Medio-Passive Agency in Psychoanalysis: Responding to Hopelessness and Despair in the Therapeutic Relationship

Abstract

This essay investigates the role of medio-passive agency in how psychoanalysts can respond to hopelessness and despair in the therapeutic relationship. We can reconstruct from Lear’s study on radical hope a mutually constitutive interplay between hope and creativity. The agency exercised in hope and creativity is medio-passive: the clinical agent incorporates an experience of powerlessness into her response to an ongoing internal process, she lets go. With Winnicott and Bion, this letting go can further be traced as grounded in faith – in an unconscious commitment to the continuous possibility of the good. When patients are incapable of standing in faith, the analyst can make her own faith accessible to them. This process is introduced here as relational medio-passivity and illustrated through clinical material.