On Patients Who Remove Their Clothing in Sessions

A solid psychotherapy training teaches us a goodly amount about psychoanalytic theory and basic psychopathology; but sadly, no training, however thorough, can instruct us how to handle those extraordinary, peculiar moments of clinical practice, the sorts of episodes that strike without warning. For instance, what does one do when the hind legs of the analytic couch break in the middle of the session, and the unsuspecting patient comes crashing onto the floor? This happened to one of my colleagues, a senior Freudian psychoanalyst. Or worse still, what happens when the patient starts to leave the consulting room, turns the door knob, only to hear a thud from the other side of the door: the doorknob had loosened and fallen off, leaving both the patient and the psychotherapist locked together in the consulting room for over an hour. To compound the problem, the psychotherapist had to wait until her own mother had returned home and could release the entrapped pair from this complicated arrangement. This happened to another one of my colleagues, a psychosynthesis psychotherapist.

Another colleague arrived late for her first session with a new patient whom she found waiting, with tolerance, on her doorstep. In her frantic attempt to open the door, the psychotherapist broke her key in the lock and had to telephone for a locksmith on her mobile phone. Rather than sending the patient away, the psychotherapist entreated him to wait for nearly an hour, until the locksmith arrived. Needless to say, this treatment lasted only three or four sessions in total; for in spite