When patients probe the analyst: Manifestations of patient testing and its complexity – An in-depth exploration of case examples of extant research

Abstract

Abstract Patients probe the analyst with the goal of challenging pathogenic adaptations to early experiences. As the core concept of control mastery theory (CMT), testing is contextualized within psychoanalytic theory. The current work examines 29 articles illustrating therapies performed or analyzed using the CMT approach for the occurrence of testing, which takes place through interaction, self-presentation, narratives, or the use of the setting. The various manifestations of testing and their potential meanings are described. An in-depth analysis of selected testing examples is performed to compare tests within patients and across studies. The results show that patients differ in their testing strategies, shift testing strategy during the process of treatment, combine tests, and test multiple conflictual themes within a single test. Therefore, the importance of applying a case-specific approach, based on a thorough understanding of a patient, becomes evident. Recommendations concerning psychoanalytic technique, including the role of interpretation, as illustrated in case vignettes, are introduced.