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Every morning, I unlock the door to my consulting room at 6:45 a.m. I do so for several reasons. First of all, I need to ensure that I arrive well before my first patient, whose sessions begin at 7:00 a.m. Additionally, I must switch on the lights, turn on the heating on winter days, and place two large tissues over the pillow on the couch so that each patient will have a hygienic coverlet on which to rest the head. I also scan through my appointment diary, refresh myself about the previous day's work, and prepare myself for the day ahead.
Now that I have been in practice for years, my patients tend to arrive with utter precision, and the bell will ring promptly at 7:00 a.m. I then undertake my work with the patient in question for the requisite fifty-minute hour, and at 7:50 a.m., precisely, I shift in my seat behind the couch and uncross my legs, thus indicating in a subtle yet clear manner that the session must now end. The patient sits up from the couch, retrieves coat, umbrella, and briefcase, and heads for the door. I now have a ten-minute gap before my 8:00 a.m. analysand arrives.
The psychoanalytic and psychotherapeutic literatures contain an entire library full of books and articles about what happens during the fifty-minute hour, but virtually nothing at all about what happens between fifty-minute hours, in that much practiced, much needed, but little theorized ten-minute gap. At various points during my day, during my working week, and throughout my clinical career, I have utilized the ten-minute gaps in different ways and for different purposes; and I hope that colleagues will permit me to reflect about this seemingly trivial, but, I would suggest, quite vital transitional space in which one bids goodbye to patient “A” before greeting patient “B.”