Modulating Phenomena:—Elusive Aspects of the Psychoanalytic Process1

Robert Shapiro, Ph.D.

PSYCHOANALYTIC THEORY AND training encourage us to notice and utilize
almost everything which transpires in the interpersonal field. Perhaps everything which
occurs does affect the process. Nonetheless, we recognize only some and analyze even
fewer of the interactions which take place. Discordant interchanges, repetitive patterns, and
behaviors which evoke powerful responses in analyst or patient are at the center of our
daily work. However, an array of communications and internal responses remain outside
the focus of our attention and inquiry.
The quality of each analytic exchange is shaped by such factors as body posture, tone
of voice, rhythm of speech, and choice of words (Bucci, 1985) ; (Dahl, 1978). Patient and
analyst continually make fine adjustments to each other. These adjustments ebb and flow
with the material. They fluctuate between foreground and background (Lichtenberg,
1983). Sometimes they are the articulated focus of the analysis: at other times, they go by
unnoted but continue to influence the process.
In my view variations in psychological posture and style of expression involve a
process of mutual accommodation on the part of analyst and patient. When patient and
analyst join in the therapeutic venture each brings characteristic ways of relating to another.
Each also brings a range of personal feelings, needs, wishes and fantasies including those
which are directly associated with the
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Contemporary Psychoanalysis, Vol. 26, No. 3 (1990)
1 This paper was presented as the Presidential Address to the William Alanson White
Psychoanalytic Society, May 17, 1989. I gratefully acknowledge the contribution of Dr.
Ruth Shapiro to both the content and style of this paper. I thank Dr. Philip Bromberg, Cathy
Krown Buirski, Drs. Peter Buirski, Constance Katz, James Levin and Marylou Lionells for
their helpful comments.
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therapeutic task. The analytic process remains viable because patient and analyst
continually accommodate and adjust to each other along many psychological dimensions.
In this paper I will explore the function of these mutual accommodations within the
analytic relationship.
Mutual regulation begins with the infant's relationship with early figures. By the time
the infant is ten days old he/she can respond to and imitate facial expressions depicting a
variety of emotions (Meltzoff and Moore, 1977). The work of Ainsworth (1979),
Beebe (1986), Bowlby (1980), Spitz (1965) and Stern(1985) clearly indicates that in the
first three months of life, the infant initiates many interactions. Mutual mimicking of facial
expressions that elicit parallel emotional and physiological reactions are part of the day to
day interchange between infants and their parents.

1
 According to Beebe and Lachmann (1988), the mutual regulations that evolve between
parent and infant lead to predictable ways of being together and contribute to the
organization of the child's personality. "Interaction structures are characteristic patterns of
mutual regulations in which both infant and caretaker influence each other. The infant
comes to recognize, remember, and expect these recurring interaction structures" (Beebe
and Lachmann, 1988p. 306). If early mutual regulations are varied, flexible, and
congruent with the child's developmental needs, these modes of accommodation should
serve the child well in later relationships. When parent and child are not in sync in adaptive
ways, the child develops defensive operations to ward off feelings of anxiety and to protect
self esteem (Schecter, 1978) ; (Sullivan, 1953).
Establishing a therapeutic relationship involves finding a mode of emotional and
cognitive interaction which is at least tolerable to analyst and patient (Shapiro, 1985). As a
consequence of history and temperment analyst and patient differ, for example, in their
comfort with emotional closeness or their tolerance for ambiguity.
It is my hypothesis that beginning with the initial sessions and throughout the course of
the analysis, analyst and patient act and react in ways which simultaneously attend to their
own needs and accommodate the perceived needs of the other. This mutual regulation,
much of which occurs out of awareness, is an integral part of the analytic exchange.
Modifications in the mutual regulations established between analyst and patient contribute
significantly to
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therapeutic change—even when they are not the focus of analytic inquiry.
My thinking about mutual regulation draws on Winnicott's (1951), (1971) concept of
transitional objects and phenomena and on his vision of the psychological space
between mother and infant. Winnicott (1965) anticipated the importance of attachment and
detachment as a central organizing principle in all interpersonal relationships. He described
an arena of experience that is difficult to delineate, the psychological space between
the mother and infant (1951). The child, and to a lesser extent the mother, use transitional
objects and phenomena as a way to negotiate the degree of involvement between them.
The child can hold on to thetransitional object when he/she is anxious and needs to feel
closer to mother. Transitional objects and phenomena exist in the world of reality and the
world ofillusion at the same time.
The object or phenomenon is neither infant nor mother, self nor object, but "something
in between" (Winnicott, 1971). Mother and child have created a space, Winnicott's "third
space" (Winnicott, 1971) in which reality and illusion as well as self and other, have no
clear boundaries. Mitchell makes a related point about the analyst and patient, "Neither the
self nor the object are meaningful dynamic concepts without presupposing some psychic
space in which they interact, in which they do things to each other. These dimensions are
subtly interwoven, knitting together the analysand's subjective experience and
psychological world" (Mitchell, 1988p. 33). Viderman in discussing the 'analytic space"
writes that "Like the transference and countertransference which contribute to its structure,
it is ambiguous: theprocesses unfolding in it are linked to its use as a resistance, yet
essential to the uncovering of truths" (Viderman, 1979p. 282).

2
 There are phenomena in psychoanalysis that are not
simply transference or countertransference, the working alliance, or the real relationship,
but are in Winnicott's words, "something in between". Yet they contain important elements
of each of the above. I am referring to the many ways that, as mother and infant do, analyst
and patient modulate activity and passivity, playfulness and seriousness, caring and
detachment, loving and hating.
I label the moment to moment accommodations, negotiations and compromises that
keep analyst and patient in an acceptable balance modulating phenomena. The concept of
modulating phenomena
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introduces a particular way of looking at the interpersonal field. This concept emphasizes
the efforts of analyst and patient to create a mutually tolerable psychological space in which
the work of the analysis can be done. Many of these modulations occur out
of conscious awareness. They include the mutual regulations that were historically
established between the child and important people in his or her environment, later
variations on these ways of interacting, and modified ways of negotiating that are
established in the analytic relationship. Modulating phenomena take nonverbal forms such
as smiling, frowning, or nodding and verbal forms such as questions, observations, use
of metaphor or irony. Modulating phenomena are an amalgam
of transference, countertransference, resistance, and working alliance factors functioning
under the conditions of the analytic situation. Modulating phenomena also reflect modified
and new ways of relating that are created jointly throughout the analysis.
Optimally, efforts at accommodation, compromise, and negotiation facilitate
the analysis. On the other hand mutual regulations may lead to reenactments of old patterns
which are not analyzed or revised. When modes of relating become rigidified and alternate
ways of approaching the relationship and the material cannot evolve there is
a transference countertransference impasse. At such times modulating phenomena are
overwhelmed by transference and countertransference influences.
Modulating phenomena 1) constitute an important part of how we engage our patients
as well as how we remain involved in the work ourselves. 2) contribute to establishing an
atmosphere in which questions and interpretations may be offered and considered. 3) help
the patient overcome maladaptive patterns of interaction by serving as a model for alternate
ways of relating.
I will address these three overlapping issues.
1) Engaging the Patient
We engage the patient and remain involved ourselves by utilizing deliberate technical
interventions as well as by our spontaneous responses. The analyst, quite consciously,
keeps the analysis moving by selectively and subtly managing the transference and the
relationship. For example Pine (1985) recommends tailoring theinterpretation to the
particular needs of the patient, Horner (1979) speaks of handling not only interpreting
the transference, and Levy (1987) discusses the formulation of deliberate strategies.
Levenson
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3
contrasting psychoanalytic therapy and psychoanalysis writes, in "psychoanalytic
psychotherapy the transference and countertransference is both utilized and
manipulated" (Levenson, 1983p. 58). In psychoanalysis this process is made explicit and
analyzed.
Modulating phenomena encompass many preconscious and unconscious aspects of our
interventions. The analyst subliminally scans the psychological space and takes a variety of
readings. He or she intuitively evaluates the working alliance, the state of
the transference and countertransference, and a host of other factors including the content
of the session and the mood of the participants.
Our way of relating does not remain static. The analyst actively—but often in muted
ways—nurtures, controls, and seduces. It is an error simply to label such
interventions countertransference even though unconscious historical motivations are
undoubtedly involved. We need not deny such efforts. They serve a necessary function.
The patient too is involved in nuanced management of the analytic relationship.
Keeping the analyst engaged in particular ways is an aspect of transference. Patients are
attentive to our style and, to a certain extent, to our needs. Even someone who enters in a
highly oppositional frame of mind must make some accommodations to the analyst's mode
of interacting if the relationship is to endure. Although the patient's efforts to accommodate
to the analyst may be less deliberate and less sustained, the patient also is feeling his or her
way, trying to see if a way of communicating can be established. Thus analyst and patient
as they talk about the manifest text of the analysis, are inevitably regulating the nature of
their interaction.
2) Creating a Climate for Interpretations
Imperceptible adjustments in behavior are made to maintain a psychological climate in
which observations and interpretations can be utilized. Interpretations themselves, their
content, timing, or intensity, have the function of altering the psychological space. The
effect of an interpretation can never be separated from the interpersonal context in which it
is given. Writing from diverse psychoanalytic perspectives, Bromberg (1989),
Ehrenberg (1982), Epstein and Feiner (1979), Levenson (1972), Loewald (1960),
Mitchell (1988), Racker (1968), Schafer (1983), Stone (1961), and
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Wolstein (1984) stress the impact of the relationship on the interpretation. The content of
an interpretation is not a neutral piece of information isolated from the analyst's relationship
to the patient.
Often the impact of an interpretation depends on our regulating the psychological space
as much as on the insight offered. Even when the content of aninterpretation specifically
addresses the patient's attempts to move closer or withdraw, both what is being said, and
the meaning which the analyst's activity has for the patient determines the outcome.
For example, a patient wanted to reduce his sessions from three times to once a week. I
made several interpretations. I suggested that he was made anxious by the previous session
in which he acknowledged his strong attachment to me. I pointed out his need to pull away
from me because he feared his growing sense of closeness was not reciprocated. He found
these explanations compelling and continued to come three times a week. It is my sense
that the patient was influenced by more than the content of what I had said. He was able to
4
tolerate the intimacy of the analytic situation because he perceived my increased
interpretative activity as a demonstration of concern and commitment. My interpretations
were consciously directed by a wish to understand his acting out. Preconsciously, my
persistence was motivated by a sense that he could not continue working so intensively
without being reassured of my interest.
In this instance the modulations involved partial gratification
of transference and countertransference wishes which followed an intuitive feeling that the
alliance needed fortification. I had not made a deliberate decision to interpret more
energetically. I suspect that unconsciously the patient perceived my interpretative style as
evidence of my personal interest in him. I am suggesting that
subtle transference gratifications occur throughout an analysis and are one way we
strengthen theworking alliance when it falters. I am arguing that some qualified
gratifications and enactments are inevitable and necessary. Recognition allows us to make
constructive use of them, and, to a certain extent, guards against their misuse.
3) Modulating Phenomena Serve as a Model for Alternative Ways of Relating
In analysis one must shift perspective, tolerate another person's
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style, overcome disappointments, and be willing to return to a common ground after a

harmonious ambience has been disrupted. For some patients, analysis provides the first
opportunity to participate in a long term relationship and work through conflicting needs,
confusions, disappointments, and failures of empathy. The myriad exchanges by which
patient and analyst have kept the analysis going suggest alternate ways of responding to
another person. When interactions in the dyad are diverse and flexible the patient can
utilize them as a model for relating to the outside world. The patient internalizes methods of
compromise and negotiation developed in the analysis.
To illustrate: A female patient, much enamored of her intellectually
powerful father entered analysis and quickly became impressed by the psychological
acumen of the analyst. She greeted each interpretation with admiration and gratitude. The
analyst was delighted to have such an appreciative analysand. At this point their interaction
was governed by her pleasure in being enlightened and his willingness to accommodate her.
The give and take of the treatment was heavily colored by
this transference countertransference dynamic. When the analyst became aware of the
perseverative nature of her admiration and invited her to examine it, he disrupted and
changed the quality of their interaction.
Although she continued to greet each intervention more with appreciation than insight,
his interest in understanding her adoration led to a subtle shift in the feeling tone of their
interaction. The patient had to find new ways to maintain the satisfying ambience of their
relationship. Sensing his concern with her acquiescence she modified one of his
interpretations. He smiled, signaling his pleasure in her apparent effort to think for herself.
Initially her step in the direction ofautonomy reflected a transference wish to please him.
However her effort to evaluate his observations more critically, begun under the sway of
the transference, allowed her to get a feeling of what it was like to think for herself in
his presence.

5
 In this instance, both analyst and patient, each from his or her own perspective, sensed
what would keep the dialogue alive. The analyst unconsciously attentive to her need to be
compliant smiled when she corrected him. He reacted intuitively to her transference need
for approval. He took this step toward gratifying her wish while indicating that their
engagement should now involve some
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independent thinking on her part. He was, at that time, relying on both gratification
and suggestion.
The patient, for her part, had found an alternate way to express
the transference desire to please the analyst. To satisfy this new father she had to
acknowledge that he was not perfect and that she knew certain things better than he did.
This compromise between her wish to see the analyst as perfect and the need to deal with
the implicit demands he placed on her led her to be a more active participant in the analytic
work. In complying with his suggestion she had a chance to discover thatthinking for
herself could provide satisfactions somewhat distinct from those of pleasing the analyst.
Developmental researchers have used slow motion or frozen frame pictures of parents
and infants to capture in Beebe's and Lachmann's words the "fleeting and subtle
interactions … that often are not visible to the naked eye" (Beebe and Lachmann, 1988p.
313). I will illustrate the concept of modulating phenomena by examining some clinical
examples in detail. I will examine two encounters with the same patient. These do not
involve major revelations or turning points. They are noteworthy because they are
representative of many similar interactions in the treatment.
Kate, 35, is the youngest of five children. She grew up in a small town whose economy
centered around a large clothing factory. Her father ran a general store that catered almost
exclusively to the factory workers. When their debts exceeded their salary the workers
would sign agreements to pay high interest and sometimes additional financial penalties.
Kate glorified her father. She described him as warm, kind and generous. In the early
years of the analysis we explored the machinations of her father's business. As she
uncovered memories, the picture of a manipulative, controlling and sadistic man emerged.
On one occasion, Kate overheard father trying to extract sexual favors from a woman to
cover her long overdue bill. She remembered being bathed by father until the age of eight.
However, she vacillated in her recall of whether he actually fondled her breasts between the
ages of eleven and fourteen. She struggled to integrate the newly formed image with
her idealization—a slow and painful task.
Mother, on the other hand, was described as incompetent, critical,
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and miserly. While occasionally depicted as a reliable figure who was capable of providing
safety and stability, mother was usually portrayed as depressed and depressing.
Kate's mother and siblings viewed the world as bleak and unjust.
Kate's analysis lasted six years. By the third year she was free of
debilitating depression, and had made an important career change. She was doing a kind of
creative work that she imagined would never be available to her. For the first time she was
in a sustained relationship with a man—one with whom she felt emotionally and sexually

6
satisfied. She generally greeted these and other changes in her life with
intellectual recognition, but refused to acknowledge any shift in her sense of underlying
despair and pessimism. We had repeatedly noted her withdrawal from me and treatment
following positive changes in her life. A need to remain linked to the family's sense of
despair, her excitement and terror in perceiving herself as powerful—an identification with
her sadistic father, and her unacceptable wish to be more successful than her mother and
older sisters are some of the dynamics that motivated her withdrawal.
The sequence which follows occurred during the fifth year of treatment. In four
consecutive sessions, Kate had returned to an old way of disengaging. She deflected
questions and interpretations by giving minimal reactions. She responded to silence with
silence. When she spoke it was to wonder why she was wasting her time coming to
sessions. In the fourth session I again pointed out that all of this followed her recent
promotion.
Kate:
—I'm sure that you are accurate but the bottom line is that my despair is the
ultimate truth and even the fact that I keep doing the same thing over and over
proves that I am not going to change.
I:
—You insist that I remember and point out all the ways that you have changed,
I get to be the savings bank for your good feelings and you just hold onto your
despair. What makes this so necessary right now?
Kate:
—I'm sure we can spend the next five years figuring that one out. long silence.
I:
—What are you thinking?
Kate:
—About how meaningless this all is. There's no point.
This continued with minor variations for another fifteen minutes. At
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one point her tone of voice sounded slightly more involved, but her verbal
message remained the same. After another round in which she refuses to
engage, I say with humor, yet clear frustration.
I:
—Don't you think that I already have enough grey in my beard?
Kate laughs:
—I guess I could turn anyone prematurely grey. (Silence) It must relate to the
promotion. (Silence) I guess it makes me feel anxious that you'll think I'm
doing too well. (Silence) If I don't behave like a nut you might start to believe
I'm really ready to be on my own. I feel about as ready to leave therapy as I
was ready to go to boarding school.
I will examine the transference, and countertransference and then their relationship to
the modulating phenomena.

7
 There are several transference issues. Kate's promotion represents a victory over
her mother and sisters. In the transference she enacts her triumph by making my efforts
at interpretation worthless and inadequate while she is creative and effective. Kate has
defeated me by rendering everything I say meaningless. She is sadistically in control as was
her father. Of course, she has to pay by sinking into a depression which makes it impossible
for her to enjoy her achievements.
Her despair, however, binds her to the family. By being a sick, unhappy child she also
reinforces her connection to me. She expects me to be the advocate of her strengths and not
to give up on her. Kate responds to my humorous, punitive and seductive intervention with
self demeaning, yet playful, submission. Thus she yields to the attention of the teasing,
sadistic and provocative father. She says, "I could turn anyone prematurely grey."
Manifestly she has yielded to my intervention. Her response appears to demonstrate the
power I have over her. Yet my intervention does not move us beyond an aspect of the
known. She has kept me at bay by saying "I'm sure it's the promotion." She has forced me
to stay in a comfortable range of interpretation. She handles me through apparent
acquiescence as she dealt with herfather. Kate has triumphed by getting me to yield to her
reluctance to go to new and unexplored territory.
My countertransference feelings are multi-fold. I feel she is trying to pull me into her
sense of helplessness and despair. Perhaps she is correct that I have only helped her to
change in superficial ways. I fight back with an interpretation, "I get to be the savings bank
for your good feelings and you just hold on to
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your despair. What makes this so necessary right now?" She easily hits it out of the ball
park by telling me we could spend another five years working on that question.
I feel frustrated and unable to get through. Yet I am secure in my knowledge that I will
help her return to my agenda. I will triumph, perhaps with a touch of sarcasm. Then I will
become the powerful seductive father who gets what he wants and controls everyone. We
have been here before. I am pleased that my humor provides the turning point in the
session, but wonder if I got a little carried away. Was drawing her attention to my beard a
version of father's sexual seduction? I am somewhat uneasy about my tack.
We have, however, re-established an alliance, albeit a fragile one. She could pull back
at any point. I know from experience that if I try to explore the comment about my beard
she will return to her resistance for an extended time. My understanding is that she will
withdraw to punish me, for breaking an unspecified yet tacitly accepted agreement. The
contract stipulates that we will not look at the interchange about my beard for the
time being. Arriving at such an agreement, maintaining and changing it are instances of
modulating phenomena.
Why am I willing to enter an agreement which runs counter to my understanding of the
analytic work which needs to be done? I am willing, after all, to let atransference-
countertransference enactment remain untouched for an indefinite period. Why do I do
this? To start with the most sublimated motives. I have sat with Kate through numerous
sessions in which she expressed hopelessness, angry withdrawal and
unbridled contempt for me. I am eager to reengage her so she can make sense of these
feelings which, on one level, are causing her great distress.

8
 Silence, questions, and interpretations have proven ineffective. I spontaneously express
my frustration by use of a metaphor which mocks us both. "Don't you think I have enough
grey in my beard?" I rely on humor to illuminate and breakthrough a stalemate. This
approach attempts to engage Kate's observing ego. It also
expresses countertransference impulses and serves to gratify transference wishes. Briefly, I
am flirtatious, exasperated, and need to re-establish control over the situation. I will not
succumb to her despair. I have drawn her back into the work by appealing to her sense of
perspective and offering her some important transference
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satisfactions. I am willing to delay examining our exchange in the service of resuming the
analytic dialogue.
Modulating phenomena pervade the interactions which have just been described. I have
been searching for a way to reach her. I sense that she is ready to move from her
resistant position if I offer her a graceful way to rejoin me as an observer of what has
happened between us. In alighting on a metaphor—a preconscious move rather than a
deliberate technical decision—I am able to make an array of observations about our
relationship in a way which is palatable to her. The metaphor speaks of her stubborn refusal
and my lack of effectiveness. My comfort in using a sarcastic metaphor even in the midst of
her angry withdrawal acknowledges her capacity for self-observation, her appreciation of
humor, and reminds us of the trust and familiarity which has developed between us. The
tone of voice in which it is delivered is not only cajoling and playful but also chastising and
even threatening.
Her laugh is surprisingly hearty given the situation. It is appreciative of more than my
humor. She is titillated by my moving to the edge of the analytic frame. Her laughter and
comment about the prematurity of my gray hair also indicates that she accepts my offer to
talk about our relationship providing it is kept on a comfortable level. Her response
acknowledges that she has made it very difficult for us to proceed. Perhaps by incorrectly
designating the grey in my hair as premature she thanks me for my perseverance by shaving
several years off my age. Of course, the mutually seductive component of this interaction
reflects her relationship with her father. Our tacit agreement not to address this aspect of
the transference-countertransferenace relationship at this point allows the gratification of
the mutualseduction to remain in place.
The mutual regulations keep us together and separated in particular ways. Kate and I
have made a deal. When I strike the right balance she will re-engage. The modulations
involved in this interaction permit us to maintain the relationship and the analytic work. I
compromise by putting aside investigation and clarification of the beard interaction. She
compromises by accepting my request that she not only end her withdrawal but that she
strive to understand what motivated her behavior.
I have hypothesized that the process, the evolution, and the eventual integration of
methods of negotiating and compromising
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become a model for other relationships. Her current relationship with a man has been
marked by an increased ability to regain perspective when she withdraws after feeling
threatened or hurt. She is much less likely to remain angry as a way of sabotaging the
9
relationship. She uses humor and playfulness, and can recall his positive attributes to
rekindle her loving feelings. I assume that this change is, in part, associated with our
experience of adjusting to each others demands, sensibilities and concerns.
During treatment, patient and analyst are constantly negotiating along a variety of
psychological dimensions. I will describe four of these. This list is not comprehensive, but
addresses issues central to all close relationships.
One dimension involves the nature and quality of intimacy and relatedness. How does
the dyad balance needs for autonomy, independence, and privacy with wishes for
merger, dependency, and self revelation? What factors are likely to trigger closeness or
withdrawal? Initially Kate was inaccessible but signaled her wish to become re-engaged.
Schecter gets to the heart of the matter: "It is uncanny how in a good analytic relationship
both analyst and analysand find the right spot to occupy in the dimensions of closeness vs.
distance and attachment vs. detachment" (Schecter, 1978p. 97).
A second dimension concerns questions of power and control. How do analyst and
patient assert or relinquish control? Do one or both stay in a fixed position? Kate asserted
her power by demeaning my efforts to resume the analytic inquiry. Yet she eventually
relinquished that stance and permitted me to have an impact on the course of the session.
A third dimension involves the sexual and sensual aspects of the patient analyst
relationship. Both direct and indirect expressions of sexual feelings must be considered. For
example sexualized aspects of the care taking role of the analyst may remain dissociated.
Requesting a change in schedule, or coming early to sit in the waiting room or use the
bathroom may reflect wishes for closeness and intimacy. Sexualized components of such
actions may not be communicated directly, but are often present and clearly affect the
interpersonal situation.
Sexual feelings are an important part of what analyst and patient modulate. With Kate, I
behaved seductively by asking about my beard. The laugh with which she answered me
was responsive
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at many levels. This interaction eventually needed to be examined.

A fourth dimension refers to the mood and level of tension in the analytic dyad. Is there,
for instance, an atmosphere of depression or anxiety? How do analyst and patient diminish
or exacerbate the tension between them? How much of their communication is marked by
controversy and caution? How much by good will and a sense of mutual trust? Kate's
defensiveness gave way to a more light hearted stance.
I will turn to another emotionally charged session which occurred some months later.
Increases in my fee and schedule changes had been upsetting for Kate as will soon become
clear. Her high income and flexible work schedule had little bearing on her reactions. She
was seldom able to discuss issues of time or money in a self-reflective way. She became
angry and insisted on proving how unreasonable I was.
I begin the session: I will be raising my fee $10 a session beginning next
month unless there are financial considerations that make this a problem.
Kate interrupts me and is clearly enraged: You really are a greedy, selfish son
of a bitch with no social or ethical scruples. How can you justify charging so

10
much money? Of course, you don't have to justify anything. Why should you?
You just give me an ultimatum and leave me no choice but to pay or leave. I
already pay more than is reasonable. There is no point in discussing it. I came
in with something on my mind to talk about and you hit me with this
bombshell. Now I don't even remember what I was thinking about.
I'm being ripped off and fucked over. You have all the power and I have none.
You charge me whatever you want and do whatever you want. (She is
screaming and is clearly feeling out of control.)
I:
Do I really do whatever I want?
Kate:
-That's how it seems. My reality has no meaning to you. You give your little
bull shit speeches about talking about things. But I'm the one who will be
paying this off for the rest of my life.
I:
Paying it off for the rest of your life?
Kate:
You know what I mean. Don't get cute with your analytic tricks.
I:
Who pays off things for the rest of their lives?
Kate (Clearly annoyed but no longer shouting):
-Everybody does, everybody pays off with their neurosis for the rest of their
life, O.K. Do you
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want me to say my mother made me pay for the rest of my life because she was
so depressed? (Reference to an earlier session.) You'll do anything not to face
the fact that the only reason that I am upset is because of your greed and
materialism. You're not the victim of this I am. (Long silence) What am I
going to do go to a different store and try to get it cheaper?
I:
Some people can't go to a different store to get it cheaper. They end up paying
it off for the rest of their lives.
Kate (Long silence, quietly weeping):
-But you are like him. (Silence) It's not my fantasy. I'm just like the god damn
factory workers to you. I yell and scream at you, but I really believed you were
different. You don't care any more about me than he cared about them. You
probably take the money and buy a beautiful ski house for your family. Then
your dumb kids think they have the most wonderful daddy in the world.
(Crying) You're not. You're not. You're a fraud.
I:
I get them to think I'm great by squeezing every dollar out of you.

11
 Kate (Quietly):
-Yes That's what you do. That's what you do.
I:
My children only see the ski house not how I got the money.
Kate:
Maybe they don't want to know (long pause) I didn't want to know. He was
stealing from them. The kids had ripped clothes and were always dirty. I'm no
better than he was, I just saw them as smelly and dirty. That's probably how
you see me, as white trash. How can I trust you? You act like you
reallycare and then you do this to me. Your stupid kids just think you're the
greatest but you really are a fraud. (Silence) It's all so confusing. It's enough to
make me crazy. You both act like I really matter and then you use me. I don't
know if he really was sexual with me, sometimes I think I just made it up.
I:
It's been so important never to blame him. You want him to be your wonderful
daddy.
Kate (Annoyed):
But he was a wonderful daddy and I'm not going to let you take that away too.
I will do a sequence analysis of this interchange in terms of the modulating phenomena.
To do this I will refer to the content, transference, countertransferenceand resistance only as
they impact on our mutual efforts to regulate the psychological space.
I begin the session. This moves me into a position of control and authority. I make
a demand even though I know this will be hurtful and precipitate Kate's withdrawal.
She feels unloved, enraged and powerless. There is heightened
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anxiety and tension between us. I attempt to engage her observing ego by asking whether I
really do "whatever I want". I emphasize her overstatement.
She momentarily accepts my invitation by saying, "that's how it seems". Kate has
briefly opened the door and acknowledged the possibility that there may beother less black
and white explanations. The use of the word "seems" is the kind of modulating
phenomenon I am attempting to highlight. The word "seems" is a compromise between her
rage and her wish to stay engaged. It is the best she can do since she feels attacked and
abandoned. But she quickly returns to the safety of her anger and rebuffs me by labeling
my effort to communicate "little bull shit speeches".
I respond to the invitation implied in the phrase "that's how it seems". I persevere by
focusing on the verbalization "paying it off for the rest of my life".
While Kate responds with annoyance, she also wants to find a way to re-connect. Her
use of language continues subtly to invite me on while the content holds me at bay: "Don't
get cute with your analytic tricks." "Cute" and "analytic tricks" are mild forms of sarcasm
for Kate. Her tone is simultaneously playful, biting and contemptuous. I sense that she
wants me to demonstrate my involvement by maintaining the inquiry in the face of her
rage. In addition her withdrawal and my pursuit may be experienced as a sexual exchange.

12
 I feel it is safe to deepen the inquiry. I ask her "who pays off things for the rest of their
lives". It is a miscalculation. I have ignored the intensity of her anger and turned too
quickly to her emotionally laden phrase. Perhaps my premature intervention reflected my
need to dilute the intensity of her rage.
Kate continues to attack me. However, through her use of irony she let's me know why
my request for a fee raise is so painful. She says, "What am I going to do go to a different
store and try to get it cheaper?" She feels that like the desperate factory workers she has to
accept whatever conditions her uncaring father imposes.
I reply, "some people can't go to a different store to get it cheaper. They end up paying
it off for the rest of their lives." This interpretative comment allows her to move closer. She
can express her hurt and rage. Although wounded and angry she feels understood because
we are touching on an array of feelings and thoughts discovered during years of
collaboration. A few highly
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symbolic phrases remind us of the ground we have covered and permit us to move forward.
Kate has rejoined me in the analytic work. She takes the risk of admitting that she really
thought I cared. She moves back and forth between envying and identifying with the
children who think they have a wonderful daddy (a term she used with her father when she
wanted to "cozy up" to him and get some special treat or concession).
We talk about how my children see the ski house. How painful it would be for them to
see me as fraudulent. We both understand that we are talking about her. At moments she
switches back to her own father. "He was stealing from them." Affectively she finds the
two views of father confounding. She approaches but then denies the possibility of sexual
abuse. "I don't know if he really was sexual with me, sometimes I think I just made it up."
The lines are blurred. I rapidly change from analyst to father, from good father to
bad father. Past and present are hard to distinguish.
We remain engaged until I interpret her desire to maintain an idealized view of father.
"It's been so important for you never to blame him. You want him to be your wonderful
daddy." I am hoping to help her examine her ambivalence, but in fact, have again moved
too quickly.
Kate let's me know that he was a "wonderful daddy" and she won't let me take that
away too. We will need some time to get over the effects of my pushing her.
In this session, Kate and I enter a series of negotiations which permit us to keep the
working relationship in tact. Kate needs to show me that I am greedy, imperious, and
deceitful. I am intent on showing her that her outrage and sense of betrayal are multi-
determined. As we pursue our divergent goals, we remain attentive to the state of our
relationship. Neither of us becomes so singleminded in our need to be heard that we allow
the situation to become intolerable to the other. Through our language and tone of voice,
through the material we focus on or ignore, we make demands, offer concessions, and
accept compromise solutions.
It is the moment to moment shifts in and between sessions that I have tried to
emphasize. The level of activity, the number of words spoken, and degree of animation are
constantly in flux. When a child is hungry, tired, angry or frustrated a parent who is attuned
to the needs of the child takes overt or subtle action. As importantly

13
 - 513 -

the child picks up the signals of the parent and responds in kind. Analyst and patient are
constantly monitoring and modifying their interactions, often withoutconscious awareness.
I will conclude with an overview which I have put in question and answer form.
1. What is the role of modulating phenomena in the analytic process?
Modulating phenomena refer to the means by which analyst and patient deal with
differences in their needs, sensibilities and styles. Analyst and patient adjust and
accommodate to each other so they can sustain the relationship and analytic
work. The vast majority of these shifts occur at a pre-consciouslevel.
Greenson (1967) emphasizes the conflict free nature of the working alliance. In
my view the working alliance is, in part, established and maintained through the
continuous mediation of needs and conflicts.
As the analysis progresses it is valuable to focus specifically on the mutual
regulations which take place. This allows us, for instance, to evaluate the extent
to which mutual regulations are driven
by transference and countertransference forces. In addition, noting less
ritualized and more reality oriented ways of negotiating within
the analysis offers the patient evidence of his or her ability to relate more
adaptively. Eventually internalized modes of compromising become a template
for relating outside the treatment setting.
2. What is the connection between transference, countertransference and modulating
phenomena?
Modulating phenomena have historical and contemporary determinants. The
compromises and negotiations which occur within the dyad are marked
bytransference and countertransference influences. Modulating phenomena
differ from transference and countertransference because they also reflect
contemporary efforts of analyst and patient to accommodate each other. The
analytic dialogue takes place in a relatively safe environment that encourages
the patient to experiment with unfamiliar ways of adjusting to the needs and
feeling states of another. Even these altered ways of interacting are, of course,
influenced by early experiences.
The extent to which modulating phenomena are rooted in the past is constantly
changing. It is difficult to know the degree to which a shift
in behaviorreflects character change and/or represents
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a more adaptive and better disguised re-creation of earlier tendencies.

3. To what extent are the modulating phenomena mutual?
I believe that the analyst, like the psychologically aware parent, makes constant
accommodations to the developmental level and emotional state of the patient.
The primary responsibility for keeping the analysis viable rests with the analyst. However
for the analysis to be effective there must be a joint responsibility to rescue the dyad and
the work when the analysis falters. Joint responsibility does not mean equal responsibility.
Each person works at the relationship within the context of his or her role. In the early

14
phases of treatment the analyst ususally takes the lead in finding ways to regulate the
interaction. As the patient clarifies and resolves areas of conflict the process of regulation
becomes more mutual.
I recently returned from a trip to Morrocco. I had the strange feeling that the passionate
bargaining I observed in the medina of Marrakech was not totally different, in it's essence,
from the mutual regulations of an analysis—a rather disconcerting thought. The rug
merchant announces that his superior silk antique rug comes from the Imperial Palace of
the great Sultan Omar and is at least two hundred years old. He is giving it away to
celebrate the Feast of the Throne for merely 300, 000 diram. The buyer looks to the sky,
perhaps hoping that divine inspiration will help him respond to this list, of, at best, partial
truths. The buyer agrees that this is indeed a very old and worn out rug but that it seems as
far from silk as it was from the good sultan, and offers 20, 000 diram. Rather than taking
offence and creating greater distance, the seller produces a tray of sweetened mint tea and
begs the buyer to partake of his hospitality. To condense the three hours of story telling,
laughing, yelling, and feigned termination of the relationship is to do to the spirit of this
nuanced negotiation the equivalent of what we do when we present our analytic work.
There is a complex interplay of nurturance, seduction, suggestion, attempts to control and
compromise. They size each other up, push the limits and then back off. This all occurs in
the service of jointly finding a way to stay involved and work out an agreement that is
acceptable to both participants. Some of the negotiations are thought out but most occur
spontaneously in response to the immediate situation. The merchant has probably
negotiated about rugs many more
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times than the buyer, and therefore has greater responsibility for keeping the process
moving.
While I obviously mean this as a parody I use this analogy to suggest that analyst and
patient also rely on nurturance, seduction, suggestion, attempts to control, and compromise
in their efforts to modulate the relationship. Our timely nods, smiles, pointed questions,
laughter, playfulness, and tentative interpretations are not entirely different from the
sweetened bitter tea.
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Article Citation [Who Cited This?]

Shapiro, R. (1990). Modulating Phenomena:—Elusive Aspects of the Psychoanalytic
Process1. Contemp. Psychoanal., 26:497-517

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