Formulation as Clinical Action: How Psychoanalytic Theory Becomes Technique

In advanced psychoanalytic training, “formulation” is often treated as a document: a coherent story you can present in supervision, polish over weeks, and revise with hindsight. In applied psychoanalytic practice, formulation is something else entirely. It is a mode of action in the session—a way of selecting what counts as signal, deciding what to hold, and choosing an intervention that fits the patient’s psychic moment. A formulation is not a portrait; it is a compass.

From Explanation to Orientation

A clinically useful formulation does not aim to explain everything. It aims to orient you toward the next right move. It answers four questions:

1. What is the patient doing to survive? (defenses, strategies, self-organization)

2. What is the patient trying to protect? (vulnerability, longing, shame, dread, annihilation anxiety)

3. What is being repeated here—with me? (transference, enactment, attachment pattern)

4. What kind of change is currently possible? (insight, symbolization, integration, rupture/repair)

Notice that none of these are purely descriptive. Each implies a technical stance.

The Multi-Axial Formulation (Not a Checklist—A Set of Lenses)

A contemporary applied formulation usually runs on several axes at once:

• Dynamic/conflict axis: wish–fear–defense–compromise. What desire is dangerous? What prohibitions organize guilt, shame, or dread?

• Structural/deficit axis: capacities for regulation, symbolization, play, and reflective function. Where does the mind fail to form?

• Developmental/attachment axis: proximity–distance strategies, separation distress, epistemic trust, secure-base demands. How does the patient manage dependence?

• Trauma/dissociation axis: state shifts, unmentalized affect, procedural “parts,” collapse, intrusion. What cannot be remembered because it is still happening internally?

• Relational field axis: mutual influence, enactment, recognition, the ethics of the frame. What is being co-created that neither of you “chose”?

The point is not eclecticism; it is diagnostic pluralism with technical discipline.

The most common advanced mistake is not “bad theory,” but wrong dose. A conflict formulation often tempts interpretation; a trauma formulation often requires pacing and containment before meaning can be metabolized. A deficit formulation may call for reliability, empathic attunement, and minimal frustration; a relational formulation may require naming what is happening between you rather than what is happening “inside” the patient. Formulation, here, is a theory of when.

A Micro-Example: One Event, Two Formulations

A patient abruptly cancels after a good session.

• Conflict reading: progress mobilized guilt or forbidden longing → cancellation as resistance, superego retaliation, fear of dependency.

• Trauma/dissociation reading: increased intimacy triggered state shift → cancellation as protective dissociation, autonomic overwhelm, loss of reflective capacity.

Same event; different action. In the first, you might interpret the fear of closeness. In the second, you might first restore safety and mentalization, then slowly link cancellation to overwhelm.

The Clinical Test of a Formulation

A formulation is “true enough” when it changes your listening, reduces acting-out, and creates interventions the patient can use. If your formulation makes you feel clever but leaves the patient more defended, more collapsed, or more compliant, it is not yet applied. In contemporary psychoanalytic practice, formulation earns its keep only when it becomes a tactful form of care.

Transference and countertransference in psychoanalysis explained

I psychoanalysis and psychoanalytic therapy, transference and countertransference are not “concepts” you apply after the fact; they are the living medium of psychoanalytic work. In contemporary applied practice, they function less like a diagnostic label (“this is a father transference”) and more like a real-time relational process that organizes attention, affect, and action in the room.

Transference is the patient’s here-and-now use of the therapeutic relationship to replay, test, and stabilize an internal relational world. It is not simply distortion; it is also communication and survival strategy. Practically, transference shows up as expectations the patient seems to hold as facts: “You’ll get bored,” “You’re judging me,” “If I need you, you’ll disappear,” “You want me to be impressive,” or the opposite—idealization, merger, insistence that “you’re different.” It also appears in micro-behaviors: apologizing preemptively, controlling the agenda, seducing, attacking, going blank, arriving late, refusing to pay, “forgetting” key material—each can be a relational move shaped by earlier attachment, trauma, or conflict.

Countertransference is what happens in you in response: your feelings, fantasies, body states, impulses, and interpretive “certainties.” Modern technique treats countertransference not as contamination to eliminate, but as data—provided it is processed rather than enacted. In practice, countertransference may feel like sudden sleepiness, irritation, rescue fantasies, dread, tenderness, impatience, sexual charge, or a push to teach, reassure, confront, or withdraw. The crucial clinical question is: what is this feeling doing? Is it pulling you into a familiar role in the patient’s relational script (critic, savior, passive object, seduced admirer, punitive authority)?

This is where enactment becomes central. When transference and countertransference lock together, something gets performed instead of symbolized: the therapist reassures too quickly, becomes cold and “technical,” breaks the frame, retaliates, overextends, or silently disengages; the patient complies, collapses, escalates, or disappears. The applied task is not to avoid enactment (impossible), but to notice it early, slow it down, and make it thinkable: “I’m aware I’m rushing to fix this—something about how trapped you feel is happening between us right now.”

Used well, transference/countertransference guide timing and dose: when interpretation will liberate, when it will crush; when holding is necessary; when repair is the intervention. The goal is disciplined participation—feeling the field without being driven by it.

Applied psychoanalysis: The clinical situation as data: countertransference, enactment, the frame

Psychoanalysis becomes genuinely applied when we stop treating the session as a transcript and begin treating it as a living instrument. “The clinical situation as data” names a shift in epistemology: the primary material is not only what the patient reports, but what happens in the room—in time, in affect, in the frame, and between two subjectivities. For advanced practitioners, this is not a poetic claim; it is a technical one. The question is: what counts as evidence, and how do we read it without collapsing into either naïve subjectivism (“anything I feel is true”) or rigid objectivism (“only content counts”)?

A contemporary applied stance reads the session on multiple tracks at once. First, manifest content: narrative, associations, themes, repetitions. Second, affect: what emotions are present, absent, displaced, or contagious—especially shame, envy, dread, tenderness, boredom. Third, process: tempo, silence, shifts in mentalization, oscillations between proximity and distance, the micro-regulations of attention. Fourth, relationship: transference configurations, attachment strategies, bids for recognition, tests of reliability. Fifth, frame-events: lateness, cancellations, fees, technology glitches, sudden requests—often treated as “administrative,” yet frequently saturated with meaning.

Countertransference as data

These tracks become clinical data through the lens of countertransference. Modern technique does not treat countertransference as mere contamination; it treats it as an instrument—an affective register of what the patient cannot yet symbolize and therefore induces, evokes, or organizes in the analyst. But instrument use requires calibration. We ask: is this feeling characteristic of me, or newly emergent here? Does it persist across sessions? Does it intensify at specific topics or silences? Does it push me toward action (rescue, retaliation, withdrawal, seduction, pedagogy)? Countertransference becomes data precisely when it is worked through: not acted out, not denied, but transformed into thought.

The concept of enactment sharpens this further. Enactments are not therapeutic failures to be avoided at all costs; they are inevitable co-productions in which dissociated or unsymbolized relational knowledge comes to life. The key clinical move is not “prevent enactment,” but “recognize it early, slow it down, and metabolize it.” When we can name the shift—something happened between us—we create a bridge from implicit procedural pattern to explicit reflective space. Rupture and repair are thus not add-ons; they are central evidence about the patient’s relational world and about what the analytic relationship can become.

This is why the frame is not merely a container; it is also a generator of data. The patient’s relationship to time, boundaries, money, silence, and separations is not external to treatment—it is the treatment, expressed in the most economical language available. A missed session may be grief, protest, triumph, panic, or dissociation; its meaning is rarely singular. The analyst’s task is to hold the multiplicity without rushing to interpret.

To treat the clinical situation as data is to practice a disciplined double attention: staying close enough to feel the field, and far enough to think it. The session is not a report about the psyche. It is the psyche—relationally instantiated—asking, in real time, whether it can be known without being crushed, and met without being swallowed.

Applied Psychoanalysis: From “drive/conflict” to multiple metapsychologies: conflict, deficit, trauma, relational

Psychoanalysis is often taught as if it were a single language—one grammar (drive), one engine (conflict), one royal road (interpretation). But contemporary applied psychoanalytic practice is defined by a different reality: we work with multiple metapsychologies at once. Not because theory is fashionable, but because patients arrive with different kinds of suffering—different forms of psychic organization—and the clinic forces us to choose, moment by moment, what counts as an intervention, what counts as data, and what we mean by change.

Psychoanalysis' centers of gravity

A useful map begins with four major “centers of gravity” that structure applied work today: conflict, deficit, trauma, and relational field. These are not schools to pledge allegiance to; they are lenses that alter what we see, what we privilege, and what we risk missing.

In a conflict metapsychology, symptoms are compromises: desire collides with prohibition, love with hatred, autonomy with dependence. The therapist listens for latent meaning, defensive operations, and the return of the repressed. Technique favors interpretation—especially of defenses and transference—timed to loosen rigid compromise formations. Change is often conceived as increased insight, affect tolerance, and a reorganization of defensive and superego economies.

In a deficit (or structural) metapsychology, pathology is less a battle than a lack: failures in psychic structure, symbolization, or self-cohesion. The clinic emphasizes functions—regulation, self-soothing, capacity for play—rather than the uncovering of forbidden wishes. Here “neutrality” can become a misattunement if the patient’s core struggle is disintegration rather than guilt. Technique leans toward provision: reliable holding, empathic attunement, and carefully dosed frustration that builds structure rather than breaks it. Change looks like sturdier self-experience and expanded capacity for relatedness and meaning.

In trauma metapsychologies, the problem is not primarily repression but excess—experience that could not be metabolized and returns as intrusion, dissociation, or somaticized affect. The analytic task becomes pacing and containment so that symbolization can occur without retraumatization. Interpretation still matters, but often later; early work may involve stabilizing arousal, tracking state shifts, and constructing dual awareness (living in the room while remembering what overwhelms). Change is measured by integration: a widening of the window of tolerance and a decrease in dissociative necessity.

Finally, relational metapsychology treats the analytic situation itself as the field where meaning is generated. The focus shifts from “what is inside” to “what happens between,” including enactment, mutual influence, and the ethics of recognition. The therapist’s subjectivity is not noise but instrument—handled with discipline. Change is not only insight but new relational experience: rupture and repair, the emergence of thirdness, the patient’s ability to sustain complexity without retreating into defensive certainty.

Applied psychoanalysis becomes contemporary when we stop asking “Which theory is true?” and start asking, clinically: What kind of suffering is this? What does my patient need from the frame right now—interpretation, holding, pacing, recognition? The art is not eclecticism. It is disciplined switching: holding multiple metapsychologies in mind while choosing one intervention that fits the psychic moment.

Back to: Contemporary Theories in Applied Psychoanalysis

Contemporary Theories in Applied Psychoanalysis

From “drive/conflict” to multiple metapsychologies: conflict, deficit, trauma, relational

The clinical situation as data: countertransference, enactment, the frame

concepts and explanations

Transference and countertransference in psychoanalysis

Counter-Clock Worlds: Decolonizing Time

Modernity loves a schedule: progress bars, quarterly targets, “on time” development. But whose clock is that? Decolonizing time begins with a simple provocation: not all communities inhabit the same temporal order, and insisting they do has been one of empire’s quietest weapons.

Anthropologist Johannes Fabian called it the “denial of coevalness”: the colonial habit of placing others in a different time—primitive, belated—so domination looks like help. Mark Rifkin names its administrative form settler time: calendars, property regimes, and infrastructure that synchronize land to colonial economies while desynchronizing Indigenous life. Elizabeth Povinelli widens the frame with geontopower, where governance distinguishes the lively from the inert to justify extraction—treating certain worlds as resources outside history. Against this, Indigenous thinkers and artists—Leanne Betasamosake Simpson, Kodwo Eshun, among many—stage counter-chronologies: survivals and futurities that refuse the metronome of “catching up.”

Decolonization and Temporalities

Three propositions anchor a decolonial approach to time:

1. Time is governed. Calendars, workweeks, school terms, planting seasons: these are not neutral containers. They encode authority—who waits, who rushes, who gets deadlines, who gets delays. The colonizer doesn’t just take land; they reschedule it.

2. Plural temporalities are practical, not poetic. Cyclical, seasonal, and ancestral times organize duties—reciprocity to rivers, obligations to kin across generations, ceremonies that pace stewardship. They are governance architectures, not folklore.

3. Futurity is contested terrain. “Progress” often means assimilation to someone else’s clock. Decolonial futures are not late versions of the West; they’re worlds timed by other rhythms.

Case in Point

Seed time vs. market time. Consider Indigenous seed keepers who plant on lunar phases and soil memory. Their calendars sync with pollinators and local weather, not commodity futures. Agricultural aid programs that demand yield “this season” misread success, penalizing long-horizon fertility as inefficiency.

Diasporic Sabbath. In migrant neighborhoods, Fridays, Saturdays, and Sundays overlap—Muslim prayers, Jewish Shabbat, Christian services—producing a braided weekend that confounds the monoclock of a national workweek. Shops open late, markets bloom at odd hours; care and cash move on transoceanic time, tethered to remittance cycles and WhatsApp midnights.

Afrofuturist offsets. Following Eshun, Afrofuturism isn’t sci-fi décor; it is time travel as counter-history. By projecting Black survival forward, it refunds what was stolen by Middle Passage time—those centuries the archive miscounts. The beat itself is a clock: polyrhythms that keep several times at once.

Climate emergency vs. seasonal sovereignty. Emergency politics shouts “now!”—often at communities long held in bureaucratic later. Firefighting funds arrive instantly; water rights cases take decades. Decolonizing time insists that adaptation requires seasonal sovereignty: letting local calendars, not electoral ones, determine when to burn, sow, harvest, or rest.

Tactics: Designing for Temporal Pluralism

If time is governed, it can be governed otherwise. A few practical handles:

• Temporal Impact Assessments: Just as projects face environmental reviews, require audits of waiting, rushing, and seasonal disruption—who bears the delay, who captures the speed.

• Layered Calendars in Policy: Build legal carve-outs that recognize ceremonial seasons, subsistence cycles, and non-Gregorian observances as scheduling constraints, not “accommodations.”

• Archive Repair: Fund community-controlled timelines that map dispossession and resurgence across generations; let public institutions cite them as official chronologies in land and water claims.

• Rhythmic Infrastructure: Transit and clinic hours tuned to community peaks (harvests, pay cycles, prayer times); utility pricing that respects heat seasons rather than flat months.

Plural time is not a romance of slowness. Some communities demand faster clocks—emergency housing now, trials before memory fades. Others need protection from acceleration—mines pushed through “on schedule.” The ethic is not speed or slowness but tempo justice: aligning pace with place, obligation, and consent.

Why It Matters

When a single chronology rules, it naturalizes inequality: late for whom, early for whom, forever waiting for whom. Decolonizing time expands the political imagination. It turns policy into pacing, development into coordination, and culture into the art of keeping several tempos without collapse.

We can’t rewind history, but we can retune it. To live in counter-clock worlds is to replace the empire of deadlines with negotiated rhythms: some cyclical, some recursive, some defiantly offbeat. The future worth building won’t arrive “on time.” It will arrive on times—plural, argued over, shared.

Learn more: An Introduction to Chronopolitics

multiple times and temporalities

The Present Is Crowded: Living Among Multiple Temporalities

Overview of Gramsci's Prison Notebooks

Between 1929 and 1935, Antonio Gramsci wrote approximately 3,000 pages in notebooks while imprisoned by Mussolini's fascist regime. Arrested in 1926 as a leader of the Italian Communist Party, Gramsci faced a prosecutor who declared, "We must stop this brain from functioning for twenty years." Instead, imprisonment became the occasion for his most profound theoretical work. Writing under harsh conditions, constant surveillance, and deteriorating health, Gramsci developed concepts that would reshape revolutionary theory.

Themes and Structure

The Prison Notebooks comprise 33 notebooks covering diverse topics: philosophy, history, politics, culture, and linguistics. Rather than systematic treatises, they consist of fragmentary notes, observations, and extended reflections. This form reflected both prison constraints and Gramsci's dialectical method—he preferred open-ended investigation to dogmatic conclusions. Major themes include hegemony, intellectuals, the state, civil society, and Italian history, particularly the failure of revolutionary movements to achieve lasting change.

Methodological Innovation

Gramsci developed what he called the "philosophy of praxis"—a sophisticated Marxism that avoided economic reductionism while maintaining materialism's insights. He insisted on analyzing concrete historical situations rather than applying abstract formulas. His approach integrated cultural and political analysis, recognizing that economic structures alone don't determine social outcomes. This methodology proved particularly valuable for understanding why revolutionary movements succeed or fail.

Legacy and Interpretation

The Notebooks weren't published until after World War II and reached international audiences even later. Their fragmentary nature and Aesopian language (necessitated by prison censorship) created interpretive challenges. Different political traditions have claimed Gramsci's legacy, from Eurocommunists seeking democratic socialism to postcolonial theorists analyzing cultural imperialism. The work's richness continues generating new readings, making it indispensable for critical social theory and political practice.

Learn about Gramsci:

Gramsci's Cultural Hegemony

Gramsci on Intellectuals, society and education

Gramsci on The Subaltern Classes