Listening and Containment: A Talk at the Mount Sinai Department of Psychiatry
This is an abbreviated version of a Book Talk at the Departement of Psychiatry, Mount Sinai Hospital NYC on Psychoanalytic Objects Near and Far (Routledge, 2025) By Eran J. Rolnik
March 4, 2025
Thank you, Dr. Lothan, for your generous introduction. I've long admired your contributions to psychoanalytic historiography, but what resonates most is the coffee we shared on the Upper East Side on October 5—just two days before the October 7 Hamas attacks in Israel. That moment has stayed with me as a relic of life in the "Old World."
To be honest, I usually find it easier to speak about a book I’m still writing than one already published. Once a book leaves the safety of my mind and goes to press, I feel a certain distance from it, even reluctance to speak on its behalf. That is why I’m especially grateful to be presenting Psychoanalytic Objects Near and Far in this distinguished setting.
The book began as a series of talks given during the COVID lockdowns—a unique moment in my evolution as both teacher and clinician. These sessions captured the collective psychological state of a global audience navigating crisis. In many ways, psychodynamic therapy as a discipline thrives under pressure. Many of the theories we rely on were shaped during moments of profound upheaval. Yet clinicians often overlook the origins of their conceptual tools. I believe we, as historians of our science, can do more to foster an appreciation of psychoanalysis’ intellectual lineage—particularly at a time when the future of dynamic psychotherapy feels uncertain.
Over the course of lockdown, I hosted nearly 50 "Psychotherapy Under Fire" Zoom sessions. Some focused on Freud’s thought; others explored the interplay between theory and technique. These weren’t structured lectures. I allowed my thoughts to roam freely, circling each topic through clinical, historical, and philosophical lenses. The result—reflected in the book’s 13 chapters—is an eclectic blend of reflections on practice, concept evolution, and the contemporary state of psychoanalytic discourse. The book, in essence, is the free association of a clinician-historian in dialogue with colleagues. It is part theoretical meditation, part clinical diary—a kind of psychoanalytic beit midrash.
Today, I want to focus on two interwoven themes: Listening and Containment.
Not long ago, someone asked my opinion of a prospective analyst. I visited his website, which featured a FAQ section. One question stood out: “As a psychoanalyst, do you believe Freud and all that sex stuff of his?” The analyst replied, “Psychoanalysis is first and foremost a technique of listening. Most modern analysts no longer hold Freud’s view that humans are solely driven by sexuality.” He added that Freud himself revised his views based on clinical experience.
This answer is telling. In distancing himself from Freud’s emphasis on sexuality, the analyst reassures potential patients—and perhaps himself—that he is a different kind of psychoanalyst. It suggests a desire to defuse anxieties about sexual disclosure and avoid outdated stereotypes. But it also reveals something deeper about the contemporary landscape of psychoanalysis.
What truly sets the analytic encounter apart is the therapist’s attention—a sustained, active presence that enables the patient to explore their unconscious world. This listening is not merely passive; it creates the space for psychic expression. It’s what allows speaking to happen meaningfully. Silence, too, plays a role, but it is the quality of attention—not its absence—that determines whether silence is productive or stifling.
Patients can feel the difference between a therapist who is merely silent and one who is listening. A therapist’s attention can be disrupted in subtle ways—by the patient’s projections, by affective overload, or by the therapist’s own internal distractions. We must ask ourselves, repeatedly: What is preventing me from listening? Because when our listening is compromised, so too is the patient's ability to speak.
Some interruptions are obvious—like a patient waving a used tissue to deflect an interpretation. But others are covert, even self-inflicted. Often, it is not the patient who interferes with our listening, but we ourselves. That’s why I’m skeptical of overreliance on countertransference explanations. Sometimes, we simply didn’t get enough sleep or were thrown off by something outside the session. It’s our responsibility to restore our capacity to listen.
Listening is the medium in which the analytic process unfolds. It supports the patient’s movement between self and other, between knowing and not knowing. It is like water for a swimmer—necessary, yet invisible when done well. Silence without presence becomes a barrier. Attention without interpretation can be transformative. The therapist’s listening must be alive.
Now to Containment—a concept rooted in Bion’s wartime experience and his recognition of the analyst’s role in metabolizing anxiety. Containment is not just about bearing psychic pain or refraining from retaliation. It is the process of transforming unthinkable mental matter into thoughts that can be thought. Bion called this the alpha function. Containment allows listening to persist, even in the face of psychic chaos.
Sometimes what sounds like an interpretation is actually a failure of containment—an attempt by the therapist to evacuate their own discomfort. True containment precedes interpretation. It enables the therapist to stay with the patient’s unprocessed material long enough for meaning to emerge. Interpretation without containment is premature and often counterproductive.
Consider two contrasting examples. A patient is angry after losing a session and the therapist calmly interprets: “You’re angry because you fear I don’t care about you.” Even if the interpretation is off, the act of offering it from a place of containment has value. In contrast, a therapist who says, “Let’s keep things civil,” reveals their inability to bear the patient’s anger. They shut down the transference rather than metabolizing it.
Containment, then, is the foundation upon which interpretation is built. It requires patience, tolerance for ambiguity, and what Keats (via Bion) called negative capability. We must sometimes hold uncomfortable states without needing immediate resolution.
Freud, for all his brilliance, struggled with containment. He could decipher dreams but often retaliated when attacked. Later analysts advanced the idea that holding and containing psychic states are themselves therapeutic. Today, we understand that not all healing comes through insight. Sometimes, helping patients tolerate their inner world is the most meaningful gift we offer.
Every container has a Third. For the mother, it may be the father. For the therapist, it is theory—a stabilizing presence that allows us to endure the patient’s projections. Even when we feel attacked or incompetent, our love of psychoanalysis, of theory itself, can sustain us. We may hate the moment but still love the work.
As Dorothy Parker once wrote, “When the phone didn’t ring, I knew it was you.” Silence speaks volumes. Our role is not to fabricate insight or fill the gaps with noise, but to remain present—to walk, as it were, an attentive dog off-leash. A quiet “Hmm” can reestablish connection. Naming silence—“You’re quiet,” or “I’m listening”—can help the patient resume contact with their inner experience.
Sometimes, more active techniques are warranted. I may suggest a topic or ask about the patient’s day. These are not deviations from analytic technique, but efforts to reestablish the conditions for psychic communication.
In the end, we study theory not just to know but to dream it—to allow it to arise organically in our listening. As Emily Dickinson wrote:
To make a prairie it takes a clover and one bee— One clover, and a bee, And revery. The revery alone will do, If bees are few.
Thank you.