2011 to Salman Akhtar for the edited collection, and to the individual authors for their contributions. The rights of the contributors to be identified as the authors of this work have been asserted in accordance with §§ 77 and 78 of the Copyright Design and Patents Act 1988. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of the publisher. British Library Cataloguing in Publication Data A C.I.P. for this book is available from the British Library ISBN-13: 978-1-85575-897-1 Typeset by Vikatan Publishing Solutions (P) Ltd., Chennai, India Printed in Great Britain www.karnacbooks.com To Henri Parens a cherished colleague and an unusually kind man CONTENTS ACKNOWLEDGMENTS ix ABOUT THE EDITOR AND CONTRIBUTORS xi INTRODUCTION xvii PART I: ALTERATIONS OF THE FRAME CHAPTER ONE Making extraordinary monetary arrangements 3 Ira Brenner CHAPTER TWO Conducting the treatment outside the office 31 Mark Moore CHAPTER THREE Changing the frequency, length, and timing of sessions 65 Frances Salo vii viii CONTENTS PART II: ALTERATIONS OF THE METHOD CHAPTER FOUR Refusing to listen to certain kinds of material 83 Salman Akhtar CHAPTER FIVE Giving advice 99 Anton Kris CHAPTER SIX Interpreting in the form of action 113 Marc Jacobs PART III: ALTERATIONS OF THE RELATIONSHIP CHAPTER SEVEN Talking about oneself 141 Alan Skolnikoff CHAPTER EIGHT Touching the patient 165 Andrea Celenza CHAPTER NINE Giving mementos and gifts to the patient 177 Andrew Smolar REFERENCES 205 INDEX 223 ACKNOWLEDGMENTS I am grateful to the distinguished colleagues whose contributions appear in the pages of this book. I truly appreciate their sacrifice of time, their effort, and their graceful reception of my editorial sugges- tions. Dr. Michael Vergare, Chairman of the Department of Psychiatry and Human Behavior at the Jefferson Medical College (my academic base for over thirty years) consistently supported my work. My patients mobilized the sort of technical questions that this book attempts to answer. My good friends Zvi Lothane and Joseph Reppen of New York (the former editor of Psychoanalytic Books) and Ivan Ward of London (Director of Education at the Freud Museum) helped in significant ways. Dr. Newell Fischer and Professor Christfried Togel, Director of des SALUS Instituts, Magdeburg, Germany, provided information that was useful for this book. My wife and fellow analyst, Dr. Monisha Akhtar, offered me valuable counsel and safeguarded the ambience necessary for meaningful thought to occur. My assistant, Jan Wright, prepared the manuscript of the book with her characteristic diligence and good humour. To all these individuals, my sincere thanks indeed. Philadelphia, PA March 15, 2011 Salman Akhtar ix