The Meaning of Suffering in Therapy

Since this discussion of the patient's (affective) experiences in therapy—whether suffering, happiness, or something in between—will be based on my experiences with the kind of therapy I do, it can have meaning only in reference to that context. My psychotherapeutic work is limited to psychoanalysis and to so-called psychoanalytically oriented psychotherapy. Since these terms are used rather loosely nowadays, a better way to describe the kind of therapy I practice might be to call it autonomous. By this I mean that I accept only patients able to maintain a socially independent existence and therapeutic relationship. In other words, I do not treat children, the legally entangled, or the socially decompensated. My patients might be diagnosed normal, neurotic, or psychotic, depending on nosological criteria. But whatever their psychological makeup might be, they must be able to maintain a private, two-person relationship with me, for which they are financially responsible, and into which they cannot inject a third party. If a person is unable to meet these criteria, I do not begin treatment with him. And if, during treatment, he insists on breaking this contract, I terminate the relationship. I cite these facts mainly because I strongly believe that it is impossible to evaluate what transpires in a psychotherapeutic relationship if the basic contract between