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I shall comment on some clinical issues arising from Marr's work with Mark, and then make some general observations about gift-giving in psychotherapy. I provide some examples of gift-giving from my own practice and, finally, draw some conclusions.
The paper is not just about understanding Mark's erotic gift-giving to Marr, it is also concerned with Marr's struggle to maintain appropriate boundaries in an emotionally-charged therapy and the challenges in working with erotic material generally.
Mark's desire to be the subject of a clinical paper can be contrasted with some clients I have worked with, who would be terrified at the prospect of disclosure to a professional audience, even if the material were heavily disguised.
We are left to speculate as to why Mark found it so hard to understand the inappropriateness of his constant gift-giving and the suggestive remarks made to Marr in therapy.
Psychotherapy work with Mark took place in the main room of Marr's home and we saw how the therapist's personal possessions, such as pictures, books and bric-à-brac became subjects of curiosity and questioning: they weaved their way into the work as Mark tried to deepen his connection and attachment to Marr. When Mark visited the bathroom, he could gather further material about Marr's private life, to perhaps fuel further questioning.