The role of the analyst's facial expressions in psychoanalysis and psychoanalytic therapy.

This paper, while acknowledging implicitly the importance of transference-distortions in the patient's perceptions of the analyst's countenance, focuses primarily upon the real changes in the latter's facial expressions. The analyst's face has a central role in the phase of therapeutic symbiosis, as well as in subsequent individuation. It is in the realm of the analyst's facial expressions that the borderline patient, for example, can best find a bridge out of autism and into therapeutically symbiotic relatedness with the analyst. During this latter phase, then, each participant's facial expressions "belong" as much to the other as to oneself; that is, the expressions of each person are in the realm of transitional phenomena for both of them. The analyst's facial expressions are a highly, and often centrally, significant dimension of both psychoanalysis and psychoanalytic therapy. Illustrative clinical vignettes are presented from work with both patients who use the couch and those who do not.