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Following my return from a week-long vacation, I found myself searching to more fully understand what it is about a separation from the analyst that so deeply affects a patient. What meaning, therefore, has the analyst come to assume to his or her patient?
This paper makes a preliminary inquiry into the subject of the patient's reaction to the psychoanalyst's vacation from a Horneyan perspective. The hypothesis inferred will be based on clinical material that emerges from my patients' usage of certain metaphors. Specifically, the two patients I will discuss use “oxygen” and “air” as metaphoric language to express what for them had been effected by my absence. Of course, this may bring to mind the renowned term “psychological oxygen” that was coined by Kohut (1984, p. 18) to convey our innate need for other people.
A sampling of the literature on this inevitable aspect of the analyst/patient relationship seems to focus primarily on the therapeutic technique of addressing the analyst's vacation with the patient. The prescribed techniques evolve from a paradigm that interprets the patient's response as a repetition of traumatic separation in the past (Blank and Blank, 1974; Langs, 1974).
The clinical examples I am about to present describe two very different responses to my absence. That is, the responses come from patients who are at different stages in the analytic process with respect to a lessening of alienation from self, which has enabled the ability to experience conflicts and to actively grapple with them.
The first clinical example is described in part through a verbatim session with David that occurred just prior to my leaving for vacation, and a summary of the two sessions that followed my return. David, 30 years old, has been in psychoanalysis three times per week for five years.