Response to Stuart Pizer

I am indebted to Stuart Pizer for his carefully considered and respectful review of my book Learning from Our Mistakes. In it he raises a number of interesting and challenging questions to which I will attempt to respond.

One problem is that I have always had to limit any presentation of this clinical work to keep within the parameters agreed with my patient Mrs. B. as to how much of it I can publish. That constraint also affects how detailed my responses can be here, because the sequences Stuart Pizer selects to comment on all took place in the context of the previous eighteen months of this analysis, the details of which I need to keep private.

What I can say, however, is that throughout the early stages of this analysis Mrs. B. knew of only one kind of security: that which she could make for herself. From the time of the initial trauma, reinforced by her mother's collapse during the surgical procedure, Mrs. B. had developed a dread of depending on anyone other than herself. Safety, for her, seemed to lie in her not needing others and in her being able to control the world around her so that she would never again be found off-guard or be taken unawares.

Until the time when I chose not to heed Mrs. B.'s signal to me not to continue trying to explore what might have lain before the known traumas, I had remained careful not to challenge her familiar defense of needing to control me in the analysis. However, during the session in which she had signaled me not to continue, I had formed a hunch that there might be some screen memory defense operating, some other alarming experience(s) hidden behind the traumas so often being described to me. It was only very much later, during the end phase of this analysis, that we came to find what had remained frozen in her mind that we did not have any direct knowledge of until her mother provided the missing detail.

When Mrs. B. was signaling to me not to go on, my choice seemed to be either to continue not challenging her need to cont