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A. Development of the Interview Schedule

In this chapter, I describe the development of the questionnaire-based interview schedule to be used in interviews of practising psychoanalysts of varying orientations in a number of different geographical locations. The interview schedule was derived from the principal dimensions of transference and transference interpretation which emerged from the literature search and the pilot studies described in the previous chapter. These preliminary studies led to the organisation of aspects of transference interpretation into two sets: one, clusters of beliefs or theoretical constructs and, two, analysts' interpretations. These are shown in Appendix 2. It was predicted that the clusters of beliefs would have specific practical implications in terms of analysts' choices when making transference interpretations.

In Part II, Chapter 5 on the link between theory and practice in psychoanalysis, I discussed the thesis that terms such as transference have meaning within a set of related concepts with which they have what Wittgenstein called 'family resemblances'. Clearly, it was impossible to investigate the practice of transference interpretation without discussing a number of related concepts: for example, the 'real relationship', the 'treatment' or

'therapeutic alliance', 'extra-transference', 'narcissistic transference', 'conflict interpretation', 'defence interpretation', 'counter-transference', 'mutative' i n t e r p r e t a t i o n s , ' p r o j e c t i v e i d e n t i f i c a t i o n ' ,

'externalisation'. Although the clusters of belief (shown in Appendix 2) were to some extent representative of different theoretical orientations - Freudian, Kleinian, British Object Relations, Kohutian 'clusters' - they were based on 'family resemblances' between concepts which came together logically and also 'anthropologically' in terms

of the literature search. I observed that analysts who wrote about specific concepts, for example the 'transference neurosis', discussed a particular set of related concepts such as the 'treatment alliance' or 'resistance', whereas analysts who wrote about the 'counter-transference' tended to refer to a different set. Thus, the questionnaire-based interview schedule was designed to reveal the inter-relationships between central dimensions of analytic technique relating to transference interpretation.

The first draft of the interview schedule was based on a number of operational definitions aimed at eliciting behavioural responses as well as attitudes towards specific beliefs. The questions in the schedule addressed issues of frequency of certain types of interpretation, the content of interpretations and the characteristic formulations and style in which interpretations were made. The questions about belief were intended to elicit the conscious and unconscious biases which 'triggered' certain types of interpretation. A preliminary list of 98 ques­ tions was compiled. In order to make the questions highly specific to clinical practice, a number of examples were given. The theoretical constructs shown in Appendix 2 were 'translated' into practical questions of the form

'How often do you say/interpret x ? ' and 'Do you think it is important to interpret y ? ' Instead of asking 'omnibus' questions which might elicit theoretical responses based upon what the analyst thought they 'ought' to think, a number of simpler questions were asked which addressed the same issue. These questions were then ordered randomly. The use of jargon terms was avoided wherever possible. Many terms, such as counter-transference, have many meanings; these different uses were broken down into separate questions designed to reveal the individual analysts' actual use of the concept. The questions were also formulated in such a way that the answers to them could be rated. Questions tended to be asked in terms of frequency of behaviour (e.g. How often do you make extra­ transference interpretations? Or Do you usually refer to

the past when making a transference interpretation?) or in terms of strength of belief (e.g. Do you believe strongly in the clinical use of the death instinct? Do you feel that it is very important to take up the defensive aspect of idealisation?)

The first list of questions was then tried out on two psychoanalytic psychotherapists at the Tavistock Clinic and the Anna Freud Centre so as to reduce the number of questions and also further eliminate those questions which could not be answered in terms of ongoing clinical practice. The responses of these two subjects were used to further refine the questionnaire. Theory-laden terms were dropped and many of the questions were reformulated using the key phrases and language of the interviewees. Questions were introduced in a non-controversial manner

...'Some people think it is important to take up x, whereas others tend to focus upon y. . . ' so that the

interviewees did not feel that there was one right and one wrong answer. A second trial run was then undertaken using a modified version of the original set of questions. This time, the interviewer made notes on the speed and ease with which the questions were answered and also noted the coherence and specificity of the interviewee's responses. It was hoped to eliminate ambiguous responses such as 'It depends' or 'Sometimes'.

The above procedure was repeated a further five times in order to eliminate ambiguous questions, to formulate the questions in current terminology and to reduce the number of questions. Each version of the questionnaire was tried out on two subjects who were trained analysts or psychoanalytic psychotherapists. The members of the Psychoanalysis Research Unit at University College discussed the results of each interview together with the notes taken by the interviewer. Accessibility of the questions in relation to clarity of response was the principal focus, although the ordering of the questions was also discussed. The 7th version of the questionnaire was then tried out on 4 subjects, two of whom were